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- Jaw breaking the bank: Financial limitations and health outcomes
- Preventive health and trauma disorders
- Always grindin’: Long-term effects of stress
- Grin and bear it: The pain of making due
- Turns out, mouthguards are worth customizing
- Like pulling teeth: Learned helplessness of patients
- Jaw dropping update
- Word-of-mouth: Wait… Why was I so excited?
- Reality bites: Intersectional considerations
- Conclusion: Raising the standards of preventive care
Financial constraints force us to be reactive, rather than proactive, with our health.
When my dentist recommended a custom mouthguard to wear to sleep, I scoffed at the estimated price. Far too extravagant for something that wasn’t an emergency.
I was delighted to discover later that my insurance would cover the bulk of the cost. However, the relative ease of the process caused me to wonder: why is preventive medical care often so unimaginably out of reach?
Jaw breaking the bank: Financial limitations and health outcomes
The high price of preventive healthcare often leaves us no choice but to refuse treatment that could significantly improve both our health and quality of life. This leaves us struggling to manage issues after they escalate and become more emergent.
One in four adults say that in the past 12 months they have skipped or postponed getting health care they needed because of the cost. Notably six in ten uninsured adults (61%) say they went without needed care because of the cost.
— KFF
High costs combined with financial hardship (brought on by the period of abuse) result in areas of my health where I’m forced to cut corners. I’ve had to put off counseling, ration inhalers, find DIY pain solutions and home remedies, and even skip a back surgery that would drastically improve my chronic pain.
Preventive health and trauma disorders
I was diagnosed with CPTSD after escaping an abusive relationship a few years back.
Abuse is a major health event. It can be a lifelong illness, whether victims escape the situation or not. Trauma disorders like CPTSD come with a whole host of symptoms, risk factors, and comorbid health issues. Anxiety, depression, chronic pain, heart conditions, autoimmune conditions, addiction… the list goes on and it’s ✨ not great ✨.
It’s almost as though being in a state of constant stress is hard on the body or something?
…although the majority of disease burden and health care resources is related to the treatment of chronic conditions, the nation’s health care system is organized and oriented largely to provide acute care and is inadequate in meeting the needs of the chronically ill.
— NCBI
Thanks to these enduring health risks, staying on top of my wellness is incredibly important to me. Unfortunately, between medication, counseling, appointments with specialists, and general costs associated with trying to make healthy choices, prices quickly add up.
Always grindin’: Long-term effects of stress
During my most recent dental exam, I was told I should consider getting a mouthguard to wear at night for Bruxism, a.k.a. teeth grinding. Normally I love learning a new word, but not so much in this context.
My dentist warned that grinding was wearing down the enamel on my teeth. This can result in jaw tightness, headaches, cracked teeth, facial pain, and other painful complications I’m absolutely not stoked on.
The kicker? This subconscious behavior is most commonly caused by (who could have guessed?) chronic stress.
Grin and bear it: The pain of making due
I’m already prone to migraines, anxiety, insomnia, tension, and a whole host of other fun, trauma-related side effects (not to mention brutally vivid recurring nightmares wherein I often grind my teeth out). As you can imagine, I’d do a lot to relieve these and reduce my risk of more severe symptoms.
To prevent further damage to my enamel, the dentist suggested trying a cheap, over-the-counter nightguard. She advised custom mouthguards are much more comfortable, but warned that the cost could be prohibitive.
I’m all about an affordable home solution if it actually helps, so I picked up one of her cheap recommendations on my way home.
Turns out, mouthguards are worth customizing
It was mega weird getting used to having a bulky foreign object in my mouth all night. It kept being unpleasantly incorporated into my dreams. This made it almost annoying that it did help in terms of grinding. I figured I’d get used to it.
The first couple of wears were fine, however, over the next few weeks I began to notice progressively worse jaw pain throughout the day. My head and neck were tense when I woke up each morning, as though I’d been clenching my teeth the entire night.
A quick search told me that since the cheap guard wasn’t molded to my teeth, I may be unconsciously biting down harder to keep it in place. The thick material could also be separating my jaw too much, causing it to clamp down in an attempt to close.
Unable to tolerate this new pain but still needing to protect my teeth, I decided I’d have to bite the dental-grade plastic and shell out the money for a custom mouthguard.
Learn from my chronic pain: I don’t affiliate link things (that aren’t books) often, but when I do, it’s because I really believe in them.
I’ve used a metal Gua Sha stone for the past year for sinus pain, face puffiness, and migraines. It turned out to be a total savior for soothing my jaw pain while waiting for my custom mouthguard. I highly recommend trying something like it out if you get headaches. I love mine so much that I gave them out as Christmas gifts last year.
Like pulling teeth: Learned helplessness of patients
When I called my employer-provided dental insurance, I was expecting to be let down.
Historically, I haven’t had the best luck getting my medical needs covered (which is what we in the business like to call an understatement). Besides, I only pay a few dollars for dental so I assumed it only covered the two cleanings a year.
Clinicians, health system leaders, and policymakers have raised concerns that persistent disruptions in health care access and preventive health screenings could have long-term public health consequences.
— JAMA
The representative recommended I call my dentist’s office and have them reach out to insurance themselves because they’d know what procedure code was needed and what they charged.
Do I ever call the right person the first time when it comes to navigating healthcare? Of course, I don’t. Typical. Still, this was not a heartening sign.
But in a rare and magical moment, I had enough social stamina and health anxiety to solve this problem now instead of putting it off for the less busy time in life that keeps being postponed. I centered myself, mustered all of my spontaneous conversation momentum, and dialed my dentist.
Jaw dropping update
To my surprise, the receptionist quickly got back to me with the wild news that my insurance would cover 90% of the cost of a custom night guard. This left me with a bill of only about $76.
I was barely able to contain my shocked delight at this news, becoming even more giddy when I somehow got on the schedule to be seen the very next day for dental impressions.
The appointment only ended up taking about 20 minutes. I was told my new mouthguard would be ready in two weeks when I’d have another quick appointment to check the fit.
I floated on a cloud of excitement leaving the dentist, feeling like this was the luckiest day of my life.
Word-of-mouth: Wait… Why was I so excited?
It was on the drive home that it hit me: I was paying to relieve yet another painful symptom brought on by my abuse, something for which I’d never gotten any kind of justice or restitution.
Not only that, but I was practically heel-clicking in the parking lot over the fact that my insurance, which I pay for, actually covered a necessary medical device for once. I felt triumphant, almost as though I’d won something, just because scheduling an appointment hadn’t been a day-ruining hassle.
Where are my standards for treatment by the healthcare system?
Actual text to my friend, who works in healthcare. Photo by author: Veronica Wren
I truly couldn’t recall ever having a health need so rapidly and efficiently met; I was still expecting something to go awry and leave me disappointed yet again.
The price paid for inadequate emphasis on prevention includes the costs of excess medical care for avertable diseases and complications, as well as the deleterious economic effects of illness on a healthy workforce, corporate competitiveness, children’s education, mental health, and community well-being.
— NCBI
Why was this worthy of celebration? If preventive healthcare is supposed to be so great for the community, why don’t we make it more easily available?
Reality bites: Intersectional considerations
Being denied access to equitable care is exhausting and dehumanizing. It can feel like a fight for validation, especially as a queer woman with a trauma disorder and a history of chronic illness.
Our healthcare system is chock full of systemic issues that stigmatize, victimize, and limit access to care for marginalized communities. In writing this, I consider the many societal privileges I still hold as a white woman who has a full-time job and can afford insurance through my employer. If I struggle this much, how is anyone managing to get the care they need?
I’m beyond grateful for the care that’s within my means. But getting a “deal” on a mouthguard shouldn’t be something about which I excitedly text the group chats (multiple chats, I was that excited). $76 is still not cheap.
Conclusion: Raising the standards of preventive care
Preventive care shouldn’t be a luxury. Medical treatment shouldn’t have to always be an emergency. A necessary medical device should not be a splurge. Healthcare should be accessible.
Am I being cynical? Does this experience show that access to care is actually improving? Honestly, I think it’s going to take more than one convenient appointment to convince me.
My follow-up dental appointment is on Thursday, where I should be checking the fit of my new mouthguard. Cross your fingers with me.