Many of California's rural and urban communities may not have enough dentists, which could limit access to dental care, according to a UC San Francisco report released today by the Center for California Health Workforce Studies.
The study found that out of 487 Medical Service Study Areas--geographic regions defined by state agencies for the administration of various programs--97, or 20 percent, are currently at or below the federal standard of one primary care dentist for every 5,000 people. Of the 97 areas that have dentist shortages, 66 are rural and 31 are urban. Thirty-two Medical Service Study Areas, most of which are rural, do not have any dentists at all.
In addition, regions that have a shortage of dentists tend to have a higher percentage of minorities, lower median incomes and a higher percentage of children. While there are a number of statewide programs aimed at increasing access to dental care, few of them work to place dentists in underserved areas, according to the study authors.
"There is a mal-distribution of dentists," said Elizabeth Mertz, MPA, and project director at the UCSF Center for California Health Workforce Studies. "Existing programs aimed at correcting that distribution have not been successful for a variety of reasons. The National Health Service Corp, a federal program that places health professionals in shortage areas, simply does not have the resources to place dentist in all shortage areas. The federal and state governments need to look closely at why shortages persist in these areas. Dentist shortages are of particular concern because they generally occur in communities with vulnerable populations in greater need of dental care."
According to the report, some of the Bay Area regions that have a dentist shortage are south San Jose, San Francisco's Visitation Valley and Oakland's Fruitvale neighborhood.
"The study had two goals. The first was to document the geographic distribution of dentists and show, based on federal standards, that there are areas in California that have a dentist shortage and may be eligible for federal money to help," Mertz said. "The second goal was to document what the shortage communities were and what characteristics they had."
The regions identified in the study could be eligible for designation as a Dental Health Professional Shortage Area, which means the National Health Service Corp. could place more dentists in those areas, Mertz said.
Access to dental services in California has been an issue of increasing concern to federal and state policy makers in recent years, according to the report. Recent research indicates that many Californians do not receive regular dental care and, compounding the problem 44 percent of California adults had no dental insurance in 1995.
Other data shows:
*More than half of all California children--twice the number of children in other states--have untreated tooth decay.
*Twenty-eight percent of the state's children have no dental insurance-roughly twice the number of children without medical insurance.
*Nearly half of all California preschool children and 12 percent of all high school students have never been to a dentist.
Some of the report's recommendations include: increasing the supply of dentists in underserved areas and conducting more research to find ways to improve access to dental care.
Co-authors of the report are Kevin Grumbach, MD, director of UCSF's Center for California Health Workforce Studies and professor of family and community medicine, Laurie MacIntosh, MSW, research analyst and Janet Coffman, MPP, center manager.
The study was funded by the Center for Health Workforce Information and Analysis, U.S. Bureau of the Health Professions.