Although it often gets overlooked in discussions of health care, dental care is an important part of staying healthy. This point was driven home to me and anybody else following health care policy issues by the tragic death of Deamonte Driver several years ago, a 12-year old who was on and off of Medicaid and didn’t get an abscessed tooth removed and died as a result of the infection. To say that bureaucratic medicine failed him is a horrific understatement.
So, dental care is important. For the most part, self-pay patients shouldn’t have too much trouble finding dentists that will treat them fairly. The same third-party payment system that dominates most other areas of the health care system is a relatively new development in dental care, so most dentists still are able to provide real prices that aren’t inflated, and payment plans are often available as well.
Still, there are plenty of people who struggle to pay for health care and finding the money for dental care can often seem like an unneeded luxury at times. In these cases, discounted or free dental care can be the difference between seeing a dentist or not.
Fortunately there are a number of programs out there that can help. I read about one in Battle Creek, Michigan yesterday, reported in USA Today over the weekend, which allows people to exchange volunteer work at local charities for free dental care (I realize this is stretching the definition of both ‘volunteer’ and ‘free,’ but work with me on this). 
BATTLE CREEK, Mich. — Kelly Price knows too well the pain of infected teeth and how they become so sensitive it hurts to eat or drink. He has suffered with that in the past and still has several teeth that need to be extracted, but the 51-year-old unemployed machinist can’t afford to see a dentist.
That’s why on a morning last month he was helping out at the Food Bank of South Central Michigan filling bags for weekend meals for needy children…
The hours Price volunteers inside the sprawling warehouse in “cereal city” will help him get to see a dentist for free. “I would rather pay with cash, but if this is the only way I can do it (that’s) fine because I am helping someone else and it all works out,” he said.
Price is one of the more than 4,000 adults who since 2007 have received care under the Calhoun County Dentists’ Partnership — a privately financed program that requires patients to perform some volunteer work to qualify for the free dental services. The “pay it forward” model enables low-income, uninsured patients to earn their care by helping local non-profits, including the local homeless shelter, Red Cross and Salvation Army…
Needless to say, there’s a lot to like about this program. One of the key elements to it seems to be that because the care isn’t free and patients are paying for it with their time instead of money, they tend to place a higher value on the services they receive. Two participating dentists explain it this way:
Kip Etheridge, a dentist who sees patients from the program in his office a few hours a month, said the volunteer work makes them more vested in their care and reduces the number of people who don’t show up for the program’s dental appointments.
“It’s not free care, they work for it, and that aspect is what has encouraged dentists to participate,” Etheridge said…
Charles Palumbo, a Battle Creek dentist who helped launch the program and has extracted hundreds of teeth from people who have come through it, said volunteering is important for the patients. “We want them to have a sense of dignity as opposed to an entitlement to what is happening,” he said. “We want them to feel like they are paying for services.”
These comments remind me of something that another cash-only doctor (a surgeon, if I remember correctly) once said in an interview about the charity care he provided, that everybody had to pay something or else they usually wouldn’t place enough value on the treatment provided, blowing off appointments and not adhering to instructions. He required everyone, even the poorest, to pay something, even if it was only two or three percent of the price he charged his full-pay self-pay patients.
In addition to putting in several hours of volunteer work at local charities, patients participating in the program also have to attend a 2-hour oral health class and be seen by a dental hygienist before seeing the dentist. The program is open to those without dental coverage and incomes below 200 percent of the federal poverty level, about $23,000 for an individual in 2013.
What happens when people don’t get timely dental care was also made clear in the article:
Lacking coverage, many patients don’t seek help until the dental pain gets severe, and then they often head to hospital emergency rooms.The number of dental visits to hospital ERs doubled from 1.1 million in 2000 to 2.1 million 2010, according to a recent study by the American Dental Association.
In 2006, at least three patients a day were showing up at Bronson Battle Creek Hospital complaining of dental pain, but the facility could offer them only pain pills or antibiotics and urge them to see a dentist. That’s when the hospital, local dentists and community health and business leaders conceived the volunteer model.
The partnership has cut by 70% the number of patients with dental pain showing up at the hospital ER, according to a study published in the journal Health Affairs in September…
Apparently this model is spreading, with about a dozen local communities across the country starting similar programs including Springfield, Missouri and South Bend, Indiana. And the Michigan program has recently expanded to begin providing chiropractic care on a similar basis.
The whole article is well worth taking time to read, and for any self-pay patients needing access to affordable or even ‘free’ dental care, it might be worth checking around to see if there is a similar program in your area.
