The Mountain Times

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Op-Ed: Addressing the dental crisis

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 learned:   

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 dentist.

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 elderly.

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.


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