Bill Before General Assembly Would Advance Oral Health Care, Supporters Say

State dental director could help draw down federal grant dollars
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JEFFERSON CITY, Mo. – Proposed legislation in the Missouri General Assembly could help draw direly needed oral health funding to the state, if approved, according to supporters of the measure.

The proposed legislation, House Bill 613, would establish a state dental director position within the Department of Health and Senior Services.

Authorizing the post would improve the state’s chances of getting grants through the federal Health Resources and Services Administration (HRSA) and the U.S. Centers for Disease Control and Prevention (CDC), said Gary Harbison, executive director of the Missouri Coalition for Oral Health.

According to Harbison, if Missouri received average or even low-end amounts from the federal grant programs, the state could bring in about $685,000 a year.

That would more than double the current budget of the state oral health program, which operates on a $650,000 funded through HRSA’s Maternal and Child Health Services Block Grant, according to health department spokeswoman Gena Terlizzi.

The absence of state funding for the program “proves a lack of emphasis on oral health in the state,” said Vicki Wilbers, executive director of the Missouri Dental Association. “There’s just a lack of attention to oral health, period.”

Missouri hasn’t had a full-time state dental director since Dr. M. Dean Perkins left state government in 2003.

Harbison and Wilbers said officials with the state oral health program do a good job given what they have to work with.

“They need a leader,” Wilbers said, “somebody who is going to be there daily for oral health, and right now, that it is just nonexistent.”

One area where the state needs to be more of a leader, she said, was in the area of fluoridation of municipal water.

Missouri was 41st and 33rd, respectively, among all states in the percentage of adults who had seen a dentist or had their teeth cleaned within the past 12 months, according to 2010 data from the U.S. Centers for Disease Control and Prevention.

The statistics were included in a report, “Oral Health in Missouri,” issued in June by a coalition of health foundations.

In January, the Pew Children’s Dental Campaign gave Missouri a “D” in a nationwide analysis of state efforts to provide dental sealants to low-income children.

A dental director, Harbison said, could be “foundational in moving those numbers forward and making oral health in Missouri move in a positive direction.”

Harbison said he expected the CDC to solicit this spring proposals for grants for the next five years but that the agency would not consider applications from states that do not have a dental director. He said Missouri could go ahead and apply, if it’s moving in the direction of having a director.

Rep. Donna Lichtenegger, a Jackson Republican, introduced HB 613 two weeks ago.

Rep. Jeanne Kirkton, a Webster Groves Democrat, is co-sponsoring the bill along with Rep. Nate Walker, a Kirksville Republican.

Kirksville is home to the Missouri campus of A.T. Still University. The university recently established the Missouri School of Dentistry & Oral Health, which expects to enroll its first class of 40 students in the fall.

Lichtenegger and Kirkton are also chair and vice chair, respectively, of the newly established Oral Health Issue Development Committee, a caucus within the General Assembly. Members plan to meet for a second time next month.

Supporters of the House measure said they are awaiting its referral to a committee and are hoping to get a hearing this session. Harbison said he does not expect the introduction of companion legislation in the Senate.

Passage of the bill could be difficult given that much of the discussion in the General Assembly is about cutting spending, he said.

The state might need to appropriate only half of the roughly $120,000 salary that a dental director might command. Funding from foundations and federal grants could pick up the rest, Harbison said.

Perkins, the former state dental director, also served as executive director of the Association of State & Territorial Dental Directors.

Now living in North Carolina, Perkins remains active with the association and is an adjunct faculty member in the A.T. Still University School of Health Management.

He said Missouri neighbors that have dental directors include Kansas, Nebraska Iowa and Illinois.

Missouri had “systematically downgraded” its oral health activities since his departure, Perkins said.

“And the department of health will argue with you,” he said. “They will tell you they have a state oral health program, but it is certainly not a state oral health program by any definition that is accepted by most people in public health.”



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