August 7

Most of our patients at work are nice people. They come in as a new patient, the assistants take a full set of x-rays, the doctor does a comprehensive exam and writes up a treatment plan for any work that needs to be done, the front desk goes over the financial aspect (insurance coverage, co-pays, and deductibles) with the patient, and then they schedule their treatment and hygiene appointments.

I've been at my job for almost a year now and I've probably met hundreds of new patients. Most are nice and forgettable, some are horrible and you hope you'll never see them again, and some just stick in my brain. Last week I met a new patient that had an extensive treatment plan. It was probably the most treatment I've ever had to record for a patient. Multiple crowns and root canals, over a dozen fillings, a few extractions, he had active periodontal disease, and he was only in his early 20's. His insurance wasn't great either, we estimated that his out-of-pocket for everything was over $14,000.

My car didn't cost $14,000.

My wedding didn't even cost $14,000.

And I was the one that got to tell him tell him how much his dental treatment was going to cost.

It turned out that he hadn't been to the dentist in over a decade and was homeless for several years as a teenager. His xrays showed decay that is consistant with someone that was a meth addict. But he gotten his life together and was holding down a good job. I gave him the estimate for all his treatment and we discussed some options for payment but it was clear that this was way, way out of his budget. He left the office without scheduling anything.

I went home and thought about him all night. It's a week later and I'm still thinking about him.

If you've been fortunate enough to have the resources to maintain consistant oral health, I think it's hard to relate to people that just don't have the means to take care of their dental needs. I was lucky enough to have parents that took me to the dentist to get my teeth cleaned, starting at an early age. They paid for me to have braces. They paid for my fillings. They had dental insurance. I don't have perfect teeth, but when I see the situation some of our patients are in, I feel very lucky.

When I was teaching, this happened sometimes too. Students would tell me about the tough time they were having at home with absent and alcoholic parents, not enough food in the house, and unsafe or unstable living conditions. I'd go home and think about them. After one of the mandated reports I wrote as a result of one of these discussions, the student was placed in the care of Child Protective Services and taken out of the area. I never found out what happened to him. I still think about him too.

Sometimes it's hard to take all this in because I know there's no way I can help everyone. I do as much as I can, and I try to care as much as I can, sometimes even to the detriment of my own mental health. It's a lot to carry.

I called that dental patient today to follow up with him. He's not sure what he wants to do. I gave him the number of the dental clinic at OSU. Their clinic has discounted rates that might be a better option for him. I hope he calls them.