Oral Health Stories

The NPA Cross-RHEC Oral Health Workgroup was formed to advance oral health equity within minority populations in the United States. In an effort to spread awareness about the importance of access to preventative and restorative oral health care, the group collected accounts from individuals who have experienced challenges in accessing such services.

Stories shared from microgrant community partners


Story 1.
I had fillings as a child and have disliked going to the dentist ever since

Story 2.
"I love my smile!!" (Sung to the tune of "I Love Your Smile" by Shanice Wilson)

Story 3.
One participant told us that she just got her first idea about a connection between oral health and overall health in December 2016. She uses inhalers for her asthma, and it was the dentist who told her during her December visit for a regular dental checkup that, following her recent bronchitis, she would have to rinse her mouth out after using her inhaler. She never thought about it, and wondered about what else she could have been doing that may have been keeping her unhealthy. Had she not been mindful of her dental care, who knows?

Story 4.
“feel ur teeth after u eat” is what one of our youth participants wrote in our “What Oral Health Means To Me Now!” survey. It is our follow-up survey, to get an idea if people got anything out of our presentations. Our nutrition consultant said for people to run their tongue over their teeth and consider how their mouths feel after eating. If it feels sticky, “funny” in some way, they should think about what that food is doing to the body. A positive reaction to this concept showed up in several surveys.

Story 5.
A single mother who raised three children and was focused on saving for their college education. She was working in a place where she enjoyed her work and shared with all her coworkers, however she never smiled in pictures at work. She and one of her coworkers shared with us she did not smile or laugh because her teeth made her uncomfortable. We knew this story after her treatment. In our oral health conversations she approached one of our volunteers and asked her for a low price service that can provide her treatment. Our volunteer knew a large private practice which as a marketing strategy to promote services provided by new professionals, has some discount for professional service. So, we approached this professional who provided her professional service for free. It was an unbelievable situation that could we understood for us later. For the dentist, her case was an interesting case that combines humanism and marketing strategy. Today, she is happy with her teeth and smile comfortable and people ask her what dentist provided her nice smile!

Story 6.
The second case was a child who loses multiple superior temporal teeth for multiple cavities with dental destruction and infection. It happened after his parents were divorced with consequently little care for this little child. One of our collaborators at LCS who works for an oral health provider was approached by his father and she referred this child for a special treatment. This patient received treatment under sedation, antibiotics and was referred for nutrition evaluation and assistance. These two cases demonstrated how social determinants of health are present and relevant in some critical situations as we mentioned in those cases. The 1st. was affected by financial factor and the second by psychological and social environment with his mother who did not find assistance for her son.

Story 7.
Participant A shared that her job had closed and she lost her insurance. She was unable to continue going to her regular dentist for care because she could not afford it. She had a toothache for months but did not seek treatment. This was on top of significant health issues which required her to apply for disability, only to be turned down the first time. She felt that she would have to choose between paying for dental treatment or her light bill. Eventually her disability was approved and she had some income. She then sought treatment for her tooth and was able to get in pretty quickly. More routine appointments she tried to schedule resulted in a wait. It was such a relief when the tooth was pulled. She said, “I felt like I had been baptized again.” Unfortunately, she hasn’t been able to afford dentures yet which makes it difficult to chew with only a partial. She has to eat very soft foods because anything crunchy or hard will make her partial come out.

Story 8.
Participant B shared that she did not have insurance at one time and would only go to the dentist if she had a problem. She did not have trouble getting an appointment if she had a problem. When she finally got insurance she went in for a cleaning, but was told she would have to have a deep cleaning that would cost her $800. She also needed to have a root canal finished, but she did not go back for either procedure because of cost. This participant also shared some unfavorable experiences her family members encountered. She did share that she learned some helpful information in the boot camp sessions that she was able to pass on to a pregnant family member who needed dental care.

Story 9.
Participant C shared that at one time she did not have insurance and couldn’t afford dental care. She would only seek treatment when in pain, but found it difficult to get an appointment. She said having insurance now means that she’ll more than likely be able to get dental treatment. The participant also expressed that she learned a lot during the boot camp sessions, and she wishes she had learned some of the things many years ago so she could have made better oral health choices back then.

Story 10.
The dentist informed us that by having an oral exam, oral cancer can be detected. therefore going to the dentist regularly can also be a preventative or early detection avenue.

Story 11.
Parents over seeing their children take the oral care challenge at the Halloween Fall Festival often mentioned how much it costs to go to the dentist. In there experience it was easier to get kids into a dental program if available than it was to get access themselves. One parent with a 10 month old and a four year old, still has not been able to find an affordable dental program for the entire family. Her four year old at the time was starting to feel a little pain and she was concerned that she would not be able to pay another bill if she has to visit the dentist to take care of her child's pain.

Story 12.
This woman grew up in Guatemala. In 2010, she was diagnosed with uterine cancer for which she underwent surgery to remove her uterus and received a month of chemotherapy. In 2012, she noticed that her teeth were moving. After bloodwork and x-rays of her gums, she was told that due to the chemotherapy she had received, she was experiencing early menopause and periodontal disease. After suffering economic hardships in their country, she and her 16 year old daughter decided to travel to the USA that same year.

Because of their immigration status, both do not qualify for any medical/dental coverage and the mother is also unable to find work that pays anything more than minimum wage. She currently works a part time job with no benefits that only pays $7.50 per hour.

At the beginning of 2016, she started to lose pieces of her teeth. She was able to schedule an appointment at Appomattox Area Wellness Center, a low income clinic who sees patients without immigration status or medical insurance. She attended her first appointment and was told her appointment had been canceled after she arrived. This went on for the next three months. After many cancelations, she decided to go to the Hopewell/Prince George Community Clinic and they were able to see her the same day due to the severity of her condition.

Today she has lost all of her upper teeth and continues to attend the same clinic for treatment. Of her bottom teeth, she only has 8 left which are scheduled for removal. Due to her financial situation and lack of dental insurance, she is unable to afford dentures. Since she has no teeth, she not only suffers from low self-esteem, but she also does not smile and cries often.

The most affordable dentures she has found would cost her $3,000. With her part time/minimum wage income and lack of insurance, this is almost impossible to attain.

Story 13.
This 5-year-old child had been under medical care for asthma. The medicine taken to combat the asthma had caused all of her baby teeth to rot completely. Because this child had access to dental insurance through Medicaid, she was able to have the surgery needed to remove all her baby teeth at once and prevent any further health complications.

Story 14.
We'll call her Lucy. She came to my office for Counseling. When she read the information on Oral Health he cried copiously, when she calmed down she told me why she had been so impressed by what she read. From childhood she had the trauma of her teeth. Which caused her low esteem. Antisocial and isolation.

She suffered bullying in both the family and school, she was about to commit suicide. She left my office with a new hope and a purpose to return to her hometown. She would go directly to the dentist to treat herself and solve the problem that had caused her so much damage throughout her life.

Story 15.
We'll call him Pablo. With a saving his marriage purpose, Pablo requested counseling services. At the end of our first session I provided the Oral Health fact sheet and suggested talking about it at the next appointment. It was a big surprise when this young man came to his second session with the information sheet in his hand and with absolute certainty told me: "I already discovered the reason why my wife wants to divorce me. She complains about my bad breath. "


Stories shared from providers (excerpts from interviews)

Story 1.
Provider: I had a patient who was 32 years old…and I read in the obituary how he had died, and it was a common name. I said, ‘Mm, I didn’t hear about that. I wonder why he died.’ Then within a matter of days, I had family members of him coming in saying that he had died of a tooth abscess, ‘He at the local Petersburg Hospital.’ Yeah, and they said he had an abscess and it poisoned his system and it went to his brain and his heart and he died within days. They had him on IV intravenous antibiotics and they were unable to save him. During the course of that next six, or up to eight to ten months, I had about six of his family members, immediate family members, come in, including his mother, who were never patients here before and it was a direct result of what had happened to that gentleman.

Story 2.
Provider: And you know I’ve seen people, I’ve had patients with bad teeth that actually they got septic from teeth like blood poisoning. It was that bad. I have seen maybe about five or six. I mean teeth were rotten, and what was left was there, but they were black and everything. They didn’t have the money to get them pulled.

Interviewer: Did those people that got them talk about how they felt about it, beyond just it being painful? Did they feel it affected their appearance and their own mental well-being?

Provider: You know a couple of them almost died, it was so bad…. But again, before then they complained about not being able to chew, that the teeth were, when they bit into something, it hurt and that sort of thing and talking, looking down or taking with their hands over their mouth.

Story 3.
Provider: You know these children come in here and they have a lot of dental work done, so either they come in with a mouthful of fillings, and/or they come in because they have to have a pre-op before they can have any dental procedure, but I would think it would bother them more and they’d question it before they have all the damange that there… but oftentimes, somewhere between the time that they first started seeing the Dentist, I see them next for a pre-op. It’s like you know we do see them regularly, but oftentimes I don’t hear them with concerns about their children’s oral hygiene until I point it out.

Story 4.
Provider: I have a young lady that had, unbeknownst to us, she had a mitral valve prolapse, and she had had some dental surgery and then she had showering of the Bactra from decay in her mouth and it went to her heart valve and she had all complications that included rheumatoid…. Yeah. She was 12. She actually ended being in the hospital for a long time ‘cause the bacteria that was showered from the dental procedure attached to her heart and then she had to have surgery on her heart, and then she was in the hospital for a long period of time. She had pulmonary embolism. I mean she had a lot of complications, and then she went home on IV fluids. So she had a very detrimental outcome.

Interviewer: Was she on Medicaid?

Provider: She was a Medicaid patient.

Story 5.
Provider: Just as we had challenges with fluoride topical treatments, we don’t get reimbursed for these services, and so it’s hard to take that time to cut out that time to do that, if we don’t have some other means of you know affording it.

Interviewer: Yeah.

Provider: I mean not to make it a profit center, but more you know that somebody has to do it, and so I can’t see where I’d be able to take a block of my staff to provide these services, because we’re barely getting through what we have to get through with the Medical, because between you know referrals and just what we have to go through to get just authorization to treat them medically. If we added the dental piece on there, I don’t know how that would work without somebody else coming in to assist with that.

Story 6.
Provider: Well when I usually go to the clinics with the students, I would say the main concern of the patients, it would be like most of the people, they just want to come like ‘Oh, I just need a cleaning,’ but they don’t know they have cavities, or maybe they need fillings or extractions or root canals. They don’t take it that seriously. They just want to come for a cleaning.

Story 7.
Provider: I think that one of the things that we’ve seen is even some of the veterans who are perhaps a part of the poverty data do have benefits, and they’re able to go on the base or to go to various others through their veterans benefits to get appropriate dental care, and many of them use it that way. So you can look in a family where you have someone who’s a veterans who has a brother who’s not and see the difference in oral health, because you know you have it and you know there’s that barrier that ‘I can’t afford it,’ and that’s just it’s unfortunate, but I think affordability probably would be higher in my list of priority than accessibility, because it’s there, but if you can’t afford it and if you don’t have insurance, you’re not gonna get it.

Story 8.
Provider: Well whenever there’s a dental problem, we’ve been told with the fund that we had and when we would pay for services for the worst-off people, that dental and gum damage can also lead to heart damage, and people with mental illness tend to die prematurely. They die between 15 and 25 years before someone without a mental illness.

Story 9.
Provider: Well you know preventative dental care is almost nonexistent. That’s one of the biggest things that we struggle with, and we try to find places in the community that do either pro bono services or reduced rate or sliding scale or something like that for them. The other thing that we really struggle with is that oftentimes because Medicaid doesn’t cover dental work, the only thing they will cover is an extraction, not any kind of fillings or cleanings, and we just feel like that’s the wrong approach for people to start to having their teeth extracted because they can’t afford dental care.

Story 10.
Provider: Well I think, yeah, you know If you aren’t able to chew your food well, that definitely impacts your health and we’ve had several people here who’ve really struggled with that nutritionally you know for their health, because of their poor dentation, and then the other thing is just self-image.

Story 11.
Provider: Yeah. I think the biggest thing is just the affordability of it, and finding a Dentist that understands the population and is willing to be patient.

Interviewer: Yes.

Provider: And you know like we had one guy who had an infected tooth and we took him three times before he’d ever let the Dentist look in his mouth, you know, but I mean it was really critical. We were like ‘You’ve got…’ and we finally had to find a Dentist that would sedate him, because his anxiety was just so high that he couldn’t do it, and we struggled with that with another client who has really bad dentation, but you know she was sexually abused and she has a lot of issues around strangers, and so it was just a difficult situation to ever get her to the point where she would sit in the chair long enough to have somebody look. So we do try to be really sensitive to their anxiety around dental work.