Oregon's legislators will grapple with many important health and wellness issues in 2017. One of the most important will be ensuring statewide access to dental care.
The delivery of quality dental care is critical for individual wellness and quality of life. The link between oral health and overall health is well-established. Yet, despite the importance, access to appropriate care in Oregon remains a challenge. Too many rural, tribal and economically disadvantaged Oregonians lack adequate access to comprehensive dental services.
Over the past 10 years, the Legislature has addressed the dental services gap in rural areas with some success. The state has provided rural practitioner tax credits that have helped expand dental services into historically underserved areas. These incentives have helped families throughout rural Oregon have greater access to professional dental care. State efforts around the concept of "medical dental homes," Coordinated Care Organizations (CCOs) and Dental Care Organizations (DCOs) have also helped.
However, rural access to dental services and holistic care will require significant legislative effort. Older dentists in rural areas must be replaced by newer, younger dentists. But too many dentists carry the burden of dental school debt well into their practice years, making it more difficult to establish practices in rural areas. Another problem is that dental access in rural and economically underserved communities is hampered by below-cost reimbursements for dental services provided under the Oregon Health Plan.
A 2017 legislative mandate to address these issues would go a long way toward expanding access for all Oregonians. First, lawmakers should renew the rural practitioner tax credit for dentists. The Legislature should also raise the credit from its current level to better reflect the reality of rising student debt.
In addition, the Legislature must look at reimbursement rates under Medicaid and the Oregon Health Plan. In many communities, reimbursement rates for dental care cover only 60 percent or less of a practitioner's actual costs. This makes it difficult, if not impossible, to maintain viable dental practices in areas where the Oregon Health Plan is heavily relied upon.
Finally, Oregon must address the issue of dental access for tribal communities. While some tribes in Oregon are well-covered by dental professionals, others are not. A partnership between the state of Oregon, OHSU's School of Dentistry and the tribes could create an endowment to help qualified students from tribes attend dental school at no cost. In return they could serve tribal communities for a set number of years - a win for both the tribes and the new dentists who would practice unburdened by student debt.
As we consider how to address the very real oral health challenges for these communities, we must recognize that first-rate dental health requires first-rate dental providers. All residents of Oregon - urban, suburban, rural and tribal - deserve access to professional dentists. Access to comprehensive oral health care really is a social justice issue, and Oregon's leaders must make it a priority in the next legislative session.
Sean Benson, DDS, is Associate Dean of Hospital Dental Services at OHSU and the former President of the Oregon Dental Association. He has a practice in Baker City, and currently resides in Portland. Dr. Benson is an employee of OHSU, however this is a personal opinion and does not represent the opinion of OHSU.
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