Population considerations
- Limited education. Level of education is a strong predictor for oral health. Individuals with less education are less knowledgeable regarding the benefits of oral health and regular dental visits.
- High costs. For low-income families without oral health insurance or Medicaid coverage, the out-of-pocket costs of tooth dental care may be too high. Other expenses such as medical costs take higher priority than oral health.
- Transportation. Lack of transportation to and from dental appointments and the need for repeated appointments may cause problems for some low-income families who require the use of public transportation.
- Few dentists accept Medicaid. A low proportion of dentists accept Medicaid as a payment source, creating an access barrier for low-income families to receive oral health care.
- Dental provider shortage. The geographical misdistribution of dentists perpetuates access problems often faced by low-income populations.
- Location of dentists. Most dentists practice in suburbia, rather than inner-city or rural areas where low-income populations are more likely to need services.
- Perceived discrimination. Research shows that low-income families sometimes experience discrimination as a result of using Medicaid and perceive their quality of care as lower than non-Medicaid families.
Strategies to address these considerations
- To supplement the supply of dental staff, innovative use of personnel and other professionals with additional training may help clinics serve more patients. Certain states allow dental hygienists with specific training to provide services in professional shortage areas.
- Free transportation or flexible scheduling may help with the time issues that low-income populations face.
- Where available, dental schools often provide low or no cost services to allow students to gain experience while in school. Interventions can help low-income populations obtain these services.
- In areas without dental schools or public health clinics including oral health departments, partnerships have been developed between academic dental hygienist programs and the community to provide low cost services.
- Specific interventions conducted with parents in Head Start or WIC programs can target low-income populations.