Consequences of Lack of Access to Dental Care in Texas Today

1
Consequences of Lack of Access to Dental Care in
Texas Today

• Johanna K. DeYoung, BSN, DDS, MPH
• Houston Department of Health and Human Services
• Texas Oral Health Summit
• Advocacy, Equity and Access
• Austin, Texas
• September 9-10, 2004

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What are the Consequences?

• Financial
• Societal
• Psychosocial

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Financial Consequences of Lack of Access

• Heroic and time ladened measures are costly,
  i.e., endodontics, crowns, orthodontics for
  malocclusions, bridges, extractions, etc.
• Dangerous consequences/life threatening
  complications can arise resulting in emergency
  hospitalization, i.e., simple extraction turns
  into a week of hospitalization.

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Who Pays the Cost?

• The patient pays the emotional costs.
• The tax-payers pick up the tab.

5
Societal Impact/Indirect Economic Cost of Oral
Disease

• More than 51 million school hours are lost each
  school year (Surgeon Generals Report)
• Poor children have nearly 12 times more
  restricted days than children from high-income
  families
• Pain and suffering from dental-related problems
  affects eating, speaking and learning

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Psychosocial Impact of Oral Disease

• Poorer quality of life due to facial appearance
  concerns
• Tendency to avoid social situations due to facial
  appearance concerns, i.e., intimacy, laughing,
  smiling, difficulty doing jobs, difficulty in
  finding employment, etc.

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Dental Emergencies Seen in TX Childrens ER

• From 1997 2001, there a 122 absolute increase
  in dental emergencies (study by T. E. Ladrillo,
  DDS, MPH)
• Costly to the tax payers
• Non definitive care rendered
• Patient encouraged to return to the community for
  dental care

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Why the Consequences?

• Because of difficulties in accessing care or in
  the availability of care, patients do not seek
  care until it hurts.
• Because of low oral health IQs, patients do not
  seek care until it hurts.

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Whats Happening Now?

• In Port Arthur, children are booked six weeks
  out. Adults are seen on a walk-in basis. Daily,
  adults are turned away.
• In the City of Houston Dental Clinics, patients
  are now booked out from six (6) to 16 weeks.
• Two (2) out of every 10 patients seen in
  Houstons two public hospitals are seen for oral
  problems.

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Dental Emergencies Outside of Harris County

• Fractured jaw in Beaumont
• Scenarios in Montgomery and Fort Bend Counties
• Frustrated parents and school nurses

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An Ounce of Prevention

• Community-based prevention programs remain the
  basis of public health dentistry.
• Preventive dental program are quick, inexpensive,
  and the most effective means of making dental
  care available.
• With preventive dental programs on board, there
  will be resources available to provide more
  dental care for more people.

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How to Avoid the Costly Consequences

• Heroic and costly measures are not needed when
  prevention and early intervention are applied.

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Early prevention and intervention are key for
optimal lifespan oral health.