Gary Rozier, DDS, MPH, University of North Carolina at Chapel Hill, Gillings School of Global Public Health
Gary Rozier has spent his career in public health dentistry, dedicated to improving the lives of America's young and disadvantaged children through comprehensive dental and oral health teaching and research. "There are millions of children with untreated dental disease -- six and a half million with dental insurance through Medicaid. What is wrong with this picture? In addition to the threats on our children's health, the dental bill for our country is close to $100 billion. We need continued investment in research to identify and address the big gap between expenditure and the needs of our population."
We know how much research can save us, in terms of real dollars as well as in health and wellness. As the director of UNC's Dental Public Health program, Gary Rozier, DDS, MPH, knows the value of research and prevention, especially for dental public health. "One of our biggest public health success stories has been water fluoridation. The Centers for Disease Control and Prevention estimate that for every dollar spent on water fluoridation, we save $38 in treatment costs."
In addition to identifying ways of protecting our public's health and doing it in the most cost-effective way possible, research also continues to identify where our health gaps are and where we need to do more to address the health of our people.
"We have learned that dental disease is getting worse in preschool age children. 40% of children in NC have dental disease -- tooth decay -- when they start kindergarten. Research has identified that most of these children have gone untreated because of three major issues: lack of access to dental care, a shortage of dentists, and barriers associated with public (Medicaid) insurance.
"Over the last 10 years, we have concentrated almost all of our research efforts in trying to reach these very young children. It is alarming that there are more children below the poverty line who have dental insurance than any other group but cannot find a dentist who is able or willing to see them. In North Carolina we are trying to reach very young children and their families through where they get medical care. The Medicaid program in North Carolina started reimbursing physicians (because very young kids rarely had dental visits) to assess the children's risk for dental disease and referral for proper care and treatment as necessary, to counsel parents and to paint fluoride on the children' teeth -- this Medicaid reimbursement for a preventive visit has been an exciting step forward and may have nationwide implications for our public health and health care system.
"With this successful prevention measure, we are preventing pain, infection and hospitalization of young children, which can approach $7,000 per child. If we get to kids early enough, we can take some pressure off of the dental care delivery system that is stretched beyond its capacity to provide care to everyone. Early results have shown actual improvements in dental health and increased access in the communities. Research has really provided the foundation and the evidence base for how we will address this national trend in tooth decay that is going in the wrong direction. We are now able to put the research into action and deliver the needed preventive care to our nation's children."
Rozier and his colleagues are helping to find solutions to some of society's big health problems. If we've learned anything, he said, it is that the mouth and dental infections are closely connected to other health issues such as birth outcomes, heart disease and diabetes control. "We need integrated systems that benefit the entire health of people."