PEWs report card still tough on dental care

May 24, 2011
The 2011 Pew grades for 22 states were higher than their 2010 grades, revealing that even in a time of fiscal distress, dental health policies can be improved, and RDH columnist Christine Nathe comments on the report.

In the 2011 version of the 50-state report card by the Pew Children's Dental Campaign, 27 states earned grades of an A or B, while 23 states and the District of Columbia received a C or lower grade. Pew emphasized that the 2011 grades for 22 states were higher than their 2010 grades, revealing that "even in a time of fiscal distress, dental health policies can be improved."

Christine Nathe, a public health hygienist, professor at the University of New Mexico, and a columnist for RDH magazine, commented, "This report promotes the use of the dental hygienists, whether it be in a school-based dental programs or as a Medicaid provider or when submitting basic screening data to track oral health programs. Dental hygienists definitely can help improve a state's status by working to meet PEW's eight policy benchmarks.

The 2011 Pew report card reported:

  • Of the 22 states raising their grades from 2010, six of them have improved by at least two letter grades: Arkansas, Delaware, Massachusetts, Minnesota, Utah and West Virginia.
  • Only seven states achieved A grades: Alaska, Connecticut, Maine, Maryland, Massachusetts, Minnesota and South Carolina. Of these states, Maryland was the only state to meet seven policy goals, and no state met all eight.
  • Fourteen states and the District of Columbia failed to improve from the C, D or F grades that they earned in Pew's 2010 report.
  • Grades dropped in six states: Indiana, Iowa, Montana, New Mexico, North Carolina, and Rhode Island. This decline was driven mostly by Medicaid reimbursement rates that have not kept pace with the growth in dentists' fees.
  • States achieving higher grades made this progress primarily by reimbursing physicians for preventive dental services, expanding water fluoridation and increasing the percentage of Medicaid-enrolled children who receive care.
  • Six of the nine states that earned an F in Pew's 2010 report card raised their grades this year-two of those states (Arkansas and Delaware) managed to improve by at least two letter grades. Only three states received a second consecutive F (Florida, Hawaii and New Jersey), while Indiana and Montana tumbled into the F range.

The report was produced with support from the W.K. Kellogg Foundation and the DentaQuest Foundation.

"Twenty-two states were able to raise their grades even though most of them faced daunting budget shortfalls," said Shelly Gehshan, director of the Pew Children's Dental Campaign. "This shows that states have smart, cost-effective ways to make progress without imposing a heavy burden on taxpayers."

"Many states earn high marks for effort, but results have fallen short of what they need to be," says Sterling K. Speirn, president and CEO of the W.K. Kellogg Foundation. "We need to support more innovative approaches to addressing the gap that leaves too many children and families without dental care."

Pew grades states on an A-through-F scale based on their performance in meeting eight policy benchmarks for children's dental health:

  • Having sealant programs in at least 25 percent of high-risk schools
  • Allowing a hygienist to place sealants in a school sealant program without requiring a dentist's prior exam
  • Providing optimally fluoridated water to at least 75 percent of residents who are served by community water systems
  • Meeting or exceeding the 2007 national average (38.1 percent) of Medicaid-enrolled children ages one to 18 receiving dental services
  • Paying dentists who serve Medicaid-enrolled children at least the 2008 national average (60.5 percent) of dentists' median retail fees
  • Reimbursing medical care providers through its state Medicaid program for preventive dental health services
  • Authorizing a new type of primary-care dental provider
  • Submitting basic screening data to the national database that tracks oral health progress

To access the full report, the methodology and the fact sheets for all 50 states and the District of Columbia, click here.

The Pew Center on the States is a division of The Pew Charitable Trusts. Pew is a nonprofit organization that applies a rigorous, analytical approach to improve public policy, inform the public and stimulate civic life.