Archive for the ‘Oral Healthcare Reform’ Category

Vermont Town Meeting on Dental Care – March 10, 2012

Thursday, March 8th, 2012

Join United States Senator Bernie Sanders for a Town Meeting on Dental Care.

Dental care is unaffordable for many Vermonters. This town meeting will be an opportunity for Vermonters to speak out about the issue and hear from Senator Sanders and Vermont officials about efforts to improve dental care access nationally and in Vermont.

10:30 am refreshments  | 11:00 am Meeting begins
Montpelier High School Cafeteria, Montpelier VT

The meeting is free and open to the public. RSVP is requested but not required. Contact Bernie Sanders’ office for more information: 1-800-339-9834

New Report: Advancing Oral Health in America

Tuesday, July 26th, 2011

The U.S. surgeon general issued a landmark report in 2000, Oral Health in America, which described the poor oral health of our nation as a “silent epidemic.” While there have been notable improvements in the oral health of Americans, oral diseases remain prevalent across the country, posing a major challenge for the U.S. Department of Health and Human Services (HHS). Evidence shows that tooth decay and other oral health complications may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes. While tooth decay is a highly preventable disease, individuals and many healthcare professionals remain unaware of the risk factors and preventive approaches for many oral diseases, and they do not fully appreciate how oral health affects overall health and well-being.

In 2009, the Health Resources Services Administration (HRSA) asked the Institute of Medicine of the National Academies (IOM) to assess the current oral health care system and to recommend strategic actions for Department of Health and Human Services (HHS) agencies to improve oral health and oral health care in America. The IOM convened a committee to explore how HHS can enhance its role as a leader in improving the oral health and oral health care of the nation. In this April 2011 report, the IOM recommends that HHS design an oral health initiative consistent with IOM’s proposed set of organizing principles, which are based on the areas in greatest need of attention and on the approaches that have the most potential for creating improvements. In addition, the IOM stresses three key areas needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest, and the involvement of multiple stakeholders.

Click here for the 2011 Report.

University of Minnesota School of Dentistry Becomes the First College to Offer Dental Therapy Track

Monday, March 7th, 2011

Despite the innovative program’s proven track record, the number of states allowing dental therapists to provide oral health care remains at two: Minnesota and Alaska allow dental therapists to provide basic care in place of a full-fledged dentist. We can only hope that more states follow their lead. More dental therapists in practice means more dentists are free to provide specialized care. At the same time, having dental therapists means better access to oral health care for vulnerable populations.

Some, however—most notably the American Dental Association—aren’t entirely sold on the idea and are offering their own alternatives to improving community oral health.

From U.S. News & World Report:

Two states, Alaska and Minnesota, currently allow dental therapists to provide oral care, according to the American Dental Association. Minnesota was the first to license dental therapists, and the University of Minnesota School of Dentistry has become the first college in the nation to offer a dental therapy track.

“We’re only in our second class,” said Dr. Patrick Lloyd, dean of Minnesota’s dentistry school, noting that 33 people applied for 10 slots in the most recent class. “We’re really proud to be the first dental school in the country to have an approved dental therapy program.”

Dental therapists receive two to three years of training in dental procedures. In Minnesota, they study alongside people who are training to become full-fledged dentists, Lloyd said.

“They use the same facilities and the same laboratories and are educated side-by-side to the same standards and level of competency,” the dean said. “The idea is that if they are educated together and learn together, they can better work together.

Read the whole story.

Pew Study Strongly Suggests New Dental Providers Can Boost Office Profits

Monday, December 27th, 2010

According to a new report from the Pew Center on the States, dentists in private practice can maintain and even improve their bottom line by hiring non-conventional dental providers like dental therapists. This is great news for underserved communities–especially children.

From Dentistry iQ:

Most private-practice dentists who hire new types of dental providers can serve more patients, including more Medicaid enrollees, while maintaining or improving their financial bottom line, according to a new report from the Pew Center on the States. New types of providers play a role in delivering dental care similar to that performed by nurse practitioners in the medical system.

Pew’s report is the first to examine the impact that hiring new types of providers — dental therapists and hygienist-therapists — would have on the productivity and profits of a private dental practice, where more than 90 percent of the nation’s dentists work. The study also assesses the impact of dental hygienists, who are currently employed by most dental practices. Dental therapists and hygienist-therapists are trained to perform a broader range of services — including filling cavities — than hygienists.


“This report is good news for dentists who work in private practices, patients who aren’t getting care and policy makers who are eager to find cost-effective solutions to access problems,” said Shelly Gehshan, director of the Pew Children’s Dental Campaign.

Nationwide, 17 million low-income children go without dental care each year. Multiple factors fuel this problem, including a shortage of dentists serving rural and poor communities. As a number of states consider authorizing new types of dental providers to fill this unmet need, dentists in private practice are looking at the effects of this potential change on their businesses.

Read the whole story here.

 –Dennis Pacheco

Reprint of Putting Teeth Into Health Reform

Tuesday, November 2nd, 2010

In April, 2009, two COHI members, dentist Toby Kravitz and foundation director Tom Roberts, teamed up to write an op ed piece that ran in The Valley News.  The article is reprinted here, in its entirety:

Putting Teeth into Health Care Reform

There’s a communicable disease rampant in many people’s bodies.

Untreated, it can lead to organ loss, the possibility of abscesses, brain infection and even death. It is the most common chronic disease in children. If this disease occurred anywhere else in the body, the Center for Disease Control would likely have declared a public health emergency.

But the body part affected is our mouths. The organs are our teeth. The disease is caries, better known as dental decay or cavities.

In Vermont and New Hampshire, we can see the signs of an oral health crisis taking place around us: People walking into emergency rooms with so much pain that they are begging to have their teeth pulled out. Too many young adults have mouths riddled with bad teeth and need of dentures or a mouthful of extensive and expensive dental care.

A local organization, the Ottauquechee Health Foundation, provides grants on behalf of individuals who can’t afford their health care for those who live in their service area. Oral health requests now pre-dominate. Last year, two-thirds of applications and two-thirds of dollars went to dental needs.

Studies show that poor oral health impacts overall health, leading to chronic pain and making it harder to succeed in school or find a job. Yet we have a health care system that continues to treat the mouth as if it was not a part of our body. And there’s a different tolerance of what’s acceptable in the way of disease, chronic pain and risk to the body. There is a different set of insurances for dental care, both private and public. Only half the population has dental insurance.

People without sufficient insurance and people without the means to pay for dental care are going without the oral health care that they need. Those with Medicaid struggle to find a dentist who will treat them. Adults on Medicaid are faced with restricted benefits and limited access.

Although many area dentists do take Medicaid patients, donate their time or work for reduced fees for needy patients, many do not. Why don’t more take Medicaid? The reimbursement rate is less than 65 percent of the true cost, which does not allow dentists to cover their overhead rates. Others are concerned about a higher no-show rate for these appointments. The limitations on Medicaid dental benefits for adults create additional barriers.

A doctor in an emergency room doesn’t get paid any less if her patients don’t pay their bills, nor does a primary care doctor working for a hospital see their salary decline if a patient doesn’t show up. Most dentists on the other hand, have small offices, with one or two dentists, where there is a direct connection between who pays and what the practice’s income looks like at the end of the month.

Too many people do not place a priority on their personal oral health. Some have learned from their parents that they likely will lose all their teeth before they are 60 and don’t even try to keep up oral hygiene.

Concerned about oral health needs in the Upper Valley, a dedicated group of dentists, health care providers and funders have formed the Community Oral Health Initiative to look for solutions to our communities’ oral health needs.

How will we improve our oral health? There are roles for all of us to play. We all need to recognize as a matter of public policy that oral health needs to be on par with other health care needs. Then coverage for care and proper reimbursement rates need to be prioritized so that they are aligned with other health care needs.

Dentists will play a part. As the Medicaid scope of coverage and rates improve, more dentists will participate in the program. Dentists will continue to volunteer their time at free clinics like the Red Logan. And they will continue to forgive a portion of their fee to participate in Ottauquechee’s Good Neighbor grant program. If there is community interest perhaps that program might extend beyond the Woodstock area to cover the entire Upper Valley.

And each of us has a role. We can help change community norms so that all children grow up expecting to have a healthy set of teeth. We need to each take personal responsibility for our oral health care and for that of our children. The basic preventive steps—brushing, flossing, eating snacks like apples that clean our teeth in the middle of the day and staying away from high sugar foods, especially sipping on soda and energy drinks throughout the day—can go a long way to ensure we only need to visit our dentist for regular preventive appointments.

Our oral health must become a priority, both in the Upper Valley and in the rest of the country. It is a problem that is ours to solve and solutions are within our reach, so that everyone, rich or poor, has the same access to care for a hole in their teeth or gums as for a hole in their arm.

As national attention turns to health care reform, one message we ought to all agree on is that we must put teeth into health care reform.

Toby Kravitz, DDS, is a Norwich dentist and chair of the Community Oral Health Initiative. Tom Roberts is the director of the Ottauquechee Health Foundation and past chair of COHI.

Tom Roberts

Oral Health and Dr. Kim

Monday, October 25th, 2010

Not long ago, I sent a letter to President Kim at Dartmouth College. In it, I asked him to consider the importance of oral health care delivery during the creation of Dartmouth’s new Center for Health Care Delivery Science. What is health care delivery science? The website for the Center states that health care delivery science “picks up where basic, clinical and evaluative science leaves off: it studies how we bring best practices of care to every patient, every time.”

In my letter, I mention that “my work at Ottauquechee Health Foundation (OHF) has enabled me to interact with a variety of professionals, from nurses and social workers to dentists and community health professionals. These interactions, alongside my own research into the current state of oral health in this country (particularly oral health among Vermont and New Hampshire residents) has underscored the immense importance of oral health to an individual’s total health. In the spirit of Dartmouth’s commitment to improving the quality of medical care and health services delivery, I would like to pass along to you my hope that researchers at the new Center for Health Care Delivery Science consider the need for effective, safe and patient-centered health delivery in all of health’s varied forms.

One of the guiding principles of my work at OHF has been that oral health should not be separated from overall health. I hope that under your leadership Dartmouth’s health services and delivery research agenda commits itself to a similarly integrative vision.”

Dr. Kim responded by assuring me that once Dr. Albert Mulley assumes his post as director of the new Center on Nov. 15, Dr. Kim and his colleague Dan Lee would begin reviewing recommendations such as my own.

Stay tuned for future updates on this effort…

Vanessa Hurley

What Health Reform Means for Oral Health

Monday, September 27th, 2010

As the excitement surrounding President Obama’s historic health reform legislation begins to settle, plenty of questions remain about how our health care system will be changed. We’re particularly interested by how the new legislation will affect oral health care in this country.

The Maine Dental Access Coalition offers a great overview of the ways in which health reform is expected to impact oral health for Americans. Some of the highlights include:

-Insurance plans created for the uninsured through state exchanges will be required to provide pediatric oral health services and prevent any patient out of pocket expenses for preventive services.

-Rebates will be used to pay for dental services provided through Medicare Advantage plans.

-Medicaid and CHIP Payment and Access Commission must create a report for Congress summarizing reimbursements to dental professionals for services rendered through these programs.

-Grants for school health centers to provide oral health services.

-Establishment of a 5 year oral health campaign which will focus on advocacy and education for the prevention of childhood caries and oral health care for pregnant women and other vulnerable populations.

-All states, territories and Indian tribes will receive funding for school-based sealant programs. This marks a fundamental change in policy since there are currently only 16 states receiving federal funding for these types of programs.

-The CDC will bolster its relationship with all states and territories to create a comprehensive oral health infrastructure to include continuous data collection, interpretation, delivery system improvements and science-based population programs

-Oral health reporting for pregnant women through Pregnancy Risk Assessment Monitoring System (PRAMS) will become mandatory (currently this reporting is optional).

-All states must participate in the CDC’s National Oral Health Surveillance System (only 16 states currently participate).

-A 5 year, $4 million 15 site demonstration project will be launched to train “alternative dental health care providers”

-Support will be provided for training general, pediatric and public health dental professionals and the establishment of a dental faculty loan repayment program for faculty engaged in public health and primary care dentistry.

Visit the Maine Dental Access Coalition’s Public Policy page for a full description of how health reform will impact oral health care.

Vanessa Hurley