The Global Pandemic of Dental Disease is in Our Own Backyard
Kirsten Roling, D.D.S.
What if you found out you had a disease of Pandemic proportions? Further what if I told you that we are losing ground in preventing this disease. I’m not talking about small pox, measles, polio or HIV/AIDS. I’m speaking of the number one chronic disease of childhood, five times more prevalent than asthma. A disease that disproportionately affects our underserved. A disease that may increase the risk of developing heart disease and alzheimers, is linked to diabetes, causes preterm labor, is responsible for low birth weight babies, maims and disfigures its victims, bars employment, and is accountable for mental illness including depression. This disease is contagious like the common cold, and it is nearly 100% preventable. Left untreated, this disease can kill.
I am referring to dental disease.
More than ever, oral health access continues to be a widening gap for the majority of Americans.
Dental decay, caused by bacteria, is an infectious, transmissible disease spread from parent/caretaker to child from saliva sharing activities, like kissing on the mouth, or sharing a spoon. In 2000, Surgeon General Dr. David Satcher released “The Oral Health Report” referring to dental disease as the “Silent Epidemic”. Dental disease was again highly publicized in 2007 when Deamonte Driver, a 12 year old boy in Prince Georges County, Maryland died of a tooth abscess. His hospital bill of $250,000 could have been prevented by a $60 extraction, had his mother been able to find a dentist to treat him.[i] Ultimately, his death would have been avoided by oral health prevention that should be available to all of us, throughout our life stages.
Recently the 2014 Federal Reserve Board of Governors’ released its Report on the Economic Well-Being of U.S. Households[ii] that revealed “alarming statistics” regarding the inaccessibility of affordable dental treatment. The report tells little improvement in access to dental care, especially for underserved populations, since the Surgeon General’s report, released by Dr. David Satcher exactly 15 years prior. Thirty-two percent polled reported difficulty in managing a three month “financial disruption” in the form of a medical emergency, and dental treatment was cited as the number one essential medical care not received due to cost. Hospital emergency departments are now seeing increased admissions due to dental related emergencies, doubling from 1.1 million in 2000, to 2.1 million in 2010.
The Huffington Post on 7.22.15 published “A Killer Toothache: How U.S. Dental Care Became a National Emergency,” detailing the story of 24 year old, Kyle Willis, who lost his life to an infected wisdom tooth, and citing nearly 130 million Americans, roughly 40% who do not have dental insurance. For those that do, low maximums, high deductibles, out of reach co-payments, and exclusionary plans still place dental treatment out of reach for the majority of Americans. From this scenario a predatory health finance lending industry was born, CareCredit, a subsidiary of GE Credit Bank. Its practice was used to enroll desperate dental patients who could not afford their care by offering lenient credit approvals and escalating interest rates.
Where do Californians fair? Today, half of all California’s children, 5 million, are enrolled in Denti-cal, (Medicaid), but they cannot access care because the state’s reimbursement rates are among the poorest in the nation, equating to too few providers. Adults in California lost Denti-cal benefits in 2009, with limited procedures recently reinstated. With Medicaid expansion the shortage of providers is now grim. According to Elizabeth Mertz a dental sciences professor at the University of California, San Francisco: California would need to spend three times the amount it currently does ($100 million more) to reach the national average for Medicaid dental provider rates.
The California Dental Association Foundation estimates currently the Pandemic of Dental Disease includes 10 million Californians that cannot access dental care, about 26% of the state’s population, roughly 1 in 4. Some say this is a conservative figure.
In our own backyard of La Mesa, the Pandemic, affects an estimated 15,000 residents unable to access care. For the entire East County, approximately 80,000 residents are affected. That is the roughly the combined population of La Mesa and Spring Valley, not able to access dental treatment.
What is the answer? Where is the cure? With your help we will explore the oral health Pandemic in future newsletters.
[i] The Washington Post, February 28, 2007; Mary Otto. “For Want of a Dentist.”
[ii] Report on the Economic Well-being of U.S. Households; 2014.
Kirsten Roling, D.D.S. is a member of LMFDC and a public health dentist residing in La Mesa, CA; and the CEO/Founder of Strategies for Oral Health, a California nonprofit, whose mission is to reduce the burden of oral disease in underserved populations through Collaboration, Consultation, Advocacy, Prevention, and Education. For further information, www.s4oh.org, firstname.lastname@example.org, (858) 333-6811.