By Shervin Shahsavari, ASDOH Class of 2023
Dental services are the number one treatment people need but don’t receive. This is largely due to barriers of care present that make it difficult for people to look for and initiate getting care. We must increase our economic intelligence of why people don’t visit the dentist before it’s possible to address these barriers.
Cost as expected is the largest barrier to care but it is not only a barrier for low income populations. In fact, cost is the number one barrier for all segments of the population except the extremely wealthy. Fear is then a factor for many but it is not always due to pain. Many patients report fear being onset by sounds as well as smells in an office that bring on discomfort. Other barriers have to do with locations and settings.
Inconvenience is a large factor for many patients in regards to both location and time. There is a large maldistribution of dentists and this lead to difficulty finding one that meets a patients needs due to cost, insurance, and timing.
We also see reasons such as the lack of perceived need to see a dentist, which in part stems from lack of education. Within lower income communities there are several barriers to adequate education, leading to lower health literacy amongst this population. Geriatric patients may feel as though they do not need to see a dentist due to lack of teeth. Others may feel as though their young children do not need to see a dentist due to not having enough erupted dentition. Many do not know that the first time a child should visit the dentist is when their first primary tooth erupts. Both these groups need to be educated on why this is necessary to increase their visits to get dental care.
These are all major factors in large segments of the population not receiving dental care and there are various ways to reduce these reasons. To reduce costs we must adequately fund and reduce burdens put on Medicaid programs. These findings must be used to treat vulnerable population and dental treatment must be seen as a medical necessity. Dental practices must also increase its efficiency to lower the end cost for patients. This will allow even larger segments of the general public to receive dental care be lowering burden on both dental providers as well as practices.
We must then address other barriers as well. By increasing patient management skills, bettering technology and using education we can alleviate patient fears in the dental office. To address location based barriers, more student loan repayment programs are necessary to incentivize dentists to work with underserved populations. We can then better experiences with less consumerism practices that leave patients with large bills due to unnecessary procedures.
Finally, we can increase oral health literacy through public health campaigns, in office education and educational outreach programs. With proper education and funding we must advocate for change and support bills that allow for these changes to take effect. It is this level of involvement that is necessary to bring oral health care to those that need it most and what we as dental health professionals should strive to achieve.
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