Guest: Don’t wait for dental care to become a crisis
As valuable as the Seattle Center event was, people should not have to go to a crisis care clinic to get the dental services they need, writes guest columnist Marilynn Rothen.
Special to The Times
THE young man from Tacoma was all smiles after a volunteer dentist at the Remote Area Medical (RAM) clinic at Seattle Center in October fixed his badly broken front tooth.
“Getting that done has already changed my life,” he told me as he sat down to have his teeth cleaned at the hygienists’ station, which I was helping to staff.
He still needed more restorative work, but many people who had been waiting three or four hours had yet to be seen at all. I asked him to come back the next day.
Unfortunately, getting from Tacoma to Seattle two days in a row would be hard for him to manage. He probably went without the care he needed.
I wondered how he and other patients we saw during the recent RAM clinic would ultimately make out.
One-time-only health clinics like this one — which saw close to 2,000 people in need of dental care in just four days — are wonderful efforts, and they make a terrific contribution to the community.
They are not, however, a substitute for routine dental care.
Across the state, our oral health-care system is failing too many low-income working families, elderly people in nursing homes, people with special needs and people who live in rural and tribal communities.
True, adult dental coverage has been restored to our state Medicaid program, and that’s a big plus. That coverage has been extended to hundreds of thousands more low-income Washingtonians this year through the Affordable Care Act. But most dentists don’t accept Medicaid: only one in 10 for adults, and one in five for kids. And 34 of our state’s 39 counties don’t have enough dentists to serve everyone.
As a result, many people wind up seeking help for dental problems in hospital emergency rooms — or at crisis-care events.
For the RAM clinic, people lined up overnight to get care. On Saturday night, we had a terrible wind storm. Many people lost their power, and the roads were littered with all kinds of debris. But Sunday morning, there was no shortage of patients. They came despite the weather. Not everyone got in.
This isn’t right. People shouldn’t have to camp overnight and brave bad weather to get dental care. They should be able to get quality, affordable dental care any day of the year, in their own communities.
Our goal should be to create dental homes where people can get preventive services, regular checkups and routine care. That’s the way to prevent oral disease from developing and impacting overall health. Poor oral health has been linked to heart disease, clogged arteries, stroke and other serious health problems, including death.
Currently, our dental-team model in Washington isn’t set up to do this. It is not flexible enough, and it needs to be strengthened.
We can fix this by adding a new kind of midlevel provider — sometimes called a dental therapist — to the dental-care team and creating an education track for dental hygienists like me to acquire more skills. These new midlevel providers would work as part of a dentist-led team, serving communities that dentists aren’t reaching to provide essential preventive and routine dental care, including fillings and uncomplicated extractions.
Dental therapists do not do everything a dentist does. But by focusing on a very narrow scope of services, they would free dentists to perform the more complex procedures that only a dentist can perform.
In Alaska, dental therapists have expanded access to more than 40,000 people since they started practicing 10 years ago. They are starting to make a difference in Minnesota, and Maine recently authorized dental therapists as well.
I was proud to be a part of the RAM event. It should be a call to action to policymakers to take leadership to address the oral-health crisis. Together, we can provide innovative care for tens of thousands of Washington families — before they have to fall back on crisis care.
Marilynn Rothen is president of the Washington State Dental Hygienists’ Association, which is a member of the Washington Dental Access Campaign.