Oral Health Priority Paper

Problem: Inattention to oral health has important implications for our ability to reach current and future physical health outcome goals. To achieve these goals, we need to recognize that health is more than primary care physicians and hospitals. We need to appreciate the interplay between oral health, medical care and behavioral health systems.

Recommended Action: Recognize the importance of good oral health care to physical health. Michigan must also reinstate oral health services for Medicaid adults. The impact on health and the cost to the health care system is too significant to ignore.

Good oral health care is extremely important in preventing, diagnosing and treating both oral and primary health care needs of their patients. Because the proponderous of research-based evidence on the impact of poor oral health, the U.S. Surgeon General has lent his leadership to efforts to eliminate oral disease from the nation's most vulnerable populations in order to preserve their general health. Here are some examples of how poor oral health affects a state and nation's health:

• Pre-term births (before 35 weeks) will increase.
• Diabetes will be more difficult, if not impossible, to control.
  
• Incidence of arteriosclerosis (narrowing of blood vessels that can lead to a heart attack or stroke) will increase.
  
• Heart disease will increase.
  
• Incidence of low birth weight infants will increase.
• Incidence of dental caries in children will increase by inoculation from untreated dental caries in their parents.
  
• Morbidity and death from oral cancer will increase.
  
• Untold increase in the incidence and suffering from dental disease.
  
• Employability will be reduced.

We need to recognize that dentists are not simply tooth technicians and that oral health care is not secondary but intrinsic to good health. While eliminating oral health benefits for Medicaid adults will save $9.2 million in up front general fund savings, we believe the actual cost to the state will be much higher. First, treating illnesses that could have been prevented or identified at an earlier stage will entail significant cost. For example, the lifetime medical costs for one premature baby are conservatively estimated at $500,000. A recent study to quantify the lifetime cost of medical treatment for women younger than 65 with cardiovascular disease, diabetes or stress urinary incontinence, found the total lifetime cost of treatment is $233,000 more than the cost of treating someone without the condition.
Michigan must begin to focus our public funding towards achieving the outcome of a healthier population rather than what is mandated or what has the strongest lobbying force.

For over 30 years, Michigan's community, migrant, HIV/AIDs and homeless health care programs have been delivering comprehensive primary care to the medically underserved communities in our state. Michigan's 26 Federally Qualified Health Center (FQHC) and FQHC 'look-alike' organizations form an essential component of the state's safety net for health care services and provide a comprehensive set of health care services at almost 100 different locations. These organizations are on the front lines of health care serving the most vulnerable populations, including rural and inner city communities lacking adequate providers, patients on Medicaid, the low-income uninsured, the underinsured (working poor), and persons living on the edges of these groups. FQHCs are committed to providing high quality, comprehensive health care services to federally designated medically underserved areas/populations.

For these reasons, we are requesting your support. For more information, please contact: