There is a large cavity in the way oral health is viewed and prioritized. Good oral health is more than a battle against bad breath and the occasional cavity. It is a branch of...

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There is a large cavity in the way oral health is viewed and prioritized.

Good oral health is more than a battle against bad breath and the occasional cavity. It is a branch of medicine that prevents diseases that can affect breathing and swallowing.
But our priorities don’t reflect this reality. While 44 million Americans lack medical insurance, about 108 million lack dental insurance. Forty percent of baby boomers do not receive dental insurance through their employers, and most older workers lose dental coverage at retirement.

Local governments facing tight budget times often leave out dental care when prioritizing basic services. For example, the state’s Basic Health Plan does not include dental services.

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The other barrier to healthy teeth is a lack of access. Five years ago, then-Surgeon General David Satcher issued a report that highlighted profound disparities among poor Americans, particularly children and the elderly. Those with disabilities and complex health conditions were found to be at greater risk for oral diseases that, in turn, further complicate their health.

In Washington state, a collaborative effort to broaden access to dentists and introduce healthy dental habits early is the Access to Baby and Child Dentistry (ABCD) program. The program is in about half of the counties statewide. The Washington Dental Service Foundation helps sign up dentists, the University of Washington Dental School trains them to work with very young children and Medicaid picks up the tab.

Unfortunately, the ABCD program reaches only a third of its target market — poor children age 6 and under. For the program to be more successful, more dentists must offer their services. Medicaid reimbursement rates have been boosted slightly to attract more dentists. But it really comes down to those in the dental profession chipping in to make a difference.

Education is a tool already in the hands of citizens. Teaching personal daily oral hygiene habits such as brushing with a fluoride toothpaste and flossing daily is key to good, lifelong habits.

Community programs such as community water fluoridation and tobacco-cessation programs, and provider-based interventions such as the use of dental sealants and early examinations for oral and pharyngeal cancers, are key to a great smile and more affordable health care.