No government provided health or dental care at all in the US, unless you are dirt poor. I've never had dental insurance, so it's always been 'pay as I go' so I didn't go as often as I should have and the dentist that I could afford wasn't very good. He only believed in 'patching up' any immediate problems and said nothing about preventing new problems.
When I complained that my gums bled when I brushed, he told me to floss more often. I explained that flossing my my gums bleed even worse, so he told me to keep at it and the gums would 'toughen up'. Yet at the same time, he told me to use a softer tooth brush and don't brush so hard.

So... Lacerating my gums with dental floss will 'toughen them up' but a medium toothbrush causes damage??? I flossed every day for a year. Didn't help. He didn't make any other suggestions. I quit flossing unless I had something stuck in my teeth. The gums bled less.
The NEW dentist did a full set of X-Rays before he did anything. I like a man who wants to SEE what he's working with before he starts making general assumptions. He found that I have 'significant' bone loss in the front. That's one of the three places my jaw was broken 30 years ago. I lost a tooth when I was 16. They used a 'Maryland Bridge' which is a butterfly shaped piece of metal across the back to glue the false tooth in, supported by the neighboring tooth. Now, THAT neighboring tooth is loose and the new dentist says that it will probably have to come out. At least I'll get a new bridge that won't be glued to weak teeth over a broken spot in my jaw where the bone is deteriorating.
Today was hell. They did their best to numb me up, but I still feel things. My poor loose tooth never gets really numb and it's the one that hurts like the devil when they touch it. So, naturally, that's the spot that needed the most 'cleaning'. The hygienist did use a rather nifty new gadget on me. It's a high powered water pick that blasts water under the gum line to get out ALL the bacteria and most of the tarter build up. Naturally, she had to go back with the evil metal pick to get the rest of it. *sigh* Torture happy, evil *bad words* and their nasty metal hooks!!!
Half my face was numb for over THREE HOURS! When that wore off, it got worse because then my teeth started to ache. They just felt like someone had been trying to pull them with pliers. Even now, TWELVE HOURS after this torture session began, I can't enjoy my food. It hurts to press my teeth together enough to chew. Plus, there's a funky after taste in my mouth. Not fun.
Best Part? I get to go back and spend another $488 and do this ALL AGAIN day after tomorrow. My life is such a joy.