Dentist of the Back Roads

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A Bite Out of the Bayou

Dentist Gregory Folse provides dental care to underserved elderly patients in and around Lafayette, La.

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In Medicare's case, "the justification was this is a routine service you don't need insurance for," said Marilyn Moon of the Silver Spring-based American Institutes for Research. Adult dental coverage was later made optional under Medicaid. But lawmakers have remained reluctant to expand benefits, given the program's spiraling costs.

Private dental insurance is expensive as well. A plan for AARP members in Lafayette, for example, offers annual premiums starting at $424.20. The bulk of Folse's patients, before entering nursing homes, lived on fixed Social Security incomes of less than $1,000 a month.

Folse estimates that adding a dental guarantee under Medicaid for the aged and disabled would cost $700 million a year. He advocated for such a provision, and a bill was introduced in Congress in 2005. It never moved past the committee level.

Last year, galvanized by the death of a 12-year old Prince George's County boy, Congress tried to include a dental guarantee for the children of the working poor in an expansion of the State Children's Health Insurance Program. The expansion was vetoed twice by the president and shelved.

Benefits for seniors and the disabled never entered the discussion.

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The twice-divorced Folse lives on a farm north of Lafayette. His hay crop this year will help pay the bills. He also sells a baling machine called the Bale Band-It. When he drives his circuit, he sometimes gets "hay calls" from people who want to buy hay or from Bale Band-It customers.

"Sometimes a bale will bust, and it's not the Band-It's fault," he says. "You gotta know what to do."

Folse drives 40,000 to 50,000 miles a year. He never uses a map.

He was born farther south, down in Raceland. His grandfather, the country doctor, was a big influence. So was his father, a livestock auctioneer. Folse worked cattle to pay his college bills. He thought about going to veterinary school, but then he found dentistry. The idea just hit him one day.

"Senior year, we did a rotation in nursing homes. The residents really inspired me," Folse said. "They had so much need."

After graduation, he worked in a nice office with regular healthy patients. But he started visiting nursing homes on Fridays, his day off. He was overwhelmed again by what he saw and how he felt treating the frail, the deranged, the forgotten, the truly grateful.