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Intersection - Missouri Health Talks on the Current Status of Missouri Oral Health

Dr. John Dane, left, wears a light blue polo and glasses. Gary Harbison, right, wears a dark blue button up and glasses.
Rebecca Smith

This week on Intersection we bring you a special on oral health from Missouri Health Talks. KBIA’s Rebecca Smith spoke with Dr. John Dane, the State Dental Director, and Gary Harbison, the Executive Director for the Missouri Coalition for Oral Health.

They followed up on their conversation with Smith in August 2017. They spoke about the current status of oral health care in Missouri, advances that have been made in oral health policy and struggles Missourians still face when it comes to accessing quality, affordable dental care.

Missouri Health Talks gathers Missourians’ stories of access to healthcare in their own words. You can view more conversations at www.missourihealthtalks.org/

On the Current State of Missouri's Oral Health

Gary Harbison: But we still have lots of access issues. We really don't have enough capacity for services, particularly in rural areas, and we have a lot of uninsured people that still find it difficult to afford [dental care].

Oral health is integral to overall health, and if you let it go, you're going to have a chance, over time, of also having your physical health deteriorate. So, we still have lots and lots of challenges, but we've made progress.

Dr. John Dane: Disparities in oral health still exists across Missouri. If you're a minority child, if you're living in a rural community, if you're lower income, you have difficulty accessing dental care, and your decay experience and untreated tooth decay is higher than the rest of the population in Missouri.

On the Status of Childhood Sealants

Dr. John Dane: Delta Dental of Missouri funded a three-year project with us. We just finished up our final report because it ended the first of August. Just in summary, we did about 32,000 dental sealants over the period of the three years. 14,000 plus kids were seen and got dental sealants, and based on what Delta Dental pays for a single surface restoration, we saved them approximately $3.5 million.

Gary Harbison: And so that means less issues with cavities in the future for that kid. More likely to hit maintain dental health in adulthood, and also, you know, for the child, they're not going to run into that pain that goes with having cavities.

On the Reintroduction of Adult Dental Medicaid Benefits

Gary Harbison: So, we aren’t relying on people going to emergency rooms. We've actually seen those numbers go down. That's fantastic.

That means a lot of people who had no alternative but wait until they were in pain and go to the ER to get painkillers – opioids and the whole addiction issues that goes with that, and antibiotics – are now going to much less expensive, regular dental care and getting resolution of those issues.

Dr. John Dane: We have worked with the folks at MO HealthNet to look at the Medicaid claims data for ER usage, and we use the diagnoses for "non-traumatic dental appointments," and it's a –

Rebecca Smith: Which means no broken teeth? No...

Dr. John Dane: No bleeding. No fractured jaws. It's just - there's a multiple, about 60 different codes, that could be and we searched all of them. What we can show you is that in January of 2015, that level, versus January of 2019., the Medicaid claims data shows a 47 percent drop.

On Emerging Oral Health Trends: Teledentistry

Gary Harbison: So, the hygenist that goes out at a remote location and collects all that information. The dentist can look at that later and determine if we need to set up a treatment plan for certain dental conditions.

The great thing about that is, we don't have enough dentist in the rural areas in particular, but even in the urban areas, we have specialized areas like nursing homes that are not getting enough access.

So, you could send a hygienist into these places. You could even work with a community, which we hope to be doing, to figure out what would be the best place that would really work for us here? That we could have hygienists come in and set these services up? 

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.
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