Homeless Don’t Get Good Dental Care

When I saw the headline, “Dental Care Just a Faint Dream for Virginia Homeless” in today’s WaPo, my reaction was, “No s “That’s news?”

After a few paragraphs of anecdotes about how horrible it is to live “a hard life,” have one’s teeth deteriorate, and live in excrutiating pain, we get to the point:

For most homeless adults in Northern Virginia, dental care is difficult to find. Medicaid in Virginia does not cover dental work for adults. Fairfax employs three 20-hour-a-week nurse practitioners who visit homeless shelters, but they are not set up to deal with serious dental issues. Shelter social workers try to get serious cases to dentists who will work for discounted rates, but there are few.

As the story notes, though, the people “contend with myriad medical issues, including drug and alcohol addiction and depression.” The issues that keep them from getting jobs, houses, baths, toothpaste, and so forth are the same ones that prevent them getting dental care. If our aim is to fix the problems of the homeless, I’m not sure I’d start with the teeth.

UPDATE: To clarify, I’m not being flip. Being in agonizing pain because of defective teeth is a horrible situation, obviously. So is sleeping outdoors in subzero temperatures, being at the mercy of criminals, and a complete lack of dignity.

My point is that the problem goes a hell of a lot deeper than inadequate access to dental care. The vast majority of these people are mentally ill and/or drug addicts without the ability to manage their lives. Unless we’re willing to institutionalize them or otherwise fix the “root causes” of their problem, expanding Medicaid benefits is unlikely to do much for them. Indeed, if medical care were entirely free, 99% of the homeless would not have any idea that the change had been made, let alone manage to get themselves to a dental appointment.

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James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.


  1. Ringo says:

    Yeah! Stupid homeless people! Let their teeth rot!

  2. Fersboo says:

    I don’t know, but maybe government dentists would help those homeless get back to work. You know, tough love. I know after having military dentists prod and pull my wisom teeth and put me in the hospital, I was motivated to earn enough money to allow myself never let a government dentist near my mouth again.

  3. Gnatman says:

    Dentist Bills are expensive even with insurance. Any program that helps the homeless get jobs, pay taxes, and become productive members of society should be looked at.

  4. Jayne says:

    “If our aim is to fix the problems of the homeless, Iâ??m not sure Iâ??d start with the teeth.”

    With all due respect, I think if you’d ever been in the kind of pain he’s talking about you’d be a little less flip. I have, but all I had to do was fork over some $$ and get antibiotics and Vicodin. And see a good dentist. I can’t even imagine that kind of constant agony. I mean, if a homeless man were lying in the street with a gunshot wound we’d HAVE to do something but in this case we don’t HAVE to? That can’t be right.

  5. LJD says:

    Except that homeless people are largely in that situation because they can’t hold a job or become productive members of society.

    Perhaps mental health care would be more productive than dentist visits.

  6. RA says:

    The solution is easy. Bumbs should get jobs. That is too sufisticated for the dopy left.

  7. John Burgess says:

    Hey! I can sympathize. The US State Dept. has just announced that it will start–sometime real soon–participating in a group dental and/or optical insurance plan! At present, dental and optical are completely outside any of the federal insurance plans.

    The dental/optical insurance will not receive any government subsidy, however: all premiums are to be 100% payable by the employee.

  8. Kent says:

    You’ve alreawdy identified the root of the matter: Most of the homeless are mentally ill or substance abusers. Their presence on the streets is the result of a misguided push for deinstitutionalization, driven by carefully researched Hollywood documentaries like One Flew Over the Cuckoo’s Nest and the desire not to spend too much money on mental institutions.

    Until we are willing to admit that these homeless are legally incompetent, and that committing them to an institution against their wills (awful as it sounds) is better than leaving them to rot in the streets, we will continue to have the problem.

  9. McGehee says:

    With all due respect, I think if you�d ever been in the kind of pain he�s talking about you�d be a little less flip.

    Because employed people never get toothaches, right?