Originally published in El Tiempo Latino.
By Olga Imbaquingo
In the United States, some 76.5 million lack dental insurance and among immigrants, especially among the elderly, there is an oral health crisis.
Oral health is not a priority of the health system. In an attempt to make up for some of those shortcomings, California-based Delta Dental Community Care Foundation just launched a pilot plan in DC. It's doing it together with Mary's Center and Howard University School of Dentistry. The goal? To offer care and education to economically vulnerable senior citizens, including immigrants.
“There is an undeniable connection between bodily and oral health, the disparities in this area are abysmal. Even older adults with Medicare don't always have dental coverage, and any costs related to their teeth are paid out of pocket,” according to Laura Blinkhorn , a family physician and geriatrician at Mary's Center. The consequences?: millions of people with minimum incomes see their quality of life diminished, with damaged teeth or without them, with problems chewing and embarrassed to smile and speak.
Dental problems have been exacerbated during the pandemic, as many clinics have closed care. In 2020, some 13 million who had some form of insurance chose to defer oral care, according to the Care Quest Institute. Among the undocumented, the problem is more serious, usually they have more of their teeth removed because they arrive at the dentist too late.
"After decades of experience in dental health care, we know that unmet need represents a national health crisis among those 65 and older," said Kenzie Ferguson, vice president of Delta Dental's Community Care Foundation. That is why through this alliance in DC, the goal is to focus attention on the poor, African-Americans, Latinos, immigrants and those who have mobility problems.
Delta Dental each year will award $1 million, up to $5 million. The metro area was chosen because of the economic disparities that affect these vulnerable populations and also because there are well-established community health systems here such as Mary's Center and Howard University School of Dentistry.
For Blinkhorn, support from Delta Dental will make it easier to work on prevention and awareness of the importance of oral health. "For those who do not have insurance, are undocumented, at Mary's Center we offer a diagnosis and we have preventive, cleaning, X-ray and evaluation services at very reasonable prices," she assured.
“DC will be our first pilot plan and seeing how it goes we will look for other places where dental care is marginalized,” said Ferguson, who hopes, at the end of this experiment, to see better results not only with healthier teeth but also a more educated population. and aware of dental health, “because neglecting it brings about a domino effect that leads to other serious problems. We must not forget that our general well-being begins in our mouths”.
Carlos Barahona is an elderly patient who three months ago had a toothache. Scared by how expensive it is to go to the dentist and due to lack of information, he began to ask where to go for help, until a friend recommended him to go to Mary's Center.
When she got there, “the doctor (dentist) checked me out, took an X-ray and sent me medicine to reduce the pain until my next appointment. He'll do a cleaning, see if I have an infection and if I need a deeper treatment or if I just need a filler." This patient, a native of Guatemala, during the pandemic did not go to the dentist. "Fortunately at that time I did not suffer any toothache," he recounted.
The problem with older people is that they take medicines for other diseases and these, in many cases, aggravate dental ailments. For example, many medications dry out the mouth, causing cavities, swollen gums, and even tooth loss. In extreme cases, such as smokers, uncontrolled oral health prevents early detection of oral cancer. "Regular visits to the dentist, in addition to monitoring the teeth, serve to monitor symptoms and signs of possible malignant tumors of the head and neck," that is Blinkhorn's recommendation.
When patients require a more complex dental procedure, Mary's Center transfers them to Howard University Hospital. With this pilot plan, it is also expected to coordinate so that visits to the doctor and dentist are made on the same day. “Dentist appointments are not free, but they are significantly discounted,” Blinkhorn insisted.
Since 2011, Delta Dental has delivered more than $80 million to increase access, quality of care, education and the scientific advancement of dental health in 15 states of the union and now in DC too.
The dentist advises