What We Have to Do

Improving Oral Health in West Virginia

To promote the health of West Virginians, save health care dollars, improve learning and worker productivity, West Virginia should pursue policies that will address and improve oral health.

1. Develop a comprehensive state plan for oral health based on the framework of the Centers for Disease Control (CDC) and similar to what many other states have developed.  All stakeholders from the public and private sector working to promote health should work together to create a comprehensive strategy to improve oral health of West Virginians, especially children.  A public/private partnership should be created to develop the plan and strategies for implementation.  The Bureau for Public Health, Office of Dental Services, should take the lead and work with the WVU school of Dentistry, the State Dental Association, Dental Hygiene Association, community programs and others.
2. Promote preventive health care for all West Virginians with all health care payers.  State and private health care payers should work together to conduct outreach campaigns that promote preventive oral health practices among children and pregnant women.  Medicaid and the West Virginia Public Employees Insurance Agency (PEIA) should study the cost/benefit of providing a limited oral health benefit for prevention and infection control for pregnant women over age 21.
3. Support legislation that will increase the number of oral health provides and services they can provide.  The West Virginia Dental Association and the West Virginia Dental Hygienists Association are drafting a proposal that should receive full consideration by the West Virginia Legislature in 2008.
4. Support the Department of Education recommendation in requiring every child entering kindergarten, second and sixth grades to have a dental exam by a dentist.  Addressing oral health problems early can save dollars, pain and suffering as well as improve learning.  Department of Education policy for voluntary pre-kindergarten already requires a dental exam for f our year-olds.  Because not all West Virginia Children participate in 4 year-old pre-school, the policy should be extended to children entering kindergarten.  A number of states including California and Pennsylvania now require such exams.  The overwhelming majority of 5 year-olds will have coverage for oral health through Medicaid or WV CHIP or their families will have the ability to pay for the service.  For those few children who do not have the ability to pay, we can work with the WVU School of Dentistry and the West Virginia Dental Association to provide for a free exam.
5. Prohibit the use and sale of sugary snacks and beverages in schools in all 55 counties.  A major cause of poor oral health as well as increasing obesity in children is a result of the excessive consumption of sugary soft drinks.  Hyperactivity that impedes learning is also linked to the excessive consumption of sugar.  To protect the health of children, schools should be prohibited from selling soft drinks and other sugary drinks and snacks.  All students should be educated about the detrimental effects of excessive consumption of drinks made with sugar or sugar substitutes.
6. Create equity between WVCHIP and PEIA by providing oral health coverage for PEIA children below 300% of the federal poverty level.  West Virginia Code 5-16-15 prohibits PEIA from using state funds to offer an oral health benefit.  Children of PEIA members earning at or below 300% of the federal poverty level should have the same oral health benefits now accorded to WVCHIP-covered children.  PEIA should cover the cost of an oral health benefit for PEIA-covered children through private dental insurance or work with WVCHIP to study the feasibility of a wrap-around oral health benefit for PEIA children at or below 300% of the federal poverty level.  Since oral infection can be a cause of poor birth outcomes, PEIA should also study the cost/benefit of providing an oral health benefit for pregnant women to treat oral pain and infection.
7. Address the benefits of early childhood dental care by promoting the integration of preventive oral health care into primary care practice.   Current practice recommends that by age one all children have an oral health exam.  Children with problems should be referred to a dentist.  Much preventive care, however, could be performed by a physician and/or staff in a primary care  practice.  Most children already see a physician for well-child care several times during the first three years of life.  We should provide training and reimbursement for primary care practices to do preventive oral health care including fluoride varnishes on primary teeth on young children.  Medicaid and WVCHIP should develop a payment code for such services.
8. Study the denial of coverage of several insurance companies in West Virginia for medical costs associated with required dental care in the operating room under general anesthesia for the very young or disabled child.  A few young children with severe oral health problems may require treatment in the hospital under anesthesia to correct the problem.  This type of care is now covered by both CHIP and Medicaid as a medical benefit.  PEIA covers care on a case-by-case basis.  Other insurers should also provide for pre-approved coverage of such treatment.