Subject: Alternative policy for proper utilization of dental care by adults in rural areas.
Background:
Oral health care is an integral part of the US healthcare system. In 2012, Sen. Bernie Sanders introduced “The Comprehensive Dental Reform Act”, which aimed on expanding dental coverage, accessible oral health care centers, increase in dental workforce, enhanced dental education and encourage dental research. (Congress.gov). The ACA, aim to curb the national health spending, by facilitating the affordability to quality care through private and public health insurance. The purpose of this bill is to cut the healthcare costs and to reverse the “silent epidemic” of dental health status (surgeon gen). This dental bill with an integrated approach towards the preventive and comprehensive oral healthcare is estimated to provide coverage to almost 17.7 million adults. (ADA
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Adults in the rural areas have increased rate of dental caries, increased loss of permanent tooth and debilitating chronic oral conditions due to under utilization of dental care, mainly attributed to the poverty, lack of or fewer dentists and increased distance from the nearest federally funded primary health care center. (4). (ADA)(5) National rural health association states that there are about 22 dentists for 100,000 people in rural areas and only 2% of dental care providers’ work for the federally funded programs. (ADA 6). National dental health care spending averaged for 111 billion dollars for the fiscal year 2012 and the spending was steady in 2013 (7). Though ACA enabled expanded affordable coverage to the eligible people, it failed to provide any solution for the lack of dentists and increased distance to dental healthcare facilities leading to underutilization of dental
Many low income areas have dental therapists as part of their local dental team. Many people in these areas have never been to a dentist or do not go every six months as recommended this poses many other health problems. There has been case studies and data showing that in these areas dental health
Underserved and Low-income populations face high rates of untreated dental diseases due to low access to dental treatment. One of the main causes of this problem is lack of participating dentists or poor distribution of dentists due to transportation problems. Untreated oral diseases are often seen in low-income communities and underserved populations The most common oral diseases that manifest in underserved populations are periodontal diseases and dental caries
In “Where are all the Dentists?”, Kristen Lewis states that there are not enough dentists in rural areas, but that can be fixed. Many people in the modern world live in poverty and don't have the dental support they need. This is because regular dental treatment can cost up to $100, which is a lot for some people who don't have regular dental access. Having a dental degree is very pricey, so when the dentists come out of dental school, they are usually in debt. Because of this, dentists like to work in modern environments where they can get good business. But in places with not a lot of money, there are less or no dentists. These “dental deserts” have many people with untreated cavities and other bad tooth diseases. Because of that, dentists
“The impact of unmet oral health care needs is magnified by the well-established connection between oral health and overall health” (Fineberg, H. 2011, p. ix). Oral health status is linked with general health, as evidenced by the association between poor oral health and chronic diseases, such as diabetes, cardiovascular disease, and respiratory disease. Poor oral hygiene can also lead to other health issues such as, oral facial pain and digestive problems. “The silent epidemic of oral diseases disproportionately affects disadvantaged communities,
Hundreds of years ago, the dental profession and the medical profession was perceived as two separate entities, however, this bifurcated health system has created an epidemic in oral disease with our aging population (Nagro, 2016). Dentistry should be more closely integrated with medicine and the health care system, however, organized dentistry has fought to stay a monopoly. They have protested regarding dental personnel being independent, even in the advancement of serving more rural areas, just as they repelled being part of Medicare. Finally, there are a few states that have alternative choices for a dental hygienist to travel to people who can’t get to a traditional dental office. Some of these states include Minnesota, Colorado, Oregon,
This proves that the lack of dental insurance within these low-income households plays a key role in whether or not these children will receive dental care. When these children do not visit the dentist, they increase their chances of developing dental caries significantly. The British Dental Journal disclosed that, “Sugars consumption varies by social class. National food surveys reveal a higher consumption of sugar and sugar-containing foods and drinks amongst low income groups”(Watt 8). Healthy food is expensive; therefore lower class families resort to unhealthy food because it is significantly cheaper. This extensive consumption of sugar-ridden foods is extremely detrimental to the enamel. The British Dental Journal also declared that “oral inequalities will only be reduced through the implementation of effective and appropriate oral health promotion policy”(Watt 6). The dental program will make the inequalities in dental care known and work to reduce those inequalities. Dental health is often times overseen because it is typically expensive and people are unaware of how the condition of their teeth affects the condition of the rest of their body. The all-inclusive dental health program will give people the treatment they need, regardless of their socioeconomic status.
The socioeconomic background of people is a major factor that dictates whether or not they will receive dental care. According to the American Journal of Public Health, “Children from a low socioeconomic status have been shown to have a high risk of dental caries”(Simmer-Beck 1764). Many children today do not receive the dental care they need because of their parents’ income. Going to the dentist is expensive for people without dental insurance so many people tend to blow it off; but what they don’t realize is that the condition of their mouth often dictates the state of the rest of their health. An internet source in correspondence with the American Journal of Public Health stated that, “More than half of low income-children without
The provision of dental treatment in Australia is a topic that ignites a wide range of opinions and emotions among the various stakeholders involved. Much of dentistry in Australia is provided in the private setting, some estimates suggesting 83%1. Australians fund up to 60% of dental care via out of pocket payments1,2. Only a relatively small amount of dental care is provided in the public sector to patients who are often disadvantaged in regards to their oral health1. It is estimated that a large amount of the population is unable to access dental care due to finances; however the capacity of the public sector to provide dental care is limited. With limited funding and resources, the public sector is unable to provide dental care for all Australians and a large proportion of people are on long wait lists, some estimates of 650,0002.
accept Medicaid and this might result in higher utilization in particular wards over others. We did not have information about parental marital status and other private insurance, which could be used for dental services and not reflect in Medicaid billing data. Also, there could be a potential bias due to delayed reporting of the data which might not be included in the dataset when we received it. Also, Centre for Medicaid Services (CMS) uses the information from these datasets and presents it by financial year whereas this analysis was done by calendar year, which may not match with the generally available information. Also, the composition of Medicaid population might not be a true representation of over-all population. People having private dental insurance might have a different utilization pattern for assigned dental home and preventive dental services. We also feel that the information of ward might not be an accurate representation of utilization since people may seek services from a provider in different wards than the one in which they reside. Having data about unique providers, along with unique patient might make a robust database to get more accurate information. Last but not the least, we restricted our definition preventive dental services to a combination of examination and fluoride application, which is not the same as followed by
Dental insurance coverage is a key determinant on whether to seek care or not. The exclusion of our mouths from the rest of our body parts and not receiving the care it requires is quite impossible to rationalize (McClymont, 2015). Dental care is essential in the maintenance of good oral health and in the identification of symptoms of systemic conditions that most likely are manifested through the mouth. As striking and conspicuous as it may sound, Canada has indeed a type of health care system wherein mouth is excepted as a part of the body. As a matter of fact, our lips, tongues, and throats are securely covered while our teeth and gums are left out from the privilege. The most common infectious disease in the world are dental diseases, and the fact that many health issues can be first diagnosed through the oral cavity validates its importance and co-relevance to the rest of our body. Studies have linked poor oral health such as severity of gum infection to AIDS, first stages of osteoporosis, reveal nutritional deficiencies, immune disorders, cancer, and so on and so forth. Xerostomia or dry mouth for an instance is often a symptom of undetected diabetes. Diabetic patients have higher risks of gum infection caused by increased blood sugar, thickening of blood vessels resulting to hindered healing process that is why they are obligated to undergo pre-medication as a form
Unlike the previous studies mentioned here, this study by Decker & Lipton (2015) looked more on adults who are covered by the Medicaid. Two key findings were revealed in this study—first of all, an increase of the likelihood of dental care visit is evidenced by those who have Medicaid coverage and second, there is also a reduction of the likelihood of untreated dental caries. It is also concluded that Medicaid is essential in promoting dental care and that it is strongly suggested that it should be expanded to further benefit a wider population of
Oral health in Australia is a concern. The impact of poor dental health can instigate ulcers, gingivitis, gum disease and damage one’s overall health. Tooth decay is extensive among Australian adults, and tooth aches are a considerable amount of hospital admission for children (Parliament of Australia, 2013). Two in three children aged 14 years have deteriorated permanent teeth, while three in ten adults receive no treatment at all. Adults living in rural Australia are 1.7 times more likely to have no teeth than those in major cities. 14 percent of children and 37 percent of adults avoid or delaying seeing a dentist due to costs (Australian Institude of Health and Welfare, 2012). The advantages of installing a dental program within
It appears to backs this notion by the lack of unified healthcare, fewer fee based dental clinics versus health clinics, lack of supportive legislation and fewer people with dental coverage versus healthcare coverage (Fingar, et al., 2015). Much to my dismay, dental care is a major health disparity. Three quarters of my career has been spent in the emergency department (ED). During these years, we continue to see patients with dental issues. Admittedly, their main reason for seeking care from the ED is that they lack dental insurance. Under the Emergency Medical Treatment and Labor Act (EMTALA), these patients cannot be turned away from the ED due to their lack of ability to pay. Daily we treat patients with mouth pain related to dental caries, mouth abscesses and fractured teeth. Patients have told me that they are saving to have the tooth pull which can cost at least $100. I have had several crowns placed in my mouth and I can attest that this procedure costs approximately $500 with decent insurance and triple this amount without insurance. The general reason for my concern, is that, dental infections can lead to other serious health problems such has respiratory infections, heart value disease or brain abscesses (Li, Kolltveit, Tronstad, & Olsen, 2000). I witnessed my 32 year old female patient die after surgery for removal of an infected brain abscess. The day prior, she confessed that it was related to dental
Lack of access to dental health services and providers also affects utilization rates within the adult Medicaid population (Licata & Paradise, 2012; Davis., Deinard &, Maïga, 2010; MacDougall, 2016; Hinton & Paradise 2016; PEW Center on the
Although many Americans have good oral hygiene due to fluoride and making everyday good decisions, others do not have any access at all to oral health care. Over the years, dentists have been trying to demonstrate the importance of oral care. (“Access to Dental Care”) From commercials to campaigns, dentists will continue to demonstrate to their patients as well as to the people who don't have insurance the importance of oral health care. They will teach them preventative care and some techniques on how to prevent from getting any diseases.