For the past 3 months or so, my Americorps partner and I have been working on a project to find an easier way to co-integrate medical and dental patients within our clinics. Although often housed in the same building, the medical clinic and the dental clinic were seen as separate entities with two different patient populations. We were working to find a way to link them up better on the administrative end, a task that requires staff from every level to be re-trained in one way or another. And finally, after months of research we presented our preliminary findings.
This first presentation came at a crucial time for the dental clinics. State funding for adult dental services has been cut as of January 1, meaning no dental reimbursements for medical coupon, or Medicare, patients. This is a huge hit for the dental clinics budget and in order to stay afloat, a new patient population needs to be exploi...I mean, reached out to. As I mentioned in my very first AmeriCorpse blog post, Idealism Waning, there are two populations that the State has reliable funding for: children and pregnant women. We have been focusing our integration project on children who are currently medical patients but are not dental patients in Neighborcare. Over half of the children seen in medical have no or unknown dental provider. We are their medical home and now we want to be their dental home too.
But isn't it funny how so many children come in to see a doctor regularly but so few come in to see a dentist? Many families only get insurance coverage for medical only or if they do get dental insurance it's a limited, high deductible plan. That could be a reason why so few of our children patients actually see a dentist. But many (maybe even most)children in Neighborcare are covered by Medicare, so all their primary medical and dental are free of charge, why isn't our dental clinic flooded with patients? After all, the dental clinic is only on the second floor and we have an elevator...
Our current health system greatly influences our persception of health values, and the current model has diverged dental health from overall health by creating separate insurance systems. So we the consumers agree that they should be separate; we agree with the status quo that the mouth is in fact not part of our bodies and that bacteria invading our tooth enamel is not as important than bacteria invading our tissues. This is why the State chose to cut adult dental services: Dental is not viewed as essential care.
But luckily, those wiley ol' lawmakers knew to keep those cute and cuddly little humans covered, well, at least for now. It turns out that the first few years of life are the some of the most important in oral health. Infants are first introduced to the decay-causing bacteria from their caretaker, typically their Mom. This bacteria spreads from person to person, then in their tiny little mouths and causes their tiny baby teeth to rot. Milk and other sweet beverages are not the cause of decay, but they create the perfect environment for the bacteria to proliferate and spread. Tooth decay is an infectious disease.
Unlike STIs, we can't just wrap the baby up in latex to prevent the spread of infection. The culprit of the spreading is actually Mom and her poor oral hygiene habits. Mom teaches baby her poor oral hygiene habits and baby grows into child with poorer oral hygiene habits. Then child becomes adult, has baby and the circle repeats. Let's break this cycle and teach Mom how important oral hygiene is! Oh wait, but dental hygiene is "non essential," so nevermind.
Nevermind, oh well, too bad, ce la vie. Budget cuts suck.
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