California is a state associated with sunshine, surfing and Hollywood glamour featuring white teeth. Despite the images of the Golden State shared by the media, the state's image is far prettier courtesy of the smoke and mirror effect, but the truth is less attractive, especially in relation to dental health.
Currently the Golden State is being subjected to major budget deficits, a retraction in services and has the unfortunate dishonor of being a national leader in regards the childhood tooth decay epidemic (influenced by factors including a dental shortage and poor nutrition). Thanks to those reasons and more, local experts have recommended instituting a public dental health infrastructure to help address the local barriers to improving oral health.
California has the largest population of any of the United States; it also ranks at the bottom in the National Survey of Children’s Health. The New York Times has reported that "It is not unusual in California for children to suffer crippling pain and disability from untreated tooth decay. By the age of 5, 28 percent of the state’s children have untreated dental decay, according to the most recent statewide figures,"(http://www.nytimes.com/2010/05/23/us/23sfdental.html?pagewanted=all).
Although California has a government funded dental services program under Medi-Cal (called Denti-Cal), finding participating dentists is difficult. A survey of 255 California-based pediatric dentists, (published in Pediatric Dentistry) revealed that less than only half survey talking dentists participated in the Denti-Cal program. Of those who did, two-thirds capped the number of program patients they accepted and that has increased the number of ER visits, missed school hours and as well as the sheer number of children going under general anesthesia (AKA sedation dentistry) in order to receive dental treatments to correct the issue.
Since many consider California to be a bit of a fantasy land, it was only fitting that action hero Arnold Schwarzenegger was elected as the Governor of California. During his tenor and influenced by the lobbying efforts by the California Dental Association (CDA), California, he signed two new dental bills into laws.
The approved acts included a non-covered services bill that prohibits dental insurance plan providers from limiting the charges dentists may bill patients for dental treatments not covered by individual dental insurance. Now dentists to charge their usual fees for dental care not covered by dental insurance plans. While this policy will force consumers to pay larger out of pocket expenses, it will provide dentists more financial freedom and may help influence them to participate more openly in the existing government dental care programs. Additionally, the law makes it mandatory for dental plan providers to issue and give a disclosure statement explaining that dentists may charge their usual and customary rate.
At the same time, Gov. Schwarzenegger signed another bill that will add a new school-based portfolio license test option for California dental students. The Dental Board of California sponsored this particular bill and it was supported by the CDA and six California dental schools and will replace the traditional California clinical exam with either the Western Regional Examining Board exam or a one-year general practice residency program.
Despite these revisions to the existing dental care policy, the CDA is still commissioning studies to help address the barriers targeting local oral health care. The organization funded a three-phase access report filed by the 2011 CDA House of Delegates and building the proper state-wide infrastructure to address public dental health is thought to be an important step to helping improve the situation.
According to reports the article entitled “California’s State Oral Health Infrastructure: Opportunities for Improvement and Funding,” highlights the perks of a proper dental public health infrastructure and while providing documentation regarding missed opportunities and examples of successful oral health programs from other states. The bottom line, the CDA indicates that in order to be a success, changes to any "oral health programs must be supported at the highest levels of state government," (http://www.dental-tribune.com/articles/content/scope/politics/region/usa/id/7279). the conversation is expected to continue for many moons to come.