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Pew Report: Children with Medicaid Not Getting Sufficient Dental Care in PA

According to a Pew report, too many Pennsylvania children are developing cavities and dental-related issues, but this is not mom and dad’s fault.

The Pew Children’s Dental Campaign report assessing states on how well they are providing children access to dental care showed that 10 percent of Pennsylvania’s population is under-served and living in a dental “shortage area.”

The U.S. Department of Health and Human Services reports about 45 million Americans live in regions that do not have enough dentists to serve the population.

Pennsylvania was one of 22 states in which most Medicaid-enrolled children did not receive dental care in 2011.

The report concludes this poor coverage is due to a shortage of dentists in the United States.

As of 2009, 42.6 percent of the dentists in Pennsylvania were over 55 years old and close to retirement.

Another issue contributing to the lack of care is the number of dentists who will accept Medicaid.

It cites the low reimbursement rates and burdensome administrative procedures.

“The reimbursement rate for Medicaid patients is always a factor, but I think there’s also an issue around transportation and other barriers for the folks to be able to access care,” Julie Stitzel, Pew Children’s Dental Campaign Manager, said.

Because many low-income families are not able to afford dental care, they are taking their kids to emergency rooms for what Stitzel calls “totally preventable dental-related issues.”

Nationally, 830,000 children showed up in emergency rooms due to dental-related issues  such as toothaches and cavities, in 2009.

“Quite frankly, it’s the wrong care at the wrong time and the wrong place, and it’s expensive," Stitzel said. "It’s costing states money that they could better spend on the front end for preventative and restorative care for these kids by treating them where they are as opposed to having them seek care in emergency rooms.”

About 15 states are tackling these issues legislatively.

The states are considering training hygienists to perform more routine procedures or licensing dental therapists, who would take on a role similar to physician assistants or nurse practitioners.

“One way to remedy the access issue is to look at the existing workforce to see if there’s a way to expand the reach of the dental team so that you can bring the provider to the patients instead of the patients coming to the provider,” Stitzel said.

The report notes new dental schools are opening in several states, but researchers say if graduates continue to stay in more populated areas and primarily serve privately insured patients or patients who pay out of their pockets, the issue will continue.