How to serve the underserved

June 30, 2010

Editor's Note: Following is an interview with Dr. Steven Adair, Chief Dental Officer for FORBA, one of the nation's largest dental practice management firms that focuses on high-quality dental care for underserved communities.

Kevin Henry, DE: What’s the main message you’re trying to get out there?
Dr. Adair: In today’s society, lots of adults have very little access to care, and some of that can be attributed to their lack of insurance. Many adults can afford little more dentistry than what is covered through Medicaid, and typically Medicaid only helps the children and not their parents. We know there are links between the oral health of parents and the oral health of their children. Studies have shown that when the parents can’t get regular dental care, their children will be adversely affected.

KH: I’ve seen some of the footage from Mission of Mercy projects from around the country, and it amazes me the dental needs that are out there.
Dr. Adair: It’s always amazing how much of a need for dental care is out there. We know that 80% of the caries burden is found in 20% of the children, and many of those children live in poverty. It may not be that obvious to those practitioners who are in affluent areas, but those children really carry a burden.

KH: What can dentists and their team members do to help when it comes to so many people in need?
Dr. Adair: Be aware of the problem, especially in low-income children. Volunteer at clinics. I would love to see more dentists accepting Medicaid, but I’m not sure how possible that would be. If Medicaid reimbursed for more of the costs of doing the procedures, I think more people would accept it, but people think the red tape can be cumbersome and a turnoff. If they can provide care and help people, I urge them to do so. Dentists and their team members can be advocates within organized dentistry at all levels. They also have lobbying capabilities through local, state, and national organizations. I encourage your readers to contact associations and see what can be done.

KH: Is there light at the end of the tunnel? When do you think giant strides will be made toward tackling caries in low-income children and adults?
Dr. Adair: Right now, I think the problem is overwhelming. In our FORBA clinics around the country, we daily see children come in with numerous cavities caused by diet, poor oral hygiene, lack of education about oral health, and more. All clinicians can do is try to keep up with the decay. If better care could be provided for the parents, I think it would turn the tide. Studies have shown that the children of mothers with untreated cavities are twice as likely to have untreated cavities. Mothers with regular dental care rated their health significantly higher than those who didn’t receive regular care. Another study has shown children are much more likely to visit the dentist if their parents visit the dentist regularly. But how can people visit the dentist when they can’t afford it? Until we get into better economic shape as a nation, that will be the tough question.

KH: When people think “underserved area,” they think of a certain section of the country, but this is truly a nationwide problem, correct?
Dr. Adair: Every state is affected. Every region of every state is affected. Rural regions and inner cities are affected. People may have to travel more than an hour to get the care they need. Sometimes it’s more a problem with the distribution of dentists than the number of dentists in an area. Affluent communities won’t see the problem, but if you’re in a rural or inner city area, the numbers game can be a big problem.