Patient's death blamed on dental Medicaid cuts

A Michigan woman with severe periodontitis died this month because the state eliminated adult dental Medicaid benefits, according to the director of a chain of clinics that attempted to arrange her treatment.

The woman, whose name has not been released at the request of her family, died October 8 after getting a blood infection, said Thomas Veryser, D.D.S., M.H.S.A, executive director of Michigan Community Dental Clinics. He said he did not know her precise cause of death, but to explain the blood infection "physical examination provided no alternative to the obvious chronic periodontitis that the patient suffered from."

"If this patient had received the care she obviously needed, she would still be with us," he said.

Michigan Gov. Jennifer Granholm eliminated adult dental benefits July 1 through the state's Medicaid program by executive order. The cut was projected to save $5 million from the state's 2010 budget and a proportional amount from its 2009 budget, but critics said it would cost the state more because of increased use of emergency services, according to a report on Mlive.com.

Granholm's office did not return a call from DrBicuspid.com requesting comment on the patient's death.

Dr. Veryser said the patient suffered from a mental disability that prevented her from cooperating with dental care. She had some cleaning and prophylaxis under general anesthesia, but not the scaling and root planing that might have controlled her periodontitis.

When a physician detected her blood infection in early July, he recommended that all her teeth be extracted. The dental clinic scheduled this treatment at a local hospital, but the hospital postponed the procedure because she had mild pneumonia that prevented the use of general anesthesia.

By the time she recovered from the pneumonia, the state had eliminated dental services and the hospital would not put her under general anesthesia because the cost -- which it estimated at $4,500 to $6,000 -- would not be reimbursed by the state, Dr. Veryser said.

"Our hospital coordinator tried to come up with Medicaid reasons to force the hand of Medicaid," but the Medicaid office wouldn't budge, he said.

The Michigan Department of Community Health, which administers the state's Medicaid program, is investigating the case, said Kelly Niebel, a spokesperson. "It sounds like a tragic situation," she said. "We would offer our condolences to the family."

The case illustrates problems with the way government programs treat oral health, said Dr. Veryser. "We have to get our arms around the idea that dental care is an essential part of healthcare and if people are not treated they can die," he said. "If she had had an infected anything else, Medicaid would have paid for it. Since it was teeth, they would not cover it. Since when is a tooth not part of the body?"

The federal government provides funds for Medicaid, but states must also provide funding in order to qualify. States must provide most types of healthcare but have the option of whether to provide dental, optical, and mental health benefits. Several states eliminated dental benefits this year because their revenues declined during the recession.

"We need to make this mandatory so that places like Michigan don't cancel dental benefits every time they have a hiccup in their budget," said Dr. Veryser.

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