Florida’s rural dental crisis is a public health failure we can no longer ignore

Basic dental care should be available to all Florida citizens, including those living in rural areas.

Federally Qualified Health Centers (FQHCs) such as Central Florida Health Care, Inc. are often the only “dental home” for Floridians living in underserved communities. Demand for our integrated medical/dental care, which is offered on income-based sliding scales, is extremely high.

Integrating dental therapists into FQHCs would strengthen this model. It would allow for broader, more flexible care delivery and increase preventive services under the general supervision of our Florida-licensed dentists. Our plan is to offer the approved Dental Therapy program through our State College to our current dental hygienists (20). This would open the doors of access to care for the people in our rural communities.

There simply aren’t enough dentists for millions of Floridians. Sixty-six of Florida’s 67 counties have federally designated dental health professional shortage areas. Nearly 6 million Floridians live in these dental deserts, where there are not enough dental professionals to meet the demand.

Several rural counties only have one or two practicing dentists; one has no licensed dentists at all. The dentists that do practice often have months or even yearslong waiting lists. Not every Floridian has access to reliable transportation to travel long distances to receive care.

Compounding that, only a small percentage (18%) of Florida dentists accept Medicaid, which rural Floridians are more likely to rely on. The result: preventable dental issues grow worse until they become emergency room visits.

Sadly, emergency rooms can only offer temporary pain relief. Once the painkillers run out, the patients must return. All of this comes at a cost of nearly $1 billion dollars for 146,252 emergency rooms visits for non-traumatic dental care in 2024, largely paid by Florida taxpayers.

This oral health crisis isn’t the fault of rural Floridians themselves. It is a public health issue that is waiting to be resolved. Oral health issues are linked with heart disease, diabetes, developmental delays in children, and more. Children especially suffer from bullying, social isolation, and emotional distress caused by poor oral health.

A key, evidence-based part of the solution to this oral health crisis is in the authorization of dental therapists: licensed, mid-level providers trained to deliver the most needed routine services such as fillings and extractions under the supervision of a dentist. Over 1,500 studies support the safety, quality, and cost-effectiveness of dental therapists, especially for rural areas.

Dental therapy also has a 100-year history and is used to expand access in over 50 countries and 14 U.S. states. Although organized dentistry might say that loan forgiveness or charity events may fill the gap, there is little evidence to support such claims.

Using loan forgiveness to lure dentists to rural areas doesn’t erase the fact that there’s a current shortage of dentists in Florida. Over 1,200 dentists are needed right now just to fill the gap. Only about 330 dentists graduate from Florida for dental schools every year.

Further, charity is not a health care system. While events such as Florida Mission of Mercy are commendable, they often have long wait times due to pent up demand and offer no opportunity for preventative or follow-up care.

Access to dental care shouldn’t depend on a ZIP code. Expanding access to oral care through dental therapists would be an excellent complement to healthcare improvements envisioned in the Rural Renaissance legislation, led by Senate President Ben Albritton and Sen. Corey Simon. Nearly every county would benefit. Continuing to ignore the problem grows more expensive by the year.

We look forward to Florida authorizing dental therapy, as 14 other states have done.

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Ann Claussen is the CEO of Central Florida Health Care. Karen McKenzie, DMD, is the Chief Dental Officer of Central Florida Health Care.