San Francisco Chronicle, May 20, 2008: State budget to chop dental benefits for poor

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Elizabeth Fernandez, Chronicle Staff Writer

Tuesday, May 20, 2008

Last June 29, in proclaiming Dental Awareness Day, Gov. Arnold Schwarzenegger praised the virtues of brushing, flossing and regular checkups.

Now, to the dismay of many patients and health care advocates, the governor’s budget seeks to eliminate most dental benefits for nearly 3 million poor, disabled and elderly people in California who rely on state-paid dental insurance.

“I’m not ready for a liquid diet just yet,” said Barbara Sloan, 64, an Oakland resident who relies on Denti-Cal for her annual checkup and cleaning. “My teeth and my dentures are important to me. Without my dental coverage, I would be lost.”

A new report released Monday, which analyzed the impact of eliminating most Medi-Cal dental benefits for adults – those living in nursing facilities are exempt – concludes that the budget proposal would cost the state $115 million in matching federal funds and cause far more expensive medical treatment. Overtaxed emergency rooms would become more crowded, and health issues for countless people would spiral.

The report, commissioned by the Dental Health Foundation and the California Primary Care Association, said children as well as adults would be hurt by the cutback because children are far more likely to receive preventive dental care when their parents regularly see a dentist, and that would be lost. In addition, periodontal disease in women has been associated with low-birth- weight babies.

Maryland and Massachusetts similarly eliminated dental coverage to the poor and saw a huge upsurge in people seeking help in emergency rooms, said Dana Hughes, co-author of the report.

In California, “the consequences of this reduction in coverage will have ripple effects, not only on the affected individuals and their families and communities, but also on Medi-Cal and the overall health care system,” according to her report.

At a news conference Monday in Oakland at La Clinica de La Raza, which last year had more than 48,000 dental visits, numerous patients and health care advocates called the budget proposal shortsighted, illogical and fiscally foolish.

Oral health is crucial to overall health, said speaker after speaker. Dental disease has been linked to numerous illness, including diabetes and heart disease.

“How can I have good health when I have bad teeth?” said Wai Ying Kwan, 65, an Oakland resident and patient at Asian Health Services who suffers from difficulties with digestion. She said she needs to have some teeth extracted but can’t afford to pay for dentures.

Coming on top of planned 10 percent cuts to Medi-Cal providers, eliminating dental coverage “will have a crippling effect,” said Carmela Castellano-Garcia, chief executive of the California Primary Care Association, which represents 700 community clinics and health centers. “Clinics up and down the state will have to face the very real prospect of closing dental services,” she said.

Denti-Cal coverage includes diagnostic and preventive dental treatment; services include fillings, root canals and tooth extractions.

“These patients represent our parents and grandparents,” said Dr. Ariane Terlet, the medical director of La Clinica. “We are talking about dentures, not cosmetic treatments. We are talking about basically being able to chew your food.”

E-mail Elizabeth Fernandez at

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