Dental care has been called Ohio's greatest unmet health need. Many low income people rely on Medicaid to pay for visits to the dentist.
Now some Ohio dentists are starting to turn them away, and say the problem will get worse, unless state lawmakers step up.
For two decades, the Franklinton Dental Group has cared for west side patients...most of whom are on Medicaid. This busy practice, headed by Dr. Jeff Wilden, serves 20,000 people of all ages. Theresa Lucas brings her family here, and comes herself. She can't imagine going without dental care.
"You probably wouldn't be able to get a job because that's the whole...the best thing you've got is your smile," she said.
She's right, the Kaiser Commission on Medicaid and the Uninsured, found that adults who lost dental coverage in Massachusetts had a harder time finding jobs because of missing teeth and poor appearance.
Theresa and almost three million Ohioans like her on Medicaid may have a harder time smiling, unless the state provides more money for dentists. Fifteen years ago, the state decided to reimburse dentists 40 percent of standard fees. Since then, prices have risen to for rent, salaries, materials, lab fees, and equipment. But reimbursement has not.
"A lot of the dentists who have taken Medicaid in the past are either dropping the program altogether, or limiting the treatment that they're doing, " said Dr. K.C. Warden.
He's a dentist who works with Dr. Wilden while starting his own practice in Westerville. Dr. Warden graduated from the OSU College of Dentistry three years ago, and also must pay back a loan on his tuition.
"The number is pretty astronomical. In fact, I chose a 25-year repayment plan, so it's very similar to a mortgage for a house," he said.
He knows of other young dentists who can't afford to take on Medicaid patients. That affects kids as well as adults. Nationwide Children's Hospital handles more than 36-thousand dental visits per year. These are kids on Medicaid who come to the hospital for care because they can't find dentists to help them.
"We are at a crisis level with regard to the Medicaid dental program," said David Owsiany, the executive director of the Ohio Dental Association. " Dentists can't even cover their overhead when they're treating Medicaid patients. Sometimes you'll find Medicaid patients who have to travel into another county to find a dentist."
He added, "We find that dentists who have been providing care for decades are now having to close their doors."
Dr. Wilden said Ohio's comprehensive dental care program does more than just fill teeth...it also saves taxpayers money. Without dentists, he said more people would wind up in hospital emergency departments for help. And there, doctors may use expensive tests to rule out other issues before sending patients home with antibiotics and pain killers. He said local hospitals already refer such patients to his practice.
"I had several patients this morning that came directly from the hospital and they got extractions done today," Dr. Warden stated.
Owsiany said the Governor has offered a one percent boost in reimbursement to dentists. But while that's a start, he said dentists need more just to pay their bills. He has been in talks with two state lawmakers to see if the Legislature can be persuaded to help.
A spokesman for the state Medicaid program says Ohio is one of only 10 or 11 states that provide money for dental care.