FRANKFORT — A $2 million effort to improve the oral health of Kentucky children will train more dentists to treat young patients, purchase portable dental equipment to serve areas in need and create community coalitions to address barriers to good oral health.

The effort will help tackle the poor oral health in Kentucky “that in some instances is unconscionable,” a state health official told members of the General Assembly’s Poverty Task Force yesterday.

Steve Davis, MD, the senior deputy state health officer for the Cabinet for Health and Family Services, told lawmakers that children’s oral health problems can have “a domino effect” that interferes with their development and ability to learn. “It’s not just an oral health issue. It’s an overall health issue as well,” he said.

The state’s new oral health initiative, funded by federal grants, seeks to increase access to dental care. “In so many of our areas we don’t’ even have a dentist available that can see young children” Davis said.

The initiative will support a training program so that more general dentists will be prepared to offer care to young children. It will also establish oral health coalitions at local levels so that oral health problems can be identified and plans to overcome them can be tailored to an area’s specific needs.

The state’s efforts will also include the purchase of portable dentistry equipment. The equipment will be transported to counties in need so that dental care can be offered in places such as schools, child care centers and senior citizens’ homes, Davis said.

Kentucky led the nation in adults missing teeth by age 65 in 2002. Nearly half of the state’s children between 2 and 4 years old have untreated oral health problems, such as cavities – more than twice the national average, according to the Cabinet for Health and Family Services.

The reasons for the state’s poor oral health are many, including poor diets, a lack of understanding of the importance of good oral health in some families, and a shortage of dentists in certain areas, Davis said.

Rep. Addia Wuchner, R-Burlington, said that a pediatric dentistry counsel she served on in Northern Kentucky found that children’s dental services weren’t being fully accessed even in some areas that had a sufficient number of pediatric dentists. Follow-up meetings with the dental community indicated that complications in the reimbursement structure in the Kentucky Children’s Health Insurance Program and Medicaid were contributing factors. “Is there anything we can do to improve that so that when the practice is available that community members are taking advantage of it?” she asked.

Davis responded that the Department for Medicaid Services has been working on the issue.

“I know within the last two years they have taken this on as a significant priority and have actually been able to raise the reimbursements to practitioners who see children by about 30 percent. So I think as a result of that combined with fact that we are now going to provide some training programs for family dentists so they feel more comfortable seeing young children that we’re really in hopes we’re going to see a higher enrollment of practitioners in the Medicaid program and thus get more of our children who are on Medicaid seen.”

Rep. Jim Glenn, D-Owensboro, asked Davis about potential budget-neutral approaches to improving children’s oral health. Davis replied that one cost-effective approach to improving oral health would be to have even wider efforts educate families about the value of good oral health and the importance of brushing teeth, flossing, seeing a dentist and eating right.

While noting that a $2 million effort to address children’s oral health issues is significant, especially during tight budgets, House Speaker Greg Stumbo, D-Prestonsburg, said he’d like to receive a recommendation on how much it would cost to take an even larger, comprehensive approach. “I would like to see what recommendations you could make in the best of all worlds on what we could do — and how much it would cost – to have the forces necessary to take a great big swat at this problem,” Stumbo said.

Davis told Stumbo he’d make sure information is compiled and provided.