For the past 4-5 years I've taken an interest in the problem of serving patients who don't have access to care. This interest grew out of the experience I had when my father's health began to decline. He ended up in an assisted living facility, but then quickly ended up in skilled nursing facilities for the remaining years of his life. I hadn't given that situation much thought previously, but when I saw what the situation was like for people 'on the inside', I realized that our society has a problem and there is currently no solution for it.
Previously I hadn't realized that there are many people in those facilities who need dental care, but have no way to receive it. Especially in the skilled nursing facilities, I saw a lot of people who could no longer physically get to a dental office, but still needed care. Many of the residents in those facilities could no longer drive, many of them had extremely limited mobility, and many of them were totally immobile. My father was one of the few lucky ones. I came to his room armed with a laptop, x-ray sensor, and a mobile x-ray generator. I could take digital x-rays and then provide rudimentary treatment, but even *that* was better than what the other residents had access to.
The facility had a dentist who would visit there every 12 months. Patients could 'sign up' to be seen by the dentist. Of course, that ponders the question of how people who weren't capable of signing the clipboard, could sign up for a dental visit.
My point here is that in addition to folks below the poverty line who cannot afford regular care, there is also a population that might be able to afford care, but have no chance of ever getting to a facility to receive that care. Over 11,000 people a day turn 65 in the US and that number continues to grow. By 2030 it is predicted that over 2.4 million US citizens will live in nursing homes and a great majority of those citizens cannot leave the facility. Dentistry is about to be hit by a huge wave of older adults that still require care... and cannot receive it. And I'm not talking about preventative care like routine prophys, I'm talking about people who could be suffering with painful infections or broken teeth. Those people will suffer and there is no plan to help them in sight.
The answer? To be honest, I don't have one. I think what dentistry needs is potentially to follow the medical model and create more midlevel providers who can at least provide palliative care to people in need. We definitely need a range of hygienists who can be certified in more expansive skills. Along with allowing hygienists to do more, we also need to increase the number of hygienists in the work force. Since the pandemic, the number of hygienists has been dropping and is continuing to move in that direction. Dentistry needs to reverse that trend as quickly as possible while still providing the amazing training that the profession requires.
For years, dentists have been opposed to expanding the roles of providers who do not have a DDS or DMD. While I certainly understand their arguments and concerns, I haven't heard of a true solution to the problem that is developing. I also want to add that as our medical treatment and pharmacology gets even better, people will live even longer. That population does not deserve to live in facilities and areas where there are no doctors.
Of course there is also the concept of Dental Therapists. The concept seems to continue to pick up momentum as there are now 14 states that allow some type of treatment by them. We often hear about people who don't have the money for care and that group certainly is important. However, I don't hear nearly as often about the folks in nursing facilities that also require care. The basic point is, dentistry needs to do something about the increasing number of individuals who are 'falling through the cracks' and I support anyone who is willing to do something about it. The current system cannot care for all those who deserve it. Solutions need to be discussed and implemented. Simply sitting and debating as a fire rages even more out of control will do nothing.
I was recently contacted with information on a meeting in Sacramento, CA for dental therapists. You can read all about the below.
The 2025 National Dental Therapy Conference (NDTC) will convene December 8-10, bringing together advocates, policymakers, educators, and dental professionals, educators, policymakers, and advocates from across the country for three days of learning, connection, and collaboration. The conference will kick off with a keynote address from legendary labor and civil rights leader Dolores Huerta. Registration closes November 19.
Conference highlights include:
- Dynamic learning experiences from national leaders and up to 17 CDE credits available
- Hands-on workshops and interactive sessions
- Exclusive insights into new policy developments and practice models
- Opportunities to network with peers, leaders, and advocates from across the nation
- Sessions on interdisciplinary collaboration and team-based care approaches
Led by Community Catalyst, the American Dental Therapy Association and the California Oral Health Equity Coalition, this year’s conference will feature an expanded agenda of opportunities for dental professionals across the industry. Conference attendees can expect up to 17 hours of Continuing Dental Education (CDE) credits with sessions led by national leaders, hands-on workshops designed to strengthen clinical skills and expand knowledge, policy and practice insights on new care delivery models, and networking opportunities with dental professionals and innovators shaping the future of oral health care.
“We really have two dental care systems in the United States: one for people with private insurance and enough money to pay out of pocket for any additional care, and then a safety net for everyone else, and that safety net is really failing folks,” said Laura Hale Brannon, Senior Project Manager for Dental Therapy at Community Catalyst. “This conference comes at a critical moment as more states recognize that dental therapists are an effective solution for expanding access to equitable, compassionate, community-centered care.”
Dental therapists are now authorized to practice in 14 states, and the movement continues to grow as communities seek innovative approaches to address oral health care shortages. About 58 million people in the United States live in areas with dentist shortages, and significant oral health disparities persist among people of color and those on public insurance.
The conference is designed for dental professionals at all career stages, including dentists, dental hygienists, dental therapists, dental assistants, educators, and practice managers.
Registration is open through November 19. Sponsorship and exhibitor opportunities are still available for organizations interested in connecting with this growing community. Visit the conference website to review the full agenda, learn more about the co-host organizations, and register.
About Community Catalyst:
Community Catalyst is a national organization dedicated to building the power of people to create a health system rooted in race equity and health justice, and a society where health is a right for all. We’re an experienced, trusted partner to organizations across the country, a change agent to policymakers at the local, state, and national level, and both an adversary and a collaborator to health systems in our efforts to advance health justice. We partner with local, state and national organizations and leaders to leverage and build power so that people are at the center of important decisions about health and health care, whether they are made by health care executives, in state houses, or on Capitol Hill. Together with partners, we’re building a powerful, united movement with a shared vision of and strategy for a health system accountable to all people. Learn more at www.communitycatalyst.org.
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