Wed, Mar 14, 2012 11:21 AM
About 40 years ago, when I lived in the tiny town of Stannard,
Vt., in the Northeast Kingdom, I saw a young man whose teeth were
rotting in his mouth. It was a sight I never forgot. I
also saw many adults in the area who had wide gaps in their mouths
or no teeth at all.
It turns out that lack of access to affordable dental care was and
is not just a Vermont problem. It's also a national problem and it
is too often ignored. As chairman of the U.S. Senate
Subcommittee on Primary Health Care, I recently held a hearing in
Washington to shine a light on this issue. This is what we
The United States is in the midst of a major dental crisis. At a
time when the cost of dental care is extremely high, 130 million
Americans have no dental insurance; one-fourth of adults age 65 or
older have lost all their teeth; only 45 percent of Americans age 2
and older had a dental visit in the past 12 months and more than 16
million low-income children go each year without seeing a
Lack of dental access is a national problem but those who are most
impacted are people who are low income, racial or ethnic
minorities, pregnant women, older adults, those with special needs,
and those who live in rural communities. Simply put, the groups
that need care the most are the least likely to get it.
What we also learned at the hearing is that access to dental care
is about more than a pretty smile. People with dental problems can
be forced to live with extreme pain which affects their quality of
life, and a mouth without teeth may make it difficult to find and
keep a job. Dental problems can have a significant impact on
overall health and can increase the risk of diabetes, heart
disease, digestive problems and poor birth outcomes. In some cases,
dental conditions have resulted in great tragedy such as the death
of 12-year-old Deamonte Driver of Maryland five years ago.
In order to address the dental crisis facing millions of Americans,
the U.S. Congress must take strong action now. My office is working
on a comprehensive piece of dental legislation which will address
the following concerns:
First, the United States needs more dental providers to serve those
in need, and the providers need to work in areas where the need is
greatest. Currently, more dentists are retiring than are
graduating dental schools. We also need to expand the dental
workforce to include allied dental providers such as dental
therapists in order to extend the capacity of dental practices and
reach underserved populations.
Second, not only do we need more dental providers, but there must
be a national call for those in practice to start serving more
low-income people. Only 20 percent of the nation's practicing
dentists provide care to people with Medicaid and only an extremely
small percentage devote a substantial part of their practice to
caring for those who are underserved.
Third, we need to expand Medicaid and other dental insurance
coverage. One third of Americans do not have dental coverage and
traditional Medicare does not cover dental services for the
Finally, we are seeing improved access through the growth of
Federally Qualified Health Centers (FQHC) which now provide dental
services to over 3.5 million people across the country, regardless
of their ability to pay. Grant Whitmer, the Director of the
Community Health Center of the Rutland region, gave very moving
testimony at the hearing as to what the new dental clinic in
Rutland has meant to the people in that area. In my view,
FQHC dental clinics must be expanded. There is also great
potential in bringing dental clinics right into schools.
In Vermont, while we still have a long way to go, we are making
good progress in expanding access to affordable dental care.
In the last several years we have seen the number of community
health centers expand from two to eight with sites in 43
communities. Today, more than 110,000 Vermonters get their
primary health care at FQHCs, including 25,000 who get their dental
care at these facilities. Beautiful new dental clinics have
recently been built or expanded in Hardwick, Burlington, Rutland,
Plainfield, Richford, Morrisville, Ludlow and Swanton. Island
Pond has had an FQHC dental clinic for years. Further, we now
have school-based clinics in Bennington, Burlington, Swanton and
Tunbridge providing dental service to about 2,000 children.
Progress is being made, but much more needs to be done.