Saving the Decaying Smiles of Poverty

She kept her head tilted slightly down so I could not see her face. She was young, perhaps 20, with silky hair and smooth skin, and bright green eyes. She looked like a girl that if she had been born to a family of means would have walked the halls of school as an alpha gal, perhaps as the student body president, captain of the cheerleading squad or a star long distance runner … perhaps. Instead, she wore clothes, mostly clean, that had a bit of the dressed up Goodwill look to them trying to mimic the fashion of the day.

I cracked a joke or two and, for a fleeting instance, she dropped her guard and laughed then quickly covered her mouth with the back of her hand, but I noticed. I had my suspicion; the room smelled a bit.

I put my gloved hand on her shoulder and brushed her hair aside.

“Let me see.” She barely nodded and quickly opened her mouth and just as quick closed it and turned away.

“Let me see,” I softly said again and gently tilted her chin toward me. She opened her mouth again, exposing teeth that were all rotten, gums swollen and decayed, some broken off at the bases. Each and every one needed to come out, a smell of infection and necrotic gums wafting from under the blond curtain of her perfectly combed hair. Quiet tears of humiliation quickly cascaded down her cheeks. She never uttered a sound.

“We need to get those fixed,” I patted her on the shoulder. “You are going to be OK. I take it you don’t have dental insurance?” It was a stupid question, I know, but I still needed to ask. She shook her head and looked at her feet.

“Give me a second, let me make some calls: We’ve got some great resources for free dental care. But we gotta get these teeth out and clean up the infection or you can become real sick. Besides, we want to get your smile back, wouldn’t that be good?” She barely nodded, wiped her eyes again, like someone who at a young age had already accepted a singular path in her life.

I sometimes wonder about the doors that stay shut when you can’t afford a smile.

Dr. Louis M. Profeta is an emergency physician practicing in Indianapolis. He is one of LinkedIn's Top Voices and the author of the critically acclaimed book, The Patient in Room Nine Says He's God. Feedback at louermd@att.net is welcomed.