The Overlooked Disparity in Dentistry

Authored By: Valentine Kim

The disparity in healthcare between different populations  in society has  been analyzed for decades. The difference in the accessibility to healthcare raises doubt as to whether people’s lives are weighed at different values depending on their social status. Therefore, it is critical that the inequalities in access to healthcare are analyzed and addressed . Oral healthcare is a relatively small sector of healthcare that is often not discussed within the topic of equitable  access to healthcare. However, this is erroneous as oral health is an essential factor to overall health [1]. Oral diseases, such as periodontitis, are linked to a higher occurrence of chronic diseases including diabetes, cardiovascular disease, and rheumatoid arthritis [1]. Hence, regular checkups and adequate treatment in the oral sector is crucial for the maintenance of one’s overall health and longevity. 

While there are multiple aspects and factors that influence the outcome of oral health, there are three large levels that contribute to oral health [2]. The first level is the individual patient. This level includes biological factors such as genetic differences that result in higher susceptibility to tooth decay or having a crooked teeth structure that requires orthodontics [2]. The next level is the interpersonal level, where the social circle and the familial relationships of the individual contributes to the clinical outcome(s) [2]. For instance, a study found that children from low-income backgrounds or of African American descent have a 38% higher chance of developing dental issues from a young age compared to children of high-income/white families [3]. What is more astonishing is that this disparity has not changed much since 2001 [2]. On the final level, upstream structural factors, such as healthcare policies, along with one’s environment, come into play. Only 43% of the US population are reported to have a dental visit in one year [1]. Furthermore, only 10% of people in rural America are able to go to the dentist in a single year [1]. As a result, adults in rural areas are at least 7% more likely to have missing teeth than their peers living in urban areas [1]. 

What can be done to resolve this problem? Like many healthcare problems on a societal level, the solution is not simple. This is because disparity is incredibly contextual and is affected by multiple factors; it is hard to satiate everyone’s needs since the solution and objective in addressing inequalities vary for different populations. For instance, there has been an argument that the lack of non-White oral healthcare professionals is the root cause to the low attention paid to the importance of oral healthcare for other races: out of all dentists in the US, 86% are white, 8% are Asian, and only 2% are African American/Hispanic [4]. Let’s account for this and simulate a scenario in which the ratio of non-White to White representation  in professional dentistry has increased. However, accounting for race alone fails to consider other reasons for such disparity. Geographical location, socioeconomic status, knowledge, and many more factors exist [4]. Therefore, the most applicable solution at the moment can be determined to be education [4]. First of all, incorporating oral healthcare knowledge as well as the opportunity to be treated in school will prevent decay and multiple oral diseases that often start at a young age [4]. In addition, the children that grow up with this education will be more aware of the importance of dentistry in the overall quality of life, which leads to more care and awareness that can transcend into the next generation [4]. As for physical problems, the government’s aid is necessary. People who are not able to afford basic checkups or go to a dentist due to their location of residence should be provided insurance and public healthcare support. At the end of the day, a problem in oral health can lead  to other chronic diseases, which negatively impacts   patients, along with the productivity of the nation as well as funding for the treatment of those patients. Preventing serious diseases from developing at a young age will be beneficial at both the individual and population-based level. 

References

1. Hannan, C. J. (2021, March 25). Addressing Oral Health Inequities, Access to Care, Knowledge, and Behaviors. CDC. Retrieved October 20, 2024, from https://www.cdc.gov/pcd/issues/2021/21_0060.htm

2. Northridge, M. E., Kumar, A., & Kaur, R. (2020, January 3). Disparities in Access to Oral Health Care. PubMed Central. Retrieved October 20, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125002/

3. Otto, M. (2017). Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America. New Press.

4. Elizabeth, M. (n.d.). Dental Therapists in the United States Health Equity, Advancing. Medical Care, American Public Health Association, 10(2), 59. https://journals.lww.com/lww-medicalcare/fulltext/2021/10001/dental_therapists_in_the_united_states__health.8.aspx