USA - Low income children miss out on dental care

Low income children miss out on dental care
Submitted by voicesweb on December 11, 2009 - 7:44pm
by Sylvia Onusic
A mother recently walked through the doors of Centre Volunteers in Medicine, the local free healthcare clinic, with her five-year-old girl. The little girl’s four front baby teeth were broken off at the gum line. In each tooth was an abscess, a longstanding infection. Aside from the discomfort, such infections in baby teeth can affect the permanent teeth just below, becoming a much more complicated health issue in the future.

“The parents didn’t want to take the child out of school for treatment but we finally got her in last week,” Dr. Heather Raymond, director of CVIM’s dental services, told Voices. “It broke my heart.”

John Kelly, a local pediatric dentist since 1977, said that “parents routinely ignore children’s abscessed teeth because they don’t cause a lot of pain, but the infection is sitting there constantly flowing into the blood stream. These children become sick children.”

The Pennsylvania Oral Health Needs Assessment and other reports continue to emphasize the association between low income and dental health. Poor children in Pennsylvania have fewer visits to the dentist, more untreated cavities and dental diseases. According to the Pennsylvania Department of Health, “this strongly suggests that access to preventive and restorative dental care, as well as effective preventive oral health education, is lacking for these poor children and their families.”

Centre County is no exception. A study commissioned by the state department of health from 1998 to 2000, found higher rates of caries and untreated caries in the northern districts, north central districts and in the cities of Philadelphia and Pittsburgh. State College is located in the north central district, and school districts sampled for this study were in Centre County and Clinton Counties.

More than 5,000 local children, an estimated one in four, are Medicaid recipients, yet only six dentists in the county accept payments from this government program for low-income residents, leaving many local children without dental care.

A 2008 list of Medicaid dentists provided by Jeffrey Foreman, executive director of the Centre County Assistance Office showed little improvement over 2004 with only one new dentist signing up in four years.

Dentists who accept Medicaid in Centre County include John R. Kelly, Robert L. Kilareski, G. Matthew Kremser, pediatric dentists in State College; Shama Kulkarni, John W. Le Clair, general dentistry in State College; and Jolene Galak-Vaughn, general dentistry in Philipsburg. Diane Ray, who has joined Dr. Kelly’s practice, is an orthodontist who has applied for Medicaid certification. Kelly told Voices that Pennsylvania is slow to certify new dentists—they don’t want to pay.

The Pennsylvania Department of Public Welfare reports that an estimated 40 percent of all licensed dentists in Pennsylvania are enrolled in the Medicaid Program, but only 54 percent of those actually participate in the program. Of those, only half provide 99 percent of all dental services rendered to eligible Medicaid participants.

Yet dentists know better than anyone the dangers to children of delayed or absent dental care.

Tooth decay affects 48 percent of Pennsylvania children by the age of eight, even those who drink fluoridated water, according to the Department of Public Welfare. By age 15, this increases to 50 percent. Thirty-three percent of low-income children have untreated tooth decay compared to only 10 percent of children in higher-income households...................