Georgia Must Correct Dental Care Disparities

July 8th, 2016 by 4 Comments

By Nicoleta Serban 

More than 58 percent of Georgia’s children – about 1.5 million youngsters –  qualify for public dental benefits through the state’s Medicaid and PeachCare for Kids programs, according to a new Georgia Tech study. Unfortunately, of the 3,872 licensed dentists providing provide preventive services in Georgia, just 337 – 8.7 percent – accept public insurance for children, according to

Research conducted by scientists in the Health Analytics Group at Georgia Tech details the extreme oral health care disparities between children eligible for public insurance and those whose families can afford care through other financial means.   

Considering common access barriers, there are roughly 865,000 Medicaid- or PeachCare-eligible children in Georgia who need to travel to reach a dental provider for preventive care services more than the state standards. (The standards are driving distances to a provider of 30 minutes or 30 miles for urban areas and 45 minutes or 45 miles for rural areas.)

 They also must travel, on average, 10 or more miles farther than children with private insurance or ability to afford of out-of-pocket care expenses to reach a dental provider.

Caption: Locations of communities where parents of children eligible for public insurance have to travel to reach a dental provider longer distances with 10 miles than those with private insurance or those with ability to afford of out-of-pocket care.
Locations of communities where parents of children eligible for public insurance have to travel to reach a dental provider longer distances with 10 miles than those with private insurance or those with ability to afford of out-of-pocket care.

The study also found that there are more than 500,000 children in Georgia whose parents will probably forgo preventive dental care for their children because of lack of financial means to pay out-of-pocket care, or lack of public or private insurance.

To address the problem, the Georgia Tech study found, 30 percent of Georgia dentists –  1,160 – would have to accept public insurance to achieve state standards for access to care for almost 100 percent of Medicaid-eligible children in large cities and approximately 85 percent in smaller urban and rural areas.

To provide dental care for these children at “equitable levels” with those whose parents can afford the care would require that 50 percent of Georgia dentists accept public insurance reimbursement.

Tooth decay is the No. 1 childhood chronic disease, according to the U.S. Centers for Disease Control and Prevention (CDC). It not only results in pain and lack of concentration, but also can result in facial disfiguration from swelling, nutritional deficiencies from inability to chew and potentially deadly infection. Lack of access to dental care also leads to missed school days for children and missed work days for their parents.

The Georgia Tech research demonstrates that an urgent plan of action is needed to ensure lower-income Georgia children receive the oral health care they so desperately need.

Among the strategies to reduce oral health disparities among lower-income children, the researchers propose providing grants to health centers that provide dental services, increasing Medicaid acceptance rates among dentists, and offering dentists federal assistance for dental school loans if they agree to relocate to dental shortage areas.

One strategy highlighted by the researchers was the focus of legislation proposed during the 2016 Georgia General Assembly session. The legislation would have enabled licensed dental hygienists to provide essential preventive dental care, such as fluoride treatment and applying sealants, without direct supervision of dentists, which is defined as requiring a dentist to be present on site for the procedures.

The legislation would have expanded that policy, which applies now to prisoners and those seen at public health dental sites, to include state-insured children as well as underserved people in nursing homes, federally qualified health centers and non-profit health care facilities. Unfortunately the measure met opposition from dentists and died in the House Rules Committee.

Dr. Nicoleta Serban of the Georgia Tech School of Industrial & Systems Engineering, an author of the Georgia Tech study, wrote this commentary for the Georgia Public Policy Foundation. The Foundation is an independent think tank that proposes market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the view of the Georgia Public Policy Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.

© Georgia Public Policy Foundation (July 8, 2016). Permission to reprint in whole or in part is hereby granted, provided the author and her affiliations are cited.

4 thoughts on “Georgia Must Correct Dental Care Disparities

  1. Oh, what a big surprise…8.7 percent of dentists will attempt to provide services to the underserved. What the Georgia Dental Association does do ( brilliantly) is fight progress by refusing to allow RDH’s to assist with treating the poor kids in this state…as well as other underserved populations like seniors in care facilities. Roughly, 45 other states allow expanded functions for dental hygienists– after all they are trained and licensed by the state to provide these services– while Geeorgia, along with other progressive bastions like Alabama and Mississippi sticks its head in the sand. The GDA has grossly mislead the public by publishing stats which reflect that the socio-economically deprived children have “plenty of dentists to serve them” and this article dispels that myth. The GDA shamefully and willfully killed HB 684 in the Rules Committee after both House and Senate committee’s had approved it unanimously. This bill would have allowed RDH’s to access underserved settings with the approval of a supervising dentist…the dentist did not have to be on-site. The supervising dentist would still be ” in the loop” and allowed to bill for the service provided. Sixteen states allow RDH’s to bill Medicaid directly and thirty nine states allow direct access. HB 684 attempted to assuage dentists concerns by, again, letting them profit directly from a hygienist working in an underserved setting and the GDA killed the bill citing completely specious and unfounded accounts of a threat to public health! Hopefully, state legislators will develop a spine this session after even more information is released on the harm the GDA is perpetrating on the less fortunate in Georgia.

  2. Why do dentists in GA want children to continue to have decay? Oh, that’s right – money.
    AMERICA! put a stop the ADA! They are a special interest group that is blocking dental hygienists from providing much needed preventive care!
    Hygienists are educated, licensed providers. The laws should support prevention NOT restorative.

  3. Georgia simply needs direct access for the licensed dental hygienists to solve this issue. #fightingforacause #directaccessfotgarhd

Leave a Reply

Your email address will not be published. Required fields are marked *

The Georgia Public Policy Foundation is the best source of the rarest and most valuable commodity in public policy debate: facts.

State Representative Bob Irvin more quotes