The Surgeon General calls dental problems the “Silent Epidemic” that results in more than 51 Million school hours of missed school each year. Medicaid is the principal insurer for poor children, and its low reimbursement rate discourages the participation of dentists.
In rural communities, transportation problems also contribute significantly to poor oral health care access for children. For example, about half of Mississippi’s counties are designated oral health Health Professional Shortage Areas, with the fewest dentists available in the rural Delta region. Poor access to pediatric dental care is not exclusively a rural problem. An Illinois study found that the limited supply of dentists who accept Medicaid leads to similar barriers for rural children as for children in urban centers like Chicago. Unmet dental need is highest for children under five years old, especially if poor and on Medicaid. Young children have the highest rates of tooth decay and dental pain but the lowest rate of oral health care visits.