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Washington State Dental Association

Dr. Brittany Dean: State Needs to Improve Access to Adult Dental Care

On Sunday, November 20, the Everett Herald featured the following editorial written by WSDA member Dr. Brittany Dean. 

For four days last month, Seattle’s KeyArena was transformed into a massive dental clinic. Volunteers from across the state — dentists, hygienists and other skilled practitioners — took over a floor usually reserved for rock bands or basketball teams to provide dental care for more than 3,000 low-income patients.

These committed dental professionals provided patients with everything from so-called routine services like cleanings and fillings to more complex procedures like extractions, root canals and crowns.

As a dentist, I can say this event was both professionally and personally rewarding. Nearly all the patients we treated were adults, and many had not visited a dentist in years.

The state of Washington has done an admirable job in adequately covering pediatric dental services through Apple Health, the state’s Medicaid system. As a result, children from low-income families are more likely to receive the oral care they need for healthy growth and development.

Unfortunately, the same can’t be said for adults. Despite critical expansion of services covered by adult dental Medicaid, Washington’s reimbursement rates are so low that often they don’t even cover the overhead costs for a dentist to see a patient. As a result, patients with Medicaid coverage continue to have difficulty finding providers who will take their insurance.

During my years of work in a community health center, our Medicaid patients had to wait three to six months for an exam and often months between treatment appointments. This effectively encourages these patients to ignore their preventive care needs and instead only seek treatment when serious — and expensive — conditions arise. The same can be said for many adults who aren’t low income, but for various reasons either don’t have dental benefits or what they have offers little coverage for even preventive care visits.

From a medical perspective, this is a troubling trend.

Routine dental care is about more than just avoiding painful oral health problems. As with children, there’s a strong correlation between oral health and overall health among adults. A patient’s mouth can provide early indicators of serious problems, such as blood disorders or eating disorders. Study after study has found that major chronic diseases such as diabetes, cancer and heart disease share common risk factors with oral diseases.

In other words, providing better coverage for oral health services is a smart investment that not only helps patients today, but also can help identify and head off more serious problems down the road.

Across our state, in community clinics and in their own offices, dentists routinely work with patients to ensure that a lack of funds or dental insurance does not prevent them from receiving the care they need. So, dentists end up providing millions of dollars and hundreds of thousands of hours of uncompensated and discounted care to low-income individuals.

Dentists see this as part of their professional commitment to maintaining and enhancing the overall health of the patients and communities they serve.

But, expecting the burden to be shouldered by the charitable efforts of any one profession alone is not a responsible way for the state to provide dental services for its residents.

In order to ensure that there are dental resources for all citizens, the state instead needs to step up and fund adult oral health care coverage for low-income adults the same way it has for children. There may always be a need for events like the one at KeyArena to help care for our low-income neighbors — and Washington’s dentists are committed to doing our part to make events like that a success.

But wouldn’t it be better if the state provided solutions to get more Medicaid patients connected with ongoing dental services, supporting a transition to ongoing health, rather than having patients wait for a once-a-year event to see a dentist?

Dr. Brittany Dean is a dentist from Edmonds. She served as one of the dental coordinators for the Seattle/King County Clinic held in October at KeyArena.

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