Editor’s note: This op-ed is by Sheila Reed and Virginia Milkey. Reed is the associate director of Voices for Vermont’s Children, a nonprofit group that promotes public policy that enhances the lives of children and youth in Vermont. Milkey is the executive director of Community of Vermont Elders, a nonprofit organization that aims to promote and protect a higher quality of life for seniors in the state.
In every corner of Vermont, from our youngest children to our oldest adults, tens of thousands of Vermonters are going without dental care, putting them at risk of tooth decay and other potentially serious health problems.
Despite the fact that Vermont provides dental coverage to all children enrolled in the Medicaid program, an estimated 24,000 children failed to get the dental care they urgently needed in 2009. Another 10,000 Vermont seniors and 62,000 adults under age 65 went without care that year, saying they couldn’t afford it.
Those numbers likely will be worse in 2012 given the fact that more and more state residents struggle just to pay the bills and have little left over to pay for dental care. Seniors for example, often live on a limited budget and might delay or put off expensive oral health care, including care that prevents additional problems from cropping up later on.
What’s the harm?
According to an Institute of Medicine report issued in 2011, a lack of routine oral health care can lead to serious consequences including teeth so badly decayed that they cannot be saved, gum disease and even the threat of a potentially deadly infection.
Dental problems that go unchecked can also increase the risk of serious and chronic health conditions like diabetes and heart disease. And people who cannot afford routine dental care often end up in the emergency room — suffering from an infection or other problems that require costly treatment. More than 5,000 Vermonters visit the emergency room each year for dental problems – the most expensive place to receive care that is typically provided for oral health problems that are often preventable by regular dental care.
Then there is the human cost.
Consider the true story of Frank, a 70-year-old from Corinth, who used to take good care of his teeth but now cannot afford to pay out-of-pocket even for reduced-price dental care at a clinic. He delayed care and now has several teeth broken off at the gum line, active decay and a molar with a broken crown. Even if he had to have all of his teeth pulled, how could he afford dentures when the cost of uppers and lowers runs around $1,000 for each?
Frank worked hard his entire life and now he cannot afford basic care that most of us take for granted.
And Frank’s not alone.
Angel was in state custody as a child and, with frequent moves among foster families and schools, did not get proper dental care. When she became pregnant as an adult her teeth were in serious need of care. She was not able to find a dentist who would take her as a patient, even though she had Medicaid, until her son was 4 and a dentist working with Head Start agreed to provide care for the family. Angel needed far more dental care than the dental cap would cover and had to opt for extractions. She has only her front teeth left and finds eating difficult.
We can do a better job at providing Vermont residents with oral health care and now is our opportunity. As Vermont begins health care reform it is imperative that oral health be included.
The Vermont Oral Health Care for All Coalition is working to expand access to dental care in the state. This broad coalition of 42 organizations with a long history of advocating on behalf of children, migrant workers, senior citizens, health care providers and people with disabilities is exploring a range of solutions, such as an innovative idea for expanding the dental team to improve access to affordable care – things like preventive and restorative services that are desperately needed by people like Frank and Angel. The bill calling for the addition to the dental team, H.398, will be heard by the House Human Services Committee.
We can no longer afford to stand by and do nothing while thousands of Vermont residents suffer from worsening decay and other oral health problems.
