Blacks Can’t Afford to Ignore Dental Health


While Medicaid and the Children’s Health Insurance Program (CHIP) provide a safety net access to dental care is a big issue, especially for children of color.

“Tooth decay is the most common chronic disease among children in the United States, five times as prevalent as asthma, and dental care is one of the nation’s greatest unmet children’s health needs,” according to Pew Charitable Trusts.

Sometimes children’s parents simply don’t arrange for them to see a dentist. Sometimes, dental services are not available in particular areas, for example, dental needs are sometimes more likely to be addressed in emergency rooms than dental clinics. A 2016 report from the Department of Health and Human Services said that dental provider shortages were at least part of the reason some children, especially low-income black and Hispanic children, lack dental care.

Children pay a big price when their dental needs are not met. In the worst and most extreme cases, as in that of Maryland’s Deamonte Driver, children can die, because they do not have access to basic dental services.

“Childhood dental decay can lead to pain, difficulty eating, speaking and sleeping, and more serious infections, some of which can be life-threatening,” said Dr. Diane Earle, the managing dental director for Kool Smiles.

To address some of the need, Kool Smiles is offering free dental care to children in need on Sunday, May 20, 2018. Forty-nine offices in 13 states plus Washington, D.C. will be open to provide dental exams, extractions, fillings, sealants and other emergency services. The free day is open to children who either lack insurance or are underinsured.

To be sure, Kool Smiles can’t possibly provide a smile for every child, but they are taking a step in the right direction. This year represents the fourth year that the organization has offered the free service. It’s first-come, first-serve, so if you are interested, visit: to find a location in your area and to register for a free appointment.

In the past three years more than 1,400 children have received free dental care with more than 500 being treated last year. Kool Smiles hopes to serve even more children this year.

Access to safe and affordable health care has been part of my portfolio for some years. In 2015, I had the privilege of spending a week at Meharry Medical College, lecturing on health policy. The challenges that people of color face around health care can be distilled to the 3 A’s: Access, Assets and Attitudes. All too often access is limited, because people live in the wrong areas, because providers are unavailable, or because there are other reasons people can’t physically get to the care they need.

Assets determine almost everything— if you don’t have the dollars, no matter what the proximity, you won’t likely have the care you need. Finally, the attitudes of both providers and patients make a difference in who seeks care and in what kind of care is provided. Recent work on maternal mortality among African American women, regardless of race, suggests that racial attitudes in treatment make a difference.

Mental health and dental health are the two parts of healthcare that are most frequently ignored. It is not enough to simply get an annual checkup. Increasing research shows that mental health and physical health are inextricably intertwined. Dental health, all too frequently,

is ignored. Even those with “good” health insurance may have limited dental insurance. And lower-income folks rely on Medicaid and CHIP, but may not have anywhere to go to get the help they need.

Dental practitioners like Dr. Earle, a second-generation Meharry-trained dentist, stand in the gap for those who may not have access to healthcare. In her role as Managing Dental Director for Kool Smiles, Earle says, “Sharing Smiles Day is an opportunity for our dentists and staff to put a smile back on the faces of children who need dental care but whose families cannot afford it.”

Kool Smile’s effort to see 500 or more children on May 20 doesn’t begin to deal with the enormity of the challenge, but it’s an effort that will make a big difference for the children who are treated. It’s also an opportunity for us to reflect on the importance of dental health that the role that organizations like Kool Smiles can play in closing the dental health gap.

Full disclosure: I’ve worked with Kool Smiles and their dental service organization, Benevis, on a program called Watch Yo’ Mouth, featuring Dr. Earle and healthy living author Debra Peek-Haynes. We plan to offer more of these programs in coming months. Meanwhile, though, I am excited about Sharing Smiles Day and about developing ways more low-income children can have access to dental care, so that there can be a healthy smile for every child in our nation.

Julianne Malveaux is an author, economist and founder of Economic Education. Follow Dr. Malveaux on Twitter @drjlastword.