Economy hits hard for oral health care

// New options for care in Tacoma

Erika Utley is a stay-at-home mother of four from Gig Harbor. Her husband is a salesman whose commission-based pay took a hard hit with the declining economy. Insurance plans were offered through his employer, but the out-of-pocket premiums were too much for the family to bear.

Dental care for their children and themselves was consistently put on the back burner until their oldest daughter Reese, age 7, needed dental care that could not be ignored.

“We did have dental coverage offered through (his) work, but it was too expensive,” Erika Utley said.

A pediatric specialty office quoted the Utleys a price that was unaffordable to pay out of pocket, and Utley said the office was also unwilling to work with the family to set up payment plans.

“(Dental) just wasn’t an option to put in our budget. I didn’t know what to do at that point.”

A rising issue

The Utleys’ story is one that has become all too familiar to the middleclass population that has been forced to take the brunt of the economic cutbacks.

Linda Gillis is a dental hygienist who has overseen the Oral Health Program at Tacoma/Pierce County Health Department for the past 16 years. She receives phone calls daily from people who are in need of dental care and do not know where to turn.

What she refers to as the local “safety net” of Community Health Care and SeaMar clinics have become increasingly overwhelmed. On top of that, the Washington Department of Social and Health Services (DSHS) cut all funding for non-emergency dental care to low-income adults ages 21 to 54 – affecting 105,000 state residents who no longer can access the care they need.

Insurance coverage that middleclass families have relied on for years has dropped significantly as well.

According to Rich Roesler, spokesperson for the state insurance commissioner, rates of insured individuals and small businesses offering employee coverage through Washington’s largest dental insurance provider, Washington Dental Services, has decreased by more than 100,000 policies in the last two years.

“I have seen an increase in folks that normally had great coverage when they were working,” Gillis said. “Now we are staring to get phone calls from families in those upper-middleclass neighborhoods who don’t know what to do.”

Cuts in DSHS and drops in insurance coverage mean more and more people are being forced to pay out-of-pocket for dental procedures, and dentist bills can add up quickly.

This also means dental care is no longer a priority for many individuals.

“With the economic times, they’re bad right now, but they’re going to get even worse. We’re going to have to do something other than calling on the current safety-net clinics that are already overwhelmed,” Gillis said.

A new option for quality care

Utley’s story did not end with her family not getting the care they needed. She is one of about 500 local individuals who have turned to a brand new player in Tacoma’s dental landscape – Comfort Dental.

As part of a Colorado-based franchise, Comfort Dental recently expanded in the local market with two offices – one on the East Side and one in Lakewood.

In Colorado, Comfort Dental has provided low-cost quality care to residents for the last 19 years, becoming one of the bigger name brands in the state; but the Tacoma and Lakewood offices are the first of their kind in Washington.

The partner offices are both run by two dentists who partner in owning the businesses. In addition to two full-time dentists and a large staff of expanded functions dental assistants, Comfort Dental operates longer hours and is able to see more patients, which means the overhead is low and the savings are passed on directly to the patients through a discounted rate plan that easily beats other offices’ out-of-pocket pricing, and even many insurance co-pay rates.

“We found someone that will work with our budget and offer the same care you deserve,” Utley said. “For us, it has been a blessing.”

Pierce County’s Comfort Dental offices opened their doors together July 5, and slowly, word has been spreading about the offices’ membership plan for the uninsured, which offers a full range of services – from simple cleanings, fillings and extractions, to more complex oral surgeries, implants, bridges, as well as dentures and orthodontics – with price points and payment plans that can make the care affordable to the average Joe.

“I feel like a lot of dentists are pricing patients out of treatment,” said Scott Probst, partner dentist at the East Side office. “Comfort Dental’s main focus is to decrease the cost of quality dental care.

“We’re providing access to care for patients who otherwise wouldn’t be able to get it.”

Many community healthcare clinics offer pricing on an income-based sliding scale, and because of the overwhelming demand for dental access, many times people in need of work cannot be seen during the community clinic’s jam-packed weekday schedule.

Comfort Dental is open six days a week, including evenings, and offers a flat rate available to anyone, increasing the access to quality care for anyone who needs it when they need it – from middle class to low income, and adults to children.

“We take walk-ins and same-day emergency appointments,” Probst said. “Our whole focus is to get people in right away. The first visit is $19 no matter what – it is an inexpensive way to get started and see where you are at.”

An initial visit at Comfort Dental includes an exam and X-rays, and a consultation to go over a comprehensive dental care plan tailored to the patient’s individual needs.

They also offer a day of free dental care on Dec. 24, for simple procedures such as cleanings, extractions and fillings.

“We had people knocking down the door when we opened,” said Brett Webley, who partners with Probst at the East Tacoma office. “This is a good, hardworking community. Our business model would work anywhere, but it just fits this community perfectly, because people are looking for ways to cinch up their belt and get by.”

A serious health concern

When the economy hits hard, routine dental care can be put to the wayside to pay for more pressing issues – like food, shelter and medical care. That is what happened in the Utley household.

But oral healthcare, which was once seen as a luxury or cosmetic expense, can lead to very serious health issues if ignored.

According to Gillis, decay, disease and infections can grow unnoticed until it is too late and the problem is much more severe.

“When people call with a serious toothache, in most cases it’s too late for that tooth.”

Probst agreed. Like all serious health issues and diseases, prevention and early detection are key.

“I can’t tell you how many times we’ve seen a serious problem that could have been saved with a simple filling,” Probst said. “The mouth is not isolated from the rest of our bodies. Whatever infection is in our mouth is spread through the rest of your body through the bloodstream.

“The biggest thing with dental care is not waiting until it hurts.”

Earlier this month a 24-year-old Cincinnati man died from an untreated toothache. He could not afford to pay for it to be removed, so the dentist prescribed him painkillers and antibiotics to treat the pain and the infection. The man could not afford both prescriptions so he opted to get just the painkillers. The infection quickly spread to his brain, and the man died.

A similar situation happened to a 12-year-old boy in Maryland in 2007. His mother could not afford to pay for an $80 procedure to extract an infected tooth, which meant a serious issue was left untreated. The infection spread, and later caused him to be admitted to the hospital, undergo two surgeries and tally up about $250,000 in medical bills for the poverty-stricken family. In the end, the boy could still not be saved.

“Dental care is a situation where I don’t think people realize the seriousness of tooth decay and tooth infection,” Gillis said. “We don’t think of it as serious as a person who has a heart attack on the street – but it is a serious issue. And it is one in the community that we are talking about.”

Gillis is currently spearheading an oral healthcare committee, which would pull together all the local players in oral health to see what can be done to help those in need, especially those ages 21 to 54 who do not qualify for youth or senior dental coverage from the state.

“We are looking to create a true safety net for hard-to-serve people in our community. Our county is a wonderful, bountiful county that should be able to take care of their own residents.”

“The situation is getting very critical out there.”

For more information on the TPCHD Oral Health Care program, contact Gillis at .(JavaScript must be enabled to view this email address).

To set up dental appointments at Comfort Dental’s new offices, or for questions about rates and procedures, call (253) 472-3006 for the East Side office located at 3820 Pacific Ave.; or call (253) 475-9120 for the Lakewood office located at 5422 74th St. W. Suite C; or visit www.comfortdental.com.

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