Your Turn: Dental care underserved priority of public health

When thinking about the most significant gains in the health of our population, often taken for granted is the increased role of public health in preventing oral disease.

One of the 10 greatest public health achievements of the 20th century as recognized by the Centers for Disease Control and Prevention was of fluoridation of water supplies that occurred in 1901. The foundation of water fluoridation in the U.S. was the research Dr. Frederick McKay. With help from G.V. Blackand other researchers, McKay, a dentist, established the link between fluoride and cavity-free teeth.

They identified the optimal concentration of fluoride to protect teeth against cavities without staining them. Current studies indicate community water fluoridation increases prevention of tooth decay by an additional 25 percent. One study estimates for every dollar spent on community water fluoridation, about $38 is saved in dental treatment costs.

While there have been concerns raised regarding adverse health effects related to fluoride, the claims remain unfounded. There have been a number of scientific reviews that continue to conclude community water fluoridation is both safe and effective.

While diseases of the mouth often are viewed independently from other parts of the body, inadequate dental care has been shown to negatively impact overall health. For example, diabetes can contribute to gum disease that can exacerbate diabetes. Studies also have suggested a link between gum disease and increased stroke risk. Weak teeth can make it harder to eat a nutritious diet, also worsening overall health.

As we jump ahead more than 100 years, dental health remains an underserved priority of public health. Dental coverage is noticeably absent in the Affordable Care Act despite the fact that more Americans lack dental coverage than health insurance. For the most part, Medicare doesn’t cover dental care; the program pays only in certain cases where dental and medical needs intersect.

And only 2 percent of retirees have dental coverage through a prior employer. Nationwide, 126.7 million Americans lack dental coverage, nearly triple the number of medically under-insured. For underserved populations on Medicaid in Illinois, very few providers are willing to accept Medicaid as a form of payment. Due to slow reimbursements that generally offer only 30 percent of usual and customary fees, who can blame them?

Seeing this trend, more local health departments provide safety net dental clinics to provide a basic level of care, but they do so at considerable economic risk. 

Right now, many of these dental clinics are struggling with decisions of suspension or discontinuation of services because they simply can’t make ends meet as a Medicaid-only clinic.

Local hospitals, seeing dozens of patients in their emergency rooms each week for acute dental concerns with nowhere else to turn for care, understand the need for these safety-net clinics. What began in 1901 as a public health interest in oral health continues to remain today under somewhat different circumstances.


Source: 
PANTAGRAPH.COM