USA - Low-income children face dental needs
Low-income children face dental needs
Study of Contra Costa County finds many youths underserved by Denti-Cal program due to limited availability of services
By Sandy Kleffman
CONTRA COSTA TIMES
Article Launched: 06/12/2007 03:07:05 AM PDT
Untreated dental disease remains a serious problem for low-income children in Contra Costa County, with 12 percent in need of urgent treatment for rotting teeth, infections and other painful conditions. Such discomfort and early tooth loss can cause children to miss school and have difficulty concentrating, sleeping, eating properly and developing good speech patterns. Yet obtaining treatment can be difficult, particularly for those living in the eastern and western edges of the county, notes a study released Monday by the Dental Health Action Group and Children's Oral Health Program of Contra Costa County. "The data and stories shared in this report describe a dire local oral health situation that requires immediate attention," the study states. During the 2005-06 school year, health workers screened 13,304 preschool and elementary school children from low-income families. Twelve percent required emergency treatment for dental problems, and another 16 percent had less-serious tooth decay and needed to see a dentist soon. Only a handful of local pediatric dentists will accept Denti-Cal patients, the study notes. Denti-Cal is California's version of a federal program that provides dental care to low-income families.
Out of 785 private dentists in Contra Costa, only 34 will see children with Denti-Cal on a regular basis, and many of those dentists will see only older children. Just 10 Denti-Cal dentists will accept children as young as age 3, and four will see children at age 2. Only one Denti-Cal dentist will accept children at age 1, the recommended time for a first appointment. "Denti-Cal reimbursement is very low," said Padmini Parthasarathy, a senior county health education specialist and the author of the report. "The paperwork and the procedure to become a Denti-Cal provider is very cumbersome." It's so cumbersome, she added, that some dentists prefer to donate their time rather than signing up with the program.
Uninsured children and those on Denti-Cal can receive dental care at county and community clinics, but some of those clinics also don't treat the youngest children. When looking for a place to open a practice, many private dentists are reluctant to choose neighborhoods with a high percentage of uninsured residents, said Lynn Pilant, manager of the Children's Oral Health Program.
Of particular concern is the fast-growing East County area, which has proportionately fewer dentists for low-income children and also has many neighborhoods without fluoridated water.
North Richmond had no private Denti-Cal dentist at the time of the study. Although the nearby Peres Elementary School has a dental clinic on site, it is not fully utilized, the study noted. Access to specialists can be even more of a problem. No endodontists or periodontists in Contra Costa were taking new Denti-Cal patients on a regular basis, the study found. The closest such endodontist is in San Jose, about 60 miles away and nearly impossible to reach by public transportation. When low-income children have such severe dental disease that they need general anesthesia, a lengthy wait may ensue, the study found. None of the private dentists in Contra Costa who use anesthesia in their offices will take Denti-Cal patients on a regular basis. Although it may cost $800 to $1,200 to provide general anesthesia in a dental office, Denti-Cal may reimburse only $100 of that amount, Pilant said. Reimbursements are higher in hospitals. But the dental clinic at county-owned Contra Costa Regional Medical Center in Martinez is allocated only 10 days per year in the hospital's busy operating room. As a result, about 30 people receive oral surgeries per year there, and few of them are children.
Many children are referred to an oral surgeon at Children's Hospital Oakland, but the wait there can be six months or longer, the study found.
The report makes a number of recommendations, including increasing the operating time for dental surgery at Contra Costa Regional Medical Center, training general dentists to treat young children, expanding water fluoridation in East County, and expanding education and prevention programs. Local health advocates are tackling the issue on several other fronts, including operating a mobile dental clinic and establishing the Lebow Children's Dental Health Foundation, which provides grants to families that cannot afford treatment.
Contra Costa County, California, is fluoridated NYSCOF
Study of Contra Costa County finds many youths underserved by Denti-Cal program due to limited availability of services
By Sandy Kleffman
CONTRA COSTA TIMES
Article Launched: 06/12/2007 03:07:05 AM PDT
Untreated dental disease remains a serious problem for low-income children in Contra Costa County, with 12 percent in need of urgent treatment for rotting teeth, infections and other painful conditions. Such discomfort and early tooth loss can cause children to miss school and have difficulty concentrating, sleeping, eating properly and developing good speech patterns. Yet obtaining treatment can be difficult, particularly for those living in the eastern and western edges of the county, notes a study released Monday by the Dental Health Action Group and Children's Oral Health Program of Contra Costa County. "The data and stories shared in this report describe a dire local oral health situation that requires immediate attention," the study states. During the 2005-06 school year, health workers screened 13,304 preschool and elementary school children from low-income families. Twelve percent required emergency treatment for dental problems, and another 16 percent had less-serious tooth decay and needed to see a dentist soon. Only a handful of local pediatric dentists will accept Denti-Cal patients, the study notes. Denti-Cal is California's version of a federal program that provides dental care to low-income families.
Out of 785 private dentists in Contra Costa, only 34 will see children with Denti-Cal on a regular basis, and many of those dentists will see only older children. Just 10 Denti-Cal dentists will accept children as young as age 3, and four will see children at age 2. Only one Denti-Cal dentist will accept children at age 1, the recommended time for a first appointment. "Denti-Cal reimbursement is very low," said Padmini Parthasarathy, a senior county health education specialist and the author of the report. "The paperwork and the procedure to become a Denti-Cal provider is very cumbersome." It's so cumbersome, she added, that some dentists prefer to donate their time rather than signing up with the program.
Uninsured children and those on Denti-Cal can receive dental care at county and community clinics, but some of those clinics also don't treat the youngest children. When looking for a place to open a practice, many private dentists are reluctant to choose neighborhoods with a high percentage of uninsured residents, said Lynn Pilant, manager of the Children's Oral Health Program.
Of particular concern is the fast-growing East County area, which has proportionately fewer dentists for low-income children and also has many neighborhoods without fluoridated water.
North Richmond had no private Denti-Cal dentist at the time of the study. Although the nearby Peres Elementary School has a dental clinic on site, it is not fully utilized, the study noted. Access to specialists can be even more of a problem. No endodontists or periodontists in Contra Costa were taking new Denti-Cal patients on a regular basis, the study found. The closest such endodontist is in San Jose, about 60 miles away and nearly impossible to reach by public transportation. When low-income children have such severe dental disease that they need general anesthesia, a lengthy wait may ensue, the study found. None of the private dentists in Contra Costa who use anesthesia in their offices will take Denti-Cal patients on a regular basis. Although it may cost $800 to $1,200 to provide general anesthesia in a dental office, Denti-Cal may reimburse only $100 of that amount, Pilant said. Reimbursements are higher in hospitals. But the dental clinic at county-owned Contra Costa Regional Medical Center in Martinez is allocated only 10 days per year in the hospital's busy operating room. As a result, about 30 people receive oral surgeries per year there, and few of them are children.
Many children are referred to an oral surgeon at Children's Hospital Oakland, but the wait there can be six months or longer, the study found.
The report makes a number of recommendations, including increasing the operating time for dental surgery at Contra Costa Regional Medical Center, training general dentists to treat young children, expanding water fluoridation in East County, and expanding education and prevention programs. Local health advocates are tackling the issue on several other fronts, including operating a mobile dental clinic and establishing the Lebow Children's Dental Health Foundation, which provides grants to families that cannot afford treatment.
Contra Costa County, California, is fluoridated NYSCOF
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