The Northwest’s ‘dental care divide’ is becoming a crisis

Nothing disrupts life more than a toothache. When a tooth hurts, no matter the cause, daily tasks can be nearly impossible. If you've never experienced tooth pain, you're in luck. For those of you with this condition, you know who you need to see first: the dentist. However, for many, this option is out of reach. As dental care becomes a luxury that few can afford without dental insurance (or even with insurance in some cases), we must take action to increase access to important dental services.

An estimated 68.5 million Americans do not have dental insurance. The whys and wherefores are complex, but the result is a huge gap in our healthcare system. The bottom line is that coverage for conditions that affect your health “from the neck up”—from dental to vision to mental health care—can be expensive and difficult to obtain because these services are often considered separate from other physical health conditions.” separate” . (Medicaid does not guarantee you will get the type of care you need when you need it, especially because coverage varies widely from state to state.)

As a result, we face a “severe” health crisis in the United States that disproportionately affects low-income individuals and other marginalized populations. Not surprisingly, there is a growing dental divide between those who are lucky enough to keep their teeth and those whose only option is to have them extracted, with little hope of undergoing the specialized care of expensive root canals, dental implants or dentures. Additionally, modern, accountable health care requires that we see, acknowledge, and address the connections between dental health and other physical and mental health conditions.

Dental Care Quick Facts

· Number of Americans without dental insurance: 68.5 million

· Washington adults without dental insurance: 477,000

· Washington residents covered by Medicaid (March 2024): 2.3 million

· Client medical teams served in the U.S. in 2023: 12,155

· Number of medical team clinics in 2023: 919

· Cost of a full mobile one-day clinic providing care and connectivity services: $5,000

As a dental provider in the Pacific Northwest, International Medical Team sees this situation all the time. Since 1989, we've been providing free, emergency dental care to adults in need in Washington and Oregon who would otherwise not have access to dental care. We're seeing thousands of people now, but there are thousands more, even those who are employed, who still need dental care.

Through our Care & Connect mobile health program, we provide emergency dental care as well as basic health screenings and referrals to help people access primary care. In the United States, we treat patients year-round through mobile clinics deployed in areas of need served by community partners and local healthcare providers. Our clinic is staffed primarily by volunteer dentists, dental assistants and nurses, and it is powerful to see how people change through compassionate, professional care.

For many of the patients we see, our clinic is the only interaction they have had (or ever had) with a medical or dental professional in years (or ever). We are encountering more and more people trapped by the gaps in the system and often suffering from unresolved chronic conditions. As mentioned before, dental problems are often associated with more serious health complications, such as high blood pressure or diabetes, that may be asymptomatic.

Our goal is to remove barriers to health and dental care and get to where we are needed most. The patients we see include people of color, immigrants and refugees, the homeless, and those who are uninsured, underinsured, or face other challenges. We screen patients for other conditions and help them get necessary health care when needed, preventing them from relying on hospital emergency rooms, which are not equipped to provide dental services.

Tooth extractions are the most common service provided by dentists at our clinic. Removing a problematic tooth is the most effective way to relieve pain and eliminate harmful infections from the body. However, the result is that patients are missing teeth, affecting their self-image and ability to chew – often not enough teeth can be saved.

Root canals are common for people with insurance, but for those without insurance, forgoing the procedure could mean spreading infection to surrounding tissue, tooth loss, or other more serious medical conditions.

When possible, the medical team offers Washington's only free root canal treatment clinic, run by Dr. Syed Bashar. Bashar understands the difficulties his patients face at these free clinics because he immigrated to the United States from Pakistan with his family and few resources. His clinic in Pakistan is similar to the one he works at at the Medical Corps' Puyallup site – a chair.

“Yes, things are not always ideal, but it challenges me as a clinician to do my job to the standard of care that patients deserve, and that's key,” Bashar said.

Daniela Aquino is a recent patient at Bashar Clinic. She endured months of pain but could not afford the full cost of a root canal. Although she works in a local restaurant, she can barely make ends meet every month, let alone bear such expenses. Bashar was able to complete the surgery and keep her teeth intact, keeping her healthy and preventing her from missing work.

“I'm so grateful for this service and that I don't have to waste days asking for help,” Aquino said.

Root canal treatment is a lengthy process, so Dr. Bashar can only serve about four patients per clinic. Still, it makes an incredible difference to those who undergo treatment. These root canal clinics are made possible through funding from the MultiCare Health System.

“Oral health has a direct impact on a person’s overall well-being and quality of life, yet access to oral health resources remains a challenge for many local residents,” explained Marce Edwards Olson, vice president and chief marketing and communications officer. “Working with medical teams to offer monthly root canal clinics is one way we can make a real and direct impact on our neighbors who might not otherwise receive care.”

I firmly believe that dental care is closely tied to our sense of dignity. It respects one of the most important parts of the human body – our smile.

“Systemic change is long overdue, and while the wheels of change are turning, many in our community are suffering,” said Chanda Moellenberg, director of the Care and Connect program's medical team. “If more health systems think broadly about population health and shift resources to facilities that specialize in treating vulnerable populations, we could see dramatic changes that will create a healthier community and nation for all.”

For the clinic calendar, visit:

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