Providing Access to Dental Care
Sarat Thikkurissy, DDS, MS, directs the new walk-in dental clinic at Cincinnati Children’s. The clinic improves access to care for families who do not have a dental home in the community.
It’s been another busy day in the dental clinic at Cincinnati Children’s. In addition to the 78 patients scheduled for appointments, the clinic served 30 walk-in patients. The walk-in clinic, launched a year ago, is the Dentistry Department’s newest effort to meet the oral health needs of our community’s children, particularly low-income children.
Access to pediatric dental care for low-income families is a national issue, and “in Ohio, oral health care is the number one unmet child healthcare need,” says Stephen Wilson, DMD, MA, PhD, director of Dentistry at Cincinnati Children’s.
Many private practice dentists do not accept children who are insured through Medicaid, due to low reimbursement and administrative issues. Some procedures in children are not reimbursed at all. As a result of these reimbursement issues, many low-income children can’t find a dental home for routine, preventative care.
“In our own community,” Wilson says, “many underserved kids don’t have a place to go.”
Filling the Gap
The Dentistry Department is committed to filling the gap by treating as many of our community’s underserved children as possible, although Wilson acknowledges that the need is even greater than his large staff can meet.
The hospital’s nationally recognized dental program is staffed by six full-time and four part-time dentists and 10 dental residents, as well as six dental hygienists and 16 dental assistants.
This large team sees about 34,000 patient visits a year. Many of the patients have an underlying medical condition that can complicate their dental care needs. Nearly 80 percent are insured through Medicaid.
Start Young
The American Academy of Pediatric Dentistry recommends that children have their first dental visit when they get their first teeth, or by their first birthday.
Early and regular checkups, along with instruction for parents on how to brush their babies’ teeth to prevent tooth decay, and of course, daily oral hygiene care are the best ways to get the child’s oral health off to a good start.
Wilson has seen children as young as 8 months old who have cavities. Once a tooth gets a cavity, he explains, it can never repair itself. Left untreated, a small cavity will become bigger, and eventually may become painful.
A cavity that could have been prevented or detected early, when it was small, may progress until it becomes an emergency.
A toothache can keep a child from eating. It can wake a child from sleep, keep the child out of school, or bring the child to the Emergency Department. Dental decay can cause abscesses or infection that can spread. If the cavity progresses enough, the tooth might have to be removed, but removing baby teeth can lead to alignment problems later, when adult teeth come in.
Yet low-income families coping with other stresses may not seek out routine, scheduled preventive dental care, or may not be able to find a dentist.
Cincinnati Children’s commitment to dental care for all children, and the flexibility of Dentistry’s new walk-in clinic, are making a difference.
“Underserved kids have the most dental decay because they don’t get routine preventive care,” explains Wilson. As the safety net dental care provider, “our program plays a tremendously beneficial role in maintaining the oral health of these kids in our community.”
