Louisiana’s dental services falls short, lags most other states

5th June 2017   ·   0 Comments

By Susan Buchanan
Contributing Writer

Louisiana and much of the South need more dentists, especially those charging moderate fees. Fifty-four of the state’s 64 parishes are classified as “health-professional shortage areas” for dental care, according to Dr. Henry Gremillion, Dean of LSU Health’s New Orleans School of Dentistry. Grads with dental degrees gravitate to urban areas but parts of the Crescent City are short of services.

Lack of access to care, because of few dentists or a patient’s income, can have serious, overall health consequences. “Untreated gum disease is a condition associated with diabetes, cardiovascular disease and stroke,” Gremillion said last week. Poor oral health is linked to premature births and low birth weights.

Affordable dental clinics are desperately needed across the state, he said. In New Orleans, low-cost, weekday clinics and occasional, free weekend clinics are well-attended. LSU’s School of Dentistry sees patients at prices determined by who does the work. If it’s by a student or resident, the fee may be only half of what a private dentist would charge. LSU’s dental school on Florida Avenue in Gentilly last year saw 60,000 patients—many of them repeat customers.

Late last September, a two-day Louisiana Mission of Mercy dental clinic kicked off at the Alario Center in Westwego, staffed partly by faculty and student volunteers from LSU Health. Turnout was high, and nearly $1.07 million of free care was given to over 1,500 patients.

Another free, two-day clinic will be held this year, but the date isn’t set, and the event won’t necessarily be in Greater New Orleans since needs are acute around the state, Gremillion said. He grew up in Avoyelles Parish, where he practiced dentistry.

Louisiana’s dental profile compares poorly with other parts of the nation, particularly the Midwest. The Pelican State ranked 44th for the number of elderly people with no natural teeth in a survey of 50 states and the District of Columbia, released by WalletHub in early February. Researchers at WalletHub, a personal-finance website in Washington, DC, used data from the feds and dental organizations for their study. Louisiana’s overall rank in the dental-services survey was 46, followed by Mississippi at 47. States with the healthiest teeth were Minnesota, Wisconsin and Illinois.

Louisiana has fewer dentists per capita than elsewhere, ranking 50th in that category. And Louisiana was 49th in the percent of adults with “low life satisfaction” because of poor oral health, WalletHub found.

As for seniors, “their health histories are more complicated than younger people, and those over 60 are a fast growing segment of the population,” Gremillion said. Seniors on fixed incomes often have serious dental-care needs. But Medicare, for those 65 and over, doesn’t cover dental work, except in very specific cases. Medicaid, a state and federal program for low-income individuals regardless of age, pays for some dental services.

In 2016-17, Louisiana’s adult dental program under Medicaid is slated to cost $11.46 million, Department of Health spokesman Robert Johannessen said last week. Louisiana residents enrolled in Medicaid have swelled to 420,000 since Governor John Bel Edwards took office last year and embraced the program.

Under Louisiana’s Medicaid dental plan—run by Florida-based, benefits administrator MCNA Dental—certain adults are eligible for dentures. MCNA Dental also administers Medicaid benefits for children in Louisiana.

Dental care for children is one of the “ten essential benefits” included in health plans under the Affordable Care Act or Obamacare. The ACA offers less dental insurance for adults, however. In the Health Insurance Marketplace, adults have been able to buy dental coverage as part of a health plan, or through a separate, stand-alone policy if they’re also signing up for a health plan. The future of these insurance policies is unclear, however, since the U.S. Senate is working on a health care bill now, after the House in May passed its version to replace Obamacare.

For low-cost dental care, New Orleans has options beyond LSU’s dentistry school. Daughters of Charity Services operates dental offices in its Bywater, Carrollton and Gentilly health centers. Qualifying, self-pay patients are charged small fees for first visits that include an exam, x-rays and a treatment plan. After that, fees for those who are eligible are discounted for extractions, fillings, crowns, dentures, fluoride treatments and cleanings. Daughters of Charity is a member of St. Louis-based Ascension Health, the nation’s biggest non-profit, health-care system, devoted to low-income patients.

Homeless individuals, with limited access to running water, need their teeth fixed. A clinic run by the City of New Orleans-Health Care for the Homeless is located in the Edna Pilsbury building on Simon Bolivar in Central City. “It offers support to children and adults, uninsured and insured,” Erin Burns, spokeswoman for Mayor Mitch Landrieu, said last week. “Every effort is made there to schedule appointments for medical patients who have fallen out of dental care.” Needs are high since the city’s un-housed population exceeds 1,700. HCH offers sliding fees, based on income and family size. “The goal is to deliver quality, compassionate, courteous care to patients, regardless of ability to pay,” Burns said.

Another city-sponsored site, the Tulane Drop-In Adolescent Clinic, offers medical services to homeless adolescents in the Tremé area, and has time slots for dental services.

As for dental costs, they surged nationally in the last decade as equipment, drugs and the expense of dental school grew. In 2016, the average dental grad in the United States had racked up debts of $261,000, Gremillion said. “That makes it tough to start a practice, where you have to pay for high-tech equipment and lease an office,” he said. “As a result, more dentists are working in corporate practices now.”

Gremillion noted that the debt load for 2016 grads at LSU’s School of Dentistry was a comparative bargain at $155,000. LSU runs Louisiana’s only dental school.

To learn more about affordable dental care in New Orleans, visit the web at http://www.ladental.org/public-resources/community-clinics#neworleans.

This article originally published in the June 5, 2017 print edition of The Louisiana Weekly newspaper.