Let’s work toward oral health equity

Almost half of all low-income and non-Hispanic Black adults have tooth decay that has gone without treatment. Kids are in pain and getting behind at school, low-income families and people of color are suffering. Too many families either don’t have coverage or can’t afford to pay for dental care because it takes money away from everyday survival. These social determinants are very real for the nearly 60 million Americans who don’t have access to dental care.

The Centers for Disease Control and Prevention (CDC) defines social determinants of health as “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.” Put simply: where you live often determines how healthy you are.

There is no doubt that there is a massive oral health equity issue in America. And we know that poor oral health leads to poor overall health. This oral health divide further deepens the overall health disparities in our nation.

While there are several answers to a lack of dental care in underserved communities -–temporary fixes such as free dental care days and toothbrush distributions do not address the lack of access long-term.

There is a sustainable solution gaining steam in the United States: dental therapists.

Dental therapists started in the U.S. more than 15 years ago, when Alaskan Native/American Indian leaders established a dental therapy program to provide needed care to their communities. Since then, the Commission on Dental Accreditation (the same group that certifies dentists’ programs) has approved three education programs and the first dental therapist on the East Coast started work in Maine in 2020.

Dental therapists are licensed dental providers who work under the supervision of a dentist to give routine care. Part of a dental therapist’s training includes working in all kinds of settings. This training makes them nimble, and able to get to remote areas and give care. This flexibility doesn’t just mean they can provide routine dental care in remote or rural areas. It means dental therapists can effectively address dental care shortages in any community. They are also cost effective and open access to good wage jobs. Since programs can be established in community colleges, the cost of a dental therapy education is affordable, turning out professionals with lower debt. Dental therapy is an access to care solution and job creator all in one.

Establishing affordable programs is key to opening the field to people from low-income backgrounds and developing a community-based workforce. Providers who share culture, language, and values with their patients often have more success building trust and providing effective care.

Twelve states, including a first step here in Connecticut, have authorized dental therapists in some form and about a dozen other states are exploring dental therapy options. As we bring awareness to health inequities across Connecticut during Health Equity Week (April 4-10), we cannot forget the critical role oral health care plays in our overall health and the deep racial, ethnic, and socio-economic divides that continue to fester in our nation. Dental therapists are a proven way to address this divide and it’s our hope that they become a common addition to the dental care team.

Pareesa Charmchi Goodwin is the Executive Director of the Connecticut Oral Health Initiative, Inc (COHI). COHI is a nonprofit oral health advocacy organization with the mission of increasing access to oral health services for all Connecticut residents. 

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