Pros and cons: Free dental care in exchange for community service

August 2, 2017

The majority of low-income Michigan residents and dentists who participated in a program that provided free dental care in exchange for volunteer work said they liked it, and most patients felt their oral health had improved.

The Care Free Pay It Forward program served Ingham County and surrounding areas from January 2014 to October 2015, and offered adult participants $25 in dental services for every hour of volunteer work, said Lorene Kline, who surveyed and providers as part of her master's thesis for the University of Michigan School of Dentistry.

Pay It Forward was a partnership between Care Free Medical and Dental, a nonprofit providing free medical services to low-income residents, and the Central District Dental Society of Michigan.

Roughly 80 percent of the 27 patients who responded to the survey (38 participated in PIF) said they liked the program and would recommend it. About 12 percent of respondents said volunteering was tough to juggle with family and work.

"That made us question whether it's a good model for working adults who have families and children," said Kline, a clinical lecturer at the U-M School of Dentistry. "It's probably more difficult for them to find the time to dedicate to community service."

Kline stressed that the program is just one tool among many to help meet the large, unmet need for low-cost or free dental care, but it's not panacea.

The eligibility requirements were fairly narrow. Pay It Forward was specifically geared toward low-income adults who fell below 250 percent of the poverty level and didn't qualify for Medicaid.

Once eligible, patients took a one-hour education class and donated four hours of volunteer work, choosing from a list of 80 nonprofits. The first hours covered the initial exam, x-rays and a cleaning, Kline said.

Next, dentists outlined treatment plans and volunteers were given the number of hours they needed to continue treatment. Cost was based on Medicaid schedule fees and patients completed the hours before receiving the services.

Patients volunteered an average of 33 hours and received more than $1,150 in treatment for a total savings of $43,815. Actual numbers varied widely based on services needed, with a range from $195 to $5,056, Kline said.

The program wasn't designed for major restorative work, such as crowns and bridges, Kline said. Most patients received preventative cleanings, exams, extractions and simple restorations, although some dentists did choose to provide more extensive work.

About 108 million people in the U.S. have no dental insurance, and even covered patients have problems accessing care because it's too expensive or too far away. But, oral health is related to many aspects of well-being such as self-esteem and employability, and poor oral health is associated with conditions such as diabetes and heart disease.

About 70 percent of the patients were in pain when they entered the program, Kline said. One-third felt that their teeth and gums limited the kinds or amounts of food they ate; 38 percent said that it caused discomfort, worry and concern, and affected their life in all of its aspects; and 40 percent said that it made them uncomfortable when eating in front of others.

Of the dentists, seven of the nine who responded to the survey rated the program favorably on all aspects. Two dentists said they didn't find volunteering for the program rewarding and voiced issues with the volunteer activities, and said that the quality of care wasn't comprehensive enough.

This and study did not make exceptions for emergencies, but Kline believes it's safe to assume it reduced dental-related , especially considering the large number of patients who were in pain already.

Data from a 2011 Delta Dental study shows that annually in the U.S., there are roughly 7,000 emergency room visits for preventable dental conditions and 1,000 require hospitalization. Hospitals collected only about $15 million of the estimated $58 million cost.

"Dental-related hospital emergency room visits are a huge cost. The average cost of one single avoidable hospitalization is about $12,448," said Kline, citing data from the Delta Dental study.

The study, "No-Cost Dental Care in Exchange for Community Service Hours: Participating Patients' and Dentists' Responses," was published in the June issue of the Journal of the Michigan Dental Association.

Explore further: Reduction in dental care and inferior oral health subsequent to dementia diagnosis

Related Stories

Reduction in dental care and inferior oral health subsequent to dementia diagnosis

July 27, 2017
Subsequent to a diagnosis of dementia, the patient's contact with the dental care services diminishes and oral health is impaired. This has been revealed by a major register-based study from Karolinska Institutet published ...

When families lack insurance, kids' dental woes rise

April 10, 2017
(HealthDay)—American children without dental insurance are far less likely to receive necessary care for their teeth than kids with coverage, a new survey finds.

The impact of ACA Medicaid expansion on dental visits: mixed results

April 3, 2017
Dental coverage for adults is an optional benefit under Medicaid, one that about half of the states offer. With thirty-one states and the District of Columbia expanding Medicaid eligibility under the Affordable Care Act (ACA), ...

What outcomes are associated with early preventive dental care among Medicaid-enrolled children in Alabama

February 27, 2017
Preventive dental care provided by a dentist for children before the age of 2 enrolled in Medicaid in Alabama was associated with more frequent subsequent treatment for tooth decay, more visits and more spending on dental ...

Better dental care needed for people living with MS

March 7, 2017
Many Australians living with multiple sclerosis (MS) do not receive adequate oral health care or access to dental services.

Research explores lasting effects of early preventive dental care in Medicaid-enrolled children

March 13, 2017
Research out of the University of Alabama at Birmingham School of Public Health suggests preventive dental care provided by a dentist for children before the age of 2 enrolled in Medicaid in Alabama may lead to more care ...

Recommended for you

Research shows aspirin could repair tooth decay

September 8, 2017
Researchers at Queen's University Belfast have discovered that aspirin could reverse the effects of tooth decay resulting in a reduction in the need for fillings. Currently about 7 million fillings are provided by the NHS ...

New dental imaging method uses squid ink to fish for gum disease

September 7, 2017
Squid ink might be a great ingredient to make black pasta, but it could also one day make getting checked for gum disease at the dentist less tedious and even painless. By combining squid ink with light and ultrasound, a ...

A new dental restoration composite proves more durable than the conventional material

August 21, 2017
Fewer trips to the dentist may be in your future, and you have mussels to thank.

Small molecule inhibitor prevents or impedes tooth cavities in a preclinical model

August 10, 2017
University of Alabama at Birmingham researchers have created a small molecule that prevents or impedes tooth cavities in a preclinical model. The inhibitor blocks the function of a key virulence enzyme in an oral bacterium, ...

Understanding genetic synergy in cleft palate

July 19, 2017
Like all of the individual elements of fetal development, palate growth is a marvel of nature. In part of this process, ledges of tissue on the sides of the face grow downwards on each side of the tongue, then upward, fusing ...

Use of prefabricated blood vessels may revolutionize root canals

June 12, 2017
While root canals are effective in saving a tooth that has become infected or decayed, this age-old procedure may cause teeth to become brittle and susceptible to fracture over time. Now researchers at OHSU in Portland, Oregon, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.