Keeping America’s Oral Health Safety Net Strong

Ask any American what they think about healthcare reform and, for better or worse, you’ll probably find very strong opinions about the role of government and spending.

However, backstage, away from the public debate about the new law, a quiet revolution is underway to help the 59 million Americans who go without medical care and the 100 million who have not had dental care this year, get the care they desperately need.

It’s not the individual mandate or the state health exchanges. It’s the most significant investment in primary care you’ve probably never heard of—an $11 billion commitment to community health centers and $15 billion to prevention programs. It may sound like small potatoes compared to the estimated total cost of healthcare reform--$940 billion over 10 years--but the impact will be significant, especially for those who need it the most.

These funds, reopened for debate by Congress, would double the capacity of community health centers (CHCs) from serving 20 million people a year to 40 million. As the only access point for care besides the emergency room, CHCs provide critical prenatal care, behavioral health services, primary and specialty care for 1 out of 7 uninsured individuals. By 2015, with new capacity, CHCs will serve 1 out 3 uninsured.

Healthcare reform requires that CHCs offer oral health services. This means as many as 17 million children will get to see a dentist, some for the first time ever. Currently, these children are significantly underserved because they can’t access to care to prevent tooth decay and, once they have decay, to get timely treatment.

There’s a reason why former U.S. Surgeon General David Satcher declared childhood tooth decay a “silent epidemic”. 6.5 million children have untreated dental disease, the majority of whom are from low-income households. Half of these children are estimated to go to school with mouth pain—as children who cannot eat properly or pay attention in class and do well in school.

For infants 3 years old and younger, this can mean a mouth full of diseased baby teeth that can only be treated through surgical intervention. This is followed by a life time of being at greater risk for tooth decay, because the corrosive bacteria that cause tooth decay have colonized their mouths in greater proportion.

Tooth decay not only disrupts development and educational attainment, it can also turn deadly. The 2007 death of a 14-year-old Maryland boy is a tragic reminder of how one ‘simple’ toothache can develop into an unchecked infection that can quickly spread to the brain. His death could have been prevented with a timely dental care, but, at the time, oral health services were difficult to find for families on Medicaid.

From our work as president of a foundation focused solely on oral health and as a lifelong practicing dentist in both a private practice and a community health center, we see evidence every day of how oral health disparities in underserved communities are every bit as cruel as violence, inadequate housing, or poorly performing schools.

Fortunately, dental disease is nearly 100% preventable with education, regular check-ups for prevention, and treatment. That is why we’re committing DentaQuest Foundation resources to supporting and strengthening the community care safety net for oral health. We want to make sure that greater numbers of health centers will be prepared to provide effective, high-quality oral health services to children and families. The DentaQuest Institute and its Safety Net Solutions program are joining us to make sure that happens.

It may take decades before the impact of this investment in community health centers is fully appreciated. That’s okay. Today we are thinking about the millions of children who will have greater opportunity in life because of accessible health care.

Blog post by Ralph Fuccillo and Dr. Mark Doherty.

Ralph Fuccillo is President of the DentaQuest Foundation.
Dr. Mark Doherty is Executive Director of the DentaQuest Institute. Its Safety Net Solutions Program is helping community health center dental programs become more efficient, effective and financially stable.