How easy is it for people living in Richmond to find and get what they need? How fair is that? How “healthy” is every Richmonder’s approach to what it takes to survive and thrive in 2023?
Natalia Chavez Choque was once in the same predicament her Latino patients often find themselves in — needing dental care but not having the insurance to cover the cost or the money to pay for a procedure.
Chavez Choque, a fourth-year student at the Virginia Commonwealth University School of Dentistry, said most of the patients she works with at the school’s student clinic are Latino.
“The beauty of looking at the Hispanic/Latinx community is for one, I’m never free. I always like to keep myself busy because I know I have so many patients to see,” Chavez Choque said.
According to 2020 Census data, approximately 104,488 Latinos (7.9% of the population) live in the Richmond region. About 1 in 8 Virginians is an immigrant, the American Immigration Council said. Overall, Latinos are the second-fastest growing group in the United States, and several reports have found that they face barriers to accessing oral health care.
Briseda Rodriguez, a 28-year-old immigrant living in the Richmond area, crossed paths with Chavez Choque at a free dental care clinic in Richmond over the summer. The mezzanine floor at the University of Richmond’s Robins Center was transformed into a makeshift dental clinic — with dental chairs lining the hallways, X-ray machines and patients waiting to be seen.
The free dental care clinic was a partnership between Mission of Mercy, Special Olympics 2023 and the Virginia Commonwealth University School of Dentistry. The goal was to provide dental care to participants and individuals with intellectual disabilities in the Richmond area. But organizers opened the event to the general public, and soon a flyer detailing the event in Spanish was circulating on Facebook.
Rodriguez and four of her children dedicated an entire Saturday to cleaning their teeth and treating their mouths. It was the first time her children had visited a dentist since they arrived from Guatemala two years ago.
“Because my kids don’t have a social security number, it’s really hard for me to get them dental insurance. It’s very expensive for me,” Rodriguez said in Spanish. “Dental assistance is very important for me and the children. Since we don’t speak English, it makes it easier when there are Latino providers, so that we have a sense of calm and can say what we are dealing with or what we need.”
Being the only dental school in the state comes with the cost of responsibility, said Dr. Carlos Smith, who was recently named associate dean for comprehensive excellence, ethics and community engagement at the VCU School of Dentistry.
“What I tell my students here all the time is, ‘When your patient sits in that chair, you’re not just treating a tooth.’ And sometimes that’s the focus, isn’t it, because they have to learn the technical skills and the art form of dentistry,” Smith said. “But that tooth is attached to a whole person who has a story and a narrative and a journey and how they got here, or what’s bothering them, or what’s led to their situation.”
The Hispanic Dental Student Association at VCU is already implementing what Smith would like to see by improving oral health care for Latinos. Last fall, Chavez Choque, who was president of the association, taught a series of dental seminars in Spanish for students and staff on how to interpret dental treatment for patients.
“I think it’s really important — impactful for me to be able to communicate a treatment to a patient, a lot of times, patients always have questions, (like) why is it so expensive,” Chavez Choque said . “But if you explain to them the necessity of treatment, they really go above and beyond to be able to afford it and improve their overall health.”
The need for affordable healthcare was evident at the MOM event. The Virginia Dental Association Foundation that runs Missions of Mercy said it treated 175 patients. A total of 527 procedures were performed from cleanings to restorations to extractions and X-rays — work that would have cost patients nearly $50,000. Not a single person has paid a dime.
The foundation told VPM News that 53% of the people they saw submitting their intake forms identified as Latino. A small number of patients did not state their race.
“When your patient sits in that chair, you’re not just treating a tooth. … That tooth is connected to a whole person who has a story and a narrative and a journey and how they got here.”
Dr. Carlos Smith
Armando Coronado brought his wife and daughter to the free dental event. Coronado — who lacks permanent legal immigration status and has no dental or health insurance — said the MOM event provided an opportunity for many Latinos to get treatment for the care they need.
“We don’t have these opportunities. I’ve been here for 10 years and because of the political situation, I haven’t had access to health care to address my needs,” Coronado said.
In addition to costs, there are a number of factors that can hinder access to dental care, such as limited clinic hours, language, promotion of services, and lack of transportation.
Virginia is also facing a shortage of dental providers accepting Medicaid-enrolled or uninsured patients — despite the state expanding its Medicaid dental coverage and raising reimbursement rates.
“The percentage of dentists who actually accept it as a form of payment has yet to move the needle. And so, that’s one of the reasons that the dental school(s) has a really big influx of patients, because we’re really the largest provider of care that a Medicaid-enrolled patient can be seen at,” Smith said.
Coronado said many people like him who don’t have a Social Security number are unable to apply for programs like Medicaid., even though they know they would qualify for help. All they can do, he said, is endure the pain.
“It’s something so basic, but so important. Because (when you have) dental care, you can do things like smile happily with joy and the most important thing – eat,” Coronado said.
This year, the Virginia Dental Association Foundation has reached an important milestone. Through its Mission of Mercy events, the organization has contributed $50 million in donated care since 2000 to Virginians.
Spanish-English translation provided by Keyris Manzanares.
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