- Nearly half of New York’s 62 counties struggle with full or partial dental care shortages.
- Rural communities on average have four dentists per 10,000 people, while metro areas have nine dentists per 10,000.
- Growing dental care deserts, gaps in dental insurance contribute to millions of Americans who have suffered minor oral infections that festered and turned into life-threatening ordeals.
Thousands of dental patients across the Lower Hudson Valley suffer excruciating pain needlessly as they wait up to two years for specialized care.
These include 15,000 patients who have intellectual and developmental disabilities and struggle to allow a dentist to look inside their mouths, requiring anesthesia for many visits. Some are unable to verbalize their dental pain to relatives or caregivers.
Most of them get dental care through Medicaid, which contributes to their lengthy waits for care. Only one-third of dentists across New York accept Medicaid, the state and federal taxpayer-supported insurance plan.
These patients are also far more likely than the general population in Westchester, Rockland and Putnam counties to end up in an emergency room for an untreated dental problem — increasing societal costs and their risk of suffering other serious health complications linked to oral infections, said Dr. Ronnie Myers, dean of Touro College of Dental Medicine in Valhalla.
In many ways, these patients with disabilities embody the broken dental care system in New York, and the nation. It’s a system that leaves millions of poor, low-income and elderly patients languishing on waitlists, while dentists and dental schools push for more state and federal resources to plug the gaps in care.
“Access to oral health care can be difficult for many,” Myers said, “and that can range anywhere from affordability to actually gaining access to dental health care providers.”
Few New York dentists accept new patients or Medicaid
Alexis Thrash spent months desperately calling dentists across upstate New York trying to book a visit, while searing pain gripped her body any time something hot or cold touched her jaw.
But each phone call derailed when she asked dentists’ offices the same two questions: Do you take Medicaid? Are you accepting new patients?
She quickly learned of the striking choice facing New Yorkers in dental care deserts: Either you live with pain for months — or years — while waiting for a dental visit, or you get the offending tooth — or teeth — pulled at an emergency dental clinic.
“Those are pretty terrible options when you’re talking about something so important,” Thrash recalled, “so I just left my bad teeth in my mouth until I was able to get into a dentist.”
Put differently, Thrash, 27, of Greece, near Rochester, couldn’t afford to pay thousands of dollars out-of-pocket for dental care, so she waited and suffered — while increasing the odds that an oral infection would trigger other serious health issues, including heart disease.
In the end, Thrash waited 18 months for a dental visit, which she secured through an Eastman Institute for Oral Health program for pregnant women. She has since had 10 dental treatments, which filled cavities and fixed broken or exposed wisdom teeth. She delivered twin boys in September.
New York’s dental crisis has thousands waiting for care
Like Thrash, thousands of patients have spent months suffering on the growing wait list at Eastman Institute for Oral Health in Rochester, underscoring New York’s growing dental care crisis.
Dr. Eli Eliav, director of the institute’s care network and school, could barely walk through its overcrowded dental office waiting areas one morning earlier this fall. At the time, its wait list included about 30,000 additional patients from across the state seeking dental care.
“Parents are calling crying and asking for help,” Eliav said, referring to kids on the wait list.
The dental institute, which is part of UR Medicine, takes patients from dozens of counties across the state due to growing dental care deserts and gaps in dental insurance. Eliav said these challenges have contributed to millions of Americans suffering minor oral infections that have festered and turned into life-threatening ordeals.
Nearly half of New York’s 62 counties struggle with full or partial dental care shortages, according to the Rural Health Information Hub. Rural communities on average have four dentists per 10,000 people, while metro areas have nine dentists per 10,000.
“We really feel helpless,” Eliav said. “We don’t know how to help all the patients.”
More than 10K New York children wait for dental care
The stakes, in some ways, become clearer through the lens of the Eastman Institute’s waiting list statistics obtained by USA TODAY Network. They include:
- About 19,000 adults from 56 counties were on the dental care waiting list at one point last month.
- More than 10,100 children from 40 counties were waiting for care, while about 840 adults with intellectual and developmental disabilities that require specialized care were on the wait list.
- New Yorkers are waiting a year to 18 months for routine dental exams through the institute, which is one of the few networks taking Medicaid-covered dental patients. Waits for advanced dental care requiring anesthesia through the institute can stretch even longer.
What New York is doing about dental crisis
At Touro dental college, Myers has plans to open a new center for treating patients with intellectual and developmental disabilities, which would also help train more dentists to care for the more than 128,000 New Yorkers statewide with these specialized dental care needs.
Fundraising has begun for the center, which Touro aims to open within 18 months at a cost of up to $5 million. It would be located inside Touro’s current space on the New York Medical College campus in Hawthorne, Myers said, adding it would build upon a state taxpayer-supported fellowship program at Touro that seeks to reduce oral health disparities.
State lawmakers this year also pushed legislation seeking to boost the ranks of dentists and remove barriers to dental care. The bills included dental school loan forgiveness for dentists working in underserved areas, insurance transparency upgrades and expanding services that can be performed by hygienists.
But the legislation, as well as efforts to increase the Medicaid reimbursement rate for dental care, stalled as lawmakers prioritized addressing other flaws within the health care system, including approving billions of dollars for supporting hospitals and nursing homes.
Dental care advocacy groups are expected to renew their lobbying effort this year, aiming to spotlight, in part, the fact Medicaid rates for dental care have been stagnant since 2012. By contrast, health care’s Medicaid funding increased repeatedly over that span.
“Dentistry is not on the top of the food chain, and we need to work on it,” Eliav said, noting Medicaid funding today falls about $50 short of the cost of providing care at an ordinary dental visit.
About one-third of dentists in New York serve Medicaid patients, leaving millions of poor and low-income New Yorkers struggling to find dental care, a Center for Health Workforce study found.
At the same time, millions of older New Yorkers have poor access to dental care due, in part, to the fact Medicare lacks a dental benefit.
Nationally, more than half of adults don’t have consistent access to dental care.
Why isn’t dental coverage added to Medicare?
The push to add dental coverage to Medicare and address other barriers to dental care has gained little traction from political leaders across the country. Debate has instead focused on other health issues like abortion and nursing home failures.
Meanwhile, ongoing efforts to fill gaps in New York’s dental care system have offered little relief to many patients. While Eastman Institute and some other networks used urgent dental clinics to help curb emergency room visits, many patients needed anesthesia that was unavailable at dental urgent care centers.
Addressing the dental system failures that impacted so many, Eliav said: “It’s about time we got into a position where we really need to do something.”
Ken Alltucker of USA TODAY and Nancy Cutler of USA TODAY Network contributed reporting
David Robinson is a veteran health reporter for the USA TODAY Network’s New York State Team. Reach him at [email protected].
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