Oral health disparities persist despite advances in prevention #ahcj14

Kelsey Ryan

About Kelsey Ryan

Kelsey Ryan (on Twitter, @kelsey_ryan) covers health care for The Wichita (Kan.) Eagle. She is a 2014 AHCJ Rural Health Journalism Fellow.

Photo by Pia ChristensenJonathan Bowser of the University of Colorado School of Medicine called oral health “the low-hanging fruit of primary care prevention.”

Photo by Pia ChristensenJonathan Bowser of the University of Colorado School of Medicine called oral health “the low-hanging fruit of primary care prevention.”

In 2007, a 12-year-old Maryland boy named Deamonte Driver died from a tooth infection that spread to his brain. His family had lost Medicaid coverage and an $80 tooth extraction might have saved his life, wrote Washington Post staff writer Mary Otto, whose story helped spotlight oral health disparities.

Oral disease is a disease of poverty, said Diane Brunson, R.D.H., M.P.H., director of public health and interprofessional education at the University of Colorado School of Dental Medicine, during a session called “Covering disparities in oral health,” at Health Journalism 2014 in Denver.

Those with lower incomes have higher tooth extraction rates and, in Colorado, older people are more likely to lack dental insurance than others, Brunson said.

For children in Colorado, public health interventions and programs are leveling the playing field of tooth decay, which affects chewing, speaking, integrity of adult teeth and self esteem, Brunson said.

There are parts of the U.S. with too few dentists or few dentists who accept Medicaid patients, said dentist Terry Batliner, D.D.S., associate director at the Center of Native Oral Health Research at the University of Colorado.

To combat this issue in rural, underserved urban areas and native lands, Batliner suggests the introduction of dental therapists, a mid-level dental provider who are trained to give basic dental care under the supervision of a dentist.

There are dental therapists in Alaska that have had success in that area, he says.

But dental trade organizations have mostly opposed the idea, arguing that it could impact dental jobs or lead to poor patient care, he said.

“If we can have PAs in medicine why can’t we have a similar mid-level provider in dentistry?” Batliner said

Batliner also discussed his work with native tribes to study oral health. What he found was that many native people have poor oral health care.

He believes that is in part perpetuated by the Indian Health Service, which prioritizes oral care for children above adults because there’s not enough funding for everyone.

Some believe that primary and mid-level providers can help with prevention efforts in places with a dentist shortage.

“Oral health is the low-hanging fruit of primary care prevention,” said Jonathan Bowser, M.S., P.A,-C., associate dean and program director of the Child Health Associate Physician Program at the University of Colorado School of Medicine.

When covering oral health disparities, Brunson suggests journalists contact their state oral health coalitions, state dental director and the public health department or dental schools.

2 thoughts on “Oral health disparities persist despite advances in prevention #ahcj14

  1. Laura Henze Russell

    There is a simple, long overdue way to solve oral health disparities. Do what other advanced nations do. Here is an excerpt from my comments on Politico today. See the specifics. They are important. Vitally important. Cover them. All of them. You can bring us out of the darkness and into the sunshine and light when it comes to oral, physical, mental and cognitive health.

    “Here’s a tip to both parties. To put aside partisan politics and reach across the great divide and do something the American people would enthusiastically approve: integrate dental insurance into health insurance, and reboot regulations on dentistry and dental materials to enter the 21st century.” http://www.politico.com/story/2014/03/the-obamacare-enthusiasm-gap-105159_Page2.html

    To learn more, and get in contact with “Deep Roots” for additional story ideas, leads, tips and sources, tweet me @LauraHRussell.

    P.S. The website’s a bit of a beta and badly needs work. Also check out http://www.facebook.com/hiddenriver.

  2. Denice@ Dental Centers in Istanbul Turkey

    We know that the biggest barriers to oral health care is the lack of insurance, the high cost of dental treatment and the difficulties of even getting to the clinics, including transportation problem and limited time for visits. Many low income families does not have access to dental care because they are unable to pay. Having an assigned dental therapist in every community will provide greater access for patients to oral care and provide greater choice to patients. It would also increase opportunity and reduce waiting times to access vital oral health advice, preventive care and dental treatment.

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