A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality



May 9, 2019

Just as the mouth is part of the body, oral health is a part of overall health. People cannot be healthy unless they have access to the dental services they need.When dental disease is left untreated it can lead to systemic infection, hospitalization, and the worsening of other medical conditions. For years, Health Care For All has worked on issues related to oral health, including public awareness about the importance of oral health, and access to comprehensive dental care for everyone.


Last Tuesday, HCFA and our allies in the Oral Health Advocacy Taskforce took to Beacon Hill to testify before the Joint Committee on Public Health in support of An Act to Improve Oral Health For All Massachusetts Residents (S.1215/H.1916) legislation that authorizes an additional dental professional, called the dental therapist, to work with a dentist to provide oral health care to more people. HCFA also testified on behalf of An Act Relative to the Restoration of MassHealth Adult Dental Benefits (S. 1212/H. 1917) A bill that will restore full MassHealth dental benefits to more than 1 million individuals, including over 113,000 seniors and 230,000 people living with disabilities. HCFA also provided key testimony to the committee in support of An Act to Promote Public Health Through the Prevention and Wellness Trust Fund (S. 1293/H. 2012) This bill would maintain the solvency of the Prevention and Wellness Trust Fund (PWTF) which funded successful clinical-community partnerships focused on childhood asthma, falls among older adults, hypertension, and tobacco use.


The room at the hearing was packed on Tuesday. A wide range of stakeholders, including: The Better Oral Health in Massachusetts Coalition, the MassLeague of Community Health Centers, the Mass Dental Hygienists Association, the Forsyth Institute, Massachusetts Senior Action Council, Rosie’s Place, and the ARC of Massachusetts, to name a few, testified in support of the two oral health bills.

HCFA’s Oral Health Program Director, Dr. Neetu Singh, led the charge in providing expert testimony for both bills. Dr Singh made the case that restoring full MassHealth adult dental benefits would not only benefit the Commonwealth’s oral health, but the state’s financial health as well, pointing out that patients who have to skip the dentist’s office are far more likely to end up in the emergency room. Dr. Singh shared research showing that MassHealth members disproportionately use the Emergency Department (ED) for preventable oral health conditions at a cost 4-7 times that of a community-based dental office visit. In just one year, there were over 36,000 preventable oral health ED visits in Massachusetts, costing the health care system between $15 million and $36 million.

Dr. Singh argued that by directing MassHealth to provide full, not partial, coverage of dental benefits for adults, the passage of S.1212/H.1917 would effectively ensure that patients receive the appropriate oral health services they need to maintain good oral, and overall, health.

Dr. Singh, along with Mrs. Katherine Pellulo of the Mass Dental Hygienists Association and ForsythKids Director Dr. Kerry Maguire, then spoke to the need for recognizing dental therapists (DTs) to address the shortfall of oral health professionals in Massachusetts. Dr. Singh pointed out a clear need for more dental professionals, testifying that “dental therapists offer one solution to address some of the significant gaps in access to care, particularly for our most vulnerable populations including children, seniors and persons with disabilities” Dr. Maguire testified that DTs can play a major role in closing the gap “Dental therapists can help public programs and private practices deliver more care in the community, long before someone seeks care in the emergency department.  Addition of the therapist to the ForsythKids dental team would allow us to see more children sooner, catching problems before they escalate into painful or even life-threatening conditions.”

But the most powerful testimony by far was that of 99 year old Lynn resident Dot Macaione. Dot had gone years without any dental care because Medicare doesn’t cover it and she couldn’t afford the out of pocket costs. She said, “I could barely eat and it was difficult to even speak.” when she was 97, she and her neighbor, Irving, started going to Tufts Dental because it was more affordable. However, as a senior reliant on the MBTA Ride for transportation she would have to take arduous trips as long as six hours to get the basic dental treatments she needed with no recourse. The strain of the journey was so great that it caused Dot’s neighbor Irving to have a heart attack, forcing him into rehab and leaving Dot without anyone to make the trip to the dentist with. Reflecting on the incident Dot said “I can’t help but wonder if we didn’t have to travel so far would that have still happened?” Dot testified that she wasn’t sharing her story for her own benefit, but for those who would come after her, stating “Dental therapists may not be a complete answer, it would be good to have more care in the community and for other seniors who can’t make it to the city”

To close out the day HCFA’s Co-Director of Policy and Government Relations, Alex Sheff, testified about how the Prevention and Wellness Trust Fund (PWTF) goes hand-in-hand with insurance coverage to lower health care costs by keeping people healthy. Mr. Sheff pointed to Harvard Catalyst research that found that the interventions on blood pressure reduction averted between 564 and 864 deaths per million, that all communities showed declines in total health care costs from the pediatric asthma prevention, and that there was a projected decrease of 3,000 falls over five years from the falls prevention work representing huge gains for community health.

One of the PWTF’s legislative supporters, Senator John Keenan, also testified about the fund’s uses for providing health equity. “The Prevention and Wellness Trust Fund made critical access to health programs to residents in the Quincy area. It had great impact in addressing health disparities. Many Asian Americans didn’t have access in my district to those programs.”

All in all, it was a huge day but the fight is still continuing, HCFA and OHAT invite you to join our fight for #OralHealthIsHealth, so together we can all be proud to smile.