Close the dental divide in Texas

Low-income children and families across Texas — who have been awaiting critical oral healthcare coverage for years now — have recently learned a difficult truth: Having dental coverage doesn’t necessarily mean having access to dental care. This unfortunate fact has emerged since passage of the Affordable Care Act, which expanded Medicaid eligibility to millions and offered dental coverage to 8.3 million Americans who previously had none. Further, similar coverage gains were celebrated in April of this year, when Congress reauthorized funding for the state’s Children’s Health Insurance Plan (CHIP), which gives more than 500,000 Texas children access to early, preventative dental care.

But having dental insurance is useless if your local dentists refuse to accept it.

Citing low reimbursement from Medicaid and CHIP — including paperwork headaches for participating in these programs — approximately 80 percent of the nation’s dentists do not accept patients with these types of coverage, or they opt only to see a very limited few. In a 2014 survey by the American Dental Association, 42.2 percent of Americans cited services not being covered by Medicaid as their reason for not visiting the dentist; roughly one-third reported difficulty finding a dentist who accepts Medicaid.

The result is a growing number of children and adults who end up in emergency rooms for expensive, non-traumatic dental care, according to a recent Health Affairs study. Expansion of dental coverage via Medicaid, according to researchers, had no impact on reducing the number of ER visits in many communities because there are simply not enough dentists who are willing to provide routine preventative care.

It’s a devastating situation especially for children, who without early dental screening and intervention — which includes basic dental health education for children and families — are more likely to develop serious issues later in life. A report from the Pew Center found that children who do not receive dental care miss a significant number of school days, use costly emergency room services more often and encounter worsened job prospects as adults, compared with their peers who have access to care.

Every child deserves access to a dentist and we know, without question, that these early dental visits make a difference.

In a six-year study recently completed by the Benevis Foundation, researchers analyzed dental outcomes among Kool Smiles dental patients in Texas, who are predominately covered by Medicaid and CHIP for their dental care. The data clearly showed that oral health improves, quite dramatically, in Texas communities served by Kool Smiles offices. With access to dentists willing to accept their insurance, Texas children with a First Dental Home visit before age three benefitted from approximately 42 percent fewer extractions and restorative procedures by age 8. Better outcomes were also seen related to use of dental sealants; Texas children with a dental sealant before turning 10, had approximately 49 percent fewer extractions and restorative procedures by age 14. This type of care leads to markedly lower healthcare costs. If all Texas Medicaid children who visit the dentist received this type of early, preventative care, it would save the state more than $54 million annually.

Notably, across the practices studied, researchers found that as preventative visits increased among this population, restorative procedures decreased accordingly. While it might seem like an obvious result, it is one we simply cannot ignore: Controlling costs and improving health depends on the availability of committed dental care providers willing to treat Medicaid and CHIP patients in their offices.

After decades of working to close the “dental divide” in Texas and across the country, quality dental care for low-income Americans feels almost within our reach. Increasing the number of providers committed to offering care to these vulnerable populations will help us reach the finish line.

Dr. D. Ray Gifford is a practicing dentist and Managing Dental Director for Kool Smiles Dentistry for Kids in Texas. Kool Smiles has 33 dental offices in Texas, including four in the McAllen, Brownsville and Mission.

Source: http://www.themonitor.com/opinion/commentary-close-the-dental-divide-in-texas/article_db745fd0-71c2-11e5-afb2-d7de33ac43be.html

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