Caitlin Hartsell’s recent guest commentary on dental therapists raised important issues surrounding access to oral health care in Missouri. I applaud her efforts to bring attention to what the surgeon general has referred to as the “silent epidemic” of dental and oral disease. However, I disagree with her recommendations of what we could and should do to improve the oral health of our state.
Caitlin’s commentary focuses on changes to the dental workforce, specifically a dental therapist. However, the commentary does not recognize the numerous other issues that currently impact access to dental care. For example:
1. Our state’s Medicaid program does not currently provide any coverage to adults, including developmentally disabled adults or the elderly.
2. The state has continued to provide Medicaid services through an inefficient managed-care system, rather than a dental carve-out, a medical managed care model that has proven to be effective in other states.
3. Medicaid currently reimburses practitioners at 38.5 percent of their usual fee, a rate so low it does not even cover the basic overhead to provide care. This low rate places Missouri 44th when compared to other states.
4. Current laws allow insurance companies to avoid prompt payment to dental providers, leaving practitioners waiting weeks, if not months, to be reimbursed for services.
5. Grant programs that encourage water fluoridation have ended, and Missouri is seeing the number of cities that provide fluoridated water decrease.
As a member of the Missouri Dental Association, I recognize the challenges many people face in trying to access oral health care and am dedicated to removing those barriers. That is why I support the Missouri Dental Association and its efforts at the state capital to provide solutions to each of the above problems, as well as other issues vital to access.
That does not mean that we should ignore proposed changes to the dental workforce. But, as a practitioner, I cannot advocate for any changes that would compromise the safety of my patients.
The Missouri Dental Association, along with the American Dental Association, are currently recommending two new providers. These auxiliaries would improve the delivery of preventive services, and oral health education, and would expand access without risking the health of the patient. I would encourage advocates and policy makers to learn more about these proposals by visiting the American Dental Association website.
Good oral health is key to good overall health. Studies have shown a link between poor oral health and increased cases of heart and lung disease, difficulties in diabetes management and even preterm or premature births. Our state and citizens should make oral health a higher priority.
I would encourage others, both inside and outside of the profession, to contact your legislators and ask them to support the Missouri Dental Association agenda. Working together, I am confident we can bring common sense solutions that will improve the oral and overall health of our state.
You can learn more about the Missouri Dental Association and its legislative advocacy by visiting the MDA Web site at www.modental.