Five Years of HSE Neglect

Published Meath Chronicle 24th June 2015. 

In 2010, the Fianna Fail/GP government removed the treatment of gum disease from Medical Card holders. Gum disease can cause bad breath, swollen, bleeding gums, loosening teeth, pain and ultimately extractions. Despite a 2014 survey on oral health showing it now affects 80% of adults, the current government is more than happy to leave nearly one-third of the Irish population with an untreated disease. 

And don´t think they don´t know! 
The government paid for the above study. Leo Varadkar while Minister of Health wrote, “Oral disease impacts on the majority of the population...the prevalence of dental decay and gum disease remains high. These conditions are preventable…” However, he´s not willing to do anything about it, his mates in the HSE are also happy to neglect Irish health. Although their website admits one of the best methods of prevention is a regular “scale and polish that involves having the plaque and tartar scraped away from your teeth with a special instrument, before your teeth are polished to remove any marks or stains”, the HSE fails to point out this treatment is not available to the vast majority of GMS patients. 

It´s not just about teeth! 
Inflammation in your gums affects other parts of your body; its presence increases your risk of heart disease and it´s also linked to strokes. Researchers have found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers. Failure to treat oral inflammation is having wider health impacts on people abandoned by the state. 

So, why aren´t people up in arms? 
Unfortunately, gum disease has few notable symptoms until it is too far gone – loose, painful teeth that need extraction. There is also a lethargy within the dental profession to deal adequately with a disease that is so prevalent; the government isn´t exactly leading by example. In addition, successful treatment of gum disease requires a commitment from both parties – dentist and patient. Although I´ve threatened it often enough, a dentist can´t be stood looking over you every night when it comes to floss those lower molars. 

Early gum disease

I´m a Medical Card holder and think I have gum disease. What next? 
Firstly, get a diagnosis. The next time you go to the dentist, ask him/her if you have gum disease – request it in writing as is your right. Once you have the confirmation inform the HSE – best to also do this in writing. Now you are in a stronger position, the government is aware you have a disease that they are refusing to treat. If your condition worsens, which is very likely, then they have a substantial liability should you wish to seek compensation in the future.
In a recent compensation case, a 51-year old man from the North of England successfully sued his dentist when he failed to diagnose and treat his gum disease – he received £20,000 in settlement. 

Maybe the current government will understand measuring people's health and well-being in terms of monetary value can be a double-edged sword.

Dr Don Mac Auley.

Toothache.

Published Meath Chronicle 21st October 2014.

He switched on the bedside lamp, the clock beamed 5.22am. It was now seven minutes since the man had become acquainted with his pain, yet he still didn´t know it. His thoughts flustered over damp floorboards, the warm air forcing him outside. A streetlamp puddled rainy light upon the stairs, the bannister led down, down until he landed in the kitchen. With the first mouthful of whisky the discomfort eased and suddenly he became aware of its absence.

As the storm abated he now felt alive and tingling like an electric fence. In the toaster´s reflection he drew back his lips to see canines project from a cloud of tartar, rattling each molar without joy, the gum looked red but that could be the light and anyway his tongue had already failed to find any cavities. He finished the glass and took off again.

At the door, the queasiness returned. Square miles of waves began to roll and pitch their heaped suffering upon his lower jaw; the pain swept him back to the table. Gently cradling his head, he popped pill after bitter pill, drowning each one in alcohol. He waited for the miraculous transition but it never came. Chaos and treachery reigned. The gates of misery opened and so started a slow, monotonous descent to hell; the man dug his nails in. Then he made himself small to resist the pain however it multiplied quickly, extending its territory until throbbing radiated from above the temple all the way down his neck.

With his head flat on the table between two bags of frozen peas, he tried to stop the advance. Contorted and gasping, he struggled again for clarity. At 6.38am, the analgesic Cavalry arrived. He welcomed them, whooping and chuckling as the pain receded but he could soon tell by their poor equipment and lack of numbers that the relief wouldn´t last long; the man grabbed the phone and dialled her number.

He heard himself imploring repeatedly “Hello? Hello? Hello?” even before she´d answered. “What do YOU want” she finally responded recognising his voice “Do you know what time it is?” “You´ve got to help me, I´m in agony…please…” She cut him off, “We´ve been through this a million times”. “But, you don´t understand, my tooth is killing me, I can´t stand it any…” Before he could finish the sentence she´d hung up. When he rang back he got a high-pitched melancholic drone that penetrated his ear, down his jaw and the ache stirred again.

Back in the bedroom, it grew worse. The dentist would be open in two hours but the man knew how he´d react from painful experience, “Don´t be a coward, man, it´s only an abscess. If you can stand a small injection we´ll take it out for God´s sake”. He could see it all clearly now, he had entered a new state, the agony had revealed his reality – he was weak and completely alone.

After that, the pills didn´t taste so bitter.

Dr Don Mac Auley.