Guest Post: decAY1c.
Last week, for the first time in far longer than intended, I spent a few hours in the dentist's chair. It was my first dental treatment in years, following an exam/consultation 10 days prior to establish what I was working with, mouth-wise. Some highlights of that visit included:
"You do know that this tooth is cracked, right?"
"Wow, that other tooth was really bad, but this is definitely the worst."
"You know, you're really not supposed to wait this long to go to the dentist."
No, you're not. Nobody is, but people with diabetes such as myself are particularly ill-advised to invite decay or surgery on themselves, oral or otherwise. Add to that my many middle-of-the-night hypos dispatched with glucose tabs (but not with an extra brushing) and my mouth was deep in the danger zone. This was confirmed by the 2-page laundry list of necessary procedures they sent me home with, including one extraction, two crowns, two rounds of scaling (whatever that is), and some other stuff, the shorthand for which I can't decode.
So how did it get so bad? In every other regard, I'm an acceptably responsible patient: I have kept my A1c at or below 6 for well over a year. I get my full blood work done 3-4 times/year, and my cholesterol is excellent. I had a full dilated eye exam this year. I refill all of my prescriptions on schedule (and am a bit of an insulin/test strip hoarder, an artifact of spending the first 9 months of my diabetic life with no insurance coverage and buying my supplies on eBay). I have trained for and completed two running races this year with mileage in the double-digits. What makes me such a disaster in the dental arena?
The obvious answer would be that I hate going to the dentist, but that's just not the case. I've never hated going to the dentist. I can't say I love it, but I definitely prefer it to the 405 during rush hour, or watching an Adam Sandler movie made after 2008.
Is it the cost? That could be a factor. The last dentist I went to see (also for a long overdue extraction) did not take my insurance, and he too sent me home with a lengthy treatment plan. This plan, however, was almost five times the cost of my current one, threatening to tip into 5 digits. That extraction cost over ten times what my most recent one did. I was in no hurry to rush back and fork over all that cash. Still, I spend significantly more than that each year on the rest of my medical expenses, between premiums, copays, deductibles, and uncovered expenses. So clearly, there is a priority gap.
I think at the end of the day, dental care is just easier for me to ignore. How many times in the past two and a half years did I say "I need to go to the dentist"? Lots. There was one missed appointment, a few half-hearted plans to seek cheaper treatment in Mexico (not uncommon here in San Diego), and guilt-ridden bouts of compensatory overzealous brushing, flossing, and gum-massaging. But, absent any acute symptoms (which, miraculously given the sorry state of my chompers, I managed to avoid) it was always easy to put off actually getting to the chair.
Diabetes care, on the other hand, is a lot harder to ignore. With 4-8 daily finger sticks, a CGM, and familiar symptoms on both the high and low end of bg-land, your head has to be pretty deep in the sand not to have a sense of what’s going on there. The effects of exercise (or not exercising) on my health are felt almost immediately. It goes without saying that if I stopped going to my endo or GP, and stopped getting prescriptions for insulin and test strips, that the consequences for my health would be impossible to disregard. But (as I so gracefully demonstrated) it’s possible to go many years without a dental exam and experience few, if any, symptoms, even while serious problems exist and continue to worsen. One of my teeth was, according to my dentist, just the tiniest bit shy of needing a root canal yet I had no idea. I couldn’t even tell that one of my teeth is CRACKED COMPLETELY IN HALF.
So what to do? Unfortunately, a Google search for "home toothometer" turned up no useful results, and so far no one has come up with a better method than dentist's x-rays for measuring decAY1c (in fact, decAY1c isn’t even a thing. yet.). So I'm going to try a more low-tech approach: schedule my next check-up and cleaning while I'm paying for my last one. That, and mentally preparing myself for an all-liquid diet starting at age 40.
(Ready? Here we go with the Formal Bio.) Christopher Angell is the Creator and Chief Person With Diabetes (PWD) of GlucoLift All-Natural Glucose Tablets. Diagnosed with type 1 diabetes in 2007 at age 30, Christopher learned first-hand that for people living with a chronic illness little things, like the taste of a glucose tablet, can have a huge impact on quality of life over time. Dissatisfied by glucose products whose chalkiness and artificial ingredients unnecessarily exacerbated the unpleasantness of the low blood sugar episodes they were intended to treat, Christopher created GlucoLift so that people with diabetes could have a delicious, effective and natural way to raise their blood sugar. He currently lives with his wife in San Diego, CA (and tonight he's on DSMA Live - be sure to tune in!)