Mom: “Did you brush your teeth?”

Child: “Yep.”

Mom: “How come your toothbrush isn’t wet?”

This is an excerpt from the script of the bedtime drama performed live nightly in the comfort of my own home.  Just between you, me and the tooth fairy … after battling on the nutrition, hygiene and homework fronts, I don’t have a lot of energy left to wage the toothbrush wars.  That’s why I’m always a bit nervous about dragging my children to their 6-month dental check-ups.  Luckily, we have good dental benefits and an understanding dentist.  With the help of the dentist and dental hygienists, we’ve managed to get through with only a couple of cavities between all three kids.  (The nightly drama slacks off a bit after a good “education session” from the dentist.)

Other parents are facing the same obstacles to ensuring their kids have healthy teeth and gums but not all of them are able to rely on a dentist.   Even children with excellent brushing and flossing habits need to see a dentist because untreated dental disease and tooth decay can have devastating health consequences.  However, about one in five children in the U.S. do not receive dental care each year according to a new report The Cost of Delay: State Dental Policies Fail One in Five Children, by the Pew Center on the States.  The report points out that states play a key role in ensuring that low-income children have access to basic, preventive dental care and that more than two-thirds of the states are doing a poor job in this area.

The good news is that the Children’s Health Insurance Program Reauthorization Act  provided states with new tools to help improve the oral health of children.  All CHIP programs are now required to cover comprehensive dental benefits. CHIPRA also allows states with separate CHIP programs to offer a dental-only plan for children who have other health insurance, but lack adequate dental benefits. Other oral health improvements include education for new parents, better access to benefit and provider information, and enhanced reporting on the quality of dental health services in Medicaid and CHIP.  CCF, the Kaiser Commission on Medicaid and the Uninsured, and the Children’s Dental Health Project just released a “CHIP Tip” on CHIPRA’s oral health provisions which is a good resource for those who want to see children receive better oral healthcare coverage.