Narrowing Oral Health Disparities in Tennessee

Heavyn Jennings | July 2022

Oral Health in Tennessee 

Tennessee ranks 38th in dental health in the nation. Oral health is essential for general health and well-being. Oral disease can cause pain and infections which can result in difficulties eating, speaking, and focusing. Poor oral health can also impact self-esteem and appearances leading to negative social interactions and reduced employment potential.  

Most Tennesseans understand oral health is important. 95% of Tennesseans value oral health and agree regular dental visits keep them healthy. However, many are unable to take action on their values because they lack access to oral healthcare. They lack access not only because treatment is expensive but also because there are so few dentists in Tennessee. While there are 60 dentists for every 100,000 people in the U.S., there are only 50 per 100,000 in Tennessee. This amount is barely enough to serve Tennessee, so one of the first steps to improve oral healthcare is expansion of the dental workforce and dental benefits. 

Children’s Oral Health 

23% of preschool-age children and 18% of children between and 18 have untreated caries. The children who are most at risk are low-income and children of color. Children with poor oral health have higher rates of school absences and lower school performances, and their caregivers often have a decreased ability to regularly attend work. A child’s oral health is extremely important, because, just like adults, it is difficult for them to stay healthy when they have poor oral health. 

Despite most children having access to dental insurance, oral health disease still poses a significant health threat to children. Many children in Tennessee are not accessing essential dental services due to difficulties in finding dental providers especially those who accept TennCare and CoverKids, Tennessee’s CHIP. Only 41% of children on TennCare received any dental or oral health treatment in 2020. Tennessee must improve the accessibility of dental services by increasing its dental provider network.  

Inequities and The Dental Coverage Gap 

Dental care has seen some massive improvement over the years including employer-sponsored and marketplace dental insurance. Unfortunately, not all Americans have equal access to these improvements. Adults who are Black, Hispanic, low-income, have less than a high school education, or current smokers artwice as likely to have untreated cavities than comparison groups. Although more adults are retaining their teeth, many continue to need and lack access to dental treatment ranging from fillings to crowns to more extensive treatment such as root canals. The necessity is greater for members of some racial and ethnic groups—about 3 in 4 Hispanics and Black adults have an unmet need for dental treatment. These typically are the same adults who have difficulty accessing dental treatment.  

Dental care disparities are partially due to the exclusivity of dental insurance. For every adult aged 19 years or older without medical insurance, there are three who don’t have dental insuranceTennCare, Tennessee’s Medicaid, currently only has dental benefits for pregnant enrollees and children under 21 on the programs. Certain adults with disabilities can access dental benefits through TennCare waiver programs. All other adults on TennCare currently do no have dental benefits. 

Next Steps 

For Tennessee to close disparities in oral health, lawmakers need to expand the dental workforce. Over 2.3 million Tennesseans live in dental health provider shortage areas where there is less than 1 dental provider per every 5, 000 residents. We need to increase the number of dental practitioners who provide Tennesseans with access to dental care. Current resources for those lacking dental insurance include federally qualified health centers (FQHCs) and charitable clinics that offer dental servicesFor example, Remote Area Medical (RAM) is a nonprofit organization that provides free dental, vision, and medical services to underserved and uninsured people at pop-up clinics in urban and rural areas. Unfortunately, organizations like RAM and others are not able to meet the need for affordable dental care across the state. Legislators must find ways to train and employ greater numbers of dental providers, including dental therapists, in order to meet this need. 


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