Opinion: Colorado must expand access to dental care

By Sara Schmitt

It is becoming more difficult for Coloradans to get oral health care.

Last Thursday, legislators who attended the Hot Issues in Health Care conference in Colorado Springs, sponsored by the Colorado Health Institute, got a sneak preview of new Colorado Trust report on oral health.

Based on findings from the 2011 Colorado Health Access Survey (CHAS), the report, A Growing Problem: Oral Health Coverage, Access and Usage in Colorado, said there are now more than 2 million Coloradans without dental insurance an increase of 17 percent since the 2009 baseline survey. The survey also found that having dental insurance makes a significant difference in whether Coloradans seek dental care, which means that fewer Coloradans are getting the dental care they need.

During the discussion, legislators raised the issue of access, questioning whether there were enough oral health providers in Colorados rural communities. They also weighed policy options to improve oral health in Colorados children, from effective public health interventions like water fluoridation and sealants, to supporting families and parents in obtaining adequate dental insurance coverage.

The discussion gave legislators the opportunity to focus on oral health an issue sometimes lost in the larger discussions around access to health insurance and health care. Oral health care, with its separate system and insurance, is often left out of these policymaking efforts, but it is a pressing concern. Going without basic dental care can lead to oral disease with unnecessary pain, speech problems, more invasive care and higher costs. Poor oral health can be a complication of diabetes, and may be linked to other chronic diseases as well.

The mouth reveals much about the health of the rest of the body.

Although a growing lack of access to dental care is affecting the entire state, there are some groups who are disproportionately affected.

The 2011 CHAS found that a majority of Hispanic Coloradans (52.8 percent) reported that they lack dental insurance, an increase from 47.6 percent from 2009. This rate of uninsurance is higher than that of both white (39.1 percent) and black (29.9 percent) Coloradans.

More than 60 percent of Coloradans ages 65 and over reported a lack of dental insurance, a troubling but not surprising finding given that most Medicare plans do not include a dental benefit. Coloradans living in rural areas experience both lower rates of dental insurance and use of dental services, perhaps a result of difficulty finding dental providers where they live.

There are ways to increase access to dental care, many of which are described in the 2012 Colorado Oral Health Plan. Despite the challenges, increasing access to dental care is a realistic and common-sense strategy toward achieving a healthier Colorado.

Colorados legislature has taken steps to increase access, such as re-funding the Old Age Pension Dental Program last year to assist low-income seniors in need of dental care. Gov. Hickenlooper is proposing a limited preventive dental benefit for adult Medicaid beneficiaries in Fiscal Year 2013-2014.

Coloradans can take steps to reverse the growing barriers to accessing dental care, ensuring that the results of the next CHAS in 2013 show there are more not fewer Coloradans getting the oral health care they need.

Sara Schmitt is director of community health policy with the Colorado Health Institute.

Opinions communicated in Solutions represent the view of individual authors, and may not reflect the position of the University of Colorado Denver or the University of Colorado system.