What Can the Poor Do about Dental Care?

Since I’ve been writing articles about dental care, I’ve wondered what people do when they need dental care yet have no money, dental insurance or credit cards. If you’re in such an impoverished state, and you have a tooth that is throbbing with pain, what are your options?

My Own Story

Recently I had my own dental horror tale. A lower left bicuspid (already crowned) started aching, particularly when I pressed down on it, which invariably means a root canal is needed. I had to wait another day before calling the dentist because the following day was Thanksgiving. The day after the holiday, I called my dentist, told him my problem and he called in a prescription for some antibiotics and pain pills. Good for me, because as soon as I started taking the pills my tooth became a thrashing, serpent-like creature that wouldn’t die for 24 hours!

I later discovered that the necrosis in the root of my tooth had descended into the bone, causing a big abscess, which eventually took months to heal. The total cost to save the tooth was $2,000, including $500 to repair the crown (the dentist had to drill down through it to get to the root of the tooth). Let me tell you, The cost of the dental care hurt more than the toothache!

As bad as my situation was, at least I could afford the drugs ($35) and the visit to the dentist for which I had to pay $200 to ascertain the nature of my trouble. You’d think I could have told the dentist I needed a root canal and saved the $200, but that’s not how modern dentistry works!

Of course, many people – millions of them – couldn’t even pay for the drugs I bought, and I couldn’t help but sympathize and empathize with these poor folks. What would I do in a similar situation? Would I try to reduce the pain with OTC drugs and wait until Medicaid (known as Medi-Cal in California) did something about it? They certainly wouldn’t have performed a root canal, because nowadays there’s little or no money for dental restoration in Medicaid. Therefore, when I eventually saw a Medi-Cal dentist, I would have needed to get the tooth pulled ASAP.

In the following paragraphs I’ll explore the various issues confronting the poor as they attempt to obtain at least emergency dental care.

A Tragic Tale

For an example of what can happen to someone who needs emergency dental care and either can’t get it or gets it too late, an article appeared in the Baltimore Examiner on March 13, 2007:

Deamonte Driver was just 12 years old when bacteria from an abscessed molar spread to his brain. By the time his mother realized he needed attention, it was too late. Not even two brain surgeries and six weeks of hospitalization - at a cost of $250,000 - were able to save him.

Maryland’s Medicaid program failed Deamonte Driver. In many states Medicaid pays so little than even routine dental care is not provided, and a little bit of that may have saved this young man’s life.

The Internet is full of such horror stories.

Oral Cancer

Oral cancer strikes an estimated 35,000 people per year, and perhaps 25 per cent of those people die from the disease. The use of alcohol and tobacco has been linked to the incidence of oral cancer, but 25 per cent of the people who get the disease don’t use alcohol or tobacco.

If treated early, this form of cancer can be easily cured by excision of the cancerous sore. Regular checkups would spot the disease but, of course, poor people often can’t afford dental checkups, regular or otherwise.

African-Americans seem particularly prone to this disease, having an incidence of one-third higher than Caucasians. Blacks are also twice as likely to die from the disease.

Can People Pull Their Own Teeth?

I hope you don’t end up like the man who pulled 13 of his own teeth because he couldn’t afford a dentist or get the job done for free via government services. This Englishman had to use a pair of pliers to do this grisly work. Now the man needs dentures; unfortunately, he can’t make those himself!

I don’t recommend that anybody pull their own teeth. If the procedure is not done properly, infection could set in, causing the person even more misery. In the United States at least, it appears the poor have access to dental services that will extract teeth for free or for a small fee. (Actually dentists don’t “pull” teeth, they simply rock them from side to side until the tooth breaks loose from the bone and then slips right out.)

County Services for the Medically Indigent

County services can provide dental care, but the services they provide are different in each county of the United States. In Sacramento County, for instance, the County Medically Indigent Services Program (CMISP) has a dental clinic that pays for front teeth fillings, extractions and medications. Naturally, as the budget axe continues to fall, these services could disappear in the coming months or years.

Dental Clinics

In many areas, dental clinics are available for low-income people, but in many cases they will charge you some money, say $10 for an X-ray, which is somewhat cheaper than you would normally pay. These clinics will also take insurance such as Medicaid (Medi-Cal) or Delta Dental. Also, if you are a Native American, some clinics provide care to people with at least some native blood in them. For a list of dental clinics in Sacramento, please click on this link.

Free Health Clinics

From time to time, a free health clinic may visit your area. In April 2012, the Tennessee-based Remote Area Medical Volunteer Corps came to Cal Expo in Sacramento, California. The free dental care offered included cleanings, fillings and extractions. This organization seems to come around about once a year, so for those interested be prepared to line up very early in the morning!

Dental Colleges or Universities

Dental colleges or universities frequently offer some services to the poor, but only cleanings, checkups and X-rays may be offered. For restorative work such as root canals and crowns, you’ve have to check with the dental colleges in large universities. By all means, look into this possibility, as it could save you thousands of dollars.

Conclusion

The solution to the problem of providing quality dental care to the poor is to make more funds available for such purposes, so vote for candidates who might make this happen. Perhaps practicing dentists could also be persuaded to provide some of their services for free to the poor. In some areas, dentists do this from time to time, so keep your eyes peeled for such a windfall and be the first in line.

My best advice for people who live on a low fixed income and have little chance of inheriting a large amount of money, you may consider getting all your teeth extracted and replacing them with dentures. You’ll save yourself much pain and trouble in the coming years and look much better as well. (Keep in mind, people on SSI may be able to get free dentures.)

As for people who would like to keep their teeth as long as they can, good dental hygiene is a recipe for success, and for more information about that process as well as more about dentistry in general, please click on the links below: