Oral health is a critical health problem facing Missouri. Overcoming
Missouri’s oral health care crisis will require a comprehensive policy that
includes cooperative actions by medical providers, oral health providers,
educational entities such as Head Start and school nurses, community agencies,
as well as local, state and federal government agencies.
Access to oral health care and treatment in Missouri is limited by barriers
that include lack of private or government-funded insurance, a shortage and
mal-distribution of dentists across Missouri, family poverty and financial gaps
caused by severe cuts in federal and state treatment programs. The consequences
of reduced or non-existent dental care are extensive, pervasive and costly.
Oral disease is cumulative. As the disease worsens, treatment requirements
become more complex and costly as the untreated oral disease advances. The low
reimbursement rates for dentists and hygienists who participate in the Medicaid
program exacerbate the lack of access to oral health services. Oral health care
professionals are reimbursed at approximately 40% of the costs for treating
Medicaid patients in Missouri; therefore, receiving 35% less than the 75% of
usual and customary reimbursement levels necessary to cover the cost of
providing the service. Low reimbursement rate discourage dental providers from
participating in the Medicaid or MC+ programs, thus creating less access, long
waiting lists and compounding the effects of disease.
Missouri has only one dental school and despite efforts by the University of
Missouri-Kansas City School of Dentistry to train dentists for service in-state,
major gaps remain. For example, there are only 56 licensed pediatric dentists in
the state and several counties throughout rural Missouri lack the services of
community based, full-time dentists. Today, it costs approximately $300,000 to
educate a dentist and $100,000 to educate a hygienist. Factoring in the average
retirement rate of Missouri dentists over the last decade, it would take a
significantly increased commitment to dental education (approximately $10
million per year) in order to meet the bench mark of 1 dentist and hygienist per
2500 people within 20 years.
Due to a lack of oral health access, education and preventative services,
individuals face staggering dental bills, risk of disease and nationally
millions of hours of lost school and work time each year. The Missouri Coalition
for Oral Health has estimated that for every dollar spent on prevention in oral
health care, $8 to $50 is saved in restorative and emergency treatment. Despite
the projected savings, Missouri offers little in the way of comprehensive
programs, coverage or planning for state residents who are most at risk for poor
oral health.
Using this document to raise awareness, the Missouri Coalition for Oral
Health, in conjunction additional stakeholders, will work with policy makers as
well as professionals in the health care and public service arena to implement
strategies and the following recommendations to improve oral health for all
Missourians.
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