Texas Children Lacking Adequate Dental Care

Texas ranks last in the nation in the percentage of children who are uninsured, so it should come as no surprise that Texas children can hardly expect to get decent dental care either when their parents can't afford to pay for it:

The lack of access to dental care is contributing to the chasm between poor children and their wealthier counterparts. While most children nationwide now have access to fluoride, sealants and other advances that protect their teeth, the poorest children still lack access, according to the U.S. Centers for Disease Control and Prevention. Poor kids nationwide represent 25 percent of all children and experience 80 percent of the decay, according to the Children's Dental Health Project, a nonprofit advocacy organization in Washington, D.C.

According to the United Way of Metropolitan Dallas, nearly 152,000 medically uninsured children live in Dallas County. A report on oral health issued by the U.S. surgeon general estimates that for every medically uninsured child, 2.6 lack dental coverage. That means there could be more than 395,000 dentally uninsured children in Dallas County.

What's the natural result of this lack of affordable dental care? Here are some stories:

At stake are young lives that can be permanently altered by dental disease. It could be easily prevented, experts say. But in Dallas recently:

• A toddler with a mouthful of cavities went untreated because a community clinic was not equipped to sedate her and her mother couldn't afford to take her elsewhere.

• A 9-year-old with nine cavities planned nine visits to a low-cost clinic, because even there her parents could afford to treat only one tooth at a time.

• An 8-year-old, who lost Medicaid coverage when his mother began work, returned to the dentist when he complained of pain and needed five fillings and three teeth removed.

How has this come about?

Even families that qualify for Medicaid and are guaranteed dental benefits for their children have a hard time finding care. According to the Texas Health and Human Services Commission, 2.26 million Texas children are on Medicaid, and about half, 1.16 million, received dental care in 2005.

Part of the problem is that not many pediatric dentists accept Medicaid patients. Many that do limit them to a small percentage of their practice. Dentists cite cumbersome paperwork and low reimbursement rates.

The state legislation restored [CHIP] benefit[s] and others last spring. But negotiations with a dental provider have dragged on, and state officials now say children won't receive CHIP dental care until at least April 1.

So Texas not only leads the nation in uninsured children, it also leads the nation in children with holes in their teeth whose parents have few or no means to get them fixed.

Reading the article, it's clear that part of the problem is parents who don't know the first thing about how to preserve their children's teeth, or are negligent in doing so. Certainly part of this can be traced to parents who have too few visits with a doctor before their child's birth, and too few visits with the pediatrician after, as there are simple steps to remedy many of these problems. But despite the best intentions and efforts by parents kids can still get cavities, and an untreated cavity can be nearly as bad as an untreated chronic illness for a child's development. Of course this is all a symptom of our unwillingness as Texans to pay for adequate medical and dental care, for which we have no one to blame but ourselves.