As finances fall, fewer know the drill

Some dentists are warning that, just as the recession has eroded the nation's job and stock markets, it's also causing another kind of decay.

With more families losing dental insurance or facing difficult choices about which costs are essential or expendable, dentists are reporting a sharp downturn in dental care as people decide to put off regular or even emergency visits.

The economic crisis is also exacerbating an already worrisome imbalance between the number of people with public insurance or no dental coverage and the dwindling number of dental clinics willing or able to treat those people, dental health advocates said. In a Chicago Dental Society poll of more than 300 dentists last fall, more than 60 percent said their patients are putting off cosmetic procedures because of the struggling economy. More than half said their patients were putting off dental work and more than 40 percent said that preventive visits were down.

"The economy is being reflected in offices; any (elective) care is being postponed," said Dr. Indru Punwani, head of pediatric dentistry at the University of Illinois at Chicago. "It's happening across the board, people asking, 'Can I delay it for a while?' These are people in the middle classes now."

Dr. Theodore Siegel of Big Smile Dental in Chicago said that he has never seen so many patients turning down their regular appointments in his 25 years of dentistry.

"There are so many now that say 'I just lost my job,' or 'my husband just lost his job, and I need to come in right now but I just can't,'" Siegel said. "It's really bad out there for a lot of people."

The slowdown has been severe enough in some quarters for dental offices to join the legion of workplaces forced to lay off employees, said Chicago Dental Society president Dr. David Kumamoto.

"Not only are people losing dental insurance, some dentists have to let staff go," Kumamoto said. "They're just not busy, it's a trickle-down effect everywhere."

While the waiting rooms at private dentist offices are emptier than usual, the small number of clinics that treat adults and children on public insurance -- or without any insurance at all -- find themselves overwhelmed by demand.

At Howard Area Community Center in Chicago's Rogers Park, where a single part-time dentist sees uninsured, pediatric and HIV patients, the wait for a non-emergency appointment has grown to five months for some patients.

"Our waiting list has never been like this," said Monica Dillon, a registered nurse at the clinic.

Efforts to add a second dentist and chair at the clinic to keep up with the need have also been thwarted by the economy, as grants and donations dry up, Dillon said.

Health advocates worry that care access is an issue for children on public insurance programs such as Medicaid or All Kids, who often face a long search to find a dentist able to accept them as patients.

"The need is tremendous and growing," Punwani said.

The Bridge to Healthy Smiles campaign, a coalition of dentists and advocates seeking improved access to dental care, estimated that there is one public dental clinic for every 8,400 children on public aid in Illinois.

Dominique Johnson, a 24-year-old single mother of two in Chicago's Bronzeville community, learned the effects of that shortage firsthand when she tried to find a dentist for her son, Jacob, who is in the All Kids program.

"It was very, very difficult. I got out the phone book and called 30 dentists, and none of them accepted Medicaid program," Johnson said. "You talk about frustrating; it was no after no after no."

Finally, by accidentally dialing a wrong number, Johnson found a dentist who would take her son _ after three months on a waiting list. Now, that dentist has had to stop taking on new public aid patients, Johnson said, leaving her relieved that she was able to get her children treatment in time.

"We hit the jackpot," Johnson said.

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