Tuesday, February 01, 2011
Chicago Sun-Times
by Lisa Donovan

After losing her job and her health insurance two years ago, Jamila Lawrence was relieved to receive her Medicaid card. That is, until the Bronzeville mother of two tried to use it last year to find a dentist willing to perform a root canal on one of her teeth.

“A lot of people do not accept that insurance, especially for anything on the level of a root canal. And everyone I called told me I had to pay up front, in full,” she said. “It was frustrating. . . . I was in excruciating pain.”

Lawrence eventually got the root canal last summer after she found a dentist who agreed to put her on a payment plan.

But she still struggles to pay out of pocket for her kids’ check-ups because their dentist doesn’t accept Medicaid, either.

Thousands of people who are uninsured or on Medicaid face similar challenges in Cook County, where the need for low-cost dental care far outstrips available services.

The Bridge to Healthy Smiles campaign, which has pushed for greater access to dental care in Illinois, estimates that there is one dental clinic in Cook County for every 15,700 children who rely on public aid.

An audit of county dental services released Monday highlights the scope of the problem.

The Cook County Department of Public Health has just four suburban dental clinics, half as many as it operated in 2005.

As a result, the number of patients seen at these clinics has dropped sharply, and wait times for appointments range from three months for routine care to as long as a year for specialty care, according to the report, which was commissioned by members of the Cook County Board.

In addition, the report found that visits to county dental clinics were suspended entirely for several months as the county dealt with the 2009 H1N1 flu outbreak.

“Right now, [Cook County] is in a crisis state,” said Dr. Cheryl Watson-Lowry, of the Chicago Dental Society.

Access to dental care in Chicago is especially scarce, she said.

Since the Chicago Department of Public Health closed the last of its dental clinics, the University of Illinois at Chicago’s College of Dentistry and Stroger Hospital are among the few remaining places city residents can go for low-cost dental care.

Community health centers do what they can to fill the gap, but there are too few, Watson-Lowry said.

Private dentists, meanwhile, are reluctant to accept Medicaid patients because the state’s low reimbursement rates barely cover the cost of care, said Dr. Greg Johnson, executive director of the Illinois State Dental Society.

The consequences of tooth decay, gum disease and other common ailments go beyond pain and embarrassment. Poor oral health has also been linked to heart disease, premature birth and diabetes.

Johnson said the crisis will continue without higher Medicaid reimbursement rates, more publicly funded dental clinics and better incentives for dentists to practice in underserved areas.

As the county’s independent hospital board begins its plan to take the health system in a new direction, Cook County Commissioner Peter Silvestri said the new report should spark discussion on how to incorporate broader access to dental care into that vision, even if it means making cuts elsewhere.

“We have to reassert the importance of dental care,” he said.