Poor Americans bear more than their share of oral disease. School children from low-income homes are more than twice as likely to suffer from tooth decay as their more affluent peers, according to federal data.
While Medicaid entitles poor children to dental care, adult dental benefits are treated as optional under the program. It is estimated that the majority of the nation’s 60 million elderly and/or disabled Medicare beneficiaries are dentally uninsured.
And even with private coverage, dentists can be difficult to find, particularly in poor and rural communities. Nearly 57 million Americans live in areas with dentist shortages, the Pew Charitable Trusts reports.
The barriers to care remain formidable, recent news stories remind us. But some of those articles also offer examples of the ways that communities are finding ways to get more dental services to people who need them.
In a deep-dive piece for South Dakota News Watch, Bart Pfankuch looked at dental care issues across that state. He found evidence of profound oral health challenges on the Rosebud Indian Reservation, home to about 12,000 tribal residents and thousands more non-Natives.
“It’s dire straits down here,” observed Marty Jones, the office manager and dental hygienist at the St. Francis Mission Dental Clinic which is located on the reservation. The facility lacks a full-time dentist and relies upon grants, donations and volunteer dentists, yet managed to serve an estimated 2,000 poor and uninsured residents one recent year. Noting that generational poverty and a lack of access to healthy foods contribute to the burden of disease, Jones shared stories of patients who had been helped at the clinic, including a young Native American student who earned a college scholarship but whose teeth were in ruins.
“She was a smart, beautiful girl, but how can she go to a university setting beyond here and have any confidence when the rest of that population does not have that level of decay in their mouth?” asked Jones, who arranged for the girl to get the help she needed to go off to school without feeling ashamed.
Pfankuch discusses how he reported the story – which explores poverty, geography, provider shortages, racial disparities and more – and how it was received by the community in this new AHCJ Q&A.
Elsewhere in South Dakota, a philanthropically-funded mobile clinic program and public-spirited providers are also helping to meet needs, Pfankuch reported.
In Sioux Falls, dentist Jaclyn Schuler noted that she finds deep satisfaction in serving Medicaid patients in her dental office, in spite of the program’s comparatively low reimbursement rates. The care makes a real difference in the patients’ lives, she said.
“You get paid less, but in some ways, you get paid more,” she said.
Meanwhile, in a recent story for the Spokesman-Review in Spokane Washington, reporter Treva Lind offered readers a look at initiatives that are tackling oral health disparities in local schools and beyond.
Lind led with an account of a program that is bringing dental hygienists into county schools where a majority of students qualify for free or reduced-price meals. With the consent of parents, the dental hygienists clean students’ teeth and apply dental sealants for cavity prevention.
The leader of a local nonprofit that is heading up the effort explained some of the needs that are driving the program.
“In Spokane County, 38% of our families are classified as being working poor with sometimes two and three jobs to make ends meet,” said Chuck Teegarden, executive director of Communities in Schools of Spokane County.
“The challenge is when you’re working that hard, when do you take your children to the dentist? One thing we and many other people have observed is when children have toothaches, they can’t study. They can’t pay attention in school.”
And local efforts to address dental needs don’t stop with the school hygiene program, Lind wrote.
Smile Spokane, a network of health care, oral health, public health and social service organizations has set a number of additional ambitious oral health goals, Lind told readers.
These include an increased focus upon care coordination between medical and oral health providers; better-coordinated care for diabetes patients, pregnant women and people experiencing mental illness; the integration of oral health services into all area primary care settings and the doubling of access to oral health services for adult Medicaid beneficiaries and seniors.
Reporters: Is there a story for you in state and local efforts to address oral health disparities?