Today the tables were turned on me. I was given “the talk” about being compliant with routine preventative health care…by my new dentist. Dr. S. is a wonderful dentist. He asked about my health history, asked about current symptoms and took x-rays. I was all fine and good with that. Then came the hard questions: “When was the last time you saw a dentist? How often do you floss? Do you know that you have five teeth that are on the verge of breaking?” My answers were not very satisfactory I’m afraid: “Two years, not often enough and yes I’ve known for seven years now.” I knew what was coming next….”the talk.”
Dr. S. very patiently talked to me about the importance of routine dental prophylaxis. He explained about plaque and gingivitis. He carefully reviewed my x-rays and showed me the deep fissures and cracks on my five offending molars. He asked me to rephrase what he told me and made sure I understood everything he said. He asked me very gently why I hadn’t had the work done on my teeth since I have known about the problem for seven years.
I told him that I hadn’t had the teeth worked on because they weren’t bothering me. I told him that I haven’t had dental insurance for the last seven years. It was easier to blame the lack of care on the fact that I didn’t have insurance. That was a politically correct reason to not get the care. I could blame the government, or my employers for not helping to afford care. I even told him about the thousands of dollars I had spent fixing my children’s teeth. Surely putting their dental health in front of my own would earn extra credit.
But that isn’t the reason why I haven’t had it done. We dropped our dental insurance when we were self employed because it was cheaper that way. We had enough money to pay for the dental care if I had been willing to do it. The real problem is I am scared of dental work. I don’t like dental pain. I hate sitting in a dental chair because I am filled with overwhelming anxiety. And I could think of a hundred other things I would rather spend a few thousand dollars on than my non-painful teeth. My real reasons had more to do with emotions and that it is easy to slip preventative care down on the priority list.
Dentists are much better about getting the importance of preventative care out to the public than the rest of the medical field. They still struggle with patient compliance though. Dr. S. asked me if I have a hard time getting my patients to do preventative health stuff too. I had to agree with him.
I stress the need for things like annual well woman exams, pap smears, mammograms, exercise and avoiding alcohol, smoking and poor nutritional choices. Many of my patients don’t come in for routine care because of insurance issues. I think more of them don’t come in because of emotional and prioritization issues. Many of my patients don’t come in at all until they are in some kind of discomfort or pain. I can’t count the number of women that I have filled out the mammogram order sheet and then had them not show up for the mammogram. The really honest ones will say they aren’t going to go get it done. Most of them rank having a mammogram up there with having their breasts run over by a car. It’s not high on their priority list. Many of the women are very busy and let’s face it; OB/GYN offices are notorious for long waits before appointments. Cervical and breast cancer are often painless. STD’s often do not have symptoms. They are easy to ignore. Pap smears and mammograms are painful and embarrassing.
I don’t know the answer to how to change the situation. I do what Dr. S. did. I try to educate. I try to remove financial and physical barriers. I try to encourage women and allay their fears. I try to make their visits pleasant enough that they will return. Experiences like going to the dentist also remind me to be just a little more understanding of the reasons patients are non-compliant.
I finally agreed to face my own fears and get those five molars fixed…thank you Dr. S.
Dr. S. very patiently talked to me about the importance of routine dental prophylaxis. He explained about plaque and gingivitis. He carefully reviewed my x-rays and showed me the deep fissures and cracks on my five offending molars. He asked me to rephrase what he told me and made sure I understood everything he said. He asked me very gently why I hadn’t had the work done on my teeth since I have known about the problem for seven years.
I told him that I hadn’t had the teeth worked on because they weren’t bothering me. I told him that I haven’t had dental insurance for the last seven years. It was easier to blame the lack of care on the fact that I didn’t have insurance. That was a politically correct reason to not get the care. I could blame the government, or my employers for not helping to afford care. I even told him about the thousands of dollars I had spent fixing my children’s teeth. Surely putting their dental health in front of my own would earn extra credit.
But that isn’t the reason why I haven’t had it done. We dropped our dental insurance when we were self employed because it was cheaper that way. We had enough money to pay for the dental care if I had been willing to do it. The real problem is I am scared of dental work. I don’t like dental pain. I hate sitting in a dental chair because I am filled with overwhelming anxiety. And I could think of a hundred other things I would rather spend a few thousand dollars on than my non-painful teeth. My real reasons had more to do with emotions and that it is easy to slip preventative care down on the priority list.
Dentists are much better about getting the importance of preventative care out to the public than the rest of the medical field. They still struggle with patient compliance though. Dr. S. asked me if I have a hard time getting my patients to do preventative health stuff too. I had to agree with him.
I stress the need for things like annual well woman exams, pap smears, mammograms, exercise and avoiding alcohol, smoking and poor nutritional choices. Many of my patients don’t come in for routine care because of insurance issues. I think more of them don’t come in because of emotional and prioritization issues. Many of my patients don’t come in at all until they are in some kind of discomfort or pain. I can’t count the number of women that I have filled out the mammogram order sheet and then had them not show up for the mammogram. The really honest ones will say they aren’t going to go get it done. Most of them rank having a mammogram up there with having their breasts run over by a car. It’s not high on their priority list. Many of the women are very busy and let’s face it; OB/GYN offices are notorious for long waits before appointments. Cervical and breast cancer are often painless. STD’s often do not have symptoms. They are easy to ignore. Pap smears and mammograms are painful and embarrassing.
I don’t know the answer to how to change the situation. I do what Dr. S. did. I try to educate. I try to remove financial and physical barriers. I try to encourage women and allay their fears. I try to make their visits pleasant enough that they will return. Experiences like going to the dentist also remind me to be just a little more understanding of the reasons patients are non-compliant.
I finally agreed to face my own fears and get those five molars fixed…thank you Dr. S.
4 comments:
I have extreme dental anxiety as well stemming from a traumatic experience as a child. It took me YEARS to go back and only to pull the bad teeth. The only way I was able to tolerate those visits was Halcion. I will someday have really nice teeth. Maybe.... Thanks for commenting on my blog!
Glad to know someone else with dental anxiety. I actually use Lamaze breathing to help me cope. Relaxation techniques and the ability to disassociate come in handy. A previous dentist was amazed that I could "fall asleep" in the dental chair. I didn't have the heart to tell him my eyes were closed, I was pacing my breathing and repeating, "I will not throw up, I will not throw up, I will not run away, I will not run away...."
Why would someone not take the medications his doctor has prescribed? Because he can’t afford them! I found a prescription discount card that helps lower the cost of prescription medications for people who don’t have health insurance. It’s at www.rxdrugcard.com. The membership fee is only $4.50 a month. Drug prices are shown on that website to check before you enroll. You can save up to 80%. Generics and brand-name drugs are both covered.
Most drug companies also offer discounted medications to those who can't afford them. I am now a big fan of the Walmart $4 prescription program. If my patients are really struggling financially, we look at those $4 meds and see if we can find something that will work for them.
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