Report identifies barriers to dental access for low-income Californians


A guidance note by UCLA’s Center for Health Policy Research identifies three of the most important factors that have led to disparities in Californians’ access to dental care.

  • There are fewer dentists per capita in some parts of the state.
  • About 79% of dentists in the state have not provided care to the low-income patients who rely on Medi-Cal.
  • Only 8% of dentists in the state are Latino or black, compared to 60% of the low-income adult population in the state as a whole.

The authors also note that a shortage of dentists is looming: some 23% of dentists are 60 years of age or older and approaching retirement age, while only 9% of dentists have graduated from dental school in Canada. over the past five years. This imbalance is likely to put additional pressure on access to oral health care for all Californians, and especially for low-income residents.

According to the 2019 of the center California Health Interview Survey, 32% of state residents are adults with incomes below 200% of the federal poverty line (the income level at which people are generally considered to be in low income). And in previous studies, the authors have reported that low-income Californians have poorer oral health and less access to oral health care than residents with higher incomes.

The latest report, accompanied by an infographic, highlights areas of the state where there is a recipe for poor access to oral health care – a relatively low number of dentists per capita, a large proportion of low-income adults and a small percentage of dentists who see patients with Medi-Cal. In San Joaquin County, for example, there are only 2.2 dentists per 5,000 people, and although 65% of low-income adults in the area benefit from Medi-Cal, only 2% of dentists see of Medi-Cal beneficiaries.

“The availability of dentists willing to provide care to the low-income and uninsured population of California is critical to ensuring access to oral health care and improving oral health status.” , said Nadereh Pourat, associate director of the center and lead author of the study. “Our results indicate regional disparities in where low-income populations live and where Californian dentists practice. We also saw a low participation of dentists at Medi-Cal and a limited number of dentists from communities of color.

“These factors perpetuate income disparities in access to oral health care and the oral health status of low-income Californians.”

The researchers analyzed data from the Dental Board of California, the California Dental Association, and California Health and Human Services. They also found:

  • Thirty-nine percent of low-income California adults said their oral health was “fair” or “poor” and 41% said they had not seen the dentist in the past year.
  • Twenty-three percent of the state’s dentists were 60 years of age or older.
  • Although 53% of low-income adults in the state are Latino and 7% black, only 6% of practicing dentists were Latino and 2% were black.

“The data clearly shows the importance of increased involvement of dentists at Medi-Cal,” Pourat said. “Policy tools to encourage participation have been used for low-income children and can be adapted for low-income adults. ”

The document offers other possible suggestions, including expanding the roles of dental hygienists and dental therapists to reduce the burden on dentists, encouraging dentists to use “mobile clinics” to provide oral health care in the community. poorly served neighborhoods and offering at least some appointments, especially for consultations. or basic diagnostics – via web-connected devices for people who can’t get to a dentist right away.


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