Election season is upon us once again, and we should not be swayed by the negativity that comes with it. The disparities surrounding oral health in the US are increasingly evident to all citizens. As the country prepares for another presidential election, the nation’s oral health care crisis is once again an issue that demands nationwide reform.
Emergency rooms continue to be flooded with patients suffering from dental pain because of their inability to be seen by a dental provider. According to the 2023 State of Oral Health Equity in America report by Care Quest Institute, when study participants were asked why they don’t plan to see a dentist for preventive or routine care in the coming year, 45% cited cost, while 28% pointed to a lack of insurance.1 Lack of accessible oral health care is a grave public health emergency and has been addressed in national reports such as Healthy People 2030 and the NIH Oral Health in America.
The FDI World Dental Federation defines oral health as multifaceted, and that it includes the ability to speak, smile, smell, taste, touch, chew, swallow, and convey a range of emotions through facial expressions with confidence and without pain, discomfort, and disease of the craniofacial complex.2
What is often not talked about is the lack of dental insurance coverage and reduced access to dental care in marginalized areas. Luisa Borrell, DDS, PhD, introduced the idea of “dental deserts.” These are racial or ethnic minority communities with very few or no dentists.3 Borrell notes that the huge lack of diversity in the dental profession attributes to dental deserts.
Acknowledgement of disparities
The acknowledgement of social determinants of health, especially in the dental realm, by several major health organizations is groundbreaking. Reports by the US Surgeon General, CDC, and WHO agree that there is limited access to dental treatment in impoverished communities. Furthermore, the disparity of minority providers leads to a disconnect with the patients who are seen by the limited number of providers who do exist in public health dental settings.
The negative impacts resulting from low socioeconomic status are detrimental to the overall health of people from impoverished communities. It’s essential that we take note of these discrepancies in overall health and well-being. But we should not forget to also address the dental aspects of these discrepancies and how they correlate to the total health and well-being of these communities.
Social action is crucial for driving change in the nation’s approach to oral health care. The connection between oral health and systemic health can no longer be overlooked. The government has left dental coverage under Medicaid to the discretion of each state, meaning some states don’t offer any form of adult dental coverage.
Without prompt federal action to improve oral health initiatives and access to care for underserved and marginalized populations, the consequences can be extensive, affecting not only oral health, but people’s overall quality of life. We can’t continue to disregard the link between dental health and total body health. Equitable oral health care is a fundamental right for everyone, not just those who can afford it.
How you can make a difference
Here are ways you can act:
- Familiarize yourself with your state’s Medicaid and Medicare dental coverage: While it’s beneficial to understand how these programs work and what’s covered, take it a step further and consider how you can advocate for improvements based on your observations as an oral health-care professional.
- Become familiar with national advocacy groups: Engage with groups such as the Oral Health Equity and Progress Network (OPEN) and Care Quest Institute. Sign up for their newsletters, follow their social media accounts, and attend their continuing education offerings.
- Encourage your dental team to become a Medicaid and Medicare provider.
- Participate in volunteer dental events: This is a terrific way to build awareness and support within the community.
- Attend CE about public health and equity: Continuing education is key! Share the knowledge from these courses with peers and advocate for the importance of these topics within the professional community.
- Demand community leaders address the topic: Find ways to actively engage with local leaders and professional associations to strengthen your voice.
References
1. Heaton LJ, Santoro M, Martin P, Tranby EP. Cost, race, and the persistent challenges in our oral health system. June 2023. doi:10.35565/cqi.2023.2005
2. Glick M, Williams DM, Kleinman DV, Vujicic M, Watt RG, Weyant RJ. A new definition for oral health developed by the FDI world dental federation opens the door to a universal definition of oral health*. Int Dent J. 2016;66(6):322-324. doi:10.1111/idj.12294
3. Borrell LN, Williams DR. Racism and oral health equity in the United States: Identifying its effects and providing future directions. J Pub Health Dent. 2022;82:Suppl1:8-11. doi:10.1111/jphd.12501
