By Homa Amini, Professor-Clinical, Pediatric Dentistry, The Ohio State University and Nationwide Children's Hospital
As we celebrate National Children's Dental Health Month in February, it is important to highlight the importance of good oral health for overall health and well-being, and bring attention to oral health disparities that exist in Ohio. Below we provide oral health data for Ohio children and identify barriers to access to dental care. Advocacy for improving children’s oral health and closing disparity gaps should be a priority for any child advocate, including policymakers.
Importance of Oral Health
Over two decades ago, the words of former Surgeon General C. Everett Koop “you’re not healthy without good oral health,” brought attention to the significance of good oral health. A few years later, the first-ever Surgeon General Report on Oral Health was released, highlighting the burden of oral diseases in the U.S., and shedding light on oral health disparities.
Since then and despite overall improvements in the oral health of our nation, many Americans still suffer from poor oral health. Poor oral health affects our ability to eat, speak, and smile. Additionally, poor oral health can impact one’s self-esteem and psychological well-being. Many systemic diseases such as heart disease and diabetes have been linked to poor oral health. If left untreated, dental disease can lead to pain and suffering, poor work performance, emergency room visits, hospitalization, costly treatments, and diminished quality of life.
Children’s Oral Health
Tooth decay is the most common chronic disease of childhood, more common than asthma and allergies. According to the Center for Disease Control and Prevention (CDC), over 34 million school hours are lost annually due to dental problems. School absenteeism is associated with poor school performance and low academic achievement.
The oral health screening survey of third grade children conducted by the Ohio Department of Health (ODH) during 2017-18 revealed about half (48%) of school-aged children had a history of tooth decay. One in five children had untreated cavities. Disparities in oral health status existed based on income and geography. Children from the Appalachian region and those from low-income families suffered from more cavities.
Regardless of income, dental care remains the number one unmet healthcare need of Ohio children, and for adults, it is second only to prescription drug coverage as the greatest unmet healthcare need.
Access to Dental Care
Financial barriers limit access to dental care for many Ohioans. Medicaid remains the main source of dental coverage for children from low-income families. Despite this coverage, access to dental care remains a challenge for low-income kids. According to the ODH survey of third grade children (2017-18), parents of children on Medicaid were 5 times more likely than children with private insurance to have trouble getting dental care. Ohio has one of the lowest dental care utilization rates for Medicaid-insured children compared to other states, and disparities exist based on insurance type (public vs private).
Geography makes access to dental care challenging for children living in Appalachia and rural Ohio. High poverty rates, shortage of dental providers, lack of Medicaid providers, limited oral health literacy, and lack of transportation are among the barriers faced by the rural population.
Strategies to Improve Children’s Oral Health Well-Being in Ohio Well-
The recent Ohio Medicaid fee increase for dental services should improve access to dental care for low-income children to some extent. Reducing providers’ administrative burdens associated with some Medicaid Managed Care Plans is needed for successful provider recruitment and retention.
Although the majority of Ohioans benefit from fluoridated water, 8% of the population on a community water system are not receiving this benefit. Drinking fluoridated water reduces cavities by about 25% in children and adults. Supporting local-level legislation, regulation, and infrastructure to ensure safe community water fluoridation helps reduce oral health disparities.
Recruiting dental providers to rural areas is a challenge faced by many Ohio communities. Promoting loan repayment programs and tax incentives through legislation and regulation can facilitate recruitment efforts.
Broadband access in some rural areas is limited, preventing access to teledentistry for rural population. Extending internet access will broaden the reach and benefits of teledentistry for rural population.
Join us for a webinar on dental health in pregnancy and young children on Friday, February 23 at 10 am. Learn more and register today.
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