What Can the Poor Do about Dental Care?

Wikipedia Commons photo
Wikipedia Commons photo
A poor man who can't get the dental care he needs
A poor man who can't get the dental care he needs
Here's the photo of the 12-year-old boy who died from dental complications.
Here's the photo of the 12-year-old boy who died from dental complications.

Should indigent people in urgent need of dental care be left in agony?


Since I’ve been writing articles about dental care, I’ve wondered what people do when they need dental care yet have no money, dental insurance or credit cards. If you’re in such an impoverished state, and you have a tooth that is throbbing with pain, what are your options?

My Own Story

Recently I had my own dental horror tale. A lower left bicuspid (already crowned) started aching, particularly when I pressed down on it, which invariably means a root canal is needed. I had to wait another day before calling the dentist because the following day was Thanksgiving. The day after the holiday, I called my dentist, told him my problem and he called in a prescription for some antibiotics and pain pills. Good for me, because as soon as I started taking the pills my tooth became a thrashing, serpent-like creature that wouldn’t die for 24 hours!

I later discovered that the necrosis in the root of my tooth had descended into the bone, causing a big abscess, which eventually took months to heal. The total cost to save the tooth was $2,000, including $500 to repair the crown (the dentist had to drill down through it to get to the root of the tooth). Let me tell you, The cost of the dental care hurt more than the toothache!

As bad as my situation was, at least I could afford the drugs ($35) and the visit to the dentist for which I had to pay $200 to ascertain the nature of my trouble. You’d think I could have told the dentist I needed a root canal and saved the $200, but that’s not how modern dentistry works!

Of course, many people – millions of them – couldn’t even pay for the drugs I bought, and I couldn’t help but sympathize and empathize with these poor folks. What would I do in a similar situation? Would I try to reduce the pain with OTC drugs and wait until Medicaid (known as Medi-Cal in California) did something about it? They certainly wouldn’t have performed a root canal, because nowadays there’s little or no money for dental restoration in Medicaid. Therefore, when I eventually saw a Medi-Cal dentist, I would have needed to get the tooth pulled ASAP.

In the following paragraphs I’ll explore the various issues confronting the poor as they attempt to obtain at least emergency dental care.

A Tragic Tale

For an example of what can happen to someone who needs emergency dental care and either can’t get it or gets it too late, an article appeared in the Baltimore Examiner on March 13, 2007:

Deamonte Driver was just 12 years old when bacteria from an abscessed molar spread to his brain. By the time his mother realized he needed attention, it was too late. Not even two brain surgeries and six weeks of hospitalization - at a cost of $250,000 - were able to save him.

Maryland’s Medicaid program failed Deamonte Driver. In many states Medicaid pays so little than even routine dental care is not provided, and a little bit of that may have saved this young man’s life.

The Internet is full of such horror stories.

Oral Cancer

Oral cancer strikes an estimated 35,000 people per year, and perhaps 25 per cent of those people die from the disease. The use of alcohol and tobacco has been linked to the incidence of oral cancer, but 25 per cent of the people who get the disease don’t use alcohol or tobacco.

If treated early, this form of cancer can be easily cured by excision of the cancerous sore. Regular checkups would spot the disease but, of course, poor people often can’t afford dental checkups, regular or otherwise.

African-Americans seem particularly prone to this disease, having an incidence of one-third higher than Caucasians. Blacks are also twice as likely to die from the disease.

Can People Pull Their Own Teeth?

I hope you don’t end up like the man who pulled 13 of his own teeth because he couldn’t afford a dentist or get the job done for free via government services. This Englishman had to use a pair of pliers to do this grisly work. Now the man needs dentures; unfortunately, he can’t make those himself!

I don’t recommend that anybody pull their own teeth. If the procedure is not done properly, infection could set in, causing the person even more misery. In the United States at least, it appears the poor have access to dental services that will extract teeth for free or for a small fee. (Actually dentists don’t “pull” teeth, they simply rock them from side to side until the tooth breaks loose from the bone and then slips right out.)

County Services for the Medically Indigent

County services can provide dental care, but the services they provide are different in each county of the United States. In Sacramento County, for instance, the County Medically Indigent Services Program (CMISP) has a dental clinic that pays for front teeth fillings, extractions and medications. Naturally, as the budget axe continues to fall, these services could disappear in the coming months or years.

Health Resources and Services Administration (HRSA)

Run by the Department of Health and Human Services, this federal agency may help you find a federally funded dental clinic, which could provide cleaning, checkups and even emergency care. This organization may ask people to pay what they can, but many services are free to indigent folks.

Dental Clinics

In many areas, dental clinics are available for low-income people, but in many cases they will charge you some money, say $10 for an X-ray, which is somewhat cheaper than you would normally pay. These clinics will also take insurance such as Medicaid (Medi-Cal) or Delta Dental. Also, if you are a Native American, some clinics provide care to people with at least some native blood in them.

Free Dental Health Clinics

From time to time, a free health clinic may visit your area. In April 2012, the Tennessee-based Remote Area Medical Volunteer Corps came to Cal Expo in Sacramento, California. Another free dental clinic took place at Cal Expo in late August 2012. The free dental care offered included cleanings, fillings and extractions. These organizations seem to come around about once a year, so for those interested, be prepared to line up very early in the morning!

The California Dental Association (CDA) held another free dental clinic at Cal Expo in March 2015. An estimated 2,000 patients received free dental care, provided by 1,700 volunteers.

The CDA provided more free dental care to the indigent the weekend of 10/28/16 thru 10/30/16. CDA also provided free dental care in Stockton, California the weekend of 10/15/16 and 10/16/16.

Dental Colleges or Universities

Dental colleges or universities frequently offer some services to the poor, but only cleanings, checkups and X-rays may be offered. For restorative work such as root canals and crowns, you’ve have to check with the dental colleges in large universities. By all means, look into this possibility, as it could save you thousands of dollars.

Denti-Cal

If you live in California and qualify for Medi-Cal, you have good news. California’s budget for 2014 includes millions of dollars for dental care for the poor, essentially replacing money that was axed from the budget back in 2009. So, when this money becomes available, stand in line and get everything done you possibly can!

Obamacare Dental Plans

Low income folks may be able to get dental insurance as part of their health insurance per the dictates of the Affordable Healthcare Act. As with regular Obamacare, subsidies or tax credits may be available to help you pay for dental care. But dental insurance doesn’t pay for dental care over a certain limit, generally around $1,500 per year, which provides little for expensive restoration work such as root canals, crowns or bridges.

Please note that for some reason that $1,500 annual limit hasn’t changed for decades, even though dental costs have increased every year. What’s up with that? Anyway, if you have a mouthful of problems, Obama dental care won’t pay for much. Sorry! Nevertheless, if you can get checkups, cleanings or filings at low cost, this coverage could save you hundreds of dollars!

Please click here for more information regarding Obamacare dental plans.

Conclusion

The solution to the problem of providing quality dental care to the poor is to make more funds available for such purposes, so vote for candidates who might make this happen. Perhaps practicing dentists could also be persuaded to provide some of their services for free to the poor. In some areas, dentists do this from time to time, so keep your eyes peeled for such a windfall and be the first in line.

My best advice for people who live on a low fixed income and have little chance of inheriting a large amount of money, you may consider getting all your teeth extracted and replacing them with dentures. You’ll save yourself much pain and trouble in the coming years and look much better as well.

As for people who would like to keep their teeth as long as they can, good dental hygiene is a recipe for success, and for more information about that process as well as more about dentistry in general, please click on the links below:

© 2010 Kelley

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Comments 49 comments

smile zone 5 weeks ago

find you best dentist @ smile.zone


Rob 14 months ago

To bad bartering is aginst the law. You vould trade for dental work but then the goverment would not get there cut. People that are to lazy to work take all the funds from the working poor.Bottom line your fucked unless you sneak in here from another country or have 15 children out of wedlock and sell drugs.


pamela 15 months ago

I had cancer and lost two son's I don't care about life anymore I have not smile n 8 year's I not pretty I just hate my self one day I just might take my life I tired I want my g kid's to look and my grandma happy and she smiling now she can take pictures with us


markenics 18 months ago

I am sure a lot of NGO's help these needy people. My heart goes for them.

Recently I heard about an NGO in Dharavi, Mumbia, India who had done an activity to help these poor and needy people. The activity was in partnership with one of the dental chains in India called dentzz http://dentzzdental.com/. An excellent job done by them.


Steve 20 months ago

Well....looks like there is always a fifth of vodka and a pair of plyers.


Kosmo profile image

Kosmo 2 years ago from California Author

Hey, Natthebrat, I really wish you'd read my whole story before you make such ridiculous comments. I've never advised anybody to not use good oral hygiene. But when you've got a mouthful of bad teeth that nobody wants to pull without charging you money you ain't got, what else are you supposed to do but pull them any way you can? Later!


Natthebrat79 2 years ago

The only thing you keep advising poor people to do is to get their teeth pulled and get dentures so the will at least "look better". You say nothing of oral hygiene. Where did you receive your dental education? What's that you say you don't have a dental degree? Please stop giving poor people dental advise. The most important thing is not that your teeth or smile look good, it's that they function as teeth are part of the digestive system. The most important teeth are posterior teeth as they take most of the brunt forces associated with chewing. Dentures will not help with this in fact most people with dentures end up removing them to eat. Not that you would know or care.


Kosmo profile image

Kosmo 2 years ago from California Author

Thanks for the comment, Vee1980. The best advice I can give anybody is for them to take care of their natural teeth, but for some people it's simply too expensive. At least, once the teeth are gone, you won't have to worry about the pain, which can be terrible. Later!


Vee1980 profile image

Vee1980 2 years ago from San Francisco, California

I think this was a good article until the end advice of people on a fixed income pulling all their teeth & getting dentures to avoid pain & trouble. That is absolutely horrible advice! One, they need to make sure they can afford dentures before they do this! Two, dentures need to be cleaned and adjusted, and fixed if they break, those are not free, they are an ongoing cost. What happens if they break or get lost, the person cannot eat? The bone deteriorates as the dentures rub against it. Some people get sores and have chronic gum pain from ill fitting dentures (especially if they cannot afford an adjustment) You can still get infections if they rub small holes in the gums. Three, it can be ver demoralizing to have to "put in your teeth" before talking or eating. Especially if you are younger and may have to live like this 40,50,60 years.

Salvaging the teeth you have with good hygiene at home and scheduling cleanings at free clinics at least once a year, perhaps using a partial denture if needed and can be afforded, is a MUCH better solution. If I would have taken your advice, I would have been toothless at 17 after I had major dental problems due to a health issue. But here I am at 34 with more teeth than not still and very happy to not have full dentures yet!


Kosmo profile image

Kosmo 3 years ago from California Author

Thank you for your heartfelt tales of woe, Penny. I hope you find the dental work you need. As for California, there may soon be some money for dental care in the budget for Medi-Cal. There is a god, and his name is Jerry Brown! Later!


Penny 3 years ago

It's not just California. New Mexico is supposed to have Medicaid or something like it even for the childless but even if you're a domestic violence victim with knocked-out front teeth, FRONT-CENTER ones at that, they turn you down for Medicaid and there are like NO dental clinics in this state that will see you if you can't pay up-front and don't have Medicaid. There's no real dental school in this state, the nearest one being UC Denver which is a 6-hour-each-way drive and they still charge. I still have my MassHealth card but getting there is going to be a chore and then I'd have to sleep in something so I'd have to DRIVE because as per the reason I left (other than Math teaching jobs in New Mexico which will take someone with a New England state's teaching license but, what, with no front teeth how am I going to GET the job?!) everything there is way too expensive to try to live in long enough to get dentures. (I'm still "technically" Massachusetts resident).

You would THINK there'd be violence-victims' assistance but it either takes years (I've been at this for THREE YEARS now and I read an article about a woman who went front-toothless for FIFTEEN YEARS) or it too is only for women WITH children. If you're childless, college educated, and a man in your own biological family beats you up it's like you'd be better off letting him KILL you because with all the disfigurement and damage the beating causes you you will gradually lose your ability to support yourself, and thus stay ALIVE. I saw a post that mentions a US Constitutional right to be free from cruel and unusual punishment? No, I went to law school. This comes under the First Amendment right to LIFE. Life, period. This kind of damage can gradually KILL you.


justMe 3 years ago

I am 31, and have NO income. I applied for Medicaid, but did not qualify_ because of my roommates income. .Meaning, the household income was too high (SRS knew of my roommate before I applied).

so... I have a roommate who is unable and unwilling to provide insurance for me. I can't smile because I'm too self conscious of my dental needs.

Even if I could find a dentist who charges only $1, I don't even have a dollar to spend.

I could qualify for medicaid if I moved out and lived on the street, but my children and I wouldn't have a roof over our heads.

My choice right now is to live in pain and never smile, or to take my kids to live on the street to save my front teeth and some of my molars.


Healthexplorer 3 years ago

Really a very thinkable topic. I can say that there are many all over the world who are not getting proper treatment or who can not reach the hospital to meet its expenses. Several people are dying out from the cancer related issues due to the avoidance of the teeth care. So approaching to the government funds related organizations to get expenses is definitely a good option.


Kosmo profile image

Kosmo 3 years ago from California Author

Thanks for the comment, Dresden. Other than wait for a free clinic to show up in your community, Medicaid or CMISP, if you live in California, should remove his bad teeth, as long as he's a low-income person; otherwise, he'll have to pay. The only other thing you can do is go to the media and see if some dentist will take pity on your husband and remove the teeth for free. Call up the TV stations and town newspapers and tell them your story - it's worth a try. Good luck. Later!


Dresden 3 years ago

My husband is having some extreme pain with his teeth. He has no current ID or Driver's license so going to Mexico is out of the question, and we do not have insurance nor can we afford it. I have tried to get him into a dental school to have his teeth removed, but most of his teeth or so far gone that they have to be surgically removed. What hope is there to help get him fixed? This country doesn't care for the people who can't afford to get help when they are asking for it. How is that the ones that pay have to suffer so much and it feels like the government doesn't care about the little people at all. Is there any indigent services that can help with our situation? I have tried to get the "Care Credit" but my credit is too low so they will not accept my application. Is there some other way to get him some help so that he is out of pain? Please help anyway that you can.


GeraDessiel Simon 3 years ago

I also suggest,

Those who do have Insurance could share,as when I was abused by prison-officers,who broke off my front teeth,and a CHRISTIAN couple had them repaired using their Insurance! It's time to be United Neighbors in America,truly! I prayed to even have this opportunity.

With many thanksgivings and all thankfulness,for all of us! HalleluYAH!


Hoshinoko 4 years ago

I am receiving SSI. Since about three of four years ago, all dental care for those receiving SSI has been suspended indefinitely, due to this alleged budget crisis in California! (This while major corporations such as Hewlitt Packard Martin Marieta, and other US Defence contractzors are still receiving billions in 'corporate welfare)!

This is unconscieable that in America, people have to be denied the basics simply for being too poor! Sooo... whaa? The poor have to wait until experiencing excruciating pain from an emergerncy dental situation BEFORE being able to 'qualify' for dental assistance? Isn't there some clause in the US Constitution agains 'cruel and unusual punishmnet'? That the poor are being 'penalised' simply for being impoverished, and cannot receive intervention PREVENTATIVE dental care BEFORE having a tooth break or the like thus causing excruciating amount of unecessary pain and suffering?

I have bad dental health. I have an upper molar in my upper left side that feels that it may break at any moment! But I can't go to any dentist, simply because I do not have the amount of money it would cost to even get this tooth extracted! So I have to risk it breaking and causing extreme pain! This should not be happening to ANYONE in America! SHAME ON CALIFORNIA!


brenda 4 years ago

my husband is a seasonal worker i lost my job 2 yrs ago we do not have health or dental insurance because we can not afford it the state says my husband makes too much money to help us with medical insurance i have kidney disease and i have an absessed tooth in which needs dental care there are no free clinics here in reading pa you have to pay 75.00 yes i said 75.00 to go to a clinic the dental clinics is 150.00 that is for 1 tooth extracted! yes i see people in line with there fs cards wearing gold jewelry,have there nails done dressed to kill here i am with 10 yr old pants and tshirts living paycheck to paycheck and no help for me! I wish the best for all those like me!


Kosmo profile image

Kosmo 4 years ago from California Author

I wanted to write in the previous comment that I will look into so-called low income dental clinics and see if they can actually help poor folks obtain affordable dental care. Later!


Kosmo profile image

Kosmo 4 years ago from California Author

Hey, pain4thepoor, I'm going to assume the story you related happened in the U.S. It sounds like you actually got lots of work done, though it may not have been the most skillful. Keep in mind that if you need a filling, you may opt for having the tooth extracted instead. It may not look good, but at least the tooth will no longer be a worry. Moreover, as soon as you can, get them all yanked and then maybe the government will pay for the dentures. That's about all I can advise. Sorry. In the meanantime Later!


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