My Turn: The barriers to dental healthcare access

For the Monitor
Published: 2/23/2022 6:00:42 AM
Modified: 2/23/2022 6:00:19 AM

From a shortage of available providers to difficulties getting coverage, barriers to dental healthcare access have proven to be a continual challenge in our New Hampshire communities.

As a child, growing up impoverished in the rural town of Groton, New Hampshire, and having state insurance meant driving to Concord to get my dental care needs met as none of the local providers at that time accepted Medicaid patients. Statewide, this has been a recurrent issue due to reimbursement rates being so low.

As I entered adulthood, I became financially independent, moved out of my childhood home, and directly entered the workforce. Having next to no learned trades meant being paid subpar wages from manual labor and hospitality jobs.

In small towns like mine, most of the jobs young adults qualify for include no benefits whatsoever. Many are seasonal, part-time or simply do not provide for their employees. When they do, the out-of-pocket costs are so high that people save their benefits for catastrophic events only. Medicaid is often one of the only ways people get access to dental care in these regions if they meet the income threshold and are made aware of the resources available in the first place.

From age 17 to 22, I completely lacked health insurance and maintained, at best, a mediocre level of care for my teeth. I endured issues including numerous cavities, impacted wisdom teeth and an abscessed tooth. Not only did these cause me immense physical pain, but the appearance of my teeth affected my personal and professional life.

As a person professionally diagnosed with Bipolar I Disorder, PTSD, and Major Depressive Disorder, many facets of my everyday life are affected. Being neurodivergent means self-care often goes to the wayside. The mood swings and other symptoms are so debilitating that social isolation can take hold. Weeks can go by spending most of the day in bed, with basic primal needs like hunger and hygiene going completely unnoticed.

At age 22, I enrolled in a private insurance plan through the first employer I had that provided insurance plans, but after being fired, my insurance was dropped, and so were my chances at scheduling an affordable appointment.

At age 24, I qualified and filed for Amerihealth Caritas for dental care. Having coverage was one piece of the puzzle, but due to the large patient load, waiting lists often stretched out six months to a year. Without access to my own transportation, I had to rely on Appointment Transportation Services to reach these appointments. One provider canceled an appointment a week in advance after a five-month wait, without giving a reason. The only rescheduling options were several months away.

After moving to Nashua last summer, I was able to get a deep cleaning, fillings, and a crown. I am still experiencing challenges with getting my wisdom teeth removed. I missed my initial appointment as a result of unforeseen circumstances due to mental health issues, and I have been unable to find a new provider since being put on a different in-network waiting list.

Our dental system is broken and continues to prove inaccessible to those most in need. I’ve lost a lot of professional opportunities, potential relationships, and suffered emotionally from the condition of my oral health over the years. I am one of the lucky folks to have gotten help with my personal dental issues.

Having accessible dental care allows for better job opportunities, improved physical and mental health, and increased self-esteem. We need to make dental healthcare accessible to everyone in New Hampshire so that no one has to jump through hoops to get the care they need.

(Trysten McClain of Nashua is a community health field organizer with Rights & Democracy.)

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