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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%.

Dental decay is the most common chronic childhood disease. Poor oral health:
  • Reduces a child’s ability to function
  • Affects behavior and socialization
  • Is associated with poor school performance and depression

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.

In the US…
  • 80% of childhood and adolescent dental problems occur in the poorest 20-25% of children

  • Poor children suffer twice as many dental caries as their more affluent peers

  • Dental disease is more likely to go untreated in poor children
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:

  1. Increase parent education and outreach efforts to underserved groups of children.

  2. Assure that all Iowa children age birth to three years get dental screening, treatment, and counseling.

  3. Increase access to preventive dental care for school-aged children.

  4. Make participation in Medicaid and serving children covered by Medicaid more attractive to Iowa dentists.

  5. Increase access to dental benefits for children, particularly underserved childhood groups.

  6. Increase the number of dentists practicing in dental shortage areas.

  7. Improve Iowa’s dental care safety net.

  8. Expand the use of dental hygienists to provide preventive care, particularly for vulnerable and special needs populations.

  9. 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:
  • Are younger than 3 years old
  • Are Medicaid-eligible
  • Have no dental benefits
  • Have disabilities

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.

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.

Drawing of pensive child sitting at desk

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