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Boston University Chamber Orchestra concert, Friday, January 31, 8 p.m., CFA Concert Hall
Week of 24 January 2003· Vol. VI, No. 18

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SDM’s BUMP UP dental program helps patients no longer covered by state insurance

By Brian Fitzgerald

Former Governor Jane Swift’s cuts in health programs — including most dental services for low-income people — in order to balance the state budget have produced anger and frustration across Massachusetts. Disadvantaged people seeking treatment for a painful toothache are now feeling the pain financially as well.

Stephen DuLong
  Stephen DuLong

But BU’s Goldman School of Dental Medicine has responded locally with a plan that provides low-cost access to many procedures no longer covered by the commonwealth. Combined with the benefits still covered by MassHealth, the state’s Medicaid program, the plan, called the Boston University MassHealth Patient Upgrade Program (BUMP UP), will enable these patients to continue to receive basic dental treatment, including emergency treatment, diagnosis and treatment planning, cleanings, fillings, and routine extractions.

“Included in our school’s mission statement is offering excellent health care services to the community, and we take that very seriously,” says Stephen DuLong, SDM associate dean for clinical services. “The cuts left many people without a way to afford basic treatment. The only treatment that had been left covered by the state were emergencies, extractions, and dentures — and that coverage for dentures has recently been eliminated.”

Indeed, MassHealth ended financial support for complete and partial dentures on January 1, 2003. SDM announced on January 13, however, that it will extend the BUMP UP plan to help clients meet the costs of necessary denture services.

BUMP UP isn’t an insurance plan, but rather a supplemental, low- cost self-pay plan. After paying an annual administrative fee of $65, patients are not charged for such services as the initial oral exam. They also receive free treatment planning, along with reduced charges for services, including cleanings ($12), fillings ($12), and periodontal surgery ($50). The program provides affordable access to basic procedures necessary to achieve and maintain good oral health.

The school recently took out a two-day ad in the Boston Metro newspaper to publicize the program, which, says DuLong, has been well received so far by patients who depend on SDM for their dental care, and by the school’s more than 300 students who are active in community clinics. About 40 percent of their patients had been covered by MassHealth, and many of those eligible are joining BUMP UP.

The SDM students’ work is not only essential to the oral health of a vulnerable segment of the population, but also is invaluable for their own education. DuLong says that working with these patients “is a tremendous learning opportunity for our students. This is one of the ways they acquire the skills necessary to learn the profession. They have developed tremendous doctor-patient relationships, so they are very appreciative of BUMP UP.” He adds that this is in addition to the program’s primary purpose: benefiting those who would have nowhere else to turn for dental services.

The plan is not a cure-all because some of the needier patients won’t be able to afford even the minimal fees. But BUMP UP is responding to crucial needs in the community during critical fiscal times. The state is facing a budget gap of as much as $600 million this fiscal year, and its short-term prognosis is poor, with the deficit projected to be up to $3.6 billion next year.

When Swift announced her proposed budget in January 2002, the Boston-area dental school community was aghast, but not silent. The following month, SDM Dean Spencer Frankl joined officials, professors, and students from both the Harvard and Tufts dental schools for a rally at the State House to denounce the $36 million in cuts affecting dental care for half a million financially disadvantaged adults. The funding decisions “are fundamentally contrary to the ethical, educational, and clinical standards taught,” according to a joint statement from the schools. The elimination of “basic adult dental services from Medicaid demonstrates an ignorant and poor understanding of the role oral health plays in each person’s general health.”

DuLong points out that Surgeon General David Satcher’s 2000 report Oral Health in America links dental health with overall health and notes that oral examinations contribute to the identification of over 100 systemic diseases, including AIDS, diabetes, and nutritional deficiencies. (See story on SDM’s Oral AIDS Clinic at www.bu.edu/bridge/archive/2002/08-30/aids.htm.) “Ignoring oral health problems can lead to needless pain and suffering, causing devastating complications to an individual’s well-being,” says the report, “with financial and social costs that significantly diminish the quality of life and burden American society.”

The cuts will stretch the financial resources of SDM, but in its 40 years, the institution consistently has been committed to the community, with such initiatives as the APEX Program, which provides dental students with the opportunity to work in a variety of urban health centers (including Boston Health Care for the Homeless). SDM’s oral health education visits at public schools have provided free sealants — a plastic used to protect pits in tooth surfaces against cavities — for children in Boston as well as in Chelsea.

However, the budget cuts have struck a blow at the very heart of SDM’s efforts to help the disadvantaged. BUMP UP won’t be able to absorb all of MassHealth’s former patients, and DuLong wonders what will happen to the people who won’t be able to afford even the minimal fees, and “fall out of the system.”

At last year’s State House rally, Mandy Louis (SDM’02) expressed the same concerns. “The thought of shutting out an entire demographic of patients, particularly the ones already compromised,” she said, “is most disturbing and perilous” and unfair to a population “that is all too often neglected and ignored.”


24 January 2003
Boston University
Office of University Relations