 Overview
 Americans have very good oral health. Generations ago, most people lost their teeth by middle age. Today, thanks to the benefits of fluoride, healthier lifestyles and professional dental care, more people than ever before are keeping their natural teeth throughout their lifetime. Yet for people who live in areas where a dentist is not available or who cannot afford treatment, access to dental care can be difficult.
There are barriers to care that need to be overcome in order to help underserved people get needed professional dental care.
Return to Top
Barriers to Oral Health Care Access
- The dental components in Medicaid and SCHIP, which are supposed to provide health care to disadvantaged Americans, are chronically underfunded.
- Federal law mandates that Medicaid cover basic preventive and restorative services. But many state programs fail to deliver care to even half of their eligible children.
- Adult dental coverage through public health programs is even worse; many states simply don't provide it.
- It's not just about the money. Patients covered under public programs still face hurdles, such as transportation and difficulty missing work. Taking care of yourself is a critical component of oral health, and too many Americans lack a basic understanding of preventive oral health, things like brushing, flossing, eating a healthy diet and drinking fluoridated water.
- About one-third of public water systems are not fluoridated, yet it is the single most effective public health measure to protect against tooth decay.
Return to Top
Raising Awareness
For years, the American Dental Association has been striving to raise awareness and advance solutions when it comes to improving access to dental care. Dentists are the leading advocates for improving access to dental care, but we can't do it alone. We all have a stake in this issue. Government, business leaders, insurance companies, health care professionals and individuals all need to work together to improve access to dental care.
It is a disgrace that so many Americans still lack access to basic oral health care. Kids and adults miss sleep, school and work due to untreated dental disease. They can't eat properly; they can't smile. It doesn't have to be this way. Dentists are willing to take the lead on improving access to dental care. But we can't fix this mess alone. The federal, local and state governments and society at large must stop shortchanging oral health and find the political will to get better dental care to the millions of Americans who don't receive it.
Oral health care needs to be a priority. Left untreated it can lead to serious health consequences-tooth loss, infection, damage to bone or nerve. Infection from an abscessed tooth can spread to other parts of the body and, ultimately, may even lead to death. Clearly, oral health is just as important as non-oral health.
Prevention is the key. Dental disease is almost entirely preventable. We need people to become empowered about their oral health-how simple measures like brushing and flossing their teeth and eating a balanced diet can protect against tooth decay, and understanding the importance of drinking fluoridated water.
Everyone has a stake in this issue. Pain from untreated dental decay results in lost school and work hours. People may seek care in hospital emergency rooms, most of which aren't well equipped to handle dental emergencies, and where the cost of treatment is far greater than a dental office visit. That's why we as a society need to invest in providing access to dental care to underserved people. All of us-government, business leaders, insurance companies, health care professionals and individuals-need to develop access to dental care solutions that work in our communities.
Return to Top
Volunteerism
Tens of thousands of dentists provide free care to hundreds of thousands of disadvantaged children each year through the ADA's annual Give Kids A Smile program.
State dental societies in Texas, Virginia and elsewhere regularly organize Missions of Mercy, in which thousands of people receive free care, often in remote areas, in temporary dental "hospitals."
Countless individual dentists routinely provide free or discounted care to people who otherwise couldn't afford it, care that, according to one survey, amounted to $1.6 billion in a single year.
Return to Top
Advocacy
No matter how much free care dentists give, volunteerism alone won't solve the problem. Charity is not a health care system. That's why the ADA, other dental organizations, and our colleagues in medicine and public health continuously advocate for repairing the broken system that is supposed to provide oral health care to low-income and other disadvantaged populations.
State dental societies work constantly with their legislatures and health agencies to increase funding for dental services in Medicaid and to raise awareness of the importance of oral health to overall health.
Unfortunately, even if a state provides a fairly decent dental benefit in their Medicaid and SCHIP programs, that benefit is at risk of being cut based on the ever-changing state budget.
Plenty of dentists want to care for people on state public health programs. But the programs are so anemically funded and poorly administered that dentists can't recoup even their overhead costs for providing treatment. Despite this, many dentists still do provide care to children and adults under Medicaid and SCHIP, often simply writing it off, rather than going through the onerous paperwork required to get paid. When state or federal governments increase funding for public health insurance programs, more people get the care they need, and the data back this up. Michigan, South Carolina, and Tennessee are excellent examples of this.
The ADA strongly supports community water fluoridation as the single most effective public health measure to protect against tooth decay. No matter what your economic status, you can help guard against tooth decay simply by drinking fluoridated water. It's estimated that for every dollar spent on community water fluoridation, $38 in dental treatment cost is saved.
Why is it that more than 30 percent of Americans who receive water through public water systems still don't enjoy the benefit of optimally fluoridated water? Community water fluoridation, school-based/school-linked dental programs and dental health education are critical components of the type of comprehensive system needed to end the scourge of untreated oral disease among the most vulnerable Americans.
Return to Top
Workforce innovation
People might think that if we just had more dentists, there wouldn't be an access to care problem. But the overall number of dentists is not the issue-it's where they're located, how many people they're able to treat and whether people can afford treatment or whether there's a way to pay for their care.
Some states, even some individual communities have helped place dentists in rural or urban underserved areas through stipends, loan forgiveness and other incentives.
The ADA is expanding the team approach for delivering care by creating a community dental health coordinator. The CDHC is part social worker and part dental assistant who, under the supervision of a dentist, can help people navigate the public health system to get the dental care they need. The CDHC works within the underserved community to provide teeth cleanings, apply dental sealants and fluoride treatments and help educate people on the importance of brushing, flossing and eating a balanced diet. The CDHC will be in contact with a supervising dentist and can triage severe cases so the dentist can provide treatment.
Additional
Resources
Advocacy by the ADA
State Children's Health Insurance Program (SCHIP)
Community Water Fluoridation
Give Kids A Smile®
White Paper
ADA Dental Minute
Please note: The ADA does not provide specific answers
to individual questions about fees, dental problems, conditions, diagnoses,
treatments or proposed treatments, or requests for research. Information about
dental referrals, complaints and a variety of dental procedures may
be found here. You can also refer to our Frequently
Asked Questions page for answers to common questions.
|
