Dearth of dentistry: Reporter explores how state's economic health affects its oral health Date: 11/14/17
By Mary Otto
The Oklahoma newspapers in the Community Newspaper Holding Inc. (CNHI) chain offered readers a series that examines the everyday challenges that many state residents face in meeting basic needs. For stories in the weekly Overextended Oklahomans series, journalists from participating newspapers have looked at the burdens exacted by payday lending, childhood hunger and the shortage of neonatal care. In one recent installment, reporting team member Caleb Slinkard offered a detailed exploration of how a scarcity of dental care is impacting poor and rural Oklahomans.
In this Q&A, Slinkard, who is the editor of the Norman Transcript, and who has overseen his paper’s 15-member newsroom for the past two years, offers insights into his “Dearth of Dentistry” package. He reflects upon what oral health can tell us about economic health and how budget decisions have influenced the availability of benefits, providers and fluoridated water in the state. He also shares tips that might help fellow journalists take a similar look at oral health access in their own communities.
Q: CNHI’s Overextended Oklahomans series has chosen many compelling angles for its exploration of economic struggle in the state. Can you tell us more about the series and how you decided to include a focus on dental care?
A: There are more than a dozen CNHI newspapers in Oklahoma, and journalists at several of the papers have been talking for over a year about projects we could work together on to leverage both our collective resources and audiences. We decided, out of all the issues that impact Oklahomans, the most important to focus on was poverty. Oklahomans in lower socio-economic brackets have to make tough choices when it comes to stretching their limited resources, and, often, consistent, quality health care is on the chopping block. Dental care is even a lower priority for many Oklahomans.
Q: What surprised you most in your reporting on Oklahoma’s “dearth of dentistry?”
A: I was surprised by how few Oklahomans had dental health insurance. Without dental health insurance, routine annual visits to the dentist’s office are all but out the window, and so oral health issues begin to compound. The dentists I talked to told me that by the time something actually starts to hurt in your mouth, the problem has existed for quite some time. Also, much of the repair work dentists due has a shelf life attached to it. So reparative work needs to be re-done at some point in your life.
Q: Your package included a good county-by-county look at the shortage of dentists in the state. Can you tell us a little bit about what you learned about the source of the problem and efforts to address it?
A: Dentistry, like any profession, survives because of the number of people willing to pay for it. It makes sense to practice in higher population areas, so more dentists are in counties like Oklahoma and Cleveland. Also, dental education programs like the one at the University of Oklahoma can only train so many people at a time. With the baby boomers retiring, dentists have been retiring faster than they’ve been replaced. The state health department is funding a program to incentivize dentists to practice in low-service counties and areas, and it’s certainly made an impact, but the health department is having to deal with budget cuts just like every state department.
Q: You highlight the lack of dental coverage that makes it harder for Oklahomans to obtain care. The shortage of adult dental benefits covered under the state Medicaid program, SoonerCare, sounds like it’s a particular problem for many poor people in the state. Have state budget decisions had an impact on the program?
A: Absolutely. State budget cuts have impacted health care options for Oklahomans, particularly individuals on SoonerCare. It’s also impacted the state’s ability to run free dental clinics for children and pregnant women. While there used to be eight such programs in the state, now there’s only one, in Cleveland County.
Q: The availability of fluoridated water is also a key issue. Your package highlights this with a really useful map and data. Can you tell us more about how you developed this aspect of your story and how you decided to present it the way you did?
A: The experts I talked to focused on fluoridated water and the benefits it provides by strengthening teeth. I was surprised to find there are several water systems in the state that aren’t fluoridated, but that’s not always due to a lack of education. The fluoridation systems are expensive to maintain and even more expensive to repair or replace, and rural Oklahoma cities often just don’t have the funds to repair their systems.
Q: Do you have any helpful advice for colleagues who might want to tackle this story in their own states? What were your best sources of data and where did you get the most help in your reporting?
A: I would start with the state’s health department and gather dental health statistics – what percentage of your state’s residents have health insurance/dental insurance? What programs does the state or nonprofits provide to assist low income residents with dental care? This was the key first step to understanding the scope of the issue and helped me prepare more pointed questions for the rest of my sources. All of the best data I received came from the state health department. The individuals there were extremely helpful.