Why would you want to finance heart surgery for people who can’t be bothered to brush their teeth?
“I have to tell you this,” she said. “You have wonderful saliva.”
I was sitting in the chair at my dentist’s office getting a report from my dental hygienist after a cleaning. I confess that I had previously taken the quality of my saliva for granted. Now I know how fortunate I am.
My hygienist went on to explain that dry mouth is quite a problem and can be caused by a number of things including certain pharmaceuticals. It’s uncomfortable, and it creates inflamed gums and infections that lead to further complications.
Due to early exposure to an impassioned young dentist, I always get good reports on the care of my teeth. Nevertheless, my hygienist proceeded with her customary zeal to review the need to angle the toothbrush just so and to practice good flossing technique. One must move the thread back and forth slowly, kind of like sawing a piece of wood, to remove plaque and avoid cutting the gums or flattening the tissue. “We need to preserve those nice, pink peaks between the teeth,” she reminded me.
As I drove away from the dental office, the exchange made me think of a column I had seen the day before by David Brooks. I don’t always agree with him, but I really enjoy reading his work because he’s so intelligent and soothingly moderate, kind of like Republicans used to be before the Tea Party started brewing.
He was basically asking what political moderates should hope for in the way of change. He wrote that in 1962, 14 cents of every federal dollar going to interest payments were spent on entitlement programs. Today that figure is 47 percent and rising. It’s obvious that something reasonable needs to be done to staunch the flow. My time at the dental office had reminded me of a possibility.
I am very interested in the whole subject of prevention and did a lot of research at one point about the importance of dental health to whole body health. The consequences of poor hygiene are amazing.
Gum disease, which begins as gingivitis and may escalate into periodontitis, taxes the immune system, so depressing it that any number of complications can result. Gum disease is especially disadvantageous to diabetics, because infections in the mouth may cause blood sugar to rise, resulting in the need for more insulin.
The Mayo Clinic reports that poor oral hygiene can undermine the cardiovascular system and lead to heart disease, clogged arteries, stroke, and bacterial endocarditis. Infection can send toxins into the amniotic fluid or placenta of a pregnant woman and cause premature birth. In children, it can lead to malnutrition, speech impediments and pain that interferes with learning.
This is a very expensive list of problems that will contribute mightily to the cost of healthcare entitlements. It seems more than obvious that there needs to be a quid pro quo afoot in this matter. Perhaps government healthcare needs to assume a maternal voice that sounds like this:
“I will take care of you in certain respects, but you have to do these basic things for yourself: Stop eating so much of the wrong things. Get up off the couch and get some exercise. Stop drinking so much. Quit smoking. No drugs unless you need them. And I want you to brush your teeth three times a day and floss in the evening.”
I’m not being entirely serious with this, of course. However, the figures provided by David Brooks do reveal that entitlements are going through the roof, and perhaps it’s time to start making at least some of the health benefits conditional.
Of course, people won’t like that because they don’t like being told what to do, even if it would be very good for them in the long run. So let’s be realistic. Let’s reduce the long list to just one requirement, that every adult beneficiary must brush his or her teeth at least twice a day and floss in the evening. How tough is that? And it could save billions of dollars.
Even the most idealistic politician will agree with this modest approach. Why would you want to finance heart surgery for people who can’t be bothered to brush their teeth? You brush yours, don’t you?
Tip: A friend informs me that 2-4 ounces per day of aloe vera juice in water (over ice makes it taste better) may eliminate the dry mouth problem.