Closing the Gap in Oral Health

The good news is that, overall, Americans have fewer cavities now than they did 20 years ago.  The troubling reality is that how many fewer cavities Americans have depends on several factors.

The U.S. Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics released a report on May 31 that highlighted the oral health disparities evident throughout the country.  This report, based on data from the National Health and Nutrition Examination Survey for 2005-2008, shows that 25% of children ages 5-19 living below the poverty level had untreated cavities compared to only 12% of their counterparts living at 200% or higher of the poverty level.  Adults ages 20-64 living below the poverty level had a much higher rate of untreated cavities (42%) than did adults in the same age range living at 200% or higher above the poverty level (17%).

According to this data, income is a major factor when looking at someone’s oral health.  People living at 200% or higher above the poverty level are more likely to have the money to visit the dentist regularly for preventive care as well as restorative care – having cavities filled, teeth extracted or getting dentures, for example.  People living below the poverty line often have a hard time making ends meet and putting food on the table.  Visiting the dentist and oral care are often seen as luxuries they cannot afford.

Other causes of these disparities include access to dentists and oral health education.  Dentists opening an office need to be located where the patients are in order to generate the income needed to support their practice.  If there are no patients there is no income to pay employees, pay office space rent, buy equipment or pay the electric bill.  Because of this, dentists are less inclined to open new offices in rural, low population areas.  A rural county with few residents will be less likely to have an available dentist than a bustling city with many potential patients.

Education is an important factor in oral health.  People who have been to the dentist have often been taught about oral health and the need for brushing and flossing twice a day, visiting the dentist every six months and limiting the intake of sugary foods.  Someone who has never been to the dentist may not have been taught these basic steps for caring for their teeth.

In light of these findings, the question becomes, “What can be done to close the gap?”

East Carolina University School of Dental Medicine (SoDM) is dedicated to closing that gap in North Carolina.  The vision of the SoDM, whose inaugural class began in the fall of 2011, is to improve the health and quality of life of all North Carolinians by creating leaders with a passion for service and by leading the nation in community-based, service learning oral health education.  One part of the solution to closing the gap is the opening of ten Community Service Learning Centers (CSLC) in rural, underserved areas across North Carolina.  Fourth-year dental students and residents will work side by side with faculty dentists to offer comprehensive oral care for the communities in which they are located.  Services offered at the CSLCs range from x-rays and cleanings to filling cavities, extractions and a full range of general dental care.

The first of the CSLCs to open is the center in Ahoskie, NC, located next to the Roanoke-Chowan Community Health Center.    The two facilities will serve as a “medical home” for their patients.  As a “medical home” they will provide comprehensive medical and dental care for their patients in a central location.  The Public Health Department will also be working with the partners to provide publicly funded transportation for those patients in need.

The ribbon cutting for the Ahoskie CSLC will be on June 28, 2012.


Michael L. Scholtz, DMD
Director, Community Dental Practices