ORIGINALLY PUBLISHED BY THE MADISON TIMES ON NOVEMBER 12, 2015 http://themadisontimes.themadent.com/article/the-war-on-childhood-poverty-part-2-prominent-madison-dentist-speaks-out/

According to the American Academy of Pediatrics, childhood poverty is a significant determinant of health. It affects not only physical and developmental health but educational achievement, emotional well being and health into adulthood. Kids that live in poverty are at higher risks for teen pregnancy, drug and alcohol abuse, high school dropout, criminal behavior, and exposure to “toxic stress,” which can have lasting physiologic and emotional effects into adulthood.

I had the honor of interviewing one of Madison’s top pediatric dentists, Dr. Eric teDuits, DDS to discuss his views on this issue, in particular how poverty is negatively affecting the dental health of children in our community and its longer lasting implications. Dr. teDuits runs one of the only private pediatric dentistry practices in Madison that accepts Medicaid patients. He has participated in the Dane County Head Start Health committee and has also been professionally active at the local, state and national level advocating for pediatric dental health issues.

According to the American Academy of Pediatric Dentistry, early childhood caries (ECC) is an infectious disease that can begin as early as the teeth begin to emerge. Tooth decay (aka “cavity”) is the single most common chronic childhood disease and left untreated can destroy child’s teeth and have a long lasting effect on the child’s overall general health later in life. For example, children with ECC can suffer much more than pain and infection. ECC can affect speech, communication, ability to learn, sleep, school attendance, and overall quality of life.

Interestingly, ECC is disproportionately concentrated among children that are socially disadvantaged, in particular those who qualify for Medicaid coverage and are living in poverty. Again, another example of how poverty is directly linked to the health and well being of our children.

“From a dental standpoint, there is a limited amount of providers that take care of Medicaid patients because of the low reimbursement and high no-show rates. Unfortunately, this is the population that needs it most. I think poverty, from a standpoint of children’s health, may limit their access to care a little but also to be honest with you, the overall effect of poverty is multifactorial. For example, we see many single parents living in poverty who have other priorities conflicting with the dental health of their children. There are higher no-show rates in this population as well. There is also a lack of education in how to properly care for their children’s teeth. It’s more that just access. It’s more difficult for parents to be invested in the dental health of their children with other stressors in their lives,” explained Dr. teDuits.

When questioned about a possible solution, teDuits said, “It’s a hard one. I want to say money, but money is not the only solution. Right now, only a small percentage of the state Medicaid budget is dedicated to dental care. There are also many providers who will not accept Medicaid patients because of the low reimbursement. I’m torn on this issue because I want to encourage other providers to accept these patients, but on the other hand I don’t want to tell them to do something they aren’t going to get paid for. We have a pilot project we are working on in the state to see if increasing reimbursement will increase access. You have to be passionate about this. I love doing this, I do. But again, it’s more than just access and reimbursement rates, it’s also education, prevention, increased parental involvement/investment in their children’s dental health, and support of the family as a whole.”

In closing, this is once again a public health issue that cannot be ignored. We once again see an example of how childhood poverty is directly linked to poor health outcomes later in life. There are so many social determinants of health that extend far beyond the clinic walls!

 

ZAPATA, JASMINE, MD. “THE WAR ON CHILDHOOD POVERTY PART 2: PROMINENT DENTIST SPEAKS OUT.” EDITORIAL. THE MADISON TIMES. N.P., 12 NOV. 2015. WEB. 10 AUG. 2016. http://themadisontimes.themadent.com/article/the-war-on-childhood-poverty-part-2-prominent-madison-dentist-speaks-out/

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