Dentist Shortage Leading to Emergencies, Tooth Decay in Rural Counties

In California's rural counties, a low number of dentists and specialists are contributing to high tooth decay rates and preventable dental emergencies, HealthyCal reports.

Details of Dental Care Shortage

Counties with one dentist per 5,000 people are federally designated dental health professional shortage areas. However, national standards recommend that regions have at least one dentist per 3,000 people. There is one dentist for every 4,539 residents in the population center of McKinleyville in Humbolt County. The area has only one dentist accepting beneficiaries of Medi-Cal, California's Medicaid program, for every 71,830 county residents.

A 2006 survey conducted in four rural counties in Northern California found that more than 28% of people living below or at the federal poverty level had not been to a dentist in at least five years.

According to the survey, only 40% of respondents had visited a dentist in the previous year.

In addition, the survey found that rural counties in Northern California have the highest rate of emergency department and urgent care visits for preventable dental conditions in the state.

Reasons for Shortage

Jessica Van Arsdale -- director of health and research at the California Center for Rural Policy at Humbolt State University -- said that dentists and specialists face financial hurdles to practicing in rural areas because both private and public health insurance reimbursement rates are lower in non-urban communities.

She added that a dentist might be willing to practice in a rural area, but his or her spouse might not be able to find employment opportunities in the community.

Possible Solutions

To address the shortage of dentists in rural areas, Van Arsdale said that Medi-Cal funding must be reinstated after program cuts were made in 2009 and that reimbursements in the program must be increased. She also suggested increasing funding for telehealth programs that could bring more dentistry and specialty care to rural areas.

In addition, studies have shown that education loan repayment programs have been effective in recruiting dentists to practice in rural areas. The federal health reform law allocated $30 million for dental workforce training, and some of the funding could be used to bolster loan repayment programs, according to HealthyCal (Shanafelt, HealthyCal, 5/30).