by Lory Laughter, RDH, BS
Traveling gives me a chance to see some of the hidden treasures of this country. Unfortunately, it also affords me an opportunity to witness some of the less spectacular acts of human nature. Like many dental professionals, I tend to look for things pertaining to the oral health of a community. Oftentimes my search leaves a smile on my face, and other times it leaves a bitter taste in my mouth.
I have traveled through small rural towns where mobile dental units provide services free of charge to the entire school population. One such program was titled “Dental Angels” and not only provided preventive, emergency, and restorative care for school children, but offered blood pressure and weight screening, as well as nutritional counseling for any interested resident. On the flip side, my ears have been witness to stories of children seeking emergency dental care in the emergency room because no dentist is available within 75 miles.
Perhaps the most startling tale came during a trip last spring to a town with an economy based solely on entertainment, specifically gaming. This was not a booming place with millions of lights and big name stars, but a small stop along the way offering drink and gambling. Other than one gas station, I did not see any other industry. There was a dental office in a neighboring town and I stopped in to have a chat: They were not busy. Almost everyone in the area has $200 in yearly dental benefits (to spend as they wish). Minimum wage is the norm and, if desired, the dental benefits can be used for any other purpose, including the residents’ gaming tab. Very few value preventive care, yet this dentist keeps battling to bring oral health to an unresponsive audience. In this rare case, access to care is not hindered by lack of professionals, but a resistance to education.
Unfortunately, many people do not see access to care as an issue at all. These people point to our traveling ability and a “dentist on every corner” as evidence that access to care is a made-up condition. Recent efforts in some states to address limited access to care by creating midlevel providers and expanded duties for educated professionals have been thwarted by those who say there is no access problem. These folks claim that misaligned priorities are to blame for rampant dental disease. In the opinion of the naysayers, if someone can afford a daily gourmet coffee stop or a mani¬cure, they can afford dental treatment.
For the sake of argument, let’s assume there are enough dental offices to serve every person that needs dental care. Even if this was the case, and it’s not, access to care is still a very real problem. Dental treatment can be expensive, and dental benefits have maximums that often pay a low percentage of actual cost — assuming one is fortunate enough to have coverage. It takes many visits to the coffee shop to equal the cost of treating one periapical infection, placing one crown, or even extracting one diseased deciduous tooth. State assistance, when available, contributes very little to these costs, and finding a dentist to accept the payment is difficult. It’s easy to judge a person’s purchasing choices, but financial restrictions can stand in the way of dental care for many citizens.
The dental hygiene profession is in a unique position to help fix the problem of citizens receiving necessary care. As a whole, we’re educated, motivated, and compassionate health-care providers. Our challenge is to let this be known to those who make the decisions regarding health care delivery. It starts by educating the population about our abilities, and then putting our resources together to make a change. Yes, it will take time and it will cost money. It will not be easy and probably not pretty. But burying our heads in the sand along with so many others in organized dentistry is not acceptable. We are better than that, so let’s prove it!
About the Author
Lory Laughter, RDH, BS, divides her full-time clinical practice between general and periodontics practice in Napa and Sonoma, Calif. She is co-owner of Dental IQ, a continuing education provider (www.dentaliq.net).