Fluoride Action Network

America’s Dental Care Crisis

Fluoride Action Network | April 2013

In the United States, low-income communities throughout the country are suffering from what many are calling an “oral health crisis.” Fluoridating water supplies is not a solution to this problem, as evident by the fact that oral health crises are occurring in virtually all urban areas — the vast majority of which have been fluoridated for decades. As is becoming increasingly clear, poor communities do not need cheap fluoride chemicals in their water; they need access to dentists. As documented below, up to 80% of dentists in the U.S. will not accept Medicaid patients — and the problem is set to worsen yet further if states continue to cut Medicaid funding for dental care services.

Rather than spending millions of dollars promoting fluoridation each year, efforts would be better spent trying to increase access to dental care services to underserved populations. Unfortunately, the dental trade associations that aggressively promote fluoridation, have done little to stem the reductions in Medicaid funding. In fact, some fluoridation proponents (such as Dr. Jayanth Kumar from the New York State Department of Health) have sought to divert Medicaid funding into fluoridation promotion activities. Making matters worse, dental trade associations are vigorously opposing efforts to expand access to dental care  by obstructing attempts to allow dental therapists to provide affordable care to low-income populations.

 In short, fluoridation provides good PR for dental trade associations, but bad medicine for those it’s supposedly meant to serve.

Reports by State: Percentage of Dentists Who Do Not Accept Medicaid


“In some states, such as Vermont and Nebraska, the majority of dentists see at least some Medicaid patients. In Alabama, only about 18 percent do. . . . Roughly 350,000 Alabamians – from infants to age 20 – are eligible for Medicaid dental care. In the last fiscal year, only 21 percent of those saw a dentist under Medicaid, agency figures show.” [Source]


In total, 21 percent of the dentists report having some Medicaid patients, and only 16 percent say they are willing to accept new Medicaid patients. . . . 20 of Colorado’s 64 counties do not have a dentist who accepts Medicaid. [Source]


“Just 28 percent of dentists in the state accept Medicaid or one of its managed care plans, according to the Universal Health Care Action Network of Ohio. Dentists say they lose money on Medicaid patients since the reimbursement rate is too low.” [Source]


“Although Deamonte was insured, he never received routine dental care. It turns out that only 16 percent of Maryland dentists accept Medicaid patients. Fewer than one-sixth of Maryland kids on Medicaid have ever had a cavity filled.” [Source]


“In Nevada, only 12 percent of children on Medicaid saw a dentist, making it the worst, while the best was Washington, D.C., with 48 percent of children accessing dental care.” [Source]


National Reports: Percentage of Dentists Who Do Not Accept Medicaid

“A 2010 by the Government Accountability Office found that fewer than half of the dentists in 25 out of 39 states treated any Medicaid patients in the previous year. In addition, some areas, including rural communities, just don’t have enough dentists. ‘We have huge and well-documented access problems in this country, with 45 to 50 million people living in dental shortage areas,’ says , director of the Pew Children’s Dental Campaign.” [Source]

“A 1998 survey of state Medicaid authorities by the National Conference of State Legislatures reported that, on average, only 16 percent of dentists in the 35 responding states participate actively in Medicaid.” Source: Dep’t of Health & Human Services. (2000). Oral Health in America: A Report of the Surgeon General. p. 254. 

States Cutting Medicaid Reimbursement Rates for Dental Care

“Facing tough fiscal times, states across the country are cutting a vitally important, but often overlooked, area of medical insurance for their low-income residents: dental care. The cuts have left many poor people with few options to pay for services such as teeth cleanings, fillings and dentures.” [Source]