This article shines a spotlight on Benevis, a leading dental healthcare delivery organization for practices that focus on providing oral care and orthodontics to underserved communities. Through comprehensive care, operational services that expand access to dental services, and a network reaching more than 100 dental offices across the U.S., Benevis has a 20-year history of providing the highest quality care to more than 5 million patients in low income and underserved communities each year. Benevis supported practices have more than 80 percent of patients on Medicaid or CHIP plans and the past eight years, the company has held a "Sharing Smiles Day" which provides free dental services to uninsured and underserved children and their families.
Dental health and the health of the economy are closely intertwined. For the economy to thrive, communities and the people supporting the local ecosystems must be healthy. Oral disease affects overall body health and has great impact on communities because of pain, impaired function, and reduced quality of life. Lack of access to regular dental care creates a ripple effect of escalating costs and related healthcare challenges. Over 215 million school and work hours are lost annually due to dental problems. There are over 830,000 visits to ER’s nationwide for preventable dental conditions which costs the U.S. healthcare system $2.7 billion each year, and Medicaid accounting for the largest share of this spending. The cost to society from absenteeism and loss of productivity from oral infections is estimated to be $50 billion per year. These numbers would not be as high if people had access to basic preventive care.
The disparity between the rich and the poor is growing in dental disease. Low-income populations have significantly higher levels of dental disease and disproportionate problems, almost 5 times higher, compared to affluent populations. This dynamic is also reflected globally with the incidence of oral problems being much higher in poorer countries. Despite numerous advances in healthcare, one statistic has not measurably improved in 20 years. More than half of adolescents in the U.S. have tooth decay. The importance of dental care in children including orthodontics should not be overlooked, as this period forms the foundation for oral health in adulthood. Adopting healthy dental care behaviors during childhood and adolescent years can have a critical impact on overall health and well-being into adulthood.
Tooth decay continues to be the most common chronic disease in adolescents even though it is generally preventable.
One-third of adolescents do not have access to preventive dental care in the U.S.
Among adolescents 12 to 19 years, about 57% have had tooth decay in their permanent teeth.
17% of 12-19 year olds have had untreated decay and older adolescents experience 18% more decay in permanent teeth than younger children with tooth decay increasing with age and poor acquired habits.
Adolescents from lower-income households are twice as likely to have untreated decay as those from higher income households.
Many oral diseases in adults begin in early childhood, with tooth decay and gum disease being the most common chronic diseases among them. Dental caries affects permanent teeth from early childhood and beyond, including the ability to eat and speak, which are critical to physical and psychosocial health. Other oral diseases carried into adulthood include periodontal disease and gingivitis, temporomandibular joint disease, and human papillomavirus infection. An overwhelming number (70%) of oropharyngeal cancers in the U.S. stem from HPV infection, making adolescence an ideal time to be vaccinated. However, only 51% of adolescents in the U.S. received the HPV vaccine in 2018.
The NIH Oral Health in America Report: Advances and Challenges cites that one-third of adolescents in the U.S. do not access preventive dental care. Social determinants of health, family educational level, income and economic disparities, race, and geographic barriers all play a role in this. Overall, adolescents from low-income families experience greater barriers to care and higher rates of decay. Also, African American, Hispanic, Asian, and Native American children receive less dental care than White adolescents and have more untreated tooth decay. About 25% of adults avoid smiling due to the condition of their mouth and teeth.
Providing public initiatives that identify and support oral health disparities during childhood and adolescence, which are vital stages of development, is essential to adult dental health and well-being. When asked about the most important activity they wanted their adolescent patients to follow to protect their oral health, Benevis dentists said they wished young patients were better educated on the importance of their oral hygiene and health. During this stage of life, tooth decay, sports injuries, tooth erosion, gum disease, and misalignment of teeth make their first appearances. Mental health issues and risk-taking behaviors like tobacco and substance abuse are also common occurrences in adolescence and these negatively impact oral health in the long term. As adolescents move closer to adulthood and further away from the support of their parents’ oversight and dental insurance coverage, establishing strong oral health habits in early childhood that can be maintained over a lifetime becomes very important.
Integrating Medical-Dental Care for Better Health
The more recent recognition that integrated medical and dental care will help to improve overall patient health outcomes is slowly beginning to happen. Given the connection between oral health and overall health and well-being, health systems are investing in dental service organizations and starting to form partnerships that support whole person care. Benevis is actively collaborating with primary care providers across 100 plus communities in 13 states to support children’s oral healthcare. The company has provided physicians and clinicians with a Dental Home Playbook to help assess risk for caries and guide patient resources and education for better dental health.
Preserving Oral Health through Education
Another important area for improving oral health in teens includes a focus on opportunities to deliver dental care in schools. “The younger we can educate kids on how to care for their teeth, the better chance they have of preserving their oral health as adults. We have an opportunity and responsibility to make sure fewer adolescents experience decay, and we can do that by teaching them earlier in life. In school, at home, and across every healthcare setting, dental education is vital to our children’s health,” says Dr. Brad Bryan, a Benevis Dentist and Vice President, Clinical Operations.
On our small scale level, Help a Child Smile that I founded, is working at grassroots level in preschools and elementary schools, to educate children and families about dental health and oral cancer. Our focus is on rural, low income, and underserved areas and Help a Child Smile is actively working in communities in Georgia, the southside of Chicago, and the Bhalswa Slum District in Delhi, one of India’s poorest and most populated areas. Our mission is to bring down the high incidence of pediatric dental disease in childhood and set up communities for a happier and healthier future.
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