While
Medicaid and the Children’s Health Insurance Program (CHIP)
provide a safety net, access to dental care is a big issue,
especially for children of color. According to the Pew Charitable
Trusts, “tooth decay is the most common chronic disease among
US children, five times as prevalent as asthma, and dental care is
one of the nation’s greatest unmet children’s health
needs.” Why? Sometimes children’s parents simply did not
arrange for them to see a dentist. Sometimes, dental services were
not available in particular areas, for example, dental needs are
sometimes more likely to be addressed in emergency rooms than dental
clinics. And, a 2016 report from the Department of Health and Human
Services says that dental provider shortages were at least part of
the reason some children, especially low-income Black and Hispanic
children, lack dental care.
Children
pay a big price when their dental needs are unmet. In the worst and
most extreme cases, as in that of Maryland’s Deamonte Driver,
children can die because they do not have access to basic dental
services. More frequently, says Dr. Diane Earle, Managing Dental
Director for Kool Smiles, “Childhood dental decay can lead to
pain, difficulty eating, speaking and sleeping, and more serious
infections, some of which can be life-threatening.”
To
address some of the need, Kool Smiles is offering free dental care to
children in need on Sunday, May 20. 49 offices in 13 states plus
Washington, D.C. will be open to provide dental exams, extractions,
fillings, sealants, and other emergency services. The free day is
open to children who either lack insurance or are underinsured.
To
be sure, Kool Smiles can’t possibly provide a smile for every
child, but they are taking a step in the right direction. This year
represents the fourth year that the organization has offered the free
service. It’s first-come, first-serve; so if you are
interested, check out mykoolsmiles.com/sharing smiles, where you can
register for a free appointment. In the past three years more than
1,400 children have received free dental care, with more than 500
being treated last year. Kool Smiles hopes to serve even more
children this year.
Access
to safe and affordable health care has been part of my portfolio for
some years. In 2015, I had the privilege of spending a week at
Meharry Medical College, lecturing on health policy. The challenges
that people of color face around health care can be distilled to the
3 A’s – access, assets, and attitudes. All too often
access is limited because people live in the wrong areas, because
providers are unavailable, or because there are other reasons people
can’t physically get to the care they need. Assets determine
almost everything – if you don’t have the dollars, no
matter what the proximity, you won’t likely have the care you
need. Finally, the attitudes of both providers and patients make a
difference in who seeks care and in what kind of care is provided.
Recent work on maternal mortality among African American women,
regardless of race, suggests that racial attitudes in treatment make
a difference. Consider the case of our superstar, Serena Williams,
who almost died giving birth to her precious Alexis Olympia, partly
because of some preconceived notions about Black folks on the part of
misguided medical professionals.
Mental
health and dental health are the two parts of health care that are
most frequently ignored. It is not enough to simply get an annual
checkup. Increasing research shows that mental health and physical
health are inextricably intertwined. Dental health, all too
frequently, is ignored. Even those with “good” health
insurance may have limited dental insurance. And lower-income folks
rely on Medicaid and CHIP, but may not have anywhere to go to get the
help they need.
Dental
practitioners like Dr. Diane Earle, a second-generation
Meharry-trained dentist, stand in the gap for those who may not have
access to health care. In her role as Managing Dental Director for
Kool Smiles, Earle says, “Sharing Smiles Day is an opportunity
for our dentists and staff to put a smile back on the faces of
children who need dental care but whose families cannot afford it.”
Pew
says that more than 18 million low-income children had no access to
health care in 2014. Kool Smile’s effort to see 500 or more
children on May 20 doesn’t begin to deal with the enormity of
the challenge. But it’s an effort that will make a big
difference for the children who are treated. And it’s an
opportunity for us to reflect on the importance of dental health that
the role that organizations like Kool Smiles can play in closing the
dental health gap.
Full
disclosure – I’ve worked with Kool Smiles and their
dental service organization, Benevis, on a program called Watch Yo’
Mouth, featuring Dr. Diane Earle and healthy living author Debra
Peek-Haynes. We plan to offer more of these programs in coming
months. Meanwhile, though, I am excited about Sharing Smiles Day and
about developing ways more low-income children can have access to
dental care, so that there can be a healthy smile for every child in
our nation.
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