Heather Richard has a toothache so bad she says she’s been “eating Orajel.”
And when the over-the-counter anesthetic gel doesn’t work, the 24-year-old takes ibuprofen to cope with the pain. But these measures barely took the edge off, the Keene resident said. She couldn’t put pressure on the tooth and chewing on that side was out of the question, she said.
“I’d rather give birth than have this,” she said.
Being on Medicaid, Richard has few options to get her toothache fixed — her health insurance doesn’t cover fillings, cleanings or root canals. And Richard, who receives Social Security disability benefits, said she can’t afford to pay for these services out-of-pocket. Though Medicaid in New Hampshire covers dental care for children, adult dental benefits are limited to emergency services.
“Insurance doesn’t cover anything,” Richard said. “Medicaid only covers extractions, and that’s one less tooth I have when I’m trying not to get dentures ’cause they don’t cover dentures either.”
On Friday, Richard hoped to stave off another extraction. Raynor Dental, a practice with offices in Keene and Peterborough, held its annual free dental day, and Richard was one of 121 patients who received free care between the two locations. This is the second year Raynor Dental offered free dental services — fillings, cleanings, X-rays or extractions — to adults who don’t have dental insurance.
Richard arrived at the Keene clinic around the time it opened for the day, 8 a.m. By the afternoon, the line of people seeking care had stretched beyond the clinic and into the hallway. Richard continued to wait. According to spokesman Oliver Strube, no one was turned away, though some — fewer than five — had to leave before they were seen because they couldn’t wait any longer.
Among those who waited was Hillsborough resident Donna Lewis, who brought Kayla Grant, 25, to have a filling done.
Grant does not have health insurance and hasn’t received dental care in a few years. A few months back, she visited Aspen Dental in Keene for free dental X-rays. The dentist there told her she needed several fillings, which she cannot afford. She gets periodic dental cleanings from her cousin, who is a dental hygienist in Massachusetts, she said, but as a worker in the produce department at a grocery store, Grant said she cannot cover the cost of fillings.
Lewis, who said Grant lives with her and her husband, wants to help pay for the fillings, but cannot afford to.
“We would help her as much as we could. (But it’s) beyond us to be able to pay for having another four fillings. But if she had something come up and it was an emergency, we would help her as best we could,” she said.
There is no data on the number of adults without dental insurance in Cheshire County, but a 2016 community assessment by Cheshire Medical Center sheds some light on what that number could be. According to the assessment, from 2006 to 2010, about a quarter of the people reached who were over age 18 said they had not had a recent dental exam. During that same period, 16 percent of adults in the county said they had poor dental health.
Cost is the biggest barrier for those seeking dental care nationwide, according to a 2014 American Dental Association research brief.
The price of dental procedures certainly deterred Richard, she said. A dental cleaning for adults without insurance costs anywhere from $89 to $147, according to N.H. Health Cost, a database by the N.H. Insurance Department and University of New Hampshire. The cheapest fillings run $141 to $284, according to the website. The database does not specify the price of a root canal, but Richard said she once received a $2,500 estimate for the procedure, which she could not afford. Instead, she opted for a much cheaper extraction.
Cost also deterred Jeremy Kelleher, 29, from getting a front tooth fixed. The Chesterfield resident said it’s been years since he saw a dentist, even for a cleaning. He used to have dental insurance, he said, but as an hourly worker, taking time off from his job as an automotive technician would mean he wouldn’t get paid for the hours he missed. Kelleher, who now works for himself, said he came to the free dental day to have his front tooth repaired. He chipped the tooth when he was a child. A temporary filling on the tooth had fallen off, but Kelleher said he had no time or money to repair it.
The repercussions of poor dental health extend beyond cosmetics or momentary pain, said Gail T. Brown, director of the Concord-based N.H. Oral Health Coalition. Lack of dental care can affect a person’s ability to find work, she said.
“This is not about cosmetics (or) aesthetics, this is about people being able to be employed, and it limits where people can be employed for a couple of reasons. One is: Do they look suitable for your front desk or for serving food?” she said.
She said young adults are at risk for not having their dental needs met either because their job does not offer dental coverage, or they cannot afford to pay the premiums. Often, she said, people who do not have dental insurance may end up going to the emergency room with dental pain, where they might receive painkillers and antibiotics. But if the underlying cause — tooth decay — is not addressed, the same people may churn in and out of the emergency department.
Many of the people who received care Friday were younger adults, ranging in ages from 20 to 35, according to Strube. She said that, on the whole, providers focused on the patients’ most urgent need, referring them to clinics that work with uninsured people for follow-ups as needed. Brown said that about 20 health clinics in New Hampshire specialize in serving uninsured adults. In Keene, Dental Health Works on Island Street serves people who don’t have dental insurance.
More than 60 percent of the patients seen Friday — or 75 — needed an extraction or a filling because of tooth decay, Strube said.
Dr. Stephanie Raynor, who co-owns Raynor Dental with her husband, Dr. Jason Raynor, and who was among the professionals providing care Friday, said that while the free dental day is not a substitute for regular dental care, it’s a good opportunity to connect people with resources and to help them see the value in preventive care.
“If you’re going to wait, (a cavity) is going to turn into a root canal and a crown, which is three times more,” she said. “There’s always more that follows.”
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