To the Editor,
I would like to offer commentary regarding your recent article, “Dental deserts: Medicaid families in southern Ohio struggle for care amid provider shortages,” dated April 18, 2024.
The article quite correctly outlines the challenges in accessing oral health care for multiple areas of the state, especially the Appalachian counties. In addition, the comment by Oral Health Ohio executive director Marla Morse is accurate in that this effort requires “sustained efforts” to improve the overall health of Ohioans through increased availability of essential primary dental care. However, the article stops short of telling the entire story as multiple efforts are currently in motion to bring the potential for significant relief of the provider shortage to fruition.
For example, as referenced in the article, the most commonly identified barrier for dental providers to participate in the Medicaid system has been low reimbursements, with fees for dental procedures remaining essentially unchanged since the year 2000. Last year, after much sustained effort by the Ohio Dental Association and others, the 135th Ohio General Assembly passed the current state budget which contains an unprecedented 93% increase in Medicaid dental fees (raising Ohio’s ranking significantly from the outdated “41st out of 50” as indicated in your article). This very long overdue increase will hopefully open the door for existing and new providers to see more Medicaid patients as the new fees strongly rival what is now paid by many commercial dental insurance plans.
Additionally, the advent of a third dental school in northeast Ohio, the Bitonte College of Dentistry (associated with the Northeast Ohio Medical University) is promising as well. Bitonte’s leadership has articulated that a primary tenet of its existence is to produce providers who will specifically migrate to health provider shortage areas in response to the need. This dental school is anticipated to convene its first class in 2025.
Finally, a not-so-recent but clearly effective program, the Ohio Dental Loan Repayment Program—funded by a licensure surcharge from each of Ohio’s nearly 7000 licensed dentists—specifically targets underserved/high Medicaid areas where newly graduated dentists practice for a designated amount of time in return for dental school loan forgiveness. Many of the dentists stay past the completion of their contract providing needed dental care to the community.
In conclusion, the challenges of closing the gap of access to high quality dental care are many. Barriers such as transportation, low dental IQ, anxiety, and lack of any dental insurance continue to plague the system. However, the efforts by multiple agencies (and by dentists themselves) as outlined above are mounting an effective and ongoing response toward the goal of ensuring equitable dental health for all Ohio residents, especially those who are Medicaid recipients.
Hal S. Jeter, DDS, President-elect, Ohio Dental Association