Dental Care

Times are tough enough for Californians; they're even tougher for Californians' teeth. "One-quarter of all adults and 28% of children in California have untreated dental caries [cavities]," says Len Finocchio, a senior program officer at the California Healthcare Foundation, a health advocacy group. "Our research tells us that many people in California have been avoiding routine care that might have cost about $100 for a checkup and cleaning, and then find themselves in the emergency room, where they get only an antibiotic, a bill that can average over $600 and instructions to see a dentist."

In his April 8 Op-Ed article on the individual mandate, the aspect of the federal healthcare reform law that requires everyone to have coverage, William Voegeli advances a false dichotomy. He states that while it may be legitimate to require people to carry health insurance that would cover the costs of their care were they to be hit by a bus, it is illegitimate to require them to carry insurance coverage that will cover substance abuse treatment or dental care for their children.

For a quarter-century, Dr. Terry Vines built his Redlands dental practice the old-fashioned way: one mouth at a time. Vines sponsored youth soccer teams. He renovated historic buildings around town to build good will. He turned his waiting room into a cozy nook with soft chairs and a big-screen TV. As business increased, Vines hired more dentists to accommodate his thriving practice, Pure Gold Professionals in Dentistry. Then the economy tanked, hundreds of patients stopped coming, and Vines decided he needed help.

For a quarter-century, Dr. Terry Vines built his Redlands dental practice the old-fashioned way: one mouth at a time. Vines sponsored youth soccer teams. He renovated historic buildings around town to build good will. He turned his waiting room into a cozy nook with soft chairs and a big-screen TV. As business increased, Vines hired more dentists to accommodate his thriving practice, Pure Gold Professionals in Dentistry. Then the economy tanked, hundreds of patients stopped coming, and Vines decided he needed help.

Remember the toothpaste commercial in which the child proclaims, "Look, Ma, no cavities!"? For many of us, that decades-old line sums up the way we thought about the benefits of fluoride. Yet more than 50 years after communities across the United States began getting fluoride from the tap, at a time when most Americans take for granted that having it in their drinking glass--and their toothpaste--gives them better dental checkups, anti-fluoride sentiment persists.

These days, you'd have to be pretty daring--or pretty dumb--to put your home at risk to open an ad agency in Los Angeles. But that's what Cary Sacks and John Fuller did. Even as business in the Los Angeles ad market hit the skids nine months ago, the two daredevils left the local office of Della Femina McNamee and took out fat home equity loans to open Sacks/Fuller Advertising. "We knew we couldn't goof up," said John Fuller, the agency president.

Fifty years ago this week, public health history was made in Grand Rapids, Mich. On Jan. 25, 1945, Grand Rapids became the first city in the world to fluoridate its water. In doing so, it launched a program destined to become what dental professionals and others have called one of the most successful public health experiments ever. "One of the most exciting experiences of my career was observing firsthand the benefits of fluoridation in the people of Grand Rapids," said Dr.

Gentle Dental Services Corp., a dental management company, said Tuesday that it has made 11 acquisitions in Southern California and Nevada as part of its ongoing plan to expand across the U.S. "Our goal is to continue to build our leadership position in the Western U.S. and . . . to achieve national market leadership in dental management services," said Michael Fiore, chairman, chief executive and president of Gentle Dental.

Millions of people each year are skipping out on their annual trip to the dentist. And it's not because they're afraid of the drill. Many people just can't find a dentist or can't pay for a visit: 33.3 million Americans live in a region with a shortage of dental professionals; kids, seniors and minorities are particularly vulnerable. And because dental care usually isn't provided as part of a standard health insurance package, even under Medicare, many Americans simply can't afford it. In 2008, 4.6 million kids skipped their dental checkups because their families couldn't pay, and in 2006, only 38 percent of retirees had dental coverage.

As members of the California State Board of Dental Examiners (the chief regulatory agency of dentistry for the state), we thank you for your public service by printing "Big Dental Plan Cheats the Poor" (June 26) and for alerting the public to potential problems when receiving dental care. We agree with your article which decries the shady practices of some dental clinics. The State Board of Dental Examiners is very concerned about practices at dental managed care clinics. We have been working to improve consumer protection in the dental clinics of our state.

Little surprises Nagaraj Murthy, a dentist in Compton for the past 32 years. He has seen patients who have suffered toothaches for years. Others who haven't been to the dentist in a decade. Some who can't chew hard food. But in the two years since California sharply reduced dental benefits for roughly 3 million Medi-Cal recipients, he and other dentists say the situation has become dire for patients who are waiting until their infections land them in an emergency room or their rotted teeth have to be immediately pulled.

Millions of people each year are skipping out on their annual trip to the dentist. And it's not because they're afraid of the drill. Many people just can't find a dentist or can't pay for a visit: 33.3 million Americans live in a region with a shortage of dental professionals; kids, seniors and minorities are particularly vulnerable. And because dental care usually isn't provided as part of a standard health insurance package, even under Medicare, many Americans simply can't afford it. In 2008, 4.6 million kids skipped their dental checkups because their families couldn't pay, and in 2006, only 38 percent of retirees had dental coverage.

One-fourth of the nation's children have 80% of the nation's tooth decay, and most of them are underprivileged. The simplicity of those numbers, from the U.S. Government Accountability Office, underscores the reality of dental care in this country but gives little hint at its ultimate effects. Oral infection is the No. 1 chronic disease in children — five times more prevalent than asthma — and experts estimate that more than 50% of children will have some tooth decay by age 5. "For those kids who are not getting care, the problems don't go away, they just get worse," says Dr. Paul Reggiardo, a pediatric dentist in Huntington Beach and public policy advocate for the California Society of Pediatric Dentistry.

Facing a brewing revolt among states wrestling with massive budget shortfalls and tattering healthcare safety nets, the Obama administration is intensifying a drive to help state leaders find ways to wring savings from their Medicaid programs. Thursday, Health and Human Services Secretary Kathleen Sebelius sent a letter to the nation's 50 governors suggesting a range of cuts they can make to Medicaid, including dropping some people from the program. "I know you are struggling to balance your budget while still providing critical healthcare services to those who need it most," Sebelius told governors in the letter.

On a day of plenty, there are still many in need. As the nation attempts to recover from recession, many remain out of work, or are struggling to get by on part-time jobs. In Los Angeles County alone, more than 1.56 million residents lived below the poverty level last year, according to the Census Bureau's American Community Survey. "You think there's signs of a turnaround, but there's no sign of a turnaround here," said the Rev. Andy Bales, who heads the Union Rescue Mission in downtown Los Angeles' skid row. "There's a lot of people barely making it. " At the same time, contributions to charitable organizations are dropping as donors become stretched.

To Santa Barbara dentist Jim Rolfe, it seemed straightforward enough: Turn a couple of shipping containers into prefab dental offices, send them to Afghanistan and set up a clinic. That was before the steely idealist encountered corrupt officials and inept bureaucrats, flying shrapnel and religious killings. It was before his private practice ebbed and his retirement account plummeted, before he spent $750,000 of his savings on a project that, to less driven types, would seem doomed.

After a year of wearing braces, Bill Bates was ready to get those puppies off. He had spent all of 1991 sporting the latest hip-colored elastic ligatures on his braces--red, white and blue in support of U.S. troops in Operation Desert Storm. Now it was time to take off the tinsel--braces that had taken him five years to get after finally convincing Scott Bates that he was dead serious about having his teeth straightened. Why the tough sell? Bill, at the time, was a 75-year-old retiree.

Congratulations on the timely article of March 19, describing the overwhelming dental problems of the less fortunate members of our community. With limited public funds and resources available to help those in need of dental care, a growing number of dental professionals are volunteering their time and skills to fill the needs of a diverse population who otherwise would lack any dental treatment. The Los Angeles Free Clinic, located at 8405 Beverly Blvd., Los Angeles, is expanding its Dental Department to provide daytime services.

It's not a pretty picture, the overall state of dental care for California's kids. That's because too many of them -- one-quarter, to be exact -- don't have it. Yep. One in 4 have never even been to a dentist. That attention-grabbing statistic is from a dental-care study released Wednesday and published in the July issue of the journal Health Affairs. It analyzed care -- or, rather, lack thereof -- for children ages 11 and under in the so-called Golden State. The researchers, from the UCLA Center for Health Policy Research and the California HealthCare Foundation, found that the picture is especially bleak for Latino and African American kids, regardless of whether they have private insurance or public insurance (Medicaid for the Children's Health Insurance Program)