JACKI LYDEN, Host:
Sarah Varney of member station KQED reports on how dentists and their patients are responding.
SARAH VARNEY: In thousands of dentist's offices and community clinics in California, from the rocky north coast to the Mexican border, it's the receptionists who are left to counsel and console patients who've lost their benefits.
M: They would come here crying, they need help.
VARNEY: Now, Claudia says, patients can't afford to pay for root canals themselves - even at the discounted rate of $600. So, they end up getting their teeth pulled.
M: They'd rather take it out because they don't have the money. It's either rent, food or dental work, and they opt for the most convenient - well, unconvenient(ph) for them - but the only thing they can do to relieve their pain.
VARNEY: Julia Paradise is a Kaiser Family Foundation health researcher.
M: In the last recession and in this recession and when states are under severe budget strains, dental benefits for adults, since they are an optional benefit, are among the first things to go.
VARNEY: Lucresha Renteria runs the Mendocino Coast Clinics in Fort Bragg, a hardscrabble fishing-and-lumber town.
M: The nutritional needs of the patient can't be met if they can't chew and eat food appropriately. So, we have patients that suffer from a form of anorexia or have to have soft foods only.
VARNEY: The mouth has long been an orphaned organ, says Burton Edelstein, a Columbia University professor of dentistry and health policy. When Medicaid and Medicare were created in 1965, Edelstein says, oral health was not well understood, and Congress didn't think to mandate dental coverage.
LYDEN: It reflected policymakers' misunderstanding that the mouth is not part of the body and that oral health is not an important component of general health.
VARNEY: But Michael Bird, from the National Conference of State Legislatures, says it will be a long time before states restore optional benefits, like dental coverage.
M: The fiscal downturn is so severe that even if you were to raise taxes or fees you still aren't going to be able to plug all of the holes that exist right now. This is all about saving part of the school year versus the early release of prisoners versus an optional dental program versus whether you're going to be able to fill the potholes on the roads.
VARNEY: For NPR News, I'm Sarah Varney.
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