Report: Children shortchanged when it comes to dental health

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at

Every year, millions of American children go without a dental visit. That lack of care weighs most heavily upon the poor.

A new report by the Pew Charitable Trusts, embargoed until 12:01 a.m. on Tuesday, June 25, takes a state-by-state look at the complex problem. It also targets two factors for blame: the uneven distribution of dentists that leaves thousands of communities underserved; and a shortage of dentists willing to accept Medicaid patients.

According to Pew’s analysis, contained in the new report “In Search of Dental Care: Two Types of Dentist Shortages Limit Children’s Access to Care,” 14 million Medicaid children received no dental care in 2011. The lack of care was particularly dramatic in some states, such as Florida, where 76 percent of Medicaid children went without a dental visit, the Pew study found.

The problem of access can be expected to get worse, Pew contends, as millions of additional children become eligible for Medicaid under health care reform and as tens of thousands of the nation’s dentists reach retirement age.

Based on data gathered from the government and from the American Dental Association, the report includes a state-by-state breakdown of the percentage of Medicaid children who went without care in 2011, as well as the percentage of dentists approaching retirement age and the percentage of the state population determined to be underserved and living in a dental shortage areas.

Pew has been a leader in the movement to expand dental services through the use of technically-trained auxiliaries known as dental therapists. The philanthropy uses the findings in the report to bolster the case that more states should follow the lead of Alaska and Minnesota and put the midlevel providers to work. But such efforts are being strongly opposed by the American Dental Association. In its own recent series of reports and newly unveiled “Action for Dental Health” campaign, the ADA acknowledged a crisis in dental care for the poor, the elderly and the isolated.

But ADA officials maintained that the nation’s existing dental workforce is capable of meeting current needs as well serving new patients entering the system through the Patient Protection and Affordable Care Act.

While opposed to dental therapists, the ADA favors a community dental health coordinator model, where individuals from the community are trained to work within the existing system to help patients locate dentists and negotiate barriers to care, such as finding transportation to appointments. And it offered a variety of other approaches to getting care to the poor, the elderly and the isolated. The group laid out initiatives that would divert uninsured patients with dental emergencies from hospital ERs to local dentists and clinics; encourage more private practice dentists to contract with federally qualified health centers (FQHCs), increase the charity care offered to poor children; expand care to nursing home patients and streamline Medicaid credentialing processes on a state-by-state basis.

4 thoughts on “Report: Children shortchanged when it comes to dental health

  1. nyscof

    The problem is that dentistry is a monopoly that has become a luxury in the US. While dentists are lobbying for more dollars from wealthier Americans e.g. tooth whitening, botox, giving flu shots and vaccinations, 80% of them refuse Medicaid patients. 130 million Americans don’t have dental insurance. Many of those with insurance can’t afford dentistry’s out of pocket expenses. Dentists receive government and corporate handouts – they should be forced to give back. They didn’t make it on their own

    As Mary Otto explains, the solution is to allow Dental Therapists to work in the US as they have successfully done for decades in other first world countries. They will fill, drill and pull teeth in mouths and areas where dentists refuse to go and will cost less because their education only takes 2 or 3 years. The first US dental therapists are working in Alaska and Minnesota

    However, organized dentistry, with its pockets full of corporate cash, lobby against DTs in every state that proposes legalizing them because dentists don’t want any viable group infringing upon its lucrative monopoly

    This dental health crisis has occurred under the guidance of the American Dental Association. It’s time to mandate that all dentists accept more low income people if dentists continue to lobby against Dental Therapists. We can’t allow organized dentistry to continue to offer false remedies, such as fluoridation, as a fix for lack of dental care.

  2. Pete Morris

    There’s no wonder that our children’s dental health is in a terrible state. There’s an education problem with parents when it comes to dental health. Combine that with lack of dental care and we’re simply asking for trouble.

  3. Joe Tagliarini

    Like many health issues, those who suffer the most are the children, the poor, and those that live in rural areas with limited access to medical support. It’s good that more children are becoming eligible for Medicaid but if dentists won’t accept that insurance the kids are in exactly the same place.

  4. Kirsty Darby

    Here in the UK we are blessed with free healthcare for children though our National Health Service. Because its free there can be a little wait to see your dentist and the service received can sometimes seem a little hurried, but its there, available to all.
    There really can be no excuse for not taking your child to the dentist other than a lack of education or just laziness.

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