11/07/11 — Clinic offers dental care for patients at low cost

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Clinic offers dental care for patients at low cost

By Steve Herring
Published in News on November 7, 2011 1:46 PM

Wayne County employs a dentist. And although the more than $130,000 salary is on the books, federal and state funds allow the program to help local needy families get the care they need, county officials said.

The Wayne County Health Department dental clinic is open to any county resident, but is designed more to meet the needs of those least able to pay for dental care -- care that could prevent dental issues from developing into more serious and costly health problems, County Manager Lee Smith said.

The clinic averages 285 patient visits a month and last year treated 3,792 -- about 60 percent adult and 40 percent children.

Located on the third floor of the County Office Building on East Ash Street, the dental clinic, which opened in July 2000, is supported by federal and state funds and fees. No local tax dollars are used, Smith said.

"First of all, a health department is charged with seeing people, low- to moderate-income," Smith said. "But I will tell you a lot of people we are seeing in our clinics are just working people. Personally, where we lived before Wayne County, both of my children went to the pediatrician at the local health department.

"They gave good service. They took our Blue Cross Blue Shield. It was a very rural area and instead of driving somewhere, we could go to the health department."

The clinic fills a gap not currently being met by the county's private dental practices and does not compete with those private practices, Smith said.

"We are really trying to treat people who have a low ability to pay or inability to pay," he said. "My understanding is that (the clinic) came about because in the past there were not a lot of dentists who accepted Medicaid.

"Most dentists, if you walk in the door and you can't pay, I think it is going to be pretty tough to get in because, let's face it, dentists are a business. They are there to make money and treat patients. They can't do it for free."

Smith said he is sure there are dental practices that work with people on cost.

However, there is not a clinic in the county where people can come in for a "very reduced cost" and there are a very few dentists who accept Medicaid, he said.

"By virtue of the number of patients that we see it is obvious there is not a lot of service out there," Smith said. "We are a gap filler."

Smith said he has told the Health Department the practice could change if the Medicaid dental businesses increase such that the county experiences a patient load where the clinic is not fully funded through sources other than county tax dollars.

"In other words, if the county has to start picking up some of that cost, then we have to re-examine why we are doing it ... if there are dental clinics that can pick up this service," he said. "Right now based on patient load, we are saying probably not. We examine that on a regular basis."

There are also residents who are not on Medicaid who can't pay for dental care -- and have no insurance.

"I think there is always going to be some limited need, kind of like WATCH," Smith said

The WATCH van travels around the county treating people who cannot pay and that is why that program has a lot of volunteers, he said. Patients at the dental clinic are charged based on a sliding scale.

"It is based on income. So if someone comes in, an adult or child, the parent or adult or the person responsible, we look at income and we base the fees on that," Smith said. "If you have Medicaid, then obviously Medicaid would pay, but we also take third-party insurance. We would take Blue Cross Blue Shield or something like that. We have a lot of people who are private pay. They come in. But most of the people we see are more acute-type issues. It is not like your standard come in and get your teeth cleaned, although some of that goes on."

The program employs a dentist, hygienist and a dental assistant.

"They are not paid what the private sector is paid, but they are qualified people and they care about those patients and they do a wonderful job," Smith said.

Dentist Dr. Chi-Chang Wang is paid $136,837.

"We tried and we have paid lower and it was hard to find someone," Smith said. "It is like anything else, when you have professionals like lawyers, doctors and dentists, you are going to have to pay them to get them. First of all, you don't want second-rate.

"The other thing is we are responsible if something goes wrong with those patients. Wayne County is responsible for that care. We are very cognizant of that that the care we give has to be quality."

The county contracts with the dentist, but all three dental office workers are county employees who are eligible for county benefits like insurance and state employee retirement.

Smith said he has seen photos provided by the Health Department of some of the "horrible (dental) situations," particularly of children who were referred to the program by the schools.

"We will deal with cavities or abscesses and teach them about better dental habits," he said. "But at the same time it is a real concern that a dental issue can turn into other medical problems from infections to other acute issues.

"So you have to be on top of that. If these kids have these problems that they are unable to learn."

The service is somewhat limited, but Smith said he would still consider it a full-service facility. A lot of patients are people in pain and having problems, he said.

"We assess them and treat them as best we can," he said. "We don't do orthodontic work. What we perform over there are very basic things extractions, fillings and treating severe infections and abscesses. Two things in particular with children, and with adults, if you allow dental issues to become acute and become severe and a lot of time unfortunately when they get to us they are very close.

"If that happens they are going to wind up at the emergency department in the hospital and cost the hospital a lot of money, particularly if they can't pay. Or they are going to wind up in the WATCH van. They are going to wind up somewhere in pain. They are going to wind up for some other treatment or medication or treatment."

There are dental emergencies that can be life-threatening because of infections, he said.

The clinic is open to anyone, but appointments are required. There can be "big waits" and sometimes it could take several days to get an appointment, Smith said.

The clinic hours are Monday through Thursday from 7 a.m. to 6 p.m. To make an appointment call 580-4050.