Forum connects dots between poverty, dental health

Talk about it

Ann Smith, who has periodontal disease with an active infection, needs to have her teeth removed and dentures put in, she said. The infection could cause stroke or heart attack.

She is unemployed, doesn’t qualify for Medicaid or Medicare, and has been denied disability coverage.

“I know my health is at risk,” she said. “I have found resources to remove the teeth but none for replacement. I need someone to put dentures in, so I can get a job.”

Smith and 25 others, including seven dentists, at Monday’s dental health forum voiced concerns about access to dental care.

At the forum, sponsored by Grand Forks Public Health and the state Health Department, participants discussed the barriers — financial, geographic, lack of transportation — that deter or prevent people from getting dental services. They also examined the role of education in dental care practices and the importance of prevention.

Many agreed poverty significantly impacts decisions on using dental services. For people who have no insurance or are on Medicaid, access can seem unattainable.

“If you’re wondering about where your next meal is coming from or if your electricity is going to be shut off, going to the dentist is just not on the front burner,” said Rae Ann Hanson, an employee of Valley Community Health Centers in Grand Forks. “For most people it’s a basic need, but to those living in poverty, it’s a luxury.”

‘Right direction’

North Dakota dentists are trying to address this issue at the state level, said Steve Erlandson, a Grand Forks dentist. “We know patients need to be seen, they need care. We’re not there yet, but we’re working in the right direction.”

He said the state’s dentists have donated $1.5 million in care in the last seven years.

Most dentists are sole providers, he said. “Medicaid reimburses less than 65 percent of our overhead costs. We’re hoping to get 75 percent.”

A small number of local dentists accept Medicaid patients, including at the nonprofit Valley Community Health Centers Dental Clinic in Grand Forks, said Debbie Swanson, a nurse with Grand Forks Public Health.

Some private dentists may also serve these patients, she said, but on a limited basis.

“We shouldn’t put the blame for lack of access on the backs of dentists,” said Brad Gibbens, deputy director of UND’s Center for Rural Health at UND. Better reimbursement rates could go a long way in alleviating the problem, he said.

The forum was part of statewide initiative, funded by a grant the DentaQuest Foundation gave to the state.

The initiative is paying for other forums around the state; surveys of dentists, doctors and tribal leaders during this month and March; and the creation of a strategic plan for dental health in North Dakota.

The plan should be completed by August and, if approved, will be implemented over the next two years, said Bobbie Will, the state’s DentaQuest grant manager.

As for Smith, Erlandson said, “It took a lot of courage for her to come here tonight.” At the end of the meeting he told her how she could get help through the North Dakota Dental Association. “We’ll take care of her.”

Reach Knudson at (701) 780-1107; (800) 477-6572, ext. 107; or send email to pknudson@gfherald.com.

Tags: north dakota, grand forks, updates, news, poverty, medicaid, medicare, dentists, health