The American Academy of Pediatric Dentistry (AAPD) released a report entitled ‘State of Little Teeth’ on January 2014 which points out that tooth decay is a significant threat to the health, welfare and future of children in the U.S. As per the report, around 60 percent of kids in the U.S. will have had cavities by age 5, and 40 percent have them when they enter kindergarten. While children with tooth decay can have ear and sinus infections, there is more chance of such children developing chronic problems including obesity, diabetes and even heart disease. The report also says that delaying the first dental exam for children until the age of 2 or 3 can adversely affect their oral health.
The survey mentioned in the report was conducted by KRC Research on behalf of the AAPD. It was a 10-minute online survey held between October 1st to October 7th with 1,000 parents in the U.S. having children ages 5 or younger. The key findings of this survey are:
- Early childhood caries – a rapid form of tooth decay in very young children found to be the most common disease faced by children and it is rising among children. ECC is harmful to a child’s oral and general health, and social and intellectual development.
- Though experts recommend babies see a dentist in the very first year of their life, only a fraction of parents bring their babies to dentists in this early age. The survey found 60 percent of participants were aware of this recommendation while only 25 percent did follow through. The study shows this may be in part due to many pediatricians and dentists being unable to reinforce this recommendation.
- The study says that there are very few dentists willing and able to treat young children (especially those who are covered by Medicaid and have barriers in finding care). The lack of unskilled dentists will make dental pain management difficult.
- Special training is required to provide dental care for younger children, especially those with special needs. In order to produce more pediatric dentists and general dentists with the knowledge, skill and willingness to treat kids, it is essential to expand pediatric dental education.
- There is very less chance for first-time patients and caregivers to take their child to see a dentist (45 percent) compared to experienced parents with two or more children with one child under age 5 (17 percent). Experienced parents and caregivers are more likely to bring their child to a pediatric dentist (48 percent) compared to first-time parents (34 percent).
The report also shows the need for providing education to parents and caregivers as most of them are simply ignorant about how to best help their children fight tooth decay despite the disease being mostly preventable. A new survey by the AAPD reveals 53 percent of parents and caregivers were unaware of the unique expertise (two to three years of specialized training past dental school in areas including addressing anxiety that some kids may have related to dental visits, treating children with special healthcare needs and tailoring the treatment to the specific emotional and dental needs of children) required for pediatric dentists. However, when they were educated about this through additional training, nearly 98 percent decided to seek a pediatric dentist for their child.
This survey showed that only nine percent had knowledge of ‘Dental Home’, an ongoing relationship with a primary dental care provider and patient so as to provide oral healthcare in a comprehensive, constantly accessible and family-centered manner. When given a proper understanding, 94 percent of parents and caregivers found the concept of Dental Home appealing while 84 percent said they are likely to take their child to a pediatric dentist. Also, AAPD is launching an educational campaign for parents and caregivers with the name ‘Monster-Free Mouths Movement’ in order to empower them with important tools and information to fight against tooth decay in their children.
ACA and Delayed Dental Care
According to the AAPD report, children from low-income and minority families are more prone to ECC risk. One of the reasons for this is they are less likely to visit a dentist compared to other children. In such a scenario, it is a great relief that the Affordable Care Act (ACA) makes dental insurance available through the insurance marketplace so as to help patients who are not eligible for either Medicaid or workplace coverage. It is estimated that the ACA can provide millions of uninsured children access to dental insurance by 2018 and thereby mark a potential advance for children’s oral health. However, it seems that these hopes have received a backlash in the first enrollment as only 63,448 children get dental coverage from stand-alone dental plans sold through the federal website in 36 states. Many families find it quite difficult to access dental benefits for their children due to the following reasons.
- Most states do not require consumers to purchase dental benefits
- No separate subsidies are offered to help consumers pay for dental coverage
There is a need for better integration of dental benefits into ACA coverage or improvements in Medicaid as the open enrollment resumes on November 15. AAPD suggests the following solutions to eliminate the unwillingness of dentists to treat patients with Medicaid coverage.
- Increase reimbursement rates
- Reduce administrative burden so as to encourage dentists’ participation in Medicaid
- Expanded Function Dental Assistants for dental offices to better serve more patients
- Increase the number of pediatric dentists
Dentists having concerns regarding ACA coverage should thoroughly verify insurance details of each patient with experts having better knowledge in dental coverage under ACA to avoid claim denials.