Access To Care Key Issue For Dentists

March 31, 2008
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As president of the Michigan Dental Association, Rockford dentist Steve Dater said one of his top priorities is to improve access to oral health care for needy adults and children.

“One out of seven Michigan residents is on Medicaid now, and we get about one out of 10 dentists that participates in Medicaid because the reimbursement is so low,” Dater said. 

“If you’re on the food stamp program, and you go to Meijer and you get $100 worth of food, you get to pay Meijer $100. You’re asking dentists to take $30. With overheads running 65 percent — if we could break even, we’d take it.”

Dater, 44, a Livonia native and University of Michigan School of Dentistry graduate who has been in practice for 20 years, will turn over his title this month at the MDA’s conference in Grand Rapids, after leading the group since last May. He has crisscrossed the state, working on issues such as programs to reach the underserved, dental mercury disposal, construction of a new MDA building, and a shrinking number of dentists as older practitioners retire and too few new graduates replace them.

But access to dental care for the uninsured remains a major concern, Dater said, and several programs are in place to help address it. For example, a program in Kent County uses Heart of West Michigan United Way funding to serve the working poor — adults who have jobs but no insurance and too little income to pay for dental care.

Another program, Healthy Kids Dental, reaches just 61 of the state’s 83 counties. And the counties that are not included are urban counties with lots of children on Medicaid, Dater said, and it reaches only one-third of the children who need it.

“The economics of the state are just killing us. The access problem is huge. We just don’t have the ability to treat these patients. We’re not going to get more money from the state,” so innovative ideas are crucial, Dater said.

For example, the American Dental Association has chosen Michigan for a pilot program that would train dental hygienists to go into the community, assess dental needs, and recommend the neediest cases for treatment by a dentist. There’s funding to train six, Dater said, and they’ll be assigned to Flint and Detroit. The program also requires a change in state law, but Dater said that would be temporary to allow for assessment of the new approach.

“What we can’t get the state legislators to understand is, if an adult gets an abscess or a kid gets an abscess and goes to the emergency room, it’ll cost the state much more money than if they could get to a dentist,” Dater said. “Oral health is primary health.” HQX

—Elizabeth Slowik

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