April 10, 2004

By: Lilian Ross
Website: http://www.teeth-whitening-smiles.com

Inadequate Dental Care – Low-Income Families Need Better Dental Care

Womble Carlyle Sandridge & Rice, a major private law firm based in North Carolina, the North Carolina Justice and Community Development Center, a nonprofit organization advocating for the interests of low-income people, and the National Health Law Program, a national public interest law firm, have joined forces to file this class action suit.

Children need to be free from pain and cavities to come to school ready to learn. Parents need to worry about getting to work and taking care of kids -- not untreated dental disease, said Cal Adams, attorney for Womble Carlyle Sandridge & Rice. Paying dentists a reasonable amount for the care they provide is the first step in helping these children and adults. Not only is it the right thing to do but it is required by federal law.

The Plaintiffs are patients who do not have adequate access to Medicaid dental services. The representative plaintiffs include Samuel and Alana Antrican:

Samuel and Alana are a brother and sister who live outside Bath in Beaufort County, NC. Their mother, Ms. Angela Antrican, works part-time at a retail store and her husband works full-time as a plumber. They are unable to afford private health insurance but Samuel and Alana both qualify for Medicaid. Ms. Antrican looked for a dentist willing to treat her children for five years before finding someone an hour's drive from her house. In that five years she repeatedly called multiple dentists in her area, contacted local and state authorities, and drew on the help of friends and relatives. Because of the years of delay in getting treatment, both Samuel and Alana have had to have extensive dental work including pulled teeth, installation of crowns, and pulpotomies. Had Ms. Antrican simply been able to find dental care earlier her children's problems could have been either prevented or corrected with simple fillings.

One in four children entering kindergarten have untreated dental disease. Dental decay is one of North Carolina's most common childhood diseases. Thirty-six percent of all children entering kindergarten in NC have a history of dental decay and 25% of these kids have gone without treatment. Dental disease is much more prevalent in low-income populations and in rural communities without fluoridated water and can lead to serious health problems. The lack of access to basic dental care such as regular cleanings and early screenings results in loss of teeth, later painful and extensive dental work, and serious infections.

Every week I see children suffering horribly because they couldn't get timely dental care, said Dr. Jim Congleton, a pediatric dentist in New Bern. We need to address this crisis as soon as possible.

Many dentists either lose money or just break even when they treat patients with Medicaid. North Carolina knows why low-income children do not get dental care. NC's Medicaid health program for low-income children and adults pays only 42% to 62% of dentist's usual charges for dental procedures. However, the average overhead cost of operating a dental practice is approximately 60% of total revenues. As a result, it is understandable that few dentists will see patients with Medicaid: Only 16% of NC dentists actively participate in the Medicaid program, one of the lowest rates in the country.

North Carolina must pay dentists a reasonable amount to care for low-income people under the Medicaid program - this is good policy and required by federal law.

The first step in solving the problem is simple. Federal law requires that dentists be paid a reasonable rate when they see patients with Medicaid coverage. North Carolina's current payment of 42%-62% of usual dental rates is simply not enough to meet the requirements of federal law and ensure that kids and adults have access to adequate dental care. Raise the rates, and more dentists will treat patients with Medicaid.

A 1996 survey showed that 56% of dentists in NC would be willing to see more Medicaid patients if the reimbursement rates were increased. Paying dentists a reasonable rate under Medicaid was the top recommendation of the 1999 North Carolina Institute of Medicine's Task Force on Dental Care Access, chaired by Lieutenant Governor Dennis Wicker. Other studies as far back as 1993 have cited the need to increase reimbursements for dentists seeing Medicaid patients in North Carolina.

For years, parents and health advocates have tried to get the State to address this problem. To date, the State has not significantly increased reimbursement rates, despite attempts by some government officials and legislative leaders.

It is estimated the increase in rates would cost the state $10 million a year. Yet the Governor and Legislature have not seen fit to make this small commitment to the children of this state.

Author Notes:

Lilian Ross contributes and publishes news editorial to http://www.teeth-whitening-smiles.com.  Everything you need to know to get a whiter, brighter smile!