To some people, it might sound unusual to go to the emergency room for tooth pain, but for the uninsured and those without dental benefits, it’s the logical option.
The ER is where Dr. Angie’s Dental Health Exchange (DADHE) gets the majority of its referrals to its program, which provides dental care to uninsured patients in exchange for community service. However, since the pandemic drove ER visits down, the program has seen a drastic drop in participants.
DADHE board president Amy Hazlewood said local emergency ERs can provide temporary pain relief and then refer patients to the DADHE, which serves St. Joseph County. The goal of the program is to keep patients from becoming ER frequenters by fixing their long term dental problems.
“That has been our No. 1 focus, not only to get patients from the ER, but to keep them from going back there,” Hazlewood said.
However, many patients stopped going to the ER for a variety of medical needs once the pandemic began last year, and therefore, fewer patients have been referred to the dental program.
“I’d say we’re probably getting less than half of the number that we were when we first established,” Hazlewood said.
In April, the Centers for Disease Control reported emergency department (ED) visits were 25% lower during December 2020-Janurary 2021 than the same time period the previous year. From March 29 to April 25, 2020, ED visits declined by 42%.
Dr. Nicole Riordan, staff emergency physician and medical director at Memorial Emergency Care Center said in an email correspondence, “Early on in the pandemic, we saw our typical patient volumes cut in half as I think that many patients were worried about the transmission of Covid.”
Riordan said now in the summer of 2021, she has seen ER visits “with volumes approaching and sometimes exceeding our pre-Covid averages,” though she could not quantify the number of people seeking ER care for dental problems.
Even though ER visiting numbers have returned to pre-pandemic levels, Hazlewood said, the DADHE’s referrals are still down, which she attributes to lack of and loss of awareness about the program.
“It’s just people are not aware,” she said.
Hazlewood added the need for dental care has heightened since the pandemic. A dental hygienist herself, she’s seen the pandemic affect the general practices of the public.
“People were nervous about coming into any medical or dental facility because they were just not comfortable knowing how easy they were going to come down with the virus,” Hazlewood said.
The hesitancy on top of the catch up dental offices have had to play since being closed early in the pandemic has meant overdue dental problems.
Dr. Susan Cocquyt with Erskine Family Dentistry has been a partner with DADHE since its inception in 2013. She agreed dental care has become increasingly in demand because of the pandemic.
“It drastically affected (the public),” she said.
Erskine has seen more patients with gum diseases and Temporomandibular disorders (TMD), the latter of which can be caused by spending hours at home on a laptop, Cocquyt said.
What goes around comes around
The DADHE partners with around 40 area dental practices to provide urgent dental care and pain relief to people without dental insurance or Medicaid with dental benefit or have limited income.
Participants earn a treatment by completing 2 hours of community service at a local nonprofit of their choice. Hazlewood said food pantries and community gardens are popular.
DADHE has had to adapt to the times as some nonprofit groups have restricted their access due to the pandemic. Participants now can clean up a park or road in exchange for dental care.
Veterans need to volunteer only one hour for each treatment, and blood donations will earn participants the equivalent of four hours of community service. The board recently decided proof of a COVID-19 vaccine will earn participants the equivalent of two hours of community service.
Some patients, Hazlewood said, have continued to volunteer at their nonprofits of choice even after they have completed their dental care. Others have even found employment at their volunteer locations.
“We’ve helped people that have had problems with their teeth and it’s lowered their self esteem,” Hazlewood said. “They felt better about themselves and were better able to get employed, too.”
Additionally, Indiana University South Bend and Ivy Tech Community College’s dental education programs donate x-rays and cleanings to patients through the DADHE, free of the community service exchange requirement.
“It’s another way we are helping the community,” DADHE patient coordinator Ashley Kosowski said about the college students providing care while simultaneously completing a learning experience.
Kosowski was at Family Dental Health Corporation in South Bend on Friday, helping Douglas Lodholtz enroll with the program. Lodholtz said he is seeking help with tooth pain and will probably undertake neighborhood clean up as his community service.
Dr. Stephen Hendricks with Family Dental Health Corporation has worked with the DADHE since 2017. He blocks out a time period every month to see DADHE patients.
The most common problems he has seen at his time with the program are tooth aches and infections. He said the program benefits all involved.
“The providers feel good because it’s nice to help out people in need,” he said. “(And) patients may not always like the feel of a charity donation. I think that is a nice combination.”
Dr. Angie’s Dental Health Exchange began in 2013 after the death of Amy Hazlewood’s daughter, Dr. Angela Hazlewood Murat. A local dentist, she died in 2011 after battling non-hodgkin’s lymphoma, The Tribune previously reported.
Friends, family and coworkers came together to create the DADHE in honor of Hazlewood Murat’s dedication to providing dental care to the uninsured.
Since the program began, Amy Hazlewood estimates, the group has facilitated around 350 treatments totaling $128,000 of dental care.
“The really nice part about the program is that people do not have to have money; there’s never any money exchanged,” Hazlewood said. “Pay it forward.”