EDITORIAL: Wider access to dental care would save taxpayers money

Jan. 10--Providing basic dental care for our neediest citizens has long been a largely unaddressed challenge in health care, both nationally and here in Massachusetts.

That is a shame, as providing affordable access to basic services such as cleanings, tooth extractions and fillings does more than meet an immediate medical need. Several studies have shown the care also reduces the likelihood of more serious health problems in the future. And it saves the state -- and its taxpayers -- money.

So count us among those in support of a plan being pushed on Beacon Hill to license a new class of dental professionals. The so-called "dental hygiene practitioners" would receive extra training and be allowed to provide care outside dentists' offices -- think community medical clinics, nursing homes or schools.

There is a great need for such services, even in a state that is home to world-class medical and dental care.

"We've made a lot of progress to expand health care coverage, but we still have huge unmet dental needs as a state," Myron Allukian Jr., president of the Massachusetts Coalition for Oral Health, told Statehouse reporter Christian Wade. "People are falling through the cracks."

He's right. Almost half of Massachusetts adults with special needs had untreated tooth decay in 2010, according to the Massachusetts Health Council. For seniors in long-term care facilities, the number rose to 59 percent.

Our youngest residents are also at risk. according to the U.S. Department of Health and Human Services. In 2014, nearly half of MassHealth patients ages 1 to 21 did not see a dentist. That's more than 290,000 people.

Many times, undertreated patients can't find a dentist who takes public insurance, or they can't get time off from work or find transportation to get to a dentist's office.

The lack of treatment can lead to more serious problems.

"This isn't just about clean teeth," said Brian Rosman of the nonprofit Health Care for All. "We know there's a direct connection between oral health and good health. Things like diabetes, heart disease and low-weight babies have all been attributed to poor health."

The lack of treatments ends up costing taxpayers in the long run. Uninsured or underinsured residents with untreated dental problems wind up at the hospital. MassHealth, the state's Medicaid program, paid more than $11.6 million for emergency room dental care for adults between 2008 and 2011.

The Massachusetts Dental Society, which represents more than 5,000 Bay State dentists, opposes the new proposal, but it won't indicate why. In speaking out against similar legislative efforts, the society said it was worried the dental hygiene practitioners would receive only minimal training.

That certainly doesn't have to be the case, and we would urge the dentist group to work with the Legislature and hygienists to craft regulations that ensure quality care. As Allukian, the former dental care director for the city of Boston, noted, "You don't have to be in dental school for eight years to do a simple filling."

It is also worth remembering how few dentists -- fewer than 1 in 5 statewide -- accept patients with Medicaid. There is a reason low-income residents are turning to the emergency room for last-ditch treatment.

Providing effective, less expensive mid-level dental treatment makes sense at the health care level. It also makes sense from a monetary standpoint. The approach has the support of fiscal conservatives like newly re-elected Senate Minority Leader Bruce Tarr of Gloucester.

These are the kinds of smart, compassionate, cost-saving solutions we expected when we elected Charlie Baker, a former health care executive, as governor. Here's hoping Baker and the Legislature get behind the proposal in 2017.

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