Hundreds lined up under outdoor awnings and in parking garages out of the rain for hours in Nashville, Tennessee, last Saturday in hopes of receiving free dental care provided by Remote Area Medical Volunteer Corps (RAM) and the Meharry Medical College School of Dentistry. Many drove hundreds of miles with family in tow for the chance of receiving care.
RAM was established to provide medical care to isolated areas. Meharry Medical College, an historically African-American medical school, is tasked with running Nashville General Hospital, established as the city’s charity hospital.
Becker’s Dental and DSO Review ranked the United States, the richest nation on the planet, ninth in the world for dental health, behind Mexico. Tennessee ranks among the bottom 10 states with the worst dental health in the country, according to Becker’s.
As a previous report in 2013 noted, poor dental health is caused by more than eating sweets or not brushing regularly. The website DentalIQ noted that the underlying causes of poor dental health are “Limited access to dental insurance, affordable dental services, community water fluoridation, and programs that support oral health prevention and education...[and] are significant factors that contribute to edentulism [toothlessness] among older Americans, particularly the most vulnerable.”
Those reasons were confirmed by the more than 300 people who were eventually treated in Nashville over the weekend.
“My daughter and my son-in-law are going to have some teeth pulled, and my wife is going to see about getting her dentures made,’’ said Mark, who traveled with his family from Jackson, Tennessee. “It is too expensive if you went to the regular dentist. To have three teeth pulled, it would cost you $2,000,” he told the World Socialist Web Site.
Mark drove 129 miles (208 kilometers) with family members, arriving at 9 a.m. the day before the clinic began handing out treatment-reservation tickets at 6 a.m. the following morning.
The RAM website urges people to arrive early because ticketing often begins at 3 a.m. or earlier the day of clinic operations.
“In some situations, such as inclement weather, volunteer cancellations, or other circumstances outside of RAM’s control, ticketing may occur earlier than 3:00 AM,” the clinic’s website advised. “RAM encourages everyone who would like services, especially dental services, to arrive as early as possible.”
Mark and his family spent the night in his van. He told the WSWS that he knew “a bunch” of people who needed dental care, and plans for another dental clinic in Selmer, Tennessee, in June already “has them lining up [and] trying to sign up.”
John, a retired construction worker, drove about 126 miles (203 kilometers) from Jamestown, Tennessee, with his 93-year-old mother, arriving at 7 p.m. the day before the clinic and spending the night in his car.
“We thought there were going to be people here lined up at 5 p.m. the day before like we were told, but as it turned out there was nobody here. And we kept going around, driving around, couldn’t find nobody, no lines or no signs,” he recounted. “Finally, I saw a little sign on the door that said ‘Line Forms Here,’ but there was nobody there. So I spent the night in the car, and at 3 a.m. I saw people coming in and came over here and got in line.”
“I am going to have all my teeth removed because I’m affected by Agent Orange,” he told the WSWS, “and a lot of my teeth have been breaking off—and not because I don’t take care of them—and because they are breaking off they have sharp edges. So I figured if I could have them all removed and get dentures [and] get it over and done with.”
“They stopped the [dental] program at the VA [Veterans Affairs] that I was going to,” John added. “They told me I would probably be the last one and get there right away and get everything done. My car broke down on the way, so I couldn’t get there. They said ‘sorry, the program for that particular disability had been terminated.’ ”
The VA did halt the program in about 2014 disputing any effects on teeth and gums despite a myriad of other disorders and diseases connected to the highly toxic and cancer-causing agent that was used for 10 years as a defoliant during the Vietnam War. The VA dismissed veterans’ Agent Orange claims until 1991, 20 years after it was last used.
“This is my mom and she is here, hopefully, to get some relining or new dentures, I don’t know what they are going to do,” John said by way of introduction. John’s mother, Maria, sat in a wheelchair wrapped in a blanket against the cold, morning damp.
There was rain off and on all morning as people gathered under metal awnings to escape it. As the lines grew, hospital security made latecomers move from under the awnings briefly out in the rain but then to a covered upper level of the parking garage and then to street-level coverings.
There is no way to confirm it, but John’s hopes for his mother’s needs were likely not met. A sign indicated that the clinic was for “Fillings,” “Extractions,” and “Cleaning,” and only for those 18 or older.
One woman originally from Egypt, speaking through a friend who served as interpreter, said she came to the clinic because her teeth were hurting and she feared something had broken. “I have no insurance,” she explained.
“Sometimes you can have insurance, but it does not cover the teeth,” her friend added.
Greg, who works as a security guard, said he had dental insurance through his employer, but it was too expensive for him to use. “Like if I want to get a new tooth in, they will charge me like $200 here, but with my dental insurance it would cost me $1,000 at a regular dentist,” he said.
The Meharry Dental School provides low-cost dental treatment but it is a service that is not advertised widely enough, Greg added. “For instance, I live down the street and I didn’t know about it,” he said. “The community needs to know about this.”
The decency and sincerity motivating many of the volunteers and dental students who participate in these free clinics was clearly on display in Nashville.
“Our goal is to have every dental school provide at least one day of services [to] bridge the gap” because many have no money for dental care, said Zelexis Morse, chair of the Student Dental Association’s third annual Oral Health Day at the Meharry Dental School. It was reported that a combined Meharry and RAM effort provided more than $162,000 in services to more than 330 patients.
However goodhearted, charity has never been and will never be sufficient to meet the needs of the working class. Health care, including dental care, is a basic human right that is denied to workers under capitalism.
Lack of money for care is especially true in a city, state and nation where income inequality grows daily. The Nashville Business Journal reported recently that to “live comfortably” in Nashville requires an income of at least $84,000 a year. But the median household income is just $64,000.
While the mantra of the ruling elite is that there is no money for the interests of the working class, including guaranteeing health care, unlimited funds are made available to the rich. Tennessee has promised $1 billion in tax incentives and grants to various corporations. Amazon’s “regional hub” received $106 million in tax incentives that included $65 million in outright cash payments from the city and state. All the while, Nashville General Hospital goes underfunded and threatened with becoming a day clinic, homelessness is on the rise, schools are underfunded, and teachers denied raises.