Oregon is in an oral health crisis
That's what a source of mine told me about a month ago. The story she helped me tell in May was a sobering one.
An estimated 77 people per day go to an Oregon emergency room to receive dental care, many because they lack access to routine and preventive care, according to a study commissioned by the Oral Health Funders Collaborative. The hospital emergency room is the highest cost place of care, but it doesn't always provide the best care.
For $8 million annually, hospitals generally will give oral health patients antibiotics and painkillers then advise them to follow up with a dentist. But considering they ended up in the ER due to hurdles barring patients from accessing dentists in the first place, a quarter of the time, they will return to the ER for the same problem.
Meanwhile, oral pain inhibits people's ability to eat, work, care for their children and learn in school. It invades every aspect of life.
Private stakeholders and the state government have both decided it's time for change. And as a reporter, it was important for me to bear witness to these efforts on your behalf. This is why, on Monday, we launched a new occasional series called Oregon's Oral Exam.
This isn't going to be an easy task. There needs to be a solution on what to do about the shortage of dentists and how to make treating under served populations financially rewarding. There are questions of new training paths and how to instill good oral hygiene habits to young children.
As the Oral Health Funders Collaborative works on its strategic plan on oral health and the Oregon Health Authority starts overseeing pilot projects targeting this issue, we'll be there to help inform the public dialogue.
Here are some aspects I'm hoping to get a closer look at:
Lives impacted
Like most other social and health issues, low-income Oregonians are disproportionately affected by this systemic problem.
Uninsured people are eight times more likely to to visit the ER for dental problems, and Medicaid patients were four times more likely compared to commercially insured people.
Because it's so difficult finding dentists willing to see Medicaid patients and paying out of pocket is unaffordable for the uninsured, the ER becomes the default care setting that guarantees treatment.
In addition, tooth decay is the most common chronic condition in children with many of them going untreated.
The financial burden
Until recently, dental health benefits in the Oregon Health Plan was in flux. If the state budget needed some relief, it was the benefit that was compromised.
It wasn't until 2014 that dental health benefits were restored beyond emergency care, so it will be interesting what coordinated care organizations do to address the new demand.
If we don't figure out a way to take care of people's teeth in low-cost, preventive and routine settings, evidence shows we will be paying through higher cost, less effective care, not to mention the cost to quality of life.
The professional shortage
It has been a while since the medical field began acknowledging that we need mid-level providers like nurse practitioners to perform at the top of their training to help expand access to care. It was a cultural shift, as we began distributing the workload off the overburdened shoulders of medical doctors.
The same question has emerged in dentistry, with dental therapists being authorized to practice in Minnesota, Maine and tribal communities in Alaska. Dental therapists provide a range of routine services like drilling and extracting teeth.
However, this too, will take a shift in mindset. The American Dental Association contends that only dentists should be able to perform irreversible surgical procedures.
As I cover this topic over the next few months, please help us by pointing me to story ideas and sources.
Source: http://www.statesmanjournal.com/story/news/health/2014/06/30/new-series-aims-inform-dialogue-dental-health/11810499/
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