that my friend who I've known for 15 years and always carried piles of papers, books everywhere and whose apartment became a toxic health hazard from the piles of written material blocking passages and rooms could not write and right now cant or wont prove he can read. Does anyone else know? I dont know. I've talked with a teacher friend who doesn't know him or his friends. Looking back I did see things that didn't add up in our first years of aquaintance. Still you dont want to believe your new friend who totes around impenetrable volumes of deconstructionism, modern Marxism and art theory is functionally illiterate. And I think he got more careful after his cover was nearly blown, or was, a couple of times. He hints at causes in childhood, angry dad who worked at newspaper but I still cant accept that the time and energy that goes into this deception couldn't have been better used learning to read and write. He seems proud of his cover up and doesn't seem to get it when I say deception at such a basic level, basic considering the very literate types of people with whom he wants to mingle and identify himself, is the worst basis to build friendships and relationships. Alas the longer it has gone on the harder it must become to say "I have this problem, I've had it for ever, can you help me?" Can anyone help me? Is it too late, at 60, and cruel to persist and should he be left in comfort of his deludings?
what's to get? A bill or two or three or 4 each month that long ago you'd never have heard of. and dont mention bundling. didn't your Granny ever tell you something about eggs and baskets?
I suspect some of my previous remarks about the Dental Hospital sound mean minded and ungrateful and I don’t want to give that impression. No one has treated me badly. They are so decent it’s another world. The students, regular staff, instructors are all courteous, kind, considerate and they try to explain things. Nothing at all like my experience of dentists in the marketplace. Maybe one reason people put off going to the hospital and give it a bad rap is that they have already been mistreated, lied and condescended to and robbed by dentists in the marketplace and they expect the hospital that trained them to be all that and worse. And it is not so. Maybe it’s that people see what they think they are going to see or later organize the story of what happened to be consistent with what they previously expected would happen. Its easier than admitting you are wrong. Most people cant cope with paradox very well. It doesn’t bother me greatly because I once studied philosophy. That’s my explanation anyhow and its no credit to me, I just had some good teachers. Anyhow there is paradox to confront. These people are helpful and kind when working in the hospital or community health centres but their peers in private practices are blatant extortionists.
Over 12 appointments in 5 months they patched me up anyhow, removed what wasn’t salvageable and filled the rest and made partial dentures for top and bottom. And with another 5 appointments over the next year all together it cost me about $250. Private treatment I calculated would come to a bit over $4000. Funny that. Same as the amount the government scheme allocated per person. I must be a very representative piece of average. The doctor who had first filled in paperwork for me to get private treatment under the Scheme was perplexed that I would choose not to take up the Scheme’s opportunity for treatment by a ‘proper’ dentist. Apart from having to explain again that no ‘proper dentist’ wanted to deal with me anyway I said I would not persist in trying to find one because I preferred the treatment I’d got at the hospital, I’d have paid them more if they’d asked rather than be a conduit for taxpayers money into the pockets of a class of nefarious shysters (the dental profession for those who are not concentrating. That’s you Gavin.)
The main problem is the dentures. I haven’t yet met anyone who is comfortable and happy about them. They look fine. They probably help keep your face in better shape. I’ve had them for a year. I’ve put them in place most days for as long as I could stand. That is about 4 hours maximum if there is no option, generally 2 hours is the limit. Then I cant wait to get home and rip them out. The mouth’s first reaction is to salivate like mad trying to sluice the foreign objects out. Then it goes on strike and dries out to a bad extent. Continual speech becomes awkward. Eating with them in the mouth is not possible. At least there is no pleasure in the experience. The first time I had them I thought ‘we’ll take this carefully to start’ and I made up a bowl of strawberries and cream. I desisted just before I choked on a nasty combo of detached lower denture, mushed berries in the wire and cream. You can’t taste food properly with most of the mouth covered in thick plastic (latex or whatever they are made of.) You cant chew food at all. The dentures don’t have the same cutting edges that teeth have and they are not long enough, just a couple of milimetres poking out of the pink plastic. ‘They’ suggest you cut the food up into little pieces. And toss it down your throat I suppose. You can’t even enjoy a cup of tea. At first I thought I was just being precious, finicky about it all but when I started talking to other people I found they agreed. It’s like a shameful secret. Everyone thinks everyone else is managing better and its their own fault somehow if they are not. ‘They’ tell you to persevere, persist and it’ll get better. It doesn’t.
All this puts a damper on your social life; at our age people’s idea of socializing seems to involve a lot of shared dining. Something I took for granted before. You have to make sure you get roughage in your diet and masticate it properly or you will become constipated and a legion of ills that spin off from that. It makes any jobs where you might have to talk a lot over 4-8 hours or look presentable to the public impossible. Earlier generations got through this; I salute them now and I’m sorry I didn’t understand sooner what they were going through. Maybe if the experience started 30 or 40 years ago it’d be easier, I don’t know. So I’ve become reclusive and apparently grumpy. Even going out for a coffee and piece of cake has become not worth the trouble either alone or in company. The result is I have lost, am losing, a lot of weight, I’ve gone from a loose comfortable size 12 to a very loose size 8 in danger of slipping right off. Some might think its great to be nothing but skin, bone, muscle and tendons, I leaned that way myself even but not any more. I try to grab a handful of flesh from my thighs or hips or bottom but I can’t. I’ve never felt so fragile and vulnerable. A robust friend gave me a hug recently and I was afraid he’d break my ribs. And I am stronger and more muscular than average.
Why has there been no research and development here? Surely there is some other material which uses suction rather than rather than twists of wire to stay in place. Why not something softer and flexible that moves with those hundreds of muscles that make up the face that could be used instead of these stiff plastic plates. Why do you think so many older people look unhappy, mouths set, faces frozen without expression? Surely the teeth themselves could be more like the real thing instead of these useless blunt stumps. Research goes on to make better implants, though the idea has been around forever but dentures remain the option for the poor and the old, you cant get rich out of them so there it goes. Forget about that. Trouble is the kind and considerate people, at the hospital at least, I’m not talking about private practitioners, forget them, who offer advice and instructions are talking about something they have no first hand knowledge of and never will usually. No one tells them because we all think ‘it is just me, I need to try harder, longer.’ And even if we do tell them they have a way of not hearing. We know that. Its a bad habit we humans all have of tuning out what we don’t want to know; ‘what smoke that smells like meat coming out those chimneys? No, someones just doing a bit of burning off’. So we give up trying to speak the unhearable.
For a long time there wasn’t a day I didn’t wake up to wish I was dead and to speculate on how that might be done. After a very long time I have become reacquainted with depression. One reason I suppose why its taken me a long time to get back to this. At first at least for a couple of hours a day it felt good to be able to walk down the street and smile at a child without scaring them. Or talk to someone without being distracted by their being distracted with the state of my teeth, or lack of them. Now I’m not so sure I care though I dislike the self obsession that comes with depression.
I know way back when I started this rant I said it’d have to have pictures and probably singing cartoons to get anyone’s interest. It will happen, but not today. You got to understand its only in the last week or two I’ve had a functioning computer of my own in my own room. My invalid housebound mate (serious medical malpractice here – that’s how I know about Erin B. and Colonel Mori) has had need of the other one most of the time to stave off the rage and despair. But pictures there are and one day they will be here.
Along with visual stimulation I plan to excavate the psychic wounds that fuel this rage because its not just me, its something to do with Mother. Isn’t it usually? But not something Mother did, something done to her which didn’t ought to have been.
nothing much happened for a long time. or I found other things to occupy my mind. and in spite of assurances to contrary I felt hopelessly pathetic complaining about a common human lot – if you live long enough. too embaressed to continue.
but now my buttons have been pressed. firstly last week, it may have started sooner but last week is the first time I noticed them, but last week the bastards (The Dental Profession, hereafter generally referred to as ‘the bastards’) started advertising on TV. Cheesy grins, assurances that your miserable life will never be the same, you too can eat an apple again, smile in family photo ops and maybe, just maybe, someone will fall in love with you. Head over heels. I really do prefer the lawyers ads, particular the local franchise of the Erin Brockavitch crew where the admirable Major (finally retired as a Colonel and may I offer congrats) Mori has come to work and stay with us.
Then, barely had I been fired up by these constant reminders of the bastards, than the wretches start to leaflet us. I kid you not. Bright, glossy, double postcard size intros to some new lot of the bastards setting up in our area, offering 50% off to us, and everyone else of course. Off what? you might ask, as did I. 50% off what they used to charge multiplied by 2? I doubt it. Its a far cry from the old days when you went when the pain was unendurable and paid what they demanded or got into a fight.
Now who wouldn’t jump at these inducements? Just about everybody otherwise they wouldn’t bother to leaflet by hand door to door and spend $whatever on advertising. We’ll just have to wait and see how low they will go, because lower they will go. They are clearly just trying to catch as many sprats as they can before the government comes back from its summer vacation and puts the new Denticare system into place by the side of the Medicare system. Which has served us moderately well since about 1972 wasn’t it? Though funny thing is in those bad old days when I was a student living on the ‘smell of an oily rag ‘ as one of my lecturers described it (no John, I never worked as an escort, call girl or any variant of the above, too squeamish, way too finicky and not even that compassionate in those days.) but oily rag or not I did used to go to the doctor from time to time, and I had to pay the usual fee, ($12 I think)and the usual cost of pills or whatever it was, and I never felt it was something I couldn’t possibly afford, I never once thought about it. Till now. I suppose (gee whiz, how slow am I? I shouldn’t be writing this stuff, I should be learning…something) it was only after the introduction of medicare that doctors’ fees became something you would take issue with. Howquickly they multiplied by 5 and have kept going. I suppose when you can be certain the government/Medicare is going to pick up the tab you will feel no compunction in screwing them for all you can get. I don’t know what that ex-doctor of mine was talking about when he said they advised their dentist mates to stay out of the scheme if they could because they could make out like bandits privately. I guess its the difference between common greed (the doctors) and mega bandit greed (dentists.)
But, gratifyingly, though too late for me, just like in an Aesop’s fable their mega greed was their downfall. We just had to wait for a generation or two of the high-fee-paying-students from south-east Asia who have been subsidizing our tertiary education system, and not unreasonably under the circumstances, hogging most of the places in high-pay-professional courses, to get back to their countries of origin and set up in competition. So that now all the ‘cashed-up bogans’ could have a holiday in Thailand and a great set of new teeth for a fraction the price they’d pay at home for just half the teeth. So now the dentists have to drop leaflets door to door like the jim-jam who’s setting up the new pizza shop or the new salon for people who are too lazy or too fat to cut and polish their own toenails.
Why, 40 years after the introduction of Medicare, this sudden concern for our teeth? Wrong question for a start. It has nothing, or very little to do with the state of our teeth. The dental “profession” has made a deal with the government, reluctantly, after all these years, that they will treat the teeth of the less wealthy if the government will fork out $4250 towards it. This enables the noble ‘profession’, which long ago almost priced itself out of its natural local market, to continue business. Few will remember that back when Medicare was introduced the opportunity to include dentistry was offered but, as a doctor who was around back then recently told me, eyes glinting with naughtiness, he and his doctor mates advised their dentist mates not to get mixed up in Medicare if, unlike the doctors, they had an option. The paperwork was hell and they could make much more money if they stayed private; in Doc A’s words, ‘We told them “you fellows can name your prices! You lucky bastards!” ‘ So they did. And as overseas students graduated and returned home to south east Asia, the Philipines and the Happy Isles of Oceania and started offering good dental service at meaningful rates to the “cashed up bogans” my Doc B told me about (see episode 1) our local dentists started to feel the absence of the usual cash cows. So, GFC and all that and never being ones for creative thinking they took a lead from the ‘banking and other financial institution’ industry. These rugged individualists went whining to the pinko socialist government to bail them out. What an awesome idea. People wont go to the dentist anymore? What if we pay them to go? But we wont give them the money, we’ll give it to the dentists. Otherwise the ratbags might spend it on drugs or school books for their kids (and that’s the last thing we want. You don’t want those layabouts getting educated, they might catch an idea) or the gas bill, or drugs or gambling, or solar panelss or drugs.
The first (very tentative) approach to this was a few years ago. The Government gave $150 to welfare recipients to get urgent necessary dental work done. Imagine how helpful that would be. About 6 months before this I had had to have a tooth out and I went to the dentist I usually went to if I had to and for $70 had the troublesome tooth removed. About 30 seconds work not counting the time for the anaesthetic to act. Then, 6 months later another tooth came to the end of its time so I rang the same dentist, arranged to come on up and just before I hung up I checked the price. “Still the same as when I had that extraction 6 months ago? $70?” I asked. “Oh no,” she told me, ” we’ve had to put the price up. An extraction is $160 now.” “The hell it is” I thought. It was time I got to know the dental hospital where this 15 mins max of work will cost me $23. It did. They were very kind, careful and I sang their praises. Well did I know that extraction after extraction is hardly the last word in dental care but it was all I could afford and I’d much rather it was done by the lovely young overseas students at the dental hospital than some oaf looking down my throat for his next trip to Provence. Somewhere along the line someone at the Dental Hospital suggested I be put on the waiting list for a ‘Course of Care’ whereby with whatever was left in my mouth by then I could have other stuff done apart from extractions.. “you’ll have to wait a bit” she said, “but what’s to lose?” Time. I think there’s a song about that. If I was good at this blog stuff a crooner would interject at this point singing “if I only had…time or time is all there is and all I’ve got is time..” and you probably know it better than me.
Years rolled on by. Teeth came out. I never expected anything to come of it and anyhow rumours continued to imply the Government planned on introducing a bigger, better Dental Scheme. And they did. $4250 per person. You could get one implant, almost, for that. Doctors wrote referrals and I went off to find a dentist. I have heard people have had good experiences after this point. I visited up to dozen dentists within reach and emailed a few more. Some didn’t want me because they only applied the new scheme to patients already at their practice. Others wanted me to pay the $4000 first, or if it was really hard for me just $500 at each visit and as they did the work and I could take their receipts to Medicare office and get my money refunded, less a bit. They regaled me with said tales about how they had to wait 3 months and more for the money from the government after they’d done the work. They were sure I wouldn’t have the same problem.
The fly in the ointment was that if I had $4000 at my fingertips odds are I’d have a lot more than that and I wouldn’t be eligible for or in need of any Government Dental Scheme. Nor would I want to spend my dollars on local dentists. I’d be off with my $4000+++ for a vacation in Thailand, India, or Vietnam with a complete dental overhaul thrown in while staying in a hospital like a 5Star hotel. Indeed, the Good Doctor told me a family he knew who all moved into the hospital for the last weeks of the holiday while mum was having her teeth done because the facilities there were much better than the 5 star hotel they’d been staying in. The hospital was delighted to accommodate them all. Lovely people.
Anyhow, back to Me. Finally, through Internet, I found a dentist who could fit me in in about 5 months. “Gee” I thought, “if they are that busy they must be good.” The day came round and I met this supercilious twerp who did X-rays but never once looked me in the eye and loudly read out the results for his assistant to take down, proudly using words like occlusion, molar, incisor, canine, bicuspids. He told me that he would extract all my remaining teeth (about half a mouthful) and replace them with top and bottom denture plates. Since the remaining teeth were strong, not loose at all like he tried to tell me, and although no longer very pretty, they did enable me to feed myself, and talk at length in comfort I said I would think about it first. My remaining teeth and I are deeply attached to each other. 15 years ago those teeth withstood the ravages of chemo and radiation while their cohorts fell under the attack and I appreciate their loyalty. Not mind you that I have yet found any oncologist who is prepared to entertain the possibility of any connection between radiation and teeth decaying. “No” they say as one, “no, the radiation is very focused”. Yes, with clever maths in 3 dimensions, (could be 5 or 11 for all I’d know) and that’s why they dump lead sheets all over you before everyone scuttles off out the door and leaves you there to be irradiated. It was about a year after these irradiations that 3 different dentists in a rural community health centre I was going to made that connection when none of us could explain why my teeth were flaking off and landsliding out from one week to another. When they found out, one of them actually guessed, what treatments I’d been having the year before it was as if a light had been turned on. Then they did everything they could, even put a bridge in, gave good advice about fluoride and calcium and things would have gone much worse without them I’m sure. So I thanked the twerp for his opinion and sneering advice that I was of course free to seek a second opinion and slunk off. The receptionist insisted I take the complementary gift package which was a nasty little toothbrush with hard bristles, little tube of a brand of toothpaste I don’t use, some floss, mouth wash and other bits of junk in a gold bag. As I left I noticed that across the road was a nursing home, a student hostel complex and a large immigration detention centre. I couldn’t help but wonder if this had anything to do with the 5 month wait for an appointment.
I hardly had time to sink into despair when I remembered a letter a few months back from the Dental Hospital that I hadn’t bothered to read carefully because I assumed that I was now safe in the hands of the new Government Dental Scheme and there would be no more visits to the Dental Hospital to extract another hopeless case. On arriving home I looked again. Ye gods! I had reached the top of the list for a Course of Care and I had 1 day left to reply and say whether I wanted to take advantage or go back to the bottom of the list or be Struck Off even. I couldn’t dial fast enough. There had been a cancellation for the next day. Was 8:30am too early for me? Saved. I thought. Again. (hope never dies in the heart of the permanent adolescent.) And so I was, to some extent but nothing is simple. Next episodes: what gets done at Dental Hospital. What doesn’t. My SECOND attempt to use the New Govt Dent Scheme. Family histories and Why I am so Down on (most) Dentists. The tear wrenching beauty of the skulls of a four year old and six year old and other pictures.
Medicare. Denticare. Public health. Anyone see the photo of the big tent in Tennessee in the latest Weekend Australian? Set up in remote areas to provide health care for those who cant afford or access it any other way. Set up by a retired Englishman. Most of what’s going on in the big photo seems to be dentistry and if you read the article most of that seems to be extractions of teeth past help.
What was it like in the Olden Days Ma? What do I know? Not much but I’m going to learn.
Galileo (the First Scientist) had a beloved, brilliant daughter who was sent at early age to a convent. This seemed to her old man the best solution as his kids were illegitimate and he couldn’t afford the dowry needed to make her marriagable. Or he was stingy and selfish. She died at about 30 but years before that had lost all her teeth. Galileo used to bring ingredients to make nourishing soups for her and the sisters. (You can reach a point where you never want to see another bowl of soup or fruit smoothie. I did in Feb 2012. I get thinner every day.)
Thomas De Quincy started losing teeth in late teens and wrote that 25% of all human misery can be ascribed to tooth pain. He would blame it for starting him on his career as an English Opium Eater. But he would, wouldn’t he? (In the immortal words of the glorious mischief maker Mandy Rice-Davies)
Queen Elizabeth I used little paper cut out squares to fill in the gaps to look better for the court.
And there is Louis XIV, the Sun King. About the most powerful man in the world in his day, at least in Europe. Whatever was the ‘gold standard’ in healthcare at the time Louis XIV got it. The Sun King could pay. He got an abscess in an upper tooth, one suspects an obvious front tooth. The “gold standard” bearer of the court assured him that with his most modern treatment the tooth and Louis’ royal looks could be saved. By the time they’d finished with him the whole mouth was infected and all the top teeth had to be drawn. Tough luck for Louis, but better than being hung, drawn and quartered. As that genius Neal Stephenson points out he could have got a better deal off the first barber-surgeon he came to on the nearest bridge over the Seine. For a tiddly fraction the cost and much less pain. Just pull the bloody tooth and paste a little white square over like Good Queen Bess. Vanity vanity. And who is this jospanner person anyway who gets her history out of science fiction? What a dippy flake!
Why does it all cost so much? Why do we have to suffer so much? And don’t lecture me about overcoming suffering by abandoning desires (for lack of pain I suppose). Bit hard to put in the necessary concentration when each breath is a spike through the head.
But what a RORT. It is a truth well known to every dealer in drugs that people in pain will pay anything they can for relief, and thank you afterwards for robbing them and leaving them a bit more disabled. Dentistry is a “profession” for upper middle class stand-over merchants: “Pay up Charley or the pain will only get worse.”
You want implants? You? Ha ha. Got credit card? That’ll do nicely, what’s your limit? Only $10k. Not high enough. Got a house you can mortgage? Any salable assets whatsoever? We’re not fussy old moralists here darling, its the 21st century. Or, maybe you are what my charming local doctor describes as a “cashed up bogan” (now I’ve heard the term is used all over the place) and you can take yourself off to Thailand or wherever and Dr Sunil or Dr Patel can fix you for a fraction of what you’d pay in Oz and you can have a holiday too. And no need to worry anymore about their competence says Doc Goodguy, mostly they are trained here or in America. Yes, it’s a pity most of their fellow country-persons can’t afford them, anymore than we can afford ours, but our cashed up bogans (whose kids will never get through the quotas into dentistry or medicine because foreign fee paying students got there first), can, sometimes.
Back to cost. Late last year I made the first of a few visits to the Museum of Dentistry at the Dental Hospital. An eye opener. You can do it pretty quick because in 3000 years there aint that much history. Plates, dentures, bridges, even implants were all thought of (they are all blindingly obvious solutions) way back. Great stories about those who hunted through the battlefields ripping the intact looking teeth from the corpses. We didn’t invent recycling in the 20th century you know. This was for the wealthy only but if its any consolation the recycled teeth usually rotted in their gums. Perhaps they waited too long or not long enough. Perhaps they hadn’t yet caught on to the transmission of germs. It was still the days of rampant childbirth related fever in hospitals, such as they were, and home births were the safest option if you wanted the baby to live. It was still the days of cholera and the Broad Street pump. We had to wait for modern infection control, hygiene, hand washing and titanium.
My point is that you are not paying for Research and Development in dentistry. There hasn’t been much. Sure there have been changes and improvements in materials technology and industrial design which dentists have utilized, as do we all. As for R and D in Dentistry, apart from creative accounting I doubt there has been much creative thought for 3000 years. It doesn’t look like it at the Museum anyhow although its a fascinating and worthwhile collection.
I’ll keep looking though because I don’t claim omniscience. I got plenty more to say but I wont say it all today. Next time I plan to tell yousall about my fun times trying to use the (old) new government dental plan. circa 2012.