A Tale of Two Women

My wife and I recently went out for dinner to celebrate our wedding anniversary. Elegant restaurant – one of our favorites. Our server was a woman, probably late 50s, well spoken and engaging. She took great care of us, but the dentist in me couldn’t stop noticing that she had no maxillary teeth distal to her first bicuspids. And her remaining teeth were obviously periodontally compromised.

She reminded us of another woman who for the past few years has worked as a front gate attendant at a golf community in Florida where we spend some time each winter. As a dentist, I could never understand how she could be hired for that position because it was so obvious  that she was missing three or four anterior teeth. Fortunately for her, this year a number of the residents got together to raise some money and bought her a beautiful smile.

This year I have read two books that eloquently describe the economic plight of so many citizens in our country. Hillbilly Elegy by J.D. Vance tells of the struggles of America’s white working class. Vance tells the true story of what a social, regional and class decline feels like when you are born with it around your neck. And Evicted by Matthew Desmond won the Pulitzer Prize for portraying poverty and profit in the American city, following eight families in Milwaukee as they each struggle to keep a roof over their heads.

From the point of view of the dentists, the dental profession unquestionably has been  negatively impacted by the effect that lowered dental insurance remuneration is having on their profitability. On the other hand, these two women I describe, and most of the people portrayed in these two books, can’t afford to go to the dentist even at PPO fees.

So we have a real problem in this country. I do not have a solution. I am not trying to make a political statement. I’m just thinking.