Access to Care
Basic preventive and restorative dental services are within economic reach of most Americans, whether they have dental insurance or not. Baby boomers and succeeding generations now can expect to keep their natural teeth for a lifetime—if they care for them properly, get regular checkups and receive preventive and restorative dental care.
Nevertheless, access to care remains difficult for too many Americans. In his landmark 2000 report on the nation's oral health, U.S. Surgeon General David Satcher, M.D., wrote, “[T]here are profound and consequential disparities in the oral health of our citizens,” and added that dental disease, “restricts activities in school, work and home, and often significantly diminishes the quality of life.”
The ADA is committed to reducing these disparities by supporting initiatives that broaden access to dental care for people who otherwise cannot afford it and encourage more dentists to practice in designated underserved areas.
In addition to the programs below, You & Your Dentist Frequently Asked Questions (FAQ) provides information about other charitable and low-cost dental care options.
Children's Health Insurance Program
The Children's Health Insurance Program, enacted as part of the 1997 Balanced Budget Act, seeks to extend medical and dental services to as many as 10 million so-called gap children—those whose family incomes exceed Medicaid eligibility but who cannot afford private health insurance. As in Medicaid, the law leaves the states great latitude in setting eligibility and reimbursing providers, causing concern that the new program will replicate old problems. And many states' CHIP programs simply extend their existing Medicaid programs, with all of the attending weaknesses. With ADA support, state dental associations are working with their legislatures and health departments to ensure that CHIP and Medicaid dental programs provide adequate care with the ancillary services needed to deliver that care to the maximum number of eligible people.
Additional CHIP information:
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American Indians and Alaskan Natives remain among the nation's most dentally underserved people. The Indian Health Service (IHS), an agency of the U.S. Department of Health and Human Services responsible for delivering the full range of health services to these populations, has historically suffered from chronic underfunding that weakens its ability to fulfill its mission. Despite the obvious dedication, enthusiasm and professionalism of the agency's dental staff, the lack of funds, coupled with bureaucratic red tape, has limited the delivery of care to a minority of the eligible population. Unfortunately, that trend is worsening—the percentage of American Indians and Alaskan Natives receiving dental care annually has declined from 33 percent 10 years ago to about 25 percent today.
The challenges facing the IHS go beyond money to include administration, culture, education, technology and geography. The ADA is committed to helping the IHS meet these challenges by assisting in recruiting both paid and volunteer dental staff, breaking down administrative barriers that hamper efficiency and expanding the agency's use of technology, especially information technology.
Additional Indian Health Service Information:
- April 16, 2001: Testimony on Fiscal Year 2002 appropriations for the Indian Health Services (IHS) | PDF File/31k
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Donated Dentistry
Although many dentists are disillusioned with the failure of government programs to provide even minimal care to needy Americans, the dental profession has an exemplary record of helping those in need. In recent ADA surveys, dentists have reported providing more than $1 billion each year in free and discounted care to needy patients.
In addition to its research and education agenda, the ADA Health Foundation is the profession's central agency for charitable support of national and regional access programs that help strengthen public awareness of oral health and make dental care available to those in need. The foundation launched the Samuel Harris Fund for Children's Dental Health Grants Program in 1999 to support programs that serve those children whose economic status places them at the greatest risk for dental caries and other oral diseases. Last year, the Foundation awarded cash grants totaling nearly $140,000 to 30 such programs across the country. (The award program is conducted annually, the application can be found at http://www.adahf.org.)
The National Foundation of Dentistry for the Handicapped, a not-for-profit charitable affiliate of the ADA, has helped almost 30,000 low-income disabled and elderly people receive more than $34.1 million in services from more than 8,000 volunteer dentists and 1,864 participating dental laboratories through its Donated Dental Services program.
State and local dental associations, other groups and individual dentists will continue working to deliver care to those with the greatest needs. But in the end, charity alone will not eliminate the disparities in access to care. State and federal governments must join organized dentistry in attempting to make good oral health and oral health care a reality for all Americans.
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