USA - Charleston kids’ tooth-pulling expenses are higher than cleaning costs

Kids’ tooth-pulling expenses are higher than cleaning costs
In battle against oral disease, prevention measures are on the declineBy Eric EyreStaff writer
With each breath of the gas, she was floating higher, fingers tingling, belly tickling, her worries so washed away that she scarcely noticed the syringe needle slowly descending toward her open mouth. Six-year-old Madison Salisbury would have a present to put under her pillow for the tooth fairy tonight.
“Are you flying on the magic carpet?” asked Dr. Bridget Boggs Stevens, Madison’s dentist. Stevens grabbed an elevating tool to pry up Madison’s infected tooth, then reached for a pair of forceps. “We’re going to wiggle, wiggle, wiggle,” Stevens said. “Won’t that tooth dance with me?” Madison kept sniffing the bubble gum-scented nitrous oxide through the plastic “piggy nose.” She never flinched. In seconds, the decayed tooth popped out, and Madison left with a fistful of “High School Musical” stickers and a cheekful of blood-soaked gauze. Madison, a Putnam County first-grader, is one of thousands of West Virginia children who have their teeth extracted every year at the state’s expense. And while health officials and lawmakers say prevention is the solution to reversing West Virginia’s widespread oral health problems, the state Medicaid office is pouring tens of millions of dollars into filling teeth and taking them out.
In each of the past four years, West Virginia dentists have billed the state more to pull children’s teeth than to clean them, Medicaid claims data show. From 2003 through last year, the state was billed more than $15 million for children’s tooth extractions, and $13 million for cleanings.
Kids’ tooth-pulling expenses are higher than cleaning costs
In battle against oral disease, prevention measures are on the declineBy Eric EyreStaff writer
With each breath of the gas, she was floating higher, fingers tingling, belly tickling, her worries so washed away that she scarcely noticed the syringe needle slowly descending toward her open mouth.
Six-year-old Madison Salisbury would have a present to put under her pillow for the tooth fairy tonight.
“Are you flying on the magic carpet?” asked Dr. Bridget Boggs Stevens, Madison’s dentist. More than 31,800 teeth were pulled last year alone. “That’s heartbreaking,” said Gina Sharps, a dental hygienist and assistant director of WVU’s Childhood Oral Health Project. “We’re obviously not doing enough wellness and prevention. Children’s oral health is so important to their overall health.”
The Gazette analyzed more than 3.3 million Medicaid claims submitted by dentists since 2003. Among the findings: The state is spending more pulling and filling teeth than on prevention measures, such as cleanings, fluoride treatments and cavity-fighting sealant applications. Last year, the Medicaid office spent $11 million on children’s extractions and fillings, but only $6 million on prevention treatments. The number of cleanings, fluoride treatments and sealants all decreased from 2003 to 2006. At the same time, extractions also declined — a positive sign.
Routine teeth cleanings dropped from 95,566 in 2003 to about 87,971 last year. And they’re on pace to decline even further, to about 86,000 at the end of this year.
A Medicaid spokeswoman said she wasn’t surprised that the state was paying more for “acute dental care” than prevention — a common practice for Medicaid recipients with other illnesses and diseases. The state spends about $32 million a year for children’s dental services.
“A lot of our members access the medical system for crisis, not for prevention,” said Shannon Landrum, executive assistant to the state Medicaid commissioner. “It’s our goal to change that. The governor has directed us to provide the right care, at the right place and the right time.”
Dr. Stevens sees the extent of the state’s oral health problems every day.
The Dunbar dentist treats children with rampant decay who live up to 70 miles away — from Beckley, Parkersburg and Huntington — whose parents say they can’t find a dentist who accepts Medicaid close to home.
Children as young as 2 will show up needing more than half of their primary teeth extracted — and the rest drilled and filled with composite.
They bring her gifts — coffee mugs filled with peppermint candies, paintings of “good teeth” and “bad teeth” — and drop into the dentist’s chair, waiting for the piggy nose and laughing gas that gives them the giggles.
“Children are in terrible pain,” Stevens said. “They can’t eat. It’s absolutely hideous. Just horrific. There’s such a crisis.”

Does Charleston Water System water contain fluoride? Yes. Charleston Water System adds one milligram per liter (mg/1) or one part per million (ppm) of fluoride to treated water. This is the amount recommended by the American Dental Association to provide maximum protection from tooth decay.
See our Water Quality Reports