Last night I was eating a Ritz cracker and all of a sudden I bit down on something hard in a cracker. The something hard was the back part of one of my upper teeth. (a tooth that I had filled 25 years ago) I now have an appointment with the dentist to fix the tooth. I will at least need a crown and I might need a root canal. (that is if there is enough tooth for the dentist to work with. Cost? 900.00-1,300.00.

I’ve had dental problems for most of my life.  My dental hygiene practices as a child were typical for a person growing up in the late 1950’s and 1960’s.  Due to a lack of money, the only time I saw a dentist was when something was wrong.  I often went years without seeing a dentist, Unfortunately, this inaction has led to a lifetime of dental problems. (and a lot of pain)

I now have dental insurance through where Polly works but the coverage is slim, a 500.00 maximum payout per year.  I am grateful for what I do have, but the lack of comprehensive dental insurance forces me to only see the dentist when I have a problem.

In the 1970’s, while a student at Midwestern Baptist College, I had several root canals done.  I was able to pay for the roots canals but I did not have the money to pay for the teeth to be crowned.  Unfortunately, years later, these teeth deteriorated and I had to have them extracted.

For a time in the 1980’s and again in the early 2000’s,  I had access to Medicaid and was able to get some much needed dental work performed. However, I noticed a disturbing trend among dentists; many of them were no longer accepting Medicaid insurance and were no longer treating the poor.

During this time I also noticed that dental costs were quickly escalating.  As anyone who have recently been to the dentist can attest, having work done on your teeth has become prohibitively expensive. (and I think dental insurance has probably played a part in the cost escalation)  While those of us with means (or credit) will usually find some way to get our teeth fixed, what about the poor?

Current Dental Services Ohio Medicaid Pays For

In Ohio, Medicaid provides dental care for the poor. (Medicaid often pays half of what Dentists receive in payment from insurance or private-pay)   The coverage is more comprehensive for children than it is for adults.  But , here in rural NW Ohio, it really doesn’t do the poor much good since NO, I repeat NO, dentist accepts Medicaid as payment for dental procedures.  There are about 40 dentists listed in the Defiance, Ohio phone book and not one of them accepts Medicaid as payment for dental procedures.

So what are the poor to do? They have three options.

• Live with their dental problems, a solution that can lead to other serious medical problems
• Figure out a way to pay for the needed dental work
• Go to the Northwest Ohio Dental Clinic in Napoleon, Ohio or the Dental Center of NW Ohio in Toledo, Ohio or Findlay, Ohio

While the Northwest Ohio Dental Clinic and the Dental Center of NW Ohio do a wonderful work and are to be commended for the work they do among the poor in NW Ohio, they are often very hard to get an appointment with and, for many poor residents of NW Ohio, too far away.  For people living in Western Defiance or Williams County, these clinics are 30-60 miles away.

It is scandalous that local dentists no longer treat the poor.  I realize the Medicaid reimbursement rates are a lot less than what insurance pays or what private-pay patients pay, but there is such a thing as providing services for the common good.

I told my dentist years ago, upon finding out his practice no longer accepted Medicaid insurance, “You built your practice on Medicaid and now that your practice is established and doing well, you stop treating the poor.”  I told him I found this to be hypocritical. (even more so since he was a practicing Christian)

I have raised this issues in discussions a few times over the years.  More than once someone has said, the poor don’t take care of their teeth. Why should my tax money pay to fix their teeth.   It is people who have never been poor that make such statements.  I grew up poor. I regularly brushed my teeth, but when dental problems cropped up my parents didn’t have the money to properly take care of my teeth. Only when the problem became severe or quite painful was a trip to the dentist warranted.  The lack of preventative and prophylactic care as a child set in motion a life-long battle with dental problems.

The long term answer to this problem is comprehensive dental care as part of  a national single-payer insurance plan.  I realize we are a long way away from such a notion.  Selling the American people on a National medical insurance plan is easier to do than selling them on notion of dental care for all. (sadly, dental care is treated as an extravagance.  Tooth problem? Pull it! This is evidenced in Ohio’s Medicaid dental coverage for adults. They only pay for root canals on the front teeth. In other words, your smile will look great but you won’t be able to chew your food)

Do you have dental insurance? Do the poor have adequate access to dental services where you live? Please share your thoughts in the comment section.