N.H.'s big step forward to improve oral health

Newly passed law puts state at forefront of access to dental care


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In 2012, there are far too many people in New Hampshire – one of the richest states in our nation -- who do not have access to basic dental care. There are too many children in our state who go to school every day in pain due to untreated tooth decay. There are too many elders in nursing homes or at home who don’t get the oral health care they need and who are needlessly suffering.

As public health dental professionals and front-line oral health service providers, we see far too many children and adults every day with a disease that is almost entirely preventable. But a new law has the potential to significantly improve access to oral health care in New Hampshire. SB 284, establishing a Certified Public Health Dental Hygienist in New Hampshire, was passed in May and signed into law in June.

The bill came out of an initiative funded by the Pew Research Center and was developed with the support and hard work of the Endowment for Health, the New Hampshire Oral Health Coalition, the Department of Health and Human Services, the New Hampshire Dental Society, the New Hampshire Dental Hygienists’ Association and public health dental hygienists like ourselves.

State Sen. Gary Lambert of Nashua was a driving force behind Senate Bill 284, and by their actions to enact this law, Senator Lambert, the Legislature and Governor Lynch have put our state at the forefront nationally.

Dental hygienists are oral health care prevention specialists and are an integral part of the solution to the dental access problem in New Hampshire. We are educated, licensed direct-care providers, but we have been under-utilized until now -- in New Hampshire and elsewhere. SB 284 will help to start changing that model.

The new law states that a licensed, registered and certified public health dental hygienist will be able to provide increased services, most notably temporary fillings, in community settings like schools, WIC clinics, Head Start, programs for those with special needs, senior centers, nursing homes, and directly to those who are home-bound.

In all areas of health care, preventive care is recognized as the best way to keep people healthy and avoid the need for costly and more serious solutions later on.

We see this most dramatically in oral health. For every $1 invested in preventive oral health care, $8 is saved in restorative dental care. The ability to intercept dental disease with basic dental procedures - like providing a temporary filling, before the hole in the tooth gets bigger and creates more complicated, more expensive problems - is a common-sense approach and a cost-effective strategy.

Those of us experienced in public health realize that one size does not fit all when it comes to causes and solutions to oral health care access. SB 284 promises to allow for flexibility and to create more options for consumers and to put more tools in providers’ tool boxes. It is a first step toward bringing vital services to those in need and to locations that currently are significantly underserved in New Hampshire.

In 2014, it is anticipated that 50,000 more adults and children may be added to New Hampshire’s Medicaid-eligible population. Certified public health dental hygienists will be part of the network of dental professionals to provide them with care.

SB 284 is a good news story from Concord this year. It represents an area where policymakers and stakeholders came together to do the right thing for some of our most vulnerable citizens and to do it in a fiscally responsible and meaningful way. We see this as the start of something big.

Kyle Messier of Claremont and Hope Saltmarsh of Bow are registered dental hygienists.

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