Oral health—the health of gums, teeth, and the collective oral-facial system—can have serious implications for an individual’s overall health, as well as the well-being of society as a whole. Dental caries, or cavities, are the leading chronic disease among children in the US. Additionally, over 34 million school hours and more than $45 billion in productivity are lost each year as a result of dental emergencies requiring unplanned care.
Although the oral health of the nation has greatly improved since the 1960s, racial and ethnic minorities, rural communities, and people living in poverty have limited access to these improvements. Children, low-income families, and Black, Latinx, and Indigenous Americans are particularly at risk for adverse oral health outcomes.
Barriers to oral health care include lack of dental insurance, limited coverage for oral health under Medicaid and Medicare programs, lack of access to dental care providers, and overall high costs. Many employers may not cover dental insurance. Those that are members of government-based insurance plans may have very limited or no dental coverage at all. Additionally, dental coverage policies within programs like Medicaid vary widely across states, which results in inconsistencies in coverage nationwide. Black and Latinx individuals are more likely to have both untreated tooth decay and more severe tooth decay overall. Low-income populations, particularly low-income older adults, face barriers in access to care. Some populations, like those living in rural communities, lack access to dental care providers based on location.
Improving access to oral health care stands to improve the overall health and well-being of society. Legislative action to expand the coverage of oral health care in governmental insurance programs like Medicaid and integrating oral health care into chronic disease prevention and medical care can improve oral health at scale. At the local level, oral health can be improved through school-based dental care delivery systems and community water fluoridation.