‘C’ on Kids’ Dental Care Doesn’t Pass

Oral health is a little like Rodney Dangerfield — it doesn’t get the respect it deserves.

Ten years ago, the U.S. surgeon general declared dental disease to be a “silent epidemic.” A decade later we’ve made some progress, but clearly not enough. The recently released Pew Report “Cost of Delay: State Dental Policies Fail 1 in 5 Children,” which the DentaQuest Foundation and the W.K. Kellogg Foundation helped fund, paints a stark picture.

In America today, 17 million low-income children still go without dental care. The consequences of that are serious. In Massachusetts, one in 10 minority children goes to school with pain caused by completely preventable dental disease. That means lost school time, challenged learning, and impaired nutrition and health, and sometimes, if left untreated, it can result in serious illness or even death. That was the case with 12-year-old Deamonte Driver, who died of a brain infection caused by a tooth abscess in Maryland in 2007.

Unlike other health care problems which seem intractable and enormously expensive to fix, providing children with the dental care they need is doable at relatively low cost. In fact, if most low-income children got the preventive dental care they deserve, they could eliminate much of the higher-cost procedures down the road.

In grading the states, Pew used eight measures, including providing sealants, fluoridating water supplies, increasing Medicaid coverage for children, expanding the role of dental hygienists in schools, and maintaining an accurate database.

Only six states got an ‘A,’ meaning they met or exceeded six of the eight measures. Massachusetts got a ‘C,’ although if the study had used more recent data, we would have received a ‘B’ because we passed legislation that allows dental hygienists to apply protective sealants (coatings on molars) without a prior dentist exam in community settings.

We’ve come a long way in the Commonwealth. Ten years ago, Massachusetts would have received a failing grade. In fact, in 2005, a federal judge ruled in a lawsuit against the Commonwealth that there was insufficient access to dental care for children with MassHealth. Delta Dental of Mass., together with advocacy partners like Health Care for All, the Mass. Dental Society, key legislators, and others, have dedicated themselves to improving oral health for low-income children and adults.

Today, we should be proud that many more children with MassHealth in Massachusetts have access to dental care and that we are one of only nine states in the nation to have met the goal of having fewer than a quarter of our children at school with untreated tooth decay. In addition, Massachusetts currently reimburses dentists who serve Medicaid-enrolled children more than the national benchmark of the Pew Report, making it more likely that more dentists will accept Medicaid patients. Still, there is room for improvement.

What will it take for Massachusetts to continue our move from a ‘C’ to ‘B’ to ‘A’? The first and most important step is to make sure that more children in high-risk schools have access to school-based dental preventive programs. Those programs provide dental sealants, clear plastic coatings on chewing surfaces of molar teeth that have been shown to significantly reduce tooth decay.

Fluoridation is another important measure. Fluoride prevents tooth decay and strengthens teeth. To pass the Pew benchmark, at least 75{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Massachusetts residents should have access to community water fluoridation. Currently only 59{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of residents have this access. This is easier said than done, as the decision to fluoridate is often a controversial local decision. Moving that needle will not be easy.

We have already done much of the heavy lifting. If we commit ourselves to improve the percentage of children who have access to oral health prevention and increase the number of communities that fluoridate their water, we can ensure that the next report will put Massachusetts in the ‘A’ column. A statewide coalition will soon release an oral-health plan that will provide a road map to achieve that goal. –

Fay Donohue is the president and CEO of Delta Dental of Mass.