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The Iowa Summit on Access to Children’s
Dental Care
A Call to Action
Kay DeGarmo,
Iowa Prevention of Disabilities Policy Council
Fall 2005
| Like many
states, Iowa is experiencing a shortage of dentists. Currently, 72 of
Iowa’s 99 counties qualify as Health Professional Shortage Areas (HPSA),
and it appears that additional counties may soon be added. With many of Iowa’s dentists nearing retirement, this shortage will
worsen in the coming decade.
Access to
dental care is a particular problem for many of Iowa’s rural counties.
In 1998, 6.2% of the state’s dentists practiced in rural areas with
populations lower than 10,000; by 2001, this percentage had declined to
3.9%.
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Dental decay is the most common chronic
childhood disease. Poor oral
health:
- Reduces a child’s ability
to function
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Affects behavior and
socialization
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Is associated with poor
school performance and depression
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To address this
issue, in February 2005 the Prevention of Disabilities Policy Council
convened the Iowa Summit on Access to Children’s Dental Care: A Call to
Action. The 57 participants included dental professionals, dental
service funders, health care associations, local public health and
education providers, legislators, state agency representatives, and
other state policy leaders. Participants agreed that in Iowa, a state
that prides itself on assuring that children start school ready to learn
and then remain healthy in order to learn, access to dental care is an
important public policy issue.
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In the US…
- 80% of childhood and adolescent dental
problems occur in the poorest 20-25% of children
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Poor children suffer twice as many
dental caries as their more affluent peers
- Dental disease is more likely to go
untreated in poor children
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They further agreed
that preventive dental care is central to solving Iowa’s access problem,
and should be considered the state’s top priority. They were in favor of
shoring up Iowa’s public dental care safety net, but felt it was equally
important to recruit dentists into private practice in areas that have a
shortage of dentists. They discussed potential changes to Iowa’s
Medicaid and hawk-i dental programs. Recognizing that access to dental
care is a community problem that must be addressed at the local level,
they supported the development of a state plan that provides communities
with resources and the flexibility to tailor programs to meet local
needs. |
Summit
participants developed a framework for an Iowa action agenda whose goals
include:
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Increase parent education and
outreach efforts to underserved groups of children.
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Assure that all Iowa children age
birth to three years get dental screening, treatment, and counseling.
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Increase access to preventive dental
care for school-aged children.
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Make participation in Medicaid and
serving children covered by Medicaid more attractive to Iowa dentists.
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Increase access to dental benefits
for children, particularly underserved childhood groups.
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Increase the number of dentists
practicing in dental shortage areas.
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Improve Iowa’s dental care safety
net.
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Expand the use of dental hygienists
to provide preventive care, particularly for vulnerable and special
needs populations.
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Develop a sustainable statewide oral
health survey system to better define the problem and target resources.
| The issue of access to dental care
during childhood is gaining recognition at the state level. Several
summit goals and strategies are reflected in the oral health chapter of
Healthy Iowans 2010, Iowa’s public health agenda. During this year’s
legislative session, the Governor and General Assembly approved the
IowaCare Medicaid Reform Act, which requires that all Medicaid
recipients 12 years old or younger have a designated dental home
and receive dental screening and preventive care (see
“Coming Your Way”). |
In Iowa, access to dental care is a particular problem for children who:
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Are younger than 3 years
old
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Are Medicaid-eligible
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Have no dental benefits
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Have disabilities
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In May, Delta Dental Plan of Iowa announced
they would provide $80,000 in start-up funding for a new Donated Dental
Services program to provide free dental care to people of all ages who
have disabilities.In the coming
months, the Prevention of Disabilities Policy Council will work with
Iowa’s public health dental director, Bob Russell, DDS, and the Iowa
Department of Public Health Oral Health Bureau to study the dental care
summit’s
identified strategies and propose specific policy solutions.
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Health care
providers who are interested in addressing this issue in their
communities can begin to make a difference now. A number of Iowa
communities have formed effective local partnerships and developed
successful dental access models. Several of these models can be easily
adapted for use in other Iowa communities.
To learn
more, visit the full report
from the Iowa Summit on Access to Children’s Dental Care: A
Call to Action (MS Word)
(PDF). For updates on
proposals for the implementation of the state dental care action agenda,
contact kay-degarmo@uiowa.edu, and request that your name be placed on
the dental summit mailing list. |
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