Despite Medicaid, rural kids often lack dental care

One of the greatest threats to the health of rural children is the lack of attention to their teeth and gums. Judy J. Owens of Kentucky writes for the Daily Yonder, "Lack of dental care, common among low-income and Medicaid-eligible adults and children, often results in severe or persistent pain, inability to eat, swollen faces, and increased susceptibility to other medical conditions." (New York Times photo by Stephen Crowley: A student in Barbourville, Ky., gets ready for a free exam through Kids First Dental, a mobile clinic.)

Poor dental health is a problem that plagues much of rural America. "In a rural state such as Kentucky, for example, dental decay is the No. 1 infectious disease in children. Dental pain is the number one excuse for public school absences." Medicaid provides dental insurance to all children who are eligible for the program, but many rural children grow up without dental care because adults don't take advantage of the benefit and many if not most rural dentists don't accept Medicaid patients, citing low reimbursement rates. (Sometimes we wonder if there are other reasons.)

"Many children grow up in homes where the adults do not have regular dental treatment, and so the children are not taken to the dentist," writes Owens. "A survey in North Carolina found that on average, only 20 percent of Medicaid recipients visited the dentist in 1998." There are signs of progress, however. This year Kentucky passed a law requiring children to have their teeth examined before beginning school. Early care is seen as the best form of prevention of poor dental health. While the law hasn't taken effect, other efforts have failed to make a dent in the rural dental health problem. "Despite years of advancement, including the establishment of two colleges of dentistry and an impressive water fluoridation program," Owens writes, "Kentucky is a national leader in toothlessness." (Read more)