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A Toll of Poverty and Neglect in Kentucky's Teeth |
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From New York Times: Dr. Smith, who runs a free dental clinic at a high school in one of Kentucky’s poorest counties, has a rare window on a state with the highest proportion of adults under 65 without teeth, where about half the population does not have dental insurance. He struggles to counter the effects of the drastic shortage of dentists in rural areas and oral hygiene habits that have been slow to change. Kentucky is among the worst states nationally in the proportion of low-income residents served by free or subsidized dental clinics, and less than a fourth of the state's dentists regularly take Medicaid, according to 2005 federal data. The state dental director, Dr. Julie Watts McKee, said that last year, Medicaid reimbursement for children's dental services was raised by about 30 percent. But even with this increase, which was paid for by cutting orthodontic benefits, reimbursement fees remain about 50 percent below market rate, said Dr. Ken Rich, the state's dental director for Medicaid. He sells a pair of dentures for $400 that many dentists sell for more than $1,200. "Bootleggers exist here for a reason," Mr. Anderson said. While Kentucky may have some of the worse oral health problems in the nation, it is by no means alone. Residents in neighboring states across the region suffer similar dental problems for many of the same reasons --- inadequate access to dental care or the inability to pay for a dentist, widespread use of chewing tobacco and a pervasive assumption that losing teeth is simply part of growing old. West Virginia, for example, which has the highest proportion of people over 65 without teeth, also has one of the lowest percentages of adults who visit the dentist at least once a year.
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