Low-Income Families Have Trouble Finding Dental Care for Kids

by Tom Henderson (Subscribe to Tom Henderson's posts) Oct 12th 2009 2:00PM

Categories: Medical Conditions, In The News

Poor families suffer from a lack of good dental care. Credit: paigewatkins, Flickr

When a 12-year-old Maryland boy died from an untreated tooth infection two years ago, it started a bigger discussion about the need to provide dental care to low-income children.

They're still talking -- and children's teeth are still going untreated.

The Associated Press reported that many low-income families can't find dentists who accept Medicaid. Dentists claim they don't get reimbursed enough money from Medicaid to cover their costs. Plus, some dentists told the AP, low-income families have an expensive habit of skipping appointments.

"The bottom line: Children's access to Medicaid dental services has been improving but remains low," Katherine Iritani, health care acting director at the Government Accountability Office, told the AP.

Two years ago, when 12-year-old Deamonte Driver died, only about a third of eligible children were signed up for Medicare dental services, according to statistics from the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services.

The Government Accountability Office issued a report last week that shows only moderate increases in participation over the last two years. Iritani told the AP there wasn't enough data to say precisely how many of the nation's 30 million children signed up for Medicaid are seeing a dentist.

"Continued attention and action is necessary to ensure children's access to Medicaid dental services," the report concluded.

A routine tooth extraction might have saved Deamonte's life. But bacteria from an untreated tooth abscess spread to his brain and his family's Medicaid coverage had lapsed.

A subcommittee of the House Oversight and Government Reform Committee began meeting to discuss inadequate dental care among Medicaid recipients. The GAO's report was submitted for the fourth hearing since Driver's death.

"It's a multi-pronged problem -- and I don't say that to get around our responsibilities," Cindy Mann,, the director of the government's Center for Medicaid and State Operations, told the AP. "I say that to say that we're rolling up our sleeves, and it's not a simple solution."

Rep. Dennis Kucinich, D-Ohio, chairs the subcommittee and told the AP enough is enough. "We're not going to stand by and watch any more little kids die," he said.

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Comments (18)

Reader Comments (Page 1 of 1)

SUEBEE 10-12-2009 @ 3:21PM

When is someone going to offer a program for families that make too much to qualify for low-income services yet still cannot afford to pay for dental'medical insurance or cash payments to dentists/doctors.

Michele W 10-12-2009 @ 7:33PM

Oh suebee I have been waiting a long long time for that question to be answered. Luckily for my child he qualifys for assistance and gets medical and dental but as for me and my husband we are the ones who are caught in the middle and cant get anything for the life of us. My husband works but I don't because of a bad back that I need operated on and 2 fusions done but since I am only 33 the doctors dont want me to get the operation now or by the time I am 50 I will be stuck in a wheel chair. It is take my meds and wait until the right time to do it. Yet I can not get disability or medical assistance. Medical is not offered through my husbands job it was me who had the insurance before i had my child that pushed my back over the line. We do qualify for what is called adult basic here but that is strctly medical, no prescription, dental, or eye . I have suffered with horrible teeth since a child and it runs in our family. I had to have all of my bottom teeth removed by 22 years old. Since i havent had insurance since then I have not been able to get my plate adjusted so it has cut into my jaw so bad that instead of having one gum line it looks like I have 3 because the plate cuts into my skin and it just keeps going deeper and deeper in. I had to have my 4 front teeth pulled and I couldnt even pay that. Now I only have 7 teethleft up top and 2 are very infected. I am also diabetic so this is very touchy for me because I just can not eat right because it hurts so bad. Yet welfare wont help me because I am not a drug addict or a drunk. Our state gives disability to druggies and drunks first no questions asked but for the people who abide by the law and CHOOSE not to do drugs or drink or have 50 kids so I can get help is stuck and cant get anything and suffer. Why is this that the people who CHOSE to do drugs and drink get every thing handed to them? Thier teeth rot from the drugs and they get all their teeth capped and brand new, they get rehab paid for 20 times after each time they fal off the wagon. yet I DIDN'T ask for a bad back and hip and I did work, paid taxes, didnt live off the system and abide by the laws and I cant get any help. This is the major thing wrong with this country is all the wrong people get the help and it is time the drunks, druggies and lazy baby makers quit getting everything and the people that deserve it get it.

SKL 10-12-2009 @ 9:50PM

Somebody should acknowledge how much better low-income kids' teeth are because this country has flouridated the water for generations. When I was a kid, I went to the dentist once when I was 11, and once when I was 16 (and discovered my first cavity). Same thing with 4 of my 5 siblings. Younger brother got to go to the dentist at 7 because he ate more candy than the rest of us. By the way, our parents didn't instruct us to brush our teeth, and I am pretty sure I didn't even own a toothbrush until I was at least 6 or 7. So what's the deal? (Don't say genetics, because my dad had false teeth by his early 20s.) Here's the deal. People who let their kids run around or sleep with bottles in their mouths and keep giving them too much sugar throughout their childhoods.

Also, what's the deal about these people skipping appointments? It's easy to waste other people's time and money, especially if you don't have much of a conscience. I don't blame the dentists for not taking these patients.

Finally, I don't believe it's the government's job to make sure kids' teeth are cared for. Or their eyes, or their basic health care for that matter. Parenting is a responsibility; deal with it (like the rest of us do). Try selling the TV and working more hours, serving real food, holding your baby when she eats, teaching your kids about hygiene. Try giving up the booze and drugs and cigarettes and pop so you can afford a trip to the dentist when your kid has a cavity. It's called prioritizing.

Elizabeth 10-12-2009 @ 10:33PM

That's a very glib statement there, SKL. You make it sound like everyone who can't afford dental care is a bad parent. The fact of the matter is that if a parent doesn't get benefits with their job, affordable dental insurance can be very hard to find, and without it dental procedures, like medical procedures, are very costly. I know. I've paid for dental work without it, and was in debt for nearly four years. Even something simple as a routine exam and cleaning can cost upwards of three hundred dollars. Of course, this cost is considerably reduced with insurance, if you can find it, but are you gonna tell your kid to wait until the insurance kicks in when they are in pain? When it's a choice between feeding and clothing your kid, and dentistry, what are you gonna pick if you only have money enough for one. Obviously you have a great job and don't have to choose, and that's great. This article probably wasn't directed toward you, but more for SUEBEE and Michele W. It's been proven that people who have healthy teeth have better overall health, so yes, people should have access to affordable dental care.

I will tell parents that if you live in California, Texas or Florida, Safeguard insurance company is really, really inexpensive, and they cover A LOT. I recommend getting this one if you're looking for something inexpensive.

SKL 10-13-2009 @ 12:14AM

Um, Elizabeth, I have rarely had dental insurance, and my kids don't have it. Dental insurance is about the most poorly designed product there is. If you have a calculator and three minutes, you can see that it is almost impossible to pay less with insurance than without - especially if you buy insurance for more than a year at a time.

My kids' only encounter with a dentist occurred because one daughter banged her tooth and bruised it. I paid cash - about $60. Divided by my kids' years of life, that's $10 per year. Most kids never even have such an accident. For myself, I pay cash too. I have never paid the kind of money you talk about in your post. Then again, I have never opted for any cosmetic-only services, so maybe that is why.

People need to prepare and save for things that "might happen," not wait until they happen and then wonder what to do. I have been alive too long and seen too much to be moved by the stories of all these poor unsuspecting parents who never had a chance to do the right thing. 95% of them spend more money on material nonsense than I do; much of which contributes to the very problems that "unexpectedly happen to them." The bleeding-heart solutions never focus on the 5% whose situation could not have been reasonably avoided by making better choices. So throwing more money at the problem is not going to fix it - it certainly never has in the past.

Elizabeth 10-13-2009 @ 2:14AM

SKL, it was not cosmetic, rather I had to have a root canal because
of several years of not going to the dentist--and I am very
meticulous about my dental hygiene. But as a child my mom couldn't afford to get dental insurance for me, and a small cavity turned into a root canal. Dentistry for children is not expensive, but as they get older, it will become more costly. Cavities cost around 300 to fill, without insurance. What's going to happen when your children need braces? Those cost a couple grand. It's interesting how people with money just don't get how poor some people are. Yes, people need to prepare for things that might happen, but a lot of us can't. Since I graduated high school, I have been working two and three jobs to pay for college and live on my own. I don't have any family or friends I can go to to ask for money, it is just me. I admit, I live paycheck to paycheck, and I don't have any savings, but when you make just enough money to cover bills, how can you? Not all of us are lucky enough to be able to "plan for emergencies" when they are threatening to cut off your power. Ideally, yes, I would love to be able to save, but after a car payment, cell phone, and food and toothpaste, there is nothing left. I don't go out drinking with my friends, I don't spend extraneous money I don't have, and yet I don't make enough to save. Would I love to get a second job, sure, but no one is hiring right now, and unless you have a college degree (which I'm still working on) it's impossible to get a "good" paying job. Not every parent can be as perfect as you are, and there ought to be some resource for those of us who have nothing. Or should we simply be punished for being poor and trying
to work hard?

What's wrong with those who have helping those who have nothing? Why are people so reluctant to share with those who can't do what they do?

SKL 10-13-2009 @ 10:50AM

Elizabeth, first of all, I am not more "lucky" than 95% of Americans. I have simply worked harder and denied myself more pleasures all my life. I am sick of being told that because of my choices, I have to pay more and more and more for people who made different choices. OWN YOUR CHOICES. I had no help from anyone either, other than my parents providing sufficient food, Salvation Army clothes, and a roof over the 2-bedroom home I shared with my family of 8; and God, who gave me a working brain, body, and conscience.

How much tax must I pay each year in order for you to think I have done enough for slackers? How many hours must I work each day for the account of other people? You already get over half of what I earn, not including the amount I pay to others to perform services for me and my kids while I am working long hours. The fact is, IT WILL NEVER BE ENOUGH, because people are not going to change as long as they don't have to. Pretty soon I am going to get fed up and just retire, and then I can join the ranks of people who cry and whine about what somebody isn't giving me. Waah, I am a single mother, etc., etc., isn't it about time you sent some money my way? After all, it's not my fault that I couldn't save much while I was paying all those taxes, is it?

I do not believe you and others who say "I just can't." I lived for decades on less than $6K per year. Stop telling yourself fairy tales about people like me having money trees in our gardens, and apply your brain. And to your question, "what should I do, pay the consequences for my own behavior?" the answer is: yes. Now you may go burn my effigy if it makes you feel better.

SKL 10-13-2009 @ 11:04AM

By the way, Elizabeth, have you ever noticed that most of the people in this country consider themselves poor? I had a boss who was easily making $500K/year and he thought those "rich people" (obviously not including himself) were making too much money and ought to pay more taxes so his burden could be eased. People in this country are so self-centered and ignorant. Have you ever visited a third-world slum or orphanage? You don't know what "poor" is unless you have. And by the way, I give from my disposable income to those truly poor children, so shame on you for trying to increase my tax rate to benefit spoiled American kids who don't even know what "hungry" means, who are going to grow up ignorant and cry with a loaf of bread under their arms like you.

Elizabeth 10-13-2009 @ 5:49PM

SKL, as a matter of fact I have visited the slums of the third world countries and worked with orphans in Northern Ireland. I know that the poor in America would be considered rich in those worlds. But the one thing they have on us is that if they get sick or need to go to the dentist, they can just go, and a lot of people here can't. I'm not saying you should pay for those who don't work as hard as you--many people who cannot afford medical work their butts off, and that's why they can't get Medicaid or other government financial assistance--they are poor, but not poor enough. For those of us just hovering above the poverty line, there are simply no resources unless we become slackers. I can't tell you how much easier my life would be if I were to become a welfare mom, but I don't want to do that because then I would just be abusing a system designed for the truly needy and that's not who I am. Do I want you to pay for slackers? Hell no. I don't want to pay for slackers. I want to pay for those who are trying their damnest, but need that little extra help, and I am okay with my tax dollars going for that.

SKL 10-13-2009 @ 9:24PM

But do you pay income taxes, and if so, are you truly willing to see YOUR personal tax bill go up significantly to pay for other people's kids' dental bills? Or are you just carefree with other people's money? Like I said, since you are such a warmhearted soul, how about sending my kids a few thousand bucks - I mean, after all, they were born poor, they are minorities, they have a single mom and no dad in the picture, and to top it all off, they don't have dental insurance. Let me know if you need our mailing address.

Oh, and Ireland is a dreamland compared to the third world. Very few truly poor people in this world have access to any dental care at all, or modern health care for that matter. That is another huge joke. One weeks' worth of our minimum wage is more than about half the world earns in a year. You really think these people have ever seen the inside of a dentists' office?? Are so many Americans really that ignorant? This is the thing that worries me the most about our country. And you think I am the one who is ignorant of suffering.

Elizabeth 10-13-2009 @ 9:39PM

But SKL, if you're doing as well as you claim, why would you need a couple thousand dollars from me, which, by the way, I really would give if I had it at the moment.

I pay taxes like everyone else. Here's my thinking: for me to have good dental and health insurance, just me, it would be about $175 a month. I figure if the government is taking that out of my paycheck so that not only I can go to the doctor and dentist for free (or at least very cheap), but someone else can go as well, yes, I am very comfortable with that. I understand that if we want our government to do things for us, the funding has to come from somewhere, and if my taxes go up a bit because of this, then so be it, because it will be better for everyone in the long run.

And in the towns along the border of Northern and Southern Ireland, it's not a dream world compared to the slums. It's better in terms of sanitation, yes, but the violence is something you wouldn't expect to see in the western world. It is downplayed in the news, but it's still pretty bad. Believe me, if I could do more for the poor kids I would, but I don't even qualify for the Peace Corps because these days you have to have a college degree to be accepted.

SKL 10-14-2009 @ 1:26AM

Wow, you believe the government is going to insure you for both comprehensive health and dental, plus include a surcharge to help those who "can't afford it," and cover all the administration costs, all for $175/month? I think you are living in a dream world.

But if you do have that kind of money to pay in additional taxes, what is stopping you from socking it away to pay for your family's next cavity? You say "I can't," but if the government wants to take it out of your paycheck, all of the sudden "I can"?

See, that's another thing I don't understand about liberals. They think they need the government to tax them in order for them to help others. Conservatives trust themselves to direct their giving (and volunteering) toward charitable and community causes that will have the greatest impact based on their conscientious priorities. Although some charities are not terribly efficient or transparent, many are (or you could start your own), and in any case, few could be worse than a government bureaucracy. It always amazes me when I hear people say "I don't mind paying more taxes to help people." Then why not just help people, and leave the government out of it?

Elizabeth 10-14-2009 @ 2:24AM

SKL, right now our tax dollars go to pay for the uninsured who go to hospitals and get reduced costs because they don't have health insurance or enough income. Why shouldn't I get some of that coverage? Why shouldn't you? Why shouldn't your kids? Why should you have to pay for insurance and taxes? If the healthcare industry wasn't getting reimbursed by the insurance companies, they wouldn't charge so much for procedures, thereby eventually lowering the amount they would take out for taxes. Is it going to be perfect the first few years, no. But then, from what my grandparents tell me, neither was social security when it was first introduced, and now people can't imagine a world without it. I'm optimistic that universal healthcare will be the same way in a few years.

P.S. Whether we agree or disagree, I do enjoy the debates we have on here. It's really nice to see someone able to articulate their opinion without resorting to name calling and Obama bashing and cursing. :)

SKL 10-14-2009 @ 11:44AM

I think it's more likely that government-run health care / healthcare insurance will go the way of public schools and most other public endeavors. And most certainly, the minority of us who already pay the vast majority of the taxes will foot most of the bill. There is no Democratic health care proposal that does not give high-rate taxpayers a large tax increase, enough to cover not just their whole families' health care but several other families' too, and in addition, none of them would eliminate actual insurance premiums, and most analyses indicate that insurance premiums would also increase.

I know we already pay for the catastrophic illnesses/injuries of that 10% of US citizens who are uninsured due to unaffordability (which may be higher now with all the job losses that have recently occurred). The actual cost of those services is paid via higher cost of service to everyone else. However, the true aggregate cost of truly catastrophic situations for these people is relatively small, compared to the costs of having the government meddle with the system. Surely you know a few people who have had this happen, but you probably know many, many more people who never have, so having the free market spread the cost is not really a big problem - especially if there's a consensus that responsible people need to pay for this one way or the other (which there currently seems to be).

I don't think people recognize the sigificance of the fact that the vast majority of Americans have acceptable health insurance that they are satisfied with, and that has the effect of paying for many costs for uninsured people as well. The significance is that if there is any spreading to be done, the market can handle it. If only about half of people were currently insured, spreading the costs within the market would be less feasible. Now, when you compare the US to relatively less developed countries that have "universal" health insurance, you have to realize that without so-called universal coverage, the majority of their population would be in a fix. That isn't the case here. So the basic reason why it might have made sense in some countries does not apply here.

Here's an example. Suppose you have a heavy table being carried by 10 people. One stubs his toe, and now you have nine people carrying it for a while, and each of those nine people is able to carry 11% more for a while, or maybe even forever. That's what the US system is like right now. Now in most other countries, you have the potential for 6 or 9 of the carriers to drop out. At some point, the remaining people can't carry the table and need to either leave it there or find some alternative method of carrying it. So the alterative of having the government buraucracy vehicle come along and charge the taxpayers to carry the table for everyone may look like a meaningful alternative there. But such a solution, which is costly, inefficient, inflexible, and politically influenced, is not appropriate in our system where the burden can be (and is) carried by the free market system.

It sounds very compassionate to say that we should pay more taxes and offer more free services. But the reality is, the healthcare pie isn't going to get bigger; it's just that the government is going to take a bigger piece to pay for administration and nonsense and policy stuff like pushing birth control and abortion on young girls/women. There will be a net loss of quality care, and that will affect everyone, rich and poor, with the poor being most affected since they cannot afford to go around the system. Not a very compassionate result in my opinion.

But I fear that you will find this out for yourself all too soon.

Don 10-16-2009 @ 7:58AM

The a lot of the private health care cost in this country right now is due to administration costs. The government has had a long standing tradition of running their own insurance plan called medicare in addition they have their own private health care system for all veterans. If you ask most senior citizens or veterans they will say that they like their health care plan.

It is compassionate to want to help a fellow human being, rather than think about your wallet, I highly doubt that just because the government starts footing the bill for your medical bills all doctors are going to start pushing every pregnant women to have an abortion(after all they make more money with pregnancies and babies).

As for the loss of health care, what health care? We're the richest country in the world yet we have one of the worst health care systems, we rank somewhere in the thirties, compared to other industrialized nations.
There needs to be a fundamental change in the way we treat people in this country. Starting with preventable health care measures, such as better food education, exercise education, lastly the idea that because your an American citizen you have the right to walk into a hospital and get same medical treatment as the person laying next to you regardless amount of money you have. It's a human right, not just a right of the economically privileged

To not have to worry about the fact you may one day get sick with cancer or some other disease, that your insurance company that you've had for thirty years comes to you and says they are dropping you because your no longer profitable for them. I've seen this happen before my very eyes, it's a difficult enough to deal with disease alone, yet in America we always have to deal with insurance along with disease.

SKL 10-16-2009 @ 9:32AM

"If you ask most senior citizens or veterans they will say that they like their health care plan." The ones I talk to complain about it all the time. And the doctors hate it even more. And furthermore, it is being subsidized by the free market, because the providers charge the rest of us multiple times as much as they charge Medicare. If there were "medicare only" hospitals you would notice a huge difference.

"I highly doubt that just because the government starts footing the bill for your medical bills all doctors are going to start pushing every pregnant women to have an abortion(after all they make more money with pregnancies and babies)." First, they make more money with non-terminated pregnancies because they spend more time on them. If they just had to spend a few minutes once to suck that baby out, they could have more patients and make more money. Do you really think abortion doctors do it because they feel they have a calling?? And secondly, once the government is in charge of payments, politics and partisan agendas will determine how abortions versus maternity care will be compensated. Liberal administrations believe it is wise policy to encourage and pay for abortions. Think ahead a little.

"As for the loss of health care, what health care? We're the richest country in the world yet we have one of the worst health care systems, we rank somewhere in the thirties, compared to other industrialized nations." Whose ranking? This is ignorant. Our health sucks on average because we eat too much and exercise too little; because we play God with aggressive fertility methods; because of drugs, fast cars, youth violence - we're spoiled, not deprived. How about enabling Americans to be even more irresponsible! Yeah, that's the ticket!

"Starting with preventable health care measures, such as better food education, exercise education," Yeah, because most Americans don't know that overeating makes you fat, and smoking makes you sick, and sitting around all day doesn't help matters! What we need is more money spent on that!

"lastly the idea that because your an American citizen you have the right to walk into a hospital and get same medical treatment as the person laying next to you regardless amount of money you have. It's a human right, not just a right of the economically privileged" This sounds like the popular thing to say, but the liberals pulled it out of their butts. How about my human right to go to sleep at night, or spend more than a couple hours with my tots, instead of having to work longer hours to pay more taxes? Also, why limit this argument to medical care? I'm sure there are some things you choose to pay for that not everyone can afford on their own. Books? Movies? Electronics? Alcohol? A vehicle or two? Nice clothes/shoes? Manicures/pedicures/massages? Domestic services? Why should you not have to pay a tax to make sure that everyone in this country has the right to have everything you have made a spending priority for you? Oh, but then you couldn't afford it yourself, could you? Good health and health services aren't a right, they are priorities that Americans have the freedom to rank. If an obese person wants to eat two big macs for lunch, instead of making a pbj and saving the difference for future health needs / insurance, that's a valid choice in this free country, and part of being free to choose has to include being free to incur consequences of choices.

What we need is a flat tax, applied to every human being in this country. Even people who don't have a paying job should have to put in their x hours per day for the government. That is the only way the voters will stop voting for higher taxes for the real taxpayers to pay. "Compassion," my hiney.

cathy 10-27-2009 @ 10:00AM

America taxes are higher than any Country.
What really should be done is to not let our
in office should not be able make others pay
for what they owe!
Low-Income family can not afford to fix their
own teeth.How are they going to help their
children.Children go on drugs because most
people have no control over their own lives.
Our schools are to busy teaching their own
agenda to care about children.

cathy 10-27-2009 @ 10:22AM

Taxes in America are higher than any other Country.
What really should be done is to stop letting those
in office make Americans pay their bills.They rob us
blind & then they turn around & make us pay for what
they did to us.Just like here in Florida with the raise
in taxes on cars also homes also insurance.