Budget proposal calls for extended outreach to get more children into the dentist chair

Jane Meredith Adams

January 9, 2014

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With student dental disease one of the most widespread public health issues in schools, Gov. Jerry Brown on Thursday put a new focus on early dental health outreach in his proposed budget for the coming year, praising prevention as a way to keep down future medical problems and costs.

But in keeping with Brown’s avowed fiscal prudence, the budget proposal does not allocate any new funds for the $17.5 million effort, deflating some advocates’ hopes. And his proposed outreach strategy is to mail a letter to parents or guardians in the Medi-Cal system whose children, from infants to age 3, have not seen a dentist recently to urge a dental visit – an approach that left some health advocates unimpressed.

“A letter is not necessarily going to achieve the end result – it’s very impersonal,” said Jared Fine, dental health administrator at the Alameda County Public Health Department. And, Fine noted, even if families wanted to take their children to a dentist, it is often difficult to find a dentist enrolled in what he described as a cumbersome Medi-Cal system that has one of the lowest reimbursement rates in the nation.

“If you don’t have dentists the children can go to, you’ve wasted $17.5 million,” Fine said.

But the state has set a goal of increasing by 10 percent the number of children 3 and under using dental care under Medi-Cal, said Andrew McCray, chief of the Medi-Cal Dental Services Division of the California Department of Health Care Services, which is orchestrating the outreach effort.

The governor’s budget proposal calls for taking $8.1 million in tobacco tax money already designated for First 5 California children’s programs and re-allocating it to “pediatric dental services outreach.” In addition, the state said it expects it would receive $9.4 million in available federal matching funds to pay for the outreach, including monies to pay for additional Medi-Cal dental costs as more children obtain treatment.

In an emailed statement Thursday, First 5 California Executive Director Camille Maben noted that the local county First 5 offices  already provide educational outreach around oral health and said the statewide First 5 needed additional details on the governor’s proposal.

“We are proud of the investments First 5 counties across the state have made to improve the oral health of young children,” Maben said. “Receiving additional details and information on the proposed oral health program will help us understand the potential participation of First 5 California.”

Along with the letters, parents may receive brochures explaining how important it is for children to consume healthy foods and beverages, to brush their teeth or have their teeth brushed, and to have a dental exam, said Jon Chin, a staff member at the Medi-Cal Dental Services Division of the California Department of Health Care Service. Some parents also might receive telephone calls to follow-up or e-mails.

Any effort to impress upon families the importance of dental hygiene was welcomed by educators. Dental problems keep California students out of school an estimated 874,000 days a year, causing students to fall behind in learning and schools to lose about $29.7 million in attendance based-funding, according to the 2007 California Health Interview Survey, considered the benchmark on oral health in the state. Poor dental health can be painful and embarrassing for students, causing them to withdraw from classroom participation and socializing, health advocates said.

“This is hopefully only a good beginning and, at some point, these letters should be followed by additional resources” to reinstate dental screening programs that were cut from the state budget in past years, said Gordon Jackson, director of the state Department of Education’s Coordinated Student Support and Adult Education Division, which oversees health, counseling and other support programs provided at schools.

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