Reason to smile
Photo courtesy of Mary Lashley
Oral healthcare initiative serves one of Baltimore’s most vulnerable populations
By Stuart Zang
TU’s Department of Nursing is partnering with the University of Maryland’s School of Dentistry and the Helping Up Mission to provide oral health services to the city’s homeless.
Mary Lashley, TU Department of Nursing, initiated an innovative oral health care program in fall 2006 with $53,000 in grants, after searching for comparable programs for the homeless but finding none available in Baltimore, let alone elsewhere.
“Federally qualified health centers have a sliding payment scale, but that scale does not slide to zero,” Lashley says. “Low cost is not the same as no cost. Even with a 30 to a 70 percent reduction in standard fees, oral health care is cost prohibitive for the homeless. If you can’t afford to pay for service, whether its $30 or $300, you can’t access that resource.
“It was an unacceptable situation. I wouldn’t allow it for my family, and I couldn’t accept it for these men. I knew we could do better.”
The oral health care program serves residents of the Helping Up Mission, a non-denominational, faith-based institution dedicated to serving about 275 of the city’s poor and homeless each year with counseling, medical and legal services, job training and placement, emergency shelter and substance addiction recovery programs.
The program, which Lashley sustained this year with an additional $140,000 in grants, has three components: education, screening and treatment. Students in Lashley’s Community Health Nursing course come to the mission at least twice a month to provide residents with one-on-one counseling and support, which includes educating them on the importance of proper dental hygiene. The students also conduct a health fair on site each term.
“I think it awakens a sense of civic responsibility in our students,” Lashley says. “It’s a life-changing experience for many of them, especially when they realize health care in America is not a right, but a privilege.”
This year, approximately 45 students from the University of Maryland Dental School screened nearly 100 residents for oral cancer and conducted triage to determine which residents needed urgent treatment. A considerable portion of the program grant covers preventive and restorative care—such as root canals, filling cavities and extractions—provided by the dental school.
Dentures, which are in high demand, can cost as much as $600 for an upper or lower set. Lashley says the results are much more than merely cosmetic.
“A lot of these men have not smiled in a long time because they’re painfully aware how their teeth look. That affects their self-esteem, which is a big problem when they’re seeking employment and trying to return to society.
“We’re trying to restore their dignity through treatment,” she says. “You can’t put a price on that.”
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