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ADA asks Congress for $44 million in funding for CDC, HRSA programs

April 27, 2018

By Jennifer Garvin

Photo of Dr. Fagan speaking at committee hearing
Testimony: Dr. Tim Fagan requests funding for oral health programs during an April 26 House Appropriations Subcommittee on Labor, Health and Human Services, and Education hearing. Photo by Fred Watkins
Washington — The ADA on April 26 testified before the House Appropriations Subcommittee on Labor, Health and Human Services, and Education to request oral health funding for fiscal year 2019.

Dr. Tim Fagan, chair of the ADA Council on Advocacy for Access and Prevention, testified on behalf of the Association. For fiscal year 2019, the ADA is requesting $20 million for the Center for Disease Control and Prevention's Division of Oral Health and $24 million for the Health Resources and Services Administration's pediatric and general dental residencies.

During his testimony, Dr. Fagan, a pediatric dentist from Enid, Oklahoma, who heads the Division of Pediatric Dentistry at the University of Oklahoma School of Dentistry, thanked the committee for "its continued commitment to oral health," but urged lawmakers to prioritize oral health when allocating funds for federal programs.

"Tooth decay or dental caries remains the most common chronic childhood disease," Dr. Fagan said. "It is five times more prevalent than asthma in children."

Dr. Fagan shared information about the CDC's and HRSA's investment in oral health including: community water fluoridation, school-based programs such as dental sealants and oral health residency training.

For community water fluoridation, Dr. Fagan cited the latest studies by the Colorado School of Public Health that found 78 million Americans do not have access to a public water system that is fluoridated. The study suggests that if those water systems were fluoridated, 2.5-billion dollars could be saved in dental costs, he said.

"I see at least three children a day with decay so severe that the only way to treat them is under general anesthesia in an operating room. Almost all come from communities without water fluoridation. If these children had access to fluoridation, it would help prevent tooth decay and reduce treatment costs," he said.

In highlighting the CDC's Division of Oral Health, he praised the agency's efforts in helping states and communities purchase fluoridation equipment and its work in providing school-based dental sealant programs.

"Each sealed tooth saves more than $11 in dental treatment costs," Dr. Fagan said. "Applying sealants to the nearly 7 million low-income children could save up to $300 million."

He also stressed the need for funding for HRSA's Title VII pediatric and general dental residencies, where dentists receive additional training in child psychology and behavior guidance, age-appropriate pharmacology, management of oral-facial trauma, caring for children with special needs and anesthesia.

For an example of one state's challenges with getting children access to dental care, Dr. Fagan said Oklahoma has only 54 pediatric dentists to treat more than 500,000 children and several counties don't have a single dentist. One solution would be a pediatric residency program at the University of Oklahoma School of Dentistry. The school currently lacks the funding to start a program.

"We need to increase the number of pediatric dentists in the state," he said. "We know that dentists tend to stay permanently in states where they do their residencies."

Dr. Fagan closed by asking the committee to help HRSA reinstate the position of chief dental officer, which was downgraded to a senior dental advisor in 2012.

"This occurred despite the administration's commitment in 2010 to establish the Oral Health Initiative, which highlighted several HRSA initiatives to improve access to oral health care, especially for needy populations," said the ADA in written testimony. "We thank the committee for its strong support directing HRSA to reinstate the CDO. However, while the title was restored last year, the function of the position remains unchanged. The CDO is expected to serve as the agency representative on oral health issues to international, national, state, and /or local government agencies, universities, oral health stakeholder organizations, etc. We urge the committee to direct HRSA to fully restore this position with the appropriate duties of a chief dental officer."

Following his testimony, Rep. Tom Cole, R-Okla., subcommittee chair, praised the dental profession for the work that dentists do, particularly in charity efforts such as the Missions of Mercy events that take place nationwide.

Ranking Member Rosa DeLauro, D-Conn., echoed that thank you and went on to say that she was "stunned" that in 2018 there are still places that don't have community water fluoridation. She also said there need to be more oral health training programs.

"We need to be increasing the number of dental professionals in this country," she said.

Watch the entire hearing here.

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