Care in Maryland is improving, but loss of jobs, health benefits

With February’s National Children’s Dental Health Month upon them, academic, industry and government leaders can point to improvements. They formed a Dental Action Committee that has won aid for local health centers; streamlined the Medicaid program; and sent hygienists into the community to provide screenings. They’ve been gaining commitments from dentists to treat poor children. They worry, however, that the bad economy will set back efforts and that there will be less money for care at a time when people are losing their jobs and private health care.
“The problem is huge,” said Rosemary Fetter, executive director of the Baltimore dental museum, where about 60 kids got some hands-on education as well as dental screenings this month as part of an annual event. “Problems with teeth keep kids out of school, some statistics say, more than anything else.”
Student volunteers from the nearby University of Maryland Dental School said the children’s mouths didn’t look too bad during the recent visit. Many had been to dentists, as evidenced by work done on their baby teeth. The volunteers also thought they were keeping the kids’ attention during the oral-hygiene lessons by using props and computers.
“This is much better than a video,” said Gloria Gillian, one of the kindergarteners’ teachers. “It’ll stick with them. They’ll go home and tell their parents. And when they’re in the store, they’ll remind them to get floss.”
Kiniya Coleman, who was missing her front teeth, said she’d brush the ones she has. Classmate Nia Thompson said her mother had already taught her “everything” about brushing.
“Up and down, up and down,” she said. Then, while demonstrating on those giant teeth, she told her classmates, “You got to get in the back.”
Such events are also reaching children who aren’t seeing dentists regularly, said Dr. Marc Nuger, president of the Maryland State Dental Association. And Nuger and others on the Dental Action Committee, including Dr. Norman Tinanoff, chair of the UM Dental School’s Department of Health Promotion and Policy, said they can point to other successes:
•The state was able to simplify its Medicaid system by reducing the number of companies serving patients to one from seven or eight. Patients and dentists will call only one number as of July 1.
•Reimbursements for dentists taking Medicaid patients are increasing, which is luring more professionals to treat the poor. The first raise came in July, and two more are planned, though the recession is causing a delay.
•State health workers received an extra $1.5 million to bolster care in community centers.
•Dental hygienists received permission to screen more children in public health settings.
•Dentists were offered training in pediatric dentistry so they could more confidently treat children.
•Doctors who treat Medicaid patients will soon be compensated for providing fluoride treatments in their offices after they complete a training course.
Nuger said the changes, including the single-payer system for Medicaid, have already netted almost 100 new dentists in the Medicaid system in the past two years, bringing the total to about 400. The group is looking for about 200 more. There are about 4,000 dentists in Maryland.
“The new system is going to be a big plus,” Nuger said. “There are some 400,000 on the Medicaid roles in Maryland, and we’d like to get more to see a dentist regularly.”
Nationwide, despite fluoridated water and toothpaste and increased dental visits, dental disease and cavities among preschoolers are rising, largely among poor children, according to data from the American Dental Association and the National Institute of Dental and Craniofacial Research.

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