FRANKFORT — While the stereotype of toothless Kentuckians is unfair, the state has a serious problem in dental health, Gov. Steve Beshear said Tuesday as he launched a three-year, $2.2 million initiative to improve the dental health of children in southern and Eastern Kentucky .
Dr. Edwin Smith, a dentist in Barbourville for 20 years, praised the move.
Smith, who was featured last winter on a ABC's 20/20 news program about dental health in Appalachia, said the state "has made the statement that oral health is a priority.
"This is a great start. We have to overcome the culture that teeth aren't intended for a lifetime. They are, and we're starting with the children."
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At a Capitol news conference that included 13 children from Westridge Elementary School in Franklin County, Beshear said the program will be paid for with more than $1.6 million from federal grants. The rest will come primarily from in-kind contributions such as help from the staff of the state Cabinet for Health and Family Services.
The initial focus, Beshear said, will be on creating a training curriculum to teach Kentucky dentists effective techniques to work with young children.
Most dentists who do not specialize in pediatric dentistry now receive limited training in working with patients younger than age 6, who pose special treatment challenges, Beshear said.
The need for the state initiative is clear, the governor said, noting that only 28 of the state's 120 counties have pediatric dentists.
A 2001 state survey found that half of Kentucky's children had decay in their primary teeth and that nearly 47 percent of children ages 2, 3 and 4 had untreated dental problems — more than twice the national average.
Once the curriculum is finalized, seminars and Web-based training will be offered, and mentors will work with local practitioners, Beshear said.
Incentives will be offered to providers in the form of continuing education credits that all dentists must earn every two years.
The program will create up to 12 community coalitions to find dental health solutions in affected counties. It will also provide two sets of portable dental equipment that the communities could use.
Kentucky has 38 distressed counties, which are designated by the Appalachian Regional Commission and based on unemployment rates, per capita income and poverty rate. They rank in the worst 10 percent of the nation's counties.
Beshear said Kentucky led the nation in 2004 in terms of the number of people age 65 or older who had lost teeth. About 27 percent of Kentuckians of all ages had lost six or more teeth to decay or gum disease, compared with 18 percent in the rest of the nation, he said.
In addition to the good things that will come from the new state initiative, Barbourville dentist Smith said, the state Medicaid program also should reimburse dentists more for their services.
Of the state's 2,300 or so dentists, only 300 to 500 are active in the Medicaid program, said Mike Porter, executive director of the Kentucky Dental Association.
"This new initiative is a good start, but we could use more dentists in the Medicaid program," Porter said.
"Reimbursement is, understandably, always an issue for providers," said Vikki Franklin, a spokeswoman for the state Cabinet for Health and Family Services.
"We would note, however, that Medicaid reimbursement for children's dental services was increased approximately 30 percent three years ago." Current budget constraints preclude any additional increases right now, she said.
Beshear said the impetus for the initiative came from people like Al Smith, a veteran Kentucky journalist, who advocated for better dental care for the state's children.
Smith said Beshear promised him that he would address the problem. "And he has kept his promise," Smith said.
The governor and health officials plan to visit several communities in Eastern Kentucky Wednesday to discuss the new plan and its goals.
They are to be at Russell Primary School in Russell at 9 a.m., at McBrayer Elementary School in Morehead at 11 a.m., at Highland Elementary in Staffordsville at 1:30 p.m. and at Dennis Wooten Elementary in Hazard at 4 p.m.