‘Action for Dental Health: Dentists Making a Difference’ Offers Real-World Solutions
Harris Interactive Study Reveals What’s at Stake in America’s Dental Divide
ADA Research Brief Reveals Failure of Affordable Care Act to Cover Many Adults
The nation’s leading organization of dentists today announced a nationwide campaign aimed at boldly addressing the dental health crisis in the U.S. The American Dental Association (ADA) campaign – Action for Dental Health: Dentists Making a Difference – aims to reduce the numbers of adults and children with untreated dental disease, through oral health education, prevention and providing treatment now to people in need of care.
The need is clear, according to new Harris Interactive data released today by the ADA. The study confirmed a disturbing dental divide in America:
· Nearly half of lower-income adults say they haven’t seen a dentist in a year or longer, while the vast majority of middle- and higher-income wage earners (70 percent) have.
· Lower-income adults 18 and older are more than two times as likely as middle- and higher-income adults to have had all of their teeth removed (7 percent vs. 3 percent).
· Nearly one in five (18 percent) lower-income adults have reported that they or a household member has sought treatment for dental pain in an emergency room at some point in their lives, compared to only seven percent of middle- and higher-income adults.
· Only six percent of those low-income adults who went to the ER reported that the problem was solved.
· Even though the Affordable Care Act offers little relief for adult Americans who lack dental coverage, 40% of lower-income adults believe that health care reform will help them obtain dental care.
The survey’s findings echo prior research from multiple sources. According to a new ADA Health Policy Resources Center analysis of 2010 MEPS and U.S. Census data, 181 million Americans did not visit the dentist in 2010. Nearly half of adults over age 30 suffer from some form of gum disease, according to the Centers for Disease Control (CDC), and nearly one in four children under the age of five already have cavities.
Complex Problem Calls for a Coordinated National Action
Surgeon General David Satcher’s landmark 2000 report “Oral Health in America” identified a “silent epidemic” of untreated oral disease among some populations groups. A subsequent “National Call to Action” articulated an ambitious agenda for ending these disparities.
“We’ve made great progress, with each generation enjoying better dental health than the one before,” said ADA President Robert A. Faiella, D.M.D., M.M.Sc. “But there’s still a dangerous divide in America between those with good dental health and those without. Our mission is to close that divide. Good oral health isn’t a luxury. It’s essential.”
The causes of the dental health crisis are varied and complex. However, dentists in America believe it can be solved, that it’s never too late to take on this challenge, both as individuals and as a nation. Action for Dental Health is national and coordinated in its scope and approach, and is designed to address the dental health crisis in three distinct areas:
Provide care now to people suffering with untreated disease
· Reduce by 35 percent by 2020 the number of people who visit the emergency room for dental conditions, by referring them to community health centers, private dental practices or other settings, where they can receive proper dental care.
· Implement in at least 10 states by 2015 a long-term care program to improve the oral health of nursing home residents.
· Expand the ADA Give Kids A Smile local community programs to provide education, screening and treatment to underserved children in order to achieve the vision statement of Give Kids a Smile: the elimination of cavities in children under five by 2020.
Strengthen and expand the public/private safety net to provide more care to more Americans
· Help provide more care to people by having private-practice dentists contract with Federally Qualified Health Centers, therefore increasing the number patients receiving oral health services 175% by 2020.
· Fight for increased dental health protections and simplified administration under Medicaid by increasing by 10% the number of states that have streamlined their credentialing process to less than one month.
Bring dental health education and disease prevention into communities
· Ensure that 80% of Americans on public water systems have access to optimally fluoridated drinking water by 2020.
· Increase from seven to 15 the number of states where Community Dental Health Coordinators (CDHCs) are active by 2015. CDHCs provide dental education and prevention services to the community and help people navigate the dental health system.
“We need to remember that every infant is born cavity-free,” said Dr. Faiella. “The key for both kids and adults to maintain their dental health is effective prevention. That’s why we’re increasing our awareness efforts in schools and underserved communities. By working to ensure all Americans understand the connection between their dental and overall health, we can begin to solve this crisis.”
Affordable Care Act Fails to Address Critical Dental Care for Adults
When it comes to access to routine dental care – a major determinant of oral health – the Affordable Care Act (ACA) falls well short in its goals of lowering costs, increasing access and improving health outcomes, according to a recent analysis by the American Dental Association. In a series of three research briefs, available at www.ada.org/1442.aspx, the association’s Health Policy Resources Center (HPRC) reports that under the ACA about 8.7 million children are expected to gain some form of dental benefit from the program, which will reduce by approximately 55 percent the number of children without dental benefits.
But for adults it’s a different story. Only an estimated 5.3 million adults are expected to gain extensive oral health coverage as a result of the ACA, almost all due to Medicaid expansion in the few states that provide extensive dental benefits. This will reduce the number of adults without dental benefits by about 5 percent, a negligible impact. Further, Medicaid-eligible adults may see few improvements in their ability to receive dental care, the HPRC analysis suggests.
“The ACA is a missed opportunity, and we have a long way to go in ensuring access to oral health for all Americans,” writes Dr. Marko Vujicic, managing vice president of the HPRC and co-author of the briefs. “This is especially true for adults, who have experienced greater financial barriers to dental care in recent years.”
Harris Interactive Survey Methodology
The ADA Dental Divide in America Study was conducted online within the United States by Harris Interactive on behalf of the American Dental Association, between April 24-29, 2013 among 1,221 US adults age 18+, of whom 310 had a household income of less than $30K and 911 had a household income of $30K or more.
All sample surveys and polls, whether or not they use probability sampling, are subject to multiple sources of error which are most often not possible to quantify or estimate, including sampling error, coverage error, error associated with nonresponse,
error associated with question wording and response options, and post-survey weighting and adjustments. Therefore, Harris Interactive avoids the words “margin of error” as they are misleading. All that can be calculated are different possible sampling errors with different probabilities for pure, unweighted, random samples with 100% response rates. These are only theoretical because no published polls come close to this ideal.
Respondents for this survey were selected from among those who have agreed to participate in Harris Interactive surveys. The data have been weighted to reflect the composition of the adult population. Because the sample is based on those who agreed to participate in the Harris Interactive panel, no estimates of theoretical sampling error can be calculated.
About the American Dental Association
The not-for-profit ADA is the nation’s largest dental association, representing 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA’s flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit www.ada.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA’s consumer website www.MouthHealthy.org.
Healthy teeth and gums aren’t a luxury. THEY’RE ESSENTIAL.
That’s because our dental health has an impact on our overall health and neglecting one can negatively impact the other. That’s why the American Dental Association (ADA) is launching Action for Dental Health: Dentists Making a Difference, a nationwide campaign aimed at boldly addressing the dental health crisis facing America today.
ALL AMERICANS DESERVE GOOD DENTAL HEALTH
The causes of the dental health crisis are varied and complex. But we know that for each of us – and for the nation as a whole – it’s never too late to get on top of our dental health.
Action for Dental Health aims to prevent dental disease before it starts and reduce the proportion of adults and children with untreated dental disease through oral health education, disease prevention and providing treatment now to people in need of care. Our goal is to help all Americans attain their best oral health.
Action for Dental Health is comprehensive in its approach and scope and is designed to address the dental health crisis in three distinct areas.
I. PROVIDING CARE NOW TO PEOPLE SUFFERING WITH UNTREATED DISEASE
- Reducing the number of people who visit the emergency room for dental conditions, by referring them to community health centers or private dental practices, where they can receive proper dental care. People suffering from dental pain need somewhere to turn for help. Frequently the place they turn is the emergency room of their local hospital. According to the National Hospital Ambulatory Medical Care Survey, the number of dental ER visits in the U.S. increased from 1.1 million in 2000 to 2.1 million in 2010. A separate study shows that in 2009, dental caries (the disease that causes cavities) and abscesses alone – almost entirely preventable conditions – accounted for nearly 80 percent of dental-related ER visits. While emergency rooms can provide pain relief and treat infection, few hospitals have dentists on staff so they aren’t able to provide comprehensive dental care. Moving patients with dental pain out of the ER and into the dental chair ensures that they get the right care at the right place.
- Expanding access to care for the elderly in nursing homes. Approximately 1.3 million nursing home residents face the greatest barriers to accessing dental care of any population group. Federal law requires nursing home facilities to provide dental care to residents, including routine and emergency care. But delivering dental care to these patients has been problematic. Now, dentists across the country are adopting nursing homes in their communities using the existing public health safety net. It’s an immediate and affordable solution for nursing home residents.
- Increasing programs where dentists can directly provide care to those who are suffering from lack of dental care today. Programs like Give Kids A Smile and Missions of Mercy provide important platforms for dentists to deliver care directly to those in need. Each year, approximately 450,000 children benefit from 1,500 Give Kids A Smile events nationwide. Missions of Mercy events across America have served more than 100,000 patients, providing nearly $50 million in free services since 2000. These programs, along with the free and discounted care that individual dentists provide every day, aggregate into an estimated $2.6 billion per year.
II. STRENGTHENING AND EXPANDING THE PUBLIC/PRIVATE SAFETY NET TO PROVIDE MORE CARE TO MORE AMERICANS
- Helping provide more care to people by having private-practice dentists contract with Federally Qualified Health Centers. By partnering or contracting with community health centers, private dentists are able to help these safety net facilities expand their capacity to provide care to underserved populations (primarily children on Medicaid), without increasing the clinics’ “bricks and mortar” expenses and staffing overhead. Patients benefit because quality care can be quickly and efficiently delivered, alleviating much of the backlog experienced by many health center dental programs. Access to dental specialty services can also be increased. Contracting with the health centers allows private dentists to work with underserved populations without having to contend with many of the administrative headaches of the Medicaid program.
- Fighting for increased dental health protections and simplified administration under Medicaid. This proven solution has dramatically improved access to care in some states. A combination of fee increases and administrative reforms in Connecticut’s Medicaid program in 2008 increased the number of participating dentists from fewer than 200 to more than 1,200. As a result, nearly 70 percent of enrolled children had at least one dental visit per year, a rate higher than that for privately insured children and dramatically higher than the 15 percent who saw a dentist prior to the state’s Medicaid reforms. But most Medicaid programs remain inadequate for children, while comprehensive coverage for adults is all but nonexistent in most states. Expanding Medicaid coverage and improving the system means more dentists providing more care to more people in need.
III. BRINGING DENTAL HEALTH EDUCATION AND DISEASE PREVENTION INTO COMMUNITIES
- Ensuring more Americans have access to drinking water with fluoride. Endorsed by U.S. Surgeon General Regina Benjamin, MD as “one of the most effective choices communities can make to prevent health problems while actually improving the oral health of their citizens,” community water fluoridation programs benefit everyone, especially those without access to regular dental care
. For most cities, every $1 invested in water fluoridation yields $38 savings in dental treatment costs. That’s why the ADA and state dental associations are working with state and local governments to extend the proven health benefits of community water fluoridation to the greatest possible number of people.
- Increasing the number of Community Dental Health Coordinators (CDHCs). CDHCs are community health workers with dental skills focusing on education and prevention. They forge strong relationships with people in underserved communities with disproportionately high rates of dental disease. CDHCs teach people about the importance of good dental hygiene, provide preventive services such as dental sealants and connect people with dentists who will provide comprehensive treatment. And, since CDHCs are often members of the communities they are serving, they are more apt to understand the unique challenges facing the people they are helping.
- Strengthening collaborations with other health professionals and organizations. Better collaboration among dental and medical professionals can be a means to ensure all Americans understand their dental health is a crucial part of their overall health. The dental health of a pregnant woman or a mother can affect the health of the baby. Maintaining good oral hygiene is one element to maintaining optimal overall health for people living with such conditions as diabetes or HIV. With minimal training, physicians, nurses, educators and others can dramatically increase the number of patients and caregivers who receive basic dental health education. These professionals also can be trained to recognize conditions needing diagnosis and possible treatment by a dentist. As part of its ongoing work to foster these collaborations, the ADA will convene a diverse group of oral health stakeholders at a Prevention Summit in November.
To learn more about ADA’s Action for Dental Health, visit www.ada.org/action. Get engaged. Follow the ADA online: @AmerDentalAssn | @MouthHealthy