LITTLE ROCK — Charity dental clinics statewide see a high demand for dental services from uninsured Arkansas adults suffering from severe tooth decay or abscessed and broken teeth.
Some patients wait more than two months for an appointment. In many areas, clinics have stopped accepting new patients or limited appointment-scheduling times to stem the steady flood of calls from people seeking relief. This month, Arkansas Medicaid launched its Adult Dental Program, which offers limited coverage for recipients 21 and older, according to the Arkansas Department of Human Services. An estimated 130,000 Arkansans are eligible.
Charity clinic officials said the program will only partially alleviate demand.
"Not everybody's going to be eligible for Medicaid, and so you're still going to have a lot of uninsured individuals out there that are going to need access to affordable care," said Sip Mouden, chief executive officer of Community Health Centers of Arkansas Inc., which has 59 clinics statewide."We're still going to have a tremendous demand, with and without insurance coverage. We always have, and we always will."
Eddie Pannell is executive director of Harmony Health Clinic in Little Rock, which opened its medical clinic in December and its dental clinic in March. Clinic workers were quickly overwhelmed when 365 people called for appointments the first two days, he said.
They have since stopped taking new patients until they can get the waiting list down.
"We're seeing about 80 patients a month now," Pannell said. "I was in Vietnam. I've been to Third World countries. I see the very same thing here in Pulaski County - people who haven't been to a dentist a dayin their lives."
In many cases, people wait so long that their teeth are beyond repair and need to be pulled, said Dr. Don Deems, a volunteer at Harmony Health Clinic who's been a dentist in Little Rock for 22 years.
"They only need help when something hurts. Too often it's too late," Deems said.
"BUILT-UP DEMAND"
Only about 38 percent of Arkansans, or 1.02 million people, have dental insurance, said Dr. Lynn Mouden, director of the Arkansas Department of Health's Office of Oral Health.
Thirty-two percent of Arkansas adults have lost six or more teeth because of tooth decay or gum disease.
Poor dental health among adults is "a matter of built-up demand," he said. People who had little or no dental care as children often grow up with persistent problems.
The Health Department is working to improve oral health with programs that offer schoolchildren free sealants to help prevent tooth decay.
The department is also pushing to get fluoride in more community water systems. Just 65 percent of the state has fluoridated water now, he said.
The new Medicaid program will help many who haven't had access to dental services until now, Lynn Mouden said.
The Medicaid Adult Dental Program covers up to $500 per fiscal year for services such as cleaning, X-rays and fluoride treatments. Enrollees can get one set of dentures or partials per lifetime, and are limited on realignments or adjustments.
Extractions are also covered with no limit, Department of Human Services spokesman Julie Munsell said. Most services require prior authorization.
The program's costs are covered by $2.7 million from state tobacco tax increases that went into effect this spring. Statistics on how many people are enrolled were unavailable Friday, Munsell said.
Statewide, 500 dentists are enrolled in Medicaid, and Human Services officials have spoken to about 100 seeing adults under the new program.
Adults on Medicaid who aren't covered by the new program can get extractions "when considered a medical necessity due to a life-threatening situation," Munsell said. Children have more comprehensive dental coverage through Medicaid's ARKids First program.
Healthy Connections Inc., part of Community Health Centers of Arkansas, has clinics in Mena and Mount Ida. Executive Director Bob Young said a lot of people are asking about the new Medicaid program.
"We're already getting an increased call volume from those folks wanting to know what will be covered and what availability of care there is for them," he said.Across the state, Dr. Susan Ward Jones, executive director of East Arkansas Health Center Inc., said they're also getting inquiries at their clinics in Lepanto and West Memphis.
"We're seeing an increased demand," she said. "People are calling every day. It's certainly going to help alleviate some of the need."
A HUGE NEED
The Arkansas Mission of Mercy is a free, two-day dental clinic offered each May. At this year's clinic in Springdale, 1,970 low-income and uninsured Arkansans received dental care, according to Delta Dental of Arkansas, which supports the event.
Each year, the clinic has opened to long lines of hundreds of people, many of whom wait overnight.
"[It] paints a clear picture of the great need for adult dental services in our state," said Chris Pyle of Delta Dental. "Anytime you witness entire families spending the night on the street and standing for hours in the rain so that they can simply get out of pain, it's a sobering sight."
Next year's Mission of Mercy is set for Monticello.
Dr. Harvey Matheny, dental director at Harmony Health Clinic, said Mission of Mercy was "a real eye opener."
"You just don't think the need is that great until you see it," he said.
Harmony Health's clinic has four exam chairs and 22 dentists who volunteer on a rotating basis. So far, the clinic has done mostly extractions but also does fillings.The clinic also has a new contract with the University of Arkansas for Medical Sciences and will soon offer cleanings by students in the UAMS Department of Dental Hygiene, Matheny said.
"For this population, there are very few services available throughout the year," he said. "We're designed to serve that niche of the population that doesn't have any other resource to get care."
James Hinton, a registered dental assistant and dental coordinator at Harmony Health, said helping ease patients' pain is rewarding.
"When they get through, they really appreciate us and say thank you." Hinton said. "You can't ask for anything better than that."
Debbie Koon of Little Rock got four fillings at the clinic Aug. 21. She had pain for weeks and was glad to finally get care, she said.
She and her husband, who works as a roofer, are supporting seven children and grandchildren. Retired and disabled, Koon said she can't afford dental insurance.
"We're raising our kids and our grandchildren. The thing that just goes lacking is your teeth," Koon said. "You don't do anything until the pain gets so bad."
CARING FOR THOSE IN NEED
River City Ministry in Little Rock began offering dental services in 2001, said Executive Director Jim Woodell. Volunteer dentists there treat about 40 patients a month.
"The demand for dental is probably the greatest demand we have experienced," he said.
When it first opened, the clinic took appointments any time but quickly had to change the practice.
"We were 600 or 800 requests behind. Some of those people would have moved or passed away or whatever before we got to them," Woodell said.
Now the clinic takes appointments for the first 40 people to call the first Thursday of each month. It takes only about 15 minutes to fill all the slots, he said. Lately, the ministry has struggled to find enough volunteer dentists to treat patients.
"We haven't been able to do 40 patients each month, so that list just continues to grow," Woodell said.
The ministry is anticipating a grant from the Health Department and plans to use the money to hire a contract dentist.
"That will give us the ability then to have more consistency and see more patients," Woodell said.
In Baxter County, the Mountain Home Christian Clinic is teaming with UAMS to expand its dental services. The clinic, which opened in 2000, offers only extractions.
In January, UAMS is starting a new dental hygiene program through its Area Health Education Centers North Central. The program will offer reduced price dental cleanings and other basic services from dental hygiene students, said Nancy Smith, UAMS assistant professor and site coordinator.
Services will be free to those who have a voucher from the Mountain Home Christian Clinic, which also offers free medical services on the first and third Thursday of each month.
The Christian Clinic's existing dental program already has high demand, Smith said.
"They come in from all areas of Arkansas and some from Missouri. They treat pretty much who gets there first, and who's in most dire need," she said. "I went there for the first time a month ago, and I was amazed. I couldn't find a parking spot."
The Northwest Arkansas Free Health Center in Fayetteville has provided health and dental care to uninsured and low income people since 1986. Director Monika Fischer-Massie said patients drive from Oklahoma, Fort Smith and Eureka Springs.
The center offers extractions for free, and cleanings and other dental hygiene services for a fee based on income. Fees for teeth cleaning, for example, range from $2.50 to $15, she said.
Because of continued high demand, the clinic only takes appointments by phone the first Wednesday of each month.
"We see probably 46 patients a month," Fischer-Massie said. "It's a tremendous demand."
Front Section, Pages 1, 6 on 08/31/2009