Access to a healthy mouth and smile shouldn’t depend on our income, race, or where we live. Yet here in Washington that is precisely what is happening. Richer whites with private insurance can easily get an appointment to see a dentist in their community, while the reverse is true for low-income people of color who have either Medicaid (called Apple Health in Washington ) or no health insurance.
How do we know this? Because we hear it all the time. Every other summer, my organization – Statewide Poverty Action Network – travels to communities across the state to hear from those affected by economic and racial injustice talk about what they face on a daily basis and their views on life. change. What we hear informs the policies we advocate in state legislature. What we hear over and over again, even when not asked, is that people all over Washington are not able to get the dental care they need. People are faced with the brutal decision to suffer and risk losing their teeth or incurring medical debts in order to seek treatment. We constantly hear stories of people delaying custody and ending up losing their smile in order to meet other needs like rent, bills, and expenses to care for their children.
Indeed, data from the Health Care Authority shows that less than 25% of people enrolled in Medicaid over the age of 21 can find a dental provider. That number is better for kids at 53 percent, but the idea that barely half of our kids can see a dentist isn’t exactly a resounding endorsement of our current oral health system.
It should not be acceptable. For something that is such an obvious (and often painful!) Need, it is troubling that our state’s legislature has not made access to oral health a top priority. While there are many solutions to improving access to dental care for everyone in Washington, only one remains evidence-based and yet fiercely opposed by the Washington State Dental Association (WSDA): dental therapy. Dental therapy is based on years of research and is already practiced in 12 other states and on tribal lands in Washington. In addition to advancing care, this creates a more affordable path to quality health care employment so that dental therapists can provide care to the community in which they grew up.
We have fought for years to protect and increase funding for adult dental care through Medicaid so that more dentists will accept patients insured through Apple Health. At the same time, we support the expansion of dental therapy to all communities in the state. But for years, the WSDA has used its influence and political action committee to spread misinformation and fear among our lawmakers to obstruct dental therapy. The success of these efforts continues to block greater access to care for black and brown children, and leaves adults in our state with more and fully preventable oral disease.
For years, lawmakers have called for all sides of the issue to come together for a full discussion. It finally happened. During the 2021 legislative session, the state legislature created a task force to examine the introduction of dental therapy to every community in Washington. I was invited to join the Dental Therapy Working Group alongside other members with a range of expertise and experience to review research and hear from practicing dental therapists, oral health experts and dentists who supervise dental therapists.
My experience in the working group was as frustrating as it was informative and inspiring. I have read mountains of research showing the effectiveness of dental therapy in improving access to care. I have heard deeply touching stories of Indigenous dental therapists speaking their mother tongue to children receiving care for the first time. I have heard of the improved oral health outcomes for communities and a sense of pride in having a local provider who has stayed in their community.
And I have seen representatives of a large, well-funded and well-organized association resort to blocking, distracting, name-calling and questioning of the integrity and experience of practicing dental therapists and their staff. supervisors working on tribal lands.
But in the end, what matters is whether or not these tactics will work. Whether the WSDA antics will continue to prevent lawmakers from adopting an anti-racism and anti-poverty policy that has been proven to improve access to health care depends on our lawmakers. Will they choose the path of fear and misinformation, or will they follow the example of our state’s tribes and allow dental therapy for everyone in Washington?
The choice is clear to me. Lawmakers are expected to consider the task force’s report, stand in solidarity with their constituents who need access to oral health care, and allow dental therapy statewide in the 2022 legislative session.
Marcy Bowers has been the Executive Director of the Statewide Poverty Action Network since 2011. The Statewide Poverty Action Network is a Seattle-based poverty advocacy organization. Bowers is also chairman of the board of directors of the Washington State Oral Health Coalition.
Read the rest of the issue from December 8 to 14, 2021.