A recent report on the state’s oral health from the Minnesota Department of Health brought to light some unfortunate facts. Tooth decay remains one of Minnesota’s most common chronic childhood diseases, even though it is nearly 100 percent preventable. Fifty-five percent of third-graders experience tooth decay, and low-income children (and adults) disproportionately suffer from oral diseases.
Minnesota dentists see firsthand the disparities that exist in access to dental care. Earlier this month, the Minnesota Dental Association held its 11th annual Give Kids a Smile event, where free dental care was provided by volunteer providers to more than 6,000 children who otherwise would have no access to care. Many had rarely, or never, seen a dentist. And last year, the MDA hosted the Mission of Mercy in Mankato, where nearly 1,400 dental professionals and lay volunteers provided free care to 2,000 low-income children and adults.
At both events, the hundreds of stories of rampant decay, poor self-esteem and crushed spirits — all due to poor oral health — were heartbreaking.
The dental profession prides itself on being charitable and serving those in need. But charity care is not a health care system. The MDA recognizes that multiple barriers to accessing dental care exist for the underserved population — but by far the greatest obstacle is a broken public system.
I am a practicing dentist in Lewiston, a town in southern Minnesota, and I serve a multiple county area. I have spent my career working with the underserved population of this region, and previously had a practice in Winona, but that office doesn’t see these people now. The office had to close and all of its employees were laid off due to underfunding. We went from the breaking point to simply being broken.
To ensure an adequate network of dental providers to serve the state’s Medical Assistance (MA) population, the method of reimbursing dentists must be modernized.
The current rate of reimbursement for MA dental providers is based on 1989-92 rates and has not been increased in 14 years, placing Minnesota 43rd nationally in dental fee reimbursements. This fee structure doesn’t even cover the cost of care. The financial reality is that it is impossible for providers to meet the needs of Minnesota’s public-program patients under this system. Dentists are concerned about their ability to continue serving existing patients, while also meeting the needs of new enrollees.
This is why the association is supporting a bill at the Minnesota Legislature that would set dental fee reimbursement at 75 percent of the 2011 rates. The legislation would improve the network of available dental providers and begin breaking down the barriers to dental care faced by so many Minnesotans. People experiencing dental pain should not be forced to visit an emergency room, where reportedly an average of $49 million a year is spent treating dental patients for conditions that could be treated more cost-effectively, and perhaps be prevented, in a dental office.
The proposed legislation is similar to action that has significantly increased the provider network and improved oral health outcomes in other states. The MDA’s top priority is making sure that every Minnesotan has access to quality dental care, and the association is committed to working with the Legislature to find effective, bipartisan solutions.
Michael Flynn is president of the Minnesota Dental Association.