Op-ed: Oral health crisis help for Arkansas

This op-ed was originally published in the Arkansas Democrat-Gazette

By Kristin Merlo and Vivian Vasallo

Lyon College's recently announced plan to open a dental school in Little Rock is exciting for Arkansas. Right now, we're one of the only states without a dental school. Without a place to educate the next generations of dentists, it's no surprise Arkansas has fewer dentists per capita than every state but Alaska, and worse oral health outcomes than the national average.

Opening a dental school is an important first step toward addressing Arkansas' oral health challenges. To fully ease our dentist shortage and improve oral health outcomes, however, state leaders must urgently pursue a wider range of solutions.

Neglecting oral health can have dangerous consequences for a person's well-being. Poor oral health has been linked to cardiovascular disease, cancer, diabetes, and other health challenges. Additionally, untreated and often preventable oral diseases send 2.1 million Americans to the emergency room each year.

These challenges are especially pronounced in our state. Arkansans consistently report worse oral health outcomes than the rest of the country; for example, almost twice as many older adults have had all their permanent teeth extracted than the national average.

A coming report by the Arkansas Center for Health Improvement, funded by the Delta Dental of Arkansas Foundation, finds that uninsured Arkansans' visits to emergency departments for dental care cost local hospitals nearly $6 million in 2019.

The report also finds that 92 percent of emergency department patients with insurance had not sought out preventive oral health care in the prior year. That's millions of dollars--and lots of suffering--that may have been prevented by routine dental visits.

Rural states like Arkansas face unique care challenges. Almost 41 percent of Arkansans live in rural communities, which often lack access to oral health providers because of geographic isolation and workforce shortages.

These barriers have staggering consequences: in 2019, just 30.4 percent of adults in Arkansas with dental insurance received oral health care, with stark urban and rural divides. Other social determinants of health like socioeconomic status, income, and race and ethnicity also impede access to care.

Earlier this month, Delta Dental of Arkansas and the Delta Dental Institute convened health-care leaders in Little Rock to discuss potential solutions for improving health equity across the state. There are several actions state leaders should explore.

Once Lyon dental students graduate, the benefits will likely not be felt evenly throughout Arkansas. Across the country, freshly minted oral health professionals, including dental assistants and registered dental hygienists, overwhelmingly choose to practice in urban areas. To attract providers to rural regions, states like Kansas and Mississippi offer loan repayment programs for dentists who practice in underserved locations.

Arkansas' Legislature could establish a program like this to incentivize oral health care workers to practice in rural areas.

Teledentistry, secure video calls which enable dentists to provide oral health guidance to patients who live in remote areas and connect remotely with other providers, can also help improve access. For teledentistry to be effective, however, patients must have high-quality, high-speed Internet, and 210,000 households in Arkansas don't.

The recent federal investment in broadband and Gov. Asa Hutchinson's roadmap to deploy broadband will go a long way, but lawmakers must commit to executing the plans in timely, equitable ways.

Finally, nonprofits, businesses, and institutions of higher education must collaborate to address all angles of Arkansas' oral health crisis.

We've seen these alliances thrive firsthand. In 2011, Delta Dental of Arkansas Foundation worked with the state government to pass an act requiring water fluoridation and stepped up to provide millions of dollars in private funding. This cross-sector partnership has provided an additional 615,000 Arkansans with fluoridated water, protecting them from preventable dental disease.

The arrival of a new dental school at Lyon College is exciting news. But state leaders must recognize it is just the first step toward addressing dentist shortages and improving oral health outcomes in our state. It's imperative that we take additional actions, and soon.

Kristin Merlo is the president and chief executive officer of Delta Dental of Arkansas. Vivian Vasallo is the executive director of the Delta Dental Institute.