Ann Arbor, MI - January 20, 2009 - Oral health disparities are a significant problem, not just in Detroit, but most of America's other big cities too. Some fresh thinking may be needed to develop new models of delivering care as well as collaboration among different groups if the problem is to be successfully addressed, according to the President of the Michigan Dental Association and U-M School of Dentistry alumna, Dr. Joanne Dawley.

Dr. Joanne Dawley

In remarks delivered at U-M Hospital as part of the University's observance of Dr. Martin Luther King Jr. Day, Dawley outlined the scope of the problem and a "perfect storm" of converging factors that will make it increasingly important for dentists and physicians, research scientists and technicians, and business and political leaders to work together. Citing her experience as a practitioner for more than twenty years and her participation in organized dentistry, Dawley said, "My purpose is to pose questions for consideration, not to give answers."

Oral health disparities are especially acute in Detroit where more than 16 percent, or 147,000 of the city's nearly 900,000 residents are uninsured. By comparison, Dawley said, the state-wide average in Michigan is about 7.8 percent. However, the problem is expected to worsen as the auto industry contracts and other manufacturing businesses jettison workers who now have dental and medical insurance.

Compounding the problem are low reimbursements for dentists providing oral health care to their Medicaid patients, now about 30 cents on the dollar, as well as uncertainty about what role, if any, dentistry might have as a part of any national health care plan that may be considered by the Obama administration. "Health care is a noble and honest profession, but it's also a business, and we need sound financial principles and policies that will allow those in the profession to deal with oral health care disparities," Dawley said.

Dawley said children are those who need care the most. She said about 33 million children receive oral health care under terms of U.S. public health programs including SCHIP, the State Children's Health Insurance Program. The federal program, which gives funds to states to provide health insurance to families with children, covers those families whose incomes are too high to qualify for Medicaid. However, millions of children are still not receiving proper care. "It's unconscionable children don't have the same kind of access to care others have," she said.

Pointing to several changes in policies that could allow other oral health practitioners to administer some of the care that is now provided by dentists, she also noted initiatives where dentists provide care in community dental clinics or where oral health care specialists volunteer their time and services. Regardless of what approach is taken, Dawley said, "I see a different environment ahead where we will have to do more with less."

The MLK Day Health Science Program was sponsored by the School of Dentistry, the School of Medicine, the School of Public Health, the School of Nursing, the School of Social Work, the College of Pharmacy, and U-M Hospitals and Health Care Centers.

The University of Michigan School of Dentistry is one of the nation's leading dental schools engaged in oral health care education, research, patient care, and community service. General dental care clinics and specialty clinics providing advanced treatment enable the School to offer dental services and programs to patients throughout Michigan. Classroom and clinic instruction prepare future dentists, dental specialists, and dental hygienists for practice in private offices, hospitals, academia, and public agencies. Research seeks to discover and apply new knowledge that can help patients worldwide. For more information about the School of Dentistry, visit us on the Web at: www.dent.umich.edu.

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