We Can and Must Improve Access to Dental Care for Minority Children
February is National Children’s Dental Health Month, a much needed opportunity to focus on the issues facing the oral health of kids in the U.S. today. According to the California Society of Pediatric Dentistry, “Tooth decay is the number one chronic health problem of children.” Minority children are particularly hard hit. African Americans, Hispanics and American Indians generally have the worst oral health among all racial or ethnic groups in America. The ill effects of these tooth decay issues are broad ranging: missed school days, impeded speaking and learning development, low self-esteem and generally poor social development.
The National Hispanic Medical Association noted in a July 2015 study that with more than one third of all Hispanics covered under government health insurance, it is unsurprising that Medicaid is often regarded as a lifeline to health care treatment within minority communities. Shortcomings within the various government insurance programs are too numerous to list while private sector solutions to public sector problems are too few.
Dentistry has traditionally been a cottage industry – a single dentist with a limited staff in a small office. Faced with the burden of Medicaid billing paperwork, as well as the unique challenges associated with treating low income populations, it is unsurprising that many dental health providers have chosen to opt out of Medicaid. Yet a new model called the dental service organization (DSO) seems to be having success where others have failed.
One recent study found that one DSO provider, Kool Smiles, provided much-needed services to low-income patients while charging 33 percent less per patient than other providers. In Texas alone, that would amount to $235 million in cost savings every year if the model were applied more broadly. Just as importantly, it would mean more access to desperately needed dental care for children who would otherwise be cut off.
More than half of Hispanic children are covered for their health insurance by Medicaid. These are children who, through no fault or choice of their own, are dependent on an inefficient government program to deliver basic coverage for their medical needs. Making that program work better should be a central goal of the politicians so desperate for Hispanic votes. The Center for Disease Control found that “the greatest racial and ethnic disparity among children aged 2–4 years and aged 6–8 years is seen in Mexican American and black, non-Hispanic children.” This is simply unacceptable, and it cannot continue.
Efforts to address the racial disparity in access to care are underway at every level. Public schools are pairing with providers to raise the awareness about the need for better oral health habits and to expand sealant programs for low-income students. Spanish and English language books are communicating these messages as well, but all only go so far if dentists aren’t available to minority children. New models that take on the deficits of the current system are much needed, by the Hispanic community and all others seeking more than just lip service from political candidates.