By Harshada Rajani
Kamla Patel couldn’t handle it any longer. The list of dental work she desperately needed was getting longer with each pain-filled day. Her New Jersey dentist explained that “the crown, dental implant, bridge and partial denture work you need will cost you at least a few thousand dollars,” but she was on a fixed income and didn’t have that kind of money readily available. Her Medicare plan only covered her regular check-ups every six months, however, every day for Patel seemed worse than the last. She could barely chew and was forced to abstain from most solid foods.
Seeing no other option, Patel arranged for a trip to India. She hated how long and exhausting the trip promised to be. She hated how she always felt sick the moment she felt the Bombay breeze. Patel bemoaned the fact that she had to fly halfway around the world to access the dental care she needed, it was only the promise of relief from immense paint that made it worth it. Her dental woes would be cured. She would be able to get the dental work she needed for almost a fifth of the cost. These prices were affordable for her, even including the pricey plane ticket.
Patel couldn’t shake the absurdity of the situation, this is America – shouldn’t there be a better way?
The FDI World Dental Federation declared that good oral health care is a basic human right. Yet, the people who need oral care the most are the least likely to receive it. Legislators, dentists, and researchers alike are focused on coming up with ways to reduce this staggering disparity.
About one-third of Americans don’t visit the dentist every year. 130 million Americans don’t even have dental insurance and 47 million live in areas where dental providers aren’t readily available. This all results in over 800,000 emergency room visits annually for very preventable dental emergencies, and 20.5 million lost workdays per year.
Thus, in 2000, the Office of the Surgeon General (OSG) identified the state of access to oral care in America as an epidemic. Despite some modest progress in the two decades since then, three stringent barriers to care remain – affordability, geographic location, and poor oral care literacy.
The cost of dental care is surprisingly a major barrier for people at all income levels. Though low-income adults are ten times more likely to have poor dental hygiene compared to adults in higher income brackets, a majority of adults across the financial spectrum cite cost as the main reason for neglecting to seek out dental visits. Dental care has more financial barriers as compared to other health care needs because many insurance plans for adults do not include dental benefits. Dentistry has always been seen by the medical world and insurance companies as a distinct entity from other health care. As a result, the Affordable Care Act and most Medicaid plans aren’t required to include dental benefits.
The main solutions to combating financial barriers to dental care are incentivizing dentists and dental students to serve vulnerable communities and convincing insurance companies to make dental benefits a priority. There’s even a big push to make dental care a part of primary care, which has the potential to solve many of the barriers to care. While these solutions could take time, advocacy, and legislation, some dental organizations have chosen to personally combat this barrier by providing free or discounted services to vulnerable populations.
There are over 5,000 areas in America that are considered Dental Health Professional Shortage Areas. It would take nearly 10,000 more providers to meet this need. A few proposed answers to this gap include recruiting dental students from underserved areas, incentivizing dental professionals to work in these areas, creating mobile dental care units, and utilizing mid-level dental professionals to a greater degree.
For example, many chapters of the American Student Dental Association are involved in programs such as Give Kids A Smile and Missions For Mercy that provides treatment to underserved communities. Additionally, the American Dental Hygienists’ Association has shown their avid support and readiness for implementing the use of mid-level dental workers like themselves in alleviating the dental care shortage.
The last barrier to care seems a bit vague but is something that can be easily overcome – poor oral health literacy. People need to learn that oral health care is all about prevention. The Office of the Surgeon General said, “oral diseases are progressive and cumulative and become more complex over time.” We need to get people to trade in their treatment mindset for a prevention mindset for all types of health care, but especially dental care. The only solution to this problem is early education.
The Action for Dental Health Act passed at the end of last year, which marked a huge breakthrough for the dental health world – it shows that Congress and the rest of the country are finally recognizing the critical importance of good oral health. The new law is specifically aimed at reducing the barriers to dental care nationwide. It will allow organizations to qualify for grants to fund projects focused on improving oral health education and disease prevention. Additionally, it will encourage the expansion of outreach programs for underserved communities and patients with special needs.
Innovative companies, like Virtudent, have adapted an approach to dental care seems that addresses all three barriers to care. By bringing mobile on-site dental clinics to you, fully staffed with dental hygienists, and utilizing teledentistry, they have found a way to streamline costs and make dental care more accessible than ever.
COO and co-founder of Virtudent, John Voith, says, “Through our model, we’ve reduced the cost of basic dental care and we’ve brought the best dentists in the country and the highest quality of care to the most underserved and remote populations — improving the quality of life of thousands of patients.”
On top of that, Virtudent dedicates a portion of its proceeds to providing dental services to disadvantaged communities completely free of charge. According to Virtudent’s research, low-income youth have a hard time finding dental providers in their area, and an even harder time finding dental providers who accept Medicaid. So, Virtudent brings state-of-the-art dental care to them. As of now, Virtudent is providing access to care to nearly 5,000 children at Boys and Girls Clubs in New Hampshire and plans to touch as many lives as possible. Virtudent is dedicated to making dental care a standard, not a luxury, through their work.