Plans for adding dental services at the Rum River Health Services (RRHS) community health clinic in Princeton may help fight the kind of problem that the Minnesota Department of Health (MDH) recently cited on tooth decay.
The MDH reported last week that tooth decay is one of the state’s most common chronic childhood diseases, with 55 percent of third graders surveyed in 2010, experiencing dental decay.
The report also stated that low-income children bear the greatest burden of oral diseases in Minnesota. Also, children qualifying for free or reduced school lunch were nearly one and a half times more likely to have tooth decay and almost three times more likely to have the decay untreated than their more affluent peers.
The report then stated what wouldn’t be news to dentists, including Princeton dentist Phil Lingle. That is that inadequate dental care has long-term health and cost consequences. “Most telling,” the MDH report states, is the $148 million in emergency department charges in Minnesota between 2007 and ‘10, for preventable, non traumatic conditions that could have been treated by a dental provider in a more appropriate setting.
The $148 million figure points to possible barriers to routine oral health care such as a lack of affordable dental insurance and clear information regarding public programs and dental benefits, the MDH says. Added to the problem is the undervaluing of the importance of dental health to overall health, the MDH says.
“It is simply unacceptable to have so many of our children and adults negatively affected by these preventable dental conditions,” Minnesota health commissioner Dr. Ed Ehlinger said. “We have to do a better job of investing in public health and access to routine dental care. If we do this, we can significantly reduce oral disease and health care costs in Minnesota.”
“A healthy mouth is fundamental to overall health, our ability to secure a job, and even our sense of self-worth,” adds Merry Jo Thoele, dental director for the Minnesota Oral Health Program established in 2008.
Minnesota’s oral health plan calls for a range of solutions. That includes the providing of dental sealants, increasing water fluoridation, enhancing the dental work force, increasing use of public insurance programs, implementing a statewide dental health tracking system and improving the integration of medical and dental care.”
The planned RRHS
Dr. Lingle has been volunteering his services in helping RRHS set up a dental office with two rooms at the RRHS community health clinic located along First Street. RRHS is planning to open the dental service this fall. It will offer the services to anyone, but will focus on the uninsured and underinsured.
Cindi Naumann, Director of Community Health at RRHS, and Lingle talked last week about the many donations of dental equipment RRHS has received so far. Caring Hands Dental in Alexandria, for example, which provides dental services to lower-income and medical assistance customers, has donated dental equipment to RRHS. So has a similar organization, Northern Access Dental in Bemidji, and so has Patterson Dental in the metro area. Naumann also mentioned a $15,000 grant from Delta Dental to help start the dental clinic.
What is already there
Children’s Dental Services (CDS) has already been providing mobile dental service for persons age birth-21 every second Monday of the month, since last August, at the RRHS health clinic. CDS Executive Director Sarah Wovcha says that payment is according to a sliding fee scale and that some of the patients have no insurance. About 80 percent of the dental patients who have no dental insurance qualify for the subsidized care, Wovcha said. CDS accepts all forms of insurance and medical assistance reimbursement, she notes.
CDS has been seeing an average of 10 patients each time it sets up its mobile dental clinic inside the RRHS community health clinic, according to Wovcha. So far, the CDS treatment there has been preventative care, including teeth cleaning, sealing, fluoride varnish, X-rays and patient education.
“We will be doing treatment starting probably in April,” Wovcha added. That would include fillings, extractions, root canals and crowns.
Naumann says she thinks CDS has seen many children in Princeton for dental work because families with only medical assistance (MA) have to travel quite far otherwise to find affordable dental care. Some dentists won’t take patients who only have MA, Naumann said.
Dr. Lingle comments
Dr. Lingle said the services that the RRHS dental clinic will provide include fillings and extractions. Lingle didn’t think there would be dentures and crown work.
While offers of donated dentistry equipment are greatly appreciated, RRHS isn’t able to take just anything, Lingle points out. A high number of dental offices are switching from film X-ray to digital X-ray and so they have film X-ray equipment to give, he said. But the film process means having photo chemicals sitting around unused for days. That doesn’t work very well for a dental office that would be open only one time per week, as would be the case for the RRHS dental clinic, Lingle said. Chemicals have an expiration time and when they sit in equipment it means more cleaning and care, he noted.
Lingle said that RRHS has even been offered a donation of a panorama X-ray machine but it is so large it wouldn’t fit inside the spaces that RRHS has for its dental rooms. Lingle was happy that it was able to get a donated air compressor made for dental offices. It also received containers of dental instruments that a retiring dentist in Rochester donated.
Lingle is coordinating the setup of the RRHS dental offices and so far is the only dentist volunteering for the program. Like his counterpart, medical doctor Peter Jensen, who has recruited other local doctors to volunteer at the RRHS medical clinic, Lingle is hoping to get some additional dentists to volunteer at RRHS.
Lingle also commented on the state of dental programs in Minnesota. He is critical of how federal subsidy money for dental care that is distributed through the state to counties, ends up in varying reimbursement rates throughout the state. Different counties use different insurance companies so the government reimbursement to dentists varies and that shouldn’t be, Lingle said.
Lingle was also critical of the state spending more on emergency dental care than preventative dental care. When someone goes to the emergency room for help with a critical tooth issue, the result is “palliative” care, meaning just something to deal with the pain, Lingle said.
Preventive care can save so much money because of reducing the need for emergency care and reducing the incidence of cavities, Lingle said.
Lingle, commenting on the MDH report cited earlier that 55 percent of third graders surveyed in 2010 were found to have tooth decay, said that is an average figure. The actual incidence of tooth decay among third graders in Princeton is probably more like 10 percent because of the high amount of preventive dental care and education here, Lingle said.
“People who are not using preventive care, get the cavities, the higher rate of decay,” he explained.
When the RRHS dental clinic opens to service dental patients on the lower end of the economic scale, it can help fill in the gap that the state leaves open, Lingle said.