Kentucky has a problem with its national image.
Whether it’s a 20/20 news show or a made-for-TV movie, too often the face of our state is that of a person missing a mouthful of teeth.
We could object to the fairness of this stereotype -- it has led to ridicule and a misleading generalization of our state’s inhabitants.
And we could put forth for alternative consideration an array of Kentuckians who have made invaluable contributions in areas like science, medicine, literature and technology.
But let’s be honest. We have an image problem precisely because the reality underlying that image does in fact exist.
Oral health care is and remains a major health challenge for this state.
· In 2004, Kentucky led the nation in missing teeth among people age 65 and older.
· Some 27 percent of Kentuckians of all ages had lost six or more teeth to decay or gum disease, compared to nearly 18 percent nationwide.
Not surprisingly, these problems start at an early age:
· In 2001, about half of Kentucky’s children had decay in their primary teeth.
· 46.8 percent of children ages 2, 3 and 4 had untreated problems such as a cavity or a missing tooth. That’s more than twice the national average.
· And nearly 40 percent of these children had never seen a dentist.
Yes, the statistics are real.
They’re also unacceptable.
Dental problems are preventable. They just have to be a priority.
Today, we begin making them a priority with a three-year initiative that aggressively focuses resources on the causes of Kentuckians’ poor dental health, especially our children.
The Kentucky Oral Health program within the Cabinet for Health and Family Services has earned three federal grants totaling just over $1.6 million.
One grant is from the federal Health Resources and Services Administration. The other two come through the Appalachian Regional Commission.
We will use these grants to undertake a three-part strategy to improve the access of young patients to dental care and to improve Kentucky's overall dental health picture by tackling root causes.
One of the biggest challenges remains access. There are too few dentists, particularly pediatric dentists. In fact, only 28 of Kentucky’s 120 counties are home to a pediatric dentist. In addition, a limited number of dentists accept Medicaid patients. And, in many areas, transportation is inadequate.
Another challenge is attitude and education. Not enough people truly understand the link between good oral health and overall health.
And another challenge, quite simple, are poor habits. We, collectively, must develop better oral hygiene practices and better nutritional habits.
Now, how are we going to do this?
The first piece of the puzzle involves increasing the number of Kentucky dentists willing and able to treat patients under 6. Child patients pose challenges, but unless a dentist is specializing in pediatric dentistry, he or she receives only limited training in dealing with them.
The Kentucky Oral Health program, working with key stakeholders, will develop a curriculum that teaches effective pediatric technique.
A key strategy in the multi-faceted approach used in Washington state, this technique will be known as the “ABCD” initiative (or Access for Babies and Children to Dentistry).
Once Kentucky's curriculum is finalized, a series of seminars, Web-based training modules and mentors will assist local practitioners.
Incentives will also be offered to providers, at no cost to them, in the form of continuing education credits that all dentists currently must earn every two years.
So that's step one, getting the right training in place and making it available to dentists statewide.
The second step involves targeting counties in Appalachia, especially the 40 counties designated as “distressed,” with extra efforts.
The ARC funds can help financially offset the time taken off from practice for those dentists who participate in the ABCD training initiative.
Another component involves creating local coalitions to create and tailor oral health care programs to the specific communities.
This recognizes that because problems differ from county to county, what works in one county might not work in another.
These coalitions will work with local public health departments and other partners to assess dental health on the community level, propose and implement solutions and – incidentally – be eligible for additional benefits from the grants to support local priorities.
We anticipate being able to fund up to 12 such coalitions, which typically will include one county but could cross county borders.
Plans developed and tailored to the local level are more likely to bring real and sustainable progress.
And our third component, which will happen in year three, is to buy portable dental equipment that will be made available to ARC-distressed counties to increase access and utilization of dental services for both adults and children.
This is not a mobile treatment van like we usually envision, but instead the latest portable equipment that can provide a full array of dental services in nontraditional treatment settings like schools, child care facilities or senior citizens centers.
We expect to have at least two sets of this equipment initially, with hopes of obtaining more later.
Now, a few things about this oral health care initiative should be obvious.
One, this effort will have a lot of partners, on the local, state and federal level. That’s appropriate given the systemic nature of the problem, and it will increase our chances of success.
I want to acknowledge the hard work of our people at the Department for Local Government in helping to prepare the grant applications for working with ARC to secure funding.
I also want to thank our Congressional delegation for making sure ARC is awarded funds.
The second thing that should be obvious is that this problem won’t be eradicated overnight.
However, we do anticipate and expect to made measurable progress with this program. Thus we have set some specific goals.
For example, within three years of the start of the project, we expect to increase the number of dental visits by children up to 6 years old by 16 percent, as measured by Medicaid service reports.
We also want to reduce the decay rate by 15 percent in children in the distressed counties.
Other goals predict other outcomes.
The third realization is that this isn’t just a dental program, it’s a health program.
Teeth aren’t just for looks, and good oral health isn’t just cosmetic. It’s a key factor in overall health.
Poor dental health has impact far beyond lack of a pretty smile.
Studies show children with untreated pain and infection because of tooth decay often choose other foods, affecting their overall nutrition.
They also can have poor speech development; and they have lower performance in school.
You can’t learn under those conditions, especially when you miss school.
This program dovetails well with one of my highest priorities as governor, which is getting our children off to a good start in life.
Previously we began work on a program to bring health insurance to the tens of thousands of children whose families don’t have any.
Already more than 25,000 additional children previously uncovered have been signed on to Medicaid or K-CHIP, and that number continues to grow.
We’ve also created a task force to streamline our network of early childhood education and health services.
The simple fact is we owe our children the promise of a productive life.
Making good on that promise is a moral obligation, but it also will pay great dividend in creating a stronger state.
You know, we have severe financial challenges in state government, just like every state does.
But a down economy is no excuse. We must fight for our families. We must improve the lives of Kentuckians. We must move forward on fundamental problems holding us back.