Barriers to care are any sort of obstacle that limits or prevents people from receiving adequate health care, including dental care. In many cases, multiple barriers to care may be involved. Common barriers to care include:
- Financial hardship
- Geographic location
- Lack of insurance
- Poor oral health literacy
- Language, education or cultural barriers
A Health Professional Shortage Area (HPSA) is an area within the United States with a shortage of health care professionals. Federal regulatiobns stipulate that, in order to be considered as having a shortage of providers, an area must have a population-to-provider ratio of a certain threshold. For dental care, the population to provider ratio must be at least 5,000 to 1 (4,000 to 1 if there are unusually high needs in the community).
As of September 30, 2020, there were 6,487 total dental HPSA designations
within the US, which would require an additional 10,716 dental providers to meet this need.
ASDA does not support the use of midlevel providers
to solve the barriers to care issue. ASDA defines midlevel providers as an individual who may perform irreversible procedures on the public, but is not
a dentist with four years of post-collegiate education (three years in the case of University of the Pacific School of Dentistry).
ASDA believes that dental students should be involved in the reduction of barriers to care, and that evidence-based measures should be employed:
- H-1 Student Involvement to Address Barriers to Care: The American Student Dental Association encourages the participation of interested dental students in efforts to impact the oral health of the public through projects, education, internships, externships and outreach to underserved populations.
- H-2 Evidence-Based Solutions for Barriers to Care: The American Student Dental Association supports evidence-based measures that are efficacious and sustainable in reducing barriers to care in underserved communities. These measures include, but are not limited to, early intervention, Medicaid expansion and co-location of health services.
What can we do?
ASDA supports the following measures, among others, as ways to address barriers to care issues:
- Oral health education
- Medicaid expansion
- Children’s Health Insurance Programs
- Emergency Room referral programs
- Student loan forgiveness programs for working in rural or underserved areas
ASDA members are very active in supporting initiatives that address barriers to care. Many chapters are involved in projects like Give Kids a Smile
and Missions of Mercy
, which provide dental care to patients who may otherwise go untreated.
What Has ASDA Done?
- In April 2022, ASDA signed onto a letter with 16 other organizations urging the Senate Health, Education, Labor & Pensions (HELP) Committee to consider H.R. 4555, the Oral Health Literacy and Awareness Act. This bill has already passed in the House of Representatives.
- In March 2022, hundreds of dental students and dentists joined together in Washington, D.C. to discuss two bills, among others, that address barriers to care:
- The Ensuring Lasting Smiles Act (ELSA) ensures children suffering from congenital anomalies and birth defects are able to receive the treatment they need. Due in part to ASDA's efforts, on April 4, 2022, this bill passed in the House of Representatives. Since this bill's introduction, ASDA members have sent nearly 1,000 letters to members of Congress in support of this bill.
- The Medicaid Dental Benefit Act of 2021 would require comprehensive dental care for adults to be part of all state Medicaid programs.
- In April 2021, nearly 500 dental students and dentists attended the virtual ADA Dentist and Student Lobby Day to meet with lawmakers and speak in support of ELSA. ASDA also lobbied for this bill at Lobby Day in 2019.
- In 2018, due in part to ASDA's efforts of sending more than 600 letters to Congress, the Action for Dental Health Act passed into law. This law allows organizations to provide dental services to underserved populations through health grants administered by the Centers for Disease Control (CDC).
What other barriers to care bills does ASDA support?
You can view all barriers to care bills that ASDA supports in the Bills tab of ASDA Action. Just sort by either Federal or state-level bills, and by the barriers to care category.
What ASDA members are saying
- “Addressing racial disparities in dental education” Contour, February 2021
- “Dentistry and medicine: a two-way street” Contour, January 2021
- “Designing a disability-friendly dental office” Contour, October 2020
- "Spotlight on an FQHC: Philadelphia FIGHT", Contour, March 2020
- "Oral health barriers of the transgender community", Contour, June/July 2019
- Florida Mission of Mercy: The importance of grassroots advocacy, ASDA Blog, May 2019
- "From Vietnam to Boston: Making a difference in the public's oral health", Contour, May 2019
- "Oral health barriers among refugees", Contour, November/December 2019
- “Using research to collaboratively address barriers to dental care” Contour, November/December 2018
- Mental health as a barrier to care, ASDA Blog, September 2018
- “Encouraging long-term oral health investment in underserved communities” Contour, April 2018.
- "Reducing barriers to care with school-based clinics” Contour, January 2018