External Barriers and Internal Barriers are factors that have an influence on the inaccessability of dental care. External Barriers include: high cost of dental care, inability to obtain dental insurance as well as the low acceptance of insurance, lack of dental professionals and misinformation. Internal Barriers include: low oral health literacy, people’s anxieties of the dentist and the misconception that oral health isn’t as important as maintaining your general health.
The graph above is data from the Center for Disease Control that looked at the United Sates as a collective. The collected data didn’t seperate rural and urban areas. From 1996-2014 there was a negative trend of dental visits. Where it then suddenly increases between 2014- 2019.
External Barriers
Poverty
- In 2009, 130 million Americans didn’t have dental insurance.
- Dental care is not in the budget for people who have low-income and yet don’t qualify for government assisted programs
- Of the 62 million Americans living in rural areas 43% lack regular oral care.
- Only about 20% of dentists accept Medicade. This is because there are low reimbursement rates, inconvientient administrative processes and high rates of no-show appointments.
Distribution of Dentists
- Rural areas don’t have easy access to public transortation. Having a vehicle is necessary for accessibility. But maintaining a vehicle could be too costly for people who live in poverty.
- There are less graduates entering the career as dentists are beginning to retire. Graduates are known to prefer working in urbanized areas because of the debts that are accummulated after graduating dental school.
- In 2014 there was a total average debt of about $380,000
Internal Barriers
Literacy
- Language causes a divide between the patients and the professionals. When patients can’t understand what they need to do and why they need to do it, they won’t act upon it.
Misinformation and Misconceptions
- In cases of an emergency, physicians aren’t qualified to provide dental care. So, the patient would still need to see a dentist. Follow-up care may be unatainable for people with the lack of a consistant relationship with the dentist.
- Women who are pregnant have concerns that treatment could harm their unborn child.
- There are people who have a fear and unwillingness to keep up with their oral care. Fear could stem from negative experiences with dental care. The unwillingness could be seen in people who don’t consider oral health to be of importance.
Cases
In 2012, emergency visits relating to oral health increased. The U.S healthcare system spent about $1.6 billion on these visits. Around this time, a 24 year old named Kyle Willis died from an infection that spread to his brain because it was left untreated. In 2007, a 12 year old named Deamote Driver was unable to access a dentist that accepted Medicaid Insurance. The child also died from an untreated dental abcess.
