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Sean David, whose developmental disability requires him to be under anesthesia to get dental care, hasn’t had his teeth cleaned in six years.

In April 2014, he was put on the waiting list at Meriter Hospital’s Max Pohle Dental Clinic, which for decades provided full sedation dental care for David and other special needs patients on Medicaid.

But Meriter-UnityPoint Health closed the clinic — the only such service in Madison and one of only a few in the state — in June, before David made it to the top of the list.

Meriter, which said it lost nearly $600,000 a year from the clinic, said then it was working with St. Mary’s and UW hospitals to start a shared dental program for Medicaid patients needing sedation.

More than four months later, no program is in place, and advocates for David and many of the 95 or so other special needs patients who used Max Pohle are wondering what to do.

“It’s a huge concern,” said Susan Heighway, guardian for David, 45, of Fitchburg. “We’re crossing our fingers that nothing is going to happen with his teeth.”

Spokeswomen for Meriter, St. Mary’s and UW said the hospitals are still planning a collaborative service.

“We are having positive conversations,” Meriter spokeswoman Leah Huibregtse said. “We do recognize this is a gap right now, and our goal is to find a solution as soon as possible.”

Some special needs patients require general anesthesia in an operating room for teeth cleaning and dental exams because their conditions cause them to move or react when dentists work on their teeth. This is different from the milder sedation dentists commonly provide in clinics.

Before Meriter closed the clinic June 26, the hospital gave $1 million from a fund named for the late dentist Max Pohle to Access Community Health Centers, saying most of the 1,800 or so annual patients at the Max Pohle clinic could get dental care at Access.

But Access doesn’t have an operating room, so it can’t do dental care requiring anesthesia, spokesman Paul Harrison said.

For now, Meriter said special needs patients can go to the University of Minnesota School of Dentistry in Minneapolis, which agreed to take Wisconsin patients though it has a months-long waiting list.

Most special needs patients can’t afford to go to Minnesota, said Kevin Keisling, executive director of Avenues to Community, a Madison agency that supports people with developmental disabilities.

“If you don’t get dental care, over time, you’re going to, minimally, have tooth loss,” Keisling said. “What if somebody has an impacted tooth and we can’t bring them anywhere?”

Dr. David Walther, a Madison dentist, has long treated some special needs patients at Meriter outside of the Max Pohle clinic. He took on additional patients after the clinic closed but has no room for more and is retiring next year, he said.

Children’s Hospital of Wisconsin in Milwaukee provides full sedation dental care, but mostly to children.

Family Health Center of Marshfield, which has 10 dental clinics in northern Wisconsin, offers sedation dental care for special needs patients at St. Joseph’s Hospital in Chippewa Falls, Marshfield Clinic’s Rice Lake Center and the Aspirus hospital in Medford.

Those programs can take some additional patients, but not enough to meet the demand left by the closure of the Max Pohle clinic, said Greg Nycz, executive director of the Family Health Center.

Ludell Swenson, 56, who has cerebral palsy, is due to have his teeth cleaned but has no place to go, said Guy Swansbro, Swenson’s live-in aide.

Swenson used to get his teeth cleaned at UW Hospital by a dentist who retired, Swansbro said.

David last had his teeth cleaned, under anesthesia, in September 2009, said Katie Bogucki, a support worker at Progressive Community Services in Verona who oversees his care. He is supposed to have it done every three to five years, Bogucki said.

He has had brief dental exams in recent years. But he can’t tolerate a thorough exam or cleaning without sedation because he is very “sensory defensive” around the mouth, said Heighway, his guardian since 1991 and a nurse practitioner at UW-Madison’s Waisman Center.

David’s severe disability stems from seizures as a child, Heighway said.

He doesn’t have any known dental problems but she said he needs a thorough exam and cleaning to make sure everything is OK.

“It’s frustrating that nothing has happened yet,” she said.

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.