Washington state gets a ‘B’ on national dental exam
March 16, 2010
By David Hayes
A national study has given the state of Washington a “B” grade for its pediatric oral dental care.
The Pew Center on the States recently released its report, “The Cost of Delay: State Dental Policies Fail One in Five Children.” It graded all 50 states in eight categories on whether and how well they are employing what the Pew Center deems as “cost-effective policy solutions to ensure dental health and access to care for children.”
The Pew Center graded each state on the following criteria:
-Share of high-risk schools with sealant programs
-Hygienists can place sealants without dentist’s prior exam
-Share of residents on fluoridated community water supplies
-Share of Medicaid-enrolled children getting dental care
-Share of dentists’ median retail fees reimbursed by Medicaid
-Pays medical providers for early preventive dental health care
-Authorizes new primary care dental providers
-Tracks data on children’s dental heath.
Washington met or exceeded six of the eight, qualifying it for a B grade, tying it with eight other states, including Alaska, Colorado, Idaho, Illinois, Main, New Hampshire, Ohio and Texas.The same number of states received failing grades, which included Alabama, Delaware, Florida, Hawaii, Louisiana, New Jersey, Pennsylvania, West Virginia and Wyoming.
Receiving A grades were Connecticut, Iowa, Maryland, New Mexico, Rhode Island and South Carolina.
The study found in Washington state at least one-fourth of its high-risk schools benefit from sealant programs, and the state makes effective use of hygienists in these settings. It also reimburses medical professionals who offer basic preventive services to Medicaid-enrolled children.
Washington’s Access to Baby and Child Dentistry program provides a national model for training general dentists to care for young children. Washington ranked in the top five states for Medicaid utilization — with about 48 percent of Medicaid-enrolled children seeing a dentist in 2007, the latest year for which data is available.
However, the state Medicaid reimbursement level for dentists fell short of the national average. In addition, the study asserts the state needs at least 110 more dentists to meet the needs of its residents in shortage areas. And only 63 percent of Washington’s population on community water supplies has access to drinking water with optimal levels of fluoride.
Dentist John Liu, practicing with Eastside Pediatric Dental Group since 1994, had mixed feelings about the study’s findings. As a pediatric dentist, Liu sees patients from birth to high school (and on into adulthood if the patient is a part of the special-needs population).
He said the population’s awareness for good oral hygiene has actually stayed about the same in his time here.
“Part of the issue, is the city’s water supply is not fluoridated,” Liu said. “Meanwhile, nearby cities are fluoridated, like Bellevue, Renton and Sammamish as well.”
Liu said fluoridation has been done in public water supplies since the 1940s and studies show benefits outweigh the risks.
“In cities that offer fluoridation, some excellent studies show that oral health improves 60 to 80 percent in the number of kids with cavities,” Liu said.
He attributes the opposition to fluoridation to a very vocal minority who point to what he deems an unproven fear of cancer risk.
Liu said he disagrees, however, with the study’s findings of the state’s use of new primary care dental providers, which he equates to the use of physicians assistants.
“The Pew study is biased toward the use of mid-level providers,” Liu said. “There have been no studies that show they dramatically improve access or cost of care.”
The problem with these mid-level providers, he said, is the slippery slope of shoveling off a portion of the population to a less trained dental care provider.
On the Web
For a look at The Pew Center on the States’ full report, “The Cost of Delay: State Dental Policies Fail One in Five Children,” go to www.pewcenteronthestates.org, click on “Children’s Dental Health” and follow the link to the report.
How well did Washington score?
Measured against the national benchmark for eight policy approaches
State National Meets or Exceeds
Share of high-risk schools with 25-49% 25% 4
sealant programs, 2009
Hygienists can place sealants Y Y 4
without dentist’s prior exam, 2009
Share of residents on fluoridated 62.9% 75%
community water supplies, 2006
Share of Medicaid-enrolled children 47.6% 38.1% 4
getting dental care, 2007
Share of dentists’ median retail fees 46% 60.5%
reimbursed by Medicaid, 2008
Pays medical providers for early Y Y 4
preventive dental health care, 2009
Authorizes new primary care dental N Y
Tracks data on children’s dental Y Y 4
Total Score: B — 5 of 8
Grading: A= 6-8 points, B= 5 points, C=4 points, D=3 points, F= 0-2 points
David Hayes: firstname.lastname@example.org, 392-6434, ext. 237. Comment at www.issaquahpress.com.