Atlanta-based DSO Benevis recently released a whitepaper titled “Poverty Shapes Oral Health,” highlighting how socioeconomic status is linked to oral healthcare access and other outcomes.
The report shows that older, lower-income adults experience triple the amount of untreated tooth decay compared to older, higher-income adults. Additionally, children with public insurance often receive less dental treatment than children with private insurance.
Jane Whang, DDS, the Regional Director of Clinical of Benevis, recently spoke with Becker’s to discuss the report’s findings and the state of dental care accessibility in the U.S.
Editor’s note: Responses were lightly edited for length and clarity.
Question: What are the most important takeaways from your whitepaper?
Dr. Jane Whang: I think the fact that socioeconomic status continues to drive persistent disparities in dental health across across the country, in terms of dental access and treatment, which ultimately affects [overall health], as we have heard so many studies of late about how your oral health impacts how your overall health is, so it does have other consequences besides just oral [health.]
Q: Are there any common misconceptions about how socioeconomic factors are connected to oral healthcare?
JW: It’s important to remember that there is a disparity, unfortunately, in how poverty casts a shadow on people’s access to care and how they understand oral health, and it just continues. It starts at childhood and continues into adulthood. I think sometimes people [think] that because they have this free dental care, that it will be easy for them to receive the care. Just because it’s free doesn’t mean it’s accessible and that it’s fair. I think that’s a great reminder.
Q: Is there anything particularly different about oral health disparities this year?
JW: In terms of this year, I think the difference between children and adult healthcare is one of the disparities. We do focus a lot on children receiving that oral healthcare, and it’s [often] due to past experiences, unfortunate incidents that have happened that have put a lot of highlight on it, but I think we’re forgetting that adults still need that support and that coverage, and that people are living longer. The coverage we have for adults is not adequate, and it continues to become inadequate as people live longer and require more services. [This is important] especially when the first area that’s cut is adult dentistry before anything else when budgets are reevaluated. I think that’s important to consider, and the fact that even the coverage adults already have is inadequate a lot of times because they cover emergency services and not preventive [services.] Adults who have had a long history of inadequate oral health services are already coming in at a disadvantaged baseline … They have to wait until they are in an emergency state and they’re in pain, and that’s when we do extractions versus restorations, and that’s always heartbreaking.
Q: What challenges are up ahead that could worsen disparities in oral healthcare over the next few years?
JW: The fear that I have is that many providers have started to even extend care and increase access to care for the Medicaid population, but with the cuts, it impacts dentists who are able to accept that insurance and still be successful in their practice, so we will have fewer providers accepting that insurance, which means decreased access to care. That’s the biggest worry. Thankfully, as a DSO we can continue to provide those services and do what we can because of the way we practice, but to have that decrease is disheartening after all the work we have put into advocating for it.
Q: What solutions do you think would be most helpful in alleviating these disparities?
JW: First of all, stop the cuts. Another is to provide access because [in] some states, I know what happens is that [people are] unenrolled, and then they have to reenroll, and that process can be very daunting for the population. I think that’s one way that they get around providing less care to patients, but I think providing them with that support so it’s easier for [people to reenroll.] Don’t just say, “Hey, we have this coverage,” but make it accessible for them so they know how to get the care they need. Also, provide ways for more providers to accept [Medicaid,] and make it easier for them and support them through it. Especially, when we have organizations where their major mission is to provide access to the Medicaid population, let’s work around how we can best work together so that we have different fee grades for practices who are seeing a different percentage [of the] Medicaid population. Let’s have a better fee package so that it makes sense and we can continue to subsist, especially with the increased costs we already have in the dental industry with staffing and supplies. We can’t continue to pay everyone the same way, but increased costs lead to non-viability.
