Dental care the political "underdog"

Take it from dentist Marty Lieberman. Putting an aspirin tablet on your throbbing gums won't kill the pain — it will make it worse by burning your mouth.

Yet he sees it all the time: desperate people trying desperate things, because they can't afford regular trips to the dentist. Lieberman has seen patients scrounge for leftover prescription pain pills or take old antibiotics from their relatives. And he's seen people take pliers to themselves to try to stop their torment.

"If you wait until it hurts that bad, then it's usually too late," said Lieberman, dental director for Puget Sound Neighborhood Health Centers in Seattle.

His five dental clinics and several dozen other community dental clinics in the region try to help. But like their clients, most are strapped for cash. So this year, they're going to Olympia to ask the Legislature for a one-time, $10 million handout to add dental chairs, shorten lines and stop minor dental problems from becoming critical.

Lawmakers seem sympathetic, but it could be a tough sell during a short session marked by a Legislature and governor both intent on reining in spending.

Dental care "is the underdog," laments Rebecca Kavoussi, public-policy director for Community Health Network of Washington. "It's not sexy."

More than twice as many Americans lack dental coverage as lack medical coverage. The last time King County checked in 2001, 27 percent of adults, or 382,000 people, did not have dental insurance.

And subsidized dental care is particularly scarce for adults. Only one clinic run by Public Health — Seattle & King County provides dental care to all adults. The rest only treat children and those over 60.

That leaves the bulk of care for the poor to Community Health Network's 56 dental clinics and about 80 medical clinics across the state, including Lieberman's clinics, which run in part on federal grants and must take all patients regardless of income.

But needy mouths outnumber dental chairs. At Puget Sound Neighborhood Health's clinic on Beacon Hill, people are already waiting when the doors open at 6:45 a.m.

Patients pay a flat rate based on what they can afford, whether they get five cavities filled or a single tooth pulled. Patient fees bring in just 7 percent of the overall revenue for Community Health Network clinics, Kavoussi said. The rest comes from Medicaid, Medicare, local and federal grants and some private insurance.

If the state were to cough up the $10 million, Kavoussi said, Community Health Network could add 100 dental chairs statewide to bring its total to 431. That would allow 175,000 more dental visits every year.

Lieberman argues that people shouldn't view oral health as secondary to other health issues. He points out that dental crises can strike even those who diligently brush and floss.

Several years ago, one of the fillings in Lieberman's own mouth turned bad. The pain was so excruciating that Lieberman said he briefly considered giving himself a shot of novocaine. Instead, he waited for a colleague to perform an emergency root canal.

The experience helps him relate to what many of his low-income patients are going through.

"You can't function if you are in pain," he said. "But there is just nowhere for these people to go."

Kyung Song: 206-464-2423