12:06 PM

Adult Medicaid dental can make the difference

Free clinics like those in Wise County, Va., remain the only option for many

WISE-Amanda and her kids

Amanda is a 33-year-old single mom from Big Stone Gap in Wise County, Va. She and her two young children came to the local fairgrounds – usually the site of the Virginia Kentucky District Fair and rodeos, among other events – for help with some dental issues. Her two children have Medicaid and she takes them to see the dentist annually. But, much like the majority of adults in her region, Amanda doesn’t have dental coverage for herself. In fact, she hasn’t been able to see a dentist in over 7 years.

This year’s Appalachia/Wise County Remote Area Medical (RAM) event, the nation’s largest pop-up free health clinic, came at a time when Amanda really needed it. She has had severe pain in her mouth for over 6 months. Her jaw was visibly swollen, and her mouth was full of gauze. Amanda and her kids drove from their home in Big Stone Gap, which isn’t too far from the fairgrounds.

The name Big Stone Gap refers to the valley created on the Appalachia Straight – the town is only about 5 square miles but is the largest town in Wise County. Once the hopeful “Pittsburgh of the South” for its coal and iron ore deposits, Big Stone Gap is now home to 5,643 people (according to the 2010 census) with a median household income of $21,584.

Big Stone Gap is a solid example of the other towns throughout Southwest Virginia. According to the Virginia Health Care Foundation, the southwest region of Virginia (including Wise County) has a very low rate of uninsured children but a very high rate of uninsured adults. Roughly 68% of those nonelderly uninsured adults qualify for Medicaid (at least based on income). The Virginia Smiles for Children Medicaid dental program is a large reason why children in this region grow up healthy. However, Virginia adults do not have access to Medicaid dental coverage.

This year, the 3-day RAM event treated 1,349 patients totaling $413,171 in volunteer services including medical, dental, and vision. This was also the first year that the similar Mission of Mercy (MOM) event took place separately but simultaneously in Wise County, where an additional 953 people received $1.3 million in free dental care. To address the overwhelming need for access to free oral health care, Virginia Dental Association Executive Director Dr. Terry Dickinson in 2000 launched the MOM program. This MOM program operates mobile clinics in strategic locations, providing preventive, restorative, and surgical dental treatments to more than 4,000 low-income Virginians each year.

Without access to affordable dental care, many people – especially those who are low-income, underinsured, disabled or seniors – are left to suffer pain and embarrassment, as well as the significant impact poor oral health has on overall health. RAMs/MOMs are necessary; without them, 2,300 people this year would not have had access to basic health care. RAM data from last year’s event, which was combined with the MOM, shows that just 16% of those treated were employed fulltime. People with disabilities made up 25%, while 92% in total were white.

Amanda had several teeth pulled that day. She said it was painful to have them pulled but she already felt relief. After the extractions, she got an antibiotic and was given the name of a clinic to contact for follow up treatment. Amanda explained that she plans to return in future years to get annual cleanings and any other needed work, further illustrating the problem. Access to preventive care in the community could very likely have prevented her tooth loss.

“Until something changes, millions of people in this country will remain without access to affordable health care,” RAM Founder & President Stan Brock said in a press release. That also means, until the system enables greater, affordable access to preventive oral health care, these types of events will need to continue filling the gap.

DentaQuest knows the answer to improving the oral health of all truly lies in prevention. These amazing and incredibly needed free clinics can only be reactive – filling, repairing, pulling. We need a system that is proactive – preventive care that reduces or eliminates the need to fill, repair, or pull.

Medicaid is how we can get there. Let’s enable the program that has helped so many low-income children gain access to care do the same for adults. Medicaid adult dental would open the door to oral health care for people currently locked out, like those 68% of Wise County uninsured (but Medicaid-eligible) adults, and could ultimately reduce costs and improve outcomes.