Issue Statement:

Lack of dental insurance coverage and access to needed dental care continue to be main issues in Boone County. Last year there were no known dentists in Boone County which accepted new straight Medicaid (non-MC+) patients. Based on the 1998 Boone County Health and Human Services Needs Assessment, as many as 23,000 Boone County adults reported no dental coverage. Many children with MC+ coverage are still not benefiting from available preventive dental care. Periodontal disease, abscessed teeth, and intractable dental pain adversely effect employment opportunities for adults and learning opportunities for children.

• Number of children on MC+ who have not accessed dental care.

• Waiting time for adults with no insurance and dental pain to be seen by a dentist in the Adult Dental Pain Relief Program.

Description of the Issue:

Access to dental care for those with "straight Medicaid", which includes dental benefits, continues to be a significant problem in Boone County. Dentists find it difficult to accept those with Medicaid dental benefits because reimbursement rates, set by the State legislature are too low and outdated. As a result there is little access to dental care for those receiving straight Medicaid. There is no dental coverage at all for those receiving Medicare.

Early and regular visits to the dentist are essential for developing healthy dental habits that will prevent dental problems that cause school absenteeism and later effect employment. Approximately 70% of Boone County children are not utilizing dental care available to them through MC+. In Columbia, the Kings Daughters program provides dental care to a limited number of students not covered by MC+. However, other school districts do not have access to this program. Many parents are still not aware of steps to prevent decay in baby teeth and the long-term implications of baby bottle tooth decay.

Increasingly, studies show a link between poor oral health and the link to other serious health problems. Periodontal infection in pregnant women is a risk factor that can result in pre-term, low-birth weight babies. Numerous studies, according to the American heart Association, have suggested a connection between periodontal and cardiovascular disease. For example, one recent study showed that the bacteria in dental plaque could lead to blood clots, a condition that occurs during heart attacks. Diabetes, osteoporosis, eating disorders, HIV Infection, and oral cancer all have complications manifested in the mouth and requiring specific oral interventions.

Progress Statement:

This year several committee members have attended two meetings sponsored by the Missouri Coalition for Oral Health Access. Members have also monitored federal trends and available grant monies by viewing a videotaped conference on oral health sponsored by the Surgeon General. Collaboration has begun between the Columbia/Boone County Board of Health and ROWEL

(Reform Organization for Welfare) to find solutions to provide needed dental services in this community.

    Organizations represented on the Dental Access Team are compiling a list of dental resources in Boone County. This list will be made available to health care providers and social service agencies that work to obtain needed dental care for their clients.

• Increase by 20% the number of children receiving MC+ who have seen the dentist in the last year.

• Expand Boone County's Adult Dental Pain Relief Program to include those with straight Medicaid dental benefits.

• Approach the City Council and County Commission about increased funding for the Adult Pain Relief Program.

• Heighten awareness of adults and children about the importance of early and regular dental treatment for children through increased education at the preschool and elementary school level.

• Continue to work with Educare to train childcare providers to educate parents about dental health, especially prevention of baby bottle tooth decay.

• Provide support for local dental hygienists to educate local primary providers to educate parents and children on preventive dental care.

• Encourage the MC+ plans providing service in Boone County to step-up their dental education efforts, including very clear statements about dental benefits offered through MC+.

• Recommend a mechanism/solution to provide dental care to straight Medicaid and Medicare patients to the Columbia/Boone County Board of Health.

Contacts:

Suzanne McDavid, RN - Field Elementary, 886-2783.

Jean Gurucharri - Kings Daughters, 449-4786.