A new report by the Institute of Medicine (IoM) and National Research Council recently revealed shocking statistics of 4.6 million children in America not receiving essential dental care in 2008. According to the report, these children did not even get to see a dentist for the simple reason that their parents did not have enough money to pay for a dental visit. The report also states that only 38% of seniors had dental coverage in 2006.
The report brought to light the fact that children are just one of the many vulnerable and undeserved populations that face a persistent and systemic barriers to accessing oral health. A point to be noted is that oral health care continues to elude people from racial and ethnic minorities, people with special health care needs, older adults, pregnant women, populations of the lower socio-economic status, and rural populations among others.
The report was prepared as recommended by the Health Resources and Services Administration (HRSA) and the California Healthcare Foundation in the year 2009. They were asked to convene a committee of experts to address access to oral health care in America for the vulnerable and undeserved populations and to assess the current oral health care system, also to develop a vision to improve oral health care for the vulnerable and undeserved populations and to recommend strategies to achieve the vision.
Image source: http://worldental.org/images/health-care-reform-children-dental-coverage.jpg
Image source: http://worldental.org/images/health-care-reform-children-dental-coverage.jpg
According to the author of the report, it is the “persistent and systemic obstacles that undermine people's access to oral health care.
The author has suggested the following measures to remove these obstacles:
1. By changing the funding and reimbursement for dental care.
2. Providing and expanding adequate training to all the doctors, nurses and other non-dental professionals so that signs of oral diseases may be better identified.
3. All the administrative, educational and regulatory practices need a complete revamp.
Frederick Rivara, the Chair of the committee that wrote the report says,
“The consequences of insufficient access to oral health care and resultant poor oral health - at both the individual and population levels - are far-reaching. As the nation struggles to address the larger systemic issues of access to health care, we need to ensure that oral health is recognized as a basic component of overall health."
According to the report, the problem is attributed to the combination of cultural, geographic, structural and economic factors, as they found that 33.3 million Americans live in areas that are not covered by enough dentists.
It is seen that improper oral heath care can lead to respiratory diseases, cardiovascular diseases and even diabetes. Therefore, it makes sense to focus more on the prevention of oral diseases and combine this with promoting good oral health care and awareness among the general population to improve the overall public health.
“Although children have to receive comprehensive dental benefits if they are enrolled in CHIP (Children's Health Insurance Program) or Medicaid from state funds, this is not the case for adults. As underserved populations rely on publicly funded programs as their primary source of health cover, authorities should include dental cover for all Medicaid beneficiaries as well, the authors state.”
"Toward that end, the committee recommended that the Centres for Medicare and Medicaid Services fund and evaluate state-based demonstration projects that cover essential oral health benefits for adult Medicaid beneficiaries. In addition, Medicaid and CHIP reimbursement rates for providers should be increased and administrative practices need to be streamlined to increase use by both dental providers and patients."
The report concluded with a vision for oral health care in America where everyone has access to quality oral health care throughout the life cycle. Of course, in order to realise this vision numerous coordinated and sustained actions are called for along with flexibility and ingenuity among the leaders at the federal, state, local and community levels to act in concert with oral health and other health care professionals. The committee’s recommendation has provided a roadmap for the important and necessary steps to improve the access to oral health care and to try and reduce the oral health disparities that exist.
