I hate visiting the dentist. For the past five years, I haven’t had to. Well, it was more that I couldn’t afford to. Because Duke University does not provide graduate workers with a dental plan, I put off regular cleanings—despite the risk of developing cavities and gum disease.
However, in March 2019, something happened that I could not put off. While running one afternoon, I tripped on the sidewalk and slammed my head against the concrete. I had shattered my two upper incisors. While one tooth could be restored with extensive bonding, the other had to be extracted almost entirely and would require either a crown, which might last me ten years, or a more durable and more costly dental implant. I was asked to choose between these two procedures, but because I did not have dental insurance, I hardly had a choice to make. I would have to take the more affordable crown. Even still, the entire operation cost more than my monthly paycheck.
Over the course of three visits lasting several hours each, I received excellent dental care and I am grateful for the doctors and dental professionals who made this traumatic injury less painful. However, what happened to me was a medical emergency and, even though I work for one of the country’s “Best Employers,” I could not get the care I desperately needed without going broke or asking family for help. While my health plan could end up covering a portion of the procedure, I am even now—nearly a year later—submitting claims to prove that the injury was an emergency and that the procedure was medically necessary.
Unfortunately, many more graduate workers at Duke will tell you that they have ignored painful and urgent dental problems because they could not afford treatment. Since I began working on this issue with fellow members of the Duke Graduate Students Union, several international students have told me that they have even flown back to their home countries to have dental work done because they could not afford a dentist visit in the United States.
For example, when Roman Gilmintinov in History started experiencing severe pain from an impacted wisdom tooth, he told me that he could not afford an extraction and would have to make do with Ibuprofen until he could return to his native Russia, where he could receive more affordable dental care through the national health program.
Some of our colleagues under twenty-six, like Austin Wadle in Civil and Environmental Engineering, may have the benefit of remaining on their parents’ insurance as dependents, but when Austin broke a filling and chipped their tooth, they did not rush to the dentist. “I waited until winter break to go back home to Miami to use my parents’ union dental insurance,” they told me.
Dental care is health care. Our bodies don’t make distinctions between broken noses and broken teeth, so why should our insurance? After all, dental injuries and diseases can very easily create problems for the rest of the body. Aside from tooth decay and gingivitis, research has shown links between poor dental health and cardiovascular disease, pneumonia and pregnancy and birth complications.
Until the national government implements a universal health insurance program, most of us working in graduate programs—indeed, most Americans—will depend on employer-provided health care to live. As part of the “award letter” that I sign as a graduate worker in the English department at Duke University, the Graduate School agrees to cover the cost of my health insurance.
Rather than include dental insurance, Duke points graduate workers to Campus Smiles, an independent affiliate of the university that charges $149 for a single visit consisting of only basic preventive procedures. By contrast, Duke offers their other employees a choice of three dental plans. Their “Plan A” offers full coverage for preventive care with no deductible and covers the majority of the cost for most restorative and orthodontic procedures.
Grad unions at the University of Washington in St. Louis, Loyola University Chicago, and elsewhere have already won dental coverage comparable to that Duke employee plan. The most noticeable difference between “Plan A” and, for instance, the plan that the UMass grad union won for their workers is that the latter requires no premium. Duke’s employee plans are prohibitively expensive—as much as $541 for a full year, not including incidental deductibles and co-pays.
Therefore, the Duke Graduate Students Union has proposed a simple, two-step solution to the lack of coverage for dental health. DGSU demands that Duke:
- Give graduate workers and their dependents the same dental care coverage that is available to other employees on campus.
- Eliminate premiums and deductibles for dental care for graduate workers and their dependents.
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If Duke meets these demands, graduate workers could be automatically enrolled in a good dental plan at no cost—just as we are with our health insurance. Cleanings, exams, x-rays and other preventive care would be free at the point of use, and restorative and orthodontic operations would be affordable for anyone earning a paycheck from the Graduate School.
The Duke Graduate Students Union has decided to push for dental care at Duke because our members, like graduate union members across the country, can't put their dental health on hold any longer. We invite you to join us in front of Duke Chapel this Friday at noon to show your support.
Michael McGurk is a PhD candidate in the English department and a member of the Duke Graduate Students Union.