LAFAYETTE, La. -- Add this to the list of things that get more difficult as we grow older: Going to the dentist.
If you're in a nursing home, a trip to the dentist can be near impossible, financially or even physically. At the same time, our stake in good dental health grows, even to the point where a dental procedure is a matter of life or death.
Lafayette dentist Gregory Folse has built a practice, Outreach Dentistry, on providing dental care for such patients, including dozens each year who cannot pay. That's why he was recently named Dentist of the Year by 232-HELP, the social service information and referral service.
"I've got a 'no suffer' policy in my office, that no patient will suffer from dental disease as long as we're in this game," Folse said. "We make sure all these folks are taken care of, regardless of the funding we may have. 232-HELP helps us organize that care."
"It's that kind of generosity of spirit that we look for in our Dentist of the Year," said Rae Logan, executive director of 232-HELP.
Folse and dental assistant Abby Trahan were at Maison de Lafayette to begin the work of realigning dentures for two patients.
"I've found that most of my patients, as was the case this morning, have multiple differing diagnoses," Folse said. "Sometimes they have 15 or 20 different diseases. They may have 15 to 20 medications.
"You tie that many diseases and that number of drugs with an abscessed tooth and an infection that won't go away, then you've got a problem for a nursing home patient."
Sometimes the problems can be lethal.
"Unfortunately, in my career I've seen numbers of patients who have passed away either directly because of poor oral health, due to an infection . or who have complications that come from the disease process combined with dental infections that worsen the diseases than they have."
So Folse goes to the patients who can't come to him.
A native of Raceland, Folse sometimes accompanied his grandfather, a physician, on house calls. After attending the University of Louisiana at Lafayette and the LSU School of Dentistry, Folse had a traditional dental practice for a few years.
"The need for what I do now is pretty profound," he said.
Going into nursing homes meant leaving behind dental chairs and other pieces of major equipment. Folse carries portable versions of some of the tools of the trade with him.
Folse said that when he started treating nursing home patients in 1992, Medicaid, the state-federal health care coverage program, covered only dentures. Since then, reimbursements to participating dentists have improved. He also discovered that reimbursement rules let nursing home residents pay for dental care with Social Security money that would normally go to a nursing home. The state must make up for the lost revenue to the nursing home.
Folse receives a stipend from the nursing homes where he sees patients. Even so, Folse estimates that he gave away about $44,000 worth of care last year.
"He's an amazing man," said Logan at 232-HELP. "His dental practice focuses on the elderly, and a good part of our clients are the elderly and those who are disabled and unable to get dental services any other way. .
"If you live at the poverty level in Louisiana, you cannot afford to get your teeth cleaned. You're unable to get your teeth pulled."
Folse is advocating for nursing home dentistry and mobile dentistry at local public schools, publishing articles and talking to professional organizations and lawmakers.
"I look forward to making a patient who has poor oral function eat and chew," Folse said, "and enjoy the three best events of the day, which are breakfast, lunch and supper."