Research and Analysis
Challenges in accessing dental care in Arizona
- 2.3 million Arizonans live in dental health professional shortage areas, including sizable portions of each of Arizona’s 15 counties.
- More than half (52 percent) of kindergarten children in Arizona have a history of tooth decay, and by third grade, the rate of increases to almost two-thirds (64 percent).
- 76 percent of American Indian children in the state have a history of tooth decay.
- In 2014, 41 percent of adults did not visit a dentist.
- In 2013, there were 25,000 visits to the emergency department (ED) for dental conditions that could have been avoided with routine dental care. Using national per visit cost data, these visits represent a total estimated cost of $19 million. Medicaid paid for 40% of these visits.
- Only 32 percent of dentists are enrolled in AHCCCS, well below the national average of 42 percent of dentists enrolled in similar programs.
Midlevel providers deliver quality dental care and improve access
Midlevel dental practitioners, known as dental therapists, have been providing preventive and basic restorative care in a variety of settings (including private practices, community health centers, schools, and nursing homes) in the United States since 2004, when they began serving native communities in Alaska. They started working in Minnesota in 2011; Maine and Vermont authorized them in 2014 and 2016, respectively.
In Minnesota, the state Board of Dentistry and Department of Health reported that dental therapists provide safe, high-quality care in rural and underserved urban settings. Clinics employing them are expanding capacity and decreasing travel and wait times for patients. In Alaska, dental therapists have increased access to care for 40,000 people living in 81 rural communities.
Savings from the lower costs of dental therapists have allowed Minnesota dental practices to treat more Medicaid patients. One small private practice in rural Minnesota has hired four dental therapists in the past four years and expanded its total staffing from eight to 20 people. Since 2012, the office has increased productivity by $776,572 and revenue by $488,788.