Commentary: Better access to oral health needed for all

By Sue Yoon and Rachel Greene

Middle school was when Anna, a patient, said she first became aware that others noticed her poor oral health. But it wasn’t the last time she said that she felt deeply ashamed about the condition of her teeth, or experienced the agony and pain of untreated cavities and gum disease.

The unfortunate reality is that tens of thousands of children and adults like Anna suffer needlessly from untreated dental disease in our state. Oral health, despite the essential role it plays in maintaining general wellness, has received almost no attention in the national health care debate.

As we look ahead to 2018, let it be the year where we strive to ensure that everyone, especially people living in underserved communities, enjoy the benefits of good oral health.

We are fortunate that many Washington state policy makers, social service agencies, health care organizations and advocates recognize that oral health is part of whole-person care. Their support has helped to make Washington a national leader in providing preventive dental care for low-income children through the Access to Baby and Child Dentistry program.

Yet, almost 50 percent of lower-income children still do not get dental care. While community health centers have expanded in recent years, far too many — 1.3 million of our lower-income neighbors in Washington — still don’t see a dentist. Too many experience the devastating effects of untreated oral disease.

Thankfully, in Washington state we have allies like Arcora Foundation, the philanthropic arm of nonprofit Delta Dental of Washington, to champion oral health. Through funding to Community Health Centers, strategic partnerships, advocacy, education and championing innovative programs, Arcora Foundation aims to prevent oral disease and increase access to care for our most vulnerable populations.

But there’s more work to do.

Neither state policy nor our health care system have caught up to the growing body of medical evidence that confirms what many of us already know — oral health is a major part of our overall health. Infections in the mouth are linked to serious health problems, including heart disease, diabetes and pregnancy complications, stroke, and in extreme cases, life-threatening complications.

Poor oral health also has broader consequences. Untreated decay can impact school attendance, nutrition, employment opportunities, self-esteem and general well-being. Imagine trying to focus in school if you have a throbbing toothache or trying to get a job if you are missing teeth. People who have experienced a painful cavity or abscess understand firsthand the relief a visit to a dentist can bring.

Equally troubling is that it’s often the poorer, at-risk populations that experience the most barriers, and the consequences, to limited dental care access. Children, adults and seniors living in underserved communities and remote rural areas face the greatest challenges. Poor oral health has become a visible sign of economic status, creating a vicious cycle of pain and poverty.

The good news is that oral disease is almost entirely preventable if people have access to care and practice healthy behaviors including brushing, flossing and smart snacking.

Arcora Foundation is working to end oral health disparities because they recognize that good oral health provides much more than a pleasant smile. According to a recent ADA study, 26 percent of low-income Washington adults say the appearance of their teeth affects employment opportunities. Some 58 percent of low-income adults in our state say they experience dental pain. And in 2016, only 23 percent of adults with Washington Apple Health (Medicaid) coverage saw a dentist, leaving the vast majority without care.

As providers, we are encouraged to see that more people are understanding the important role oral health plays in overall well-being. Collaboration among medical providers and oral health care providers also is happening, and smart investments in preventive care show promise. But, we can do better.

Ending the oral health disparity is not only necessary, it is possible. Please join us and Arcora Foundation in efforts to prevent oral disease. Let’s make the expansion of dental care access for all a New Year’s resolution.

Dr. Rachel Greene is regional clinical drector and clinical instructor at the University of Washington School of Dentistry. She practices dentistry in Snohomish. Dr. Sue Yoon is the director of Dental Services for Community Health Center of Snohomish County. She has committed the last eight years to increasing access to dental care for underserved populations and improving the county’s oral health status.