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Medicaid dental care at the nursing home

August 20, 2012
by Kathleen Mears
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I have always had very good teeth and few cavities. But my dentist warned when I moved to a nursing home I would have to be strident about my dental care or my teeth could rot out of my head. So, I asked the aides to brush my teeth thoroughly, and for the most part they did. 

When I saw the facility’s visiting dentist, he said I had several cavities that needed to be filled. That alarmed me so I saw my old dentist to get another opinion. He found the “supposed cavities” were spots on my teeth he had been watching for years. He said a new dentist could fill them prophylactically. My dentist suggested since I was private pay I should see a dentist closer to the facility where I would get better dental care. This worked out well for several years.

When I was eligible for Medicaid, the closest Medicaid dentist was 20 miles away. At first my treatment there seemed good enough. But it varied depending on which dentist I had. But several attacks of tooth sensitivity sent me to appointments where my teeth were X-rayed but no treatment was suggested.  Reluctantly, I wrote a complaint letter to the dentist. 

When I called to make my next dental appointment, I learned that dentist was no longer seeing Medicaid patients. I was disheartened when I was referred to a Medicaid dentist 30 miles away, and asked the activity director if she could help.  She got me an appointment with a Medicaid dentist eight miles away.

I saw that dentist for several years. My teeth seemed to be fine with the yearly cleaning paid for by Medicaid. But due to aging, my gums were receding and I needed sensitive spots externally bonded. Even though Medicaid paid  I was surprised it had to be redone so frequently. 

I also had a tooth fracture and had to get a crown. Luckily, it was not visible. But for someone like me who had never had any serious dental work, I was experiencing quite a bit after age 55. 

When I moved to this facility, I went to a dental business that accepts Medicaid patients. I was pleased I could get my teeth X-rayed, cleaned, and, if necessary, a tooth filled during one appointment. The care seems to be good and I hope it will remain that way. 

In a little over a year I have had my first root canal, due to another tooth fracture, and a porcelain crown (which I paid for myself). It is difficult for me to compare dental care between Medicaid providers, because my teeth need more attention. 

I know flossing daily would help. So I am researching the new tooth flossers on the market. One may allow me to have healthier teeth without using much more of an aide’s time.  

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Comments

A topic near and dear to my heart! Unfortunately, reimbursement for dental services through Medicaid is poor in our state, making it challenging to find dentists who accept Medicaid. This is further complicated by the fact that it is very difficult for some residents to travel, and not all dental offices are equipped to provide care to a wheelchair-bound patient. We are fortunate to have recently found a dental program that will send a dentist to our facility.

It's also a continuing challenge to make both staff and residents appreciate the importance of good daily oral care.

Tooth aches always seem to happen at 4:58pm on Fridays. Of course, good teeth make it easier to eat, and a healthy smile is important for self-esteem too. I hate to see residents in pain so I do what I can to advocate for good daily oral care and regular check-ups twice annually.

Kathleen Mears

www.ltlmagazine.com/blog/kathleen-mears

Kathleen Mears has been a nursing home resident in Ohio for 20 years. She is an incomplete...