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By taking care of adult teeth through AHCCCS, lawmakers would improve child health

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I am a pediatric dentist, but I couldn’t be happier about the restoration of emergency dental benefits for adult Medicaid patients. I won’t see one dime from it, but it should mean fewer extreme cases in the children I do see. That makes me smile.

I use a standard risk assessment for every child who comes to my office. Certain characteristics, such as a low family income or how much sugar a child consumes, indicate a high risk that the child will develop cavities. So does a parent with a history of cavities and abscessed teeth. I see this regularly, and at least two scientific studies have confirmed the link.

Kirk Robertson

Kirk Robertson

Yet the Arizona Health Care Cost Containment System, while providing full dental benefits for children, has never covered preventive care for adults. During the Great Recession, emergency dental care was zeroed out. That meant adults in the AHCCCS program who experienced serious dental issues had to go to emergency rooms, which could only ease pain or treat infections, not the underlying problem. It was the health care equivalent of putting wallpaper over mold.

The Arizona Dental Association has sought to restore the emergency benefit ever since. This year, Gov. Doug Ducey and the Arizona Legislature wisely agreed. The Legislature approved restoration of the emergency dental benefit in this year’s budget, and Gov. Ducey signed it into law. From the bottom of my heart, I want to offer my sincere thanks; this critical decision will help reduce the number of heartbreaking cases I see.

We tend to think of dental disease differently from other health conditions. A child whose parent has a contagious disease is at risk of catching the same disease, so we make sure the parent gets treatment.

Oral infections spread the same way, yet state policy hasn’t recognized this. If I don’t see the child of a parent with a history of oral disease until the child is 3 or 4, it’s already too late. They will require extensive work. This is deeply saddening because it’s so preventable.

Restoring the emergency dental benefit for adults brings an infectious disease approach to oral health, something we’ve long needed. Take care of the parent’s mouth, and the odds greatly increase that the child will have healthy teeth and gums. The cost to the state will be offset by lower emergency room bills and fewer children needing extreme treatment.

The restoration should be applauded and celebrated.

Dentists this year also advocated for extending preventive dental care to pregnant women on AHCCCS, making the same case for an infectious-disease approach. Ample evidence shows how easily infections spread from a woman’s mouth to her fetus, and how expensive it is when that leads to babies born pre-term or with a low birth weight or respiratory distress. It didn’t make this year’s budget. It should be a priority for next year.

I would much rather spend my time on routine dental care for children, not on the gut-wrenching cases I see too often. The more we do to make sure parents get proper care, the sooner I can reach that goal. Restoring emergency dental care in AHCCCS starts us down that road. Let’s keep going.

— Dr. Kirk Robertson owns Around the Mountain Pediatric Dentistry in Flagstaff and Lakeside.

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The views expressed in guest commentaries are those of the author and are not the views of the Arizona Capitol Times.

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