Fall 2014

Access to Care: ‘It’s a Crisis’

53 regions in Massachusetts don’t have enough dentists

By Jasmin Henville, D07

A few weeks ago I looked into the mouth of a 90-year-old patient who was having difficulty swallowing food and had a recurring infection commonly known as thrush. The patient’s physician thought that old dentures might have been the cause of his pain, but upon examination, I found a worrisome swelling under his tongue that extended from the floor of his mouth to the jawbone. It was locally advanced carcinoma of the tongue—oral cancer—a potentially life-threatening condition.

Because we caught it early, my patient was able to seek treatment and can now enjoy more time with his family. But I’ve also seen sadder cases, when diagnosis came too late to help. One man had an inexplicable toothache caused by an undetected and ultimately lethal tumor.


Illustration: Ward Schumaker

Dental care isn’t just about shiny white teeth. The mouth is the gateway to the whole body, so dentists play a crucial role in keeping people healthy all around. That is just one of many reasons it is so vital that Americans have regular access to dental care. Unfortunately, a lot of people don’t.

Fifty-three regions in Massachusetts, home to almost 1.3 million people, have been designated by the federal government as dental health professional shortage areas (HPSAs)—where there simply aren’t enough dental professionals to serve all the people who need care. The consequences are stark. For example, 90 percent of residents between ages 25 and 44 living in HPSAs have lost at least one tooth, far more than those living outside HPSAs.

I began my medical career in the early 1990s as a dental assistant at Boston Medical Center, working with patients whose immune systems had been compromised by HIV. This was a time when hysteria over AIDS ran high, and far too few practitioners were willing to help even in the face of great need. This experience fueled my desire not just to become a dentist, but to touch the lives of as many patients as possible and help those who lacked access to proper health care. That’s why I recently participated in the Healthy Mouth Movement, a community-giving initiative that provides free dental care to the people who need it the most—the poor, the elderly, the underserved.

Although I know it was only a drop in the bucket, it was rewarding to be part of an effort to help hundreds of people who would otherwise have to go without dental care, hoping that nothing bad ever happens in their mouth. Very often, that path leads to the emergency room. The American Dental Association reports that the number of dental ER visits in the U.S. increased from 1.1 million in 2000 to 2.1 million in 2010. This means millions of people suffered until they had to get help in the most unpleasant and most expensive way possible. ER visits cost the U.S. health-care system millions more each year than proper preventive care. That’s more than a problem; it’s a crisis.

As a state, we are a leader in dental education, with three dental schools, 10 dental residency programs and eight dental hygiene programs. We should be doing much more to expand access to quality dental care, encouraging more young people to study dentistry and increasing funding for community-based oral health programs. I encourage everyone to become more educated about dental health and what our state can do to support it.

Jasmin Henville, D07, is the owner and operator of Aspen Dental in Auburn, Massachusetts.

This article first appeared in the Boston Herald and is reprinted here with permission. 

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