USA - Filling a gap in Bay State dental care
Filling a gap in Bay State dental care
By Barbara Dawidjan and Katherine M. Pelullo
April 21, 2008
IMAGINE walking into a dentist's office with a severe toothache and being told by the dentist that there is good news and bad news. The good news is that because you are poor, you qualify for free dental care from the state in the state's Medicaid program, MassHealth. The bad news is that your dentist won't be able to treat your toothache because he or she only takes patients who have private insurance or who can pay out-of-pocket.
more stories like thisUnfortunately, this is not the exception but the norm in the delivery of oral healthcare in Massachusetts. Of the 351 cities and towns in Massachusetts, 69 do not have a single dentist. Of the communities with dentists, 30 percent don't have enough to care for all the people who live there.
And the most disturbing statistic of all: Of the state's more than 5,000 active licensed dentists, more than 80 percent refuse to see even one MassHealth patient, including the more than 460,000 MassHealth-eligible children. A bill now on Beacon Hill would allow dental hygienists to help fill this gap.
Without access to oral healthcare services for all residents, disparities in oral health will continue to plague our state. A 2004 state report found that nearly 50 percent of third-graders had a history of dental disease, and 26 percent live with untreated cavities. Research has linked oral health problems to heart disease, diabetes, and other diseases.
However, unlike these other diseases, dental disease is preventable through the use of fluorides, dental sealants, and access to professional care.
Because current law in Massachusetts prevents a dental hygienist from delivering services except under the supervision of a dentist, low income patients typically have no access to either a dentist or a dental hygienist.
Pending legislation would modernize state law to allow dental hygienists to practice in public health settings without the direct supervision of a dentist. This is not some new-fangled Massachusetts idea. Twenty-two other states have passed similar laws, including Rhode Island, Maine, New Hampshire, and Connecticut. In these states, dental hygienists may go directly to patients in public schools, Head Start programs, and nursing homes to perform the same preventive oral health treatment they do in a dentist's office.Unfortunately, the Massachusetts Dental Society seeks to block this legislation from becoming law.
Even though the bill requires a dental hygienist to establish a collaborative agreement with a dentist and refer patients to dentists for the kind of care that only a dentist can provide, and specifically bars hygienists from independent practice, the dental society remains vehemently opposed.
At a time when dentists are turning away thousands of Bay State residents who need their services, they choose to spend thousands of dollars on ads meant to scare the public into thinking that dental hygienists are somehow unqualified to treat patients "outside of the traditional practice."
This rhetoric fails to note that under current state law, "supervision" of a dental hygienist does not require the dentist to be physically present in the same location where the dental hygienist provides care. Hygienists are more than qualified to see patients in a dentist's office (and allow the dentist to make a healthy profit from that service) when the dentist is at a continuing education conference or on vacation, out of state or even out of the country.
But when hygienists seek to provide the same care to kids in schools or to seniors in nursing homes, all of whom are now often denied services from the dentist for whom they work, the hygienist is suddenly labeled "unqualified."
The bill has gained the endorsement of the two prominent health-related committees in the Legislature. Also, the state Department of Public Health supports its intent. In a recent report the department endorsed the use of registered dental hygienists to help close the gap in access to oral health care.
It is one thing for dentists to refuse to see poor kids and seniors, but it is quite another for them to stand in the way of other perfectly qualified health professionals who are trying to help.
Barbara Dawidjan is president of the Massachusetts Dental Hygienists' Association. Katherine M. Pelullo is chairwoman of the association's Council on Regulation and Practice.
By Barbara Dawidjan and Katherine M. Pelullo
April 21, 2008
IMAGINE walking into a dentist's office with a severe toothache and being told by the dentist that there is good news and bad news. The good news is that because you are poor, you qualify for free dental care from the state in the state's Medicaid program, MassHealth. The bad news is that your dentist won't be able to treat your toothache because he or she only takes patients who have private insurance or who can pay out-of-pocket.
more stories like thisUnfortunately, this is not the exception but the norm in the delivery of oral healthcare in Massachusetts. Of the 351 cities and towns in Massachusetts, 69 do not have a single dentist. Of the communities with dentists, 30 percent don't have enough to care for all the people who live there.
And the most disturbing statistic of all: Of the state's more than 5,000 active licensed dentists, more than 80 percent refuse to see even one MassHealth patient, including the more than 460,000 MassHealth-eligible children. A bill now on Beacon Hill would allow dental hygienists to help fill this gap.
Without access to oral healthcare services for all residents, disparities in oral health will continue to plague our state. A 2004 state report found that nearly 50 percent of third-graders had a history of dental disease, and 26 percent live with untreated cavities. Research has linked oral health problems to heart disease, diabetes, and other diseases.
However, unlike these other diseases, dental disease is preventable through the use of fluorides, dental sealants, and access to professional care.
Because current law in Massachusetts prevents a dental hygienist from delivering services except under the supervision of a dentist, low income patients typically have no access to either a dentist or a dental hygienist.
Pending legislation would modernize state law to allow dental hygienists to practice in public health settings without the direct supervision of a dentist. This is not some new-fangled Massachusetts idea. Twenty-two other states have passed similar laws, including Rhode Island, Maine, New Hampshire, and Connecticut. In these states, dental hygienists may go directly to patients in public schools, Head Start programs, and nursing homes to perform the same preventive oral health treatment they do in a dentist's office.Unfortunately, the Massachusetts Dental Society seeks to block this legislation from becoming law.
Even though the bill requires a dental hygienist to establish a collaborative agreement with a dentist and refer patients to dentists for the kind of care that only a dentist can provide, and specifically bars hygienists from independent practice, the dental society remains vehemently opposed.
At a time when dentists are turning away thousands of Bay State residents who need their services, they choose to spend thousands of dollars on ads meant to scare the public into thinking that dental hygienists are somehow unqualified to treat patients "outside of the traditional practice."
This rhetoric fails to note that under current state law, "supervision" of a dental hygienist does not require the dentist to be physically present in the same location where the dental hygienist provides care. Hygienists are more than qualified to see patients in a dentist's office (and allow the dentist to make a healthy profit from that service) when the dentist is at a continuing education conference or on vacation, out of state or even out of the country.
But when hygienists seek to provide the same care to kids in schools or to seniors in nursing homes, all of whom are now often denied services from the dentist for whom they work, the hygienist is suddenly labeled "unqualified."
The bill has gained the endorsement of the two prominent health-related committees in the Legislature. Also, the state Department of Public Health supports its intent. In a recent report the department endorsed the use of registered dental hygienists to help close the gap in access to oral health care.
It is one thing for dentists to refuse to see poor kids and seniors, but it is quite another for them to stand in the way of other perfectly qualified health professionals who are trying to help.
Barbara Dawidjan is president of the Massachusetts Dental Hygienists' Association. Katherine M. Pelullo is chairwoman of the association's Council on Regulation and Practice.
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