Medicare is the federal health insurance program mostly known for serving adults over the age of 65 regardless of income. Nearly half a million Nevadans are enrolled, but they must still pay out of pocket for dentures or routine dental procedures like cleanings, fillings and tooth extractions. As a result, some seniors must forgo dental care or seek out low cost clinics. KUNR’s Lucia Starbuck has more.

Barbara Auberry is patiently sitting in the cozy waiting room at Compassion Community Clinic in Reno. There’s a table with free toothbrushes and thank-you cards written by patients. This non-profit provides free services for low income and uninsured adults.

“Even though I have a little insurance, it doesn't pay for dental,” Auberry said.

Before retiring from International Game Technology (IGT) in 2010, Auberry used the insurance through her employer. But since then, she has gone without oral care for eight years and was on the clinic’s wait list for a year and a half. Over that time, poor oral health impacted her confidence.

“The missing teeth right now are what are really embarrassing for me, so my self-esteem is in the basement,” Auberry said.

Auberry’s daughter, Angele Navares, is keeping her mom company in the waiting room. It's been difficult to hear about her mother’s tooth pain and she misses her mom’s smile.

“With the loss of that front tooth, she really didn't want to take pictures, and I finally was like, ‘Mom, we are going to have pictures of you; you don't have to smile or you don't have to open your mouth, whatever you're comfortable with.’ So, that's what she does now. She just keeps her lips closed and does that kind of a smile, and it's so not her smile,” Navares said.

Navares is thankful for the free services Compassion Community Clinic provides. For years, she felt helpless and even had to sell a family car to manage costs.

“We didn't have the funds to help keep up with paying cash for her dental work,” Navares said. "I talked with people who had elderly parents. It's like, ‘What do you guys do for dental work?’ and nobody had an answer. They said, 'We don't do anything.' And then the people that have money said, ‘Well, we pay for it. We pay cash for it.’ "

Unfortunately, on this day, after two and a half hours, Navares and her mom are sent home from the clinic because Auberry’s blood pressure is too high. If seniors have other health problems, that can complicate their ability to receive care.

Kathy Secrist is the executive director of the clinic and often works with seniors.

She’s supervising dental hygienists who are volunteering their time to perform cleanings and other procedures. Her staff often sees seniors who are missing teeth due to taking prescription drugs.

“Our patients, it’s usually side effects from major medications, like diabetes, high blood pressure. Those medications, almost the number one side effect is it deteriorates their teeth, so our entire, you know, older generation that are on all these medications because of their health, didn't know that they were going to be breaking down their teeth during this process and now they're suffering from it,” Secrist said.

More than half of Americans older than 65 take at least 4 prescription drugs. A common side effect of these medications is dry mouth, which can lead to tooth decay and infections. Medicare doesn’t cover denture sets and they can often cost $600 to as high as $8,000.

Beth Chartier is Nevada’s Interim State Public Health Dental Hygienist.

“If you do have that problem where you have an ill-fitting denture or a partial denture or you don't have teeth at all in the back, it creates a major problem for the elderly to be able to take care of themselves nutritionally,” Chartier said.

The back teeth are used for chewing, so without those, people tend to avoid fruits and vegetables, which can result in a poor diet. In addition to physical effects, there are other impacts, too.

“When you don't have teeth...you may be self conscious and you may isolate yourself,” Chartier said. “All of these types of things can definitely affect how you feel about yourself as an individual and even, perhaps, unfortunately, in fact, how others see you as an individual.”

As you grow older, so do your teeth. After a lifetime of eating, and maybe even grinding your teeth, the enamel can wear away. Basically, this is a crucial time to access care, but many seniors are forced to go without.