Lack Of Dental Care Making College Difficult for Former Foster Youths

Kassaundra Peterson
Kassaundra Peterson

The dentist warned Kassaundra Peterson that having all four of her wisdom teeth pulled without general anesthesia would hurt. But getting the procedure done without extra anesthesia would only cost $1,100, instead of almost $2,000.

It was a week before the former foster youth’s graduation from University of California Riverside, her senior thesis was due, and her teeth were throbbing. Badly.

Without dental insurance, she had to do what she could to make it the most affordable. She told him to do it anyway.

For 40 minutes, she cried uncontrollably as dental assistants physically held her down during the teeth removal. Her teeth were rooted deeply in her jaw, so drilling them out was extra work for the dentist. She can still remember the smell and the feel of the entire procedure.

“It was super traumatizing,” said Peterson. “I cried the entire time. I cried two days after.”

Peterson was part of the 61 percent of former foster youth across the country who don’t have access to dental insurance. Currently, federal law only requires that youth who grow up in foster care are automatically eligible for Medicaid (which includes dental coverage) until they exit the system.

According to a 2007 study by the University of Chicago Chapin Hall, 50 percent of young adults reported having had medical insurance and only 39 percent had insurance for dental care. Approximately one-fifth of the young adults reported that they had not received medical care or dental care when they thought they needed it during the past year because they did not have insurance.

That may all change if the Affordable Care Act rolls out as expected next year. But for now, students like Peterson can see medical insurance run out before or during college. And because a number of university health care providers don’t accept Medicaid, dental care for many gets left behind.

“The kids need health care, and they need dental care,” said Tuppett Yates, Director of Guardian Scholars at University of California-Riverside, whose campus health care service doesn’t accept Medicaid. “It’s crisis to crisis, there is no regular dental care. No preventative care. That conundrum is happening at a developmental age when wisdom teeth are coming in.”

She says her program, which supports former foster youth on campus, has had at least one student a year with a dental care crisis since they started in 2008.

Eventually the Guardian Scholars program was able to reimburse Peterson for her dental care costs, thanks to emergency scholarship funding.

They have also been able to help students before they receive a bill. Tim Legere, a junior at UC Riverside, reached out to the program for help when he could no longer take the feeling of his wisdom tooth decaying.

“It was decaying pretty badly, and I could feel a tingling,” he said. The pain had infected the whole left side of his face, as he could feel it in his cheek and even his ear.

Because the “constant, irritated, feeling” also caused consistent headache and fever, the beginning of his sophomore year ”was a tough start. I had to catch up.”

Luckily the Guardian Scholars program was able to find emergency funds to send him to a dentist. But three months later, the three other wisdom teeth needed to be removed.

Legere told another dentist about his new medical need. “I told him I was in foster care, and I couldn’t afford it.”

Each tooth was supposed to cost $300-$350 to remove, and $350 for the anesthetic.

The dentist charged him only 99 cents per tooth.

“It’s not every student who will be able to find a dentist like that,” said Yates.

Many of the dental care issues youth face are a result of a lack of regular oral care, according to the American Academy of Pediatrics (AAP). About 35 percent of children and teens enter foster care with significant dental and oral health problems according to research from Healthy Foster Care America, an initiative of AAP.

While in foster care, a number of barriers can prevent foster youth from seeing a dentist regularly including:

  • Insufficient funding for complexity of health needs
  • Poor coordination and communication among disciplines and systems of care and among professionals and families
  • Frequent transfer of doctors as youth move to different foster homes

“It can be difficult in some areas to find a dentist who accepts Medicaid,” said Dr. Adriana Segura, chairperson of Children’s Oral Health at the AAP. “We are pushing for all children and youth to have a dental home. Most pediatric dentists see kids up to 12 and after that we depend on our general dentists. All the dental organizations support the idea of having a dental home by age one.”

The Affordable Care Act has the potential to address the lack of dental care for older youth in care.

Starting January 1, those who were in foster at age 18 and enrolled in Medicaid at any time will be eligible to remain on Medicaid until age 26. Even those who have aged out could access care.

For students who go to college in another state, states will be able to choose whether or not to include Medicaid coverage for foster youth from a different state.

Peterson is thankful that the Guardian Scholars program was able to pay for her dental service. But she thinks more foster youth should have better access to dental care.

“It’s a basic health necessity. A lot of my friends have their parents’ health plan, but we don’t have that,” said Peterson.

On October 23, leaders of programs that support college students who are former foster youth will convene at the Blueprint Conference sponsored by California College Pathways, where they will discuss barriers and difficulties uniquely facing students from foster care. Oral care will be part of the discussion.

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