MANCHESTER, N.H. — An economy that is pushing more workers into unemployment or part-time jobs without health benefits is also fueling increased demand for dental care at community health clinics.
“I saw a patient this morning who is unemployed, he lives in Manchester, and he came down this morning to start his work,” said Dr. Steven P. Calawa, who is partially retired, but recently joined the Greater Nashua Dental Connection.
“He said ‘I can’t go out and look for work because I’ve got these huge cavities all on my front teeth, and how can I go out and smile? No one’s going to hire me,’ ” Calawa said.
Calawa agreed that appearance affects job prospects.
“He’s got to be appropriately appearing to land one,” he said.
“There’s a whole segment of society that just cannot go to a private (dental) office,” Calawa said. “Dentistry has almost become beyond the reach of the average American, it’s so expensive.
“This is an affordable option to private care.”
“Children we are bringing in right now are totally uninsured,” said Dedra “Dee” Twomey, business manager at the clinic.
The clinic also gets referrals of dental emergencies from both Nashua hospitals. St. Joseph’s Hospital recently renewed a $35,000 grant to the Nashua dental clinic.
On a recent Wednesday, patient, Angel Mojica, 74, of Nashua, came in with a broken front tooth. Calawa said he could repair the tooth the same day.
“We have a lot of minority patients who come, and we’re lucky to have three assistants who can speak Spanish as well as English,” Calawa said.
“In many ways, this has been the most gratifying aspect of my professional career, just because there’s an opportunity to help people who otherwise just could not have the help, and they certainly could never seek me out in private practice,” he said.
Calawa, 60, retired in June from full-time private practice in Rockefeller Center in New York City after 30 years. He works one day a week at Nashua, one day at Bedford Dental Arts and one day at Dr. Richard Workman’s office in Windham.
Kristen Platte said the state Oral Health Coalition, which she chairs, has focused on workforce access to dental care and fluoridation.
“Everyone’s vision is to improve the oral health of the people of New Hampshire because it’s been proven that oral health is tied to your entire health. It’s not something that’s separate,” Platte said.
Like the Greater Nashua Dental Connection, Families First Health and Support Center, which has a dental clinic on the Seacoast, is also seeing increased demand. Families First Executive Director Helen Taft said, “At our community health center, we serve about 2,000 men, women and children.”
Both Families First and Greater Nashua Dental Connection offer their services on a sliding scale to those who cannot afford full payment.
But Families First operates under a medical home model that requires dental patients to also be medical patients. That limits the number it can serve, Taft said.
Families First has a mobile dental van that reaches out to the homeless and transient in Portsmouth, Rochester and Hampton.
“Most people don’t have dental insurance, particularly if they have low income,” Taft said. “That definitely is a group we try to support through a sliding fee scale, with payment plans, and we try to help with payment for dentures. We have a special fund to reduce the cost of dentures.”
The 20 percent growth in Families First’s dental practice speaks to the need in the community, Taft said.
“Quite frankly, our state oral health contracts were cut this year along with our medical,” Taft said. “I had to cut back on dentists’ time here so that doesn’t help in terms in of meeting the needs,” she said.
The Nashua clinic’s hygienist, Terry Miller, a 12-year employee, said fluoride is the most effective prevention for dental decay. Manchester has fluoridated water, but Nashua does not, she said.
“People don’t realize that dental decay is a disease and it’s a very preventable disease if you get (patients) started early with fluoride,” she said.
“We see a lot of little children who have never been to the dentist and have some serious decay issues — some life threatening.
“It makes us sad,” Miller said.
“Healthy primary teeth are really necessary for the permanent teeth to come in,” Miller said.
Dr. Calawa said dental disease is an inflammatory process that is linked to diabetes, heart disease and cancers.