Every week, hygienist Joanne Puente sees patients at the People’s Health & Wellness Clinic in Barre who have not seen a dentist in years and come to her with severe tooth decay.
They are newly in recovery from opioid abuse or just out of prison. Or they are simply in pain, without savings and unable to find a dental practice with a sliding scale that is taking new patients.
Puente can offer free dental exams, cleanings and X-rays. But for crowns, tooth extractions and other treatments, she needs to refer patients to a dentist.
Lately it’s been those who have dental insurance who are actually the hardest to place, because that insurance is through Vermont Medicaid, Puente said.
Across all of central Vermont, only two dental practices will reliably accept her Medicaid referrals, and one only for emergency extractions. That’s a difficult fact to explain to patients.
“They’re reaching out for help. They finally have a chance to get to a dentist. They’ve got Medicaid,” Puente said. “But their mouths are totally, totally blown out. And there’s one dentist.”
Medicaid — the federally supported, state-administered program for children and low-income and disabled adults that has grown during the pandemic to cover one-third of all Vermonters — has not significantly raised its payments to dental providers for more than a decade. Over that same period, more and more practitioners stopped accepting new patients with the insurance.