The challenge of the dentally challenged

jaws_profile_tempMEDIBANK Private’s decision this week to pay a little bit for dental checkups comes just as I am feeling like “Jaws”, the character in the James Bond movies.

“Jaws” first appeared in in the 1977 James Bond movie “The Spy Who Loved Me” two years after the original shark “Jaws” movie.

The Bond “Jaws” and his steel teeth could bite through anything. The reality is different, of course. The actor Richard Kiel could only wear the steel teeth for a short time during filming because they hurt so much.

I am feeling like “Jaws” because I have just had my first tooth implant. There is no give in the tooth. It feels powerful, but it certainly hurts (in the pocket).

In 1964, when I was in my teens, my front left tooth was snapped off in a car accident. The (pardon the pun) cutting edge Wangaratta dentist engaged (for rural Victoria) some revolutionary dentistry. He ground out the tissue, blood vessels and nerve from the stump of the tooth, inserted a post and glued a crown upon it.

Then in about 1995, the front right tooth got clouted by a squash racquet, but it survived with a bit of chip.

By the way, a word of advice: never play contact sport without a mouth guard. Let me repeat that: never play contact sport without a mouth guard.

Anyway, this year, the squash tooth went maggoty. Dentist I wasted $1000 on a root canal treatment. After which, my wife complained about my bad breath, despite electric brushing, flossing, picksters and industrial quantities of Listerine.

After the root canal failure, Dentist I suggested two implants and that his specialist in a capital city far, far away was the best person to do it. No change out of $12,000.

What about dental tourism and Thailand? How about we sail there? How about we do a bit of research? Let me repeat this, without stating it the first time: do not get dental implants via dental tourism in India or Thailand, especially if you are over about 50.

Dental implants require a lot of personal attention and a lot of staged timing. Rip out dead tooth. Wait for some bone to grow back (a month). Insert titanium implant in to jaw to gum level. Wait for titanium to knit with bone. (another month or two). Tap crown into implant, with a tiny screwdriver, mind you. You can feel the stress on the jaw. Announce the 2 out of 10 pain, as required. Stop the screw. Wait for bone growth. Come back in a month to retighten.

Not happening in India or Thailand.

I found this out with Dentist II. Dentist II oozes competence and is, at least so far, utterly competent – the sort of person you could back your front teeth on.

He pulled the 1964 crown off the left front tooth and said, “Most people think a tooth is the part you see. In fact the important part of the tooth is the bit below the gum and this is fine.”

I asked, “So you can save the root? How will you drill the old post out?”

Dentist II: “The post is good. We can put a new crown matching the one on the implant on that post.”

Astonishing. Fifty-two years after the Wangaratta dentist put that post in, it is still good. They made good Araldite in those days.

Well, now I have suckered you in thus far with a little personal anecdote, let me expand. Yes, I have private health “insurance”. My wife has private health “insurance” with all the bells and whistles.

I have put the quote marks around “insurance” because it is not insurance. The private heath insurers simply do not do the very thing that insurance is designed to do – cushion against expensive catastrophe.

If my house catches fire; if by boat sinks; if my car makes someone a paraplegic or wrecks a BMW, the insurance company pays. And they do. But not “health insurers”. If your cancer is horrific; if your heart has bombed out; if you are smashed to bits in a car prang and raced to hospital, ultimately the private heath “insurer” will not be able to cope. Even Kerry Packer got treated by the public system because the private system could not deliver. Do not forget that.

We are lucky in Australia that our public system is so good. Despite all the attacks on the public health, especially by people who naively think that their private insurance will cover their catastrophic illness indefinitely.

I do not have dental cover, and even if I did, there are so many limitations, it is hardly worthwhile for things like implants.

There was little change out of $7000 for my teeth, but worth it to feel like Jaws and be able to bite into fruit, sandwiches and the like.

But what of those who do not have $7000? If you have got bad teeth you are always eating bad food. Without preventative and early repairing dentistry you get other health problems. Ultimately, the whole health system pays.

Perhaps this is why Medibank Private is to cover some dental check-ups (but not expensive repairs). If people find out about their dental defects they will fix them at their own cost and not be a drain on the health fund later.

But surely it would be better if Medicare covered all dentistry for everyone. And better still, to abolish subsidies for the cumbersome, inefficient and inequitable private health insurance system and deregulate it.

It should stand on its own feet in the market.

Medicare, meantime, should be properly funded through the tax system, to pick up where the market fails – basically all health care.
CRISPIN HULL
This article first appeared in The Canberra Times and other Fairfax Media on 24 September 2016.

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