Health – Take the Bite Out of Dental Health Pains

Since most Americans lose their dental insurance benefits when they retire, the majority of people over 65 pay out of pocket every time they visit a dentist. Medicare does not cover routine dental care (nor does Medicaid in most states) and more than 80 percent of older Americans have no private dental insurance, according to a recent report by nonprofit advocacy group Oral Health America.

Yet, older adults may need dental care more than any other age group.

“Patients age 65 and over will have potentially an increase in cavities or decay on the root surfaces of the teeth,” said Dr. Matthew Messina, an American Dental Association consumer adviser and practicing dentist in Cleveland. “And that comes secondary to the medical condition of dry mouth — a decrease in the amount of production of saliva because of age and certain medications…. We also see periodontal disease in patients of that population.”

Messina advises his older patients to see a dentist at least once every six months for an oral cancer screening and recommends an annual visit for denture wearers.

So what’s a person with no dental insurance to do? If you can pay out of pocket, ask your dentist if he or she will offer a discount or work out a payment plan.

“A lot of times for patients paying in full at the time of service, some offices will offer some degree of bookkeeping courtesy,” Messina said. “There are a number of ways that offices are creatively handling finances for patients of all ages to make dentistry affordable.”

Local dental schools are another option for reduced-cost care — if you’re not in a hurry.

“Our fees can be about half the cost of private practitioners,” said Dr. Janet Yellowitz, director of geriatric dentistry at the University of Maryland Dental School in Baltimore. “The downside is that because it’s a training program, it takes time — you’re working with students who are being supervised.”

She suggests contacting schools with graduate training programs for slightly more costly but quicker treatment, or looking into clinical trials at your local dental school.

Neighborhood health clinics sometimes offer dental services, according to Yellowitz and Oral Health America’s Elizabeth Rogers. However, they are not always widely publicized. Of course, people in extreme pain can go to the closest hospital emergency room, where they most likely will be given painkillers and get their tooth pulled, Rogers said.

“But that is by no means a solution,” she added.

If this doesn’t sound like a lot of options for those without dental coverage, it’s not. But a few organizations around the country are trying to change that. One is Minneapolis-area Apple Tree Dental, a nonprofit clinic that aims to improve access to dental care for underserved populations, including seniors. The full-service clinic — which treats more than 30,000 patients each year in the Twin Cities area, including on-site visits with patients in long-term care facilities — has been cited as a national model for dental care and has received requests from all over the country and Canada to present on their model.

“What I’m interested in is ensuring that we have programs in place that at least get primary care needs met for seniors,” said Dr. Carl Ebert of Apple Tree Dental. “Because when you look at the demographics and the fact that more people are keeping more of their teeth as they get older, you’re going to be facing a huge dilemma…. Then add to that the nationwide problem of the significant decrease in the sheer numbers of dentists … and the sort of seller’s marketplace we have right now in dentistry where dentists can pick and choose who they see — some exclude all insurance patients, some just cater to high-end patients seeking cosmetic services. When you start to multiply all these factors, you’re looking at a tremendous problem.”

Abigail Green is a freelance writer and editor based in Baltimore.


A Reason to Smile

Attention Jewish Angelenos: now you can become more
beautiful and help Israeli victims of terror at the same time. Two programs,
Smiles in Spite of Terror and StandWithUs tooth whitening campaign, donate half
the fee from your teeth bleaching sessions goes to help fix the teeth of terror

Smiles in Spite of Terror was started by Dr. Alan Howard, a
Los Angeles dentist who felt frustrated at not being able to help Israel more
throughout the terror attacks. He made some inquiries and found out that the
terror victims were getting their dental treatment through Kupat Cholim, a
government-sponsored managed care that only provided low-end dentistry. Howard
thought he could do better than that, and he started organizing volunteer
dentists from the United States to go to Israel and offer high-end dentistry to
the terror victims free of charge at Hadassah hospital.

“The terrorists fill the bombs with nails and bolts, so when
they explode people have facial injuries and they lose teeth,” Howard said.
“The easier way to fix this is with removable dentures, but we put implants in,
which is more expensive, but it is also permanent, like having your own teeth

Since the organization started in September 2002, five
dentists (including Howard) have volunteered their services in Israel, and have
treated more than 60 patients, out of a pool of 600 victims who have applied
for treatment.

“There are over 750 people who have been killed in terror
attacks in Israel, but thousands of other victims have survived,” Howard said.
“For those who survived, we just want to give them back their smiles.”

Whitening costs $400 ($200 of which is a tax-deductible
donation to Smiles in Spite of Terror and StandWithUs) and dentists are
available in Los Angeles, Lakewood and the San Fernando Valley.

They are not the only Angelenos using their expertise to
help Israelis. In December, Max Castiel of IX Optical donated 800 eyeglass
frames to Israel, which his wife, Chantal, personally distributed in Haifa, as
part of an effort by ABSI — a French organization that helps indigent Israelis
get their sight back.

To make an appointment for bleaching, contact the StandWithUs
office at (310) 836-6140.