Sick of all the bad facts about Kentucky's health? Here's encouraging news about oral health and drug treatment

Despite the plethora of bad news about Kentucky's poor health status, there are many positive initiatives for Kentucky's oral health and substance abuse treatment, which were stories buried under health news headlines about Medicaid expansion and low health rankings.

The Kentucky Board of Dentistry recently established the position of public heath dental hygienist, permitting hygienists to go into Kentucky schools to assess teeth on the front lines, which will provide basic preventive dental care to underserved kids with tooth problems through local health departments, Al Smith, left, reports in an opinion piece for the Lexington-Herald Leader.

"These hygienists will be able to do school fluoride varnish programs, place sealants, refer kids in pain, and promote dental health programs (like brushing and better nutrition) in the schools without being supervised by a dentist," Dr. Rankin Skinner, director of the Clark County Dental Health Initiative, told Smith. "I think this is a major step in developing dental health program like ours across the state and moving our kids towards better health in general."

The initiative, comprising 17 dentists and 127 volunteers, was selected as a national model by a national association of all the health departments. "It isn't often that a private volunteer program in Kentucky sets a national standard," Skinner told Smith.

Meanwhile, in Florence, Kentucky's first lady, Jane Beshear, a Democrat, joined her Republican co-chair of Recovery Kentucky, Lexington homebuilder Don Ball, to celebrate the Brighton Recovery Center's fifth birthday and nearly 800 graduates.

Brighton is one of the 10 new homes for Recovery Kentucky, a program that is also becoming a national model, Smith writes. Since its inception during the Fletcher administration, the program has provided supportive housing and addiction recovery programs to over 10,000 men and women, writes Smith.

Beshear said the next steps are for her and Ball to create more drug-free housing and jobs for graduates of the program, Smith reports. This goal creates hope for other successful initiatives and shines a ray of light at the end of a dark and dreary tunnel.

Despite the plethora of bad news about Kentucky's poor health status, there are many positive initiatives for Kentucky's oral health and substance abuse treatment, which were stories buried under health news headlines about Medicaid expansion and low health rankings.

The Kentucky Board of Dentistry recently established the position of public heath dental hygienist, permitting hygienists to go into Kentucky schools to assess teeth on the front lines, which will provide basic preventive dental care to underserved kids with tooth problems through local health departments, Al Smith, left, reports in an opinion piece for the Lexington-Herald Leader.

"These hygienists will be able to do school fluoride varnish programs, place sealants, refer kids in pain, and promote dental health programs (like brushing and better nutrition) in the schools without being supervised by a dentist," Dr. Rankin Skinner, director of the Clark County Dental Health Initiative, told Smith. "I think this is a major step in developing dental health program like ours across the state and moving our kids towards better health in general."

The initiative, comprising 17 dentists and 127 volunteers, was selected as a national model by a national association of all the health departments. "It isn't often that a private volunteer program in Kentucky sets a national standard," Skinner told Smith.

Meanwhile, in Florence, Kentucky's first lady, Jane Beshear, a Democrat, joined her Republican co-chair of Recovery Kentucky, Lexington homebuilder Don Ball, to celebrate the Brighton Recovery Center's fifth birthday and nearly 800 graduates.

Brighton is one of the 10 new homes for Recovery Kentucky, a program that is also becoming a national model, Smith writes. Since its inception during the Fletcher administration, the program has provided supportive housing and addiction recovery programs to over 10,000 men and women, writes Smith.

Beshear said the next steps are for her and Ball to create more drug-free housing and jobs for graduates of the program, Smith reports. This goal creates hope for other successful initiatives and shines a ray of light at the end of a dark and dreary tunnel.

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Oral health care for the poor in Kentucky suffers under managed care as dentists leave Medicaid; how about your county?

Kentucky's serious oral-health problems are getting worse because fewer dentists are participating in the Medicaid program -- a result of "new paperwork issues compounding Medicaid's reputation" for low payments to providers, Laura Ungar reports for The Courier-Journal.

Ungar's source for that is Dr. Raynor Mullins of the College of Dentistry at the University of Kentucky, who told her that only 700 to 800 of the state's nearly 2,500 dentists, about 30 percent, accept Medicaid patients.

That makes now seem like a good time for journalists to ask their local dentists if they accept Medicaid -- and if not, why not; and if so, whether they are considering dropping it.

Ungar notes that 28 of Kentucky's 120 counties are deemed not to have enough dentists to serve the local population. Most if not all of them are rural. You can find out which counties are under-served by physical, dental or mental health providers at this federal Health Resources and Services Administration website.

Kentucky's serious oral-health problems are getting worse because fewer dentists are participating in the Medicaid program -- a result of "new paperwork issues compounding Medicaid's reputation" for low payments to providers, Laura Ungar reports for The Courier-Journal.

Ungar's source for that is Dr. Raynor Mullins of the College of Dentistry at the University of Kentucky, who told her that only 700 to 800 of the state's nearly 2,500 dentists, about 30 percent, accept Medicaid patients.

That makes now seem like a good time for journalists to ask their local dentists if they accept Medicaid -- and if not, why not; and if so, whether they are considering dropping it.

Ungar notes that 28 of Kentucky's 120 counties are deemed not to have enough dentists to serve the local population. Most if not all of them are rural. You can find out which counties are under-served by physical, dental or mental health providers at this federal Health Resources and Services Administration website.

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Poll shows more than half of Ky. adults have no dental insurance and many go without essential dental care

Routine dental care is essential to overall health, but a new poll shows 1.7 million Kentucky adults do not have dental insurance. That is more than times the number of people who will be at Churchill Downs for the Kentucky Derby, notes the Foundation for a Healthy Kentucky, which co-sponsored the poll.

The poll also showed that many Kentucky adults are going without the dental care they need. While the poll found that few owe money for dental bills, only 61 percent said they visited a dentist or dental clinic within the past year. The national figure is 70 percent.

“Oral health is essential to overall health,” said Dr. Susan Zepeda, president and CEO of the foundation. “Yet, our research indicates a majority of Kentuckians do not have dental coverage, so it is not surprising that a large number of adults do not have a personal dentist or oral health provider.”

Poor oral health or oral pain can lead to poor nutrition and can reduce someone's quality of life by making it difficult to sleep, work or interact with others, and having dental insurance is an important factor in determining whether someone is getting the dental care they need.  More than 50 percent of poll respondents indicated not having dental insurance of any kind, and almost half of that group said they skipped getting dental care or check-ups in the past year due to its cost.

Whether or not someone has a normal source of care is also an important factor in determining health care outcomes because those with a personal dentist or doctor are more likely to seek care. Almost 40 percent of poll respondents, however, said they do not have a personal dentist or oral health provider, and almost 80 percent of those respondents said its been more than five years since they last visited a dentist or dental clinic.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati. The poll was conducted last year from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones, and the poll has a margin of error of plus or minus 2.5 points.

Routine dental care is essential to overall health, but a new poll shows 1.7 million Kentucky adults do not have dental insurance. That is more than times the number of people who will be at Churchill Downs for the Kentucky Derby, notes the Foundation for a Healthy Kentucky, which co-sponsored the poll.

The poll also showed that many Kentucky adults are going without the dental care they need. While the poll found that few owe money for dental bills, only 61 percent said they visited a dentist or dental clinic within the past year. The national figure is 70 percent.

“Oral health is essential to overall health,” said Dr. Susan Zepeda, president and CEO of the foundation. “Yet, our research indicates a majority of Kentuckians do not have dental coverage, so it is not surprising that a large number of adults do not have a personal dentist or oral health provider.”

Poor oral health or oral pain can lead to poor nutrition and can reduce someone's quality of life by making it difficult to sleep, work or interact with others, and having dental insurance is an important factor in determining whether someone is getting the dental care they need.  More than 50 percent of poll respondents indicated not having dental insurance of any kind, and almost half of that group said they skipped getting dental care or check-ups in the past year due to its cost.

Whether or not someone has a normal source of care is also an important factor in determining health care outcomes because those with a personal dentist or doctor are more likely to seek care. Almost 40 percent of poll respondents, however, said they do not have a personal dentist or oral health provider, and almost 80 percent of those respondents said its been more than five years since they last visited a dentist or dental clinic.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati. The poll was conducted last year from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones, and the poll has a margin of error of plus or minus 2.5 points.

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Kentucky parents' overall perception of Kentucky children's health doesn't match the statistics, foundation survey finds

Many Kentucky parents' perception of their children's health doesn't match statistics, suggesting that many health problems are going undetected or untreated.

That is the upshot of the Foundation for a Healthy Kentucky's first Kentucky Parent Survey, conducted by the University of Virginia's Center for Survey Research this summer and released today.

Only 4 percent of Kentucky parents said a health professional had told them their child was obese, but the National Survey of Children's Health in 2007 found that almost 37 percent of Kentucky children were obese.

Just 5 percent of Kentucky parents said they had been told that their child had depression or anxiety, but about 25 percent of children 13 to 18 will have struggled with anxiety and 11 percent will have battled depression, according to a 2010 national study. And a recent study found that Kentucky teens were more likely than the national average to have attempted suicide.

About 17 percent of Kentucky parents reported that their child had decayed teeth or cavities, but a national survey of third graders in 2001-02 revealed that 35 percent had untreated dental issues.

Only 3 percent of parents said their child was diagnosed with a hearing problem, but 15 percent of children nationally have measurable hearing loss. And 14 percent reported being told their child had a vision problem, but about one in four preschoolers nationally have vision issues.

Parents also seem not to get enough advice from health care providers about how to treat their children's health issues, even though there are high rates of children suffering from tooth decay, vision problems, asthma, ADHD, depression/anxiety, obesity, hearing impairment and diabetes, the survey found.

While 92 percent of parents said their child had a regular doctor, just 80 percent said their child had a regular dental care provider. And a 74 percent majority of parents surveyed said they were always encouraged by their child's healthcare provider to ask questions during visits. "The exceptions are worth noting," said Susan Zepeda, president and CEO of the foundation. "If three in four parents said their child's provider always encouraged questions, this means that one in four were not always encouraged to ask questions." (Read more)

Many Kentucky parents' perception of their children's health doesn't match statistics, suggesting that many health problems are going undetected or untreated.

That is the upshot of the Foundation for a Healthy Kentucky's first Kentucky Parent Survey, conducted by the University of Virginia's Center for Survey Research this summer and released today.

Only 4 percent of Kentucky parents said a health professional had told them their child was obese, but the National Survey of Children's Health in 2007 found that almost 37 percent of Kentucky children were obese.

Just 5 percent of Kentucky parents said they had been told that their child had depression or anxiety, but about 25 percent of children 13 to 18 will have struggled with anxiety and 11 percent will have battled depression, according to a 2010 national study. And a recent study found that Kentucky teens were more likely than the national average to have attempted suicide.

About 17 percent of Kentucky parents reported that their child had decayed teeth or cavities, but a national survey of third graders in 2001-02 revealed that 35 percent had untreated dental issues.

Only 3 percent of parents said their child was diagnosed with a hearing problem, but 15 percent of children nationally have measurable hearing loss. And 14 percent reported being told their child had a vision problem, but about one in four preschoolers nationally have vision issues.

Parents also seem not to get enough advice from health care providers about how to treat their children's health issues, even though there are high rates of children suffering from tooth decay, vision problems, asthma, ADHD, depression/anxiety, obesity, hearing impairment and diabetes, the survey found.

While 92 percent of parents said their child had a regular doctor, just 80 percent said their child had a regular dental care provider. And a 74 percent majority of parents surveyed said they were always encouraged by their child's healthcare provider to ask questions during visits. "The exceptions are worth noting," said Susan Zepeda, president and CEO of the foundation. "If three in four parents said their child's provider always encouraged questions, this means that one in four were not always encouraged to ask questions." (Read more)

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Brushing teeth twice a day, two minutes at a time, is the way to prevent cavities, a new campaign advises

Kids should brush their teeth twice a day for two whole minutes at a time, a new public-service campaign urges. The “Kids’ Healthy Mouths” campaign includes TV spots, print ads, a website, social media messages and other materials, reports Jennifer LaRue Huget for The Washington Post.

Campaign materials point out that “dental decay is the most common chronic childhood disease.” More than 16 million children across the United States suffer from it. In Kentucky, nearly 35 percent of third-grade students had untreated tooth decay, the Centers for Disease Control and Prevention's State Oral Health Profile shows.

“The mouth is the gateway to a person’s overall health, and an unhealthy mouth can be linked to diabetes and even heart disease,” the campaign says. “In the U.S., oral disease causes kids to miss 51 million school hours and their parents to lose 25 million work hours annually. Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.”

The campaign includes a YouTube video channel on which there are videos that are each 120 seconds long. The goal is for kids to watch the videos while they’re brushing.

Research has shown brushing two minutes at a time, twice a day, is the “optimal prevention brushing regimen,” because it “takes two minutes for the tooth enamel to uptake the fluoride” in toothpaste, said Maria Lopez Howell, consumer adviser for the American Dental Association. When enamel absorbs fluoride it makes the surface harder and more resistant to bacteria. Brushing for two minutes additionally removes plaque on teeth. (Read more)

Kids should brush their teeth twice a day for two whole minutes at a time, a new public-service campaign urges. The “Kids’ Healthy Mouths” campaign includes TV spots, print ads, a website, social media messages and other materials, reports Jennifer LaRue Huget for The Washington Post.

Campaign materials point out that “dental decay is the most common chronic childhood disease.” More than 16 million children across the United States suffer from it. In Kentucky, nearly 35 percent of third-grade students had untreated tooth decay, the Centers for Disease Control and Prevention's State Oral Health Profile shows.

“The mouth is the gateway to a person’s overall health, and an unhealthy mouth can be linked to diabetes and even heart disease,” the campaign says. “In the U.S., oral disease causes kids to miss 51 million school hours and their parents to lose 25 million work hours annually. Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.”

The campaign includes a YouTube video channel on which there are videos that are each 120 seconds long. The goal is for kids to watch the videos while they’re brushing.

Research has shown brushing two minutes at a time, twice a day, is the “optimal prevention brushing regimen,” because it “takes two minutes for the tooth enamel to uptake the fluoride” in toothpaste, said Maria Lopez Howell, consumer adviser for the American Dental Association. When enamel absorbs fluoride it makes the surface harder and more resistant to bacteria. Brushing for two minutes additionally removes plaque on teeth. (Read more)

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Students with tooth problems don't do as well in school

More evidence shows students who have dental problems struggle more in school. A new study of almost 1,500 disadvantaged students in Los Angeles public schools found those who had had recent tooth pain were four times more likely to have a low grade-point average (below 2.8) than those who didn't have problems.

Another recent survey found that one in nine American children ages 9 to 11 have untreated tooth decay in their permanent, adult teeth. A 2011 study in North Carolina concluded students with poor oral health were three times more likely to miss school because of dental pain.

Parents and policy makers should be concerned with the findings, says Matt Jacob for the Pew Center on the States. In California, about 504,000 children missed at least one school day in 2007 because of a toothache or another oral health-related problem. (Read more)

More evidence shows students who have dental problems struggle more in school. A new study of almost 1,500 disadvantaged students in Los Angeles public schools found those who had had recent tooth pain were four times more likely to have a low grade-point average (below 2.8) than those who didn't have problems.

Another recent survey found that one in nine American children ages 9 to 11 have untreated tooth decay in their permanent, adult teeth. A 2011 study in North Carolina concluded students with poor oral health were three times more likely to miss school because of dental pain.

Parents and policy makers should be concerned with the findings, says Matt Jacob for the Pew Center on the States. In California, about 504,000 children missed at least one school day in 2007 because of a toothache or another oral health-related problem. (Read more)

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Research suggests dental therapists could provide care to Medicaid-eligible kids at terrific savings

The recent revitalization of the Kentucky Oral Health Coalition was a reminder that our state ranks 49th in dental health, behind only West Virginia. So was the news then Tuesday from the University of Connecticut, where research suggests that adding a new kind of health provider -- dental therapists -- to clinics known as federally qualified health centers could significantly expand the availability of care for millions of American children. (Pew Center photo)

The white paper from the Pew Children's Dental Campaign of the Pew Center on the States notes that, "In particular, by including dental therapists as providers in school-based programs operated by FQHCs, the researchers estimated states could provide access to care for 6.7 million Medicaid-eligible children, nationwide." The analysis also suggests that this significant increase in access could be realized for a cost of approximately $1.8 billion or just one half of 1 percent of combined state and federal 2009 Medicaid spending. To read the full Pew report, go here.

Nationwide, 830,000 emergency room visits in 2009 were due to preventable dental problems, according to the center, many of those in rural areas. Most of the children lacking care don't have insurance, live in areas without enough dentists or can't find doctors who accept Medicaid. Problems accessing dentists could grow in 2014, when 5 million more children are expected to get dental insurance under the federal healthcare reform law.

Despite the undisputed need, not everyone is behind the concept. The American Dental Association argues that dental therapists lack the training and education needed to perform irreversible surgical procedures and to identify patients' other medical problems, writes Anna Gorman in the Los Angeles Times. Therapists would be properly educated and would help close vast gaps in care that can lead to costly emergency room visits for dental problems, said Shelly Gehshan, director of the Children's Dental Campaign. In 2005, Alaska became the first state to try out the new dental care model, when therapists began treating native populations. Minnesota authorized the new tier of practitioner in 2009, and the first graduates of dental therapy programs began practicing last year. 

The recent revitalization of the Kentucky Oral Health Coalition was a reminder that our state ranks 49th in dental health, behind only West Virginia. So was the news then Tuesday from the University of Connecticut, where research suggests that adding a new kind of health provider -- dental therapists -- to clinics known as federally qualified health centers could significantly expand the availability of care for millions of American children. (Pew Center photo)

The white paper from the Pew Children's Dental Campaign of the Pew Center on the States notes that, "In particular, by including dental therapists as providers in school-based programs operated by FQHCs, the researchers estimated states could provide access to care for 6.7 million Medicaid-eligible children, nationwide." The analysis also suggests that this significant increase in access could be realized for a cost of approximately $1.8 billion or just one half of 1 percent of combined state and federal 2009 Medicaid spending. To read the full Pew report, go here.

Nationwide, 830,000 emergency room visits in 2009 were due to preventable dental problems, according to the center, many of those in rural areas. Most of the children lacking care don't have insurance, live in areas without enough dentists or can't find doctors who accept Medicaid. Problems accessing dentists could grow in 2014, when 5 million more children are expected to get dental insurance under the federal healthcare reform law.

Despite the undisputed need, not everyone is behind the concept. The American Dental Association argues that dental therapists lack the training and education needed to perform irreversible surgical procedures and to identify patients' other medical problems, writes Anna Gorman in the Los Angeles Times. Therapists would be properly educated and would help close vast gaps in care that can lead to costly emergency room visits for dental problems, said Shelly Gehshan, director of the Children's Dental Campaign. In 2005, Alaska became the first state to try out the new dental care model, when therapists began treating native populations. Minnesota authorized the new tier of practitioner in 2009, and the first graduates of dental therapy programs began practicing last year. 

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Looking for 'a few short-term wins' to start, Kentucky Oral Health Coalition formally reorganizes

By Amy Wilson
Kentucky Health News

LOUISVILLE, July 25 – There was no whitewashing the ruinous state of the state's teeth Wednesday when the Kentucky Oral Health Coalition formally reorganized with the goal of fixing as much as they can as fast as it can. With almost a fourth of Kentuckians over 65 having complete tooth loss and almost half of children between 2 and 4 already having twice the national average of cavities, there is work to be done on every front.

As the state with the 49th worst-looking mouths in the country, explained Andrea Bennett, senior policy analyst for Kentucky Youth Advocates, "What we're looking for is a few short-term wins."

It appears that the top priority, as voted by the coalition's members, is to improve oral health literacy and education. That means that members will be looking for ways – including maybe getting themselves a celebrity spokesperson – to explain what good oral hygiene is and how to get it.

Close behind in priorities will be efforts to expand school-based oral health services, including for those in Head Start and all child-care settings. Members also expressed a desire to increase the number of Kentucky dentists who accept Medicaid, thus expanding the numbers of those who can be treated.

How they do that is under discussion. The group, which existed a decade ago but lost momentum, has decided to revitalize into a more active, more inclusive, perhaps even more legislatively inclined group. It all depends on its new leadership, said Dr. James Cecil, a national leader in public health and a former University of Kentucky dental school professor.

Cecil, who now works with KYA, a nonprofit whose staff will handle a lot of the coalition's workload, explained that funding for the initial work of the group is expected to come from the renewal of a grant from DentaQuest, a continuous source of funding for Kentucky dental projects for three years. New programs, as drawn up by and agreed to by the new executive committee elected Wednesday, will seek other sources of funding through corporations and other grants, Cecil said. In their current treasury is $20,000, left over from the old KOHC.

The coaltion is now chaired by Laura Hancock Jones, Western Kentucky Dental Outreach Program director in the University of Kentucky College of Dentistry's Division of Public Health. A well-known and well-respected practicing pediatric dentist, she is self-described "passionate" advocate for education and literacy about oral health. She runs a program that provides a fluoride varnish on children as young as 2.

"I have seen how much we've done and it's not been enough," Hancock-Jones said. "We have not moved the needle." The answer, she said, is "from the bottom. You have to talk to the kids." In her own health-department experience, she dogged one family for three years, she said, through the school Family Resource and Service Center, social workers, and eventually the judicial system, to get their children care. Eventually, she did and "the kids are" getting care and thinking "It really is a good thing to go to the dentist."
 
Members of the coalition include dentists, dental hygienists, insurance providers, public health officers, school nurses and students. Donna Ruley, executive director of the Kentucky Dental Hygienist Association, was elected secretary of the group Wednesday. She said she believes it's important that her profession is at the table when talking about dental priorities and potential scope of job description legislation. "Our impact on education is huge," said Ruley. "The legislature just recently passed a public-health hygienist role that would allow for a greater number of people to be taught prevention services without a dentist's supervision." That, she added, is a great need in a lot of far-flung rural reaches of the state.

The vice chair of the group is Linda Poynter of the Kenton County Health Department. The treasurer is Dr. Lee Mayer of the University of Louisville dental school.

By Amy Wilson
Kentucky Health News

LOUISVILLE, July 25 – There was no whitewashing the ruinous state of the state's teeth Wednesday when the Kentucky Oral Health Coalition formally reorganized with the goal of fixing as much as they can as fast as it can. With almost a fourth of Kentuckians over 65 having complete tooth loss and almost half of children between 2 and 4 already having twice the national average of cavities, there is work to be done on every front.

As the state with the 49th worst-looking mouths in the country, explained Andrea Bennett, senior policy analyst for Kentucky Youth Advocates, "What we're looking for is a few short-term wins."

It appears that the top priority, as voted by the coalition's members, is to improve oral health literacy and education. That means that members will be looking for ways – including maybe getting themselves a celebrity spokesperson – to explain what good oral hygiene is and how to get it.

Close behind in priorities will be efforts to expand school-based oral health services, including for those in Head Start and all child-care settings. Members also expressed a desire to increase the number of Kentucky dentists who accept Medicaid, thus expanding the numbers of those who can be treated.

How they do that is under discussion. The group, which existed a decade ago but lost momentum, has decided to revitalize into a more active, more inclusive, perhaps even more legislatively inclined group. It all depends on its new leadership, said Dr. James Cecil, a national leader in public health and a former University of Kentucky dental school professor.

Cecil, who now works with KYA, a nonprofit whose staff will handle a lot of the coalition's workload, explained that funding for the initial work of the group is expected to come from the renewal of a grant from DentaQuest, a continuous source of funding for Kentucky dental projects for three years. New programs, as drawn up by and agreed to by the new executive committee elected Wednesday, will seek other sources of funding through corporations and other grants, Cecil said. In their current treasury is $20,000, left over from the old KOHC.

The coaltion is now chaired by Laura Hancock Jones, Western Kentucky Dental Outreach Program director in the University of Kentucky College of Dentistry's Division of Public Health. A well-known and well-respected practicing pediatric dentist, she is self-described "passionate" advocate for education and literacy about oral health. She runs a program that provides a fluoride varnish on children as young as 2.

"I have seen how much we've done and it's not been enough," Hancock-Jones said. "We have not moved the needle." The answer, she said, is "from the bottom. You have to talk to the kids." In her own health-department experience, she dogged one family for three years, she said, through the school Family Resource and Service Center, social workers, and eventually the judicial system, to get their children care. Eventually, she did and "the kids are" getting care and thinking "It really is a good thing to go to the dentist."
 
Members of the coalition include dentists, dental hygienists, insurance providers, public health officers, school nurses and students. Donna Ruley, executive director of the Kentucky Dental Hygienist Association, was elected secretary of the group Wednesday. She said she believes it's important that her profession is at the table when talking about dental priorities and potential scope of job description legislation. "Our impact on education is huge," said Ruley. "The legislature just recently passed a public-health hygienist role that would allow for a greater number of people to be taught prevention services without a dentist's supervision." That, she added, is a great need in a lot of far-flung rural reaches of the state.

The vice chair of the group is Linda Poynter of the Kenton County Health Department. The treasurer is Dr. Lee Mayer of the University of Louisville dental school.

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Lacking money, insurance and dentists, oral health takes a back seat, and many rural areas are barely on the bus

A dentist works at a Remote Area Medical Clinic in Wise, Va.
(Associated Press photo by Steve Helber)

Dr. Nikki Stone is a dentist who works in Hazard, Ky., at a community-run clinic. A native of the mountains, she knew that children in the region weren’t getting enough dental care, but she was still "staggered by the prevalence of dental disease when she began examining them in 2004," Margot Sanger-Katz reports for the National Journal. "Large numbers of the kids had never seen a dentist. Half had untreated tooth decay, and nearly 20 percent had urgent needs -- more than six cavities or an active abscess. She and her staff 'cried a lot,' she recalls. Crisscrossing four counties in her van, she painted fluoride on all the teeth and sent notes home with the children who needed immediate attention. In the early years, only 8 percent of those youngsters with urgent problems got the care they needed. The job was like fighting a forest fire on a mountain, she says. 'I felt like I was standing here on the line of the fire with a squirt gun.'"

In a world of medical priorities, dentistry takes a back seat to most, and In a world of health care, and rural America sometimes appears to not even be on the bus. The net result, writes Sanger-Katz, is that the United States faces a shortage of dentists that is particularly acute in poor, rural regions. "Huge pockets of the country have few (or no) providers. The federal government counts 4,503 mostly rural regions where more than 3,000 people share one dentist," she notes, "making it tough for many residents to find someone to fix their teeth."

There seems little hope for any change soon in rural America, even if the federal health-reform law survives. "It deems dental coverage an essential part of any health plan for children, but regulators have yet to spell out what insurers must cover to meet that definition," Sanger-Katz writes. "The law expands existing loan-repayment funds for dentists who relocate to underserved areas, but it offers no expansion of dental coverage for adults and doesn’t try to integrate dental health into the larger health care system."Dental disease is the largest unmet health need in the U.S. among both children and adults, according to the Pew Children’s Dental Campaign. The worst-off are the poor, the young, the old, and those in rural America, reports Margot Sanger-Katz reports.

Dental disease is among the most common reasons that children miss school. It’s the most common medical reason that soldiers can’t deploy. It is a leading cause of emergency-room visits in several states. For proponents of a freer health care market, who want patients to be motivated by financial incentives to shop around and avoid “unnecessary” care, the dental system offers a glimpse of how such a system might work. And research shows that poor oral health can lead to disease elsewhere in the body.

"For more than 100 years, dentistry has run on a separate -- and more laissez-fair -- track than the rest of medicine," Sanger-Katz writes. "Dentists have their own schools and treat patients in their own offices; fewer laws and regulations govern the field. Insurance plans typically demand high co-pays and limit their payouts for invasive procedures. About half of all dental expenses are paid out of pocket, compared with less than 10 percent of costs in the overall medical system. This is the free market. And, in some ways, it has worked: People do not drive up insurance rates by seeking frivolous procedures. Patients tend to shop around for care, and prices vary according to local economies. The rate of dental inflation, although higher than the rate for the economy overall, is lower than the rate in medicine, which is typically several points above the growth rate of the gross domestic product. (You don’t hear policymakers complain about the burden of 'runaway' dental costs.)"

“It’s very much a free market, with a greater spread between the haves and have-nots,” said Burton Edelstein, a professor of dentistry at Columbia University and the founder of the Children’s Dental Health Project. "Dental insurance is much less widespread than medical insurance; 130 million Americans lacked dental coverage in 2009, but only 50 million lacked medical coverage," Sanger Katz-writes. "And with most payouts capped at $1,000 to $2,000 per year, insurance can’t cover much beyond basic services. Medicare does not pay for dental care at all, so 70 percent of seniors lack any dental coverage, according to an Institute of Medicine report. Medicaid also fails to provide meaningful dental access for many of its beneficiaries: The program pays dentists so poorly for treatment that only about 20 percent of them see Medicaid patients." Meanwhile, seven of 61 dental schools closed in the last 30 years, meaning 2,000 fewer dentists every year, a 33 percent drop in supply, just as an older generation of dentists started retiring.

The result is a crisis. And, in a few lucky rural towns, the result looks like this: A mobile van outfitted with a volunteer dentist comes to a rural elementary school and offers free check-ups but no fillings. Or, better yet, a volunteer army of dentists, dental students and oral surgeons in a region volunteer for a two-day event at a vast arena where everyone is welcome to camp overnight for a place in line for care. Some of the dental expertise and hospitality is donated by Ronald McDonald House, or Remote Area Medical out of Knoxville, Tenn., or local community health centers. And while are limited in their ability to do much more than prevention, others can offer real dental care but no follow-up. The result is often a brutal kind of dentistry that involves, at best, mass extraction, some advice about what not to drink and explanations about how oral health is connected to overall health. (Read more)

A dentist works at a Remote Area Medical Clinic in Wise, Va.
(Associated Press photo by Steve Helber)

Dr. Nikki Stone is a dentist who works in Hazard, Ky., at a community-run clinic. A native of the mountains, she knew that children in the region weren’t getting enough dental care, but she was still "staggered by the prevalence of dental disease when she began examining them in 2004," Margot Sanger-Katz reports for the National Journal. "Large numbers of the kids had never seen a dentist. Half had untreated tooth decay, and nearly 20 percent had urgent needs -- more than six cavities or an active abscess. She and her staff 'cried a lot,' she recalls. Crisscrossing four counties in her van, she painted fluoride on all the teeth and sent notes home with the children who needed immediate attention. In the early years, only 8 percent of those youngsters with urgent problems got the care they needed. The job was like fighting a forest fire on a mountain, she says. 'I felt like I was standing here on the line of the fire with a squirt gun.'"

In a world of medical priorities, dentistry takes a back seat to most, and In a world of health care, and rural America sometimes appears to not even be on the bus. The net result, writes Sanger-Katz, is that the United States faces a shortage of dentists that is particularly acute in poor, rural regions. "Huge pockets of the country have few (or no) providers. The federal government counts 4,503 mostly rural regions where more than 3,000 people share one dentist," she notes, "making it tough for many residents to find someone to fix their teeth."

There seems little hope for any change soon in rural America, even if the federal health-reform law survives. "It deems dental coverage an essential part of any health plan for children, but regulators have yet to spell out what insurers must cover to meet that definition," Sanger-Katz writes. "The law expands existing loan-repayment funds for dentists who relocate to underserved areas, but it offers no expansion of dental coverage for adults and doesn’t try to integrate dental health into the larger health care system."Dental disease is the largest unmet health need in the U.S. among both children and adults, according to the Pew Children’s Dental Campaign. The worst-off are the poor, the young, the old, and those in rural America, reports Margot Sanger-Katz reports.

Dental disease is among the most common reasons that children miss school. It’s the most common medical reason that soldiers can’t deploy. It is a leading cause of emergency-room visits in several states. For proponents of a freer health care market, who want patients to be motivated by financial incentives to shop around and avoid “unnecessary” care, the dental system offers a glimpse of how such a system might work. And research shows that poor oral health can lead to disease elsewhere in the body.

"For more than 100 years, dentistry has run on a separate -- and more laissez-fair -- track than the rest of medicine," Sanger-Katz writes. "Dentists have their own schools and treat patients in their own offices; fewer laws and regulations govern the field. Insurance plans typically demand high co-pays and limit their payouts for invasive procedures. About half of all dental expenses are paid out of pocket, compared with less than 10 percent of costs in the overall medical system. This is the free market. And, in some ways, it has worked: People do not drive up insurance rates by seeking frivolous procedures. Patients tend to shop around for care, and prices vary according to local economies. The rate of dental inflation, although higher than the rate for the economy overall, is lower than the rate in medicine, which is typically several points above the growth rate of the gross domestic product. (You don’t hear policymakers complain about the burden of 'runaway' dental costs.)"

“It’s very much a free market, with a greater spread between the haves and have-nots,” said Burton Edelstein, a professor of dentistry at Columbia University and the founder of the Children’s Dental Health Project. "Dental insurance is much less widespread than medical insurance; 130 million Americans lacked dental coverage in 2009, but only 50 million lacked medical coverage," Sanger Katz-writes. "And with most payouts capped at $1,000 to $2,000 per year, insurance can’t cover much beyond basic services. Medicare does not pay for dental care at all, so 70 percent of seniors lack any dental coverage, according to an Institute of Medicine report. Medicaid also fails to provide meaningful dental access for many of its beneficiaries: The program pays dentists so poorly for treatment that only about 20 percent of them see Medicaid patients." Meanwhile, seven of 61 dental schools closed in the last 30 years, meaning 2,000 fewer dentists every year, a 33 percent drop in supply, just as an older generation of dentists started retiring.

The result is a crisis. And, in a few lucky rural towns, the result looks like this: A mobile van outfitted with a volunteer dentist comes to a rural elementary school and offers free check-ups but no fillings. Or, better yet, a volunteer army of dentists, dental students and oral surgeons in a region volunteer for a two-day event at a vast arena where everyone is welcome to camp overnight for a place in line for care. Some of the dental expertise and hospitality is donated by Ronald McDonald House, or Remote Area Medical out of Knoxville, Tenn., or local community health centers. And while are limited in their ability to do much more than prevention, others can offer real dental care but no follow-up. The result is often a brutal kind of dentistry that involves, at best, mass extraction, some advice about what not to drink and explanations about how oral health is connected to overall health. (Read more)

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Free dental, health, vision clinic to help hundreds this weekend

This weekend, about 1,000 people will get free dental, medical and vision care in Pike County. The effort is sponsored by Kentucky's Remote Area Medical Volunteer Corps, which hosts a free clinic that provides free treatment to those who come from all over the state to receive it. (University of Louisville video)

Last year, 882 patients received services from volunteer health-care professionals. That meant 455 pairs of eyeglasses were given to 407 people who needed them; 386 patients received free dental services, including 974 extractions, 348 fillings and 264 cleanings; and 303 patients got free medical services.

This is the fourth year of the effort. The clinic opens at 6 a.m. Saturday and closes Sunday afternoon at Pike County Central High School. Patients are seen on a first-come, first-served basis. Numbers will be handed out starting at 3:30 a.m. each day. For the best chance of being seen, patients should plan to arrive by 3:30 a.m. on the day they wish to be treated.

RAM-KY, modeled after a national organization with a similar name, was founded by Dr. Bill Collins in 2008. Since then, the Kentucky General Assembly has passed a law that allows licensed dental practitioners from other states to apply for and received charitable licenses so they can participate in events like Saturday's.

For more information about RAM-KY, click here.

This weekend, about 1,000 people will get free dental, medical and vision care in Pike County. The effort is sponsored by Kentucky's Remote Area Medical Volunteer Corps, which hosts a free clinic that provides free treatment to those who come from all over the state to receive it. (University of Louisville video)

Last year, 882 patients received services from volunteer health-care professionals. That meant 455 pairs of eyeglasses were given to 407 people who needed them; 386 patients received free dental services, including 974 extractions, 348 fillings and 264 cleanings; and 303 patients got free medical services.

This is the fourth year of the effort. The clinic opens at 6 a.m. Saturday and closes Sunday afternoon at Pike County Central High School. Patients are seen on a first-come, first-served basis. Numbers will be handed out starting at 3:30 a.m. each day. For the best chance of being seen, patients should plan to arrive by 3:30 a.m. on the day they wish to be treated.

RAM-KY, modeled after a national organization with a similar name, was founded by Dr. Bill Collins in 2008. Since then, the Kentucky General Assembly has passed a law that allows licensed dental practitioners from other states to apply for and received charitable licenses so they can participate in events like Saturday's.

For more information about RAM-KY, click here.

Read More