Seeking Free Dental Care, Californians Pack Anaheim Convention Center

Natasha Lee, a San Francisco dentist, provides a deep cleaning of Delfina Ragudo’s teeth at the Anaheim Convention Center, April 27, 2018. Photo Credit: Ron Shinkman

Jodi Fullmer-Glau spent last Friday afternoon sitting in a chair against a long folding table as dental volunteers prepared dentures for her upper jaw. A powder blue bag containing her two small dogs, Snickers and Doodles, sat on her lap. All three waited patiently.

The dentures will finally restore the ability for Fullmer-Glau, a 58-year-old resident of Corona, to consume solid food. “I’m tired of soft foods,” she said. “I’m ready for a steak.”

Fullmer-Glau was among about 2,000 Californians who came to the Anaheim Convention Center on April 27 and 28 to receive free dentures, fillings, extractions and cleanings at the semi-annual event sponsored by the California Dental Association and its charitable foundation. Would-be patients started lining up at 3 a.m Friday morning, two-and-a-half hours before the doors opened, officials said. By Friday afternoon, they were waiting in a roughly 300-foot line that snaked through the convention hall’s lobby—just to be referred to a provider. They would then wait even longer to see a dentist.

Fullmer-Glau walked right in because she had an appointment. It was essentially a follow-up from the prior free CDA-sponsored event in Bakersfield last October, where she had her upper teeth pulled.

Altogether, about 2,000 volunteers staffed the event, including some 500 dentists and 400 hygienists, according to Craig Yarborough, the event manager and an associate dean at the dental school at the University of the Pacific in San Francisco.

Dentists extract teeth from patients at the Anaheim Convention Center, April 27, 2018. Photo Credit: Ron Shinkman

To treat so many patients so quickly, the convention hall was essentially turned into a human assembly line. Portions of the venue were clearly partitioned, and large signs announced the service being provided. In those areas, dentists filled, extracted or cleaned teeth from dozens of patients simultaneously. At rows of long tables, technicians fabricated dentures and sterilized instruments. At other tables, volunteers performed patient intakes and exit interviews.

The Kansas-based America’s Dentists Care Foundation, which supplies roving oral health clinics known as Missions of Mercy, provided 130 dental chairs for the event, along with x-ray and other ancillary equipment, Yarborough said.

Lack Of Dental Insurance A Big Driver

The Anaheim event resulted in mixed feelings for the volunteer dentists, who came from all over the state to participate. Many were elated to be able to provide care that alleviated pain and enhanced the quality of life for people who often have a tough time getting breaks.

But they were also troubled that obtaining oral care—which many experts believe has a direct correlation to a person’s overall health—is so nettlesome for low-income Californians. And given the time constraints of a two-day event, some dental procedures, such as crowns and bridges could not be provided.

None of the dentists interviewed at the event say they accept California’s low-income dental coverage, known as Denti-Cal, in their private practices. Only 15.4 percent of dentists who practice in the state accept Denti-Cal, according to data from the Center for Oral Health. Patients who have the coverage often have trouble finding a dentist who will accept it.

“It’s easier to provide pro bono care than it is to do it through Denti-Cal,” said Natasha Lee, a dentist who practices in San Francisco and is also the current CDA president.

According to CDA data, only about 10 percent of visitors to these events are enrolled in Denti-Cal. Patients at the event are assessed for eligibility, but Yarborough estimated only about 100 of them—or about 5 percent—would be eligible for enrollment. Most simply don’t have private insurance coverage or the means to pay for a dentist out of pocket.

Anthony Wright, executive director of Health Access California, a Sacramento-based non-profit that advocates for expanding insurance coverage, noted that even though about half of the state’s residents receive health care coverage through their employers, a far smaller percentage receive dental insurance.

“In a better world, dental would be integrated and just assumed to be part of health coverage—just like any other (medical) specialist would be,” he said. “But dental and vision coverage are just seen as supplementary, even though they’re just as essential.”

Wright noted that the Affordable Care Act’s mandate that policies sold on the health insurance exchanges provide mandatory pediatric dental coverage is a start toward such a movement. He added that lawmakers have begun discussing offering subsidies to adults to help purchase such coverage, although it is far from becoming a reality.

Pain Leads Many To Seek Care

“It’s wonderful to be here, and the patients are very nice. But it’s also terrible that so many people have so many barriers accessing care,” said Richard Nagy, a periodontist who practices in Santa Barbara.

In his private practice, Nagy rarely extracts more than two teeth in a session, and that’s usually followed up with bone grafts in order to properly implant a new tooth directly into the jawbone. One patient he saw on Friday required seven extractions just from the upper jaw.

Yarborough, who estimated that at least 2,000 extractions would occur during the two days in Anaheim, believes many patients showed up because the pain they lived with every day became too excruciating.

That was the case with Nagy’s patient who underwent seven extractions. He was so overwhelmed both by the current pain and the anticipated pain of novocaine injections into the hard palate that he burst into tears. “He was crying, anxious and screaming,” Nagy said. But eventually, he calmed down and underwent the extractions.

Not every patient had teeth pulled. Delfina Ragudo, a 63-year-old resident of Long Beach, underwent a deep cleaning known as a root planing to try and stave off the effects of severe gum disease. CDA President Lee of San Francisco, performed the procedure. She said it was required to help keep Ragudo’s remaining seven teeth in place.

“I’m very happy,” said Ragudo, a retired caretaker, during a break in the treatment.

Barry Katkowski, a 52-year-old construction worker from Garden Grove, saw the event mentioned on the news and decided to visit on his day off. He obtained an appointment for an exam and cleaning on Friday and would return the next day. Katkowski is able to afford medical insurance for himself but has no dental coverage. He said the services he will receive are a stopgap before he inevitably loses his six remaining teeth.

“I have a couple of years left at the most,” he said. “This is a way to help keep them stable.”

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