The Senate Health, Education, Labor, and Pensions Committee held a June 25 hearing to examine children’s dental health. The hearing was chaired by Sen. Jeff Bingaman (D-NM), who opened the hearing, saying that Congress needed to find “ways to improve access to and delivery of dental health services to our nation’s children.” Citing a U.S. Surgeon General’s report on oral health, Sen. Bingaman called it “a silent epidemic,” adding that “prevention programs in oral health have the potential of virtually eliminating dental caries in all children.…Unfortunately, children do not have access to care.”
Sen. Jeff Sessions (R-AL) agreed saying, “It really is inexcusable that so many children suffer…We must do better.”
The committee heard testimony from former U.S. Surgeon General David Satcher, a senior visiting fellow with the Kaiser Family Foundation, who detailed the findings of the May 2000 report, “Oral Health in America: A Report of the Surgeon General.”
Dr. Satcher pointed to tremendous disparities in oral health, noting that “over one-third of the U.S. population (100 million people) has no access to community water fluoridation,” and that “over 108 million children and adults lack dental insurance, which is over 2.5 times the number who lack medical insurance.”
Detailing the statistics, Dr. Satcher said that tooth decay is currently the single most common chronic childhood disease. Additionally, “poor children suffer twice as much dental caries as their more affluent peers, and their disease is more likely to be untreated.” Furthermore, “more than 51 million school hours are lost each year to dental-related illness,” and “over 50 percent of 5- to 9-year-old children have at least one cavity or filling, and that proportion increases to 78 percent among 17-year-olds.”
During the question and answer period, Sen. Bingaman asked whether it would be a good investment to provide dental sealant programs in schools, pointing to the success of such a program in his home state.
“I’m under the impression that it would be a very good investment if we invest in access to dental sealants at a young age,” responded Dr. Satcher, adding, “There are other things that need to be done at home: brushing, flossing, good nutrition, etc.”
Dr. Burton Edelstein of the Children’s Dental Health Project in New York said, “My message is simple: far too many children suffer far too much disease that is consequential to their lives and overwhelmingly preventable.”
Dr. Edelstein detailed some of the barriers to access to dental care. He noted that there is a declining number of dentists relative to the population, as well as a maldistribution of dentists. Additionally, there are education and training issues that need to be addressed, and he added that the “dental safety net is small, understaffed, and sparsely distributed.”
Representing the nation’s dentists, Dr. Gregory Chadwick of the American Dental Association (ADA) agreed with the concerns of the other witnesses. “The ADA wants to make clear that dentists find it unacceptable that in 21st Century America there are children who cannot sleep or eat properly and cannot pay attention in school because they’re suffering from untreated dental disease—a disease that can be easily prevented.”
He urged Members to invest in oral health prevention programs, noting that next year the ADA will launch a nationwide program, “Give Kids a Smile,” to provide a day of free oral health services. “Prevention programs like fluoride and sealants are truly a cost-effective investment in the oral health of our nation’s children and must continue to be expanded to ensure equal access for all populations.”
Speaking to the issue of access, Dr. Chadwick detailed the need to improve the Medicaid dental health program. “One of the most critical strategies is for states to raise Medicaid rates to more closely mirror the marketplace, rather than allow dentists to be reimbursed for care at significantly less than what it costs them to provide it.”
The committee also heard testimony from Timothy Shriver of the Special Olympics, who discussed the oral health needs of persons with mental retardation. Additionally, Dr. Lynn Douglas Mouden of the Office of Oral Health at the Arkansas Department of Health detailed his state’s dental public health program, and Ed Martinez of the National Association of Community Health Centers discussed the efforts of his clinic, the San Ysidro Health Center in San Diego, Calif.
