Dental program serves Massachusetts seniors

Norwood, Mass.鈥擨n 1999, the Neponset Valley Community Health Coalition was established with a goal to advocate and help provide access to medial care for underserved residents in the region.

The coalition invited local dentists Dr. Stephen Stone, a periodontist, and Dr. Mark Stone, a pediatric dentist (who are not related), to help assess and address the area’s oral health needs.

“In 2000, a patient about 80 years of age came to speak at our meeting,” said Dr. Stephen Stone. “She was a widow without insurance or other financial means other than a part-time job. She tried to secure dental care and her needs included extractions, a maxillary denture, restorations and a mandibular partial. She was turned away by two practices because she was unable to pay for completed treatment at the final visit. A third practice advised her to come back in a year after saving as much of her Social Security income as she could. The story was so poignant and shocking, we decided to hold a screening clinic to see if her plight was unique to her or a generalized problem for seniors living on a fixed income.”

With one-time donations from the local chamber of commerce, a local hospital and three towns’ public health departments totaling $3,500, the Elder Dental Program, a project of the community Visiting Nurse Association, was born. Volunteer dental professionals screened 48 patients at the first clinic in April 2002. Now the program has 49 participating dentists who also supervise volunteer dental assisting students at screening events that are held twice a year in the spring and the fall. Patients receive clinical dental examinations, orofacial cancer examinations, nutritional counseling, oral hygiene instruction from volunteer dental hygiene students and denture cleaning. Patients receive follow-up care on a sliding fee scale from dentists who treat patients in their own offices.

“The other participating dentists saw the same needs as we did,” said Dr. Mark Stone. “They signed up because they wanted to help. Each doctor decides how many patients and how often he or she will accept a new patient. This model is very effective in allowing a practitioner to tailor involvement. Once they began, the program flourished. Although fees are charged on a sliding scale, the costs are about 20 percent of normal fees and the remainder is absorbed by the volunteer practitioners.”

Dr. Stephen Stone says the program grew rapidly because participating dentists aren’t burdened by administrative tasks and because patients are investing in their treatment.聽

“Appointments are made by the executive director and transportation is arranged if needed,” he said. “The fee for the procedure is told to patients prior to their appointment. This makes for聽a simple, effortless, paperless access to treatment for the dental offices.

“Our patients represent generations who are proud, responsible and uncomfortable accepting charity,” he added. “Understanding this traditional temperament is the reason a token fee is charged, allowing patients to pay for treatment within their financial restraints.”

The program targets seniors over 60 years of age who live independently. Though patients need to have transportation to volunteer dentists’ offices, many communities offer transportation services for seniors and the area also has regional transportation options that are safe and affordable, says Elizabeth Perry, program manager.

Ms. Perry says the program serves patients who don’t have dental insurance, don’t qualify for Medicaid, live at 150-200 percent of the federal poverty level and cannot afford dental care out of pocket.

Through the screening process, she also refers patients who qualify for Mass Health Medicaid to those participating dentists, or accepts them into the Elder Dental Program if they don’t have access to a Medicaid provider.

In 2009, after holding 13 screening clinics that served 408 seniors, program statistics showed 19 percent of patients presented with acute discomfort, nearly 32 percent had untreated decay and nearly 47 percent had progressive periodontitis. More than half (55 percent) had no dentist of record and most鈥?2.6 percent鈥攈ad no dental insurance. Patients’ average annual income was around $12,000 and a third of them had an income under the federal poverty level.

The town of Attleboro, Mass., replicated the program last year for their community, and the town of Brookline is also in the process of developing a similar program.

“We have even heard from officials from the state of Arizona who would like to launch a similar program statewide,” said Dr. Stephen Stone. “That’s very exciting for us.”

Dr. Stephen Stone will also provide more information on how the program works or how to set up a program. Call 1-781-769-0818 or e-mail sstonedmd@yahoo.com.