The hole in health care

Greg Mann

The next time you read news reports about rising health-care costs, consider this: Some 39,000 Coloradans sought treatment last year at hospital emergency rooms for toothaches and other dental problems.

Such unnecessary and expensive emergency-room care affects all of us by contributing to health-care costs. An estimated $2 million to $5 million could be saved each year in Colorado by preventing needless emergency room visits through timely dental care.

Most hospital emergency rooms simply aren’t equipped or staffed to provide the ideal treatment for dental problems. Typically, the emergency room can offer a pain reliever and an antibiotic, and refer patients to a dentist – which is where they should have gone long before their problems escalated to the level of visiting an emergency room.

Many of those unnecessary visits are by people who are struggling to make ends meet. That is why the Colorado Dental Association is encouraged by Gov. John Hickenlooper’s proposal to include, for the first time, a dental benefit for adults who qualify for the Medicaid program for low-income Coloradans. Such a development is critical to Medicaid cost savings, as well as taming health-care costs in general.

Neglecting oral health amounts to much more than just an inconvenience; neglect affects overall health. Gum disease, for example, has been linked to many other health conditions, including strokes, stomach ulcers, lung disease, pneumonia, low birth-weight babies, increased pre-term births, heart attacks, diabetes, hypertension and heart disease. The cumulative impacts of these conditions can have wide-ranging ripple effects throughout society.

As just one measure, 7.8 million school hours are lost each year in Colorado because of dental pain and infection. National studies have shown that adults lose more than 164 million hours of work each year because of oral-health problems; plus a national study of Medicaid families found that when parents don’t visit the dentist at least once a year, their children are 13 times less likely to visit a dentist.

Clearly, too many Coloradans are not going to the dentist regularly, or at all, and in most cases, economic barriers are at fault. These challenges in accessing dental care afflict our state’s rural areas and our cities. It is a complex problem with no easy solution.

However, there are policy steps that could help us make significant strides toward bridging the gap in dental care. Expanding dental benefit options for the most vulnerable Coloradans would go a long way toward stemming the costly neglect of oral health. This is where the governor’s initiative comes in.

Because oral health is directly linked to overall health, poor oral health inevitably increases other health-care costs for the Medicaid population, taxing scarce state and federal resources. A dental benefit is especially important for high-risk populations such as pregnant women, those with developmental disabilities and the elderly, for whom oral health complications can result in very high medical costs.

The governor’s broader plan for expanding Medicaid coverage still faces a long road ahead in the Legislature, and the Medicaid program has a number of shortcomings that must be addressed. As dentists and physicians alike can attest, there are long-standing problems with the program’s inadequate funding levels that put patients and health-care providers at a disadvantage.

The call to expand dental eligibility under Medicaid is long overdue. Amid competing budget priorities, it is one investment that promises substantial savings for a sector of our state budget that urgently needs to contain costs. It is an ounce of prevention that can result in a ton of cure – not only for some of Colorado’s most vulnerable residents, but also for all Coloradans who are financially affected by rising health-care costs.

Greg Mann is a dentist practicing in Durango. Reach him at durangodentistry@ident.com. Quinn Dufurrena also contributed to this piece. He is executive director of the Colorado Dental Association.

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