Improving Rural Access To Dental Services

While oral health in America has improved dramatically over the last 50 years, these improvements have not occurred evenly across all sectors of our population, particularly among low-income individuals and their families. An estimated 25 million Americans live in areas lacking adequate dental services. Astoundingly, as many as 11 percent of our nation's rural population has never been to a dentist.

The situation is exacerbated by a shortage of dentists. Our dental workforce is growing older. More than 20 percent of dentists nationwide will retire in the next ten years, and the number of dental graduates by 2015 may not be enough to replace these retirees. As a consequence, many states, including Maine, are facing a serious shortage of dentists, particularly in rural areas.

In Maine, there is one general practice dentist for every 2,300 people in the Portland area. The numbers drop off dramatically, however, in other parts of our state. In Aroostook County, for example, where I am from, there is only one dentist for every 5,500 people. And, of the 23 practicing dentists in Aroostook County, only six are taking on any new patients. Moreover, at a time when tooth decay is the most prevalent childhood disease in America, Maine has fewer than ten specialists in pediatric dentistry, and most of these are located in the southern part of the state.

I have been working on this problem for a number of years. In 2002, the Dental Health Improvement Act, which Senator Russ Feingold of Wisconsin and I authored, was signed into law. This law authorizes funds to help States develop innovative dental workforce development programs tailored to their individual needs. To support these programs, the Senate recently approved an amendment I offered with Senator Feingold to provide $5 million next year to help States improve access to oral health care by strengthening the dental workforce in our nation's rural and underserved communities.

The Collins-Feingold Dental Health Improvement Act authorized a State grant program that is designed to improve access to oral health services in rural or underserved areas. States are able to use these grants to fund a wide variety of programs. For example, they can use the funds for loan forgiveness and repayment programs for dentists practicing in underserved areas. They can also establish or expand community or school-based dental facilities or to set up mobile or portable dental clinics. In order to assist in their recruitment and retention efforts, States could use the funds for placement and support of dental students, residents, and advanced dentistry trainees. They could even use the grants for continuing education, through distance-based education, and practice support through teledentistry.

There clearly is a need to make oral health care services more accessible in our nation's rural and underserved communities. Dental care is an integral part of overall health care, and this funding will help improve the health of individuals in our nation's rural and underserved areas by expanding that access.

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