April 29, 2007
Part 1: Peroxide and pliers for those too poor to pay
Advertiser

Click to watch slideshow

First in a series of four parts.

FORT GAY — In the end, it came down to this: hydrogen peroxide, 150-proof moonshine, wire pliers and two teeth that shrieked with pain.

Deborah Crites, 50, couldn’t sleep at night. Her face was swollen like a grapefruit. She was losing weight — 15 pounds at last count. She couldn’t slurp down soup her teeth hurt so much.

Crites called a dentist first, but the price of extractions — $100 per tooth — was out of the question. She had no private dental insurance, no Medicaid, no paycheck.

So one night last fall, after drinking beers with a friend at The Wildcat II tavern here on the banks of the Big Sandy River, Crites descended into the depths of her garage apartment below the bar and took matters into her own hands.

She rubbed her gums with hydrogen peroxide, swigged a pint of moonshine and retrieved the orange-handled pair of pliers from her kitchen drawer.

“You just wiggle it and jerk it right out,” explained Crites, who would later have all of her remaining teeth extracted by a dentist.

Crites is one of an estimated 260,000 West Virginians who have suffered through pain and now live without teeth.

West Virginia has the highest percentage of older adults without any teeth in the nation.

Nearly 43 percent of state residents ages 65 and older are living without teeth, according to the National Oral Health Surveillance System. That’s double the national average.

West Virginia has a higher percentage of toothless older adults than impoverished countries, such as Madagascar, Gambia, Cambodia and Indonesia, according to the World Health Organization.

Tooth loss isn’t just a problem that affects West Virginia seniors.

Among all ages, nearly one of every three West Virginians — more than 580,000 people — has lost six or more teeth because of disease or decay. Nearly 15 percent of West Virginians are living without any teeth at all.

“The old philosophy is don’t go to a dentist,” said Barbara Hughes, a dental hygienist who works in clinics in Southern West Virginia. “We don’t need to be taking people’s teeth out. We need to be saving them.”

State health officials have acknowledged they have done little to improve oral health among older West Virginians. They’ve launched no initiatives. No money has been distributed to address the problem in recent years.

Health officials say we should not define West Virginia’s oral health status based on tooth loss. The statistics are misleading, they say.

Adults ages 65 and older make up 15 percent of the state’s population. West Virginia has a higher percentage of seniors than all but four states.

Even though the state hasn’t tried to improve oral health among older adults, the percentage of West Virginia seniors without teeth has dropped by 5 percent since 1992, though the numbers have increased slightly in recent years.

“You’ve got to look at the total picture,” said Phil Edwards, who directs the state’s Division of Infant, Child and Adolescent Health. “These people age 65 and older grew up in a different West Virginia than what we have now. There are more dentists. More people have [dental] benefits.”

Not everyone is as optimistic as Edwards about West Virginia’s oral health future. Consider:

s West Virginia has one of the lowest percentages of adults who visit the dentist at least once a year.

s Medicaid, the state-administered health insurance program for the poor, will pay only for tooth extractions for adults ages 19 and older in West Virginia. It won’t pay for teeth cleanings, fillings, crowns, dentures or any other dental procedures. Medicaid does pay for dental services for children — a federal mandate.

s Medicare, the federal government’s health insurance program for seniors, pays for no dental services whatsoever.

s West Virginia has the second-lowest number of older adults in the nation with dental insurance — the No. 1 factor in determining if someone sees a dentist. Only 14 percent have insurance that covers dental services.

s West Virginia has high rates of smoking and smokeless tobacco use — two habits that contribute to poor oral health. The state has the highest rate of spit tobacco use in the nation and the third-highest percentage of smokers.

Studies have shown that poor oral health isn’t a problem confined to the mouth. Decay and infections in teeth have been linked to other health problems: heart disease, diabetes, pneumonia, stroke, and premature and low-birth-weight babies.

Seven years ago, former U.S. Surgeon General David Satcher declared oral health disease a “silent epidemic,” saying those who suffer the worst are poor Americans and the elderly.

The description is especially apt in West Virginia.

Spend time at dentists’ offices in rural West Virginia, and you’ll see people with swollen faces, toothaches, gaping cavities, painful abscesses, lip cancer, gum infections, teeth rotted black with decay and molars cracked off because of an unsuccessful attempt at do-it-yourself dentistry.

“When they pull their own, they usually never get the whole tooth out,” said Dr. Dan Brody, a dentist who extracts dozens of teeth a week at clinics in Wayne, Cabell and Lincoln counties. “Sometimes, we have to go in and cut the rest of them out. I’m willing to bet there are people in Third World countries with teeth not this bad.”

‘I didn’t feel a thing’

Joyce Collier tried to talk Deborah Crites out of pulling her own teeth. She really did, but Crites already had made up her mind.

“I said, ‘Oh, my God. That’s so crazy,’” recalled Collier, Crites’ longtime friend. “I thought she was only going to make an attempt, but she did it.”

Collier and Crites were at the Valley Health dental clinic one morning last winter. Crites sat back in a dentist chair, recounting to Brody the night she yanked out her teeth, proud of her handiwork.

“I didn’t feel a thing,” she said.

Crites had since qualified for a state “medical card” through the Medicaid program. More of her teeth were hurting. She wanted a professional to take them out this time.

Crites had lost count of how many teeth she had left. She reckoned at least five had been extracted by dentists. Other teeth had decayed, deteriorated and fallen out on their own.

“Had some knocked out by my ex-husband, too,” she said.

Brody counted the last of Crites’ teeth. Eleven. They all were coming out that day.

Crites’ oral health problems are shared by thousands of other low-income West Virginians.

Sixty percent of older adults in the state who earn less than $15,000 a year have lost all their teeth because of disease and decay. Ninety percent of that same group has lost six or more teeth.

Compare those numbers to West Virginians who make more than $50,000 a year. Among that group, only about 10 percent have lost all their teeth, according to the Centers for Disease Control and Prevention.

Crites traveled with a construction crew for 18 years, building houses and restaurants in West Virginia, Tennessee, Michigan and Ohio. She never had health or dental insurance. The money she made was to “keep you going.”

Now, months after celebrating her 50th birthday, she would have the last of her teeth extracted.

“You’re looking at some ugly teeth,” she said.

Brody gave Crites three shots of a local anesthetic to numb her mouth. He picked up a pair of forceps.

“I’m just going to rotate it,” he said. “OK, honey, this might pinch a little bit. These eye teeth can be trouble.”

Crites didn’t flinch.

With the last of Crites’ teeth out, Brody slipped a wad of gauze into her mouth. A dental assistant handed her a list of instructions.

“Stay off the moonshine today, OK,” Brody added. “That will make you bleed more.”

Crites mumbled, “Uh, huh,” the gauze soaked red with blood. She gave Brody a thumbs-up sign, then drove home with Collier to her apartment under the bar.

Tooth loss: a problem for all ages

Brandy Taylor doesn’t like to go to the dentist. Never has. Never will.

But the 28-year-old’s tooth was aching. Brandy kept calling her mother in Florida. She was crying on the phone.

So her mother finally grabbed her bags, traveled to West Virginia and saw to it that her daughter saw a dentist.

In January, the two made their way to the Fort Gay dental clinic, where Brody diagnosed the problem as an abscessed tooth.

“I’ll tell you this: I don’t want to be here,” said Taylor, her mother sitting beside her in the operatory. “I don’t like the dentist.”

Two weeks earlier, Taylor’s face swelled. She took some antibiotics. That seemed to help for awhile, but the pain came back, sharp, throbbing.

“She’s cried about it for the last two months,” her mother said. “I don’t think anything hurts like a toothache.”

Taylor, a former mental-hospital worker, has six brothers and sisters. Everyone except her and her 44-year-old sister has false teeth. Her oldest brother had 31 teeth pulled in one day, she said. He was 40 years old at the time. Taylor said she has friends in their early 20s who have lost all their teeth because of gum disease.

Across the state, about 7 percent of West Virginians ages 25 to 34 have lost six or more teeth, according to the West Virginia Behavioral Risk Factor Surveillance System. That percentage climbs to 18 percent among people 35 to 44.

In interviews with the Sunday-Gazette Mail, some people said they believed tooth loss was inevitable with aging, unaware that teeth, with proper care, can be expected to last in good condition for a person’s entire life.

Brody used a root pick to loosen Taylor’s tooth. He twisted and pulled until it snapped out, then sanded the bone with a metal file.

Taylor quickly exited the chair.

“The farther I can stay away, the better off I am,” she said. “I’m going to get them all taken out and get false ones, and the hell with toothaches.”

Medicaid pays only to pull teeth

Robert Abbott’s tooth had been aching for months.

Report a violation or offensive comment.
[X] Close
to report abuse.
Advertisement - Your ad here
By nearly all measures, West Virginians have the worst dental health in the nation. Find out why.
Slideshow
Advertisement - Your ad here
CROSS LANES FLORAL
We are a Local Florist providing same day flower delivery to Charleston, Cross Lanes, Dunbar, Hur...
Advertisement - Your ad here
Inside wvgazette.com