Meeting the Demand for Dental Work in Underserved Communities

Dr. Douglas York, CEO of the Union Community Health Center (UCHC) in the Belmont section of the Bronx, said the center’s waiting rooms for a dental check-up are always packed. They’re open six days a week and even some nights, hoping to get as many patients on their dentists’ chairs so they can utilize their services sometimes at no cost.

There’s a shortage of dentists in the Bronx, with 33 dentists per 100,000 people in the borough, about half the national average, according to data from the ADA and The Center for Health Workforce Studies. Dr. York said this creates problems for some patients.

“There’s a provider shortage, which means there’s an access issue,” he said.

It’s common thought that dental care is just cosmetic, or non-essential to the point where it can be ignored. In ignoring dental hygiene, conditions could worsen over time and even present social barriers, such as obtaining a job.

“Someone’s ability to get employment is critical often on how they look and how they may be perceived,” said Dr. York. “If people don’t have the financial resources to maintain oral health, and the cosmetic appearance of it, that could certainly impede their ability to be emotionally satisfied and financially successful.”

The dental director of the Montefiore School Health Program, Dr. Debra Sperling, agrees on the social impact of dental care. “It affects self esteem, how people interact with others and peers, how they present on job interviews, [and] how they present in schools with their teachers,” she said.

According to a 2015 study from the New York City Department of Health, 42 percent of Bronx residents hadn’t had a preventative dental visit in 2014. Preventative dental visits usually ward off development of even serious medical issues.

Dr. York said that annual cleanings and screenings are integral to keeping up with oral health, but “ if you can’t get in [for an appointment], you can’t start this good preventative care that will prevent you down the road from having something more serious.”

For individuals who don’t have access to preventative annual dental checkups, the only time they address their oral health is when they end up in the emergency room. Dr. Robert Margolin, the dental site director at UCHC, said patients who go to the emergency room for most dental issues won’t even receive, but over-the-counter pain medication that’s followed by a dentist referral. Follow-up visits could present even greater barriers: traditional Medicare and Medicaid barely cover dental procedures.

For many people, dental care is an issue of affordability. Community programs throughout the city are working to provide dental services for little to no cost to Bronx residents.

To bridge the gap between some Bronx residents and their ability to receive adequate dental care, some health centers offer services at little to no cost to families. Many of these programs have developed creative ways to serve the Bronx.

According to Dr. Sperling, the Montefiore School Health Program goes into public schools and sets up clinics to treat children. “So many people in the Bronx are facing issues like transportation, caring for family members, [and] job commitments,” said Dr. Sperling. “It’s just basically hard sometimes to find the time, so we’re committed to finding easily accessible dental care right in the schools where the children are for the better part of their day.”

UCHC–which provides patients with more complex dental work regardless of their ability to pay– is also slated to open up a mobile dental unit to bring services directly to the community.

Dr. York said because of transportation issues and childcare needs people may be unable to make it into the office. “We have individuals who are in housing units, senior centers, homeless shelters, and it’s very important you try and meet them where they can so they can get state-of-the-art dental care as well,” he said.

Even though these social safety net programs exist and help many different people, Dr. York said there is still an unmet need.

“Making sure there are funding streams for oral health programs in communities such as where Union serves is critical. It’s absolutely critical,” he said.