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By Mary Cassesso

Imagine preparing for prom or graduation if our kids had to add dentures to their wardrobe. Growing up in Somerville, my family, like most of our neighbors, were low income and no one had dental insurance. A dentist would periodically visit us at school and sadly some kids would have teeth extracted instead of restored- it was cheaper.  We all know that oral health has implications and impact on your overall health and nutrition. You need your teeth to eat healthy – for example vegetables and fruit. It’s funny how there are certain things that you never forget; I remember a teenage girl whose dentist extracted all of her teeth. Like many, we were too poor to visit a dentist twice a year and there were no fluoride treatments, so decay and cavities were much more prevalent.

We have opportunities to close this gap and make dental care more accessible and equitable. One way is to support legislation that would create the role of the dental therapist. The dental therapist would provide expanded duties for dental hygienists – it would also enable the expansion and diversification of the workforce. The dental therapist would provide preventative care services and some restorative procedures such as simple fillings. This would address the shortage of dental providers and be cost effective. We also have to promote more affordable training programs for the dental profession, including programs for dental hygienists and dental assistants.

Dental care continues to be overlooked decay is almost 100% preventable-it’s not a big lift but simply has never seemed big enough or important enough to address. As a new mom I was quite unaware of issues like baby bottle syndrome and the impact of sugar sweetened beverages like juice. Conversations at the primary care office about healthy growth and development should include oral health and how it is related to overall health. Kids’ first visit with a dentist is recommended at the age of 1 but many parents are unaware of this and among those who are, lack of dental insurance may preclude access to care.

In 2000, the Surgeon General wrote on the state of oral health in America. Many oral health professionals and advocates saw this as a call to action and had hoped for change based on the integral link and importance of oral health to overall health. The condition of the oral cavity tells much about a person’s overall health; early signs of health conditions can show in our mouth or oral cavity. Here we are, 22 years after the surgeon general’s report and many of the same challenges remain. Yes, we have made advances that whiten, straighten or replace decayed or missing to enhance our appearances- clearly we all understand the impact of the smile on self- esteem and beauty. It’s time to go beyond appearances and make policy changes to to improve oral health for all members of our community and alleviate the struggles and inequities in oral health care! Let’s expand the health workforce and integrate dental care into primary care  and support policy changes to ensure appropriate, accessible and affordable dental care.

Mary Cassesso is a lifelong Somerville resident and activist. She has devoted her career and community service to social justice, equity and advocacy primarily focused on health, housing and safety-net services.