Pennsylvania Project Works on Connecting Medical and Dental Health

What do the number one chronic infectious disease in children and the number one chronic health problem in children have in common? It’s oral health.

Early childhood caries is the most common infectious disease – five times more common than asthma, and seven times more common than hay fever. Childhood obesity continues to vex the health care community. Both are rooted in excessive sugar intake.

Nationwide, medical-dental collaboration initiatives are bridging the gap between oral and overall child health and striving to increase rates in children’s preventive dental care.

Pennsylvania is in the fourth year of a five-year action plan submitted to the Centers for Medicare and Medicaid Services (CMS) Oral Health Initiative in 2011. According to a July 10, 2014, CMS bulletin, while 15 states met or exceeded their first-year goals for preventive services provided to Medicaid and Children’s Health Insurance Program (CHIP) children, Pennsylvania did not. While Pennsylvania set a goal of 46 percent by 2015, the most recent data shows Pennsylvania at 37 percent in 2012.

Physicians play a vital role in oral health, says C. Eve Kimball, MD, FAAP, managing partner at All About Children Pediatric Partners, Reading, and a longtime champion of medical-dental collaboration.

“In the first three years of life, we’re seeing children at least every six months, and for the first year of life, every two or three months,” she says. “The education of the family and the finding of caries need to be done in the first year of life, because otherwise you don’t prevent. You’re into treating.”

Children enrolled in Medicaid and CHIP are “more likely to suffer from dental disease and less likely to use dental services than privately insured children,” CMS reports. However, Kimball says, both public and private insurance must reimburse physicians for risk assessment, fluoride varnish application, and counseling.

To help physicians promote oral health, Dr. Kimball urges physicians to advise parents to put only water in sippy cups between meals, and to develop relationships with local dentists who accept children under the age of three, for rapid referrals as needed. With the rise in early childhood caries, the dental profession is lowering the recommended age for first visits from three to one.

Physicians can get more information, training and education by contacting Healthy Teeth Healthy Children (HTHC), operated by the PA Chapter of the American Academy of Pediatrics to promote medical-dental collaboration, access to care, and oral health literacy.