Green Smiles: Can Dentistry Help Save the Planet?

                            courtesy photo

All Things Considered by Lorra

🌱 Introduction: The Overlooked Footprint of Smiles

When we think about climate change, we imagine oil rigs, airplanes, and plastic in the oceans. But what about the dentist’s chair?

Every year, millions of dental visits leave behind a surprising trail of plastic waste, carbon emissions, and chemical byproducts. From the disposable gloves and suction tips to the daily sterilization cycles, dentistry is a small but steady contributor to the planet’s environmental burden.

In a time when health and sustainability are deeply linked, dentistry has an urgent question to answer: Can we care for teeth without harming the earth?

This is the emerging field of eco-friendly dentistry — or what some are calling green smiles.

🔎 Section 1: The Carbon Cost of Dentistry

Dentistry has long prided itself on being “clean.” But that cleanliness has a cost.

Studies from the UK’s National Health Service (NHS) revealed that a single dental practice generates a notable carbon footprint — largely from:

Patient and staff travel (car rides to and from appointments make up a significant chunk of emissions).

Single-use plastics, like suction tips, cups, and packaging.

Water and electricity use, from sterilization to high-powered lights.

Mercury amalgam waste, still present in some fillings worldwide.

Multiply this by tens of thousands of practices globally, and dentistry quietly becomes a major player in healthcare’s environmental toll.

♻️ Section 2: What Is Eco-Friendly Dentistry?

Eco-friendly dentistry is more than a buzzword. It’s a philosophy of care that tries to reduce the environmental footprint of oral health.

The Eco-Dentistry Association (EDA) defines it as the commitment to “reduce waste, save energy, and promote wellness” while maintaining the highest standards of care.

Some practices seek green certification, while others take grassroots steps — swapping paper cups for biodegradable ones, or installing water-efficient systems.

It’s dentistry that asks: How can we make a healthy smile without leaving a scar on the planet?

⚡ Section 3: Sustainable Innovations in Dentistry

Eco-friendly dentistry is not just an idea — it’s happening. Around the world, forward-thinking practices are embracing innovations like:

Digital impressions instead of plaster molds → fewer materials, less shipping.

3D printing for models and appliances → reduces waste, speeds up care.

LED lighting and solar-powered clinics → cutting down electricity usage.

Biodegradable toothbrushes, floss, and cups → less plastic in landfills.

Non-toxic sterilization methods → minimizing harsh chemical runoff.

Waterless vacuum systems → saving thousands of gallons per year.

Even something as simple as moving appointment systems online reduces the use of paper.

🧑‍🤝‍🧑 Section 4: Why It Matters

Dentistry doesn’t exist in a vacuum — it serves communities. And often, the same populations struggling with poor dental health are also the most affected by environmental harm.

Think of:

Low-income neighborhoods near industrial pollution sites.

Rural areas where water scarcity makes sustainability essential.

Urban centers where air pollution exacerbates health inequities.

When dentistry goes green, it’s not just about polar bears and oceans. It’s about aligning oral health with public health justice.

⚠️ Section 5: The Challenges

Of course, going green isn’t simple.

Cost: Sustainable technologies often require upfront investment.

Regulation: Strict sterilization laws sometimes clash with eco goals.

Inertia: Many clinics don’t prioritize sustainability if patients don’t demand it.

Awareness: Few patients realize that dentistry has an environmental footprint at all.

This makes eco-dentistry an uphill climb — but a necessary one.

🔮 Section 6: A Vision for the Future

What could a truly sustainable dental system look like?

Community dental hubs powered by renewable energy.

Government incentives for green retrofitting.

Education campaigns for patients to choose eco-conscious providers.

Dental schools training future dentists in environmental stewardship.

Waste-reduction goals embedded in public health policies.

It’s about merging the ethics of care with the ethics of sustainability.

✅ Conclusion: Taking a Bite Out of Climate Change

The climate crisis is the greatest health challenge of our time. Dentistry cannot afford to ignore it.

By shifting toward sustainability, dentistry can protect smiles and the planet at once.

Because the truth is this: every appointment, every glove, every light turned on in a dental practice adds up. And every small change, multiplied across thousands of clinics, can make a measurable difference.

The next time you lean back in the dentist’s chair, ask yourself: Is my smile good for me — and good for the earth too?

All Things Considered by Lorra

By Lorra

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The Great Divide: Why Medicine and Dentistry Still Don’t Talk — and How That Hurts Patients

                           courtesy photo

All Things Considered by Lorra

💡 Introduction: Two Worlds, One Body

Imagine this: your primary care doctor diagnoses you with diabetes. A few weeks later, your dentist notices gum inflammation and bone loss around your teeth — both clear complications of uncontrolled blood sugar.

But here’s the problem: your doctor and dentist will almost never talk to each other. Your medical chart won’t include your dental records. And your dental insurance, if you have it, won’t connect to your medical benefits.

This invisible wall between medicine and dentistry has existed for over a century. It’s a divide born out of history, education, and policy — but its impact is modern and painful. Millions of patients fall into the cracks of this fractured system, often with devastating consequences.

The question is: Why does this divide exist, and what would it take to heal it?

🏛️ Section 1: A Historical Split

To understand the problem, we need to rewind to the 1800s.

Medicine and dentistry were once closer cousins. But when professional institutions began formalizing healthcare in the late 19th century, dentistry was deliberately carved out as its own specialty.

Medical schools trained doctors.

Dental schools, often separate and underfunded, trained dentists.

Insurance systems evolved apart, with dental benefits treated as an optional perk, not essential care.

By the mid-20th century, dentistry had become a parallel universe: same body, different rules.

🧬 Section 2: When the Mouth and Body Don’t Talk

The irony of this divide is striking. Modern science shows us that the mouth is not separate from the body — it’s the gateway.

Diabetes & Gum Disease: Poorly controlled diabetes worsens gum disease, and gum inflammation makes diabetes harder to manage.

Heart Disease: Bacteria from periodontal infections have been linked to heart attacks and strokes.

Pregnancy: Poor oral health is associated with premature births and low birth weight.

Cancer Treatment: Patients undergoing chemotherapy often develop painful oral infections that impact recovery.

Yet, despite all this evidence, medicine and dentistry rarely collaborate.

Your cardiologist may never ask about your bleeding gums. Your dentist may never know you’re on chemotherapy. The patient — already juggling multiple appointments, bills, and anxieties — is left to connect the dots alone.

💰 Section 3: The Insurance Wall

If medicine and dentistry don’t talk in practice, insurance makes sure they don’t talk on paper either.

Medical insurance covers heart surgery, insulin, or chemotherapy.

Dental insurance — when it exists — is capped, often at a measly $1,000–$1,500 per year. That doesn’t cover much beyond a cleaning and a filling.

This siloed approach sends the false message that oral health is a luxury, not a necessity. It also discourages collaboration: doctors don’t bill dental codes, and dentists don’t bill medical ones. Patients are trapped in between.

🧑‍⚕️ Section 4: Patients Who Pay the Price

Who suffers from this broken system? Always the most vulnerable.

A senior on Medicare who can’t afford dentures loses weight because she can’t chew.

A child with untreated cavities misses school, while their pediatrician has no record of their oral health.

A construction worker delays a root canal, the infection spreads, and he ends up in the ER.

A pregnant woman never gets referred to a dentist, despite research linking gum health to healthy pregnancies.

The divide between medical and dental care isn’t just inconvenient. It’s dangerous.

🌍 Section 5: Models of Integration

There are glimmers of hope. Across the world, a handful of programs are experimenting with integration.

Community health centers in the U.S. now place dental clinics alongside primary care.

Electronic health records in pilot programs link dental and medical charts.

Teledentistry brings oral health screenings into pediatric and OB-GYN visits.

Nurse practitioners in some rural areas are trained to do basic oral exams.

These models show us that integration is not only possible — it’s life-saving.

🚧 Section 6: Barriers to Change

So why isn’t this happening everywhere?

Professional turf wars: Medical and dental institutions guard their autonomy.

Education gaps: Dental students and medical students rarely train together.

Financial disincentives: Insurance companies profit from keeping benefits separate.

Cultural inertia: “This is how it’s always been” still dominates.

Breaking down these walls requires not just policy shifts but cultural ones.

🌟 Section 7: A Future Without Divides

Imagine a healthcare system where:

Your dentist and doctor share one chart.

Your insurance doesn’t distinguish between a root canal and a heart stent.

Your annual physical includes an oral exam.

Your health outcomes improve because your providers see you as a whole person.

This isn’t utopia. It’s achievable with political will, patient advocacy, and professional collaboration.

✅ Conclusion: Healing the Whole Body

The mouth is not separate from the body. Our policies, education systems, and healthcare structures are the only things keeping them apart.

Medical-dental integration is not a luxury or a dream. It’s a necessity for a healthier, more equitable future.

Because until medicine and dentistry learn to talk, it’s the patients — especially the poorest, the sickest, and the most vulnerable — who will continue to pay the price.

It’s time to heal the divide.

All Things Considered by Lorra

By Lorra

Why Are We Still Pulling Teeth in Emergency Rooms?

 

                                     courtesy photo 

By Lorra

All Things Considered by Lorra

🚨 Introduction: A Crisis Behind the Curtain

In trauma bays, ER nurses rush patients in for strokes, overdoses, and heart attacks.

But in a quiet corner of the emergency department, another kind of patient waits — clutching their face, sweating through the pain, and praying for antibiotics.

They’re not here for a medical emergency.

They’re here because their tooth won’t stop hurting, and there’s nowhere else to go.

Every year in the U.S., over 2 million people visit the emergency room for dental pain.

And what do they get?

Temporary painkillers

A round of antibiotics

And a warning: “See a dentist.”

But many of them can’t.

Let’s talk about why we’re still pulling teeth in the ER — and not fixing the system.

📉 Section 1: The System Wasn’t Built for This

Emergency rooms are not equipped for:

Dental X-rays

Tooth extractions

Root canals

Gum disease treatment

Long-term care planning

Instead, patients with dental abscesses or advanced decay receive:

IV fluids

Temporary prescriptions

A quick discharge

Some may return days later — worse than before.

This cycle wastes millions in hospital resources, while offering almost no relief to the patient.

🧾 Section 2: The Insurance Trap

Why don’t people go to dentists instead?

Because:

Medicaid in many states doesn’t cover adult dental

Private dental insurance is separate, expensive, and limited

Uninsured patients face $300-$2,000+ upfront for even basic procedures

Community clinics are overwhelmed or too far away

In rural areas, people drive 3-4 hours just for a cleaning — if they’re lucky enough to get on a waitlist.

> “I knew it wasn’t an emergency emergency. But it was the only place open. The pain was unbearable.”

— Kevin, 38, ER dental patient in Kansas

🧠 Section 3: The Human Cost

ER dental patients are often:

Working class

Uninsured

Living paycheck to paycheck

Parents caring for others while ignoring their own pain

People in recovery, housing insecurity, or systemic neglect

And the cost of dental neglect goes deeper than pain.

It means:

Missed work

School absences

Poor sleep

Mental health issues

Life-threatening infections if left untreated

> “I waited 8 hours. They gave me Tylenol and told me to find a dentist. I cried all the way home.”

— Angela, 24, temp worker in Georgi

💸 Section 4: Public Dollars, Private Pain

Emergency room dental visits cost the U.S. over $1.5 billion annually.

But they rarely resolve the problem.

Instead, they:

Delay treatment

Increase opioid exposure

Waste taxpayer dollars

Turn manageable decay into emergencies

If those funds were redirected to community dental care, mobile clinics, and Medicaid expansion, the impact would be transformative.

🔁 Section 5: The Revolving Door

The same patients return every 6–8 weeks:

Same pain

Same prescription

Same ER

This isn't neglect — it's survival.

They’re doing what they can with what they have.

But the system isn’t built for chronic oral illness. It’s built for trauma — not teeth.

🛠️ Section 6: What Real Reform Would Look Like

We need to move from emergency reaction to preventive response:

Expand Medicaid dental coverage in all states

Fund 24/7 emergency dental walk-ins in high-need areas

Place dental hygienists in ERs for triage

Train hospital staff in oral infection management

Build mobile dental units to visit rural and urban “dental deserts”

Emergency care should be the last resort, not the only option.

📣 Final Word: Stop Sending Toothaches to the ER

Every ER dental visit is a red flag — not just for pain, but for policy failure.

We must ask:

Why can’t they access care sooner?

Why was the ER the only option?

What will happen when the antibiotics run out?

If we truly want a just, efficient, and compassionate healthcare system,

then dental pain must be treated like health pain — not a side issue.

Because in America, no one should be stuck in the ER over a tooth.

All Things Considered by Lorra

By Lorra

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Chew on This: When Diet and Dentistry Collide

                            courtesy photo

By Lorra

All Things Considered by Lorra

🍽️ Introduction: You Are What You Chew

In public health, food and dental care are often treated as two separate silos.

But for the millions of people living with untreated dental issues, what they eat is directly dictated by what they can chew.

Rotten molars. Cracked incisors. Painful abscesses. Gum disease.

These conditions don’t just make eating uncomfortable — they reshape entire diets, worsen chronic diseases, and quietly fuel a cycle of poor nutrition and poor health.

This isn’t a fringe issue. It’s happening in nursing homes, low-income kitchens, school lunchrooms, and food pantries across America.

Let’s chew on it.

🦷 Section 1: Pain That Dictates the Plate

If chewing hurts, people adjust — often in dangerous ways:

Swapping raw vegetables for soft bread

Avoiding protein-rich meats in favor of processed carbs

Drinking sugary drinks for quick calories

Skipping meals entirely

Even young people with cavities often report self-limiting diets:

> “I just eat chips and applesauce. Crunchy stuff hurts too much.”

— Samira, 14, high school student in Ohio

Over time, this can lead to:

Malnutrition

Blood sugar spikes (especially for diabetics)

Weight loss or gain

Increased reliance on soft, processed foods

Mood changes and fatigue

🛒 Section 2: Food Insecurity, Meet Dental Insecurity

Low-income communities are often trapped between two insecurities:

Food insecurity: Lack of access to nutritious, affordable food

Dental insecurity: Lack of access to timely, affordable oral care

When your teeth hurt and your pantry is empty, you reach for:

Ramen noodles

Instant mashed potatoes

Sugary breakfast cereals

White bread and soda

These are cheap. Soft. Calorie-dense.

And devastating for both blood sugar and oral health.

It’s a double burden: the food that’s easiest to eat with bad teeth is also the most likely to cause more decay.

🧓 Section 3: Seniors, Dentures, and the “Soft Food Trap”

Older adults are particularly vulnerable.

Many lose their teeth but cannot afford dentures

Those with ill-fitting dentures often avoid fruits, vegetables, or meats

Nursing homes often serve pureed or overly processed meals

The result? A plate full of starches and soft sugar, but few nutrients.

> “My mother can’t chew broccoli, so they give her pudding and toast.”

— Carla, caregiver in Texas

For seniors, this contributes to:

Weak immune systems

Poor wound healing

Cognitive decline

Weight loss or frailty

🧠 Section 4: The Hidden Psychological Toll

The inability to enjoy food has emotional consequences, too:

Shame around eating in public

Embarrassment when declining food at gatherings

Isolation from family meals

Anxiety about what to eat at work or school

Food is love. Food is culture. Food is connection.

But without dental health, food becomes a source of pain, stress, and sometimes fear.

🩺 Section 5: Medical Conditions That Spiral Without Teeth

Poor diet caused by dental problems can worsen nearly every chronic condition:

Diabetes (due to high glycemic load from soft processed foods)

Heart disease (linked to poor nutrition and gum inflammation)

Hypertension (exacerbated by sodium-rich processed meals)

Gastrointestinal issues (from under-chewing food)

And when ER doctors treat these conditions, they rarely ask:

"What can you actually eat?"

"Do your teeth hurt when you chew?"

That silence keeps the cycle alive.

🌱 Section 6: Food and Dental Justice Go Hand-in-Hand

Solutions must recognize the interconnectedness of mouth and meal:

Include dental screenings in SNAP/WIC programs

Add dental hygienists to community nutrition clinics

Provide dietician-led counseling for people with major oral health issues

Offer tooth-friendly food boxes at food pantries

Restore dental benefits in Medicaid and Medicare

Expand mobile dentistry to reach food desert areas

If someone can’t chew a salad — it doesn’t matter how many nutrition classes they attend.

We must start by restoring the ability to eat.

📣 Final Word: What’s On Your Plate Starts With Your Mouth

When we talk about hunger, we talk about access, affordability, and dignity.

It’s time we add one more: ability.

The truth is simple:

If your teeth are broken, your diet will be, too.

And if we want to build a healthier, more just nation — we must fix both.

All Things Considered by Lorra

By Lorra

The Shame of the Smile: Mental Health and Dental Neglect

                          courtesy photo
    

By Lorra

All Things Considered by Lorra

😶 Introduction: Smiling Through It

We are taught that a smile is a gift — a way to greet the world, make friends, and feel human.

But what happens when your smile becomes a source of shame?

Millions of people avoid mirrors, skip social events, and even turn down jobs — not because they don’t care about their appearance, but because they can’t afford to fix their teeth.

Dental neglect isn’t just a health issue. It’s a mental health crisis. And yet, almost no one talks about it.

🦷 Section 1: Teeth and Identity

Your mouth is one of the first things people see — and one of the first places shame takes root.

Dental issues like:

Broken or missing teeth

Stained enamel

Gum disease or halitosis

...can lead to deep embarrassment, social withdrawal, and even depression.

> “I stopped smiling at my kids. I didn’t want them to see how bad it got.”

— Maria, 42, uninsured mom of three

💭 Section 2: When Avoidance Becomes Isolation

People living with dental issues often begin to isolate themselves:

Skipping parties, dates, or public outings

Avoiding photos

Refusing to speak up at work or school

Using their hands to cover their mouths

Internalizing shame as personal failure

This shame is compounded by:

The stigma of “bad hygiene”

Assumptions of addiction, laziness, or poverty

Public messages that equate white, straight teeth with morality and success

🧠 Section 3: Depression, Anxiety, and Oral Pain

Studies show a direct link between poor oral health and depression:

Dental pain contributes to chronic stress and sleep disruption

Tooth loss is associated with self-worth issues and increased risk of depression

Gum disease has even been linked to cognitive decline and Alzheimer’s risk

But very few mental health providers screen for oral health, and almost no dental offices screen for mental health distress.

> “I wasn’t suicidal. But I stopped caring. I figured my mouth was just part of how I’d always be treated.”

— Eli, 28, former foster youth

🔁 Section 4: The Vicious Cycle

Here's how dental neglect and mental health issues feed each other:

1. Anxiety about judgment leads to skipping appointments

2. Skipping care leads to worsening conditions

3. Pain and shame increase, triggering depression or self-loathing

4. Depression reduces motivation to seek help or maintain hygiene

5. And the cycle repeats...

Add poverty, trauma, or abuse histories into the mix — and this cycle becomes nearly unbreakable.

🚪 Section 5: Why Therapy Can’t Fix a Broken Tooth

Mental health support is essential, but it can’t replace access to affordable, humane dental care.

Imagine telling a patient struggling with suicidal thoughts caused by dental shame that their only option is to "love themselves more" — without addressing the root cause in their mouth.

We need:

Integrated care models that include dental in mental health clinics

Dental trauma-informed practices, especially for survivors

Subsidized cosmetic/restorative services for people in recovery or reentry

Policy changes that treat oral health as a core component of total health

🌱 Section 6: Toward Dignity and Recovery

There is hope. Small-scale programs are helping:

Nonprofits offering free smile makeovers for abuse survivors

Mobile clinics inside addiction recovery centers

Peer-led dental advocacy groups sharing lived experiences

Trauma-sensitive dental providers who understand the emotional toll

These efforts are restoring more than teeth — they’re restoring dignity.

> “When I got my new smile, I felt like I came back to life.”

— Vanessa, 37, formerly incarcerated

📣 Final Word: Let People Smile Again

A smile shouldn’t be a luxury.

It shouldn’t be a source of fear, judgment, or loss of self.

And yet for millions, it is.

Dental neglect is mental neglect. And if we truly believe in treating the whole person, we must finally say it out loud:

No one should feel unworthy of being seen — because of their teeth.

All Things Considered by Lorra

By Lorra

No Dentist for Miles: Rural America’s Silent Oral Health Crisis

 

courtesy photo
 

By Lorra

All Things Considered by Lorra

📍 Introduction: Miles from a Smile

Imagine waking up with a raging toothache, but the nearest dentist is 80 miles away.

You don’t have a car. Public transit doesn’t run that far. And the clinic only accepts cash.

This is not a rare scenario — it’s everyday life in rural America.

Across thousands of small towns and remote counties, dental care has vanished. Not reduced. Not limited. Just gone.

These are America’s dental deserts — and they are silently rotting the health of millions.

🚫 Section 1: Dental Deserts Defined

A dental desert is a region with fewer than one dentist per 5,000 residents.

In some rural counties, it’s 1 per 20,000+ — or none at all.

According to the Health Resources and Services Administration:

Over 68 million Americans live in dental shortage areas.

2 out of every 3 live in rural or semi-rural regions.

Many rural counties have no practicing dentist, no dental hygienist, no mobile clinic.

> “You can find a liquor store before a dentist in some towns.”

— Former rural health commissioner, Arkansas

🚗 Section 2: The Travel Barrier

In rural towns, dental care isn’t just hard to find — it’s often physically unreachable.

Patients travel 50 to 100+ miles for cleanings or fillings.

Clinics often have 3- to 6-month waits — if they take new patients at all.

Public transportation is rare. Gas is expensive. Time off work? Not possible.

Many choose to delay care entirely. A cavity becomes a root canal. A root canal becomes an ER visit.

The mouth becomes a crisis point.

💰 Section 3: Affordability Meets Absence

Rural communities are more likely to be:

Low-income

Uninsured or underinsured

Dependent on Medicaid, which many rural dentists don’t accept

If you’re poor and rural, the barriers stack fast:

Can’t afford care.

No one nearby.

No dentist takes your plan.

And even if they do, they might prioritize private-pay patients first.

> “They told me it would be nine months before they could see me—unless I had cash.”

— Jared, 52, Montana ranch worker

🧓 Section 4: Aging Without Access

Rural seniors face unique oral health risks:

No dental coverage under Medicare

Limited mobility

Reliance on fixed incomes

Many haven’t seen a dentist in 5, 10, even 20 years.

They resort to pulling their own teeth, using over-the-counter kits, or simply living with pain and infection.

> “I use clove oil and prayer. That’s all I can do.”

— Marla, 76, retired teacher in rural Mississippi

👩‍⚕️ Section 5: A Shrinking Dental Workforce

Rural America is also facing a dentist shortage crisis:

Most dental graduates choose to work in cities.

Private practice in rural areas is often financially unsustainable.

Rural dental clinics struggle to hire and keep hygienists or assistants.

Many aging dentists retire without replacements.

The result? One-by-one, small-town practices close their doors — permanently.

💡 Section 6: What’s Working (and What’s Not)

Innovative solutions have emerged, but they remain underfunded or underutilized:

Mobile dental vans serving remote communities

Teledentistry consultations (though internet access can be unreliable)

Loan forgiveness programs to encourage rural dental practice

Mid-level dental providers like dental therapists (allowed in only a few states)

What’s not working:

Relying on volunteer pop-up clinics

Hoping private dentists will “choose” rural areas

Cutting public health funding

📢 Final Word: When Silence Hurts

The crisis in rural dental care is quiet — but devastating.

It doesn’t get headlines. It doesn’t trend. But it’s rotting rural health from the inside out.

To fix it, we must:

Treat dental care as essential, not optional

Fund rural dental infrastructure like we do roads and hospitals

Train and deploy providers who will serve remote communities

And most of all, listen to those who have been forced to live without care for far too long

Because no American should go toothless for lack of a map.

All Things Considered by Lorra

By Lorra

The Real Cavity: Racism in Dental Care

  

                         courtesy photo 

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