July 27, 2012

The Need for Oral Health Care at Safety Net Clinics

Categories: Health

By Guest Blogger Michelle Vacha, RDH, BS, Founder, Senior Mobile Dental
Oral health is an important part of overall good health. However, many people in this country are not receiving proper dental care because they do not have dental insurance and therefore can’t afford treatment.
Oral disease is associated with pain as well as speech, behavior and self-esteem problems in children. Untreated dental caries (the disease process that causes cavities) is the most common disease in children, occurring five times more often than asthma, according to the American Academy of Pediatrics. In adults and seniors, poor oral health is associated with chronic diseases such as diabetes and cardiovascular and pulmonary disease.
Studies have shown that having insurance coverage directly impacts whether people receive health or dental care or not. Children who are uninsured, for example, are more likely to have unmet dental needs. However, many child and adults throughtout the U.S. do not have dental insurance.
I live in Colorado, where only 56 percent of adults aged 18 and older have dental insurance coverage, according to the 2011 Colorado Health Access Survey. This study also found that nearly half (47 percent) of the uninsured Coloradans surveyed reported that they did not receive needed dental care because of the high cost associated with it.
While this survey may only report findings from Colorado, it is a good basis for what is happening across the country.
Most people get dental insurance through their employers. However, throughout the last 20 years, the percentage of employers offering dental insurance as a benefit has decreased nationwide. For those employers still offering dental insurance, often the employee pays the full premium. As a result, a significant portion of dental care is paid for out-of-pocket.
The 2008 Colorado Household Survey found that, “Although poor and minority adults experience greater levels of dental disease, they frequently face cost and other system-level barriers to obtaining dental care.”
Adults are eligible for Medicare health insurance at age 65. However, Medicare does not offer dental benefits, resulting in more than 60 percent of seniors not having dental insurance coverage.  Many seniors are on fixed incomes that prohibit high out-of-pocket expenses for dental treatment.
It is well known that prevention is critical when it comes to health care, and this includes oral health care. However, many adults and children in Colorado are not receiving preventative dental care because of the cost associated with it. Colorado ranks 38th among the 50 states in the number of children receiving preventive dental visits in the previous year. Nationwide, more than 16 million children each year go without seeing a dentist.
The successes in products and developments, such as fluoride, power tooth brushes, etc., have allowed people to maintain their oral health and retain their teeth. These are all preventive measures. Yet Medicaid and Medicare do not cover preventive oral health care over the age of 18.
How much money is spent in medical costs that have contributing factors stemming from poor oral health? Conclusive research indicates relationships between cardiovascular disease, pneumonia, low birth weight, diabetes – to name a few. Lack of dental care also puts a strain on emergency rooms. A report by the Pew Center on the States estimates that more than 830,000 visits to emergency rooms in 2009 were the result of preventable dental conditions (this represents a 16 percent increase from 2006).
Senior Mobile Dental (SMD), a nonprofit organization I founded, believes no elderly or person with a disability should live their life in pain that is controllable. Every day we see vulnerable adults in advanced disease and neglect, because they cannot afford or get to a dentist.
Even though SMD’s focus is on elder and adult care, these findings and concepts span all vulnerable age groups. SMD was founded to address the two key barriers vulnerable people face in receiving professional dental care: transportation and financial costs. SMD brings professional preventive oral health care directly to where this population lives or congregates. Disease findings are then reported and referred to dentists for treatment. Funding helps provide services and identify pain and infection for those with no financial resources.
As a federally qualified 501c3 nonprofit organization, we have overcome the access to care issues this population faces. Our mobile concept for in-house care is an innovative solution to the cost, liabilities and inefficiency of transporting to a dental office or motor home type delivery.
Children’s programs have been successfully implemented within community based programs and school systems, yet the adult population is left with no resources for care. After retirement, many people are on a fixed income and are faced with the choices of using their money to pay for utilities or medications, for example, or continuing their preventive oral health care needs. With the high cost of dental services, most have let their oral health fall to a lower priority of needs, which then predisposed them to advancing, uncontrolled oral disease.
Research and tracking of uncontrolled oral disease and its relation to chronic disease needs to happen in order to institute the needed change for coverage and necessary collaborative care between medical and dental professionals. The successful approach Senior Mobile Dental has used to address the lack of access to dental care this vulnerable population faces is a simple solution to begin the process for inclusion and change, and can be replicated by other organizations.
For more information:
To find out more about Senior Mobile Dentistry, visit http://seniormobiledental.org/. For more information on help for children in Colorado who need dental care, visit Kids in Need of Dentistry (KIND).
ACKNOWLEDGMENTS
The Colorado Household Survey is funded by The Colorado Trust. Analysis of the data and preparation of the figures contained in this report are provided by the Colorado Health Institute.
Michelle Noblet-Vacha RDH, BS, is the founder & executive director of Senior Mobile Dental, a nonprofit charity based in Colorado Springs, and focused on providing senior citizens with access to professional oral hygiene care. Michelle founded Senior Mobile Dental in 2006 after experiencing firsthand the nation’s “oral health crisis” among a growing-yet-neglected population of senior citizens. Since founding the organization, she has received 13 national awards and recognition in paving a pathway to increase access to care for the vulnerable elderly citizens of our nation.

Source: http://usodep.blogs.govdelivery.com/2012/07/27/the-need-for-oral-health-care-at-safety-net-clinics/