Kan. dental group takes oral care concerns to state capitol

The Kansas Dental Association (KDA) has introduced a legislative package aimed at expanding dental services, including increasing access for Medicaid recipients and providing community loans to attract dentists to rural and underserved areas.

In a news conference held February 3 at the state capitol in Topeka, KDA President David Hamel, DDS, and other supporters of the initiative urged lawmakers to remove barriers to advancing good oral healthcare in the state.

"A host of barriers prevent people from accessing good dental care," Dr. Hamel said during the news conference. "We know that one single step taken alone won't be effective in addressing this public health issue. That's why we are presenting this comprehensive legislative approach, which includes numerous policy initiatives. Our hope is that seeing how these various elements can work together, lawmakers will support their enactment."

The dental association's proposal includes the following:

• Create a Dental Bridging Loan Program to assist local communities in attracting dentists to rural and underserved areas in the state.

• Restore funding for the Donated Dental Service Program. State officials cut funding for the program last year, but an investment of $70,000 to cover lab and administration would provide more than $500,000 in free dental services to elderly and disabled Kansans annually, according to the KDA.

• Expand dental education opportunities for Kansas students by adding three to five seats for residents at the University of Missouri-Kansas City (UMKC) School of Dentistry, with the stipulation that they return to practice dentistry in underserved areas of the state.

• Require a four-year Kansas service agreement for UMKC's Kansas students who receive tuition subsidized by the state.

• Include Medicaid dental coverage for adults in health reform plans proposed by Gov. Sam Brownback. Like most states, Kansas does not provide dental services for low-income adults in the Medicaid program. It is the single largest barrier to dental care for residents who cannot afford basic preventive dental services, according to the KDA.

• Create a working group to recommend improvements to Medicaid's limited dental program for children.

• Clarify that nonprofit foundations can contribute to pay for training of dental providers and charitable dental treatments.

• Expand the existing Registered Dental Hygiene Extended Care permit program, which would allow more dental procedures to be offered in nursing homes and community health centers/federally qualified health centers, as well as to children in schools.

"These policy initiatives would address our state's most pressing oral health needs," said Kevin Robertson, KDA executive director.

Robertson estimated that the average Kansas dentist provides $33,000 in charitable dental services to patients every year, which equates to $46.3 million in assistance donated annually by the state's dentists.

Kansas has 1,427 dentists, but more than a dozen counties lack a dentist, Dr. Hamel said.

The W.K. Kellogg Foundation has started rolling out a $16 million initiative to help five states, including Kansas, develop midlevel providers programs similar to the dental health aide therapist program in Alaska. Kellogg's Dental Therapist Project is intended to support community-based efforts in Kansas, New Mexico, Ohio, Vermont, and Washington to add therapists to dental teams providing care in underserved areas.

And last fall three nonprofit organizations in Kansas formed the Kansas Dental Project, which supports the dental therapist model. The project -- spearheaded by the Kansas Action for Children, the Kansas Association for the Medically Underserved, and the Kansas Health Consumer Coalition -- is focused on addressing the shortage of dental professionals and increasing access to dental care for Kansans living in underserved communities.

But the KDA and dental associations in many other states remain unconvinced that this approach will be safe and effective. The KDA would rather see a new level of hygienists who would provide palliative care but would not diagnose or do surgical procedures, according to Robertson.

"Providing access to all Kansans cannot be accomplished by simply creating a new dental therapist or other new dental provider whose inadequate training and education puts the very patients they are intended to help at serious risk," Robertson said in a statement on the organization's website following the Kellogg Foundation's announcement of the Dental Therapist Project.

"Preserving and increasing dental health to all Kansans is a complex issue requiring personal choice, action, and responsibility ... as well as many diverse strategies," Dr. Hamel added. "The KDA is happy to see a new organization seek to raise awareness of oral health issues in Kansas. In the past, the KDA has offered proposals to improve oral health that have gone unnoticed or unsupported, and we hope that this renewed interest will result in collaborative initiatives that will actually help improve and preserve the oral health of Kansans."

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