As a fourth-year dental student at the University of Florida (UF), I’ve served patients across the state and found that dental caries was the most common condition I saw. This is no surprise, though, since it is the most prevalent of all oral diseases around the world, according to the Global Burden of Disease Study 2016. There also are other severe oral pathologies such as trauma and congenital diseases that I see in the UF Student Dental Clinic, which can be devastating to patients and their loved ones.
I recently volunteered at the Florida Dental Association’s Mission of Mercy in Orlando. There was over $2 million worth of dental care services provided to nearly 1,900 patients for free.
I recall my first patient of the day: He looked fatigued, timid and sheepish. After discussing his current dental status, I learned he was hesitant to speak due to the discomfort brought on by caries on his anterior teeth. He neglected to see a dentist because of the lack of education on oral health and the potential associated costs. After the procedure, what transpired next was inspiring. His enthusiasm upon looking in the mirror and the smile that followed was contagious. The patient realized that he would be able to eat pain-free and smile effortlessly again!
After participating in this event, I decided to look at oral health in the state of Florida from a public health perspective. It was shocking to learn that, according to Florida’s Burden of Oral Disease Surveillance Report, 20% of children ages 3-5 in Florida are believed to have untreated dental decay — almost double the national rate. This burden of disease is not limited to our adolescent population, though. The National Center of Health Statistics reported that one in five Americans aged 65 or older have untreated cavities, and two out of three have gum disease. The AARP reported late in 2018 that there is a growing problem with the aging population foregoing dental care because of costs.
One of my professors, Dr. Scott Tomar, investigated this oral health problem and found that 163,900 Floridians visited emergency departments due to oral problems, for a bill of $193.4 million in 2014. I was troubled by these findings, but now I’m determined to take action and make a difference.
We all can make a difference by advocating on behalf our profession and supporting key legislation. One such bill is the Student Loan Refinancing Act, which would give dental students the opportunity to refinance federal student loans multiple times throughout the life of the loan, thereby helping reduce our overall debt burden and offering more freedom to work for underserved populations and federally funded programs or to pursue careers in teaching, research and administration.
Another piece of federal legislation that can ease the burden of oral health is the Ensuring Lasting Smiles Act (ELSA). According to the CDC, one in every 33 babies born in the United States has a congenital anomaly, with cleft lip and palate being the most common birth defect of the head and neck. These birth defects are commonly associated with other health issues, such as difficulties eating, speaking and breathing, which can culminate into psychosocial stresses and multiple surgeries to improve their quality of life.
According the ADA, many insurance companies determine these surgeries to be cosmetic, leading families to turn to Medicaid and the Children’s Health Insurance Program (CHIP) to afford care. ELSA would require private group and individual health plans to cover necessary services related to oral and facial congenital abnormalities, including adjunctive dental services. Passing this act will help reduce the burden on families of affected children.
We have an obligation to improve oral health across the nation through our participation in advocacy and community-based outreach. The Mission of Mercy is one way to volunteer, and has served 480,000 patients and provided millions of dollars in dental care nationally since 1994. Coupled with your legislative support, we all can work towards healthier and wider smiles.
~ Onni Franco, Florida ’20, and Benjamin Schachner, University of Miami Miller School of Medicine
