Illustration by Bob Scott
Although some consider dental care optional, oral health has an important connection to overall health. Ignoring it opens the door to larger problems.
Poor oral health can lead to tooth and gum disease and contribute to conditions such as cardiovascular disease or endocarditis, pregnancy and birth complications, and pneumonia, according to the Mayo Clinic. Conversely, many diseases and conditions can negatively impact dental health, including diabetes, eating disorders, some cancers, HIV/AIDS, Alzheimer’s disease and osteoporosis.
Even knowing the importance, many people face barriers to accessing proper dental care that mean they will continue to suffer pain and discomfort associated with dental problems.
More than 747,000 Virginia residents under the age of 65 — including children, students, undocumented, homeless or disabled Virginians — have no health insurance or access to proper dental care, according to the Virginia Dental Association.
Several options for underserved Richmond-area residents exist to address that gap in care, each with individualized resources, specialties and demographic focus. Still, there is always a need for more, says Julie Bilodeau, CEO of CrossOver Healthcare Ministry, one of a handful of providers of dental care to Richmond’s underserved populations. “We need more community support. We need extra sets of hands, donations, volunteers,” she says. “If patients don’t come here, they’re either going to an emergency room or they’re going to let the problem get worse.”
The Most Vulnerable
Based on data from the National Survey of Children’s Health, the Virginia Dental Association reported that tooth decay and cavities in children were up an estimated 44% in Virginia from 2018-19 to 2020-21, due largely to lack of dental care during the COVID-19 pandemic.
A Virginia Health Catalyst survey reported that 27% of children aged 1 to 2 years and 59% of children and young adults aged 3 to 20 years have had preventive dental visits through Medicaid. “It is recommended to visit a dentist around a child’s first birthday and to have regular checkup visits every six months,” says Dr. Jayakumar Jayaraman, VCU School of Dentistry associate professor of pediatric dentistry.
Health care should be available for everyone.
—Julie Bilodeau, CEO of CrossOver Healthcare Ministry
VCU Dental Care’s pediatric clinic has taken several initiatives to bridge this gap, he says. One such initiative is the clinic’s involvement in the American Dental Association’s annual Give Kids a Smile project each February. At this year’s event, more than $50,000 in dental treatments were provided at no charge to 98 children in underinsured families.
Older adults, especially those on fixed incomes, also often struggle to afford dental care. Specifically for adults over age 65, Lucy Corr Dental Clinic (6800 Lucy Corr Blvd., Chesterfield) offers free care using funding provided by the Jenkins Foundation and VCU School of Dentistry. The clinic’s website notes that older adults benefit from improved food intake, lower infection rates and better quality of life when their dental needs are met. The services for older adults include routine care, dentures and partials, extractions, and X-rays.
Overcoming Barriers
Richmond residents experiencing homelessness and housing insecurity issues are among those who often struggle to find affordable health care. Since 1969, Daily Planet Health Services has served this demographic regardless of housing, finances, citizenship or insurance status. In addition to accepting most dental insurance plans, Daily Planet offers a sliding fee scale for those who qualify.
Daily Planet offers general and pediatric dental care at its two locations: West Grace Health Center (517 W. Grace St.) and Southside Health Center (180 E. Belt Blvd.), tele-dentistry visits for patients who are unable to visit in person, and limited emergency walk-in care and extractions, according to its website. The integrated care clinics allow team members to coordinate and compare notes and provide holistic care for patients’ needs.
Transportation to dental appointments is also an issue for some Richmond residents. Daily Planet offers detailed transportation information for Medicaid patients on its website. Medicaid patients may receive rides free or at a reduced cost to appointments at any clinic locations offering Medicaid services. Some organizations, such as The Shepherd’s Center of Richmond, which caters to seniors over age 60, offer round-trip transportation to medical services. Other clinics, such as nonprofit CrossOver Healthcare Ministry, have clinics along Richmond’s GRTC Transit System routes.
Dr. Velma Barnwell, dental director of CrossOver Healthcare Ministry, with a patient (Photo courtesy CrossOver Healthcare Ministry)
More Resources
CrossOver’s Henrico clinic (8600 Quioccasin Road) features primary care, dental and vision services, pediatrics and an HIV clinic. Dental services are only available for low-income uninsured and Medicaid patients enrolled in its primary care services, allowing health care providers to bridge the connection between oral and overall health. Staff believe primary care is key, especially in situations of serious health risk, and they offer preventive care and restorative services, says Megan Mann, director of communications.
“One of the special things about CrossOver is how integrative the care is,” Mann says, citing a recent example of a late-stage pregnancy obstetrics patient who came in with a severe tooth infection. The team immediately started antibiotics and scheduled a next-day extraction before the patient went into labor.
Like many dental clinics, CrossOver relies on donations, volunteer workers and community partners for its operating budget, CEO Bilodeau says. CrossOver asks a fee for services but never refuses care or initiates billing or collections if a patient is unable to pay.
CrossOver served more than 1,800 individual dental patients totaling nearly 4,000 visits in its previous fiscal year. The nonprofit also provides community support and health literacy services, especially for immigrants who struggle to navigate the U.S. health care system.
“Health care should be available for everyone,” Bilodeau says. “We have served patients from 114 different countries. We don’t screen for any type of documentation or citizenship, so we don’t know percentages, but we do know that our pediatrics program comprises much of this particular population.”
Through Virginia Commonwealth University’s VCU Dental Care, patients can make appointments with graduate students supervised by faculty members for general dentistry needs, crowns, bridges, dentures, root canals and periodontics. New patients attend an initial screening to see if their needs can be met by the student practice while also meeting the educational objectives of the student dentists.
Although there is no sliding scale for their initial screening fee (currently $75), there are no financial screening requirements for new patients, according to the VCU Dental Care website. Richmond-area college students may also benefit from the program’s Student 2 Student Discount Plan. Full-time VCU students receive higher discounts with the Black and Gold Plan, but all full-time college students in Virginia (including community and technical college students) are eligible for discounted dental care. Although VCU Dental care also offers both specialty and faculty practices, its student practice is the most affordable option.
In Hanover County, ministry-based Hanover Interfaith Free Clinics offer free medical and dental services to eligible low-income, adult Hanover County residents without health insurance at Mechanicsville Dental Clinic (8067 Shady Grove Road), including dental hygiene, exams, extractions and restorations. The Ashland Medical and Dental Clinic, located in the St. James the Less Episcopal Church (125 Beverly Road), offers the same services, plus dentures. Since 2006, the clinics have served as an outreach base for volunteers of all ages, as staff are all volunteers.
