Oral health can be one of the most neglected health needs for a large portion of Kentuckians. That is especially true for some in Louisville who live in so-called “dental deserts.”
That’s why Cara Brenner was handing out toothbrushes on Wednesday morning. She gave out supplies at the Neighborhood Place in Fairdale, which bundles social services under one roof. Brenner works for Community Dental, a nonprofit with two locations in medically underserved neighborhoods in Louisville. Community Dental accepts Medicaid and private insurance, but also takes cash and charges a relatively low price for a dental cleaning and exam.
Lee Mayer is an associate professor of community health at the University of Louisville School of Dentistry. He said there are plenty of dentists in Louisville but they are not evenly distributed.
“So the solution has been federally qualified health care centers and community health care centers,” Mayer said.
This is especially important for the kids who live in these dental deserts. Last year, Kentucky Youth Advocates found that third and sixth graders who were eligible for a free or reduced lunch – an indicator of a low-income household – were three times more likely to need urgent dental care versus kids with higher-earning parents.
Brenner said that ends up impacting a child’s ability to go to school.
“One of the top reasons children miss school is for oral health problems, for cavities or toothaches,” she said.
Brenner said transportation is also a big issue for families, which is why Community Dental is located on a TARC bus line.
“These families are having to really schedule,” Brenner said. ‘OK, I have to ride the bus there, and get back and pick up the kids on time,’ and it’s a lot. The dental care drops on the priority list for many families because it’s extra work for many families.”
And while many adults and children have gained health insurance because of the expansion of Medicaid in Kentucky, reimbursement rates are low and care isn’t guaranteed.
“So even if — though they take the insurance, they may limit the number of Medicaid patients they see for that day or for that week,” Brenner said.
Daniel Saman, a research scientist who co-authored a study on dental workforce in Kentucky, said places like Community Dental fill a gap, but not completely.
“In the absence of a health care system that incentivizes providers to see vulnerable populations, [community health clinics] are a necessity,” Saman said. “But unless we have tons of those clinics, they’re really just band-aids.”