Opinion :: Guest Opinions
How changing dental coverage affects those living with HIVTuesday May 18, 2010 Massachusetts has a long legacy of innovation and leadership in protecting the health of all our residents, and in particular individuals who are the most vulnerable and face the greatest challenges accessing health care services. Our state’s commitment to health care reform is a testament to this value, and we are making strides towards universal access to medical care. However, dental care is a critical and too often overlooked core medical service, and historically an early target when budget cuts are necessary. Governor Deval Patrick and the House of Representatives have both proposed budgets for FY11 that would eliminate access to most oral health care for the 700,000 adults on MassHealth, the state Medicaid program. This is a dangerous and shortsighted approach, and cannot be tolerated.
For individuals living with HIV or other chronic medical conditions or disabilities, dental coverage is essential, not optional. A diminished ability to fight infection due to a compromised immune system leaves people with HIV at risk of minor troubles escalating into major health problems. Poor oral health and missing teeth also affect the ability of people with HIV to maintain adequate nutrition. Anyone without adequate nutrition is medically vulnerable and it becomes more difficult for them to fight off infections and recover from illnesses. Dental problems can interfere with medication adherence, and since some prescriptions must be taken with food in order to be effective, this can place patients at risk for problems with medicine absorption, effectiveness, or may even lead contribute to the development of drug resistance.
Since dental decay is a bacterial infection that can spread to the rest of the body if left untreated, what begins as a cavity can quickly progress into a life-threatening condition. Both detection and timely treatment of oral infections is critical, resulting in a positive and major impact on overall health and well being. Oral infections are often preventable and/or highly treatable. Preventive care remains important; however, restorative dental treatment is effective in helping individuals avoid pain, potential infection, serious medical complications, and results in significant cost-savings to hospitals and emergency rooms. Restorative dental treatment is not cosmetic or discretionary; it is vital and potentially life saving for people living with HIV, viral hepatitis, cancer, diabetes, and other chronic illnesses.
The fight is not over. There is still a chance to save adult MassHealth dental coverage! As the Senate debates the FY 2011 State Budget, it is critical that we stand up and let our elected officials know that dental care is health care.
This opinion piece was prepared by:
Calvin Cohen, MD, MSc, Research Director, Community Research Initiative
Helene Bednarsh, BS, RDH, MPH, Director HIV Dental Program, HIV/AIDS Services Division, Boston Public Health Commission
Michael Goldrosen, Director of HIV/AIDS Services Division, Infectious Disease Bureau, Boston Public Health Commission
Frank E. Schiano, DMD, CAGS, Director of Dentistry, Fenway Health, Clinical Assistant Professor, Boston University Goldman School of Dental Medicine, Member, Ryan White Part A Planning Council
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