Policy Priorities

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Health Coverage, Early Childhood Dental Care and Education

October 2009

Michele is a year old, and her mother is well aware of the importance of early dental examinations for children, so last week Michele had her first appointment. The dentist gave her a good report, and they scheduled the next visit. After completing the insurance paper work, Michele and her mom left with a new toothbrush and a pleasant memory.

Jacob is also a year old and lives with his mother, who works at a fast food restaurant and is studying to get a cosmetology license. During the day, Jacob stays with his grandmother while his mom is at work. He is on the waiting list for Early Head Start and will hopefully be in the program soon. His mother has also tried to enroll Jacob in Medicaid. However, as she struggles to juggle work and school, she hasn’t yet been able to find the time to take Jacob in for the required face-to-face enrollment procedure.

FACT: Health insurance is a strong predictor of access to dental care. Uninsured children are 2.5 times less likely than insured children to receive dental care. Children from families without dental insurance are three times more likely to have dental needs than children with either public or private insurance. For each child without health insurance, there are 2.6 children without dental insurance. (1)

October 2012

Michele and Jacob are now four. Michele attends preschool. Her mother has continued annual dental examinations. At Michele’s last check-up, the dentist filled two cavities and spoke with Michele’s mother about using better brushing habits. Michele’s mom is grateful that her husband’s employer has such a good dental insurance plan for the employees and their families.

Jacob, however, was not able to get into Early Head Start, and his mother’s income was just slightly too high for him to qualify for Head Start. He still stays at home with his grandmother while his mother works at a small hair salon, makes just above minimum wage, and has no medical or dental benefits. Jacob often complains of tooth aches. Unable to afford a dentist’s visit, his mother gives him baby aspirin and tells him to keep his mind off the pain.

FACT: Low-income children are nearly twice as likely to experience tooth decay at a young age than higher income children. (2)

October 2014

Two years later, Michele and Jacob are now kindergarten students at the same school. After the first quarter, Jacob’s teacher scheduled a conference with his mother to discuss Jacob’s progress. The teacher told his mom that she is concerned about Jacob’s short attention span in class and him missing school days because of bad head aches.

FACT: Dental caries (tooth decay) is the single most common chronic childhood disease—five times more common than asthma and seven times more common than hay fever. (3

FACT: Pain and suffering due to untreated dental diseases can lead to problems in eating, speaking and learning. (4) 

Following the conference Jacob’s mother had with his teacher, she took Jacob to a local medical clinic to ask about his head aches. As the doctor checks Jacob’s throat for signs of infection, the problem is quickly identified: a mouthful of decaying teeth and infection of the gums. By the looks of Jacob’s teeth, the doctor believes this problem has gone on for at least three years. The doctor gives Jacob some antibiotics, and tells his mother to contact a dentist as soon as possible. Barely able to afford the clinic visit and the medicine prescribed, Jacob’s mom is repeatedly turned down by dentist offices she contacts to set up a visit for Jacob.

Michele, meanwhile, is making great strides in kindergarten. Her first reporting period shows she is on track with her studies and has perfect attendance. However, Michele’s mother has scheduled a conference to tell the kindergarten teacher that Michele’s father has lost his job, and that the couple has been having difficulties with their marriage.

FACT: 12 million children in the United States lack insurance coverage for dental care. These children are substantially more likely to lack regular dental care, to have unmet dental health needs, and to have cost barriers to care. (5)

October 2017

Jacob and Michele have now reached third grade, and are each having problems with reading and math. Both have also missed a significant amount of school due to head and tooth aches. Michele’s parents are now divorced; her father has a new job out-of-state, and her mother works full time as a receptionist at a small real estate company. The child support payments owed by her father are not paid regularly, and her parents’ communications are often confrontational. At the last check-up, the dentist found two cavities Michele needs to have filled, and two more teeth which need to be capped. Unfortunately, Michele’s mom can no longer afford dental insurance, nor can she afford to pay for the services Michele needs out-of-pocket.

FACT: If untreated, oral diseases in children can lead to serious general health problems and significant pain, interference with eating, overuse of emergency rooms, and lost school times. (6) In fact, children miss more than 51 million hours of school each year due to dental-related illness. (7)

The stories of Michele and Jacob are not unique. In an instant the financial security once enjoyed by a family can evaporate. For others, that security will never exist.

Should our children be missing school because of tooth aches and gum disease?

Should our children be dropping out of school after falling behind because of easily preventable health problems?

Not in our country!

1 U.S. Department of Health and Human Services.  National Call to Action to Promote Oral Health.  Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Dental and Craniofacial Research.  NIH Publication No. 03-5303, Spring 2003

2 Eugenio D. Beltrán-Aguilar, DMD et al. “Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism, and Enamel Fluorosis—United States, 1988-1994 and 1999-2002.” Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention. August 26, 2005. 54(03);1-44. Accessed October 1, 2009.

3 U.S. Department of Health and Human Services.  National Call to Action to Promote Oral Health.  Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Dental and Craniofacial Research.  NIH Publication No. 03-5303, Spring 2003.

4 ibid.

5For 12 Million Uninsured Children, High Barriers to Dental Care.” C.S. Mott Children’s Hospital National Poll on Children’s Health. Vol. 5 Issue 5; February 9, 2009.  University of Michigan Child Health Evaluation and Research Unit. Accessed October 1, 2009.

6 ibid.

7 U.S. Department of Health and Human Services.  National Call to Action to Promote Oral Health.  Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Dental and Craniofacial Research.  NIH Publication No. 03-5303, Spring 2003.