Inside Dentistry, April 2006


Dear Readers:

This month all of us at Inside Dentistry continue our commitment to delivering relevant and thought-provoking coverage of the issues affecting the greater oral healthcare profession. Specifically, we turn our attention to the challenges we face to provide our nation’s under-served populations with quality, affordable dental care as we present this month’s feature story, “Access to Care: Who Gets It…and Who Doesn’t.”

Multiple causes, frightening implications. There are many factors contributing to the problems of access to dental care. Among them are a lack of providers in certain geographic areas and financial constraints that result from patients having no insurance, poor insurance, and/or being ineligible for the limited Medicaid support that’s available. The severity of the issue has implications for all of us. Federal, state, and local initiatives to improve access to dental care must concentrate on low income and minority rural populations because these groups are most susceptible to oral health problems.

No simple answers, no singular solution. As I and others have alluded to in previous editions, making dental care accessible to those who cannot find it and/or are unable to pay for it is a challenge facing the collective dental industry that has no simple solutions. Although many aspects of oral healthcare are improving, our nation remains faced with large numbers of low-income, underinsured, disadvantaged, and otherwise underserved children and adults who are in dire need of preventive, restorative, and therapeutic treatments. It is not a problem of want for these individuals; it is a crisis of need. Dental school clinics have traditionally been invaluable for providing many of these patients with the care they need. For example, I am aware of people living in underserved areas who drive 3 hours each way to obtain treatment at my dental school clinic because it is the most affordable way for them to care for their families’ oral health needs. Having come from a low-income, single-parent household, my first dental experience was in a dental school pediatric clinic. My 3 siblings and I—from the age of 3 through high school—received all of our care in such a setting. We were fortunate enough to live near a dental school. I had such a positive experience that it made me choose dentistry as a career. However, such localized facilities are insufficient to meet the growing demands of people in need of basic oral health care.

Efforts are underway. The dental profession increasingly impresses upon the public and policymakers the significance of access to quality, affordable dental care, with children being a special consideration. The American Dental Association has produced a white paper that also challenges policymakers and our nation to improve access to dental services. For more information about this document, visit In recognition of the need to serve these individuals, there are many local, state, and national organizations that routinely sponsor events at which necessary care and treatment are provided by dentists and laboratories who volunteer their time and skills. And, thankfully, there are many clinicians throughout our country who regularly—and without praise or recognition—open their practice doors to those less fortunate in their communities.

We hope that you find the presentations in this issue of Inside Dentistry to be enlightening, motivating, and worth considering as you move forward in your day-to-day practice. Please let us know that we’ve engaged you in the topics we’ve discussed—as well as how we can best meet your needs in the future—by continuing to share your opinions and thoughts with us at [email protected]. Thank you for reading, and for your continued support.

With sincere thanks,

Gerard Kugel, DMD, MS, PhD
[email protected]