What Can the Poor Do about Dental Care?
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 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.
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.
In September 2017 another free dental clinic was held at Cal Expo in Sacramento CA.
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.
If you live in California and qualify for Medi-Cal, you may also qualify for Denti-Cal. California’s budget for 2018 includes millions of dollars for dental care for the poor, essentially replacing money that was axed from the budget back in 2009, and then at least partially restored in 2014. Approximately seven million people are enrolled in Denti-Cal. This dental care may include preventive care, diagnostics, tooth restoration, frontal endodontic treatment, complete dentures and denture repair.
Please keep in mind that California may provide more free dental care than any other state in the US, because it’s a rich state and also accepts all federal money regarding healthcare for the poor. If you live in a poor state such as Alabama or Mississippi and/or a state which doesn’t take federal subsidies per Obamacare, then you will have more trouble getting cheap or free dental care!
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.
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!
Anybody interested in finding more information regarding dental care for the poor can click on these links:
© 2010 Kelley Marks