The Action for Dental Health law signed by the president last month is like the dental floss of federal initiatives: designed to reach those hard-to-reach people and places. Communities throughout Southern Illinois stand to benefit as the law specifically targets the advance of dental health care in struggling rural and urban communities, experts say.
“I think you’ll see more programs develop out of that, allowing for more care in rural and other underserved areas,” said Dave Marsh, director of government affairs for the Illinois State Dental Society.
Marsh said dentists in Illinois have made great strides in bringing programs to underserved areas with mobile dentistry vans and in-school screening and preventative programs. But many families still face barriers to affordable care.
The new law has the potential to expand existing programs and allow states to come up with innovative new ideas to improve access and education, Marsh added.
According to the American Dental Association, the new law enables the U.S. Department of Health and Human Services to award grants and enter into collaborative agreements with states and other partners to develop programs to that end.
There has been little federal funding made available for these initiatives in the past. The law is intended to bolster support for programs that reduce the use of emergency rooms for dental care and help patients establish “dental homes” so that they have a regular provider to turn to for preventative or emergency care. Programs that reduce language and cultural barriers to dental care, and improve access by nursing home residents, are also prioritized in the new law.
As Southern Illinois’ population ages, access to dental care for seniors is a growing concern, as Medicare does not cover routine dental services. Coverage under Medicaid, for individuals who qualify based on income, also is extremely limited, said Ryan Gruenenfelder, director of advocacy and outreach for AARP Illinois.
Older Americans, he noted, need dental care as much or more than younger populations. The aging process results in enamel wearing away, making teeth susceptible to damage and decay. Furthermore, a recent AARP nationwide poll found that nearly a third of Americans aged 50 to 64 lacked dental coverage, and many are forgoing routine dental health care as a result prior to reaching the age of Medicare eligibility.
Young children whose families cannot afford dental care, or who may face additional barriers to accessing it, also are vulnerable, said Dr. Katie Kosten, director of community dentistry and assistant professor at the Southern Illinois University School of Dental Medicine, based in Alton. “For me, it’s two-pronged,” she said. “Opening up access is great, but it also requires real, thoughtful effort and support from the providers.” Other barriers to care may include transportation and child care issues, or a lack of education about the importance of dental health, she said.
Though many dentists offer discount rates to low-income patients and volunteer their time at free clinics, it’s not enough to close the resource gap. For children who participate in Medicaid, the reimbursement rate in Illinois is so low for dental services that families struggle to find offices willing to provide care. That’s especially true if children have complex dental problems requiring general anesthesia to correct, Kosten said. Only a handful of clinics in the entire state provide that service to children, and the wait can stretch for months. For the SIU School of Dental Medicine, the wait is close to two years.
On Jan. 1, a new Illinois law also became effective regarding dental screenings for children. It requires that children visit a dentist prior to entering ninth grade. This expands the existing requirement for children to have dental screenings prior to entering kindergarten, second and sixth grades.