Toothless, Homeless—That Bites!

She smiled as I cooed over her adorable 2-year-old daughter. I cringed.

I didn’t count, but I’d guess this girl’s mother had all of 5 teeth in her mouth, none appearing to be healthy.

This homeless mother and daughter rely on the goodness of a community-based shelter, a stopgap effort to ensure homeless adults and children don’t freeze to death for want of a place to sleep. These shelters don’t have dentists or docs on staff. And every single person staying there has grossly neglected dental and medical needs.

But this mom’s smile. How many smiles—toothless all or most—would you see in the average shelter? Based on what I’ve seen and heard—shockingly too many. My shelter director-friend Pat LaMarche told me, “Half the people there (at the shelter) have no teeth. I have a guy with no teeth and a broken jaw so he can't get dentures. They set his jaw wrong when he broke it and no oral surgeon will do Medicaid work that extensive. He’s had no real solid food in 5 years.”

And that doesn’t include the millions of kids and adults who aren’t “lucky” enough to be in shelters, those doubled up with friends and family, or staying in the no-tell-motels, shacking up illegally and uncomfortably in storage units, or desperately eking out a place to safely catch just a little sleep.

A healthy mouth is important. The American Dental Association describes the dental dearth, “But tens of millions still do not, owing to such factors as poverty, geography, lack of oral health education, language or cultural barriers, fear of dental care and the belief that people who are not in pain do not need dental care.” Not to mention homelessness.

The North Bay Business Journal reported on a recent study by the Pacific Health Consulting Group, “A growing body of research indicates that poor oral health is directly linked to a number of major health conditions including cancer and diabetes as well as heart disease and stroke. Untreated dental problems during pregnancy can contribute to poor birth outcomes and neonatal mortality.”

Millions of children on Medi-Cal (Medicaid in CA) lacked access to dental care, prompting an audit with appalling findings.  State Auditor Elaine Howle described the ghastly gap to Governor Jerry Brown, blaming “poor provider participation on low reimbursement rates, some of which have not increased since fiscal 2000-01.”

And Florida was recently chastised for neglecting over 80% of children on Medicaid.

Rural communities have their own set of challenges to reach their dental-deprived adults and kids. The Rural Assistance Center offers solutions to the gaping problem. And Dr. Jay Grossman has led the way for urban dental action for those most desperate for oral health care.

But the growing inadequacies in access to dental care seem to be low priority for elected officials and others controlling access to the drill. The Affordable Care Act specifies that kids can get dental check ups. But a shortage of dentists willing to accept ACA/Medicaid rates makes the dream a nightmare. And adults are out of luck. As are all members of families not deemed citizens.

And yet parents of a dental-care deprived 7-year-old girl in Pennsylvania face jail time for allegedly neglecting their daughter’s teeth. “The girl's oral health was so poor a dentist needed to remove seven teeth, remove a nerve from eight others and cap another,”  although the Lehigh Valley Live story points out the extenuating circumstances that may keep the parents from the slammer.

In my perfect world, those who mangled the economic system—not those who fail to use the dental health system—would be held responsible for the incalculable suffering of millions and millions of adults and kids without access to oral health care.

Expecting people with disintegrated teeth to rush out and get jobs requiring smiling faces is, well, insulting. Witnessing the human degradation that occurs with dental decay is heartbreaking. Explaining to this little girl that brushing her teeth is an exercise in futility is a task for the 3 dentists, all ADA members, in Congress.

Sign this petition created by HEAR US Inc. to the American Dental Association and the ADA members of Congress to increase access to dental care for those unable to afford it.