Focus on St. Petersburg - West Coast Dental Association

The Role of Organized Dentistry in Access to
Oral Health Care for Underserved Communities
For too long, dental disease has been a silent epidemic.
Further, there is a huge disparity that exists in oral health
care amongst lower socio-economic populations. It is
apparent not only in children, but the elderly, homebound
and handicapped populations as well.
What we know:
1. In general, disadvantaged groups have 2-3 times the
unmet need for dental care than average.
2. Low socio-economic status persons are 3-4 times less
likely to have an annual dental visit.
3. Only 22 percent of Medicaid–enrolled (low income)
children receive an annual dental visit in Florida.
4. There has been little increase in sealant use for schoolaged
children in low income families.
Barriers for disadvantaged persons include:
1. Low access to dental care through publicly funded and
volunteer programs.
2. Transportation difficulties.
3. Loss of work time without pay.
4. Low perceived value of dentistry.
5. Lack of understanding of the importance of routine
dental visits for prevention and early detection of
chronic disease.
Even though the problems are numerous and complex, they
are not insurmountable. Prevention and Education have to
be our main focus. Prevention, by advocating community
fluoridation, early school oral health screenings and school
sealant programs is essential. Education, with regards to
the importance of oral health to overall systemic health, and
early and regular preventative visits is equally important.
It is important to note that 90 percent of practicing dentists
in the US are in the private sector. Safety net facilities
that target the underserved population employ about 2700
dentists. Even after significant growth in health centers, that
is still less than 2 percent of the total 178,000 active dentists
in the US.
Three things we must do as members of “organized
dentistry” to improve dentist participation in Medicaid:
1. We must continue to advocate for realistic Medicaid
reimbursement rates.
2. We must advocate easing the administrative burdens for
Medicaid providers. Make the paperwork requirements
like claim submissions, look more like the private sector
plans. The complex system that exists adds to the cost
of providing care and might result in errors that trigger
costly reviews.
3. Involve all state and local dental societies and
individual dentists as active partners with existing
safety net providers in improving the access to care
issue.
Charitable volunteer programs must remain a part of the
solution. According to ADA’s 2000 “Survey of Current
Issues in Dentistry,” 74 percent of private practice dentists
provided free or reduced rate oral health care services
to one or more groups (homebound, handicapped,
low income). The value of this care was $1.25 billion
dollars. “Give Kids a Smile” was launched by the ADA
in 2003, with more than 47,000 dental teams registered
to participate, treated more than 500,000 children at an
estimated value of $29.8 million.
Political pressure has intensified by the existing Governor
and the newly appointed State Surgeon General, Ana
M.Viamonte Ros M.D., M.P.H. Under the direction of the
State Surgeon General and Deputy Secretary, Ms. Kimberly
“Kim” Berfield, (a former state legislator), the formation
of a state Oral Healthcare Workforce Ad Hoc Advisory
Committee. Its charge is to address multiple issues ranging
from public policy, professional practice issues, supply
and demand influences, educational and training matters
and regulatory questions, as they relate to the access to
care disparities that exist in our state. Your current FDA
President, Dr. Chuck Hoffman, and other members of
organized dentistry make up a part of the task group that
includes many communities of interest such as the Florida
Dental Hygiene Association, Community Colleges, and the
Public Health sector.
(continued on page 14)
6 West Coast District Dental Association • January 2010