Of all the things I thought I’d have taken for granted in the transition from kid to teen to adult, having a dentist was not in the top ten of that list.

But it is now.

Between high school and now (ten years), I had not visited a dentist. At first, it was time. I had classes, internships, traveling. There wasn’t time to schedule in a cleaning.

Then I graduated and moved to a rural area. The barrier was then cost. Between rent, bills, and student loans, I couldn’t afford to go to a dentist without health insurance and my job wasn’t offering it.

A few years later, I was finally in a position where I had dental insurance and could afford treatments and I was hit with another barrier, one (for once) not of my own doing.

I had moved to a dental desert and had no idea. A quick google of my small town shows four dentists. Great, right? Wrong. The standard dental practice can handle about 2,000 patients per dentist per year. So, my small town of 18k was about 5 dentists short.

What this meant for me was I spent weeks calling dental offices only to be told that the practice was not accepting new patients. I was put on the waiting list for three of the dental practices and have yet to receive a call that they have an opening. It’s been five years.

Asking around town, the situation wasn’t much better for patients who were lucky enough to have a dentist. If for some reason they had to reschedule an appointment, the new appointment could be as far in the future as six months. In six months a simple cleaning could turn to a cavity or worse. But when you are lucky enough to even have a dentist in a dental desert, you take what you can get.

The other options for dental care involved traveling a minimum of forty-five minutes to a larger town (including out of state) where my insurance did not cover. In a single car household where both people worked, that would mean one or both of us taking a half or whole day off of work for a dentist appointment.

My luck changed only because a new dentist moved to town.

By then, it had been over a decade since my last dentist appointment and I needed four fillings, three crowns, and my wisdom teeth removed. With insurance, it was over $2,000 out of pocket.

This isn’t a situation unique to my town.  According to a 2017 study by the CDC 55.7% of adults outside of Metropolitan areas visit the dentist compared to 65.2% inside of Metropolitan areas. The choice between a day’s paycheck and a dental cleaning is a very real decision that has to be made, and having been in those shoes, I can tell you, unless there is tooth pain, the paycheck often wins out.