Des Moines refugees struggle getting dental help

Many Afghan refugees resettling in Des Moines are struggling to find oral surgeons who are willing to take Medicaid — resulting in long drives to find care.

What's happening: Some of the refugees arrived with severe oral needs, like root canals and extractions, because they were unable to get care in Afghanistan and at the U.S. base camps, said Kerri True-Funk of USCRI-Des Moines.

• One Afghan refugee got off the plane in Des Moines with a wadded-up napkin containing several of her teeth.
• She lost them while chewing gum that someone gave her to keep her ears from popping, said Emily Mendez, of local nonprofit Dental Connections.

Between the lines: The Medicaid reimbursement is so low for dentists in Iowa that many of them lose money if they accept it, resulting in a backed-up system, said Laurie Traetow, executive director of the Iowa Dental Association.

• And there's been a "significant" decline in dentists accepting Medicaid since the program privatized in 2016, Traetow said.
• Dentists accepting Medicaid receive about 30-40 cents on the dollar, Mendez said.

Zoom in: There are no oral surgeons that accept Medicaid in central Iowa — resulting in patients seeking care two hours away at the University of Iowa College of Dentistry.

• Dental Connections said outside of their work with the refugees, they've had to stop taking adult patients themselves, unless they're referred by a community partner. But they still get around 20-30 calls a day from people seeking care.

How it works: When refugees arrive in Des Moines, resettlement agencies help them process Medicaid, which can take up to six weeks, True-Funk said.

• Nonprofits like Dental Connections are willing to see them in the meantime, where they're able to get regular dental care.

• But for cases that require surgery, refugees have to be referred to UI or a Cedar Rapids clinic and may wait up to six weeks for an appointment.

Of note: Children have an easier time finding care because they're covered under the Healthy and Well Kids in Iowa program.

What they're saying: If one or two dentists in Des Moines could take a few patients a week, it would make a significant difference both for the refugees and the overstretched organizations, True-Funk told Axios.

• "Those are intense procedures and you're in a lot of pain and you have to think about being in the car for hours on top of that," she said.

Editor's note: This story has been revised to include an update from Dental Connections that the nonprofit is unable to take all adult patients that haven't been referred by a community partner, not only Medicaid patients.