Access to Care
Policy Statement
Oral Health in America: A Report of the Surgeon General, identifies huge disparities in the oral health status of certain populations in the United States, including low-income families, those living in rural communities, racial or ethnic minorities, children, the elderly and the developmentally disabled. The 2005 California Oral Health Needs Assessment reported 54% of kindergarteners and 71% of third graders have a history of tooth decay and more than 25% of elementary school children have untreated decay. A report card issued in 2007 by Children Now gave California a “C-“ for dental insurance and access stating “ One-quarter of California’s children do not have dental insurance, dramatically decreasing the chances they will receive regular check-ups and treatment.”
California has a growing population of seniors that face similar access issues. As baby boomers with teeth age, dental professionals are faced with the responsibility to care for a population often challenged with multiple medical conditions, physical frailties, mental ailments and numerous medications. Many seniors live on a fixed income and lack dental insurance, further compounding the problem.
Identified barriers to care include: no perceived need for oral care and/or the public and policymakers placing a low priority on oral health and prevention strategies; lack of access to dentists; low socio-economic status and/or lack of financial resources to pay for care; inadequate reimbursement by government insurance programs and excessive paperwork required for reimbursement; lack of providers trained to care for diverse populations, very young children and people with special needs; and Medi-Cal beneficiaries being unaware that dental benefits are included as part of their insurance plan.
The California Dental Association has supported a variety of activities designed to improve access to care and the oral health of Californians. These efforts include legislation mandating an oral health assessment upon school entry, state legislative and regulatory initiatives to expand school-based dental sealant/oral health education programs, creation of student loan forgiveness programs, licensure by credential, increases in funding to broaden the benefits of government-funded programs, as well as increases in reimbursement levels for services provided under these public programs. At the state and local level, the number of Californians benefiting from community water fluoridation has quadrupled since CDA became involved in 1990.
Additionally, the CDA Foundation collaborates with the Dental Health Foundation to administer a 4-year, $7 million First 5 grant to provide training to dental and medical teams, as well as early childhood educators, on the early detection and prevention of ECC in children under five years of age, and those with special health care needs. To date, nearly 8,300 dental professionals and over 3,400 medical professionals have received training through live lectures and web-based learning.
CDA Foundation also administers the Pediatric Oral Health Access Program (POHAP). POHAP is a free training program that provides a sustainable increase in access to dental care by strengthening the skills and raising the comfort level of general dentists to treat young children, including children with physical and/or developmental disabilities. POHAP enlists general dentists who practice in underserved areas, treat uninsured patients and/or currently accept publicly-funded dental insurance programs. Prior to completing the intensive training course, participating dentists agree to routinely accept young children, including children with special needs, as well as provide free restorative treatment to a limited number children who have no ability to pay.
CDAs local dental societies are active throughout the state, providing services and support through community clinics, school-based educational programs, and mobile dental services. In addition to participating in the programs and efforts previously mentioned, individual dentists provide significant pro bono work within their own practices. Through all of these charitable efforts, an estimated $120 million of dentistry was donated in 2006.
CDA affirms that access to oral health care is important to maintain overall health and recognizes the complex nature of the problem and the need to address this pressing issue. Successfully addressing this issue will require multi-agency and multi-organizational cooperation. The organization remains committed to seeking cooperative alliances with other health professions, federal, state and local governments, nonprofit organizations, consumer groups and private entities to improve access to oral health care.
Last revised November 2007