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LARGO, Fla. (AP) — Brian Bunch had been experiencing a pain in his mouth he described as "kind of horrible" for years. The feeling grew worse a few months ago when a tooth in the upper right side of his mouth broke off.
"I'd had a root canal on it when I was a kid, and the filling fell off," Bunch said. "It's been falling apart ever since."
Without insurance or anywhere to turn for help, he had been dealing with the pain the best he could, trying to eat with the front of his teeth and to avoid the sensitive spots.
For the first time in five years, Bunch, 31, sat in a dentist's chair recently as one of the early participants in a program between the public defender's office for Pinellas and Pasco counties and the Florida Department of Health that provides for offenders in serious need of dental care.
The two agencies entered an agreement effective Aug. 1 that provides dental care for individuals enrolled in the jail diversion program. The health department provides pain relief, extractions, fillings, exams and cleaning for those referred by the public defender.
Dentist Tasha Ward evaluated Bunch, who will have to return to the clinic to have five teeth removed. Four have to be taken out, the fifth was Bunch's choice. The tooth could be saved, but only at the cost of a root canal and crown, services that can't be provided at the free clinic.
"A lot of times they just don't have the finances," Ward said. "There's a way to save it, but it's so expensive."
He left the Largo clinic with a prescription for antibiotics waiting at a local pharmacy. Bunch is living in a treatment facility after spending 8½ months in jail on two counts of drug possession. His access to painkillers and other drugs at the facility is very limited, and everything has to be run through management there.
The last time Pinellas did a survey on resident needs, dental care topped the list. Homeless populations often have neglected medical needs, which can lead to problems with drug and substance abuse.
"So now we've got a guy in jail on felony charges because essentially the guy had a toothache," Public Defender Bob Dillinger said. "I don't think most people think that's what the jails were assigned for."
The program is set to address some of those problems in one of the county's most vulnerable population: low-income residents with a criminal history.
When possible, Pinellas will be billed for services performed at the Largo health department. When coverage is not available, however, the public defender's office will pick up the bill at a $70 agreed-on rate, with costs coming out of its existing $400,000 budget.
The plan is for the health department to make two half-days a month available for dental checks. When referred patients come in, they are given an exam, and if more treatment is needed they will get an appointment for the next session, as was the case with Bunch.
Public defender's office officials may drive the referred patients to the clinic. Of the seven people scheduled for care one recent Monday, only three showed up.
Ward said it will take some time and word of mouth before the new program starts to take off.
Sarah Dent, 33, said her teeth had been hurting for three or four years before her recent appointment, where she was prescribed antibiotics and made more appointments with Ward. Many of her teeth have decayed and broken off at the gum line, requiring fillings and extractions.
For Dent, it was a checkup that was long overdue. Without the clinic, she wouldn't know where to turn.
"I'd pretty much be suffering," she said.
Information from: The Tampa (Fla.) Tribune, http://www.tampatrib.com