Inequity extends to dental care access in the mountains, as few providers accept Medicaid
The newly opened dental office at the Summit Community Care Clinic in Frisco is busy these days. A steady stream of patients has led to a months-long waiting list. Chief dental officer Stephanie Barnett oversees this clinic as well as satellite clinics in Leadville and Lake County. “Our waiting list for procedures is months-long at this point, with or without Medicaid,” Barnett said. Her clinics are busy for a critical reason: They are among the few dental offices in the mountains that accept Medicaid or provide low-cost dental care to uninsured patients.
Dental care might not be a priority for most mountain residents. The general good health of a very active population, combined with a high cost of living, can make dental work seem like an optional luxury that won’t really affect health in the long run.
However, there is evidence that dental health may have a startling impact on overall health. Periodontitis, a condition that causes gum inflammation and eventually tooth loss, has been found to be a contributor to poor cardiovascular health. A recently published study in the medical journal Stroke found that individuals who regularly see the dentist have half the risk of stroke as people who do not get proper dental care.
Barnett regularly sees the consequences of ignoring dental health. After Colorado added dental coverage to its Medicaid program, Barnett said she started seeing patients who had not been to a dentist in a very, very long time.
“We had individuals who hadn’t been to a dentist in 10, 15, 20 years,” she said. “In one case, we had to take out all of a patient’s upper teeth because they hadn’t seen a dentist in so long.”
Erin Major, director of the Care Clinic’s School-Based Health Center, said that avoiding the dentist can also lead to serious financial difficulties. “Avoiding a $100 or $200 annual dental visit may lead to a $20,000 procedure down the line,” she said.
Major added that the impact of poor dental health for kids could go beyond health, and impact their futures.
“Tooth pain is the leading cause of missed school for children,” Major said, adding that dental health is also important for pre-natal care. According to the Journal of Periodontal Medicine, a simple cleaning to alleviate an expectant mother’s gum disease may reduce the risk of premature birth by as much as 34 percent.
Even with pediatric and adult dental coverage under Medicaid, there is no guarantee of dental care.
“Just having insurance doesn’t mean providers will accept it,” Major said, pointing out that private dentists only receive 20 cents to the dollar to see Medicaid patients, unlike the Care Clinic which receives better rates due to its status as a federally qualified health center.
According to Medicaid’s dental provider search tool, aside from the Care Clinic, only two private dental offices in Summit accept Medicaid for adult dental care — Comfort Dental in Silverthorne and Frisco Dental on Frisco’s main street. Only one dental office in Eagle County, Comfort Dental in Vail, accepts Medicaid patients.
Major said the accessibility problem is even more prominent in the surrounding rural mountain communities. “Counties like Park, Lake, Chafee and Grand have minimal dental care access for Medicaid patients, both kids and adults,” she said.
Tamara Drangstveit, executive director of the Family & Intercultural Resource Center, said that dental care is one of several medical areas that are inaccessible to lower income residents.
“It’s a major issue in a lot of rural areas like Summit County,” she said. “We see this problem with almost all kinds of specialty care. Many people here are eligible for Medicaid, but we don’t have enough specialists who accept it. The number of patients far exceeds the number of providers.
Barnett said that she and her team are trying to do the best they can for as many patients as they can, regardless of income. She points out that more well-off individuals with dental insurance can help alleviate the problem for lower-income patients by seeing the dentist regularly. “The more people who can pay with insurance, the more resources will be available for people who can’t,” Barnett said.
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