Each year, more than 16 million low-income children go without even basic dental care. There are several reasons for this disturbing reality.

Many Americans don’t fully understand the importance of oral health. For example, they may not realize that studies show a link between gum disease and stroke, heart disease and other health concerns. More should be done to educate parents about the importance of seeking regular dental care.

Millions of Americans live in areas that are far from the nearest dental practice. Another concern is that many dentists don’t accept Medicaid, the program through which millions of kids seek dental care. States with low reimbursement rates for Medicaid discourage dentists’ participation in the program.

The health care reform law will extend dental coverage to an estimated 5.3 million more children by the year 2014. These kids will enter a system that does an inadequate job of serving the low-income children it now is supposed to serve.

What can be done? There are several strategies worth pursuing.

• Schools are a good place to reach kids who may not otherwise get the dental care they need. School-based sealant programs are one sound approach for young children. Sealants are clear plastic coatings applied to the chewing surfaces of molars (the most cavity-prone teeth) that prevent 60% of decay at one-third the cost of filling a cavity.
• States should ensure that Medicaid-enrolled patients have the supports they need to successfully make and keep dental appointments. This could include offering help with transportation, translation assistance, or case management services to help patients navigate the Medicaid system.
• States that are seriously committed to improving dental care access must ensure their Medicaid reimbursement rates are high enough to cover the cost of care. States that do so will be more successful in encouraging broad Medicaid participation by dentists. It is unrealistic to expect dental practices to accept Medicaid patients if doing so means their practices take a significant loss of profit.
• Because many children see doctors and nurses earlier and more often than dentists, another solution is to encourage pediatricians to check teeth, educate parents about dental care, and apply fluoride varnish as part of routine exams.