Oral health is a window into overall health. Poor oral health is associated with higher rates of diabetes, cardiovascular disease, and pulmonary infections. Oral health also is linked to pregnancy complications such as low-birth weight and premature birth. Moreover, studies have shown that regular dental treatments for those with chronic conditions such as diabetes lowers overall health care spending. Regular cleanings and preventive dental care also have the potential to lower total costs of care.
The sooner children start getting routine dental screenings and checkups, the healthier their mouths will stay throughout their lives. Cavities and tooth decay can lead to pain and trouble concentrating for young students. And there is the intrinsic lifelong value of a healthy smile.
New Jersey’s Medicaid program has one of the nation’s longest running and most comprehensive dental benefit programs. This commitment to oral health provides a strong foundation from which we can strive for better results. This commitment is especially important because poor oral health is directly linked to income and other social determinants of health. Beyond dental care, access to healthy foods, avoidance of sugary snacks and drinks, reduction of stress, and on-going education about dental hygiene all contribute to improved oral and overall health.
Our State’s long-standing commitment to a dental benefit for both children and adults is admirable but must be delivered upon. The data surrounding New Jersey’s dental benefit shows that we have more work ahead to improve access to care and to connect more people to dental services. Despite our long and impressive track record of providing this benefit, New Jersey’s Medicaid program is just above the national median on the percentage of Medicaid beneficiaries in New Jersey from age one to 20 who receive one preventive dental visit annually. While the national median is 49.1 percent, New Jersey was ranked 11th and achieved 52.8 percent. This statistic reveals that about 47 percent of our Medicaid beneficiaries ages 1 to 20 years old are not receiving basic preventive oral health care each year. We can and must do better.
This issue of our newsletter features a Take Five with Nicole McGrath-Barnes, DDS, FACD, who saw the access problem firsthand in her community and decided to make a difference by creating the KinderSmile Foundation. You can read Dr. McGrath-Barnes’ personal story and learn about the organization’s mission to provide comprehensive dental care to residents of underserved communities in New Jersey. Dr. McGrath-Barnes also serves as an Advisor to the Quality Institute’s Medicaid Policy Center.
Dr. McGrath-Barnes cannot do this alone. We need a path a forward, in partnership with the state and federal government, dentists, and insurers. Improving access to dental care through Medicaid is critical, but there are other paths as well. For some time, many organizations, including the Quality Institute, have called for changes in Medicare to include an oral health benefit. There now is a movement in Congress to make that change a reality.
In New Jersey, one issue is adequate access to dentists. According to the American Dental Association’s research, New Jersey is the ninth lowest state in dental participation in Medicaid and CHIP with only 26.7 percent of dentists participating. In her Take Five, Dr. McGrath-Barnes mentions reimbursement rates and the Medicaid insurer credentialing process as two causes of low participation rates. Both issues should be reviewed, especially given that Medicaid enrollment is now at a historic high and needs a robust network to serve its over two million beneficiaries. We also encourage the state to move forward on the uniform credentialing platform that the Quality Institute, the New Jersey Association of Health Plans, the New Jersey Dental Association and almost every provider association in the state has endorsed and called for over many years. Having one uniform credentialing platform would make it easier for dentists, and other health care providers, to sign up to accept Medicaid and participate in various insurers’ networks. A common platform would also improve information about network access across all insurers.
Finally, as with other measures, we must collect demographic information to understand the racial disparities in performance. Not having regular preventive dental care can lead to a life of pain and related negative consequences, which furthers the inequities that we are trying to eliminate. Given the importance of this issue, we are working with Dr. McGrath-Barnes to address these issues specifically for pregnant individuals and infants. We welcome your engagement in problem solving and improving oral health in New Jersey.