At last, the legislature funds a state dental director

Volunteer dentists and hygienists performed about 5,400 services at the LA Sports Arena. (Roger Smith/CHCF Center for Health Reporting)

Dentists in California, and their patients, are on the cusp of a major breakthrough. The legislature has included money in the state budget for a state dental director, a top priority of the California Dental Association.

Naming a bureaucrat may not sound like a big deal. But in California, where dental access for the poor is a crisis, getting a top voice in the Department of Public Health is critical.

The new director, who must be a licensed dentist, will be charged with establishing and implementing a state oral health plan. The budget contains $474,000 to get the program rolling.

In a press release, CDA president James Stephens said “this is the most impactful state oral health achievement in decades.” The appointment will be “a significant step toward addressing the oral health care crisis facing millions of Californians through coordinated state oral health education and preventive programs led by a dental director and partnered with care provided by dentists across the state.”

High on the agenda should be knocking down barriers to access. Although some improvements were made this spring when Medi-Cal eligible adults gained dental benefits, one-quarter of Californians may have difficulty accessing the dental care they need to be healthy, according to various estimates. Certainly anyone who has attended free dental clinics and seen the lines wind around the host arenas doesn’t doubt it.

According to the Kaiser Family Foundation, 341 areas in the state have dental professional shortages, meaning the ratio of dentists to residents is 1 in 5,000, or 1 in 4,000 in populations demonstrating "unusually high need."

A state director also will be a needed advocate within the administration for reversing the chronically low reimbursement rates and dense bureaucratic practices of the dental Medi-Cal program. The failure of the legislature to reverse a 10% cut in reimbursements in this budget adds an incentive for dentists drop out or not take on new Medi-Cal patients.

The new director will focus on applying for and managing federal and private grants that promote oral health. The CDA has long maintained that California has left money on the table that could have been used on preventative initiatives, particularly for children.

As soon as Governor Brown signs the budget, the state can start looking at candidates.

The best candidate “should be a dentist with extensive experience running a state or large county dental program,” said Alicia Malaby, CDA Director of Communications, in an email response to questions. “We also know that the state has its own requirements for this position, including an active California dental license. When all is taken into account, it is probably a relatively small field of qualified applicants.”

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Roger Smith

Roger Smith, editor, joined the Center in 2013 after 35 years as an editor and reporter with the Los Angeles Times. He became national editor of the Times the week after Barack Obama was elected president, and closely supervised coverage of the Affordable Care Act from inception to implementation. For a decade he was editor of the Column One feature on page one, the Times’ premier spot for narrative stories. He also directed coverage of two presidential campaigns, and was principal editor on two Pulitzer Prize-winning projects. Before becoming an editor he reported for the paper’s business and metro sections. He joined the Times from Business Week magazine. He is a graduate of the USC School of Journalism.Phone: 818-512-5123Twitter: @rilmotsEmail: Rogersmi at usc.edu (link sends e-mail)

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