Teeth

The permanent teeth, viewed from the right. The external layer of bone has been partly removed and the maxillary sinus has been opened. (Spalteholz.)

Talking about toothaches is pretty much guaranteed to make me curl up in a ball and make pitiful noises, like guys do when they see someone on TV get hit in the balls. I once had a botched root canal abscess, and since I’d recently moved, I didn’t have a new dentist other than the one who’d screwed up my tooth in the first place, so when the pain manifested itself at 2 a.m., I had no one to call. I took every kind of painkiller we had in the house. I chewed ice cubes. I begged Mr. A to pull my tooth out with pliers. I started seeing things. It felt like an ice pick inside my face trying to force its way out. Just typing it out right now is making my jaw twinge.

We called three emergency rooms, all of which did not have a dentist on duty. Call your dentist, they urged, like I’d be on their line if that was an option. I finally did call the quack, whose emergency line was an answering machine, probably in her garage. I toughed it out overnight and the next morning got in my car (with a bag of ice basically rubber-banded to my head) and drove 70 miles to my old dentist, who gave me six shots of Novocaine that felt so good I offered to name my first-born after him. He yanked the tooth and put me on antibiotics the likes of which they usually give anthrax victims, and then delivered a long lecture about the dangers of ignoring a toothache. I listened. I now go to my (new, non-quackative) dentist if I bite down too hard on a peanut.

I tell it to you to illustrate that there is truly, truly no way that you would ignore that kind of agony unless you were incredibly, horrendously desperate. And that’s the kind of desperation we live in now:

“People don’t realize that dental disease can cause serious illness,” said Dr. Irvin Silverstein, a dentist at the University of California at San Diego. “The problems are not just cosmetic. Many people die from dental disease.”

Willis’ story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.

“When people are unemployed or don’t have insurance, where do they go? What do they do?” Silverstein said. “People end up dying, and these are the most treatable, preventable diseases in the world.”

Getting access to dental care is particularly tough for low-income adults and children, and it’s getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn’t afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.

A.