As Providence Sacred Heart Medical Center’s emergency room director, Dan Getz regularly sees patients with tooth infections.
Many share a common thread: Someone with a cavity doesn’t have dental insurance or can’t find a dentist who’s willing to accept Medicaid, so they delay treatment until the tooth is infected, causing them incredible pain and sometimes spreading to the jaw or other parts of the body.
“Frequently it’s that they don’t have the money to seek the dental care,” Getz said.
A new partnership between Providence and the Community Health Association of Spokane is hoping to change that by opening two dental clinics staffed by dental residents who serve low-income patients.
Delta Dental of Washington, the state’s main dental insurance provider, is contributing $1.6 million toward capital costs, and its foundation, the Arcora Foundation, will contribute an additional $400,000. That funding will be matched with $2 million from the state.
One six-chair clinic will sit on the Sacred Heart campus and treat patients with complex dental needs in partnership with other hospital departments. That could mean extracting an infected tooth before a patient is scheduled for an unrelated surgery, or giving better options to patients who show up at the emergency room.
“Rather than giving them antibiotics or pain meds and sending them on their way, the goal is to treat the patient in the emergency department,” said Siobhan Dehaney, a business development consultant for Providence who is working on the dental clinic project.
A second, 20-chair clinic, operated by CHAS, will be located in north Spokane by Providence Holy Family Hospital and provide routine and preventive care, including cleanings and fillings. It will join six existing CHAS clinics across the region that provide dental care.
“Right now, unfortunately, we are at capacity for dental services,” said Kelly Halverson, CHAS’ vice president of administrative services. That means new patients often face long waits for appointments.
Dental health has historically been separated from other areas of medical care, and reimbursement rates for dentists taking Medicaid are so low that patients often struggle to find a provider or schedule an appointment. In 2016, only 22 percent of adults with Medicaid saw a dentist, Halverson said.
Oral disease is almost “100 percent preventable,” said Diane Oakes, president and CEO of the Arcora Foundation, which works to expand access to dental care among underserved people in Washington. But cost and access barriers mean many people wait until it’s too late and end up with serious medical problems down the line.
CHAS, which offers sliding scale treatment and cares for a large number of Medicaid patients, has been a leader in integrating the two by offering dental services alongside medical care. The opportunity to open a new clinic came as the health organization is working to expand dental access in Spokane.
“There really is a lot of effort to look at the whole person,” Oakes said. “Oral health is part of overall health.”
Unlike doctors, dentists are not required to complete a residency to practice. But many choose to because it allows them to work on more complex dental cases and partner with other providers. The Providence residency will host six dentists for a one-year general practice residency.
CHAS will hire an additional seven or eight dentists to help run the north clinic and provide training to residents.
The Sacred Heart dental clinic should open by the end of the year, Dehaney said, with the North Side clinic following sometime in 2019.
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