Invest in a diverse WA dental workforce to improve oral health equity

Originally published by the Seattle Times

It’s time for policymakers to focus on oral health care once again for our state’s most at-risk populations. Washingtonians in Seattle and across the state deserve sustainable, long-term solutions to access health care to improve the health of our communities. These solutions must also prioritize oral health, which plays a crucial role in overall health.

Children in pain from untreated tooth decay have difficulty learning, eating, sleeping and socializing. The chronic inflammation of gum disease can make it harder to manage chronic conditions like diabetes, while increasing risk for heart attack and stroke. Tooth loss among older adults impacts healthy aging. Yet only 8% of the more than 1 million adults with Apple Health (Medicaid) coverage received a preventive dental visit in 2020, and less than half of Apple Health covered children. 

We are fortunate that since 2021, the Legislature took steps to improve access to oral health care by increasing Medicaid reimbursement rates for pediatric and adult dental providers. While work is still necessary to further improve reimbursements, to make it simpler for dental providers to participate in the Medicaid program, and for patients to have the supports they need to access care, increased reimbursement rates are a significant improvement.

While there are challenges in almost all sectors of our economy right now, the dental workforce suffered significant reductions, exacerbated by COVID-19, for which it has yet to recover, and it will take years to repair the damage. The majority of dental offices in Washington report exceptionally long vacancies for dental hygienist and dental assistant positions, which often lead to long waits for patients to access preventive dental services.

The state’s Community and Technical Colleges train the majority of dental hygienists and assistants, and we must do all we can to sustain and enable them to add capacity to educate and train the dental workforce of tomorrow.

Expanding the oral health workforce is also an opportunity to better represent our state’s diversity. Nationally, Indigenous, Black and Hispanic dentists are underrepresented in the profession. Creating a more diverse workforce is essential to improving oral health equity. Research shows patients fare better with diverse health care teams. And there are improvements in innovation, team communications and risk assessment with more diversity.

Investing in the dental workforce is some of the most important work Delta Dental of Washington does. We are investing in dental hygiene programs, and launched a dental careers program to expose youth, especially those from historically underserved groups, to oral health professions. This helps ensure future generations are afforded better employment opportunities and responds to the serious shortage of oral health professionals, including hygienists and dental assistants, that we face in King County and across the state. Arcora Foundation — the foundation of Delta Dental of Washington — is partnering with providers to improve cultural awareness, including free continuing education courses to help meet state health equity training requirements for health care providers beginning in 2024.

We know we cannot do this work to increase access to dental care and improve health equity alone. In October, more than 20 leaders in government, health, academia, technology and community engagement gathered with us to discuss the state of health care in Washington in the wake of the pandemic. Our charge now is to convert this conversation into action.

We urge legislators to support opportunities — which will be introduced in the upcoming session — to provide vital resources to expand and sustain the oral health workforce in Washington, ensuring that our providers better reflect the demographics of our state and are equipped to meet the health care needs of our communities most at risk. Now that new and returning leaders have been elected in Olympia, it is imperative that we use these lessons learned to improve oral and overall health outcomes across our state.

Mark Mitchke is president and chief executive officer of Delta Dental of Washington.

Vivian Vasallo is executive director of the Delta Dental Institute, which supports oral health research, community outreach, and advocacy.