Pew Kid

The two types of dentist shortages that limit children’s access to care

July 17, 2013

July 17, 2013

In June, The Pew Charitable Trusts issued a brief on children’s dental care in America, focusing on the two types of dentist shortages that limit children’s access to care.

Of the many obstacles that prevent children from accessing dental care, the two most prominent issues have to do with a shortage of dentists.

Though the American Dental Association will argue thata dental desert does not existin America, they cannot argue that there is an uneven distribution of dentists throughout the country, partially due to the fact that it’s better to manage a practice in an affluent area. Not only are most dentists business owners, the newer ones are paying off increasing student loan debt, while the more experienced dentists are preparing to retire in a weaker economy than they may have anticipated.

The other obstacle for pediatric dental care is the number of dentists who accept Medicaid. Because the reimbursements for Medicaid patients are so low, the amount of time spent on paperwork alone deters many dentists from accepting their cases.

Dentists have the best job in 2013

Despite the ADA’s official stance, there is a lot of support from the dental industry for mid-level providers
More states are considering legislation that would expand access to care for its citizens. Two states – Alaska and Minnesota – have signed into law legislation that allows dental therapists to provide care that a dentist would typically provide. Similar to physician’s assistants or nurse practitioners, dental therapists are able to do more than dental hygienists, but less than dentists, allowing them to treat some of the patients that can fall through the cracks – often in public health settings.

The best states for pediatric health are those that provide dental sealants to children

Though the ADA is very publically against midlevel providers, the dental industry as a whole is beginning to strengthen its support for the profession. According to the June Pew Report, a 2012 survey showed that most dental school deans – 75% – thought that dental hygienists and dental assistants should be able to do more in terms of providing care to patients. “Over half felt that the future of dentistry should include a dental-therapist-type midlevel practitioner,” said Dr. Mert Aksu, the dean of the school which published the survey – the University of Detroit Mercy School of Dentistry.

Conclusion
The report concludes with the following:

“Though some states have bolstered Medicaid reimbursement rates and streamlined paperwork requirements, neither of these strategies is likely to significantly improve low-income children’s access to care. Unless states take steps to expand the dental workforce, the shortage of providers in many areas of the country and for low-income children will not only persist, but willgrow worse in the coming years.

You can read the concise nine-page report,“In Search of Dental Care: Two Types of Dentist Shortages Limit Children’s Access to Care” here.

THERE'S MORE TO THIS CONVERSATION:
Read the ADA's response to this article:Dentist workforce size is not a major factor in access for the underserved
Read a dentist's response to the ADA: "I'm confused" – A Florida dentist tackles recent statements made by ADA in regards to access to dental care

Lauren Burns is the editor of Proofs magazine and the email newsletters RDH Graduate and Proofs. She is currently based out of New York City. Follow her on Twitter: @ellekeid.