Making Children’s Oral Health a Priority in California

As the Governor and legislators deliberate over the details of the 2015-16 state budget, it is important to remember that the budget is a reflection of our values and priorities as a state. California’s fiscal condition has fully recovered from the deep deficits of the Great Recession, and it is time to invest in key programs that benefit children’s health, many of which are still operating at diminished, recession-era levels of funding. As a part of this, it is time for the state to invest in children’s oral health.

Why is children’s oral health so important? Consider that dental disease is the leading chronic health problem for children in the US, and California currently ranks 47th  in the nation in oral health, according to the most recent data available. What’s more, oral health issues such as cavities, tooth decay, and gum disease disproportionately affect children in low-income households, children of color, and children with special health care needs.

Oral health affects children’s lives in various ways, sometimes with lifelong consequences. Oral health problems have an impact on children’s quality of life, causing depression and self-esteem issues, as well as infections, chronic pain, and speech problems. In rare situations, these health issues also may even result in death. These health issues can make it difficult for children to participate in class and focus on schoolwork, and affected children often miss more school due to chronic pain and untreated infections. In sum, oral health problems affect children’s ability to learn and excel.

Despite the importance of children’s oral health, California is not ensuring adequate access to dental care for many of the children in the state. Last December, the California State Auditor released a report detailing how weaknesses in Medi-Cal, California’s Medicaid program, may limit children’s access to dental care. Medi-Cal provides public health care coverage to over half of the children in the state. However, the Auditor’s report revealed that 56 percent of children enrolled in Medi-Cal did not receive dental care in the 2013 federal fiscal year. This means that more than one-quarter of the children in California didn’t see a dentist during that time period. The audit also revealed that many counties lack an adequate number of dentists who provide care to children enrolled in Medi-Cal.

In addition, as discussed in our recent report, state policymakers cut funding for the California Children’s Dental Disease Prevention Program (CDDPP) in 2009. CDDPP was established in 1979 to provide school-based preventive services in low-income communities. In 2007-08, the program served over 300,000 children throughout the state. For many, this may have been their only source of dental care. Yet, policymakers slashed the entire program budget of $3.3 million in 2009 and shut the long-standing program down. While stakeholders continue to advocate for a restoration in funding, state policymakers have yet to make it a priority.

State policymakers should take action to support the oral health of low-income children in California. In a recent Sacramento Bee op-ed, Assemblymember Rob Bonta outlined several ways in which California could improve upon the existing system, including boosting Medi-Cal reimbursement rates for dentists, increasing outreach in hard-to-reach corners of the state, and creating innovative ways to serve children, such as mobile dental clinics and school-based dental programs. Both the Senate and Assembly budget committees have separately voted to eliminate recent Medi-Cal payment rate reductions for dentists. The Assembly, but not the Senate, voted to restore a portion of funding to the CDDPP.

Swift action is necessary to help children now. A recent news report revealed that one of California’s largest Medi-Cal dental providers will no longer accept new patients due to low reimbursement rates. This means that even more children throughout the state may not be able to access dental care in the near future. Governor Brown and leaders in the Senate and the Assembly should act to ensure that children have access to dental services in the next fiscal year and beyond.

— Kristin Schumacher

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To learn more about how state policies could better support children’s health and well-being, tune in to the Budget Center’s webinar tomorrow.