I was enjoying chips and salsa while out with friends when I felt a jolt in one of my back teeth. I ran my tongue over the area and realized I’d lost part of a tooth from a particularly hard tortilla chip.

“What’s wrong?” my friend asked.

“I think I just chipped my tooth.”

My other friend waved her hand at me. “Just go to the dentist.”

It wasn’t an unreasonable suggestion, but I didn’t have medical insurance, let alone dental: a whopping 33.6 percent of US adults don’t have dental coverage.

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Not only did I not have dental insurance, but I hadn’t been to the dentist in more than a decade. My parents, who both had all their teeth pulled in their forties, had stopped taking me to the dentist when I was around ten. I assumed it was because of the cost. Even with dental insurance, most plans only cover one to two grand of dental work per year, with a deductible. This seems reasonable until you need something more than a cleaning, like a crown, which costs between $750 and $1200.

When I got back home, to the house that I lived in with six other people, I looked in the bathroom mirror and discovered a whole side of the tooth had come off, right down to the gum line. I didn’t want to get an infection, so I did a Google search for cheap dental care.

There was a college nearby with a teaching school, meaning that students worked on you while supervised. The only problem was that it required an initial interview and then a separate exam on a different day before they even started treatment. A car was a luxury that I couldn’t afford, and the trip to the dental school would take hours and multiple buses, not to mention unpaid time off of work.

The next best option was Superteeth, a dental clinic that advertised most basic dental services at $99. Fortunately, Superteeth was on a busy road easily accessible by one bus. A few days later, I headed to the clinic. It was hard to miss, as the outside of the building was covered with signs advertising cheap dentistry.

I walked in without an appointment and filled out some forms, crossing out the insurance section. After an hour, the dentist saw me and told me, without even doing an x-ray, that I needed a root canal.

“How much is that going to cost?”

“The procedure is between six and eight hundred dollars.”

Six hundred dollars was what I made in two weeks. I did not have that kind of money. Then she explained that it was just the cost of the root canal. I’d also need a crown, which would push the total past a thousand dollars and require multiple visits. I must have looked shocked, because she added that they could just pull the tooth for $99.

“Can I think about it and come back?” I asked.

“Sure, but don’t wait too long.”

I'd rather have a missing tooth that wasn't too noticeable than a rotting tooth.



For the next week, I smiled in front of mirrors and windows, trying to figure out if a missing tooth would be noticeable. The tooth was on my left side, third from the back. My biggest concern was how a missing tooth would affect my job prospects. In a list of common nonverbal mistakes made during job interviews, not smiling came in third, with 38 percent of hiring managers citing it as an issue. Smiling is hard when you’re self-conscious about your teeth. Sure, I could do a closed-mouth smile, but it doesn’t have the same effect on people.

In the end, I decided that I’d rather have a missing tooth that wasn’t too noticeable than a rotting tooth that could get infected and cause further, more expensive issues. Even if I could get my hands on a thousand dollars, I would have used it to pay down my credit card that was maxed out from college expenses instead.

When I got the courage to go back, the dentist asked for the $99 upfront. I wasn’t sure what to expect, since I’d never had a tooth pulled before. My friends all had their wisdom teeth pulled and they were all knocked out for the procedure. This was not the case for pulling other teeth.

The dentist shot up my gums to numb them. She then grabbed what seemed to me like regular pliers that you would find in a hardware store. I was awake as she clamped down on the tooth and used all her strength to yank it out.

I was expecting something more surgical and less brutal. I heard the tooth shatter and then the sounds of the dentist scraping the area.

“I think I got all the bone fragments out, but it’s hard to tell. You might have some bone fragments come through the gums in the next few weeks. You can just pull them out yourself or you can come back and we can do it.”

She didn’t mention if it would cost me or not to come back. I didn’t ask, because I knew I’d just go the DIY route. She told me not to drink from straws, as this could cause the blood clot to dislodge, and then sent me on my way without so much as a Tylenol.

I was planning to take the bus home but called my sister for a ride instead. I didn’t want to scare strangers with my bloody gauze and slack mouth. A day later, I was back at work, as I didn’t have vacation days and was now out $99.

I remembered the dentist telling me to “get back in for an exam soon.” She looked concerned. I was having pain in other teeth and was using copious amounts of Orajel to deal with it.

I landed a job with better pay and benefits a few months later. As soon as my dental insurance kicked in, I made an appointment. I had 16 cavities and had to get them filled four at a time over four sessions. As I’d just started work three months earlier, I still didn’t have the money to pay all the out-of-pocket costs and ended up putting some of the expenses on a high-interest credit card.

My dentist kept pushing me to get a dental implant. He warned me of gum loss that could disfigure my face. He also told me my teeth would shift to fill in the gap, causing my bite to change. He did a thorough job of scaring me, but I didn’t have the $2400 to cover the out-of-pocket costs.

A few years and a few raises later, I was able to get the dental implant. I had been experiencing TMJ jaw pain due to the shifting teeth that got so bad that I went to the dentist to make sure I didn’t have an infection.

Like getting the tooth pulled, I was awake for the whole implant procedure. The dentist drilled into my gums, placed a metal screw in the hole, and stitched my gums back up around it. It would be a couple of months before the gums were healed enough to place the fake tooth on top of the screw. Again, I was thankful that the tooth was in the back. A missing tooth was one thing, but a screw sticking out of the gums was quite another.

Years have gone by and the fake tooth still gives me issues. Because I waited too long, I lost a lot of gum tissue and the fake tooth doesn’t fill the space well. Food gets stuck underneath the tooth and when I run the floss all the way under, I sometimes cut the gums. This leads to bleeding, puffiness, and a few days of pain. Once, it led to an infection.

The implant troubles are a constant reminder of how lucky I was to find a job in time, before I — like my parents — lost all my natural teeth. Not everyone is as fortunate.