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Originally published Monday, May 6, 2013 at 4:05 PM

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Guest: State should provide basic dental care for low-income adults

Fully funding dental care for low-income adults would save money, improve health and help people become more employable, according to guest columnists Fred Kiga and Mark Secord.

Special to The Times

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THE budgets proposed by the governor and both houses of the state Legislature acknowledge the importance of oral health by including funding to restore dental coverage for low-income adults.

One of the key goals was to reduce emergency-room visits due to dental issues. However, that cannot be accomplished by funding only cleanings and dentures, as proposed by the state Senate. Filling cavities and root canals, essential to stopping dental disease, also must be covered.

The Legislature should adopt the House budget and fully fund dental coverage for low-income adults. This is a smart investment that will save money, improve health and help people become more employable.

Early dental care, such as fixing cavities, can prevent minor problems from turning into serious health issues that are more expensive to treat. Without this crucial early care, people with dental pain will have few options other than getting their teeth pulled. They will still turn to ERs for pain relief, driving up health-care costs for everyone.

About 450,000 Medicaid-eligible adults lost dental coverage due to state budget cuts in 2011. By restoring coverage this session, the state can take advantage of an opportunity to have the federal government pay the full cost of dental care for all new enrollees through Medicaid expansion. This means that a state investment of $24 million in the 2013-2015 budget will provide dental coverage to more than 700,000 people.

Restoring coverage can also save the state’s Medicaid program millions of dollars in health-care costs. That’s because poor oral health is linked to many serious and costly health issues including heart disease, stroke and diabetes. When people with diabetes get dental care, they are hospitalized much less frequently, according to a 2012 study by United Concordia that looked at medical and dental claims from 1.7 million people. This contributes to savings of more than $3,200 per person per year.

Providing dental care could add up to huge savings for Washington, even if only 25 percent of Medicaid patients with diabetes receive dental care and treatment results in only half of the projected cost savings. Conservatively, the state could save $24 million over the biennium.

The state could save more because of fewer emergency-room visits. Today, dental pain is the No. 1 reason uninsured people seek ER care. But ER care is expensive, and costs for the uninsured are passed on to everyone else in the form of higher health-care costs. Plus, ERs usually just deal with pain and infection, instead of the underlying problem, so people frequently return several times. Over an 18-month period, 54,000 dental-related visits to ERs in Washington cost more than $36 million.

People who have been without dental coverage for more than two years are suffering. Low-income adults in the state have told us how the pain of dental disease keeps them from eating and sleeping. Some say they have pulled their own teeth out because the pain was unbearable.

It’s also hard to find work. Employers are often reluctant to hire those who have obvious and unsightly dental problems. Productivity suffers if an employee is in pain or missing work because of an agonizing toothache.

Local community health clinics are helping meet some of the need by providing emergency dental care for low-income adults who have no dental insurance and nowhere else to turn. But emergency care basically means extracting teeth.

People need to be healthy to get jobs and be self-reliant — and when they are in good health, medical costs go down.

Good health must include oral health. For the savings it will generate and all the other good it will achieve, legislators need to adopt the House funding proposal to fully reinstate adult dental coverage. It is a smart investment and the right thing to do.

Fred Kiga, left, is senior vice president of government affairs for Vigor Industrial and a board member of Washington Dental Service Foundation. Mark Secord is executive director and CEO of Neighborcare Health.


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