Dental Care Just a Faint Dream for Va. Homeless

An abscessed tooth long left Jim Overgaard, now in Fairfax County, in unrelenting pain.
An abscessed tooth long left Jim Overgaard, now in Fairfax County, in unrelenting pain. (By Jahi Chikwendiu -- The Washington Post)
By Bill Turque
Washington Post Staff Writer
Monday, June 12, 2006

There are moments when the pain is so intense that it overtakes all of Jim Overgaard's senses. It roars through him in palpable waves, with its own taste, sound and color.

"It's brown," he said. "I don't know how else to describe it. It's just brown."

Overgaard is a 62-year-old homeless man with bad teeth and few options in Fairfax County for getting them fixed. Treatment has often meant long treks to the District or taking care of it himself. When you're homeless, home dentistry is a pair of pliers, which he once used to extract two teeth. By his own count, he has about 12 healthy ones left.

At the moment, his upper right canine is broken off and has become abscessed. Medicine has held the pain in check, but it will run out in a few days. Then the pain will start, as it has before.

"It's bad. You howl. There's no way out of it," said Overgaard, a frail man with frizzy gray hair pulled back into a tight bun who carries a walking stick he occasionally uses to whack cars that don't heed pedestrians.

He is among the slightly more than 2,000 homeless people in Fairfax, about half of them single adults, according to the most recent survey. They contend with myriad medical issues, including drug and alcohol addiction and depression. Dental problems are among the most insidious and undertreated.

Years of hard living and neglect have created mouthfuls of cracked, broken, blackened and rotted teeth as well as bleeding gums. For people with already-weakened immune systems, dental infections can be life-threatening.

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.

"To be perfectly honest, resources are scarce for dental care," said Michelle Milgrim, assistant director for patient-care services in the county's health department. The county is developing a program to more aggressively extend health services to the homeless, especially to those like Overgaard, who resist going to shelters.

Stories of dental calamities are legendary among social workers who deal with the homeless. Marte Birnbaum, director of the Embry Rucker Community Shelter in Reston, recalled a man who tried to use Super Glue to keep his dentures in place. Many have teeth so vulnerable, Birnbaum said, that the shelter tries to keep a supply of soft, canned fruit so that clients avoid losing them to apples and other firm produce.

Overgaard, currently staying with a friend of a friend in Falls Church, went to the Fairfax Department of Family Services' offices in Baileys Crossroads on Tuesday to find help.

A social worker gave him a phone number for the county's Department of Human Services. The woman who answered said that the place closest to him, the Northern Virginia Dental Clinic in Falls Church, wasn't even taking names for its waiting list at the moment. It also charges $30 for a visit, money that Overgaard said he does not have.

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