Dental care is what patients who come to Remote Area Medical’s pop-up clinics need most. They start lining up 24 hours in advance for RAM’s services, which are provided free of charge by volunteer professionals who have served hundreds of thousands of patients over the years. Sixty percent of them are there because of bad teeth.

Haley Harbin, a digital media specialist with RAM, is too young to have been part of these events for most of RAM’s 35-year history, but she’s seen plenty – and one of the patients who stands out in her memory is a woman from Pahrump, Nevada, whose kidneys had failed. She desperately needed a transplant, but she wasn’t at the RAM clinic for help with her renal failure. She was there to get her teeth pulled.

Why?

Because she couldn’t get on the transplant list with a mouth full of infected teeth, and she didn’t have the money to pay a dentist. Her situation was hopeless until RAM came to town last year.

RAM officials report that 60 percent of the citizens they serve are there for dental care.

“The need for dental care in the United States is great. While we are not a solution to this problem, Remote Area Medical is glad to fill in the gaps by providing free dental care through our pop-up clinics to people who otherwise would not have access,” says Chris Hall, RAM dhief operations officer.

Last week, Jonathan Thawley asked me to help him get the word out about a GoFundMe campaign he’d started in hopes of raising money to see an oral surgeon. He works hard, is good at what he does and sometimes juggles two jobs to support his family. His dental care needs have overwhelmed his insurance benefits and his paychecks. He has investigated all the options and has not yet found anyone who can help with his problems. As a last resort he has started a GoFundMe campaign to raise money to help him deal with this painful problem. Please read what he has to say, and don’t hold the fact that he’s my friend against him. (He is a conservative Republican; we argue sometimes. But this is not about politics – it’s about a system that makes no sense.)

It was pure coincidence that I’ve been conducting my own eyeball survey this summer at fast-food carryout windows after being handed slushy drinks and salads by folks with missing and rotten front teeth – mostly young people.

Sparkling smiles are pretty to look at, but dental health is not cosmetic – it’s healthcare. And it has become one of the most visible signs of the class divide. In some cases, like the woman from Pahrump, it’s a matter of life or death. There are some local providers of free or low-cost dental services – the Interfaith Health Clinic and the Knox County Health Department do their best – but the needs are overwhelming.

Volunteer dentists provide free dental care at the RAM pop-up clinic in Morristown, Tennessee, May 1-2, 2021. (Remote Area Medical)

Sadly, dental care has gotten so expensive that it is out of reach for the majority of working people. At the same time, by mutual agreement of insurance conglomerates and government regulators, it has been excluded from most comprehensive health insurance policies or is offered at unaffordable premiums. Dental coverage provided by Medicare is limited to procedures required to treat non-dental medical conditions.

So, who decided to separate our mouth from the rest of our body, anyway? And why? That’s been difficult to suss out, and I’m not there yet. I’ll report back when I find out (and maybe some of KnoxTNToday’s smart readers can help out).

A U.S. Senate survey conducted in 2012 showed that 17 million children from low-income families had no access to dental care. A 2009 study revealed that 139 million Americans had no dental insurance. Even Medicaid offers very little in the way of dental coverage.

A comprehensive NBC News study pointed out that dental care has historically been divorced from other kinds of medical care. “Until the 1800s, dentistry was the domain of barbershops, practiced in the same chair and usually by the same guy who shaved your beard.”

I’m not sure what the solution is, and I haven’t been able to find a definitive answer to the question of why we are in this deplorable situation beyond the eternal question of who’s going to pay for it. And I realize that this column is little more than a popcorn fart in the anti-science wind that is filling the sails of Republican politicians nowadays. But knowing that millions of working Americans are going to be kept awake by toothache pain tonight ought to make it hard for any of us to sleep.

If you are inclined to help, here is a link to Jonathan Thawley’s GoFundMe campaign. Please consider his plight. He shouldn’t have to do this.

Betty Bean writes a Thursday opinion column for KnoxTNToday.com.