Why should dental care be different than medical care?

Rotten teeth1There was a tragic story published in the Washington Post today about a 12 year old boy, Deamonte Driver who died as a result of an untreated tooth infection; the family was uninsured and had lost their Medicaid coverage.

This story demonstrates how easily children can fall through gaps in our health care system and how important regular examinations and care are for any child. A routine $80 tooth extraction could have saved this child’s life.

Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

Action for Children has put forth a proposal called Carolina Care for Children, which provides health insurance coverage for children whose families earn between 200% – 300% of the federal poverty level. The program is along the same lines as Governor Easley’s recommendations for expanding the children’s health insurance program.

Carolina Care for Children is a good proposal BUT it does not initially cover dental care.  Dental care the proposal says “will remain under study.”  That’s a polite way of saying we have bigger problems with dental care in North Carolina.

It boils down to a supply problem. According to health experts we do not have enough dentists willing to accept Medicaid or Health Choice payments. Nor do we have enough dentists serving patients in rural areas.

One solution would be to open our borders to dentists currently practicing in other states.  
We have created a barrier by requiring dentists, even those who have been practicing for years, to take the North Carolina dental exam at considerable expense.

The current policy appears to benefit the dentists in North Carolina by keeping the number of dental offices low and the prices for care high but it does not help our children. Isn’t it time we made dental care as accessible as health care?

3 Comments

  1. Steven D. Slott, DDS

    February 28, 2007 at 11:14 pm

    Well, yes, good ideas but don’t just limit this to dental care for children. There are over 1 million adults without adequate access to dental care. As exemplified by this tragic case, the cost to the healthcare system incurred as a result of ignoring dental is enormous in relation to the cost of increasing dental reimbursement rates to the point where sufficient numbers of dentists would participate. The current number of North Carolina dentists who provide a significant amount of Medicaid reimbursed work, as benchmarked by $10,000 per year, stands at 24%. Increasing the rate of reimbursement to the 80% level, roughly the level currently paid for medical, would double the number of dental providers at the least.

    As well, the ECU/UNC Joint dental initiative should be supported. As a private dentist whose practice is 80% Medicaid, I am fully confident that the proposal for the new school at ECU along with the expansion of our existing one at UNC is solid. While not a cure for the dental access problem, and not meant to be so, this plan shows the most potential, to me, for making a significant improvement in the access situation that I can remember in my 25 years of practice. At 4.2 dentists per 10,000, NC is 47th in the nation per capita, the national average being 6 per 10,000. Yes, an increase in dentists does not mean an immediate increase in the number going to rural areas. However, over time, it will have a positive effect for these underserved areas. In the meantime, the outreach clinics of the ECU plan will provide immediate help for those underserved areas in which they locate, from one end of the state to the other.

    Lest it be thought that my adamance for increases in Medicaid reimbursement be self-serving, I point out that such an increase would put a huge dent in my practice. Even at the increased rates, the increase in number of providers accepting Medicaid would mean a negative impact on the finances of my practice. The dental access situation is abhorrent in this state as well as the rest of the country and something has to be done, by us all.

  2. Sally Buckner

    March 2, 2007 at 2:56 pm

    I had wondered when the subject of public dental care would be brought up. Dental disease can lead to worse–even fatal—health conditions. Dental pain is real and can be debilitating. Why should dental care not be considered the same as care for joints, blood, skin?

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    September 7, 2009 at 8:32 am

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