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Clinic Restores San Diego Seniors' Smiles With Much-Needed Dental Care

Shirley has a dental appliance inserted into her mouth, Feb. 15, 2017.
Kris Arciaga
Shirley has a dental appliance inserted into her mouth, Feb. 15, 2017.
Clinic Restores San Diego Seniors' Smiles With Much-Needed Dental Care
Clinic Restores San Diego Seniors' Smiles With Much-Needed Dental Care
Clinic Restores San Diego Seniors' Smiles With Much-Needed Dental Care GUEST:Dr. Irvin Silverstein, director and advisor, UC San Diego Student-Run Free Dental Clinic

This is trying to. I'm Maureen Cavanaugh. Cavities and gum disease and lost teeth are commonplace among seniors. That is in part because Medicare doesn't pay for dental care. That means a trip to the dentist is a luxury many seniors cannot afford. Kenny Goldberg tells us how a unique dental clinic and Downtown San Diego is trying to make a difference. She is missing teeth so we are making her partials on the top and bottom and say we are doing the tooth try in visit. She's getting brand-new teeth. The doctor make sure that the partials fit right. She's terrible teeth. She never really took care of them. My teeth were really crooked so it was hard to get the dental floss in their. So tooth decay and really not eating great. Combine that with the fact that she could not afford to see a dentist. Thanks to the senior dental center she's getting her long oral health needs. It's on the second floor on the Gary and Mary westing your wellness center and Downtown San Diego. The centers like a one-stop shop for seniors. They can get two meals a day, see a doctor, and have access to financial mental health counseling. The dental center is funded primarily by the Gary and Mary West foundation, which put up $2 million to get the Clinton off the ground. Shelley Lyford is the CEO. She says they came up with the idea when they were serving meals to seniors. They actually discovered seniors covering their mouths when they would talk to them. Even though the seniors were often malnourished and very hungry they were not able to eat the food that they were serving. Most patients lived below the federal poverty level. Their mouths tend to be in horrible shape. The clinic cental director points to an x-ray of her typical patients. They had an abscess that came with paint and they have lots of missing teeth. The bite is completely off and the teeth has come out. She says the problems could been taking care of years ago with much simpler and less expensive treatment. Now it's up to her and her colleagues to restore patient's oral health as best as they can. All of the services are provided on a scale based on the ability to pay. The clinic has treated more than 350 people since it opened. She says because of high demand, many patients have to wait months to be seen. She says our society need to do better by -- for the seniors. The longer we wait the more it's going to cost us and the more that the quality of life is going to be affected and the more they will have to have diseases that are advancing. Low income seniors can qualify for 10 tical. -- Denti-Cal . We will go ahead and do your teeth today. The foundation want to find out if the dental clinic is viable. There collecting data on a variety of issues. They want to see at the center could improve their operations and become more efficient. They also want to find out whether dental intervention make seniors happier improve their quality of life. A foundation CEO Shelley Lyford. We are providing more access to seniors in collecting the data and in order for us to be sustainable and not depend on philanthropy were going out to change of policy. It remains to be seen whether their policies towards funding senior dental care will change. In the meantime patient is just thankful that the center exists. The clinic is giving him a new set affronting. I am on a fixed income so I don't have thousands of dollars extra so this is been great. The nonprofit oral health America says more than 70% of seniors have gum disease and about 25% of adults no longer have any natural teeth. The senior dental center is trying to take a bite out of those numbers. Kenny Goldberg, kpbs news. Joining me is Silverstein. We heard people talking about how lack of dental care makes eating difficult and it is a static problem but can it lead to more serious health problems? Absolutely. We've seen that dental disease can cause death. People have gotten different diseases and have died from it. The other big problem is we have a society that has lots of diabetes and diabetic people cannot get it under control. There is many different aspects of medical health. On top of the issue of not getting routine dental care, to seniors face special dental issues because of aging? Yes, they do but more so than that. I am part of the baby boomers and as the population ages we are finding more older people who had dental insurance who were being taken care of and sing every six months or every three months depending on what kind of dental care they needed. Now they become 65 and retire and they are no longer seeing the dentist. We know that unchecked dental disease leads to strokes, heart attacks and also helps other diseases go rapid. So as we get older our immune systems go down. A lot of seniors don't realize that Medicare doesn't cover dental checkups. What you think it is not covered Mike It is very expensive. The biggest thing about dental care is that we are very advanced that we can replace every crater smile. The basic needs need to be covered. Infection control, making sure people can get cleanings, because I feel if dental care is covered, we would see a decrease in medical costs. Also I was a first hospital trained dentist back years ago and because I was brought into the field is because transplant surgeries. The first five heart transplant patients died from dental infection. They were technically successful and learned that without getting people clearance for any kind of transplant surgery are really invasive surgery or autoimmune problems can lead to days in the hospital. The free dental clinic at the wellness center is not the only free clinic in San Diego. One features predental students from UC San Diego. How does that work? Basically we have four sites right now and we have a better insight that takes care of veterans. We take care of children that maybe they don't fit into the system. We have one right now elementary school, junior high, and preschool at the Lemon Grove school district. We have one downtown and we have one over in Pacific Beach. The unique thing is that we tied into the educational system and we don't just have predental students from USD. We have from sending a state, University of San Diego, anybody that is thinking about changing a career we even have people that are professionals that want to think about going into the dental field and we get them trained as dental assistants, x-ray tax and they work under the professionals and the dentist that volunteer their time. So we created this program and the need is so great and Sanyo County, we can't take everybody. So what we do is we have on Wednesday night we are at the Pacific Beach clinic. People can come in and try to get emergency care whether we take them as a full patient it really depends because our resources are tapped to. We heard about seniors going to the wellness center for this free dental clinic. Sub procedures they were getting were pretty sophisticated. The other free clinics are they more basic kinds of dental care? No. The volunteer dentist we bless all the time they don't get paid. They volunteer the time and become instructors. We teach all aspects of dentistry. So we do a case management see what that patient needs and see if we get funding or grants but we do all the procedures that we can and what is right for that patient. Some patients we see our only to get them out of pain and affection. We saw patient became and that if he had not gone and he probably would not be around today because he was so badly infected. If the dentists are willing to volunteer, why are so many dentists loath to take 10 tical payments -- Denti-Cal payments. They are so low that the dentist cannot break even in some cases. We are one of the lowest reimbursements of Denti-Cal in all 50 states. So it is an issue and the other issue is once you accept Denti-Cal , it's hard to turn away other patients and then you get flooded. So there is a need to look at the Denti-Cal fees. They are so low. We do have a lot of dentists that want to come and volunteer and after a hard days of work and they work until 5:00, they come to work with us for another five or six hours. It does feel like their satisfaction for dentist that treat seniors. Because they been dealing with bad teeth for a long time how does that change your lives? It changes everybody's life. Changes the patient. The patients are out of pain and we've heard many stories the first 11 that's that we worked with in our new project that got us funding for the veterans had been unemployed for 20 years. All 11 got jobs after we fixed their mouths. All of them and three went back to families that were separated. We now have 62 beds. A working person who misses so much work can keep a steady job. She is in pain and we create a smile. We've had several people that been working at the same company for 20 years. Children they don't miss school or classes. The two biggest things for people missing work and missing school is dental pain. If we can get the basics it helps our economy. Doctors love to see that they get hugs and sometimes the hugs are worth more than money. You talk about elderly people and a big problem we have we talked about losing the dental insurance and a lot of these people become in convalescent homes and they don't have access to dentists and their homes to take care of their teeth and they deteriorate. Once in a while you will have a man that comes by and check some and then the patient becomes fast and they can't eat. So they can no longer eat solid foods. It affects their weight and it's really sad because we are going to have a elderly population that will do without dental care and increase their dental pain and also their simple needs which will drive up medical costs. I've been speaking with Irvin Silverstein. Thank you so much. Thank you for having me. I just want you to know that we really want to help people.

Shirley Ruiz has terrible teeth. She never really took care of them.

“Not brushing regularly. I didn’t really floss, ’cause my teeth were really crooked," Ruiz explained. "And so it was hard to get the dental floss in there and that. And so, yeah, tooth decay. And really not eating right, neither.”

But thanks to the Senior Dental Center in downtown San Diego, Ruiz is getting a set of new teeth.

Dr. Vicki Petropoulos makes sure the so-called “partials” fit just right.

“Shirley here is missing some teeth," Petrpoulos said. "So we’re making her partials on the top and the bottom, and today we’re doing what’s called the tooth try-in visit.”

She slipped a device into Ruiz's mouth.

“Gently close, Shirley, thank you. Good. Very good.”

Gum disease, lost teeth

Cavities, gum disease and lost teeth are commonplace among seniors. That’s due in part to the fact that Medicare doesn’t pay for dental care. That means a trip to the dentist is a luxury many seniors can’t afford.

A new dental clinic in downtown San Diego is trying to make dentistry more affordable for needy seniors.

The dental clinic is on the second floor of the Gary and Mary West Senior Wellness Center in downtown San Diego.

The Wellness Center is like a one-stop shop for seniors. They can get two meals a day, see a doctor, and have access to financial and mental health counseling.

Gary, Mary West Foundation

The dental center is funded primarily by the Gary and Mary West Foundation, which put up $2 million to get the clinic off the ground.

Shelley Lyford, the foundation's CEO, said the Wests came up with the idea when they were serving meals to seniors.

Gary and Mary West Foundation CEO Shelley Lyford is shown in her office, Feb. 7, 2017.
Kenny Goldberg
Gary and Mary West Foundation CEO Shelley Lyford is shown in her office, Feb. 7, 2017.

“And it was during their interactions with seniors that they actually discovered seniors covering their mouth when they would talk with them, and actually, even though the seniors were often malnourished and very hungry, they were not able to eat the food that Gary and Mary were serving," Lyford said.

Most of the patients at the Senior Dental Center live below the federal poverty level. Their mouths tend to be in horrible shape.

The clinic’s dental director, Dr. Karen Becerra, describes an X-ray of one of her typical patients.

“This patient had an abscess in that area, came with pain, they have lots of missing teeth, the bite is completely off on that side, this tooth has come out," she said. "If you see, lots of bone loss in the upper and the lower.”

Becerra said these problems could have been taken care of years ago with much simpler and less expensive treatments.

Services provided on a sliding scale

Now, it’s up to Becerra and her colleagues to restore patients’ oral health the best they can.

All of the services are provided on a sliding scale, based on a patient’s ability to pay.

The clinic has treated more than 350 people since it opened last June. But Becerra says because of high demand, many patients have to wait months to be seen.

She said our society needs to do better by its seniors.

The clinic's dental director, Dr. Karen Becerra, points to a patient's X-ray, Feb. 15, 2017.
Kris Arciaga
The clinic's dental director, Dr. Karen Becerra, points to a patient's X-ray, Feb. 15, 2017.

“I think the longer we wait, in providing the services that they need, the more it’s gonna cost us all, the more that their quality of life is gonna be affected, the more that they’re gonna have to have disease that is continuing advancing," Becerra said. "We’re trying our best, but we only have four chairs.”

Low-income seniors can qualify for Denti-Cal, California’s dental program for the poor. The problem is most dentists won’t treat Denti-Cal patients because the reimbursement rate is so low, it doesn’t even cover their costs.

The Gary and Mary West Foundation wants to find out if its dental clinic is viable.

Dental intervention

The foundation is collecting data on a variety of fronts.

CEO Lyford said researchers want to see if the center could improve its operations and become more efficient. They also want to find out whether a dental intervention makes seniors happier, and improves their quality of life.

“What we’re doing is we’re shining a light on the problem, we’re providing more access to seniors, we’re catalyzing some really important public-private partnerships, we’re collecting the data, and in order for us to be sustainable, and not depend on philanthropy, we’re going to have to change policy," Lyford explained.

It remains to be seen whether the government’s tight-fisted policy toward funding senior dental care will change.

In the meantime, patient Ron Hilton is just thankful that the Senior Dental Center exists.

The clinic is giving him a new set of front teeth.

“I’m on fixed income, you know, Social Security," Hilton said. "I don’t have thousands of dollars extra under the mattress, so this has really been great.”

An unidentified patient waits to be seen at the Senior Dental Center, Feb. 15, 2017.
Kris Arciaga
An unidentified patient waits to be seen at the Senior Dental Center, Feb. 15, 2017.

The nonprofit Oral Health America says more than 70 percent of seniors have gum disease. And about 25 percent of adults 60 and older no longer have any natural teeth.

The Senior Dental Center is trying to take bite of those numbers.