Time has come to fix Denti-Cal

A youngster on his visit to the dentist. (Photo: Wavebreakmedia, via Shutterstock)

What if I told you there was a straightforward way to raise kids’ grades, increase funding for schools and cut costly emergency room visits?

You’d probably tell me to get my head checked by a doctor.

And I’d tell you to see a dentist.

Regular dental care for California’s children contributes to all of the positive outcomes listed above. And yet, leaders in the Governor’s Office and the Legislature have not adequately funded the state’s Denti-Cal program, leading tens of thousands of the state’s poorest children without adequate dental care. Our leaders have a chance to remedy this by putting $90 million into the program, which represents 1/10 of one percent of state Medi-Cal spending.  It’s vital that they do – particularly since Governor Brown left it out of this latest budget.

The state’s Denti-Cal program is mandated to provide oral health coverage to more than 5.1 million low-income children. To do this, money must be included in the state budget to reimburse dentists who provide treatment to poor kids. But according to a December 2014 report by State Auditor Elaine Howle, 56 percent of kids enrolled in Denti-Cal in 2013 did not receive care through the program. That’s 2.8 million children.

Howle’s audit also revealed that 32 of our 58 counties don’t have enough participating dentists to provide needed care. Yet incredibly, in state as rich as ours, in an era of modern dentistry, preventable tooth decay is the Number 1 chronic childhood disease.

How did it come to this? A big part of the answer is money. California simply doesn’t reimburse dentists enough to cover their costs. Nationally, the average reimbursement rate for the 10 dental procedures most frequently authorized by Medi-Cal is $61.96. California’s reimbursement rate is a third of that: $21.60.

As a result, fewer and fewer dentists are willing to take Denti-Cal patients. Dental benefits took big hits in 2009, when the state cut funding for school dental health programs, and then again 2013, when a 10% provider-rate reduction went into effect. Now with many more millions of Californians receiving Denti-Cal coverage as a result of the Affordable Care Act, this problem is getting worse.

It’s true that more and more kids have health and dental coverage for the first time. But kids who are covered by Denti-Cal are finding it increasingly difficult to actually find a dentist willing to treat them.

This type of disinvestment ends up costing the state in the long run.

In 2007, more than 500,000 California students missed a day of school due to toothaches, which translated into a $30 million loss to school districts in attendance-based funding. That’s $30 million dollars that didn’t go into our classrooms.  School-based dental screenings and treatment improve attendance and academic achievement, but coverage remains a hurdle.

Poor dental health has a big impact on children. A 2012 study of LAUSD students found that children who suffered from toothaches were 4 times more likely to have a lower-than-average grade-point average. Many thousands of these children ended up in our hospital’s emergency rooms for preventable dental conditions—exponentially increasing the cost of their care. School-based dental programs like those run by The Los Angeles Trust for Children’s Health and other partners are decreasing these odds and could do so much more with adequate funding of Denti-Cal.

These are just a few of the costs of bad dental health. The link between tooth loss and gum disease to heart disease, strokes and dementia is well documented.

These outcomes are preventable, and doing so has the added benefit of promoting better grades, increasing money to schools and decreasing emergency room visits. Tell our legislators and Governor Brown that it’s time to fund Denti-Cal and give our children the care they need. It’s clear that the benefits outweigh the costs.

Anyone who doesn’t see that should get their head checked.

Ed’s Note: Serena Clayton of HelpingCaliforniaSmile.com is the executive director of the Oakland-based California School-Based Health Alliance

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