The late Senator Ted Kennedy said it best: “Health centers are really an extraordinary example of responding to very significant health needs.” As a “safety net provider” in western Massachusetts, we are extremely proud of our role in meeting the healthcare needs of everyone in Franklin County.
But our work is challenging. Many of our patients have long-unaddressed health problems and have either limited healthcare coverage or coverage with very high deductibles. Many people on Medicaid have trouble finding healthcare providers who are able and willing to treat them, and this is especially true for people in need of oral health care.
Every day, our dentists, dental hygienists, and primary care staff treat people who might be healthier had they received care sooner. They lament that with just a few more resources, they could extend our reach to more people before their dental problems become too severe that toothaches become tooth extractions very quickly.
Thankfully, there is a proposal in the state legislature that could help put more ‘boots on the ground’ in addressing the dental needs of our Franklin County neighbors and friends.
Pittsfield Representative Smitty Pignatelli and Worcester Senator Harriette Chandler are advancing a bill to authorize a new class of midlevel dental professionals to help clinics like ours and private practice dentists serve more people in more places and potentially lower the cost of dental care.
The concept of a midlevel dental provider – similar to a physician assistant – is not a new idea.
Maine, Vermont, Minnesota and Alaska also permit similar providers who work under a dentist’s supervision and perform routine care like filling cavities, placing temporary crowns, and extracting badly diseased teeth. These ‘dental therapists’ are not meant to replace dentists but to work with them in improving the oral health of everyone in need of dental care.
At the Community Health Center of Franklin County, we endorse this model because we know it works: Three of our dentists and hygienists recently visited Minnesota to observe their ‘dental therapist’ program and offered high praise for its safety and efficiency at expanding access to care.
New approaches to dental care access could not come sooner, because the need is dire.
Nearly half of all children on MassHealth did not see a dentist last year. In Franklin County, children have higher rates of caries experience — a leading indicator of poor oral health — than the rest of the state. Additionally, only about one quarter (26 percent) of dentists statewide actively treat people on MassHealth, and Franklin County has fewer than one percent of overall private dental practices in the state.
Put simply, it is tough for people — especially those of low-income and in rural areas — to find adequate dental care.
When dental care is scarce, many people end up in the emergency room for tooth pain.
According to the Massachusetts Health Policy Commission, children and adults on MassHealth are six and seven times more likely, respectively, to visit the emergency room for preventable dental conditions compared to commercially insured children and adults.
That creates higher costs for all of us.
Every community health center is looking for new ways to reach more patients. Unfortunately, inadequate reimbursement and a serious shortage of providers are constant challenges – especially in our part of the state.
This approach solves both of those problems. According to an estimate using 2014 dental clinic data from the Edward M. Kennedy Community Health Center in Worcester, a health center could offer an additional 1,920 appointments and earn an additional $60,000 per year above the costs of hiring a midlevel dental provider.
These numbers, plus the ability to improve access to quality care, are why we are such strong supporters of this initiative.
We can do more. This is one way to expand dental care access to more people and strengthen the reach of your community health center.
Edward Sayer is the CEO of the Community Health Center of Franklin County. It has locations in Greenfield, Turners Falls and Orange.