Meet the Children

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.”

Lizbeth, 5 years old
Sacramento County 

Lizbeth Vera’s first visit to the dentist did not go smoothly. The 5-year-old saw strange metal instruments lined up on the tray, and fear took over. “When the dentist tried to insert a tool in her mouth, she bit his finger,” said her mother, Erica. “The dentist said that he could not treat her cavities because Lizbeth was being uncooperative.” Even though the Healthy Kids program covered Erica Vera’s daughter, she was unable to find another dentist who would accept her insurance. Traveling to a dental appointment was also a problem. Erica and her family live in Sacramento, but her husband drives their one family car to work in San Francisco.

In 2008, the Healthy Kids program lost funding, and Erica enrolled her daughter in a plan through Kaiser Permanente. However, Erica was unable to find a dentist who accepted the insurance. That same year, the Smile Keepers mobile van began visiting her daughter’s school. Funded by First 5 Sacramento, Smile Keepers provides dental exams and flouride varnishes. The atmosphere was much more kid-friendly, and Lizbeth finally had an exam and cleaning. Due to serious decay in one of her molars, the hygienist referred Lizbeth to Smiles for Kids.

Smiles for Kids is a project of the Sacramento Dental District Foundation. Throughout the year, children receive dental screenings, and serious cases are referred to the program for free treatment once a year. Lizbeth was on the waiting list for a year before seeing a participating volunteer dentist. During that time, Lizbeth’s appetite had diminished greatly, and her energy and mood were low. “I felt helpless,” said her mother. “I had her gargle with salt water, hoping it would stop the pain.”

When Lizbeth was finally seen on Smiles for Kids day, one of her molars was pulled due to extensive decay. Lizbeth, now 13, has continued to be “adopted” by dentists in the volunteer program. While Erica appreciates the volunteer dentists, it is not a permanent solution. Lizbeth still does not have a regular dental provider, and Erica never knows if, and when, she will be able to get Lizbeth an appointment. The office visits are often spread all over Sacramento.

“It’s about 40-45 minutes away,” said Erica. “I pay someone to take us, but when they can’t, my husband has to take time off work.”

Joseph, age 1
Humboldt County 

In February 2011, Tina’s 1-year-old son, Joseph, had a bad fall. She rushed him to the hospital thinking the worst. Thankfully, the physician found him to be fine, except for a broken front tooth. However, Tina was unable to find a pediatric dentist who accepted Medi-Cal. What started as a broken tooth, requiring minor treatment, resulted in a year’s worth of pain, health risks, and accumulated costs.

Tina Infante lived in Mendocino, an area that has a shortage of dentists who will care for low-income children on Medi-Cal. Tina did not own a car, and the pediatric dentists were 100 to 150 miles away. To make matters worse, she was unable to find a provider that did not have a long wait list. “They sent me a letter stating it would be three or four months before they could see him,” Tina said. “Later, they said it would be even longer.”

Tina felt helpless, as she noticed her son’s teeth begin to rot. Joseph’s dental caries were spreading. In September, the family moved to Eureka. “One of the reasons we moved to Humboldt County was to find more resources for Joseph,” she said. Still, there was a long wait time before Joseph could be seen. The waiting was agony, as Joseph’s health began to deteriorate. He cried and fussed most of the day, clinging to Tina’s legs. He lost his appetite. 

Then, Tina noticed something strange about his face. “At first, it was slight,” she explained. “Then, his face got really puffy, and we took him to the emergency room (ER).” Joseph had facial edema caused by his oral infection. Facial swelling is serious and can prevent swallowing or close off a person’s airway. Joseph had a high fever and severe infection. He was taken to the ER twice for antibiotic treatments. The second time he was almost admitted to the hospital.  “Over the next couple of weeks, Joseph got better and he was able to receive the dental treatment he needed,” Tina explained.

What started with one broken tooth ended nine months later with two visits to the ER and four extractions by a pediatric dentist. However, most of the trauma, and additional cost associated with it, could have been avoided if Joseph had simply received timely care. 

Unfortunately, the future is a mystery for Joseph’s smile because diseased baby teeth can adversely affect permanent teeth. “Our dentist said that he may have deformed teeth or really crooked teeth,” Tina said. “We won’t know until he’s older and his permanent teeth come in.”

Juan Carlos, 19 years old
San Luis Obispo County 

Most of Juan Carlos’ childhood involved dental pain and discomfort. “I don’t remember when it started,” said Juan Carlos Ubias. “I think it began when I was 8 or 9 years old.” Juan’s parents are agricultural field workers, and for most of his adolescence, the family could not afford or find proper dental treatment. Today, Juan, 19, is wrapping up his senior year at Mesa View Community School in Oceano, CA. For the first time in a decade, Juan is pain free and happy with his smile.

In 2011, Juan received a dental screening at the school’s annual health fair. Michelle Herber, the school nurse, relayed what the dentist wrote, “Dental attention is needed now. Family dentist should be consulted immediately. Multiple cavities front upper teeth.” Over half of the students at the school required referrals. Juan’s decay was very noticeable on his front teeth. “I used to cover up my smile,” said Juan. “But, most of the time, I’d just let loose and laugh. Sometimes, people looked at my teeth and said that I needed to take care of that.” Juan also had severe dental caries in his back molars and occasionally told his school nurse that he was in pain. “He’s not a complainer,” said Michelle. “He’s quiet, polite, and very respectful. When the pain was bad, he didn’t come to school.” Michelle eventually worked out a treatment schedule with Community Health Centers of the Central Coast. “He’s been twice, and his treatment is still in progress,” she said. “The sad part is that all this could have been so easily avoided if Juan was able to get regular treatment when he was younger.”

For now, Juan feels good about himself, his smile and future. “I’m going to Cuesta College after I graduate,” said Juan. “My dream is to play in the NBA, but for now I’m looking for a job, and I’ll start college in the fall.”