Plunged into darkness

Apr 28, 2007 04:30 AM

Moira Welsh
Staff Reporter










Korean-born Moses Han, 45, lost his business after he went blind from a tooth infection he couldn't afford to have treated.


For want of $1,300 to pay an emergency dental bill, Moses Han went blind.

It was a simple problem to fix for those with the money or private dental insurance.

But Moses, born in Korea with the name Jae-Bum Han, did not have either. He worked 14-hour days, seven days a week, in his Oakville convenience store, the sole source of income he and his wife, Gloria Joung-Rae Lee, used to raise three young daughters in their nearby townhouse.

Too embarrassed to tell his dentist he didn't have the money, Moses decided to take the pain. When he walked out of a Mississauga dental clinic last October, Moses knew only that the nerves in his back left molar were dying.

What he did not know is that abscesses can develop in dead teeth. Dr. Hazel Stewart, of Toronto Public Health, says these infections can expand swiftly, sometimes creating severe distress within 48 hours.

Left unchecked, infection can spread through the neck, jaw and torso. It can creep upward to the nerves and blood vessels that surround the brain, and the orbital cavities around the eyes.

Three days after he left the dental office, Moses' face grew red and swollen. It was the first sign of the infection and despite another visit to the dentist, bouts of antibiotics and hospitalization, it would ultimately consume his eyes.

Moses' story illustrates the need for access to dental care for those without private insurance, said Stewart, an advocate of publicly funded oral health care, especially for the poor.

It is not unusual for financially struggling parents to live with the ache of rotting teeth, with no public dental insurance in Ontario and only basic coverage for those on social assistance.

"I feel like crying when I hear this," Stewart said. "This shows what happens when there is nothing in the system that allows people to readily access affordable dental care.

"People don't realize that your teeth are vital organs. If your finger was rotting away, you wouldn't just sit there with it."

In January, the Toronto Star published a story about young Jason Jones, who lost all his teeth because of a lifetime of poverty. The response from readers calling for better dental care was swift. Stewart and the Toronto Oral Health Coalition wrote to Health Minister George Smitherman, asking him for dental clinics in existing community health centres.

Earlier, Stewart had said it would cost about $2 million a year to provide dental care in health centres across the GTA, a fraction of the province's annual health budget of $35.4 billion.

The centres are funded by Smitherman's office. Yet he passed the letter to the Community and Social Services Minister, Madeleine Meilleur.

So far, said Stewart, no one from the Ontario government has responded. "We are just asking for basic services."

Dental care is not included in Canada's medicare system so provincial health insurance does not cover it. There are some options for treatment. For those on social assistance and the Ontario Disability Support Program, there's basic coverage, but no preventative treatment.

In Oakville, where Moses lives, there is some help available, but only for those on social assistance or with special needs. Dr. Bob Hawkins, dental consultant for the Halton Region Health Department, said there is nothing for low-income earners. "The working poor, that is the group that is missing out."

Moses did go to the same dentist occasionally, since 1999. With no insurance, he paid for cleanings, fillings and once, had a root canal. But last October, he did not realize the significance of one sore tooth.

A lay minister with a local Korean Christian church, Moses blames no one for his blindness. He said through an interpreter, that he has a new sense of peace. He did not want the name of the dentist revealed, fearing that he would make the man feel bad.

Yesterday, the dentist who treated him said that Moses came on October 13, with pain and swelling. The dentist was busy, so Moses arranged to come back three days later, at which time the dead tooth was drained and he received a prescription for antibiotics. The dentist said Moses did not tell him that he could not afford the $1,300 fee he quoted for the root canal and crown.

For the cost of that first dental bill, the system is now paying hundreds of thousands of dollars for Moses' medical care.

Moses took the medication. But he called the dentist at home two weeks later, to say the swelling had come back. The dentist said he prescribed more antibiotics and told him if it didn't clear up in a few days, he should go to the hospital. From there, he said, the hospital took over Moses' care.

"It is an unforeseen, very unfortunate incident," the dentist said. "Who knew?"

Dr. Lesley David, an oral surgeon in Mississauga, said infections can quickly spread through the bloodstream or the body. "The issue is catching it early enough," she said.

Moses went to Oakville Trafalgar Memorial Hospital and doctors decided that the infection was so bad he had to be hospitalized. (The hospital said it could not comment on his treatment.)

He said he was put on antibiotics, staying for roughly three weeks. After his release in December, he was sent to an oral surgeon, who removed the rotten tooth. Moses said his mouth was swollen so badly the surgeon had to wait that long.

He spent Christmas at home. But in mid-January the infection returned. He noticed a black mark on his right eye and went back to the hospital.

The infection was spreading.

He doesn't remember losing his sight. There were operations to remove more pus, and when his conditioned worsened, he was sent to Sunnybrook Health Sciences Centre.

While he was in the acute care hospital, tubes in his torso draining the infection, Gloria ran the store, and cared for their daughters, aged 6, 4 and 2.

In their family, everyone had a role to play. Their survival was dependent on each person's hard work. Without Moses to run the store, Gloria struggled.

Dave Sayer is a retired Oakville firefighter, and customer. He noticed Moses' swollen face in December. Over the winter, he saw Gloria at the store. She said they were fine.

"Finally, I could see it in her eyes," Sayer said. "She was just overwhelmed with everything."

In March, after he learned about Moses' health, Sayer helped in the store, relieving Gloria, while she went to hospital and cared for her girls. But without Moses working, they were forced to sell the store, barely covering their debt.

Sayer spoke to the Oakville Professional Firefighters Association and, with the Salvation Army and Oakville councillor Marc Grant, they planned a fundraising dinner for May 26 at Munn's United Church. A Scotiabank trust fund has been created for the family. "These are very gentle people, very positive people. We are going to do what we can to help."

This week, Moses spoke of his experience. His English is limited, as is his understanding of the medical system.

In a lounge at Oakville hospital, his youngest daughter wiggling at his feet, Moses sits with a white cane on his lap. He is tiring. Instead of using the interpreter, he speaks in English, quietly, saying he is finding happiness again, but his words portray a pleasure of the most melancholy kind.

"It all stopped in January. My daughters are growing fast. But I remember them (as) little."

He stands up, trying to walk, his thin legs knocking the table. Gloria takes his arm. His youngest daughter dances, smiling for her Dad, unaware he does not see her.