Access to Dental Care

Question 1

what does “access” mean?

Answer 1

that ppl can get the dental care they need when they want it

*it is a complex, multidisciplinary concept

Question 2

what is more likely to happen if ppl can access healthcare?

Answer 2

• receive basic preventitive services and edu

- oral diseases detected earlier

Question 3

what are the current delivery systems of dental care?

Answer 3

• private practice
• hospital dentistry
• public programs

Question 4

access to dental care is typically assessed by measuring what?

Answer 4

• number of ppl w dental visits
• number who are uninsured
• those who identify dental care as an unmet need

*self-reported insurance data, however, tend to overestimate dental visits and insurance coverage

Question 5

what % of the US pop had a dental visit in the last year?

Answer 5

65% (majority private practice)

*35% not receiving at least one visit annually

Question 6

what % of children ages 2-17 had a dental visit in the last year?

Answer 6

83%

Question 7

what % of adults ages 18-64 had a dental visit in the past year?

Answer 7

61.7%

Question 8

what % of adults ages 65 and over had a dental visit in the last year?

Answer 8

60.6%

Question 9

what was the most commonly identified unmet health care need for ohio children regardless of income?

Answer 9

dental care

*prescription drugs were a close second

Question 10

what groups have the majority of access problems?

Answer 10

• low SES and working poor
• minority groups (ethnic and racial)
• elderly and very young
• special needs and medically compromised
• institutionalized
• rural/run-down areas

Question 11

what are the disparities for untreated caries based on ethnicity?

Answer 11

white kids = 26%
AA kids = 36%
Hispanic kids = 43%
American indian or native american = 69%

Question 12

what are the disparities for untreated caries based on income?

Answer 12

• income greater than 200% FPL = 30.7%
• income greater than 100 but less than 200 = 45.2%
• income less than 100 % FPL = 55.3%

Question 13

what is the dentist to patient ratio that gives an adequate enough number to establish a practice?

Answer 13

1 to 1,507

Question 14

have the areas of shortage of dentists in ohio risen or fallen in recent years?

Answer 14

risen (we need more dentists)

Question 15

what are the 2 major reasons people do not visit the dentist

Answer 15

• they lack insurance and cannot afford care

- they do not perceive the need for dental care unless there is pain or an infection

Question 16

what does federal law require for all states in regards to dental benefits?

Answer 16

must have dental benefits for kids in medicaid programs

• not the same for adults
• 35% of children in medicaid programs received dental services in 2009

Question 17

why is it such an issue that ppl with medicaid coverage cannot have the care they need?

Answer 17

shortage of dentist wanting to participate in medicaid programs

because of:
-low reimbursement rates, paperwork, failed appts, time consuming and complex, disruptive behavior

Question 18

when do dental benefit levels for medicaid pts increase the most?

Answer 18

only when state officials are sued by advocates for poor ppl

Question 19

what is the difference in health care received by kids in medicaid as opposed to no insurance at all?

Answer 19

medicaid is only 10% higher than uninsured

Question 20

what are potential barriers to medicaid pts getting care?

Answer 20

• lack of preparation of dentists to treat children, elderly, and those with special needs
• private dentists more likely to practice in urban metropolitan areas with a high proportion of middle and higher income residents than in rural areas

Question 21

how many dental visits to the emergency dept were there from 2010-2011?

Answer 21

100,000

• higher rate of utilization among NH blacks
• most visits by pts who were uninsured or had private coverage

*over 58 million dollars

Question 22

when did most dental patients visit the ED?

Answer 22

on the weekdays (69%)

Question 23

what are the strategies to improve access?

Answer 23

• the pipeline, professions, and practive program
• initial funding of programs in 15 dental schools
• focus in recruitment of minority applicants, curricular changes to prepare students to care for underserved pops

Question 24

how long has New Zealand had a dental therapist program?

Answer 24

more than 75 years

*alaska is also considering this idea

Question 25

what is the DHAT scope of practice?

Answer 25

• all ages
• supervised provider
• part of a TEAM of dental and medical providers

Question 26

what is the schooling for dental therapists in minnesota?

Answer 26

-four year, baccalureate program to train dental therapists and establishes a two-year master’s program for advanced dental therapists

Question 27

is there sufficient evidence that introduction of dental therapists will improve access to care?

Answer 27

no

Question 28

with the health care reform act, is access getting better or worse?

Answer 28

millions of children have become eligible for medicaid