I've mentioned it before, but I'll say it again: vaccines and not pooping in our drinking water may account for most of the gains of modern medicine, but dentistry is an interventionist treatment that actually works, and is constantly undervalued.

Over last weekend, one of my rear molars started to hurt. By Sunday night it hurt so much I could barely sleep. Fortunately, my dentist could take me Monday morning. He examined me, found that the molar had cracked, and sent me off to an endodontist that had a slot for me in the next hour.

There the endodontist examined the tooth, determined that it was worth saving, shot lidocaine into my gums and went to work.

This was my first endodontic procedure (root canal). It's extremely anxiety provoking. You're leaned all the way back, your face is covered with the rubbery blue sheet of a dental dam, you can't talk, you can barely breathe, and you see the mist of abrading tooth enamel, as well as hearing and feeling the work of the drill.

But it didn't take long. It's now packed with a temporary filling. She will take a look Monday to determine whether, in fact, it is salveagable. I couldn't tell if she was naturally optimistic, or giving me a real read on the probabilities.

Two things about this.

One: the cost. I'm a freelancer, and don't have dental insurance. The cost was almost a week's earnings, payable in advance. I put it on my credit card. And that's not the end of the expense, because if it is indeed saved, I need to get a crown on it. I have no idea how much that's going to cost.

Bad teeth are one of the real horrors of being poor. Consider this NYT story about a three-day open-air free clinic. It starts with a man grateful to have 18 teeth pulled. He's been in pain from untreated cavities for years. I have some savings, but this one hit me pretty hard. Many people have a lot less flexibility. If I hadn't been able to afford it, would I just have gone home, suffered, had the tooth eventually crack all the way through, and then, finally, gotten it pulled?

In discussions of healthcare, dentistry is very much in the background, as if it was some kind of cosmetic thing, or a "nice to have". Because a bad tooth won't immediately kill you? Most of healthcare is not about preventing imminent death, it's about helping you live without pain, without impairment, without increasing weakness. I'm not even really sure why dental work is not regarded as "healthcare".

Second. I asked my endodontist about something I'd heard: that endodontists get specific calluses from their work. I thought it might be in along the forefinger or something, but she said they did, on the thumb and forefinger, from using their delicate instruments. Then she became very self conscious and remarked that she also overdue for a manicure. This transformation from competent but warm healthcare professional to individual with some personal vanity was quite startling, and more than a bit charming as well.

Then I had to bicycle home a fair distance in the pouring rain (the endodontist was a fair way from my dentist in a direction away from my apartment), take some pain killers, and have a nap. I've been tired all week, whether from this tooth adventure or just general malaise.

Note, apropos of the cost: I don't expend healthcare to be free, and don't think it should be, save for the poor. I went from a person in agony from a cracked tooth to someone without pain, and with the potential of a repaired tooth, in short order, after some work from a skilled professional. Sure, I feel like I spent a lot of money to just not get quite back to the state I was in previously. But guess what: that's pretty great! Pretending it shouldn't cost any money seems to be a mistake, to me.