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Gaps in dental treatment are getting harder to fill

On Tuesday, we told you about free and low-cost health-care treatment options for those who have no health insurance. Today, we explore what's available for low-cost dental care.

For those with low incomes or no insurance, finding dental care is possible, but even more difficult than obtaining medical care, say local health experts.

With dental costs high, many people without dental insurance or the means to pay, and a resulting lack of dentists willing to treat them, this country faces "a silent epidemic of oral diseases," says a U.S. surgeon general's report.

Heightening the problem is the current recession, which is leaving more people jobless.

"We're overflowing" with patients, said debi Masterman of Northwest Medical Teams Mobile Dental Care Clinic, whose low-cost dental-care unit visits four sites in King County.

Making things worse: "We desperately need volunteer dentists," Masterman said.

At the same time, increasingly studies link chronic oral infection with such medical problems as stroke, diabetes and heart disease.

One reflection of the mouth-body disconnection in health care is that many more people go without dental insurance than go without medical insurance. While figures for those without health insurance range from about 8 percent to 12 percent — in surveys taken before the recent layoffs — more than a third of King County residents have no dental insurance, says Sharon O'Dell of the Puget Sound Neighborhood Health Centers, which operates four nonprofit dental clinics in Seattle. They are among 13 low-cost dental clinics in King County and 44 across the state operated by various organizations.

And in the case of Medicaid insurance, which provides free dental care to those eligible, just because someone is signed up for it doesn't guarantee getting dental care, O'Dell says. Low reimbursement rates for Medicaid patients — about 40 percent to 50 percent of the cost of a procedure, according to O'Dell, which is not enough to even pay overhead costs — have prompted many dentists to bar new Medicaid patients.

These patients then end up crowding the community dental clinics, which have sliding-scale fees based on income.

But even people who are insured often don't take advantage of it, because of a lack of education, fear or time constraints, say dental experts. Only about 30 percent of Washington residents covered by Medicaid saw a dentist in 1999, according to statistics compiled by the state.

Perhaps the most vexing component of dental care among the nation's low-income people is that most oral disease is almost completely preventable, with education and regular treatment.