Nonprofit Clinics Fill Gaps from Cuts to Medicaid Dental Coverage


After suffering from excruciating, prolonged dental pain, Mary (name has been changed to maintain confidentiality) stopped brushing her teeth, stopped eating and stopped smiling.

As a low-income adult with mental illness from a lifetime of abuse, the only words she told Dr. Quynh Nguyen were “it hurts so bad” as she stared timidly and ashamed at the floor of Eastside Family Dental Clinic in Santa Barbara, Calif.

Mary could not afford to treat her agonizing condition sooner. Her Medicaid covers only extractions. It was not until a friend took her to Eastside Clinic – a local Direct Relief partner – that she was able to receive care. The clinic treats patients regardless of their ability to pay.

According to Dr. Nguyen, Mary’s story isn’t uncommon.

“[Eastside Clinic] has seen a steady increase in the number of patients seeking dental care at our clinic, especially adults who are unemployed, underemployed, homeless, or in shared-housing situations,” she said.

Since California eliminated adult Medicaid dental coverage in 2009, Direct Relief has ramped up support of Dr. Nguyen’s efforts as well as a substantial number of other providers like her at safety net community health clinics and health centers across the country. These facilities provide basic dental care to all types of patients, including adult Medicaid patients.

It is this population that has experienced sharp cuts in their routine dental care benefits since 2008, the New York Times recently reported.

“In about half the states, Medicaid now covers dental care only for pain relief and emergencies,” the article states, citing a current report by the Kaiser Commission on Medicaid and the Uninsured, a national health research group.

As a result of the decreased coverage, many low-income adults are deferring care until they require emergency services. Others are turning to community health centers and nonprofit clinics for free or reduced-cost care.

There are thousands upon thousands of people like Mary turning up for care at community health centers across the country. It is an extraordinary challenge to help them all, requiring the combined efforts of government, businesses and nonprofits like Direct Relief.

When these efforts work together positively, change is possible.

Dr. Nguyen said Mary has become a new person since she received care. After treating her for the initial emergency, the staff at Eastside Family Dental Clinic continued to help Mary learn basic preventative care skills.

After much initial pain and resistance, she began to floss and brush. Steadily, her overall health and appearance improved.  The staff was able to save some of Mary’s teeth and made her a partial set of dentures, to which she responded with a very big smile and a tearful “thank you.”

Mary now regularly volunteers for her son’s class, and even returned to Dr. Nguyen to challenge her to match her donation to his science class project.

Dr. Nguyen reflected, “I realized then that in fixing her teeth, we not only gave Mary’s life back, but also gave her son a chance in life: having his mom back!”

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