VIEWPOINT: Preventing childhood dental disease saves taxpayer money

DR. LISA BLOCK AND CLINT SANER

With budgets declining, local policy makers have a difficult task ahead. As they evaluate how to save money, the cost-effectiveness of disease prevention needs to be part of the discussion.

It makes sense to help people stay healthy rather than spending money to treat illnesses that could have been prevented. Unfortunately, when budgets are stretched thin, preventive services are often among the first to be cut.

Dental disease offers a good example of the financial benefits of prevention. Dental disease can be intensely painful, costly and lead to other serious health problems. They are the No. 1 reason uninsured patients visit hospital emergency rooms for a health issue not generally classified as an emergency. This places a burden on already overcrowded emergency rooms and is expensive for families. Hospitals, taxpayers and consumers often have to cover the costs for the uninsured.

In 2008, the Medicaid program spent more than $47 million dollars in Washington to treat children’s dental disease. Much of this expense could be avoided through increased prevention.

Although almost totally preventable, children’s dental disease is a significant health problem in Pierce County. According to the most recent survey, more than half of second- and third-graders in Pierce County have a history of decay, and the severity of decay is worse here than in the rest of the state.

Among low-income preschoolers, almost 40 percent suffered from severe early decay in their upper front teeth. This is about double the rate reported for the rest of the state.

These disease rates are not acceptable. Children in our community are suffering needlessly. Many may experience delayed speech development, can’t sleep, have difficulty paying attention in school and are at risk of further health problems. Some even end up in the operating room because the disease has reached such an advanced stage.

Fortunately, Pierce County has a program that is improving children’s oral health. The Access to Baby and Child Dentistry (ABCD) program began in 2005 and has increased the number of young children from low-income families who are receiving early dental care.

This early intervention results in a lifetime of better oral health for children and reduces future treatment costs. ABCD has received national recognition for innovation and success in addressing the children’s oral health crisis. It is a cost-effective approach for ensuring that dental disease prevention is available to Medicaid-eligible children from birth to age 6.

The challenge is to keep ABCD viable during difficult economic times. Any cutback in local funding will put this program at risk.

ABCD is a true private/public partnership. The program was established with the help of private foundation money (a three-year startup grant from nonprofit Washington Dental Service Foundation) and matched with federal Medicaid funds.

Today, ABCD is able to leverage contributions from local funders with state and Medicaid dollars. The program uses private dentists in our county to provide dental care to children from low-income families. The Tacoma/Pierce County Health Department also plays an important role in the success of this program. They are responsible for identifying eligible children and linking them to ABCD-certified dentists.

ABCD is an innovative approach to preventing children’s dental disease that other states are doing their best to duplicate. It is a program clearly worth maintaining.

Currently an Advisory Group is working locally to give ABCD a solid foundation for the future. The partnership includes United Way of Pierce County, the Tacoma-Pierce County Health Department, Pierce County Dental Society, the business community and Washington Dental Service Foundation.

There is a strong local commitment to ABCD because preventing children’s dental disease — and the associated pain and expense – makes sense. Given the scarcity of health care dollars, dental disease prevention is a wise investment for our community. We all benefit when children are healthy.

As the saying goes, “you pay now or you pay later.” We have a responsibility and a financial incentive to provide dental care before a child’s overall health is impaired. Protecting the oral health of our youngest residents will yield both health and financial dividends.

Dr. Lisa Block is a pediatric dentist with Harbor Kids’ Teeth in Gig Harbor, an instructor with the University of Washington School of Dentistry and a Pierce County ABCD Dental Champion. Clint Saner is a wealth advisor with Bank of Tacoma and chairman of the Pierce County ABCD Advisory Board.

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