Smiles Change Lives participant Kristhan (Rob) at his orthodonist Dr. Steven Tottori’s office. Photo courtesy of Smiles Change Lives
They call it “the neglected epidemic.” An estimated 49 million Americans, especially in rural areas and the West, live in areas facing a shortage of dentists. Worse, many insurance plans don’t include dental benefits, and those that do often only cover the most severe issues. Even for foster youth — an especially high-need population that typically receives special medical benefits — dental care is “erratic,” as one of the few peer-reviewed studies on the issue found.
That’s where Smiles Change Lives comes in. The Missouri-based nonprofit has a network of 800 orthodontists (dentists with higher-level certifications) nationwide who regularly donate their time by offering their services to low-income youth, including those in foster care. According to the American Academy of Pediatrics, nearly 40 percent of children in foster care have a serious oral health issue. But, in many states, only the most serious of those issues are covered under state Medicaid programs — and braces are often considered not serious enough.
Major medical associations argue otherwise. Keeping clean teeth is much easier with straight teeth, and crooked teeth can affect speech, causing slurring and other speech issues. Not to mention, if you have crooked teeth or a tooth that sticks out you get made fun of. A large majority of children who apply to Smiles Change Lives suffer measurable psychological issues related to self-esteem.
“Kids are cruel and will find anything to make fun of,” says Janell Pallanich, legal counsel for Smiles Change Lives.
California’s Medicaid program, known as Medi-Cal, is one of many that often don’t cover braces. That’s why Smiles Change Lives has enlisted a new partner to help: Dr. Brian Bergh of Glendale, Calif., in Los Angeles County is volunteering to give 50 youth braces — the equivalent of $300,000 in dental services. Smiles Change Lives’ corporate partners will donate the wires and brackets that will soon stud hundreds of young teeth.
Smiles Change Lives participant Emily with Dr. Struckoff. Photo courtesy of Smiles Change Lives
“We think it’s important to help them feel better about themselves socially and academically,” Pallanich said.
Smiles Change Lives has served 12,000 children and youth to date, with significant growth in recent years to an average of 1,200 per year. Pallanich says the national average for braces is $5,000 or $6,000, but the typical dental benefit through insurance would only cover $1,000. Most families don’t have dental coverage at all.
By comparison, Smiles Change Lives charges only $650, usually paid by foster care agencies, foundations or sometimes foster parents.
“We used to not require anything but, to be quite honest, the typical orthodontic treatment takes two to three years, to make sure treatment is working effectively. We’ve found families are more invested if they have skin in the game,” says Pallanich. “We do advise caseworkers applying on behalf of children in foster care that they need to be in a stable placement before beginning treatment as moving can disrupt treatment.”
