I try to avoid setting up an appointment for next year because I don't know what my financial situation a year from then will be like. I've been skipping doctors appointments for years and nothing bad has happened, there exist places that will sell you glasses if you know the lense measurements but there doesn't seem to be much you can do about teeth. Brown stuff eventually grows no matter what. Flossing and brushing twice a day can keep my teeth good for maybe 3 years but I have a permanent retainer on my lower 4 front teeth that is hard to clean. I'm going to have to see about getting that thing removed.