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Connecticut Improves Dental Care For Children, Pew Report Says

By ARIELLE LEVIN BECKER

February 24, 2010

Patricia Baker didn't need a national report to tell her: When it comes to dental care for children, Connecticut has made a major turnaround.

A decade ago, less than a quarter of the children in the HUSKY insurance program for low-income families received preventive dental care — in part because only 100 or so dentists were treating the majority of them. And the state paid stingy rates to dentists treating Medicaid patients, prompting lawyers to file a class-action suit accusing the state of violating the rights of 300,000 poor residents who struggled to find a dentist to treat them.

It was a "national disgrace," said Baker, president and CEO of the Connecticut Health Foundation, which began trying to improve oral health in the state in 2000.

A report released Tuesday suggests how far the state has come. Connecticut earned top marks in a study of state dental policies for children by the Pew Center on the States, which declared Connecticut a "national leader." Connecticut was one of six states to earn an "A" in the report, "The Cost of Delay: State Dental Policies Fail One in Five Children."

Baker said the Pew report affirms the work that has been done in the past decade — oral health education, a boost in Medicaid rates paid to dentists who treat children, a significant increase in the number of dentists who participate in HUSKY, and collaboration among dentists, school-based health clinics, community health centers, schools, parents and the state Department of Social Services, which oversees Medicaid.

"You're talking about a real change in the cooperation around the delivery system," Baker said.

According to the report, most other states did not fare as well. Nationwide, an estimated 17 million children do not get dental care each year.

The report notes that poor dental health in children can have significant effects, ranging from problems with nutrition and speech development to an inability to concentrate in school because of tooth pain. In adults, gum disease has been linked to cardiovascular disease, diabetes and stroke.

Pew evaluated states based on whether they met eight benchmarks. Connecticut met six.

It allows hygienists to provide sealants in schools without a dentist's exam. The percentage of residents who have fluoridated water supplies, 88.9 percent, beat the national average of 75 percent.

The share of Medicaid-enrolled children who received dental care in 2007, 41.4 percent, also beat the national average of 38.1 percent. The report cited a program in Hartford in which a team of 10 hygienists, three dentists, four dental assistants and two dental clerks performed 47,000 dental procedures in 2008.

The state also met the benchmarks in Medicaid payments to dentists, tracking data on children's dental health and paying medical providers for early preventive dental care.

The state fell short on two measures: Fewer than 25 percent of high-risk schools have programs for children to receive sealants, and Connecticut, along with all but one other state, did not authorize new types of primary-care dental providers, according to the report.

Connecticut children on Medicaid are still less likely to receive dental care than children with private insurance, according to the report.

For all of Connecticut's progress, Baker said the state should not rest on its laurels. Among the areas that need to be addressed, she said: raising the level of dental care among children on Medicaid to that of children with private insurance and improving adults' access to dental care.

"Kids have been taken care of," she said. "We have to continue to think about the moms and the parents."

In a written statement, Bruce Tandy, president of the Connecticut State Dental Association, said the state should be proud, but not satisfied.

"If anything, this report should motivate Connecticut to work even harder to make sure that other populations within our state — such as the elderly and low-income adults — have access to equally high-quality care," Tandy said. "Many children and adults still go without adequate care. Given Connecticut's economic struggles it will be vital that in the months and years ahead our state continues to focus on long-term solutions to our dental care needs."