The extensive dental work that Robert Brown is having done in the coming weeks will change his life.
“I could be able to actually smile again,” Brown said. “I don’t smile much. Everybody wonders why. My smile is a closed smile.”
Brown, who makes $9.50 an hour working on a loading dock at a retail store, and who doesn’t get 40 hours a week, has four broken teeth that need to be removed.
“I laugh and put my hand over my mouth,” he said. “It’s just an automatic thing.”
The dental work will be done by the Ascension Seton Mobile Dental Clinic at Outreach Community Health Centers.
Brown, who has not seen a dentist in six years, is among the first dental patients at Outreach Community Health Centers’ new dental clinic.
The community health center — one of four in Milwaukee — has contracted with Ascension Wisconsin to have a dental hygienist see patients from 9 a.m. to 3 p.m. on Wednesdays and Thursdays at its main clinic at 210 W. Capitol Drive.
And in the coming months, while many schools are closed, Ascension Wisconsin’s mobile dental clinic will be at Outreach one day a week. The mobile dental clinic is staffed by a dentist who can do fillings and other restorative work.
“It’s a blessing — it’s a long time coming,” said Rodney Ivy, director of clinic and provider relations for Outreach Community Health Centers.
Brown learned of Outreach’s new dental program during a basic checkup.
The physician warned Brown that his dental problems could affect his health and gave him a referral. The community health center then contacted him to set up an appointment with a dental hygienist.
Brown does not have health insurance, but Outreach and the other community health centers provide care to uninsured patients on a sliding fee scale tied to their income.
The dental hygienist told him that he needed to have the broken teeth removed. That and other restorative work will be done over several visits to Ascension Wisconsin’s mobile dental clinic.
It is care that Brown otherwise would be unable to afford.
“It costs thousands of dollars,” he said. “I don’t have thousands of dollars.”
His dental problems were not painful but were worrisome and annoying.
“I would be scared to bite down on certain areas of my mouth,” Brown said.
The dental hygienist who will work at Outreach will be able to provide basic preventive care — such as screenings, cleanings, sealants and fluoride treatments — to about 20 people a week. It works out to about 1,000 patients a year. And Outreach’s new service, which began last month, is another small step toward improving access to dental care.
That has been a longstanding problem for people who are covered by Medicaid programs, such as BadgerCare Plus, or who are uninsured.
Most dentists don’t accept or limit the number of patients covered by Medicaid programs because the state’s reimbursement costs don’t cover their costs. For adults, the rates paid by the state are one-third to one-half — or less — of the rates that commercial insurance pay.
Dental care accounts for about 1{20335960d828ac45ef5fde98a5aa7f4c1fb21de0715bafc997f46433d5bf3454} of the state budget for health programs.
In 2019, Gov. Tony Evers proposed a roughly 20{20335960d828ac45ef5fde98a5aa7f4c1fb21de0715bafc997f46433d5bf3454} increase in what the state spends on dental care for children and adults — the first significant increase in spending on dental care in more than 15 years — but the proposal was rejected by the Legislature.
Access is even more limited for people who are uninsured.
Statewide, 28,498 people — an average of 548 a week — last year went to hospital emergency departments because of dental pain, according to the Wisconsin Hospital Association.
And based on the 2018 Milwaukee County Community Health Needs Assessment, roughly one in seven households — the number of adults and children would be larger — had insufficient access to dental care, according to Ascension Wisconsin.
Progressive Community Health Centers and Milwaukee Health Services have long employed dentists and provided dental care. Children’s Wisconsin also has several dental clinics for children covered by BadgerCare Plus.
Free clinics, including Ascension Seton Dental Clinic, also have tried to fill the gap in access to dental care.
The Waukesha County Community Dental Clinic — partially supported by donations, including from ProHealth Care — has clinics in Waukesha and Menomonee Falls. The clinic in Menomonee Falls was made possible by a $1.65 million gift from Froedtert Health. And Lake Area Free Clinic in Oconomowoc opened a dental clinic in 2017.
When Lake Area Free Clinic opened its clinic, it almost immediately began seeing more patients seeking dental care than medical care.
Ascension Wisconsin also has dental hygienists two days a week at its Ascension St. Ben’s Clinic and Ascension Angel of Hope Clinic. And Sixteenth Street Community Health Centers began employing dental hygienists when a change in state law in 2017 allowed then to work without the supervision of a dentist.
Outreach, which provided care to 8,685 people in 2018, has hopes of expanding its dental services in the future.
But it already is making a difference in people’s lives.
“I am very careful of how I talk and how I interact with people just because of this,” Brown said. “So, for me to get all this done, it would boost my confidence in a lot of stuff I want to do.”