By Guest Blogger Michelle Vacha, RDH, BS, Founder, Senior Mobile Dental
Oral health is an important part of overall good health. However, many people in this country are not receiving proper dental care because they do not have dental insurance and therefore can’t afford treatment.
Oral disease is associated with pain as well as speech, behavior and self-esteem problems in children. Untreated dental caries (the disease process that causes cavities) is the most common disease in children, occurring five times more often than asthma, according to the American Academy of Pediatrics. In adults and seniors, poor oral health is associated with chronic diseases such as diabetes and cardiovascular and pulmonary disease.
Studies have shown that having insurance coverage directly impacts whether people receive health or dental care or not. Children who are uninsured, for example, are more likely to have unmet dental needs. However, many child and adults throughtout the U.S. do not have dental insurance.
I live in Colorado, where only 56 percent of adults aged 18 and older have dental insurance coverage, according to the 2011 Colorado Health Access Survey. This study also found that nearly half (47 percent) of the uninsured Coloradans surveyed reported that they did not receive needed dental care because of the high cost associated with it.
While this survey may only report findings from Colorado, it is a good basis for what is happening across the country.
Most people get dental insurance through their employers. However, throughout the last 20 years, the percentage of employers offering dental insurance as a benefit has decreased nationwide. For those employers still offering dental insurance, often the employee pays the full premium. As a result, a significant portion of dental care is paid for out-of-pocket.
The 2008 Colorado Household Survey found that, “Although poor and minority adults experience greater levels of dental disease, they frequently face cost and other system-level barriers to obtaining dental care.”
Adults are eligible for Medicare health insurance at age 65. However, Medicare does not offer dental benefits, resulting in more than 60 percent of seniors not having dental insurance coverage. Many seniors are on fixed incomes that prohibit high out-of-pocket expenses for dental treatment.
It is well known that prevention is critical when it comes to health care, and this includes oral health care. However, many adults and children in Colorado are not receiving preventative dental care because of the cost associated with it. Colorado ranks 38th among the 50 states in the number of children receiving preventive dental visits in the previous year. Nationwide, more than 16 million children each year go without seeing a dentist.
The successes in products and developments, such as fluoride, power tooth brushes, etc., have allowed people to maintain their oral health and retain their teeth. These are all preventive measures. Yet Medicaid and Medicare do not cover preventive oral health care over the age of 18.
How much money is spent in medical costs that have contributing factors stemming from poor oral health? Conclusive research indicates relationships between cardiovascular disease, pneumonia, low birth weight, diabetes – to name a few. Lack of dental care also puts a strain on emergency rooms. A report by the Pew Center on the States estimates that more than 830,000 visits to emergency rooms in 2009 were the result of preventable dental conditions (this represents a 16 percent increase from 2006).
Senior Mobile Dental (SMD), a nonprofit organization I founded, believes no elderly or person with a disability should live their life in pain that is controllable. Every day we see vulnerable adults in advanced disease and neglect, because they cannot afford or get to a dentist.
Even though SMD’s focus is on elder and adult care, these findings and concepts span all vulnerable age groups. SMD was founded to address the two key barriers vulnerable people face in receiving professional dental care: transportation and financial costs. SMD brings professional preventive oral health care directly to where this population lives or congregates. Disease findings are then reported and referred to dentists for treatment. Funding helps provide services and identify pain and infection for those with no financial resources.
As a federally qualified 501c3 nonprofit organization, we have overcome the access to care issues this population faces. Our mobile concept for in-house care is an innovative solution to the cost, liabilities and inefficiency of transporting to a dental office or motor home type delivery.
Children’s programs have been successfully implemented within community based programs and school systems, yet the adult population is left with no resources for care. After retirement, many people are on a fixed income and are faced with the choices of using their money to pay for utilities or medications, for example, or continuing their preventive oral health care needs. With the high cost of dental services, most have let their oral health fall to a lower priority of needs, which then predisposed them to advancing, uncontrolled oral disease.
Research and tracking of uncontrolled oral disease and its relation to chronic disease needs to happen in order to institute the needed change for coverage and necessary collaborative care between medical and dental professionals. The successful approach Senior Mobile Dental has used to address the lack of access to dental care this vulnerable population faces is a simple solution to begin the process for inclusion and change, and can be replicated by other organizations.
For more information:
To find out more about Senior Mobile Dentistry, visit http://seniormobiledental.org/. For more information on help for children in Colorado who need dental care, visit Kids in Need of Dentistry (KIND).
For information about lower cost dental care options throughout the U.S., read the article on the topic in the July edition of the Disability Connection newsletter.
ACKNOWLEDGMENTS
The Colorado Household Survey is funded by The Colorado Trust. Analysis of the data and preparation of the figures contained in this report are provided by the Colorado Health Institute.
Michelle Noblet-Vacha RDH, BS, is the founder & executive director of Senior Mobile Dental, a nonprofit charity based in Colorado Springs, and focused on providing senior citizens with access to professional oral hygiene care. Michelle founded Senior Mobile Dental in 2006 after experiencing firsthand the nation’s “oral health crisis” among a growing-yet-neglected population of senior citizens. Since founding the organization, she has received 13 national awards and recognition in paving a pathway to increase access to care for the vulnerable elderly citizens of our nation.
Thank you so much for the awesome information about Oral Health Care and Safety Net Clinics. I am also searching these type of information. Great!
Nice Blog…. Thanks for posting.
I know a dentist in Tarpon Springs who is also involved in doing some charity dental work, like teeth whitening and dental cleaning. He is also performing some wellness checkups apart from that. He’s also accepting payments through healthcare insurance.
Very good post, informative and thorough.
Yes, I agree with what you guys have mentioned above. Taking care of your teeth and gums is very important if you want to prevent oral health problems such as tooth decay, gingivitis (gum disease), receding gums, or even tooth loss. Brushing your teeth for two minutes twice a day and flossing once a day are small investments to make if you want healthy teeth and gums, as well as fresh breath. If you neglect your oral health, you may end up having hundreds or thousands of dollars’ worth of dental work: fillings, root canals, crowns, or even dentures. In the case of your teeth and gums, an ounce of prevention is definitely worth a pound of cure.
Help in Texas. Help in OUR Country. I live on SSD and have been taking serious medications for my health, but it hurts my oral health, which in turn makes my other problems even worse. I feel for the poor people of other countries BUT what about our people of this great land of the proud and free? I love my USA, but come on – help is needed in a serious way. Please if anyone knows of a Dental Program for the poor (children and adults) and not a Health Department Program either, where they just pull teeth and see you for that only. I know I used to be a Dental Assistant and trained in one of those establishments. Yes and I am ashamed to go to a Dentist because of that and mainly I can’t afford one or find one to offer help even at a discount price. I don’t want anything free, but try to go to any dentist and we can’t afford to go past the front door. Thanks and God Bless.
It’s good to see a very informative blog about disability. Keep up the good work and thanks for sharing.
Thank you for all of your comments. For more information on lower cost dental care options, read the article on the topic in the July edition of the Disability Connection newsletter at https://www.disability.gov/home/newsroom/disability_connection_newsletter/2012/july#dental-care
Thank you Dr. Himmel, and the Disability.Blog Team. We have developed the beginning of some solutions, just need a champion to help us replicate it nationally. Funding is limited for adult programs, with more support going towards children’s programs. We are too small yet for federal funding, yet the problem is so large.
I’m on disability, and cannot get payment. i had an upper plate, but it broke in half in a few places. They want $500 for a new one. I have a partial with only 5 teeth, all of which need work or to be pulled. If there is any info or help, I would be very greatful.
Please help HELP HELP HELP
I feel like crying when I see all these pages saying all the help for housing that disabled people have. I’m frustrated with all these lies. I’m disabled, very sick and I’ve been asking for a place to live for years and all doors are closed. At the time we started getting the disability benefit, we were only with food stamps “very limited” and a very, very low income that we can barely survive on and if we do not have a place to live, we have to go to the street because there is no help from the housing dept. This is the way it is now:
1) We get help with utilities, for example (electricity) and we got in the medical program because we are oxygen dependent. There are a few agencies that help us two times a year and another in crisis, but that is not enough, the check we get is not enough to pay rent and utilities and the electric bill is about the same amount we monthly get, so we can’t pay our basic and we are victims of harassment from FPL with the continuous threat of disconnection. We live in terror.
2) Section 8 most of the time is closed and if you are lucky and can apply for it, it could take a few years to get the voucher, if you get the voucher. The rental offices refuse to rent to section 8 vouchers because section 8 to process rental apartments takes 2 or 3 months and that is money that the owners lose and because the procedures are so complicated with all the restrictions they refuse to rent to section 8 vouchers. Also most of the people that apply for section 8 are low income and have a bad credit report, so they refuse to rent to people with bad credit. I have so much stress it is affecting my health. And section 8 vouchers are below the rent prices.
This the real situation. Stop giving so much money to these institutions and start giving more money to individuals. I need a place to live. I need help. It’s urgent because I’m losing the voucher because I can’t find anyone who wants to rent me an apartment because of what is mentioned above. Something have to be done to fix this problem. We are suffering big time. I need help. I need money to buy a place to live and an increase in monthly income. I need a government grant. I’m an individual that needs urgent help. Millionaires donate lots of money and lots of that money goes to other countries like India, Africa, etc., etc. Stop sending money to other countries. First help the people here that need help and then help the other countries.
I am disabled for several reasons. I was taking growth hormone for a pituitary problem and my doctor closed his practice and I haven’t found a doctor yet who does adult growth hormone therapy. It took 6 years for someone to figure out what was wrong with me after a lightning strike. Now I am loosing fillings and my teeth are breaking. I have lost 5 fillings and broken 4 teeth in the past 8 months. I have an appointment in Sept. at a dental clinic that I have had to cancel twice because I can’t even afford that. This cyst is getting bigger and I think it is giving me a head and neck ache. There is no recourse for people like me.
This “cyst” should be looked at. If you are on Medicaid, some oral surgeons will accept it, you’ll have to do some footwork in calling around. If not, go to an emergency room, as many people have had to do. Good luck.
Thanks ladies! If it’s just to acquaint her with the dentist, I think we’ll wait until she’s 3. We’ve been brushing her teeth (when she lets us) so unless something looks suspicious, I think 3 is cool.
Do you have this program listed in the state of Hampton Roads, Virginia? If not, are there services listed in the Hampton Roads area of Virginia? Thank you.
I have created this organization to be replicable nationally. If you find any hygienists or funders who are interested in starting a chapter, please connect them through our website, http://www.SeniorMobileDental.org
I know I have some type of disease in my mouth because I know it has been over 7 years since I have had any work done to my mouth except an X-ray which cost me $90.00 and I could not afford to pay for the other things wrong over a period of time. I also have an odor also. Thank you for listening and thanks for the article.
There is a program called “Mission of Mercy” that provides one day of dental care from volunteer dental professionals. Contact your local denatl association to see if there is one coming to your state. Good luck
I am disabled and in desperate need of dental work. I have very few teeth in my mouth, and have quite a few broken off to the gum. I cannot afford to go get any kind of help. I have a lot of problems with tooth aches, and swelling of the gums and I am very very ashamed to smile or even talk. If there is any way you could find someone to help me, it would be highly appreciated. Thank you and have a blessed day.
See response above.
Oh I forgot, I am 60 years old now, this started when I was almost 59. Did not go to dentist for a total of about 5-6 years. Just before Katrina was the last time I went until May 2012.
I had to retire early due to health issues. I waited about 20 months or so for approval, and money to start coming in. I had a bridge, the teeth underneath it rotted away in that amount of time. There was no way for me to afford dental insurance. I became somewhat ill, running low grade temps, facial skin seemed to get strange white bumps, ruddy looking. Bad breath, sore throats, fluid behind, or inside ears, just feeling tired most of time. I did not know that my teeth were bad at the time. My dr. kept saying I had allergies, I kept telling them is was not an allergy. Went to denist, had three teeth pulled right off the bat. Starting to feel better. A lot of money I can’t afford to spend on my teeth is being spent. Prob $2,000.00 so far and I’m not done yet. Partial plates will be needed soon. This is a lesson, go in and have dental care every six months, or you will pay a lot when you really don’t have the money.
I agree that us disabled adults need dental care. I myself have teeth that are rotting and cracking out of my mouth. I even get real bad kanker sores that cause my mouth to bleed all the time. Im on ssd and medicare. We need the help.
I live in Michigan. I am disabled and there is no where to go for dental care. I have several broken teeth from falling. And have been refused Medicaid. Even with that no dentist close takes it and the 2 that do are unprofessional. 3 people that went to these dentist were in pain just from getting the teeth pulled, no numbing, no gas. And then the dentures didn’t fit right afterwards. So people in Michigan have to live with dental disease if they want to or not. It is part of the new life.
My own personal experience as an adult with a disability is most dentists could care less about servicing someone without money or means at the time of the visit. Those visit are/were usually emergency in nature and would never refer me to any dentists or oral surgeons that would help. I would end up going to the ER where all that they could do would be get me pain pills and antibiotics. Where once they taught me how to put crushed aspirin on a hurting tooth to kill its root and future pain from it. At the ER the would also give me clinics’ numbers but often they were unreachable via bus line, never answered their phones, or closed. When I did finally get receive the state Medicaid it came with a spenddown that was so confusing patient or dentist office didn’t understand it fully.
The state caseworkers would just read a script about how to use the program with a spenddown explaining nothing! So again I was left on my own with my teeth starting to go bad. When I was finally able to pay for the spenddown before the beginning of each month I was in such bad shape with me rotting teeth. The Medicaid would not pay for root canals or other options that save the teeth, only to pull them all, which I did but because the fearful dentist did not want to get burned by Medicaid, he would only do 5 teeth a month. He spread it out over several months which cost my more money and didn’t really save me money verses if the dentist would have set up payments from me to pay for it in the first place. It was sad that me a grown adult had to go to a children’s dentist for help since no adult dentist would help or accept Medicaid. So now I have no teeth, a throat condition that makes it impossible to wear the dentures I got years later. So I am toothless, but not in pain anymore, eating a relatively bad diet compare to what I was when I had teeth, so major weight gain here.
So as you can see the wonderful healthcare circle will go on for me because it wasn’t right to help me with my teeth earlier on. I was lucky a few times that the infection for the teeth did immediately kill me, but I always do wonder what the long term affects are to that. So when I see someone doing the type of thing like stated above I have to share my story and give them a shout out for the good work they are doing and many thank yous. Even though I never benefited from their services in my time, I would not want anyone to have to go through what I did. My story is toned down a bit, too. Just remember compassion is a good thing to have in this world and it will come back to you for everything you do. Peace and Blessings
What about dental coverage to reset a jaw and teeth that were dislocated by doctors during a spinal cord fusion operation!! The patient is over 16…But THIS IS NOT COSMETIC!!!
I’ve often wondered how much Medicaid money could be saved if dental problems were treated. The money saved from prescriptions, medical tests, emergency room visits, office visits and hospitalizations should be enough to fund Dental Care for Seniors and Disabled Adults and still have money left over.
Thank you for long overdue but essential and necessary information.
I truly believe this will be the only institute for change: once the government realizes how much money is lost for untreated dental disease and lack of preventive oral health care. I wish Senior Mobile Dental had the resources to create and publish the study of untreated disease and it’s effects on overall health. We are too small yet for federal funding, but we are working hard to grow, provide the needed research it issue this needed change.
What about people that are about 56 yrs old and been waiting on their disability for 8 yrs and their teeth are bad? We just have to suffer along with the disability they already have. I wonder if it’s a racial thing. I am in Mississippi. I have contacted the senator, lawyers, and the president of the United States and I’m still suffering. What about that?
Keep at it. Forward this blog and responses to all of your senators and policy makers. Maybe if they get innundated, it will become a issue for them to address.
I can attest to this. The last several years I have been without health care. Prior to that, dental was almost like an “extra” since it was so expensive… so my dental health has declined considerably.
I have 2 very severe and painful issues currently and struggled to get assistance from the local community health center -it took 3 months, and then to discover that the only assistance they can offer me is to pull them at a cost of $47 each. To make that more unpalatable, their policy is to work on only one tooth per visit when they have their weekly dental day. One has to wait several hours to get in w/ many others who need emergency assistance. Very disheartening.
I told them I’d like to see if I can find another way, in order to save my teeth, but I have not been able to. Very regretfully, I have made an appointment to have one pulled on Aug. 3 and then I suppose I will have to repeat the process on another “dental day”. I am only 43.
This is what I hear repeatedly; an ineffective system for the people needing help.
As dental professionals, our careers are focused on helping people keep their teeth. Yet with no resources, the only solution is extractions. Just wrong.
The need is nationwide, not just in Colorado. I am in Massachusetts, live on disability and make $50 a month too much to qualify for Mass health or dental coverage. $50 a month is very little and I believe the poverty levels in the US needs to be adjusted. With the cost of food, cost of housing and cost of travel to and from appts, these things affect what’s left after you pay your bills. You cannot make the income of people in third world countries the standard for poverty in the USA to qualify for benefits. After all, they make less but pay less for everything. We on the other hand pay premium for everything, yet the government uses their oncome as our poverty level.
Agreed!