Too few Illinois kids on Medicaid getting needed dental care

Too few Illinois kids on Medicaid getting needed dental care
Dr. Francis Tham takes care of a young patient
at Chicago Family Health Center. Tham says
not enough poor children have access to
quality dental care.

A kid who doesn't go to the dentist can wind up with something much worse than a toothache--poorer overall health, missed school days, expensive emergency room care and even sparse job prospects as an adult.

In Illinois, that's a majority of kids on Medicaid, according to a new report in the July issue of Pediatrics.

The study says that only one third of kids on Medicaid in our state have had a dental visit. The numbers are even lower for young children and adolescents. Among school age children, over half had at least one dental visit, but only 5 percent of kids under three, and one-quarter of those aged 15 to 18, had seen a dentist.

How does Illinois fare compared to other states? About average, although no state in the study had even 50 percent of children on Medicaid with at least one visit to the dentists' chair.

Why are numbers so low? I asked Dr. Francis Tham, dental director at Chicago Family Health Center, one of the few places in Chicago that children on Medicaid can see a dentist.

"I think access is a problem. There are just not enough dentists accepting Medicaid patients. The reimbursement rate is very low. The number of dentists enrolling is not very high," said Tham.

According to the Pew Center on States, Illinois reimbursed dental services at a rate of 48.4% of the retail rate, meaning that if a dentist would normally charge $100 for a procedure like a filling or a cleaning, they'd get around $48 dollars for the same procedure for a patient on Medicaid.

Tham says the lack of providers means patients not only have trouble finding a dentist that will accept Medicaid, but if they do, it's not likely to be close by.

"A lot of people don't have access to their own transportation and rely on public transportation. That's a barrier as well," said Tham. "We do our best to reach people by partnering with head start programs and schools."

Tham noted that only 5 percent of children three years of age or younger on Medicaid have had a dental visit, a number he said is troubling. Many parents believe that children don't need to see a dentist before three, but that's not true.

"We want to see them beginning at six months until the age of 20," said Tham. "It's really for us to educate parents as well. Oral health is a lifetime habit."

Chicago Family Health Center has started a new program at their dental clinics, dedicating one dentist at each location for walk-in patients. Any child who sees a pediatrician through CFHC can see this dentist without having to make an appointment. Tham said the new system has helped a lot of kids see a dentist who may not have in the past.

Tham said there's also false perception that dental care is an "extra," not a necessity for good health. He pointed to the recent bill passed by the General Assembly that cut dental services for low-income adults, a move he says the state will likely regret.

"Instead of going to the dentist to have their mouth checked, we are forcing these patients to reach a point where it hurts them so bad in the middle of the night that they can't take it anymore, and they'll simply walk into emergency rooms to seek care," said Tham.

He sees adult patients who have serious dental problems because they haven't had consistent dental care throughout their lives. That's a habit that begins in childhood, he says.

"We really want to cultivate good oral health while they're young," says Tham.  "We want to help them realize that their teeth can last the lifetime. That's our job."

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