Proposal to Shut Clinics Has NYC Dentists Worried

ALBANY, N.Y. (AP)  -- New York City dentists fear Mayor Michael Bloomberg's proposal to close dental health centers citywide could endanger the well-being of the city's neediest children.

The plan to close clinics by June 30, 2009, is part of Bloomberg's proposals to cut all kinds of city services as he contends with a worsening economy and the possibility of tax hikes. There are similar concerns for health clinics across New York as state government also faces deficits.

The New York State Dental Association says the closings will affect 44 city clinics that serve 17,000 children. The Oral Health Program was designed to provide dental care for low-income children in New York City. Its clinics work to prevent and treat dental disease and to help families practice good dental hygiene. Many of them are in public schools or in hospital settings near education centers.

``We feel we have to make this reduction,'' said Louise Cohen, deputy commissioner for the City Department of Health and Mental Hygiene. ``We wish we didn't have to. We are doing everything we can to mitigate the impact on the city's children.''

The agency plans to encourage families with access to other types of low-cost dental services like Medicaid to pursue those options. Cohen said dental care through Medicaid is dramatically underused in New York City, and the agency will use the final months dental clinics remain open to close that gap through education.

``If a child has a cavity, and it's aching and there's a school dental clinic _ they can save that tooth,'' said Robert Raiber, a New York City dentist on the board of the state association's board of governors. ``But if it gets to the point that a tooth has to be extracted, that might have to be dealt with in the emergency room. Closing these clinics means the only place that some of these parents can take children is to emergency rooms.''

A total of 92 employees, including dentists, dental hygienists, and dental assistants, will be laid off, according to the city's health department. Closing the program will save the city $4.4 million gross in the next fiscal year.

Medicaid and other public health insurance offer dental benefits, and the agency says families will still have access to those services.

Cohen said about 170,000 children in New York City don't have medical coverage, but the city's health department provides less than 1 percent of the target population's dental services, Cohen said.

``We believe all those children are coverable,'' she said.

But even if they were covered through Medicaid, only about 45 percent of children who are covered for dental care saw a dentist in the last year, she said. So the problem requires more education so parents learn the importance of regular dental checkups and preventive treatment, including sealant for the teeth.

The dental association says dental disease is the most prevalent disease among New York children, but is also one of the easiest and cheapest to prevent.

The death of a 12-year-old boy last year in Maryland by brain infection that started as a toothache, has more parents and schools taking dental health seriously. But a recession and diminishing health care coverage can push dental care further down a family's priority, where it may be seen mostly as a cosmetic issue, according to national dental associations.