KENNEWICK -- A simple trip to the bathroom changed Linda Cochrane's life forever.
In 2002, she tripped and broke her neck, suffering permanent spinal cord damage that has cost her some of her movement and left her disabled for the past nine years.
She lost the job she loved as a receptionist at a veterinary clinic and spends most of her days sitting in a recliner in her home watching life go by.
She describes her life since the fall with one word" "Hell."
What she didn't know is that hell could become even worse than she imagined.
The pain medications that helped Cochrane tolerate life for years are causing her teeth to rot -- she lost three teeth on one recent February day. An oral surgeon has told her she needs to have her remaining teeth pulled and a full set of dentures made, but that requires surgery that Medicaid no longer will cover because of state budget cuts.
"She couldn't eat an orange yesterday -- not even a slice," said Kevin Hare, Cochrane's romantic partner and caregiver. "It's almost inhuman what the state is putting her through."
Cochrane is just one of thousands of adults in Benton and Franklin counties -- and more than 100,000 across the state -- who have lost access to dental care because of budget cuts.
The state Department of Social and Health Services stopped paying for dental services for adults on Medicaid on Jan. 1, except in the case of emergency.
Jim Stevenson, a department spokesman, said emergency is defined as pain, infection or trauma of the mouth or jaw. Anything else won't be covered unless the Legislature restores funding.
The cuts do not apply to children or adults with developmental disabilities, but does apply to physically disabled adults such as Cochrane.
There are 12,152 adults in Benton County and 5,784 in Franklin County enrolled in Medicaid, according to number provided by the Department of Social and Human Services.
The elimination of adult dental services came after the state reported a projected $520 million deficit for the remainder of the 2009-11 biennium -- which runs through June 30 -- and Gov. Chris Gregoire ordered all state agencies to cut 6.3 percent of their budgets across the board.
Other cuts affecting Medicaid patients included the elimination of money for eyeglasses, contact lenses and hearing aids, but Gregoire asked the Legislature to restore some of those services in her 2011-13 budget request.
Stevenson said in the meantime, the department cleared all of the requests for dental services that it received by Dec. 31, and stopped taking new ones in January.
Dianne Riter, senior program officer for the Washington Dental Service Foundation, said that she is concerned that lack of access to preventive dental care could lead to serious health problems for many people.
Tooth decay is caused by bacteria, and the amount of bacteria in someone's mouth tends to spiral once they have one tooth that's seriously decayed, she said.
"When decay gets so severe, it can cause swelling of the face or can cause the eyes to close from swelling," Riter said. "The swelling and infection can spread to the brain and cause severe symptoms or even death."
Mothers also can spread the bacteria that cause tooth decay to their young children, which can translate into lifelong problems, Riter said.
Before Jan. 1, pregnant women were provided dental care during their pregnancies and until two months after birth.
"Now that benefits have been cut, women no longer have the same access to care," Riter said. "That will put their children at much greater risk for getting early tooth decay."
The irony of Cochrane's situation is that she already was approved for the dental work she needs back in the fall of 2009, but miscommunication and crossed wires among her various dental and health care providers led to her authorization expiring. Her oral surgeon submitted a new request in October, but she has yet to get a response and is afraid she has fallen through the cracks.
Hare is frustrated to see the woman he loves in pain, and being told there's nothing anyone can do to help.
"This is no fault of her own," Hare said. "Animals get treated better. They need to see the kind of suffering they're making people go through. People need to see how cold-blooded what's happening right now is."
The state of Cochrane's teeth has left her unable to eat except for soft, mushy foods such as oatmeal and Cream of Wheat. It also has eroded her self-confidence.
"What really hurts the most is I don't go out because my teeth are so bad," she said. "I can't go out to dinner because I can't eat. I used to be happy. I don't smile. Who wants to smile with their two front teeth out?"