Confronting the Dental Health Crisis
July 27, 2010
Everywhere we look, we see stories about high-risk pools, insurance exchanges and the crisis facing the U.S. health system. But there is another health crisis in America that few are talking about—oral health.
It’s an unfortunate reality: many Americans see oral health as unnecessary or cosmetic. When money is tight, dental visits are often the first to go. But oral health is critical to overall health. Though largely ignored in national health reform, oral health is important, and for some—like 12-year old Deamonte Driver who died from an untreated tooth infection—it’s a matter of life and death.
The numbers aren’t encouraging. A recent study in the July issue of Health Affairs (a Burness client) found that one in four California children has never seen a dentist. Nationally, the numbers aren’t any better. Tooth decay is the most common chronic childhood illness, and a third of the entire U.S. population does not receive adequate dental care. Minority children are hit hardest, and the impact on Indian Country is devastating. American Indian and Alaska Native children have the nation’s highest rates of tooth decay: five times the national average for children two to four.
We are ignoring an oral health crisis—and Americans are falling ill or even dying as a result.
Here are some key areas of concern:
- Cost and insurance: Dental care and dental insurance are expensive. More than 100 million people in the U.S. lack dental insurance. And for low-income Americans insured with Medicaid, it is often nearly impossible to find a dentist who accepts Medicaid. For many dentists in private practice, accepting Medicaid is financial suicide because state reimbursement rates are so low.
- Workforce and access: It’s not only hard to pay for a dentist; it’s hard to find one. Especially in rural areas, we simply don’t have enough dentists. By 2014, the number of dentists retiring will outpace the number entering the workforce, and 49 million people in the United States live in Dental Health Professional Shortage areas today. To meet their needs, we would need nearly 10,000 more dental professionals. States are beginning to consider new oral health providers to expand the reach of dentists and get care to people who need it.
- Oral health awareness: Americans—whether they are policymakers, families or health providers—don’t know how important oral health is. But it’s critical. Dental infections, if left untreated, can enter the blood stream, leading to life-threatening health conditions. Experts are also finding links between poor oral health and chronic conditions like heart disease and diabetes. An American Dental Association study found that 78% of parents would take their children to see a dentist before their 1st birthday if they knew that oral health was important for growth and development. But they don’t know.
- Prevention: Water fluoridation and dental sealants (preventative tooth coatings) improve dental health and reduce rates of cavities. Yet only 60% of the population drinks fluoridated water, and many other crucial preventive programs are either under-funded or are being cut.
Solving this crisis will be complex and difficult, but as all Psychology 101 students learn, the first step in solving a problem is admitting that one exists. Now that we’ve started to address health problems in the United States, it’s time to admit we have a problem with oral health, too.
