For those who have an issue with Celina's dental care, what type of housing the family lived in, their lifestyle, etc:
This is a VERY rural area. It is mostly woods and mountains and then some farmland. There are no cities or big towns. The small towns (a few hundred people) are 15 miles apart. The big towns have a few thousand. People here are predominantly poor. If you fell down in the woods a few feet from a road and were seriously injured or died you might NEVER be found - period. Same goes for drowning in a river. You can get lost in the woods up here and die from hypothermia in the dead of summer.
Other than people in service industries and education like healthcare , skilled trades, teachers, etc the people here are farmers, loggers, laid-off paper makers, etc. Most of the paper mills that were the highest paying employers here 10 years ago have closed. Dairy farms have sold off their herds. Logging, well it's what men do when they can't find ANYTHING else. Economically the "north country" has been hit very hard. Most of the new jobs that have been created are minimum wage junk with no benefits. Even most people who have dental insurance don't have policies that covers much beyond preventative and fillings - heck, most don't have or have lost their health insurance entirely.
As to the children having different surnames - there are a lot of moms up here who had children (usually when very young) with multiple fathers. These are poor people, most do not go on to college, many don't finish high school. Just the way it is.
This is a very different life than what most Americans experience. We don't go shopping at malls (we don't have any). We pretty much don't go "shopping" - we go somewhere to buy something if we NEED it. If a stranger "hangs out" around town, like at a small restaurant, EVERYBODY notices. If it's cold, you don't turn up a thermostat, you go outside and get some more wood for the stove. Friends, both IRL and Facebook could be virtually anybody you know - from gradeschool to geriatric in age. I'm friends with almost all of my kid's friends. Everybody pretty much knows everybody else. Because there just aren't that many people. It isn't unusual to have friends 20 years your senior or 20 years your junior.
So to the uninitiated, welcome to rural america, where people are poor and don't live like those in suburbia. We don't have perfect teeth, nor do our children. Orthodonture is for "rich people". We mostly don't have nice new houses. Mostly we have old houses - if were fortunate enough to be able to afford to buy one. If not, we rent an old house from somebody. Bedrooms are where there is space for a bed. Anywhere from attic to basement. The "north country" is in some respects a third world nation to many - but it just happens to be in the USA.
