February 15, 2006
BIRMINGHAM, AL — Smiles are contagious, and UAB School of Dentistry and United Way of Central Alabama hope grins will soon spread among some of the 61 percent of Alabama children who are eligible for Medicaid benefits but haven’t visited a dentist.
For the last three years, scores of volunteers have brought smiles to nearly 1,000 uninsured and underserved children at the UAB School of Dentistry during the annual “Give Kids a Smile” event. Through a potpourri of free preventive treatments such as screenings, cleanings and fillings, along with restoration and surgical treatments and education on proper oral care, they have attacked decay one mouth at a time.
But this year, dentists hope to use the success of the annual event as a springboard for further outreach and awareness.
“Charity care alone is not enough,” said Stephen Mitchell, D.M.D., UAB pediatric dentist and chair of the UAB GKAS Committee. “It doesn’t address the pulp of the problem. It is not a long-term solution to making oral health care accessible to the millions of Americans who do not get it — specifically the 23 million children in the United States without dental insurance.”
Barriers To Care
Federal law requires states to cover dental benefits of Medicaid eligible children, and all states except Texas and Delaware also provide dental services to children eligible for the State Children’s Health Insurance Program (CHIP). So why does pediatric access to dental care remain such a problem? Some reasons include:
- Medicaid reimbursement rates are often inadequate, and administrative burdens so onerous that dentists are often reluctant to participate as Medicaid providers. In many cases, reimbursement rates fail to cover dentists’ overhead costs for providing care.
- Even when care is available, programs often fail to provide the case management services needed to help people get to dental appointments and comply with post-treatment instructions and oral hygiene protocols.
- Low levels of oral health literacy often lead to severe dental disease that could otherwise be prevented cheaply and easily.
- Economic conditions discourage dentists from practicing in some inner city and rural areas, creating location-specific dentist shortages.
Simple Solutions to a Complicated Problem
Studies have shown that early diagnosis, preventive treatments and early intervention can prevent or halt the progress of most oral disease. “The problem is complicated and multifaceted,” Mitchell said, “but the solution doesn’t have to be. It can be as simple as education. If we can teach parents to teach their children the importance of oral hygiene at an early age, so that when they grow up they will continue good habits that contribute to their overall health, then we can make progress. Oral hygiene, just as diet and exercise, should be factored together when teaching children how to keep themselves healthy.”