UCSF study finds many areas in California have a dentist shortage

Many of California’s rural and urban communities may not have enough dentists,
which could limit access to dental care, according to a UC San Francisco report
released today by the Center for California Health Workforce Studies.

The study found that out of 487 Medical Service Study Areas—geographic regions
defined by state agencies for the administration of various programs—97, or 20
percent, are currently at or below the federal standard of one primary care
dentist for every 5,000 people. Of the 97 areas that have dentist shortages, 66
are rural and 31 are urban. Thirty-two Medical Service Study Areas, most of
which are rural, do not have any dentists at all.

In addition, regions that have a shortage of dentists tend to have a higher
percentage of minorities, lower median incomes and a higher percentage of
children. While there are a number of statewide programs aimed at increasing
access to dental care, few of them work to place dentists in underserved areas,
according to the study authors.

“There is a mal-distribution of dentists,” said Elizabeth Mertz, MPA, and
project director at the UCSF Center for California Health Workforce Studies.
“Existing programs aimed at correcting that distribution have not been
successful for a variety of reasons. The National Health Service Corp, a
federal program that places health professionals in shortage areas, simply does
not have the resources to place dentist in all shortage areas. The federal and
state governments need to look closely at why shortages persist in these areas.
Dentist shortages are of particular concern because they generally occur in
communities with vulnerable populations in greater need of dental care.”

According to the report, some of the Bay Area regions that have a dentist
shortage are south San Jose, San Francisco’s Visitation Valley and Oakland’s
Fruitvale neighborhood.

“The study had two goals. The first was to document the geographic distribution
of dentists and show, based on federal standards, that there are areas in
California that have a dentist shortage and may be eligible for federal money
to help,” Mertz said. “The second goal was to document what the shortage
communities were and what characteristics they had.”

The regions identified in the study could be eligible for designation as a
Dental Health Professional Shortage Area, which means the National Health
Service Corp. could place more dentists in those areas, Mertz said.

Access to dental services in California has been an issue of increasing concern
to federal and state policy makers in recent years, according to the report.
Recent research indicates that many Californians do not receive regular dental
care and, compounding the problem 44 percent of California adults had no dental
insurance in 1995.

## Other data shows:

* More than half of all California children—twice the number of children in
other states—have untreated tooth decay.
* Twenty-eight percent of the state’s children have no dental insurance-roughly
twice the number of children without medical insurance.
* Nearly half of all California preschool children and 12 percent of all high
school students have never been to a dentist.

Some of the report’s recommendations include: increasing the supply of dentists
in underserved areas and conducting more research to find ways to improve
access to dental care.

Co-authors of the report are Kevin Grumbach, MD, director of UCSF’s Center for
California Health Workforce Studies and professor of family and community
medicine, Laurie MacIntosh, MSW, research analyst and Janet Coffman, MPP,
center manager.

The study was funded by the Center for Health Workforce Information and
Analysis, U.S. Bureau of the Health Professions.