Dental Health

Ethan, age 3
Modoc County 

Ethan has serious cavities in his front teeth and needs treatment soon. In fact, the cavities are so bad that he needs oral surgery. Ethan is enrolled in Medi-Cal dental coverage, and the nearest oral surgeon that accepts Ethan’s Medi-Cal is 8 hours away. Getting him to the appointment presents many problems for his parents, Caroyln and Jake Loughry.

For regular check-ups, Carolyn takes her son to a dentist 20 miles away from their home in Alturas, California. “There are three dentists right here in town, but none of them take Medi-Cal,” she said.

Several months ago, Ethan’s dentist said that oral surgery was needed to treat his front teeth. The dental office referred Ethan to an oral surgeon in Stockton, an 8-hour drive away. “I asked them if there was someone else, but they said that no one closer takes Medi-Cal,” she said. There is an oral surgeon in Susanville, 90 minutes away, and Redding, about two hours away, but neither office accepts Medi-Cal.

Carolyn is a stay-at-home mom, caring for Ethan, who has spina bifida, and his 1-year-old sister, Elizabeth. Jake works on a ranch. Ethan is unable to walk due to the spina bifida, requiring Carolyn’s husband to help with the trip. “To get Ethan to the dentist means that my husband has to take three days off work. He’s been harvesting, and it’s hay season right now; he just can’t take that much time off work,” she explained. “Then there’s the gas and motel room. It’s a big burden to travel that far, and it’s a huge financial impact for us. He’s needed the treatment for two months now, but we just haven’t been able to afford the trip.”

Carolyn is thankful for the insurance coverage provided by Medi-Cal. “I just wish there were more dentists who accept Medi-Cal,” she said. “We’re saving money out of every paycheck to pay for the trip. We’re hoping next month my husband will be able to take the time off, and I think we’ll be able to afford the trip.” Currently, Ethan’s teeth are sensitive to cold, but he is not in pain. “I’m worried that his situation will get worse quickly,” Carolyn said. “We need to get him to the dentist soon.”

Dominic Guttierez
Siskiyou County

Anjelig Gutierrez discovered that her son, Dominic, had fragile teeth when he was a toddler. “He chipped a tooth when he was about 2 years old,” she said. “He also gets cavities easily.”

Anjelig lives in Yreka, CA, an area with only one dentist who accepts Medi-Cal, and where it takes months to get an appointment. “The staff at Early Head Start kept telling me that he needed to get his teeth seen, but the appointment was a long time away,” she said. Eventually, they were able to get an appointment in Sacramento, where the wait was three months. “Thankfully, Head Start helped me with transportation, because it was three hours to get there. Dominic was in pain, and he cried the whole way.” While waiting months for an appointment, Dominic’s dental needs had worsened so much that he needed to have six silver crowns on his teeth.

Over the next three years, Dominic, now age 5, periodically complained about his teeth hurting. “Three times I made appointments, waited months to get in, then they didn’t find anything wrong,” Anjelig said.  During the third dental visit, an abscess was discovered above several front teeth. Dominic and Anjelig listened to the dentist describe the treatment, which involved pulling several teeth. “With my son sitting next to me, the dentist said that I was going to have to hold my son’s head hard and keep it still, while he got in there and yanked the teeth out,” she said. “I could tell from my son’s face that he was terrified.”  Anjelig was unwilling to participate in the treatment, and asked for a referral instead to a pediatric dentist. It took nearly four months, but the dental office eventually complied and gave Anjelig a grant to see a dentist more than 65 miles away.

The pediatric dentist she saw gave Dominic a different prognosis. He said that there was no abscess. The teeth that were supposed to be pulled were loose naturally. “They’re baby teeth that will fallout soon,” Anjelig said. Anjelig appreciates the positive outcome for her son’s oral health; however, she is worn-out by the difficulties with seeing a dentist.  “If he says that his teeth hurt, I should be able to get him an appointment without waiting for months and months. But there’s only one dentist, so we have to wait.”

CaliforniaHealthline

As California forges ahead to resolve several key questions about how insurers will provide pediatric dental and vision benefits under the federal Affordable Care Act, a new study examines dental benefits in California's implementation of ACA.

"The study raises good questions," said Jenny Kattlove, who coordinates dental access programs for The Children's Partnership. "We want to make sure that children of all ages have access to dental coverage. We want to make sure families understand that children are eligible for pediatric dental benefits and that enrollment in both health and dental coverage will be coordinated."

Download the full article here. (PDF)

Download TCPs comments to California's Health Workforce Development Council, which is  charged with helping to expand California’s health workforce in order to provide access to quality healthcare for all Californians.