Letter to the Editor published by the Columbus Dispatch
June 6, 2021
by Lawrence F. Hill
I was pleased to see the May 27 editorial “Having a child too often a life, death struggle” regarding the importance of oral health as it relates to pregnancy outcomes and overall health.
In a limited space, the authors did an excellent job of describing how poor oral health and the lack of routine dental care can lead to very serious health and life consequences, which disproportionately impacts the health and well-being of low-income women, women of color and their families. The information provided was to support the extension of Medicaid benefits, including dental benefits, beyond 60 days postpartum and finally to integrate medical, dental and behavioral health.
So here’s the problem.
Only a very small percentage of Ohio dentists provide care to a significant number of Medicaid enrollees. Most take none. Many low-income folks live in communities with few or no dentists. Federally Qualified Health Centers (FQHC’s), though they provide wonderful care, are often not sufficiently funded or staffed to meet the dental needs of the communities they serve. So even if Medicaid is extended, and/or if dental benefits ever get included in Medicare, how will we meet the new demand?
One response that has already been proven to work and adopted in 12 states — with legislation newly introduced in eight since January — is adding dental therapists to the dental care team. They work in a similar fashion in dentistry as nurse practitioners, who have greatly increased access to medical care. Dental therapists receive extensive training and provide high quality, cost-effective care under the supervision of dentists. They can work alongside their supervising dentist or work remotely, providing basic dental disease prevention and treatment in communities or to populations not served by dentists. Dental therapists are not the only response to the problem, but they have been clearly demonstrated to be an important piece of the puzzle. It’s time for the very few opponents in Ohio to get out of the way and open up care to those not being served by the current system.
Lawrence F. Hill, DDS MPH, dental consultant, Ohio Public Health Association; chair, National Coalition of Dentists for Health Equity