HJAR May/Jun 2022

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2022 41 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement of claims data for 2020 found that dental use by Arkansans with dental insurance decreased by 56% for the period of March through May. Monthly utilization returned to pre-pandemic levels by the end of 2020. Dental offices in Arkansas were allowed to provide routine care for most of 2020, but even so, fewer Arkansans with dental insurance used dental services at all that year compared to 2019. The percentage of adults who visited a dentist dropped from 30% in 2019 to 25% in 2020, and the percent- age of children with dental insurance who visited a dentist dropped from 51% in 2019 to 44% in 2020. ACHI also looked at access issues that could be affecting Arkansans’ oral health. ManyArkansas counties, particularly rural ones, appear to have too few active den- tists providing services. The Health Research and ServicesAdministration classifies a geo- graphic area as having a shortage of dental care providers if it has a ratio of 5,000 or more residents per dentist. Our analysis of claims data found that there were 11 Arkan- sas counties withmore than 5,000 residents per one active dentist in 2019: Chicot, Cleve- land, Lafayette, Lawrence, Lee, Little River, Newton, Pike, Prairie, Scott, and Woodruff. One of those counties, Scott, had more than 10,000 residents per dentist in 2019. Two, Cleveland and Lafayette, had no ac- tive dentist - which we defined as a dentist providing services to at least 20 residents in the study year. We also found that too few dentists serve children with coverage under ARKids First, Arkansas’ children’s health insurance pro- gram. On average acrossArkansas counties, 61% of dentists served anyARKids enrollees in 2019. The percentages varied widely from county to county: in 13 counties, 100% of dental care providers servedARKids enroll- ees in 2019, but in the most populous coun- ties in northwestern and westernArkansas — Benton, Boone, Carroll, Crawford, Madison, Sebastian, andWashington — 45% or fewer dentists served any ARKids enrollees. Regular dental visits can help patients avoid dental problems that require emer- gency treatment. ACHI found that among patients with private, Medicaid, or Medicare Advantage dental coverage who sought den- tal care in an emergency department in 2019, over 92% had not received any preventive dental care in the previous 12 months. Historically, those with no insurance cov- erage are more likely to seek emergency dental treatment, which can result in non- optimal patient experiences and can add to hospitals’ uncompensated care costs. Our study found that visits by uninsured Arkansans to emergency departments for dental care in 2019 resulted in nearly $6mil- lion in charges. What can Arkansas do to increase the use of preventive dental services? There is no simple answer, but the following policy approaches could contribute to a healthier future: • Increase support for mobilized dental resources in underserved areas. • Support the addition or expansion of dental services at existing healthcare provider locations, including clinics and schools. • Expand training opportunities for den- tal care providers. • Incentivize dentists to accept patients with ARKids First coverage. • Encourage schools, parents, and healthcare providers to do more to educate Arkansans about the impor- tance of preventive dental care and good dental hygiene. Finally, for any parent reading this col- umn who has a child enrolled in private cov- erage orARKids First, I challenge you: make sure your kid sees a dentist this summer. n REFERENCES 1 U.S. Department of Health and Human Services. “Oral Health in America: A Report of the Surgeon General.” 2000. https://www.nidcr.nih.gov/sites/ default/files/2017-10/hck1ocv.%40www.surgeon. fullrpt.pdf