Low-income children are not getting good dental care, even though many of them have coverage through the state. Shelley Rouillard would like to do something about that.

Rouillard, deputy director of benefits and quality monitoring at the Managed Risk Medical Insurance Board (MRMIB), is leading an effort at MRMIB to get more young children to see the dentist — as early in their lives as possible, she said.

“Studies show that the younger the child (who gets dental care) the less it costs over their life for dental services,” Rouillard said. “So we want the percentage of kids who see a dentist to change, and we’re targeting the youngest kids. We’d like the children ages 0 to 3 to start being seen.”

Many low-income children don’t get dental checkups, and have diets high in sugar, Rouillard said. Many infants and toddlers sip on fruit drinks from bottles and sippy cups, setting the stage for drinking lots of sodas among youngsters and teens.

“Once kids are past 7, it’s hard to change their pattern,” Rouillard said. “When you look over a larger population, getting to them when they’re young gives you the biggest bang for the buck.”

The oral health program at MRMIB, called Healthy Families Healthy Smiles, attacks the utilization problem in several different ways:

• Health plans in Southern California (in Santa Barbara, Ventura, San Diego and Los Angeles counties) are participating in a collaborative effort to change beneficiaries’ dental habits. “We have a directory of preferred providers, and we’re developing a risk assessment program,” Rouillard said.
• MRMIB is contacting pediatricians, trying to get more providers to give an oral exam.
• A community engagement program and outreach education effort is being coordinated with existing programs such as First Five and the Women, Infants and Children nutrition program, to emphasize dental health for children. For instance, organizers try to connect with families at health fairs in the community. “We’re building support for getting services where kids are,” Rouillard said, “rather than always getting them to come in.”
• MRMIB has asked health plans to report on utilization, such as the rate of preventive dental exams among specific age groups. “We just received baseline data from all of that, and there will be quarterly reporting of data,” Rouillard said. That means MRMIB could see the first preliminary signs of progress sometime in November, she said, though getting a real idea of outcomes will take a year or more.

“All of these efforts are important,” Rouillard said, “because you have to attack this issue from all angles. It’s a synergistic effect. I mean, you’re impacting behavior here, and that takes coming at it from all sides.”