The Inequities in American Oral Health

Posted February 07, 2017 by Josh Grant

Young Boy At Dentists Office
Inequities in oral health are keeping every child from having healthy teeth.

Not everyone has the same smile, and inequities in America’s oral health system are keeping some communities from having healthy teeth, let alone a bright grin.

February is National Children’s Dental Health Month, making it a perfect opportunity for understanding the challenges that many families face in accessing adequate dental care. Only through learning about these inequities can solutions for real change be developed, tested and implemented.

Racial and Economic Barriers Create Gaps
As is the case in other types of healthcare, inequities in oral health exist primarily along racial and socioeconomic lines. In children ages 2 to 8, the rate of untreated tooth decay is twice as high for African American and Hispanic populations as it is for the white population. Further, 37 percent of American Indian children ages 1 to 5 have untreated dental decay.

This is despite a high rate of dental insurance coverage through Medicaid. The issue lies in the difference between coverage and access to care. Because Medicaid funding varies from state to state, programs are often underfunded so few providers participate and accept Medicaid. Even in cases when providers accept Medicaid, families have trouble connecting with them.

In other cases, many parents may wait for emergencies to go to the dentist because treatment is not affordable on a regular basis. In the U.S., the high cost of care is the top reason why both the insured and uninsured avoid going to the dentist.

For a further look at health inequities among underserved populations, read our features on:

· Smoking cessation
· Safe sleep
· Birth spacing
· Preterm births

New Strategies to Close Gaps
At the federal, state and local levels, efforts are underway to improve oral health for vulnerable populations and communities. Representative Robin Kelly’s (D-Illinois) 2015 report “Health Disparities in America” includes some potential paths forward for closing gaps in care. In addition to bolstering Medicaid and introducing new policy to create grants for oral health outreach programs, it also includes recommendations to expand assistance services like Women, Infant and Children (WIC).

But some local WIC agencies are not waiting for federal assistance when it comes to dental services. In Oregon, some offices are participating in a project with the University of Washington and Advantage Dental Services, a provider for Oregon Medicaid beneficiaries. This a test to determine whether Medicaid payments for providers to offer care in an efficient setting will improve the rates of children who receive dental care. If it achieves that goal, more children will have access to preventative treatments, which can help prevent larger issues and emergencies down the road.

Another path forward is increasing education around oral health for patients, providers and policymakers. Within communities, this would mean empowering families to take greater control of their health by showing them how to access care despite the inequities they face.

These actions and similar efforts should help ease the challenges underserved populations face when searching for dental care. Oral health is a key component of a person’s overall health, so resolving these inequities will be one step in ensuring that every child has an opportunity to achieve their optimal health. 


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