How many people are quietly rotting in small ways because of a childhood beyond their control and a medical system they can't afford?

On the surface, it was a very uneventful moment. Last week I sat in my living room with my front jaw aching just enough to distract me from the delight of having at least two of my children home. I thought nothing of it.

Now, I’m devastated.

Before dinner that night I made the innocent mistake of having some almonds. Nothing unusual for most, but for me, a luxury. I never had the privilege of almonds on demand before being an adult. They were what I imagined “other” families got to enjoy.

Almonds, mixed nuts, chocolate covered bits – they were distant memories from my time with grandparents that had become weirdly specific goals. Now there I was a success – eating my almonds.

Then my quiet revelry became a pain that shot through me violently. A front tooth had cracked. Split down the middle as I bit down on another nut. I covered my face and retreated so as not to upset my family.

When I stepped into the bathroom and opened my mouth it became very clear there was no saving my shattered tooth. What was worse was the sudden gut punch of my past. I was reduced once again to a girl with nothing.

First, rage filled my reflection. Then an insurmountable sadness. All of my leaps and bounds suddenly felt empty like the space soon to occupy my mouth. I hugged everyone and retreated to bed.

When I had the tooth removed I saved my tears for when I returned home. I wanted it to be private and complete. Then I returned to work the next day and carried on. When night came, however, waves of frustration and grief crashed on me.

When seeing a dentist I'm always compelled to share too much. I dread the embarrassment of explaining why my teeth are so bad, but I'm more afraid of being wrongly judged. I also walk with the fear that it was ultimately my mother's teeth that killed her. An infection that spread from her mouth and affected her heart.

I'm heavy with those things, but I have learned to lower my face and push ahead. I tried to steel myself again all the while knowing this seemingly simple loss was a divine confrontation. A call to again be honest.

The truth is poverty has haunted me my whole life. Just as it trails and hovers above others. In spite of all I have accomplished something as silly as a nut was able to snatch me back to being the kid with the crooked smile everyone teased. The new gap in my mouth reminding me of every moment I was hurting, but couldn't see a doctor.

Growing up, being poor meant being neglected in ways so basic that they are almost never considered by anyone who has not lived through much the same. No one changed my toothbrush every six months. I only had a toothbrush because they had given some away at school. There was no one to show me how to care for my teeth and there was no insurance for it to make a difference. Half the time there wasn't even money for toothpaste. So I just pushed ahead, swallowed the insults and slowly figured it out for myself. By then, of course, it was too little, too late.

I was also a thumb sucker. It was a small comfort that took me through some of my worst moments of pain and hunger. I had already accepted the gaps in my teeth because of that and thought I could just keep ignoring it all. An almond proved me wrong.

Looking now at this face – this gapped visage with other teeth threatening to fail – I have to admit I'm lucky. I have the means to fix it. Slowly and painfully, but it will get done. But how many people are quietly rotting in small ways because of a childhood beyond their control and a medical system they can't afford?

It feels surreal that I live in a nation that will drop billions on parked planes and bailouts but let my neighbor die because they can't afford diabetes medication. I might twist my mouth with discomfort, but there is someone else whose teeth will decay because they don't "qualify" for assistance. Being human should be the only qualifier.

I am truly baffled by the political outrage against even a hint toward universal health care. Most developed nations have embraced it while the United States stands almost starkly alone in ignoring this basic human need.

I only have had pay with a goofy smile, so far. Can we not all see our way to each paying a little so others won't pay with their lives? Being poor should not be a death sentence.

While there are angry shouts about socialism and who should pay for what, I imagine now how the lines of my adult face might be different if I had access to dental care as a girl. It is a small thing with such a deep impact, a proud and healthy smile.

Editor's note: This opinion column is a revised and expanded version of a column that ran in the print edition of the Aug. 14, 2018, Miami News-Record.

Dorothy Ballard is the managing news editor for the Miami News-Record. Email her at and follow her on Twitter @dm_ballard.