Access to Oral Health Care Dental Safety Net Resources for Uninsured and Underinsured Children and Adults

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Access to Oral Health Care Dental Safety Net
Resources for Uninsured and Underinsured Children
and Adults

• The Utah Oral Health Coalition

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Dental Disease

• Even though highly preventable, dental disease is
  the single most common chronic health problem in
  children and one of the most common health
  problems in low-income adults.
• In Utah
• Over 500,000 school hours are missed every year
  due to dental related illness.
• Over 1.6 million work hours are lost
• every year due to dental related illness.

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Early Childhood Dental Decay
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Adult Dental Decay
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The Effect of Poor Oral Health
Although dental problems dont command the
instant fears associated with low birth weight,
fetal death or cholera, they do have the
consequence of wearing down the stamina of
children and defeating their ambitions. Educator
Jonathan Kozol writing about low-income children
in New York City and East Saint Louis in Savage
Inequalities
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The Effect of Poor Oral Health

• Lack of good oral health can lead to
• Chronic pain
• Chronic infections
• Poor social relationships
• Problems in speaking and learning
• Malnutrition
• Problems in getting employment

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Oral Health Important to General Health

• Association between chronic oral infections and
• Diabetes
• Heart disease
• Lung disease
• Stroke
• Low-birth-weight
• Premature births

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Oral Health

• Oral health is an integral and important
• part of general health
• vital to the development of children and
• the effectiveness of adults.

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Access to Oral Health Care

• In Utah -
• Oral health care services are one of the most
  difficult services to obtain among low-income
  families, children and adults enrolled in
  Medicaid and children and adults with special
  health care needs.

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• Poor children are twice as likely to suffer from
  dental decay and their disease is more likely to
  be untreated.

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Savings in Early Dental Visits

• Average dental related costs birth to age 5
• Childs first visit before age 12 months 262
• Childs first visit between ages 1-2 340
• Childs first visit between ages 2-3 492
• Childs first visit between ages 3-4 547
• Savage MF. Lee JY, et al. 2004 Early preventive
  dental visits Effects on subsequent utilization
  and costs. Pediatrics Electronic Pages
  114(4)e418-e423.

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Access to Dental Care in Utah

• Enrollment closes Sept 1 for CHIP
• Fewer than 1/2 of Utah dentists see Medicaid
  patients (reimbursement rates most often cited
  reason).
• Dental safety-net clinics are at capacity.

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• Clinic Facilities Salt Lake Donated
  Dental Services

• Clinic Staff Salt Lake
  Donated Dental Services

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Consequences

• When individuals do not receive basic oral health
  services, their untreated dental disease
  progresses until it ultimately requires
  complicated and expensive medical treatment.
• Dental Care is Primary Health Care

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Utah Oral Health Coalition

• Composition
• Made up of key partners, stakeholders and policy
  makers representing agencies and organizations
  who have shown interest, support and influence in
  improving the oral health of Utah residents.
• Goals
• Prioritize strategies identified from the Oral
  Health Summits and NGA Policy Academy and develop
  an action plan that will improve the oral health
  of Utah residents.

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Utah Oral Health Coalition Membership

• Voices for Utah Children Primary Childrens
  Medical Center
• Intermountain Pediatric Society University of
  Utah Dental Education
• Salt Lake Valley Health Department
  Salt Lake Donated Dental Services
• Intermountain Healthcare Utah
  Issues
• Utah Dental Association Health Access Project
• Alliance to the Utah Dental Association
  Utah Medical Education Council
• Association for Utah Community Health Utah
  Public Health Association
• Community Health Centers, Inc. Utah Department
  of Health
• Utah Academy of Pediatric Dentists Area
  Health Education Centers
• Utah Dental Hygienists Association Coalition
  for Medicaid Consumers
• Salt Lake Community Action Program Community
  Health Connect
• United Way of Greater Salt Lake Utah March of
  Dimes
• Regence Blue Cross Blue Shield Caring Foundation
  for Children

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Oral Health in Utah

• Mobilize community partnerships to identify and
  solve oral health problems
• Link people and resources to obtain needed oral
  health services
• Assure Access to Quality Oral Health Care

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Examples of Collaborations Addressing the
Challenges

• United Way Sealants for Smiles
• Currently in Salt Lake District Title 1 schools
  will expand to include Murray, Davis and Tooele
  schools with screenings, follow-up care, and case
  management.
• Intermountain Healthcare Volunteer Healthy Teeth
  Project
• Volunteer auxiliaries provide demonstrations,
  education and supplies to elementary schools near
  Intermountain hospitals
• Children brushing teeth at Parkview Elementary
  School
• Teachers include breaks for children to brush
  their teeth onsite

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More Collaborations

• Annual oral health screenings
• Health assessments in Salt Lake, Utah, and Weber
  Counties provide follow-up care involving local
  dentists
• Vouchers
• Southwest Community Health Center provides
  vouchers used with co-pay paid by patient
• Case management
• Targeted to arrange for volunteer dentists in
  accept uninsured patients

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What can you do to improve oral health in your
community?

• Increase public awareness, promote connection of
  oral health to physical healthteach parents,
  kids, political leaders, funders, etc.
• Utah Oral Health Coalition has data, strategies,
  local contacts, models of success
• Support health reward alternatives to candy.
• Maintain referral networks of dentists who will
  care for low-income and uninsured families
• Teach children and adults how to properly
  brush/floss

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Working together promotes long-term improvements
for children and families
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Next Steps

• Where do we go from here?
• Suggestions for how to collaborate more in the
  future?