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

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.

Early Childhood Dental Decay

Adult Dental Decay

The Effect of Poor Oral Health “Although dental problems don’t 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

The Effect of Poor Oral Health Lack of good oral health can lead to: l Chronic pain l Chronic infections l Poor social relationships l Problems in speaking and learning l Malnutrition l Problems in getting employment

Oral Health Important to General Health Association between chronic oral infections and –Diabetes –Heart disease –Lung disease –Stroke –Low-birth-weight –Premature births

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

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

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

Savings in Early Dental Visits Average dental related costs birth to age 5 –Child’s first visit before age 12 months $262 –Child’s first visit between ages 1-2 $340 –Child’s first visit between ages 2-3 $492 –Child’s first visit between ages 3-4 $547 –Savage MF. Lee JY, et al Early preventive dental visits: Effects on subsequent utilization and costs. Pediatrics Electronic Pages 114(4):e418-e423.

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.

Clinic Facilities … Salt Lake Donated Dental Services Clinic Staff … Salt Lake Donated Dental Services

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

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.

Utah Oral Health Coalition Membership Voices for Utah ChildrenPrimary Children’s 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 AssociationHealth 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 Hygienist’s AssociationCoalition for Medicaid Consumers Salt Lake Community Action ProgramCommunity Health Connect United Way of Greater Salt LakeUtah March of Dimes Regence Blue Cross Blue Shield Caring Foundation for Children

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

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

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

What can you do to improve oral health in your community? Increase public awareness, promote connection of oral health to physical health—teach 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

Working together promotes long-term improvements for children and families

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