San Bernardino County residents are falling behind when it comes to their dental health.

Children, pregnant women and older adults in the county are seeking dental work at rates lower than the state average. There’s also a need in the county for more dentists who serve young children, people with intellectual and development disabilities, and Medi-Cal patients, county research shows.

This is why county public health officials have created a plan to educate the public on the importance of oral health and to improve the availability and use of dental services. The plan, San Bernardino County’s first of its kind, uses data and input from dental professionals, community groups and residents with the goal of boosting oral health countywide through 2024.

“When we take away all the numbers and then just look at individuals in this area, the community is experiencing pain because of all these issues,” said Bonnie Flippin, program coordinator with the county’s Local Oral Health Program, which commissioned the plan.

Poor dental health can embarrass people, affect their chances to get a job and make it harder to eat healthy foods, Flippin added. There’s also an economic impact, she said.

“When we look at schools across the state, they’re losing millions of dollars because of absentees due to dental issues,” she said. “The health system is spending money on severe oral health diseases when really a lot of this stuff is preventable.”

The county’s findings include:

• Dental disease is prevalent among children, with many being taken to hospital emergency departments for preventable conditions. About 30% of low-income children up to 5 years old suffer from untreated tooth decay. Less than half who are eligible for Medi-Cal visited a dentist in 2017, which is lower than the state average.
• Pregnant women use dental services at a lower rate than the state average.  Between 2015 and 2016, 33% of pregnant women reported visiting a dentist during their pregnancy, compared to 43% statewide.
• More than 40% of adults over 65 said they have not visited a dentist in the past year. Statewide data show that older adults, especially those living in skilled nursing homes have many unmet needs, the plan states.
• Health professionals believe lack of awareness drives poor dental health, but residents in a focus group said they’re aware of recommended treatments, but it is not a priority. They have other, more pressing, concerns such as employment and poverty.
• The county needs more dentists who serve children under 3, those with intellectual and developmental disabilities and who accept Medi-Cal.

“When it comes to the amount of dentists we have in the area, we don’t have as good a dentist-to-patient ratio as the state does,” Flippin said. “When you dial into that even further, only one in 10 accept Medi-Cal dental insurance, so it’s really difficult for folks to find a dentist they can use for their care.”

As a house-call dentist in San Bernardino County, Dr. Wade Banner has seen the benefit of residents getting dental work at home. Many Medi-Cal patients don’t know they also get dental benefits, but the number of dentists accepting Medi-Cal is growing.

Part of the problem, Banner said, is that many dentists don’t know that Medi-Cal now fully covers dental services — from root canals to cleanings.

The county’s Local Oral Health Program was created in January 2018 with money from the California Department of Public Health to improve county residents’ oral health, especially among vulnerable and high-risk populations. As part of the program, an advisory committee was formed and will meet quarterly to gauge the county’s progress.Wade Banner, DMD House Call Dentist

The plan calls for partnerships to expand dental services, monitoring oral health and offering dental services through healthcare providers.

“We have some great things already going on,” Flippin said. “It’s not like we have to invent a lot. It’s really more of a matter of taking those things that are working really well in some places and expanding that to the places that have nothing.”

For example, Flippin said, school districts with dental programs have brought mobile dentists to campuses and referred students to dentists or community clinics.

County officials are also working to ensure the public has accurate information on taking care of their teeth, which includes going to health fairs, school and community events. Officials handed out toothbrushes and information on dental services during the California Dental Association Cares clinic hosted by the California Dental Association Foundation in San Bernardino last week.

The clinic provided $1.46 million in charitable dental work to 1,626 people over two days, a foundation news release states.

Francine Brady, 64 of San Bernardino, was among them.

Brady, who attended the free clinic in need of a denture repair, said she neglected her health while she cared for her husband, who recently died.

“I didn’t take care of my health at all,” Brady said. “That’s a priority right now. My teeth were my first priority. Now that I don’t have an income it’s really hard to get a dentist.”