LINCOLN COUNTY –– Over the course of many years doing public health work, Gary Lahman often saw Lincoln County children with horrible dental problems.
“I used to see children, particularly small children, with rotted teeth,” Lahman said. “The really frustrating thing for me is it’s hard to locate information on children’s dental care, since there’s no central authority that collects that information.”
The co-chair of the Lincoln County Public Health Advisory Committee credits the little dental care resources there are in the area to the school district, at least for children covered by Medicaid. Similar to many other public school districts around the state, the Lincoln County School District has dental professionals come out to do school-based dental health clinics for children who can’t get that care elsewhere.
“The dental hygienists provide urgent dental care,” said Britny Chandler, a dental program clinical coordinator with Samaritan Health Plans, which works with the Lincoln County School District. “They treat pain, infections, large cavities or broken teeth.”
While children get at least some dental care in local schools, there are some things that the hygienists who provide care on campus can’t do.
“They don’t do root canals,” Chandler said.
Many adults in the community, too, aren’t getting the dental care they need, although it’s not just residents here. A common practice all over the country, Lahman stated during a recent public health advisory committee meeting, is that dental health professionals don’t approach their practice of dental medicine in the same way as other medical professionals.
“It never occurred to me, unlike in the medical community, where there are international diagnosis codes, there’s no comparable thing in the dental industry,” Lahman said.
Dental professionals, rather, have procedure codes, Lahman said, where they don’t diagnose a patient and then treat them.
“We’ve worked on trying to figure out what’s going on with the dentists, and it’s hard to figure out what the disease rate is when they don’t diagnose the disease,” Lahman said.
Another increasingly common practice in the dental industry is that dentists are choosing to practice cosmetic dentistry in greater numbers, leaving those who need basic dental care without a dentist who can help them.
“There are certain areas, rural areas in particular, where there is a shortage of dentists,” Lahman said. “Yet, what I’ve read is that 20 percent of the available dentists at this time are focusing more on cosmetic dentistry than they are on preventative dentistry. They can make more money selling a good smile than they can taking care of a bad mouth or expanding their treatment to people.”
Despite easily-trackable numbers detailing how many people have access to dental health care on a national level and how economic and social constraints limit that care, there’s little to no data concerning availability of dental care in Lincoln County.
According to Lahman, all children covered by the Oregon Health Plan can receive dental care. However, most dentists don’t take Medicaid, leaving most children with OHP but no private insurance with no other option but to get school-based dental care.
Even though Medicaid covers dental care for children across the state, even the public assistance Medicaid offers falls short of giving adequate coverage for many children. Most children who receive Medicaid get their dental care in clinics at school or from visiting dentists. However, if a child has a cavity, that cavity goes untreated.
“They don’t take care of cavities in schools,” Lahman said. “There’s not a lot that can be done for them.”