Monday, August 18, 2008

Getting a dental appointment is like pulling teeth

Dave called me out the other day, saying that I only post "self-promotional" entries-- after my experience trying to find a dentist this week, I decided to expand my range of blog topics.

Just being up-front-- unless you've got cash or non-Medicaid insurance, you're going to have a real difficult time finding a dentist in Southern Illinois. How do I know this? I just got off the phone with someone from the Adolescent Health Center in Carbondale-- I'd been calling to try to get my son a dental appointment, and they had told me last week that some openings were going to be made available.

The only catch? Like all services for poorer folks, it was going to be a cattle call, scheduled promptly at 8:30 a.m. this morning. I started calling at 8:29, and actually got through. However, it was about 10 seconds before 8:30, so like a radio show call-in contest, I found myself at the end of a polite hang-up.

82 calls and almost exactly 30 minutes later (I counted, seriously) I got through again. All the appointments were taken, and my son wasn't going to be able to be seen after all. He's got a good smile right now, so I guess the message from all those "I-don't-take-IDPA-insurance" dentists around here is that a toothbrush and floss is good enough. According to the beleagered woman answering the phone, she had more than 125 calls on her voice mail when she walked in-- and the previous woman answering at 8:29 said she had received nearly 400 early calls since 8 a.m. Say what you will, but these numbers speak for themselves-- Southern Illinois is in need of dentists willing to serve Medicaid/IDPA recipients. After all, state-sponsored health care isn't much of a benefit if nobody accepts it!

As for me, I'm a bit too old for the Adolescent Health Center. They do their best, but still had to laugh when I told them that Doral Dental (the "handy" phone service Illinois uses to connect Medicaid recipients with participating physicians) had given me their phone number. They also gave me the phone number of five other dentists who also don't take IDPA for new patients, or at all!

On the other hand, I'm loving the fact that one office told me of their "emergency" openings for those of us with severe tooth pain-- from now, until I try the Tom Hanks-approved ice-skate to the face, I get to call their office each morning and hope someone cancelled.

Drop everything, family! Some better-insured person might practice a bit of that trickle-down economy!

I'm apparently not the only one who noticed. Check a University of Illinois study about availability of dentists in rural populations-- here's a quote:

"More dentists should be recruited to enroll in the Medicaid program. Efforts should be made to increase the number of children treated by currently enrolled dentists. This recommendation includes discussion of: adequate reimbursement rates; outreach to enroll new dentists in Medicaid; increasing participation levels of currently participating dentists."

"A low supply of dentists in rural areas affects the entire rural population, not only Medicaid enrolled children. For Medicaid, as well as uninsured, children, it exacerbates the existing barriers to care. There were 18 rural Illinois counties that had no dentists who participated in Medicaid. The rural region also has few dental specialists, especially pediatric dentists. Also, the rural region had a slightly higher proportion (27%; 178/648) of active dentists who were 55 19 years of age or older. National ADA data show that older dentists treat fewer patient visits per year. the slightly higher proportion of older rural dentists and their estimated lower productivity leads to even further competition among all potential patients for the dentists’ time. As these older dentists retire, and there are not enough new dentists to replace them (see #3 below), it will affect access for all people in their communities, especially those with Medicaid coverage or who are uninsured."

Carterville resident John Flora's "Create-a-Smile" Dental Foundation initiative is also doing great work, helping those who otherwise have no access or ability to afford dental care. CAS receives some of its funding from their thrift store at 115 N. Division St., in Carterville-- and one at 33 Circle in Zeigler. Here's a small portion of what CAS has managed to accomplish:

"1. Purchased a pair of dentures for a woman. 2. Paid for numerous cleanings, oral examinations, and x-rays at John A Logan Dental Hygiene School. 3. Obtained a Root Canal and restorative dental procedure for a 12 year old girl. 4. Help people by referring them to others that might help them. 5. Obtained charity cases for our applicants. 6. Done extensive outreach. 7. Attended various Health Fairs with dental poster and info as well as toothbrushes and toothpaste free to the people who come through the health fair."

You might even consider giving them a tax-deductible donation, eh? Sounds like money well-spent. Maybe you'll help this guy:

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Have to wonder how many of those people taking the appointments are actually middle class types trying to get health care on the cheap. I remember several years ago, a faculty member at SIU, who was well able to pay for it, wanted to get their dog neutered. Instead of going to a vet and paying full price, they opted to wait and get one of the limited number of subsidized ones the Jackson County Humane Society offers.
I sometimes go for a couple of years without a dental appointment being sure to floss and brush daily. The Gripit Floss Holder ( got me into the flossing habit because using it I don't have to put my fingers in my mouth. Flossing has made a world of difference in keeping my mouth healthy.
I had the same problem trying to get myself in to one of the call everymorning, but 5 minutes later all the appts. for that day were taken so call back tomorrow morning only to be told the same thing each morning. I was in agony with my wisdom teeth hurting, causing me earaches and headaches to accompony the toothache. There definitely needs to be more dentists, and more oral surgeons in Illinois who accept public aid. I was put on a waiting list last year in april, for an public aid oral surgeon. I was told, and was given paperwork that says the wait to see the oral surgeon was 3-6 months. O.K. I thought. At least I was on the list. I called in December,(8 months later) to see how soon I was going to be seen. I was told it was still going to be a long time because the oral surgeon was just now working on people whom have been on the list since November of 2007, and he hadn't even looked at my file. So my pain, agony, sleepless nights continued. I finally saved up enough money to get the ones pulled out that have been really hurting me at a regular oral surgeon. It was not cheap beings the only insurance I have is the medical card so I had to pay full price.
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