In Search of Dental Care: Two Types of Dentist Shortages Limit Children's Access to Care

Abstract

Each year in the United States, tens of millions of children, disproportionately low-income, go without seeing a dentist.This lack of access to dental care is a complex problem fueled by a number of factors, with two different dentist shortages compounding the issue: An uneven distribution of dentists nationwide means many areas do not have an adequate supply of these practitioners. As a result, access to care is constrained for people in these communities regardless of income or insurance coverage.The relatively small number of dentists who participate in Medicaid means that many low-income people are not receiving dental care.National standards set by dental and pediatric organizations call for children to visit a dentist every six months.The federal government requires state Medicaid programs to enact their own standards after consulting with these organizations, but new data show that more than 14 million children enrolled in Medicaid did not receive any dental service in 2011.According to the most recent comparison, in 2010, privately insured children were almost 30 percent more likely to receive dental care than those who were publicly insured through Medicaid or other government programs, even though low-income children are almost twice as likely as their wealthier peers to develop cavities.4 In 22 states, fewer than half of Medicaid-enrolled children received dental care in 2011.In 2012, Dr. Louis W. Sullivan, secretary of health and human services under President George H.W. Bush, said, "In a nation obsessed with high-tech medicine, people are not getting preventive care for something as simple as tooth decay." He pointed to the inadequate dental workforce as a driving factor, stating, "The shortage of dental care is going to get only worse."This issue brief examines the lack of access to dental care, especially for low-income children and families, in the United States. It also explores strategies states are employing -- particularly expansion of the dental team by licensing additional types of providers -- to address workforce shortages and better serve low-income children