PASO ROBLES PRESS — Even on a slow day, Tolosa Children’s Dental Center’s waiting room is full of people and inside the center, every dental chair is occupied by a child receiving anything tooth-related — from cleanings to fillings.
And though the privately-run nonprofit center is one of only two North County dental care providers that offers affordable dental care for children with Denti-Cal, the organization says the demand for low-cost care is even larger than what they have capacity to provide.
“We’re always packed,” said Alexandra Chamberlain, Development Director at Tolosa. “Six thousand kids a year — that’s almost the almost the amount of kids in the entire San Luis Obispo Coastal Unified School District that we see through our doors.”
Tolosa Children’s Dental Center (TCDC) once had to “close their doors” to new appointments for almost an entire year to catch up on their list of dental patients. It wasn’t easy for the front line office staff to turn new families away, but if they kept accepting patients, those already on the list wouldn’t be seen in a timely manner.
In order to keep expanding access to those in need of low-cost dental, Tolosa’s leadership knows it’s critical for their center to grow because they hope not to slow the flow again. Just how they will do this remains to be explored. Extra money isn’t exactly sitting on their laps, yet Tolosa’s staff and board knows without their services, the county cannot meet the dental needs of its youngest smiles.
The bustling center is about to celebrate its 15-year anniversary in San Luis Obispo County. A board of directors started the organization after a study confirmed the undeniable need for improved oral health in children.
According to the National Children’s Oral Health Foundation, pediatric dental disease (otherwise known as childhood tooth decay) is the number one chronic childhood illness in America and one in five of U.S. children presently go without any dental care at all.
The foundation reported that children with poor oral health are three times more likely to miss school as a result of dental pain and dental care is the most prevalent unmet health care need for children with special needs. The doctors at Tolosa are specialized in special needs dentistry and all dentists have taken the classes necessary to deal with fears and anxieties in dental work.
Tolosa meets the need for affordable, high-quality pediatric dental work for children because it accepts Denti-Cal, Medi-Cal’s dental component. Tolosa’s has been around since 2003, but the board learned from a survey that Paso Robles had the largest need for low-cost dental in the region, and though it already has a center in SLO (open only on Thursdays), the board felt the need to also open up in Paso.
So in 2011, due in part to funding support from First 5 SLO County, the dental office in Paso Robles increased its capacity to serve more children by gaining some space from the adjacent Public Health Office and undergoing an interior remodel to allow for more treatment chairs (for a total of seven), an additional exam room, added storage space, and a proper staff break area.
The Paso Robles center is completely child-centered and comprehensive, with soft, pastel landscape paintings on the walls, and all the latest in dental equipment. The atmosphere is upbeat and lively, with dentists singing songs to children wearing their choice of sunglasses under the lights. One can hear giggles and electric brushing sounds.
At the end of their visit, the children receive a well-deserved sticker.
“We’re very passionate about what we do,” said Suzanne Russell, Tolosa’s Executive Director. “We’re all very dedicated to helping these children and committed to our mantra of doing what’s best for the child.”
Tolosa serves about 6,000 children each year; approximately 1,200 individual children are seen each month and more than 16,000 individual children have been seen, in total, since it first opened.
“We served over 5,600 children last year,” Russell said. “That’s individual children – multiple appointments for each of those kids.”
Tolosa’s dental services are preventative, such as exams and cleanings; restorative, such as fillings, crowns and extractions, and specialty care that requires general anesthesia. It employs 23 staff members, including licensed pediatric specialists and dental assistants.
Tolosa’s dentists pride themselves on compassionate, continuing care, with a mission to “improve children’s dental health in SLO.”
Infants and children up to age 18 who are MediCal insured, low-income insured or in the Foster Care Program may call for an appointment to be seen within a few weeks at TCDC. This covers many children in the North County and yet the center still knows there are more children to reach.
“The American Academy of Pediatric Dentistry recommends a child’s first visit to the dentist be by the age of one or when their first tooth erupts. Age three is too late.
“We do know if we can start seeing a child at age one, we have a really, really good chance of preventing dental decay or at least minimise the amount of dental decay that they will experience,” said Russell. “That’s what we’re here for.”
More children need dental care than the center can accommodate, but there all also challenges unique to each family such as gas costs, missing work and school, and convenience, that keep children from getting the dental care they need, according to Russell. People are travelling to Paso from Cambria and San Simeon just to be seen, since the hours of the Paso Center are all day, Monday through Friday. Families will drive from Morro Bay, Arroyo Grande, Los Osos, Cayucos to get their children into the SLO dental center, which is more centralized but is only open on Thursdays.
“Ideally we would also be on the coast,” said Russell, adding that Tolosa wishes to expand their hours in San Luis Obispo as well. Also being talked about is a mobile dental service, a teledentistry model which is growing in popularity, to provide service to students on site at schools so that children will not have to leave school for appointments, or their parents will not have to miss work to get them there.
“It has hurdles and challenges, but all the studies show that the closer the services are to the residents, to where these children are residing, the more likely they are to get care and be more healthy, because you’ve removed a large number of barriers preventing them from accessing care,” Russell said.
The center provides a sliding-fee scale for cash paying patients.
“100 percent of our patient base is low-income, underserved,” Russell said. “Ninty-nine percent of our patients are enrolled in the State Denti-Cal program… They’re all coming from families with restricted financial means.”
Russell explained that since the Affordable Care Act of 2010 raised the income threshold for families, and the qualifying income for children, more children qualify for Medi-Cal and Denti-Cal.
“We went from 75 to 80 percent of our patient base being insured under the state program to 99 percent,” she said. Under Denti-Cal, there is no out-of-pocket cost for a child to see a dentist (orthodontics excluded) for most services. “In the eleven years I’ve been here at Tolosa, this is probably, in regards to coverage, the best time that we’ve seen probably in the history of the Denti-Cal program.”
The Government reimburses Tolosa about 40 cents on the dollar for what they bill, Russell said, this reason being why many private dental practices cannot afford to accept Denti-Cal. She added, “Just imagine trying to meet your monthly budget only trying to get 40 cents on the dollar. If you had 60 cents less, would you be able to pay your bills?”
She said this is the reason we don’t have more providers for low-income families.
“The challenge is access to care,” she said. “The children have coverage, but it’s insufficient to encourage private dentists to accept it in any volume to meet the need.”
TCDC runs on a budget of approximately $150,000 a month. The Community Health Centers (Templeton) are the other centers in North County that accept Denti-Cal for dental work, as well as health care across the medical spectrum (accepting Medi-Cal).
“Dentistry’s expensive,” Russell said. “The equipment’s expensive. The product’s expensive. Staff is expensive…” She said to meet the need of 6,000 children a year they simply must expand their access.
“We are looking for a site to expand into San Luis. We’re only one day a week there, and we’d like to expand to at least three,” she said. Adding a brick and mortar center may take a capital campaign, she added. “Access is not going to improve until reimbursement rates are much closer to what a private insurance company would pay. That’s what’s keeping dentists from enrolling as a provider,” she said, not to mention how complicated the state makes the process of processing the claims. She said it’s not because dentists don’t care to help children – they simply cannot afford it or sustain it.”
On June 24 Tolosa will be hosting “Sip for Smiles,” a snack and wine fundraising event at Filipponi Ranch. DJ Bob will be providing the dance music, and Pulcinella Woodfired Pizza and wine will be provided by Filipponi Ranch Winery. Visit TolosaChildrensDental.org
or call 805-238-2216 for more information. On Sept. 8, Tolosa would like the public to save the date for a second event to benefit the center. “Sunset Safari BBQ” will be a fine dining dinner with cocktails and auction held at the SLO Country Club. More details will be available at TolosaChildrensDental.org
as the event approaches.
Tolosa Children’s Dental Center is located at 717 Walnut Drive in Paso Robles. Hours are Mon.-Fri. From 8 a.m. to 5 p.m. (closed from noon to 1 p.m. for lunch). Closed all major holidays. Call 805-238-5334 for an appointment.
You may reach Reporter Beth Giuffre at [email protected]
for questions and/or feedback.
Photo by Beth Giuffre
Suzanne Russell, Tolosa’s Executive Director and Alexandra Chamberlain, Development Director at Tolosa, stand in front of the Tolosa Children’s Dental Center in Paso Robles.
Photos courtesy of Alexandra Chamberlain
Dentists and staff in costume pose for a photo at Tolosa Children’s Dental Center.
Tolosa Children’s Dental Center offers low-cost dental care to underserved children.