By Lorra
All Things Considered by Lorra
Introduction: Not Just a Tooth Problem
In America, a smile can be a signal — of confidence, health, status.
But behind the smile lies something more invisible: structural racism.
From segregated dental schools to unequal insurance access and provider bias, oral health in the United States tells a clear story:
Race determines access, quality, and outcomes in dental care.
This isn’t about one bad dentist or one bad day. It’s about a system that’s been extracting more than just teeth from Black and Brown communities for decades.
This is the real cavity in American health care — and it runs deep.
Section 1: A Brief History of Dental Exclusion
The roots of racism in dentistry go back over a century:
In the 1900s, Black students were excluded from most dental schools.
The first Black dental school, Meharry Medical College, opened in 1886 to address this exclusion.
Segregated clinics and waiting rooms existed well into the 1960s.
Many private dentists refused to treat Black patients well after segregation "ended."
This legacy created a scarcity of Black dentists, and a cultural mistrust that persists today.
Section 2: Black and Brown Mouths, Worse Outcomes
Today, racial disparities in oral health are well-documented:
Group % of Adults with Untreated Tooth Decay % with Complete Tooth Loss (Age 65+)
Black 42% 29%
Hispanic 36% 21%
White 22% 16%
Black and Brown children are also:
Less likely to receive sealants or fluoride
More likely to visit the ER for preventable dental issues
Less likely to see a dentist regularly
Section 3: The Dentist Won’t See You Now
Many patients of color report racial bias and mistreatment in dental settings:
Feeling rushed or dismissed
Being offered extractions over restorative options
Dentists assuming patients “can’t pay”
Being told to find another clinic
This is compounded by:
Few dentists of color: only ~3.8% of U.S. dentists are Black
Language barriers with non-English speaking Latino communities
Geographic deserts in majority-Black or immigrant neighborhoods
> “I was told I should just get the tooth pulled — like it wasn’t worth saving.”
— Luis, 38, Bronx resident
Section 4: Medicaid Discrimination
Even when care is technically available, many dentists refuse to accept Medicaid — and this disproportionately affects people of color.
In some states, fewer than 1 in 5 dentists take Medicaid
Some providers even schedule Medicaid patients on separate days
Medicaid reimbursements are lower — and stigma is higher
This leaves low-income families, often Black or Latino, with long waits, fewer options, and reduced care quality.
> “I had to drive 90 miles just to find a dentist who’d take my son’s Medicaid.”
— Tanya, 29, mother of 3
Section 5: The Cost of Discrimination
Oral health discrimination has cascading effects:
Missed school days due to untreated cavities
Job discrimination due to missing or discolored teeth
Mental health strain from shame, embarrassment, and pain
Medical emergencies when infections spread beyond the mouth
And let’s not forget:
Oral health is health.
Poor dental health is linked to diabetes, heart disease, premature births, and more.
When racism shapes who gets preventive care, it literally shapes who lives longer.
Section 6: Rebuilding Trust and Equity
Change is possible — but it requires more than brushing tips.
What Needs to Happen:
1. Diversify the dental workforce
Fund scholarships and support for students of color in dental schools
Expand programs like SMDEP, Meharry, and Howard’s dental pipeline
2. Mandate cultural competence in dental education and licensing
Include anti-bias training and community health integration
3. Fund community dental clinics in underserved areas
Mobile units, free days, and school-based programs work
4. Enforce Medicaid equity
Require providers to take a percentage of Medicaid patients
Penalize discriminatory scheduling practices
5. Listen to Black and Brown voices in public health and policy decisions
Because a healthy smile should never depend on the color of your skin.
Final Word: Justice Starts at the Gums
Racism in dental care is real — but rarely discussed.
Why? Because we’ve learned to separate teeth from health, and race from treatment.
But oral health inequality is a racial justice issue.
It’s about who gets to chew, to speak, to smile — without pain, shame, or silence.
And until we fix the roots of this system, the rot will continue.
Let’s fill the real cavity — with equity.
All Things Considered by Lorra
By Lorra
No comments:
Post a Comment