The writer is dean of the Creighton University School of Dentistry and a professor there.
An Aug. 24 World-Herald editorial wisely brought to light the importance of dental care and stressed the need for Nebraskans to address a host of tough challenges coming down the road. These include the lack of dentists in outlying counties; the aging work force in dentistry; and the predicted rise in demand for services as a result of the Affordable Care Act (ACA).
The editorial also outlined many steps being taken by the state’s two leaders in dental education — Creighton University’s School of Dentistry and the University of Nebraska Medical Center’s College of Dentistry in Lincoln — to address these and other issues, especially those involving underserved populations.
There is a growing understanding of the relationships between oral health and chronic diseases that include diabetes and cardiovascular disease, among others. In children, untreated dental disease is a leading cause of absenteeism in school. Regular dental care for our youth helps to ensure their overall optimum health and helps establish health patterns that will continue over the lifetime of the child.
A comprehensive plan to address the oral health of our citizens must include a focus on education and awareness, in addition to the delivery of care.
The availability of dental care and the problem of accessing it are looming issues, but access to oral care is not just a rural issue. People in urban centers face these challenges, too.
Creighton’s School of Dentistry has had a tremendous positive impact on the health of the local community, through more than 43,000 patient visits a year to the on-campus dental clinic and through outreach efforts that impact more than 11,000 patients every year, many from the area’s working poor.
The school has established valued partnerships with several organizations, including the OneWorld Community Health Center, Heart Ministry Center, Charles Drew Health Center and Building Healthy Futures, to expand community-based services. Local practicing dentists make significant, even heroic, contributions to these expansive outreach efforts.
However, more must be done.
The ACA specifically mandates pediatric dental care as an “essential health benefit.” It is estimated that as a result of the ACA, beginning in 2014, the number of children without dental health benefits may decrease by as much as 55 percent, with an estimated 8.7 million children gaining extensive dental coverage by 2018.
However, the ACA mandates dental care for children only. The effect of the ACA on adult care is dependent on each state’s Medicaid program and that state’s specific program guidelines for the services covered. The number of adult patients with extensive dental benefits is predicted to increase by only 5 percent.
Lack of preventive care or early intervention for dental disease often leads to an increase in visits to emergency rooms for severe and acute dental problems — an outcome that is costly to the health care system. In many cases, emergency rooms are able to offer only palliative treatment, not definitive dental care.
Nebraskans will continue to need strong advocates at the state level who will help shape the dental work force and health care benefits and provide adequate coverage for children and adults, making certain that patients have the dental health coverage they need, at prices they can afford. Because the ACA gives individual states some latitude in determining how the law is implemented, it will likely prove most effective in states that have assigned a high priority to protecting the health of their citizens.
We echo the position of the editorial that Nebraska policy- makers must chart a strategy that will move our communities forward, toward optimum health. Faculty and administrators of the Creighton University School of Dentistry welcome ongoing dialogue about ways in which our school, in concert with our sister dental school in Lincoln, can consider ways to expand our contributions to the state.