A Youth Leader’s Perspective on Access to Oral Health Care

Jacquelyn Hedrick, YES! Youth Staff

According to data collected in 2008 from North Carolina schools, students with poor oral health were three times as likely as those with good oral health to miss school. What this means is that over 3.4 million academic hours were missed due to dental care, and approximately 720,000 of those hours were missed due to pain. Regardless the quality of the school or education, if students aren’t mentally and physically present, they aren’t able to learn. Absences can significantly impact a student’s performance in school; dental decay, dental pain, and other conditions, while completely preventable, can and are adversely affecting the lives of me and my North Carolina peers.

Lack of access to oral health care plagues North Carolinian students and hinders them from reaching their full potential as learners. There are four counties within the state that do not have a single dentist within their borders. For those without access to transportation or the ability to take off work, this is a major obstacle to care. Even for those people who do live in areas that do have dentists, disparities exist. In 2014, the American Dental Association highlighted that only 27% of NC dentists accepted public forms of insurance because of its low reimbursement rates, leaving those in lower income brackets still without care despite being close to a dentist. While the argument often made is that people can visit free clinics or mobile dental offices, this is not always an option. Nothing better exemplifies this struggle than the tragedy that befell Deamonte Driver.

Alyce Driver of Maryland, Deamonte’s mother, was searching high and low for a dentist that would treat her other son’s six rotting teeth. As they experienced homelessness, lacked transportation, lapsed out of Medicaid, and struggled to maintain phone numbers or addresses, Alyce Driver’s search proved fruitless and exhausting. Even those the Driver family sought help from at shelters could not find a dentist that would treat them. On January 11, 2007, twelve-year old Deamonte Driver arrived home from school complaining of a headache. After visiting the hospital, he was given medicine to treat his headache, a dental abscess, and sinusitis. However, the next day, things were much worse, and they returned to the hospital where he was rushed into emergency brain surgery. He then experienced severe seizures and underwent a second operation to remove his abscessed tooth. It was at this point that his condition began to improve. One morning, at 6 AM, Alyce Driver received a call from Deamonte’s grandmother. He was unresponsive. When she arrived, her son was dead. His causes of death were listed as “meningoencephalitis” and “subdural empyema,” both associated with brain infections. Today, many advocates argue that his cause of death was really a lack of access to preventative care.

It is important to analyze which students these issues most often affect. The study listed above found that the variables most often associated with poor school performance were “gender (male), race (Black), grade in school (6–12), parental educational level (high school), health insurance (public), and those with special health care needs”.

Eliminating the dental pain a student experiences, ensuring they receive preventative care at a permanent dental home for the student, and guaranteeing the student is covered by health insurance which provides for oral health care can improve the attendance, performance, and confidence of a student who would otherwise struggle. This statement begs the question of how we, as a community of students, parents, and teachers, can support the provision of these things for and improve the oral health of all students of North Carolina.

One of the most attainable solutions to this problem focuses on the variable of health insurance, especially in the current legislative climate. Raising reimbursement rates for Medicaid would make accepting this form of insurance a more attractive and viable option for dental practices across North Carolina. 1,833,630 people were enrolled in Medicaid as of July 2015, but only a quarter of dental practices in NC accepting Medicaid. Another strategy that is being implemented in 39 other states is modernizing North Carolina’s Dental Practice Act to allow all dental health providers to practice up to their educational capacity, and therefore increasing access to care. These strategies would allow a greater proportion of that already large population to receive regular, preventative care which greatly reduces the chance of what happened to Deamonte, happening to a North Carolina student.

To get involved with our movement, go to OralHealthNC.org and join the mailing list. Also, mark your calendar for April 5th when North Carolinians will gather for Oral Health Day at the Legislature. Together, our voice is powerful.