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[Comments] (2) Teeth Suck: The Continuing Saga: I'm pretty well-off now, but up until I graduated from college I was poor. Not where's the next meal coming from poor, thank goodness, but working all your spare time to pay the bills poor. There are many ways it sucks to be poor, but one part that I really hated was being treated like I was poor.

Being poor is like going through airport security all the time. You always need something from someone who doesn't need you, doesn't care about you, and suspects you're trying to scam them. In fact, airport security is just a pathological case: it's for people too "poor" for fractional jet ownership. All of America's great leveling experiences: jury duty, the DMV, phone support, the emergency room, etc., are leveling in that they treat everyone the way America treats the poor.

I've made it a goal in life to be treated that way as little as possible. I don't think anyone should be treated that way, so I also do what I can to stop it in general, which as it turns out is not much at all. Which brings us to tonight's word: dental insurance.

Due to circumstances previously discussed, Sumana and I are on student health insurance and have our dental work done at the NYU dental college. The waiting room is always crowded and chaotic, the waits are long, you have to fill out the insurance forms yourself, and the actual work is very slow (it's done by dental students who frequently need to bring real dentists over for help). And of course it's done by dental students, which means it's more likely something would go disastrously wrong. It's dental work for people who can't pass up an opportunity to spend time to save money. Compare to the ritzy Dentist 2.0, where we shelled out big bucks out-of-pocket, but had a really good experience with little waiting.

So dental work is more aggravating for me than it used to be. But why complain about it now, apart from weblogs being places to complain about things. Because six months ago it was discovered that I have a magic lesion. The dental student assigned to me said that there are always dental students who need to fill minor cavities of a certain dimension for the board exams. She asked if I'd be willing to have the cavity filled as part of someone's board exam in the spring. I said sure. Go in and have it filled as part of a checkup, go in and have it filled as part of an exam. The only difference is that in the latter case you're helping someone become a dentist.

Well, I found out the second difference around February, when I got my first call from a dental student wanting to fill my cavity. When you get a cavity filled as part of a board exam, you have to make the trip to the NYU dental school twice: once to get an X-ray of the tooth in question for grading purposes, and once for the actual filling. Oh yeah, the X-ray will happen in the middle of the day on, say, Tuesday, and the actual filling will happen at 7 AM on Sunday. But! I'll get the filling done for free and $100 on top of that.

Oh yeah. I recognize this. The lure of the hundred dollars. When I was in college I considered, among other biology-related money-making schemes, having board work done at the UCLA dental school. In retrospect I should have gone for it. That $100 would have been welcome, and going to the dentist at all back then would have saved me a root canal down the line.

Now? Not so much. I have the privilege of putting a high price on my time. The 7AM on Sunday thing doesn't bother me much, but I'm not interested in making a separate trip in the middle of a workday just to get some X-rays. I asked if they could reuse the full-spectrum X-rays I'd gotten when I started getting work done at NYU. They weren't very old at that point. Nope, they had to be new X-rays of the tooth in question. Sorry, I said. I'm not interested. I was stoic in the face of reminders that I was being offered $100 for my time.

Last week I got another call from another dental student preparing for the boards. I turned him down and explained why I had turned down the first dental student. But this guy sounded desperate. I'm like the only guy in New York City with a lesion that's the right shape. And after I explained why I'd said no the first time, he said he could meet me halfway. I didn't have to come in the middle of the day for the X-rays; he would meet me at 6PM on, say, Tuesday, and we could do them then. And he'd pay me $100! I hemmed and hawed and eventually agreed.

Today I went down to the land of dentistry and met the dental student, and he was really good. He fast-talked his way into an X-ray booth downstairs so I wouldn't have to wait 15-20 minutes for one of the overbooked booths reserved for my ilk. He took the X-rays and a cast of the tooth. It was an even better experience than Dentist 2.0. I actually started thinking things like "Wow, things move really smoothly when it's just you and the dentist getting things done!"

You knew it was coming. At this point I found out the third difference between getting the cavity filled as part of the appointment and getting it filled as part of a board exam. He's explaining what's going to happen on Sunday and he says something like "Oh, it's going to be an amalgam filling. I noticed you've got composite fillings. Is that going to be a problem?"

Yes. Another one of the things I can do now that I'm well-off is not let people put silver and mercury into my head. I have lousy teeth but they're mine, and I want to keep them looking like teeth. A dental student can see I've got lots of fillings just by looking at my teeth, but I don't want to advertise that fact to laymen.

Thus begins the Tense Situation. The rules say that the lesion has to be a certain size and that it has to be filled with amalgam, or maybe the amalgam's a cost-saving measure or whatever. The dental student suggests I can have the cavity filled with amalgam for the exam, and then have the amalgam taken out and composite put back in. I ask how long that will take. It turns out he's talking about two different visits: the board exam, and then a follow-up appointment where I do what I was planning to do in the first place: have a tooth drilled and filled with composite. So after the board exam I'll be where I am now. Except I'll have to pay for the second appointment, which will wipe out any $100-related gains I may have made from the first, and then some.

I ask if my student insurance will cover the second appointment. Oh. I have insurance! No problem! All I have to do is show up for two dentist appointments, which I'd agreed to do earlier. True, I've already wasted an evening coming over here for a third dentist appointment, but that's a sunk cost at this point.

That's when all the stuff I mentioned earlier really hits me, about when I was in college and thought about having board work done. This program isn't a way for the helpful rich guy with bad insurance to help dental students pass the boards. It's a way for a poor person with no insurance to get a cavity filled and make a little money on the side. I've broken the parameters of the program with my snobbish insistence on fillings that don't look like crap or activate my fear of biting a piece of aluminum foil while eating a burrito.

I feel terrible but I'm not going to go through a dental procedure just so I can have it done again a week later. I say I'm sorry a lot and walk out. I walk out knowing that the dental student is probably in the same situation I was in in college. He probably has a bunch of loans. When he graduates he'll start making good money, but right now he needs to spend $100 on some lab equipment for a demonstration. And his lab equipment has just walked out. Now I'm the one acting like I don't need someone else. I'm the one with the power to say no, and it doesn't make me feel better that the alternative to 'no' is a deeply unpleasant experience for me.

Teeth suck.

The only bright side is that the dental student told me this after he saw my other fillings, instead of on Sunday. If he'd sprung the filling surprise on me in front of the people giving the exam, he said, they would have flunked him for poor patient management. Now at least he's got a chance to find someone else.


Posted by Rachel at Wed Apr 30 2008 07:09

wow I hadn't seen that post before.

Posted by Susie at Wed Apr 30 2008 16:27

That does suck. You are too nice.

We have really great dental insurance. We had no co-pay for cleaning and my filling is only $15.

When I complained that my last filling was very sensitive to cold, they were surprised to notice that it was an amalgram filling because the composite ones are more sensitive. yikes, I hope my new filling will be ok.


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