Facts

Oral Health and Dental Access – The National Perspective

The U.S. Surgeon General’s Report on Oral Health

In May 2000, the U.S. Surgeon General released the government’s first comprehensive report on oral health. It showed that Americans’ teeth and mouths are in the best shape ever, but with many poor people and racial groups having untreated oral diseases, serious disparities in oral health exist.

This is not surprising considering that an estimated 108 million Americans, including 26 million children, have no dental insurance. According to former U.S. Surgeon General David Satcher, those who suffer the worst oral health are found among the poor of all ages, with poor children and poor older Americans particularly vulnerable.

These disparities amount to “a silent epidemic of oral diseases” among the nation’s most vulnerable citizens.

The Link Between Oral Health and Other Diseases

Calling the mouth a mirror for many diseases, Satcher also highlighted surprising links between oral health and general well being. For instance, chronic oral infections are associated with diabetes, heart disease and stroke. Oral diseases can also be a sign of HIV infection as well as osteoporosis.

Oral Health in Seniors

Nearly one-third of people 65 years of age and older have untreated dental caries. (Souce: Center for Disease Control: Aging Trends). This statistic is indicative of problems in access to dental care for seniors.

Children’s Oral Health and Access to Dental Care

With regard to uninsured children, a recent study presented at the Families USA conference in January 2001 revealed that more than 70% of parents of uninsured children report that the lack of access to dental care and dental coverage is a greater problem than access to medical care. (Source: New York Times, 1/31/01).

Tooth decay is one of the most preventable childhood diseases, yet dental care remains the most prevalent unmet health care need for children in the United States. A 2003 brief from the Child Health Insurance Research Initiative, reports on the topic and gives strategies for improving access to dental care.

Oral Health and Dental Access – The Local Perspective

Symptoms of this oral epidemic are easy to find in Champaign County, where there is a serious lack of affordable dental services for low-income adults. This problem is made worse because there is virtually no affordable access to oral surgeons. Even those who qualify for public aid find that the limited number of local dentists accepting Medicaid or KidCare is a barrier to care.

This problem of dental access for low-income and working families and individuals, and for people with Medicaid or KidCare, has been well-documented and is well-known in our community. Seniors and people with disabilities are included among those in our community who suffer from lack of access to dental care.

Callers to CCHCC’s Consumer Health Hotline Seek Dental Care

CCHCC operates a Consumer Health Hotline, which is a service to assist consumers who are having any kind of problem with the health care system. Most of the calls CCHCC receives each month are from consumers seeking access to affordable health care. CCHCC receives over 100 calls a month, and on average, over half of those calls are regarding access to dental care.

Lack of Affordable Dental Care for Champaign County Residents

Calls to the CCHCC Consumer Health Hotline show that there is a serious lack of affordable dental services for low-income individuals and families in Champaign County. Access to affordable dental care affects a large portion of Champaign County residents, including the low-income uninsured and underinsured (very few health insurance or HMO policies cover dental care). The lack of affordable dental care for Champaign County residents of all ages is a health care crisis in this community. The health disparities, which the U.S. Surgeon General’s report documents, exist in Champaign County.

Oral Health Crises and the Emergency Room

People should not be getting their oral health care through the ER but that is exactly what they have to do – these are primarily people who lack access to affordable dental care and do not know where to turn for help and therefore delay treatment until they are in great pain. People with broken or crushed teeth, infected mouths, and those seeking dental care and relief from pain go to the only place where they know they will be seen and from which they cannot be turned away – the ER. Most of the people who go to the ER or are referred to CCHCC are people with dental problems that could have been prevented years ago, but instead have gone untreated and have blossomed into devastating and painful health conditions that will also require greater expense to treat.

These patients typically need antibiotics and pain medications, which CCHCC helps them get, but then they have to start on the long road of seeking affordable dental care to take care of the problem once and for all. It can be months before they get the care they need, and so they are forced to “manage” their dental problem by seeking more antibiotics and pain medications through the ER, where they also incur significant medical costs.

Many of the clients CCHCC sees who are in this situation are people who are in incredible pain, and who are sometimes even emaciated from their incapacity to eat and from stomach problems resulting from pain and infection as a result of the oral health problem. Some clients lose their jobs as a result of sick days from the pain or from spending too much time in the ER trying to seek relief and treatment.

The Dental Referral Program

CCHCC coordinates the only affordable dental care program for low-income adults in Champaign County, called the Dental Referral Program (DRP). Every month, CCHCC receives dozens of calls from consumers seeking to enroll in the DRP, or seeking affordable dental care, including oral surgery, dentures, child dental care, and other oral health services.

Through the Dental Referral Program (DRP), local dentists agree to provide discounted dental services to adults in Champaign County who do not have dental insurance and cannot afford needed dental care. In order to qualify for the program, individuals must reside in Champaign County and live in households with incomes below 185% of the poverty level. Patients must pay $15 for their initial appointment. Then, based on income level, they receive a 20%, 40%, or 60% discount on the dentist’s services for all follow up work. CCHCC administers the program, provides the financial screening, and qualifies the applicant. In addition, CCHCC provides written and verbal reminders to clients to ensure that they keep their appointments.

Currently, the DRP is considered the primary source for dental assistance for low-income adults in the community. Unfortunately, the DRP is very limited. Even for patients that meet DRP qualifications, there are barriers to receiving all the care they need. For instance, many patients are in need of lab work or the services of a specialist such as an oral surgeon. Patients must pay full price for these services that are not directly provided by DRP participating dentists. Also, when major dental work is needed, patients often find themselves unable to afford the portion of costs that they are responsible for paying.

Local Efforts to Prioritize and Improve Dental Access

The Champaign County Health Care Consumers (CCHCC) and many other local social service organizations have identified and prioritized dental access as a major problem to be addressed in our community. The recent community-based efforts to understand and begin addressing this problem began in earnest in 2001. The following public and community efforts and events indicate the community’s awareness of, and willingness to address the problem of dental access:

• CCHCC and local dentists initiate the only affordable dental care program for low- income adults in Champaign County, called the Dental Referral Program (DRP). Through the Dental Referral Program (DRP), local dentists agree to provide discounted dental services to adults in Champaign County who do not have dental insurance and cannot afford needed dental care. (1992)

• CCHCC releases report titled “Champaign County – A Community at Risk: Health Care Out of Reach,” in which we described the problems of access to health care in our community and dedicated a section to discussing the problem of dental access for low-income, uninsured, underinsured, and Medicaid and KidCare persons in our county. (April 2001)

• The Champaign County Community Health Partnership is formed, with over 50 local organizations participating, including health care providers, social service providers, labor groups, consumer health advocates, faith-based organizations, and others. The Community Health Partnership (CHP) undertakes process to prioritize community health concerns. Dental Access is one of the community health priorities identified, and the CHP Dental Access Work Group is formed. (Spring 2001)

• A community meeting for residents of East Central Illinois is held to discuss local oral health care problems and to recommend solutions to the state. Official from the Illinois Department of Public Health are present, as well as Rep. Tom Berns, and a staff member of Rep. Rick Winkel’s office. Approximately 100 community members attend meeting and provide testimony regarding problem of dental access. (June 26, 2001)

• CCHCC, the CHP Dental Access Work Group, the Friends of Public Health coalition and the Human Services Council of Champaign County all prioritize dental access for Champaign County children and take their message to the Champaign County Board of Health, which governs the Champaign County Public Health Department. The Board of Health and the County Board agree to allocate funds for a “children’s dental access program” to be implemented through the County Public Health Department. (November 2001)

• CCHCC and the CHP Dental Access Work Group hold a public study session on dental access programs around the country and use the information gathered to help inform how the County Public Health Department’s children dental access program might best be structured to meet the local needs of county residents. (January 2002)

• The Champaign County Health Department’s Child Dental Access Program is implemented, and Lisa Bell, a dental hygienist, is hired as coordinator of that program. Ms. Bell recruits dentists to participate in collaborative program, and county children begin receiving free dental services. A Dental Advisory Committee is created to help support and guide the development of the new program. Several members of the Dental Access Work Group serve on the Dental Advisory Committee. (Spring/Summer 2002)

• CCHCC (and the Dental Access Work Group), WILL-AM Radio, and WBCP Radio join together in the Sound Partners-funded effort to create the SmileHealthy! program – a collaborative effort to educate the Champaign County community about oral health and dental access and to address, through community-initiative, the problems of oral health and dental access. (Summer/Fall 2002)

Stories of Need

Monday, July 28, 2003
Tour de Smile!
Lisa Bell raises $3,000 for Kids’ Dental Health on her "Tour de Smile!" (More)

Dental Fair reaches 136 kids and their parents
136 kids and parents came to the Smile Healthy! Dental Fair February 22, 2003. (More)

The Connection Between Oral Health and Overall Health
AM-580 news reporter Ali Kawa connects oral health and overall health telling one man's story. (More)

Wednesday, November 13, 2002
Community Meeting on Dental Access
Listen to the audio from the community meeting held November 12, 2002. (More)

Thursday, October 31, 2002
Anna Armstrong, mother of six children, goes without dental care because she cannot afford to pay. (More)

Smile Healthy is a collaboration between WILL-AM 580, WBCP-AM 1580 and Champaign County Health Care Consumers. Smile Healthy is underwritten by Sound Partners for Community Health - a program of the Benton Foundation, funded by The Robert Wood Johnson Foundation, which is dedicated to improving health and health care for all Americans.

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