HCV infection and veterans’ oral health


dental

Click image to read this report–Dental and Orofacial Health and Hepatitis C. Image: Cover of report by Australasian Society for HIV Medicine

According to a 2012 report published for dentists by the Australasian Society for HIV Medicine, which also covers hepatitis, health problems associated with HCV are numerous. The report, Dental and Orofacial Health and Hepatitis C contains a few graphic images including one of an oral Non-Hodgkins lymphoma lesion (fig. 7).  

abq va

One smart starving Vietnam vet who accidently lost his dentures and lost several pounds because he couldn’t eat, turned to a News program for help with the Albuquerque VA. CLICK FOR STORY. Image credit: KOAT TV

Medicare is no help because “Congress has not amended the dental exclusion   since 1980 when it made an exception for inpatient hospital services when the dental procedure itself made hospitalization necessary.” The VA isn’t much better if a veteran is not 100% service-connected but there are a few exceptions (page 3).  To download a Word document describing the VA’s classes of care, click: Class VI

Shamed Phoenix VA nicely states:

Established eligibility for dental care is required to receive dental care from the Dental Department. If you are without service-connected eligibil­ity for dentistry, and your medical con­dition may be aggravated or adversely affected by your dental condition, you may be evaluated and treated upon consultation between your physician and the Dental Department….

Finger-wagging, Minneapolis VA adds: finger

…Be aware that this does not automatically make you eligible for routine care, and treatment may be limited.

(If you have a dental emergency, you must go to the ER first and may be charged $500+.)

 If the treating physician won’t give a referral, can you write up a NOD?   The VA’s new pay-for-your-own Dental Insurance programs, even the most expensive Met Life plan, has massively high co-pays for say, gum treatments.  Delta is worse and throws in waiting periods.

After viewing the images of the awful HCV-related dental deterioration and oral diseases (beginning on page 4) such as Lichen Planus, lymphomas, it’s clear that the VA should provide all vets with active HCV or SVR veterans suitable dental care.

Do you have experiences in trying to get VA dental care while under care for HCV (or any other condition) that fits the above statement. If HCV treatments are causing dry mouth, and then painful gum disease, can you see a VA dentist? Or, if you are SVR, and due to gum disease caused by HCV and medications, are you out of luck when your teeth start falling out?   Any advice for accessing VA dental care for non-100% SC vets will be appreciated.

 

 

 

 

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5 Responses to HCV infection and veterans’ oral health

  1. Joris Hines says:

    I got Hep C from the air jet injectors in Basic Training, but getting them to admit it is like pushing a hotel up a mountain. I’ve been fighting the V.A. since February 2007. My attorney is beside herself, and can’t understand why it’s been taking so long. They stopped communicating with me altogether. I’ll never give up. Now I was diagnosed with cirrhosis. I’m really pissed about them. My teeth are shot, had to have several pulled, they became brittle and were breaking. I went two years of their toxic treatments and finally was undetectable in 2005, but that’s after 3/4 of my liver was dead. My attorney needs help with my case. I need help. I’ve been on rations since they cut my pension in 2007. Lost a lot of weight and I’m having a rough time continuing to be patient. Has anyone here won their case? I was not in Vietnam, I was stationed at Rhein Main Air Base in Germany. I don’t see how that matters though, since they injected me with tainted blood in Basic. It was still while in the military.

  2. ray says:

    Do you have to be awarded a claim for C before they will look at you? How do you become eligible?

    • Kiedove says:

      Do you mean to be seen by a VA dentist? No, being service connected for HCV is not necessary but service connection is is necessary for some condition that you think is connected to a dental condition for Class III. Class VI vets don’t have to be service connected. But you do need to been enrolled in VA care and have been seen by a VA Primary Care Provider and he has to give you a dental consult. And if you have private physician records, you should give them to the doctor. Then the VA PCP will discuss your case with the Dental Department. I would also print out this post and the URL for the
      report: Sorry, it’s long.
      http://www.ashm.org.au/images/Publications/Booklets/PBB_DentalOrofacialHepC_V4_Aug2012_WEB.pdf

      Most VA PCPs will not know this information so you have to give it to them. You can also use secure messaging with your dental complaints which you believe are either associated with your HCV or another condition the VA is treating you for.

      For example, suppose you are being treated for COPD or another breathing problem. Your medicine might be causing you dry mouth, a common problem. Complain weekly via secure messaging about dry mouth even though you rinse and use dry mouth products. See http://www.biotene.com/
      They might try other meds on you which will eliminate the problem. If it doesn’t help, you can ask to have a VA dentist check out your gums because dry mouth will wreck them.
      Chronic Dry Mouth symptoms can lead to:

      Enamel demineralization
      Increased caries
      Periodontal disease *******expensive!!!
      Infections
      Mucositis
      Halitosis
      Biotene says that “more than 400 drugs include Dry Mouth as a possible side-effect.”
      I guess I’ll include this information in a post because dental issues among vets is a huge problem.
      If you get denied, I’d go to a free/income based dental clinic and talk it over with that dentist and get a diagnosis letter. (not a nexus letter) Then send it to your VA PCP AND the dental clinic at the VAMC (hospital) you are enrolled in. This is a lot of effort but it will be worth it if you prevail.
      Thanks for your question and report back!

  3. HCVet says:

    This is a huge problem. Well said Keydove. We’ll spread the word. Gary was denied dental care as his teeth fell out and he had to wear worn dentures by the end.

    • Kiedove says:

      Hi, I’m so sorry Gary was abused like that. I’m going to have to look into how the VA handles vets with HIV/HCV co-infection and HIV vis-à-vis dental care. If an exception is made for co-infection then the case can be made that a veteran shouldn’t have to also contract HIV to get dental care! The ABQ vet lesson is good. If you can only consume liquids and you start wasting away due to toothlessness that condition–starvation–will make ANY condition the VA is treating you for and the exception should apply. So if someone is denied dentures or a referral from their VA primary they should threaten to stop drinking ensure in 2 weeks if they don’t get dentures because they don’t want to die of starvation bit by bit. Put it in writing to the VA primary and senators and let the local TV action news segment know. This BS has to stop.

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