Health Equity Needs Teeth

Abstract

People who are poor or members of communities of color face inequitable oral disease burden. Continued separation of dental and oral health from general medical care exacerbates inequity and forces members of underserved communities to seek nontraumatic dental emergency care in hospital emergency departments. This trend is unnecessarily costly and results in antibiotic prescriptions and pain management that are neither restorative nor responsive to patients' primary complaints. Value-based approaches to health care need to unify mouth care with general medical care, motivate medical-dental interprofessional practice, promote oral disease prevention, and support restorative dental care. Value-based approaches to health care must also innovate fiscal structures (eg, payment models, data sharing) to improve health outcomes for everyone.Weekend Mouth Pain Imagine it's Saturday evening at 6 pm, and you find yourself in pain-a pain not from a hurt foot or shoulder, but a throbbing, radiating pain in your mouth that feels as if your head and ears are on fire. You cannot sleep or eat. Previously, the pain was dull and only bothered you when you ate something sweet or cold. But now, at 6 pm on a Saturday, you find yourself in extreme pain and unable to function. While you are employed, your minimum wage job does not provide dental insurance and you live in a state that does not provide comprehensive, adult dental benefits through Medicaid. Consider also that when you saw your physician 3 months ago for your check-up to renew your blood pressure prescription, you mentioned the tooth bothering you. It is likely that your physician did not examine your mouth or refer you to a dentist for care. You thought the tooth could wait! To make things worse, because of your lack of dental coverage and your inability to pay for the out-of-pocket expense of dental care in a private practice office, you do not have a dental home to call for an emergency appointment. The last time you saw a dentist was at a charity dental event in the local college's gymnasium several years ago. In the United States, where should you go and what should you do?

Does Where We Live Matter To Oral Health?

“…Poor oral health among older Americans is also more likely when they report low income (Griffin et al, 2012;Northridge et al, 2020), lower educational attainment (Assari & Bazargan, 2019;Northridge et al, 2020), lack of insurance, and/or they belong to racial/ethnic minoritized groups (Assari & Bazargan, 2019;Fleming et al, 2022). For those living in rural areas, the impact of these social factors is compounded by barriers inherent to rural areas such as lack of transportation and limited access to healthcare services (RHIhub, 2022a).…”