A pilot dental clinic operated by the Coastal Health Alliance, which will serve low-income patients two days a week in Point Reyes Station, opened for business on Wednesday. The project, which will run at least till the end of the year, will allow the nonprofit to gauge what dental needs are not being met in the area and provide a way for at least a small portion of the population to receive treatment for oral pain and infections.

The idea for a local dental clinic originated with the West Marin Collaborative, a coalition of about 20 local organizations that meets monthly. They decided to focus on improving access to oral care in 2011, after a number of groups reported hearing many in the community bemoan their lack of dental coverage and inability to afford it out of pocket. 

Dental care has long been separated from general care and regarded as less important. But in reality, they are inseparable. To Craig Crispin, a dentist in Point Reyes Station who is offering chairs in his office for the pilot, dividing the two doesn’t make sense. “The mouth is the gateway to the body,” he said. (Another dentist, Tina-Lise Curtis, will see pilot patients.)

According to Jack Luomanen, an oral health consultant for the project who was interviewed on KWMR last week, cavities are actually infections of the teeth that can be transmitted among people; children, in fact, often “catch” cavities from their mothers. There are cases of young children dying from infections that started in their mouths, he said. Additionally, the plaque that can cause cardiovascular disease is linked to the plaque on your teeth.

Though it is not always clear exactly how oral health is connected to other health problems—the exact nature of the relationship between tooth and heart plaque is unclear, for instance—the importance of oral health to the rest of the body is no longer in question.  

But for those on limited incomes, trips to the dentist become a heavy expense to bear, though the long-term consequences can be painful. “Some people who are low income can’t afford any kind of oral health services, so they put up with the inability to eat, to smile. They learn to live with the pain. They exist with untreated dental decay because they feel they have no other option,” said Kathleen Roach, a nurse and member of the collaborative who represents the county’s department of health and human resources.

Dr. Crispin said he didn’t doubt the need was here; many similar programs, including a Petaluma-based clinic where he works one day a week, have four or six month waiting lists, he said.

Adding oral health care to the alliance’s list of services was complicated, said Steven Siegel, the Coastal Health Alliance’s executive director. The organization decided to pursue it early in 2013, but since the nonprofit is federally funded, it had to undergo a lengthy process to approve a new site and program, and procure all the tools and supplies. 

The program kicks off at an auspicious time; just last month, Medi-Cal, the public health insurance program for low-income people, re-instated its dental coverage program, Denti-Cal, which state legislators cut in 2009 as part of a budget deficit reduction plan.

Although 1,000 or more patients at the Coastal Health Alliance make little enough income to qualify for Medi-Cal, Ms. Roach said the group won’t know what the their dental needs are until they sign up. “We want people to call and schedule services so C.H.A. can provide dental services and capture data to determine if there is an unmet need for oral health care in West Marin,” she said.

The pilot is kicking off as the county as a whole is undertaking an oral health needs assessment; they’ve hired a public health consultant, Wendy Todd, to evaluate what services are accessible, which needs are going unaddressed and which sub-populations are struggling to access dental care.

Though the county gave the alliance a $90,000 grant to start up, Mr. Siegel said they hope the project will fund itself; the alliance will get reimbursements from patients who are ensured through Medi-Cal, which hopefully will balance out patients who have no insurance and pay a sliding scale fee.  

“We’re trying to put the mouth back into the body,” Mr. Siegel said. Addressing infections and other oral problems right when they pop up—not years down the line—is critical, he added. “Oral heath diseases are progressive, although they are episodic—it might go away, but it’s getting worse.”

 

The Coastal Health Alliance is only taking established Coastal Health Alliance patients. The clinic will be open on Wednesdays and Fridays, 8 a.m. to noon and 1 to 5 p.m. To make an appointment call Sandra Alvarez at (415) 787.1123