Oral health a key element of state’s health care reform

By Harriette L. Chandler

Last April 2007 Massachusetts showed the nation the power of innovation and collective action when we brought people from all across the state together to work on one common goal: reforming our health care system. As we head into the first stages of this landmark achievement, we must remember that this is just the first step in improving the health of our state and there is still much work to be done.

True health care reform must ensure the health of the whole body, rather than leaving critical pieces of our bodies uncovered. True health care coverage must include dental care.

Dental decay is the single most common infectious disease of childhood. It is caused by bacterial infection in the mouth and is five times more common than asthma. For children, the effects of untreated disease can impact life’s most basic activities like eating, sleeping and succeeding in school. Adult dental disease has been linked to a multitude of complex health problems such as heart disease, stroke, diabetes and low birth weight and premature infant births.

Dental disease also affects our economy. For children, the lost school hours can translate into lost opportunities for learning and progressing in school. Nationally, 51 million school hours are lost each year due to issues related to dental disease. For adults, we can see the impact on today’s work force. Each year 164 million work hours are lost nationally due to issues related to dental disease. What is perhaps most remarkable about this issue is that it is almost entirely preventable. Just like medical visits, regular dental visits keep infections in check. We know that people who are able to access routine checkups and preventive care generally have better health than those who do not.

In fact, a 2002 study by the Institute of Medicine found that people living without health insurance generally had worse health than their peers with health insurance.

The same rings true for dental insurance. As the numbers of medically uninsured Americans continue to grow, consider this: For every one person who lacks medical insurance, three lack dental insurance.

By working together we have taken several important steps over the past two years to improve access to dental services and to recommit the state to its focus on prevention. As part of health reform, dental benefits were restored to adults enrolled in MassHealth, and were included in some of the benefits packages of Commonwealth Care — the new program that connects eligible residents with approved health insurance plans — but only to individuals with incomes at or below the federal poverty level ($10,210 for an individual, $20,650 for a family of four).

Much more remains to be done in order to ensure that all children and adults in the commonwealth achieve optimal oral health. This session I have filed legislation (S656) that would require that all Commonwealth Care plans provide comprehensive dental benefits to enrolled individuals with incomes up to three times the federal poverty level.

To be sure, there are still questions to be answered regarding cost and the number of individuals affected. A public hearing on the bill scheduled tomorrow before the Joint Committee on Health Care Finance will provide an opportunity begin to get those answers and move forward.

The U.S. Surgeon General said in the nation’s first-ever report on the oral health of Americans, “You can’t be healthy without good oral health.” Put even more simply, oral health is health.

The health of our state and each of our communities is too valuable to go halfway with health reform. It is essential that dental benefits be included in all levels of Commonwealth Care.

We have seen that when we work together we can make incredible change. That’s the Massachusetts we all know and love. And if anyone can do it, Massachusetts can. We know the problem and we have proven solutions. The answer is, after all, right under our noses.

State Sen. Harriette L. Chandler, who represents the 1st Worcester District, is Senate chair of the Oral Health Caucus.

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