Editor’s note: This op-ed is by Dr. David Averill, the president of the Vermont State Dental Society.
Sheila Bannister’s recent editorial about “Vermont’s health crisis” delineated many of the challenges our state faces accessing and paying for quality oral health care. As a native Vermonter, a longtime dentist practicing in Burlington, and president of the Vermont State Dental Society (VSDS), I can attest that the state’s dentists strongly agree with her assertion that “Good oral health is part of being healthy and everyone deserves access to dental care.”
On the frontlines, dentists see firsthand the complex and intertwined oral health care barriers Vermonters face, including:
• Non-existent, insufficient or minimal dental health insurance coverage;
• A separation between oral health and overall health management both in policy and individual wellbeing practices;
• Costly out-of-pocket expenses;
• Stagnant and inadequate Medicaid reimbursement rates;
• The state’s rural geography makes transportation to and from dental practices difficult and time consuming;
• Access to dental care is challenging in geographically underserved communities; and
• A need for more extensive oral health preventive care education.
With the “same spirit of innovation and collaboration to providing accessible and affordable oral health care for all Vermonters” that Ms. Bannister mentions, Vermont’s oral health doctors have actively initiated, supported and partnered on a number of innovative programs to expand access to oral health.
• Most recently, Vermont’s dentists championed a comprehensive oral health bill that called for expanded dental education in the classroom and expanded loan repayment and loan forgiveness programs. VSDS also advocated for a Community Dental Health Coordinator (CDHC) pilot program in Vermont. CDHCs work in their communities to help patients find and access oral health services, much like a social worker. They also provide some limited preventive care, such as fluoride treatments and simple teeth cleanings.
• These proposals build on VSDS’ past legislative efforts to expand access to oral health. In 2012, VSDS successfully pushed for legislation to expand dental benefits for pregnant women and breast-feeding mothers. The bill, which passed the Legislature and was signed into law, encourages prevention and healthy oral hygiene habits for mothers and their young children.
• In addition to VSDS’ activity in the Legislature, we have an established dentist and dental student recruitment program that aims at bringing more trained dentists to practice in underserved areas of the state. This effort will soon be bolstered by the opening of the University of New England’s College of Dentistry this fall, which will bring even more new dentists to Vermont and the New England region.
• Annually, the VSDS, Northeast Delta Dental, the United Way, and local dental practices collaborate to sponsor free dental care. This year, oral health doctors across 10 Vermont counties will participate by donating their time and services to provide care to residents free of charge.
• Finally, Vermont dentists and the VSDS continue to support existing programs that expand access to care and improve oral health for Vermont’s citizens. For example, community water fluoridation programs are helping prevent tooth decay across 60 percent of the state’s cities and towns. Also, each of the eight Federally Qualified Health Centers (FQHCs) in the state has a dental center associated with it. These dental centers serve as conduits to care between underserved residents and dentists.
Although these programs are not a total panacea to the challenges and obstacles we face statewide, they do offer avenues and system foundations that can be built on to help solve these interrelated and difficult issues. Dentists are oral health care leaders and recognize that there are barriers to care and will continue to work collectively and collaboratively to ensure that Vermonters have access to care. I am glad that this important issue is gaining attention and look forward to working closely with stakeholders to ensure that our neighbors, family and friends have their oral health needs addressed.
