Commentary

More smiles. More health. More life.

July 8, 2021 12:02 am

(Sean Gallup/Getty Images)

Kyle Willis is the poster man for the importance of maintaining healthy teeth.

Not “poster child.” The 24-year-old’s story is one sadly shared by too many low-income adults across the country, though not always with the tragic outcome Willis endured. It’s astounding what he experienced could happen in the United States. 

That’s why a new Medicaid dental benefit for adults the commonwealth started July 1 could truly mean the difference between life and death. It also could improve the everyday oral conditions for Virginians who, because of poverty, may have neglected their teeth while focusing more on physical health. It can often be a painful balancing act.

The state previously expanded dental benefits to pregnant women and children until they turn 20. The latest move provides coverage to adults who would go untreated and simply live with the pain. Before July 1, adults in Virginia on Medicaid could get help in emergencies – but they couldn’t receive basic preventative care.

That’s backward. Poor Virginians had to get to a point where they neglected their teeth so badly before they could get help. 

The Richmond Times-Dispatch noted the expansion is part of a two-year budget that includes $35 million in state and federal money to provide a range of dental care to adults. 

Legislators in the past had complained about the potential costs of such a program. A 2020 report from the American Dental Association Health Policy Institute, however, estimates Virginia would save nearly $14 million by the third year, based on a likely reduction in dental-related emergency room visits and lower medical costs for Medicaid patients with diabetes and coronary artery disease.

Back to Willis. 

In 2011, he was suffering from a toothache, as PBS’ Frontline reported. He was jobless at the time, and the Cincinnati-area man had no medical or dental insurance. The single father had delayed getting a wisdom tooth pulled because he couldn’t pay for it. 

Later, when his face swelled and he suffered a headache, Willis went to an emergency room. Doctors there prescribed him painkillers and antibiotics, but the latter was more expensive. So he just bought the $3 painkillers. Shortly afterward, an infection spread to his brain, and Willis died. 

It’s incidents like his that have dentists, advocates and state officials applauding the change in Virginia. The shift in treatment options can improve people’s health, job prospects and self-esteem. A set of good teeth can make things as simple as eating a sandwich a pleasure, rather than a chore.

“These provisions finally address the total health and wellness of a person with the focus on preventive oral healthcare services — decreasing the risk of oral diseases and tooth loss,” Sharon Stull told me by email. She is a lecturer at Old Dominion University’s School of Dental Hygiene and vice president of the board at the Chesapeake Care Clinic.

The nonprofit free clinic has physical and dental operations. The dental side serves eligible people living in South Hampton Roads who don’t have insurance. In 2019, the last full year before the pandemic, Chesapeake Care’s dental clinic had 1,476 visits from 443 patients.

So the state’s Medicaid change won’t affect the folks seen in Chesapeake Care’s state-of-the-art, five-chair clinic. Yet, officials there know how much the work of volunteer dental practitioners can make a difference. 

They spoke of a woman named Maria, featured on one of the clinic’s fliers, who had suffered a toothache for months. Dentists eventually removed nine of her teeth, and they then fitted her with dentures. Maria couldn’t afford services otherwise, because she earned just $6,000 a year working at a retail store. 

Her smile in the “After” photo, broad and proud, speaks volumes. 

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The new state program will pay for teeth cleaning, preventive care, X-rays, fillings, dentures and more. 

That’s good, because inadequate dental care has costs both tangible and intangible. 

Poor oral health has long-term effects associated with serious illnesses like cardiovascular disease, cancer, pneumonia, dementia and birth complications, notes the University of Illinois Chicago College of Dentistry

The Kaiser Family Foundation also says the rate of untreated dental caries – or tooth decay – is highest (44%) among adults with income below 100 percent of the federal poverty level. That’s more than twice the rate (17%) among adults with income at or above 200 percent of the federal poverty level. 

Racial and ethnic minorities were also disproportionately affected by oral health problems, the foundation said.

One major issue for Virginia is whether enough dentists will accept the new Medicaid patients, even following an entreaty by Gov. Ralph Northam earlier this year. Reimbursements under Medicaid are low, and some parts of the state have been underserved by medical professionals in health and dental care. 

The gaping dental gap: As Virginia prepares to expand Medicaid, thousands still lack access to dental care

That will be hashed out in the months ahead. For now, many Virginians will finally get a chance to get better dental care. Here’s what that means:

More smiles. More health. More life.

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Roger Chesley
Roger Chesley

Longtime columnist and editorial writer Roger Chesley worked at the (Newport News) Daily Press and The (Norfolk) Virginian-Pilot from 1997 through 2018. He previously worked at newspapers in Cherry Hill, N.J., and Detroit. Reach him at [email protected]

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