by Tegwyn H. Brickhouse, DDS, PhD
Despite what we see on the news lately, I think we can agree that when everyone in our communities succeeds, all of us flourish!
Unfortunately, no matter where you live there are people who are struggling to stay healthy and do well. The COVID-19 pandemic and recent civil unrest have amplified concerns about social equity, including access to health care.
I’ve dedicated myself to understanding oral health disparities and currently serve as Chair of the Department of Dental Public Health and Policy at Virginia Commonwealth University School of Dentistry, and as a Board Member and the Scientific Advisory Board Chair for America’s ToothFairy. Throughout the course of my career I’ve learned there are multiple factors within our control that determine how healthy we are, such as the food we choose and if we exercise regularly. However, the conditions in which many Americans are born, grow, live, work, and age, known as the social determinants of health, are outside of their control, sometimes leaving them without the resources necessary to prevent poor oral health.
According to the CDC, “Oral health disparities are profound in the United States. Despite major improvements in oral health for the population as a whole, oral health disparities exist for many racial and ethnic groups, by socio economic status, gender, age and geographic location.”
Millions of Americans live in Dental Health Care Provider Shortage Areas, while others don’t have access to reliable transportation or can’t afford to take time away from work to take their child to the dentist. Some lack dental insurance or are underinsured, even for standard procedures, or are simply uneducated about the importance of good oral health. Children who grow up under these circumstances have a rate of untreated tooth decay that is 2.8 times higher than the national average.
Our children’s future health depends on preventing small health problems now. Children with dental disease have trouble eating, speaking and learning in school, and are also more likely to experience other health problems. We can either prevent this disease now through school-based screenings and clinics, or pay later in expensive treatments, increased school absence and missed opportunities for our children. We need to make children’s oral health a priority today, to get ahead of future issues.
Ideally, everyone should have a fair opportunity to attain their full health potential. This is what is known as “health equity”, which is defined by the The World Health Organization as “the absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification.”
In reality, not everyone in America has a fair opportunity to attain their full health potential, which has led to heated discourse about equality and fairness. We clamor for the federal government to intervene, but we have mostly ignored our best option to solve this problem. While our government is designed to defend our rights and protect our equality as citizens under the law, when it comes to healthcare we don’t need equality, we need equity. One size does not fit all.
Equity is achieved when those who have more than they need give to those who don’t through charitable organizations supporting the very communities that need help the most. For example, community-level organizations can provide school-based dental programs that identify children with unmet oral health needs and refer them to a dental home. School sealant programs also protect children who may not receive routine dental care. This includes children at highest risk for tooth decay: those from low-income families and certain racial and ethnic groups. When we support programs like these we can help people in marginalized communities reach their full health potential.
Americans want to help. We just don’t always know how.
Most Americans are unaware of the marked oral health disparities in vulnerable communities and why it’s important to address these disparities. Thankfully, through partnerships between dental professionals and nonprofit organizations like America’s ToothFairy, we can improve oral health equity and provide comprehensive health care that includes oral health.
Support Community Oral Health Education
You can help Community Oral Health Workers and volunteers that provide community outreach and education through America’s ToothFairy’s Smile Guardian initiative. Focusing on prevention, Smile Guardians help kids and their families by providing the information and basic tools they need to protect their smiles and prevent tooth decay. Learn more here.
Help Children Access a True Dental Home
Help children in underserved communities access dental care through the use of dental homes, mobile care, and teledentistry to promote patient-provider relationships that build trust, cultural competency and continuity of care. Our Dental Resource Program provides essential resources to 72 nonprofit, safety-net dental clinics and organizations in 24 states. Your generosity will help them provide routine dental care and preventive services, and education to help kids avoid the need for emergency care.
Give of Your Time
Visit classrooms and daycare centers to teach kids about the importance of oral health. Our ToothFairy 101®Community Education Kit has everything you need to give a complete lesson.
Or help safety-net clinics expand their hours of operation by volunteering regularly. (For a list of our Dental Resource Program members, click here; or find a nonprofit clinic near you and reach out to them.)
Advocate for Systemic Changes
Share your voice through national and state advocacy groups that influence legislation and government policy affecting the oral health of all Americans, but especially those experiencing disparity. For example, the ADA, who works closely with lawmakers and regulators, is also fighting to maintain federal requirements for states to cover dental services in their respective CHIP programs, which together cover nearly 8 million children from low-income families. You could also contact your state legislature and advocate for changes such as:
• mandatory age-one year oral health visits for all children,
• a patient outcome-based reimbursement system that emphasizes early oral health prevention for children.
Make Your Patients Aware of the Problem
Americans have big hearts, but many simply don’t understand the barriers that marginalized communities face and how they can help. America’s ToothFairy’s website is designed to walk everyday people through the problem and point them to solutions that truly make a difference! Or engage your staff and patients by holding a Smile Drive to help kids in your community have the basic oral hygiene products they need to maintain a healthy smile. Opportunities to give lift morale by providing a way for everyone to work towards a common goal.
As divided as our country currently is, we have the capacity to do great things when we all unite behind a common good. What better good than to ensure our nation’s kids can grow up with healthy smiles and a brighter future?
Tegwyn H. Brickhouse, DDS, PhD, is the Scientific Advisory Board Chair for America’s ToothFairy and serves as Director, Oral Health in Childhood and Adolescence at the Institute for Inclusion, Inquiry and Innovation, and Professor and Chair for the Department of Public Health & Policy at Virginia Commonwealth University in Richmond, Virginia.