A healthy smile is more than just appealing. It is one of the greatest indicators of overall health. Improper oral care can lead to pain, tooth loss, infection or even cancer.
Unfortunately, a report released by the Center for Health Policy at the University of Nebraska Medical Center indicates that in many areas of the state people do not have easy access to a dentist.
“The state of Nebraska designates 48 counties as general dentistry shortage areas and 20 counties don’t even have a dentist,” said Jim Stimpson, Ph.D., director of the Center for Health Policy in the UNMC College of Public Health. “Even more alarming, the study found that there has been a steady decline in the number of practicing dentists in the state over the last five years.”
The American Dental Association estimates that dental issues contribute to 164 million lost work hours and 51 million lost school hours annually.
“Many of those issues can be prevented if caught early through annual checkups,” said Kim McFarland, D.D.S., a professor with the UNMC College of Dentistry and co-author on the study.
But, for many Nebraskans, an annual checkup is not so easy to arrange when the nearest dentist is two hours away, Dr. Stimpson said.
On average there are 55 dentists for every 100,000 people in the state, the report found. Of the 1,028 dentists practicing in the state in 2012, 53.6 percent of them practiced part-time and only 39.2 percent practiced in a rural area.
What is even more concerning is that some of those rural practitioners are getting ready to retire, Dr. McFarland said.
“The need is so great that we have dentists who are in their 70s and 80s who are still practicing,” she said.
In counties where there are few or no dentists, people turn to their local medical provider, health clinic or emergency room for care. Often though, those practitioners are not fully equipped to address their dental needs.
“More often than not people wait until they are in pain to seek care and often by then it is an abscessed tooth that needs to come out,” Dr. McFarland said. “At this point, the patient is given an antibiotic for the infection and pain pills. Some clinics even have pamphlets indicating where the nearest public health dental clinic is located in the state.”
The study did outline several possible solutions, she said.
- Giving dental hygienists a wider range for preventive and basic practice, such as allowing them autonomy to provide sealants and cleanings to patients. Currently, Nebraska state law allows them to obtain a public health permit;
- Utilizing practice sites of other providers, such as a pediatrician’s office, or health clinic, where a dental hygienist could provide preventive care;
- Increase the number of graduates;
- Increase the student loan reimbursement rate for those dentists who would agree to practice in a shortage area for a period of time; and
- Fluoridated water.
Some of these options would work, Dr. McFarland said, and others such as increasing the number of graduates would not, simply because the two dental schools in the state are already at capacity.
Fifteen years ago the state began offering a reimbursement for students of $80,000 over four years. However, it has not kept up with the rising cost of tuition to attract students to the program she said, as the average student loan debt is more than $200,000.
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