On behalf of the family physicians practicing in North Carolina, I am responding to Dr. Meskin’s editorial "Look Who’s Practicing Dentistry" (October JADA).
We are grateful for the opportunity to make an impact on the number of high-risk children suffering from early childhood caries. Caries is one of the diseases we see most often in our offices, and one of the most frustrating to resolve.
As physicians, we are not interested in diagnosing or treating the dental problems of our patients. In a perfect world, we would recognize when a problem exists and successfully refer the patient to a dentist. My colleagues and I can tell frustrating stories of trying to refer children with dental problems and infections, to no avail.
Something must be done, and family physicians are attempting to address the prevention aspect by offering the oral screening and fluoride varnish procedure in our offices.
I would point out that we are highly trained medical providers, and performing oral screening is a procedure many of us already provide for our patients when we examine the throat and pharynx. We also see these high-risk children in our offices eight to 20 times before they are 3 years old.
Since we are already familiar with oral anatomy and have access to these children, it makes us the obvious choice for providing oral preventive services. I invite you to visit a participating office and observe the thoroughness and professionalism with which these services are being rendered.
As busy as we are providing treatment for all of our patients and their health care needs, North Carolina’s family physicians would probably agree that it would be much easier not to have to deal with the caries problem at all. That approach is impossible when you see very young patients with tooth decay day after day.
The problem is compounded by the fact that only 20 percent of dentists in North Carolina accept Medicaid, and even fewer treat children younger than 3 years of age. Just recently, a colleague of mine begged her personal dentist to see a young child with an oral infection secondary to caries—and the dentist refused because the child had Medicaid.
As health professionals, physicians and dentists have a responsibility to our patients, regardless of age, income level or the politics that surround the issue. I invite the dentists of North Carolina to join us in serving this very young group of Medicaid-covered children. Working together, I know we can make a difference in their health and in their lives.
