Plan would add rules for mobile dental care
Practitioners say parts of legislation are onerous, repetitive.
LANSING — A new bill would add more regulations for “mobile dental facilities” that bring dental services to disadvantaged children.
The bill aims to provide better documentation of services and to prevent incompetent practitioners from harming patients, supporters say.
“It isn’t meant to stop access because it’s a wonderful service, but to make sure bad apples don’t spoil it by having minimal standards of care,” said Rep. Peter MacGregor, R-Rockford, the lead sponsor.
Organizations like Smiles on Wheels and Michigan Dental Outreach work sort of like blood drives, MacGregor said.
They use vans to transport much of the equipment found in a dentist’s office to facilities like schools and senior centers. They take the equipment into the school, sanitize a work space, and provide both preventive and restorative care.
Co-sponsors of the new bill include Reps. Thomas Hooker, R-Byron Center; Jon Switalski, D-Warren; and Frank Foster, R-Petoskey.
Margo Woll, co-founder of Farmington-Hills-based Michigan Dental Outreach, said, “The need for the children is great and access to care is a problem.
“Nationally, one out of five children do not see a dentist in a year and 52 million school hours are lost each year due to oral problems. Dental disease is the number one most common infectious disease of childhood and it’s five times more prevalent than asthma,” said Woll, a dentist.
In addition, a 2013 Pew Center study found children made more than 49,000 trips in 2009 to emergency rooms across the United States for preventable dental problems, Woll said.
MacGregor said mobile services increased with Medicaid coverage of dental care in Michigan.
The services are usually covered by Medicaid or private insurance. Many practitioners are paid, while others volunteer.
“There’s a true need in a lot of urban and rural areas that don’t have access to dentists, so they’re providing a huge service for a big population,” he said. One reason is that many parents cannot afford to take a day off work to get their child to a dentist.
But there is a need for regulations beyond those that oversee bricks-and-mortar offices because mobile service is different, supporters of the bill say.
“It’s a great concept — the problem is there’s nothing in our health code that has oversight over how mobile dentistry continues its operations,” MacGregor said. “There’s oversight on dentists themselves, but there’s a lot of holes that have to do with follow-up care.”
For example, if it’s discovered that a child has gum disease, he or she will need more comprehensive care in the future that mobile dentists can’t provide, MacGregor said.
An important outcome of the bill would be to require an agreement with the patients to put their information into a record-keeping system so that they can get other necessary work done, he said.
“Otherwise, if all you’re doing is cleaning and you know that child has a problem, it never gets addressed — these are the kids that are going to end up in the ER (and) possibly have to get multiple X-rays when X-rays have already been taken by these mobile dentist units,” he said.
Many organizations doing such work oppose the bill as written, saying it could increase costs and hamper dentists’ ability to get services to those who most need them.
“Number one: It’s very onerous and burdensome to the mobile dental provider,” said Woll, the outreach co-founder. “Number two: It sets regulations that are already heaped on by the state Board of Dentistry.”
Solomon Pesis, a Farmington-Hills-based former member of the board and a participant in Michigan Dental Outreach, said, “There’s talk about all these unscrupulous companies out there.
“I’m thinking, well, that’s just like general dentistry — there are a few people that create problems for the rest.
“I feel that the state board can certainly take care of any complaints that are handled, and we don’t need special legislation that’s going to make it more difficult to go into the schools,” he said.
Pesis said basic legislation is needed, for example, on keeping records and X-rays.
“If somebody’s got a problem, who do they call? Is that company going to be here tomorrow?” Those are just two of the questions ideal legislation could address, he said.
“If I was a parent and my kid was getting treated somewhere and I had a problem, I would want to make sure I could call Dr. Pesis back and find out what happened. But what mobile dentists don’t deserve are double standards because they’re doing something priceless — they’re helping our children,” he said.
Pesis added: “It’s pretty exciting. It certainly changes the pace of what I do in my office. It can be stressful, but for me, emotionally, it just feels so good that I’m doing what I’m doing.”
MacGregor, the sponsor, said he will continue to meet with all sides. The bill has been referred to the House Health Policy Committee.