Dental health equality remains a dream for many Americans.
People living in poverty, rural areas and people belonging to certain ethnic/racial minorities and genders typically experience higher barriers to care than most.
According to the Centers for Disease Control and Prevention, about 10% of people in rural America have less access to dental services than their counterparts living in urban areas. The CDC further reveals that children and adults living in rural areas are 5% and 7% less likely to receive dental care, respectively, than those living in urban areas.
Dentists have a significant responsibility to ensure equal dental health, to secure access to oral care for the public and to ensure that people from different walks of life enjoy high-quality oral care. I encourage all of us to learn, research and take on leadership roles to help achieve justice.
About health equality
We may wonder why we use ‘equality’ instead of ‘equality’. While both words illustrate honesty. health equality This means that everyone has a fair chance of optimal health care, regardless of their socio-economic status.
Health Equity means everyone has the same opportunities and treatment options, regardless of their immediate needs.
At the same time, health equality means that people have options based on their needs. A person who cannot afford care can get it for free, while another person can pay for the same care. Examples include offering free or low-cost checks to anyone; this will be ideal, but it can be difficult for any healthcare system to survive from a practical and operational standpoint.
In short, health equality means that everyone gets the same standard while health equality means that everyone gets individualized care to bring them to the same level of health.
Unfortunately, many patients face several barriers, especially when it comes to dental care. These barriers include, but are not limited to, childcare, oral health knowledge, annual limits on their dental insurance, access to transportation, language barriers, and much more.
In April 2020, the ADA Health Policy Institute has a set of data and infographics research into differences in oral health. The barriers hurt brown and black Americans disproportionately.
Research shows that black adults are 68% less likely to meet their dental health needs than white adults. Similarly, Latino adults are 52% more likely to report difficulty performing their jobs than white adults due to poor oral hygiene. In addition, the CDC says tooth decay is one of the most chronic dental diseases in the U.S., with nearly half of adults age 30 and older having some form of periodontal disease. The CDC also reported an estimated $45 Billion Lost Annually Due to Unmanaged Dental Disease†
The cost of dental care remains high for many. For this reason, it is difficult for most low, middle-income people to value and prioritize oral health when they struggle to get food on the table and good housing. According to HPI data, cost barriers affect black and Hispanic people more than whites and Asians.
What it takes to achieve dental equality
There is a need to actively find sustainable solutions to barriers that hinder equity in dental health rather than ignore them. From my perspective, for long-term solutions, we must continue our political advocacy to ensure that local, state and national leaders take an active part in introducing policies that will eliminate or subsidize the struggles faced by ordinary Americans.
I believe it is important to prepare leaders who can improve and strengthen existing systems, such as improving Medicare and Medicaid. These dental leaders can exert influence using solid, evidence-based claims about the correlation between oral health and overall health, demonstrating how equity in dental health will lower the cost of health care, which will require an expansion of dental coverage.
We need leaders who can help community clinics raise more money. These are the places where our underserved communities can be seen. The funding opportunities can further help dentists respond to their patients’ oral health concerns through a wider range of treatment coverage. Many community clinics do not provide complicated RCT, indirect, or fixed restorations due to current Medicaid reimbursement or coverage. At the same time, tooth extraction is unlimited.
Public health dentists can also help re-analyze health care spending, taking into account quality and actual need, minimize waste, and redirect spending towards the standard of care. For example, we would be better off investing in digital technology, which in the long run can be cheaper and provide better quality care.
In December, the National Health Institutes of Health released Oral Health in America: Progress and Challenges† This comprehensive report provides a “comprehensive picture of the state of oral health in America.” The report contained several calls to action to help improve the country’s oral health. Policy changes help reduce or eliminate social, economic and other systemic inequalities that affect oral health behavior and access to care. It also strengthens the oral health workforce by diversifying the makeup of the country’s oral health professionals.
Achieving equality in dental health is one of the steps that can usher in a healthier generation for working Americans. It may also motivate more young people to consider dentistry in various capacities to reduce inequalities in dental health. This points to the need to promote the racial and ethnic mix of the dental workforce.
A recent survey by HPI suggests that the US population continues to diversify, and this trend is predicted to continue for the next 20 years. And while younger dentists and dentistry students are more diverse these days, more work is needed to ensure dentistry has a more racially diverse workforce.
According to data from the Health Policy Institute, the number of active white dentists dropped from 78.2% to 71.9% between 2008 and 2018. The largest increase among minority groups came from Asian backgrounds, from 12.9% to 17.1%. Hispanics rose from 4.6% to 5.6% and professionally active black dentists fell from 3.8% to 3.7%. Dentists of different racial/ethnic backgrounds increased from 0.5% to 1.6%.
Establishing equitable public policies essential to taking dentistry to the next level to serve all patients will also target dental education institutions to address implicit bias, institutional culture and faculty privileges.
Dentists and other dental workers will also need to take leadership courses to help them embrace diversity in the field as they work for equality in dental health. In this way, the future offers an important dental care sector that will become an important part of an excellent interdisciplinary care modality.
dr. Muhalab Al Sammarraie is a guest blogger from New Dentist Now. He grew up in Baghdad before coming to the US as a foreign trained dentist. He received his DDS honors in 2019 and became a member of the ADA, California Dental Association and the San Diego County Dental Society. While working on his second degree, he gained notable leadership experience in the public, private and non-profit sectors. He led many departments and oversaw process improvements in education, social services and public health. dr. Al Sammarraie is currently a dental director at AltaMed Health Services, the largest FQHC in the country. In addition to dentistry, Dr. Al Sammarraie activist groups in Iraq that help war victims and displaced persons find educational opportunities and medical care.