Dental News - New risk of dental caries in the US

Dental Tribune International

Wed. 23. April 2025

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LEIPZIG, Germany: Rural communities across the US are facing a growing oral health crisis as access to fluoridated water and dental care diminishes. This dual challenge threatens to reverse decades of progress in preventing dental caries, particularly among children and low-income families.

Water fluoridation has been implemented since the mid-twentieth century and has been instrumental in reducing caries by approximately 25% in both children and adults. However, concerns over potential health risks have led to the cessation of fluoridation in some communities. Public health experts warn that such decisions could disproportionately affect underserved populations who rely on fluoridated water as a primary means of caries prevention.

Compounding the issue is the shortage of dental professionals in rural areas. Many counties lack sufficient dental providers, and some have none who accept Medicaid, leaving residents with limited options for oral health services. This scarcity forces individuals to travel long distances for care or forego it altogether, leading to untreated dental issues and increased health disparities.

The erosion of Medicaid support will further exacerbate the problem and stands to have a severe impact on dental care. Proposed federal budget cuts threaten to reduce funding for dental services, making it even more challenging for low-income families to access necessary care. Without adequate insurance coverage, preventive treatments and routine check-ups become financially out of reach for many.

Efforts to address these challenges include treatment with silver diamine fluoride to halt caries, a particularly useful alternative for patients who cannot easily access traditional dental services. Additionally, some states are exploring the use of dental therapists to provide basic care in underserved areas, aiming to bridge the gap in provider availability.

Despite these initiatives, the combination of reduced water fluoridation, a limited dental workforce and potential Medicaid cuts poses a significant threat to oral health in rural America. Public health officials emphasise the need for comprehensive strategies to ensure that all communities have access to essential dental care and preventive measures.

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