Filling the gaps in dental care

VIRGINIA BEACH 

The waiting room of a dental clinic for the uninsured is filled with stories of just how bad a toothache can get.

Juleah Best buys temporary fillings at a drugstore to relieve a decaying tooth.

The word "temporary" aptly describes them.

"Every time I inhale, it hurts my top and bottom jaw, clear up to my temple," said Best, a 29-year-old single mother who hasn't been to the dentist in more than a decade.

Marchia Dolbow, 51, won't drink anything cold for fear of aggravating exposed nerves in her mouth. The physical pain isn't the worst thing, though; it's the ache of how she looks with only seven teeth in her mouth.

"I have been turned down for jobs I knew I qualified for, but because of my appearance, they say, 'I'm sorry, we're not hiring.' "

The Beach women were among 26 people who showed up in mid-May for the Beach Health Clinic's first free dental clinic.

The dental services were a collaborative effort that involved volunteer dentists, the Navy, Old Dominion University, funding from foundations and companies, and the Beach Health Clinic, which serves the uninsured of Virginia Beach.

Dental care is a gaping hole for the uninsured in Hampton Roads, according to a community health survey commissioned by Sentara Healthcare five years ago. Community health professionals tagged dental care as one of the top medical services the uninsured had trouble finding, even higher than prescriptions and mental health care.

They often turn to emergency rooms instead. During a one-year period starting in 2003, there were 1,577 cases of uninsured people showing up in Sentara hospital emergency rooms with problems that would have been better treated in a dental office.

"All they can do is give them pain medication or an antibiotic and tell them to see a dentist," said Candice Driskell, executive director of Access Partnership, a coalition of health and community groups working to increase access to health care.

There are a number of places locally with free or reduced dental care, and various organizations are working together to bolster those programs and start new ones.

Susan Hellstrom, executive director of the Beach Health Clinic, started laying the groundwork last summer for the dental clinic there, which she hopes can be conducted quarterly.

Hellstrom lined up mobile dental vans from the Navy. She used grant money from the Virginia Beach Foundation, Wal-Mart and the Virginia Association of Free Clinics to buy equipment and supplies. Local dentists volunteered their time, and Old Dominion University's dental hygiene department pitched in to help as well.

Jim Milonas and David Crouse, two Virginia Beach dentists who volunteered at the Beach clinic, said people often think of dental care as less critical than other medical services, but an increasing amount of evidence is showing links to general health.

For instance, studies have shown that gum disease can trigger or worsen conditions like heart disease, diabetes and stroke, and is also linked to higher rates of premature birth.

At the Beach clinic, dentists and dental hygienists worked together to take X-rays, make evaluations and pull 52 teeth during the clinic on May 15 and 16. Some people had to be referred to other resources, since only extractions and evaluations could be done.

Driskell said people often have to cobble together services, since clinics offer varying levels of care and different eligibility standards. She recently had a call from a radiation oncologist about a patient who couldn't start treatment until some dental issues were resolved.

Stephanie Morrison had moved to Virginia Beach from Arizona in February, hoping the job market would be better here. She hadn't yet landed a job when she went to see a doctor about a sore throat.

"My sore throat was, in fact, cancer," said Morrison, 52.

But before she could start chemotherapy and radiation therapy for throat cancer, she needed to have some decaying teeth pulled. Driskell was able to hook her up with a volunteer dentist, and Morrison later had seven teeth pulled at Healthy Smiles Dental Center in Portsmouth.

She'll start cancer treatment this week.

"My mouth has a clean bill of health," Morrison said.

Driskell said much of the dental work for the uninsured and underinsured would not be possible if it weren't for health care providers throughout the community pulling together: "Collaboration is key."

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com