Study finds disparities in Virginia’s dental care
Patients recieve free dental care inside the Roanoke's annual Mission of Mercy Project Friday, March 30, 2012. (Photo by Sarah Bruyn Jones)
A new study says many Virginians don’t have access to dental care because of costs and a lack of dentists, according to the Associated Press.
Virginians in the rural western and southern regions of the state are less likely to have received dental care than residents living in the highly urbanized northern and eastern regions, according to a news release about the study.
Here’s more from the Associated Press:
“The study by two University of Virginia economists says cost is the greatest barrier. Those least likely to visit a dentist are low-income residents without insurance or who have low-cost public health care.
“According to the study, more than 15 percent of Virginia’s population lives in areas designated by the federal government as dental Health Professional Shortage Areas.
“The study recommends allowing dental hygienists to offer fluoride varnish and routine cleaning without a dentist’s supervision. It says that would expand access to care at a low cost. Dental hygienists also could identify patients who need additional care and refer them to a dentist.”
Here is some additional information provided in the university’s news release about the study:
- Low-income residents without insurance or with low-cost public care are least likely to visit a dentist.
- African-Americans in Virginia are less likely than other groups to have visited a dentist or dental clinic in the past year.
- Northern Virginia, Richmond and Hampton Roads areas have higher concentrations of dentists than less urbanized portions of the state.
- Four rural counties with relatively high percentages of African-Americans have no dentists at all: Charles City County, King and Queen County, Surry County, and Sussex County.
- Approximately 15.6 percent of the state’s population lives in the designated dental Health Professional Shortage Areas, which are mostly in Virginia’s western and southern regions.
August 17, 2012 - 3:08 PM
If cost is the barrier, then who is going to pay the dental hygienist? Who is going to pay the referrel dentist? They haven’t solved anything.
@Amy I think the idea is a dental hygienist is less expensive than a dentist, so it could lower the cost and maybe help reduce the barrier. So, public health dollars, grant money and other resources could be stretched to meet more needs.
I run into this problem all the time with the population I work with. No one wants to accept the low payments from Medicaid or Virginia Premier, so they will only see those patients on a cash only basis. Where I used to live they had a “traveling dentist” that would set up at the school for 1-2 weeks at a time and see kids who did not have insurance or could not afford dental care.
So how much money did they spend to figure out that people with cash and insurance get better (fill in the blank) than those without? Or that minorities get worse (fill in the blank) than the general population?
I see nothing that looks like “news” here.
@Kristen The research was intended to inform public policy by assessing what is working to address the disparities and to suggest a roadmap for going forward. I don’t have an immediate answer to your question of funding for the research, but will seek an answer. The research appeared in the Cooper Center’s online public policy publication The Virginia News Letter.
Sarah. You are wrong and do not understand dental economics. 3rd party reimbursement for basic dental services are the same wheather a dentist performs the procedure or a hygeinist, or an expanded duty assistant. The overhead cost of providing a service, from real estate/facility cost to the price of floss is tremendous fixed cost. If you want to lower cost, you perform that procedure in an office with dirt cheap rent, not a multi million dollar non profit, federal community center. In some areas of the state, dental hygeine salaries will excede an associate dentist’s pay.
@Amy The authors of the study are talking about changing practices, policies and requirements to allow more people to provide the services.
“There is considerable evidence that improvements in oral health in underserved populations could be achieved by expanding the services offered by dental professionals other than dentists,” the authors wrote. “Expanding the functions that dental hygienists can perform and relaxing the requirements for supervision by dentists would increase the quantity of services actually delivered to underserved residents and would lower the price of receiving basic care.”
The authors also talk about rethinking the model for delivering dental care that goes beyond the system that you are describing.
“The expansion of alternative providers may also improve the viability of alternative service delivery models,” the authors wrote. “For example, offering a limited number of affordable and transparently priced dental services in a retail setting such as a retail outlet or mall, have gained popularity and are a promising avenue for expanding preventive care access. Improved access to the underserved depends on how this model evolves. But, ultimately, its viability may depend on permitting mid-level professionals to practice independently.”
Can you or these researchers give us any statitics on the rate of edentoulism, or partial edentoulism with the very poor, underserved population? I worked at a VA clinic some years ago. There was a dental program for homeless vets to provide basice services, but the reality is that almost everyone treated needed dentures, not cleanings.
@Amy The authors didn’t provide a statistic like that in this study. I’ll see what I can find. Earlier this year I was told the government reported in 2000 that of the estimated 37 million people are living without teeth and about 20 percent didn’t have dentures. But that doesn’t get to the population specific information you are seeking.
Here is a chart from the CDC that looks at lack of natural teeth by age and poverty level: http://www.cdc.gov/nchs/data/hus/2011/fig34.pdf So, in 2010, 40.6 percent of people 65 and older living below 100 percent poverty didn’t have their natural teeth.