ORAL HEALTH: Access to Dental Care Eludes Poor Children
Despite the perception of dental care as "optional" or "secondary," lack of access among CHIP beneficiaries is leading federal health officials to characterize cavities as "the most prevalent chronic childhood disease in the country, much more common than asthma" and responsible for 52 million missed school hours every year, according to a front page article in Saturday's New York Times. While the majority of Medicaid beneficiaries maintain some form of dental coverage, only about 50% of federally funded community clinics provide dental care. Dentists allege that they have been forced to turn away Medicaid patients due to the inadequacy of federal reimbursements. Additionally, some parents seem unconcerned about their children's oral health, downplaying tooth loss as "just a part of life." Dr. Burton Edelstein, a national authority on the subject, said, "There are profound disparities in the oral health status of children in the United States. Dental diseases, tooth decay in particular, are overwhelmingly concentrated in a small subset of kids," -- totaling between 5 and 10 million kids living in rural and inner-city regions. The National Institute of Dental Research reports that 80% of cavities occur in 25% of children between 5 and 17 years of age. Poor oral health can lead to "rare heart damage," pain, malnutrition due to a reluctance to eat, and sleeplessness.
Changing Public Perception
The Surgeon General's office is drafting a report on the state of America's dental health, to be published next year. Meanwhile, three bills pending in Congress advocate tax breaks and Medicaid reform for dentists who treat indigent patients. In August, the American Dental Association will hold a conference "on children's access to Medicaid-covered dental care." In the meantime, one New Hampshire mother who called 15 dentists before finding one willing to treat her son is suing the state for failing to provide Medicaid beneficiaries with the same coverage as private- paying patients (Goldberg, 6/26).