Regarding “NJ kids’ teeth are rotting more than the national average. Here’s why,” NorthJersey.com, Jan. 23:
As a public health dentist in New Jersey for 25 years, I regularly treat children in dire need of oral health care. Many have never been to the dentist before coming to KinderSmile Foundation. Not long ago I made dentures for a 15-year-old girl who had lost most of her permanent teeth by age 10. She never smiled. Her mental health had suffered. After the care she received from KinderSmile Foundation, where I am the chief operating officer, she was finally able to fully smile, with her teeth and with her eyes. At 15, she took her first selfie, ready to post on social media like the rest of her friends.
This child, growing up without dental care, is not alone. KinderSmile Foundation was founded in the community and for the community to care for our patients, nearly all from marginalized communities. The need is urgent, as Scott Fallon recently reported in NorthJersey.com.
Our state is well behind other states in providing access to dental care, particularly for those in marginalized communities. The first Basic Screening Survey by the New Jersey Department of Health found that children in Head Start have untreated dental decay at twice the rate of the national average. We are failing our kids.
That should not happen in New Jersey, where Medicaid-insured patients have their benefits managed and paid for by managed care organizations, or MCOs. Yet at KinderSmile Foundation, we regularly treat children whose parents tell us they cannot find a dentist in their community — or anywhere — who will accept their Medicaid insurance. These children often come to us with extensive dental decay.
There are lists of dentists in the Medicaid MCO directories. But these directories are a mirage. Inspired by our experiences, the New Jersey Health Care Quality Institute conducted a “Secret Shopper” survey of Medicaid MCO directories of dentists who treat children ages 0 to 6. The survey found that only 49% of the listed dental practices would schedule an appointment for a 2-year-old child. The survey also found that 37% of dental practices in the 0 to 6 directories said they did not, in fact, accept the specific insurance — even though they were listed as being in network. Fourteen percent of the practices were unreachable, with no answer after two attempts. These “ghost networks” harm our children, as families struggle to find a dentist for essential care.
When we don’t have enough dentists willing to accept Medicaid, the program fails. The driving problem is the Medicaid rates. New Jersey Medicaid fee-for-service rates have been frozen for nearly 20 years. Furthermore, the MCOs pay even less than the fee-for-service rates.
More:NJ kids’ teeth are rotting more than the national average. Here’s why
If, as a state, we truly want to prioritize the health of our children, we must acknowledge that oral health is the gateway and critical part of overall health. The state Medicaid program’s oral health system is broken. We need to fix it for our children’s future.
Dr. Nicole McGrath-Barnes, our founder and CEO, established KinderSmile Foundation nearly 18 years ago. Her own experiences as a dentist and news of the death of Deamonte Driver, a 12-year-old boy from Prince George’s County, Maryland, prompted her to leave her private dental practice and create KinderSmile Foundation. Deamonte died from a tooth infection that traveled to his brain after his family could not find a dentist who would accept him. Let that sink in. Untreated oral infections can kill.
As a leading nonprofit organization with a mission to provide underserved communities in New Jersey with access to oral health care, we advance our mission daily, opening the doors to all patients starting at infancy, regardless of means, insurance coverage or immigration status. Our vision is a future where every child has access to a dentist and preventable dental diseases are eradicated.
A Newark schoolteacher reached out to me last month about one of her first-grade students. The 6-year-old needed urgent dental care. This brave young boy had never visited a dentist. He was experiencing severe pain along with advanced dental disease and multiple oral infections. He needed extensive care on 16 of his 22 teeth. We began treatment.
Often overlooked, oral health affects overall health, mental health, school absenteeism, school performance and employability. New Jersey admirably expanded access to mental health benefits in the last year. New Jersey must do more for oral health as well if we want the state’s children to thrive. About a third of New Jersey children are covered by Medicaid.
With budget hearings approaching in February, I urge our state legislators to make long-term investments and improvements. That can be done by raising the Medicaid oral health rates for children to 2025 rates and requiring in law that all MCOs pay dentists at least those 2025 rates for care. This is a critical first step to getting more dentists in the state to participate in Medicaid and thereby increasing access to oral health care. New Jersey must invest in the overall health of all our children.
Dr. Michal Herman is chief operating officer of KinderSmile Foundation Inc. The Foundation has offices in Bloomfield, Trenton and Newark.