Doctors are taking on dental duties in low-income areas

Dental deserts are emerging across the country, especially in low-income and rural areas. Because of this, many people do not have access to necessary oral health care, which can lead to worse health outcomes over time. In order to accommodate the lack of dentists, some primary care practices are incorporating dental care in their health offerings. 

Not a dentist in sight

Access to dental care is a problem many low-income, minority and elderly Americans face. According to the Health Policy Institute, rural areas have less than half the number of dentists per 100,000 residents than urban areas and that is not for lack of dentists in the field. While enrollment in dental schools has been rising, the "majority of those graduates aren't practicing in underserved communities and don't accept uninsured patients or those enrolled in federal health insurance plans," said the Tampa Bay Times. This has resulted in dental deserts across the country, where there is little to no access to oral health care.

Along with dentists opting to not practice in rural areas, Medicaid does not offer comprehensive dental reimbursements to everyone. And many dentists do not accept Medicaid as an insurance option. Even when a dentist does take Medicaid, the carrier usually only covers emergency procedures and not routine preventative care and screening. "Across the nation, vulnerable and marginalized communities — already prone to higher rates of chronic disease and limited access to health care — are left behind in these dental deserts," said the Tampa Bay Times. "There, patient volume exceeds the capacity of providers, or too few dentists are willing to serve those on Medicaid or the uninsured."

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The lack of regular dental checkups and procedures can have a greater effect on a person's health. "Poor oral health can have far-reaching consequences, not only as a precursor to other physical health issues but as a factor in depression and mental health issues," said Myechia Minter-Jordan, the president and CEO of the CareQuest Institute for Oral Health, to USA Today. "We have to raise the visibility of interconnectedness between oral health and the rest of the body." 

Introducing all-rounders

To combat the lack of dental care, some primary care doctors are opting to accept some of the burden. "Federally qualified health centers have a long history of co-locating dental services within their systems," pediatrician Patricia Braun said to CBS News. "We're taking that next step where care is not just co-located, meaning, say, we're upstairs and dental is downstairs, but we're integrated so that it becomes part of the same visit for the patient." Some places have also introduced mobile clinics. "Rural residents face more significant health care provider shortages, including dentists, compared with their counterparts in larger cities," said NPR. "Since the beginning of the pandemic, mobile clinics have increased access to a range of services in hard-to-reach places with sparse populations."

"Providing these services during medical visits increases the frequency of fluoride application," and "improves parents' knowledge of caring for their child's teeth," Tara Callaghan, director of operations for the Montana Primary Care Association said to CBS News. This can have a positive effect, not only on children's health but also on their education and confidence. "The literature documents very clearly that if you are in pain, you're going to miss school more often than other kids, and you're not going to learn as well," Frank Catalanotto, a founding member of Floridians for Dental Access and former dean of the University of Florida College of Dentistry, said to the Tampa Bay Times. "You're also going to have social issues, because if you've got broken-down front teeth, kids are going to make fun of you."