February 29, 2012
"As a nation, we don't talk about it much but there is a dental crisis in America," Sen. Bernie Sanders said Wednesday at a Senate hearing he chaired. A new report released at the hearing said more than 47 million people live in places where it is difficult to access dental care. More than 130 million Americans do not have dental insurance. One quarter of U.S. adults ages 65 or older have lost all of their teeth. About 17 million low-income children do not see a dentist each year. Only 45 percent of Americans age 2 and older saw a dental provider in the past 12 months. In Vermont, Sanders noted, there has been progress.
There now are dental facilities serving 25,000 patients at community health centers in eight of Vermont's 14 counties. There was only one in Island Pond as recently as 2000. Vermont now ranks first in the nation in access to dental care for children, but more than 40 percent of the children still don't have a regular dentist.
"There is a critical need for increased access to comprehensive preventive and restorative dental services, Grant Whitmer, executive director of Community Health Centers of the Rutland Region said at the Senate hearing. Community health centers, he added, "are uniquely qualified and well positioned to be a positive and useful vehicle to expand dental access in the most efficient and cost effective manner."
Sanders' subcommittee also heard evidence that more and more Americans are turning to expensive hospital emergency room care for routine dental problems. Nationwide, the number of ER visits for dental problems rose 16 percent from 2006 to 2009, according to a study presented at the hearing by the Pew Center on the States. In Florida alone, there were more than 115,000 hospital ER visits for dental problems in 2010 with costs of more than $88 million.
While oral health problems can affect anyone, low-income people, racial or ethnic minorities, pregnant women, older adults, and people who live in rural areas have the hardest time getting to see a dental provider.
Unless the situation is addressed it is likely to get worse. At a time when there are nearly 10,000 too few dental providers in the United States, dental schools are graduating fewer new dentists than the number who retire each year.
In preparation for the hearing, Sanders asked people from Vermont and across the country to share their experiences.
One of the more than 1,200 who wrote to the senator was Heather Getty of East Fairfield, Vt. "My husband and I and our four kids are the working poor. We have to think about rent and electricity before we think about dental care. My wisdom teeth have been a problem for over a decade now. I take ibuprofen and just keep on going. My husband has not seen a dentist since he was a teenager. He's afraid of the costs if they find something. So it's been 20 years," she said.
Shawn Jones of Brattleboro, Vt., wrote: "Last year, I had a toothache that was so painful I had trouble eating and sleeping. My girlfriend's dentist ... wouldn't see me. So I called 12 more dentists in the area, but they all said the same thing: they weren't taking new Medicaid patients. A few said to call back in three months, which seems like a long time to live with a bad toothache."
It has been 12 years since the U.S. Surgeon General called dental disease a "silent epidemic, Sanders noted. "It is my hope that through this hearing we will better understand the problems that exist in accessing dental services and will become better educated about the solutions that can help us to reduce barriers to care to improve health and reduce costs."