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Public Affairs coverage from our award-winning staff |
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Dental Neglect: Illinois's Oral Health Care Shortage
Produced by Gabriel Spitzer on Sunday, March 22, 2009
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Patients wait outside the Oral Health Clinic at UIC. (WBEZ/Gabriel Spitzer) |
There’s a little-noticed public health crisis brewing in Illinois. It’s not especially sexy, but it’s serious. It’s connected to life-threatening ailments, nutrition and even job prospects—the problem is access to dental care. Illinois has the third largest underserved population in the country. The few clinics that treat poor people are overwhelmed. Now they’re bracing for a new flood of patients, as more people lose their jobs.
The clinic at the University of Illinois at Chicago’s dental college opens at 7:30 in the morning, sharp. Well before that, at 6:45, the sun is just peeking over the horizon ... about 30 people have already queued up outside the doors. This is not a happy line.
VOICES: It’s like a very dull throbbing … it’s kind of a dull pain, so it’s really weird … I can’t sleep at night time. I haven’t been able to sleep the past two days … I mean like the 1967 war between the Israelis and the Arabs is goin’ on in my mouth.
The folks up front got here at 5:30 in the morning. They’re here because this clinic treats people on public aid, and some with no insurance at all. This is Michael Angelakos.
ANGELAKOS: Can’t afford the dentist no more. They tripled in the last 15 years. It’s a racket. SPITZER: What other options are available to you, besides paying out of pocket, or coming here? ANGELAKOS: Nothing. You gotta either come here or go to Cook County.
By 7:30, the line has stretched to about 75 people. A security guard turns a key, and people file in. It’s orderly this morning, but Dr. Gary Drahos says some days, there are tussles at the door. The clinic sees about 40 urgent care patients a day. The rest get a little sympathy, and a list of other places to go.
DRAHOS: There’s very little out there. We try to update these lists constantly, and as we do we find out that most of them are overbooked, just like we are.
Drahos says people drive hundreds of miles to come here. More than half of Illinois counties have a dentist shortage, according to the feds.
It’s not a new problem – but it’s gotten worse. Chicago’s lost two of its three dental schools. Cook County has slashed dental services. Now, just one in 10 dentists regularly sees Medicaid patients, leaving Illinois with a much bigger share of underserved people than the nation as a whole. Dentists say the problem starts with the paltry checks they get for treating poor people.
KUAMOTO: The Medicaid reimbursement does not cover most dentists’ overhead. So you’re probably losing money.
Dr. David Kuamoto is president of the Chicago Dental Society, one of the groups lobbying for more state investment in oral health. Advocates want almost a hundred million dollars – a steep request right in the middle of a budget crisis. Their idea for how to pay for it? Tax sugary soft drinks.
But there may be just too many competing priorities. Even Governor Pat Quinn, who’s made oral health a pet project, didn’t include a cash infusion in his proposed budget last week. Kuamoto says the shortage of care is pushing people into emergency rooms.
KUAMOTO: They’re tying up the doctor’s time, the staff’s time, and it is a ripple effect that will affect the whole hospital system.
But if people don’t get treatment somehow, they could wind up in the ER for something much more serious. Studies link bad oral health to heart disease, stroke and low birth weight.
Inside the UIC clinic, the line has reconstituted in front of a check-in desk. The doors opened at 7:30. By 7:43, there’s an announcement.
WOMAN: If you’re in line for adult urgent care, our clinic is already full today …
OZCILINGIR: Oh, it’s so exasperating!
Elva Ozcilingir needs a tooth pulled. Badly. And there’s no way she can afford a regular dentist.
OZCILINGIR: I only make $1,235 a month. Sometimes I don’t even have money for my medication, or for food.
Ozcilingir is diabetic, and she has to use the bathroom a lot. That makes it kind of tough to wait in long lines. Now she’ll have to come back tomorrow and do it again.
OZCILINGIR:Today I really needed the care. I wanted to be here at 7:00. Maybe I have to get here at 6:30. But then if I get here at 6:30, I have to go pee, where am I gonna go! Ha ha! Tell everybody get around me and hide me and I’ll do it like the dogs.
People here say when you’re dealing with a serious toothache, you’ll endure a lot. More and more, that means either higher bills, or longer lines. For people with much more time than money, that’s hardly a choice at all.
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Jenny Lipow, Berkeley, CA // Sunday, March 22, 2009 @ 10:20 PM
This is such an important issue. With a small investment in preventive dental care, we could save enormous amounts of money on chronic cardiovascular diseases (and acute episodes) that are clearly linked to dental infections.
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nyscof, Old Bethpage // Monday, March 23, 2009 @ 4:09 PM
Dentists are the problem. They don't fill poor people's cavities then lobby against any viable group who is willing to, such as Dental Therapists
Dentists’ high income is derived mostly from private insurance and patient’s pockets, says the ADA. Dentists aren’t hurting. Rated among the highest-paying jobs by bizjounrnals.com, the top ten money-making cities for dentists range from Charlotte ($195,540) to Omaha ($176,830).
Meanwhile, 6.5 million children aged 2 through 18 in Medicaid have untreated tooth decay, according to the Government Accounting Office.
The logical solution is to require dentists to treat more low-income Americans – either for free, for what Medicaid offers, or on a sliding scale. We know dentists approve of mandates because they are behind virtually every fluoridation mandate because they profess to care so much for the poor.
Dentists didn’t make it on their own. Government subsidizes dental tuition and dental schools and regulates their licenses. Dentists need to give back or allow other viable groups to fill the void.
Dental Health Aide Therapists are currently repairing and pulling teeth in rural Alaska where no dentist would live or work. The American Dental Association and the Alaska Dental Society spent $1 million on a lawsuit trying unsuccessfully to stop them.
Organized dentistry now lobbies against solo-practicing dental hygienists, denturists (false teeth makers) from working directly with the public and Dental Therapists in any other state.
Organized dentistry uses its credentials, political clout and deep pockets filled up with corporate cash to lobby our legislators to pass laws that benefit themselves while an oral health epidemic occurs on their watch. See: http://tinyurl.com/PoliticalClout
In effect, organized dentistry is holding poor people hostage until the government pays them more money to treat them.
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K. Kowalsky, New Jersey // Monday, March 23, 2009 @ 5:03 PM
The way I see it, there is a lack of education for both the general public as well as our governmental institutions on the importance of good dental health. I remember reading somewhere that one state is considering allowing pediatricians to applied dental sealants on children's teeth to help reduce the amount of tooth decay. Of course, the dentists object to this as they would rather have people pay them to apply even though the children that need it most have parents that can afford to go to the dentist in the first place! Anyone interested in finding free or low-cost dental care to download my free report on the dental care crisis in America by going to http://www.discountdental4u.net/report.htm
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asad, manchester (UK) // Wednesday, March 25, 2009 @ 4:26 AM
This has been going on in the UK for a few years now and its getting worse. The dental school here opens at 9am but Ive heard of people queuing from 6am. It feels very much like third world.
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