California – still large disparities in access to dentists
California is the most populous (39.7 million) and the fifth wealthiest state in the US. It is the capital of the U.S. film industry (the Los Angeles metropolitan area) and the world center of new technology (Silicon Valley adjacent to San Francisco). But it's also a state of great disparity: Californians are not only residents of Beverly Hills or Malibu, but also poor settlements with a predominantly immigrant population, mainly from nearby Mexico. It should come as no surprise, then, that the income level of the population translates into health, including oral health.
As a result, not all residents of the Golden State have the same access to necessary dental care. According to information recently published by the Center for Health Policy Research at the University of California, Los Angeles (UCLA), large disparities still persist when it comes to the oral health of California residents.
Worst in California Valley counties, best in San Francisco
The aforementioned document stresses that the level of income in an area (county or region) translates into the number of practicing dentists. The worst situation in this regard is in the San Joaquin Valley, where there are only 2.2 dentists for every 5,000 residents. This may not be surprising, given that the region has 6 counties with the highest percentage of people living below the poverty line in California.
What's more, among the region's dental patients, Medicaid beneficiaries account for just 2%, while Medicaid insurance covers as many as 65% of low-income adults in the San Joaquin Valley. In contrast, the best situation is in the neighboring Greater Bay Area region covering the m.in. San Francisco metropolitan area – here there are 5.4 dentists for every 5,000 people. The statewide average is 3.56.
According to the authors of the UCLA document, the majority of California dentists (about 79%) do not treat low-income patients who receive Medicaid support. In addition, only 8% of dentists are Hispanic or African-American, while 60% of the state's low-income adult population is made up of these ethnic groups. In addition, last year 41% of low-income adults in the state received no dental treatment at all.
Will dentists be in short supply in California?
Unfortunately, the current disparity in access to dentists may widen further, as about 23% of California dentists are approaching retirement age, and young dentists (graduates within the last five years) make up only 9% of dentists practicing in California.
The authors of the UCLA report suggested how problems with access to dental services could be alleviated. They suggested that dentists should be relieved of their workload, and some of their duties should be ceded to hygienists and dental therapists (the latter deal primarily with prevention in the US). In addition, researchers encourage dentists to work in "mobile clinics" and engage in tele-dentistry.
Good dental material is not a guarantee of success, because no less important than the quality of the product is how it is used. – But the instructions given by the manufacturer do not always coincide with current literature – warns Dr. n. med. Agnieszka Pacyk, dentist, university lecturer.