Where can you find dental care in Florida without insurance?
According to a new study, for an increasing number of Floridians — especially children — their only dental plan is the nearest emergency room.
High prices, low or no insurance coverage, and a severe shortage of dentists in rural areas have left families with few or no other options. A report from CareQuest Institute for Oral Health found that Florida had the highest rate of non-traumatic dental emergency room visits for children aged 14 and below in 2020 among the 13 states they tracked, 26.7 per 10,000 people. Wisconsin was the next highest, with 17 visits per 10,000.
The most common diagnoses were abscesses, tooth decay, cavities, mouth ulcers and chronic gingivitis, all largely preventable with proper preventative oral care and annual dental checks which can catch small issues before they become large, painful, expensive ones.
Florida also had the highest average bills for those visits, ranging from $1,900 to $2,600 depending on the age of the child, the report said. Medicaid covered 80.6% of them.
For children ages 14 and under, the most emergency room dental visits in 2020 were for Black boys (50.2 per 10,000 people) with Black girls the next highest (47.3). Hispanic boys were next (24), followed by Hispanic girls (21.9) and white boys and girls (both 19.5).
Dental care costs, insurance premiums rising
Most people with dental insurance get it through their workplace so unemployed people and those whose jobs don't offer a dental plan have to do without. In 2019, the University of Illinois Chicago’s College of Dentistry reported about 74 million Americans had no dental coverage.
And even with dental insurance, many people find themselves paying out of pocket. Dental insurance works differently from medical insurance since the potential financial losses are much smaller, according to Adam Powell, healthcare economist and president of consulting firm Payer+Provider Syndicate, and they're more like a discount program than actual insurance.
“Really what you're doing is you are pre-paying for some services, like preventive care. And then you're getting some coverage,” he said. “It is not really true insurance that covers catastrophic risk.”
Dental care prices rose dramatically in 2022, nearly 10% over the year before, according to the consumer price index, largely due to increased costs from COVID-related changes and a reduction in labor. And when insurance premium rise but paychecks don't, the dental plan is often one of the first things to go.
Medicaid in Florida covers some dental services, especially for children. But nearly 8 in 10 dentists in Florida won't take Medicaid patients according to a survey from the state Department of Health. Many of them said the reimbursement rates were too low. In 2020, reimbursement for child dental services in the state were 42.6%, according to the American Dental Association, among the lowest in the country.
Dentists are disappearing in Florida's rural areas
A report by the Tampa Bay Times found that of the 67 counties in Florida, only one has enough dentists to treat all its patients, nine have fewer than three dentists each, and Lafayette County has no dentist at all. Over 95% of dentists surveyed in Florida work in private practices, leaving fewer than 5% in publicly funded dental offices and community clinics.
The biggest reason: student debt. According to the American Dental Association, the average dental school graduate left college in 2022 with $304,824 in debt. That doesn't give much incentive to open a clinic in a rural area.
So what can you do if you have little or no dental insurance? You've got a few options to consider before the ER, which may not have the specialized tools and personnel to handle some dental problems anyway.
Step 1: Take care of your teeth
It's an obvious answer, but an important one. Prevention is by far the best and cheapest method for inexpensive health care. The American Dental Association recommends the following:
Brush twice a day for at least two minutes with a soft bristle toothbrush and fluoride toothpaste. Studies have shown that reduces the risk of tooth decay, gingivitis and periodontitis.
Clean between your teeth every day. People hate flossing, but cleaning between your teeth is important to dental health. If you can't bear or be bothered to pull string between your teeth, use interdental brushes, water-based irrigators or wood sticks.
Cut back on the sugar. The sugar in your drinks and snacks combines with the bacteria in plaque in your mouth to produce acid, which slowly dissolves the enamel in your teeth and creates cavities. Untreated, that can led to tooth abscesses.
The Florida Department of Health also recommends drinking plenty of water, especially fluoridated water.
Community clinics
Many of the community health clinics run by the U.S. Health Resources and Services Administration offer reduced-cost dental care. You may have to wait for an appointment so look for one here (adjust to search your area) and call ahead as soon as possible. You also can find one near you by calling (877) 464-4722 (ASK-HRSA).
Public dental clinics
Some clinics run by health departments or community health centers focus on dental care and charge low prices or sliding fees based on what you can afford, often with payment plans for patients without insurance. Routine cleanings and basic care is available and many locations offer advanced or emergency dental care and even orthodontics. You can search AuthorityDental.org for public dental clinics near you.
Dental schools
Dentists and dental hygienists have to learn on someone, and that could mean cheaper services for you and your family. You might pay considerably less for fillings, root canals and other services, but expect appointments to take longer as every step may be checked by experienced, licensed supervisors.
You can search for dental schools in Florida here, or search here for dental hygienist schools for basic cleaning and preventative care. Not all schools may offer reduced rates, and some may offer appointments with faculty with fees comparable to private practice, check to make sure what you're getting when you contact them.
Clinical trials
Occasionally the National Institutes of Health conducts clinical trials through the National Institute of Dental and Craniofacial Research for specific dental and oral issues, and they may provide free or low-cost dental treatments to volunteers who meet their needs. You can look for current and upcoming clinical trials in Florida at ClinicalTrials.gov .
Florida KidCare and CHIP
Medicaid and the Children's Health Insurance Program (CHIP) provide no-cost or low-cost health coverage through the KidCare program for eligible children in Florida through age 18 for routine check-ups, immunizations and dental care. KidCare's partners are MediKids (for children 1-4), Florida Healthy Kids (5-18) and Children’s Medical Services Health Plan (Birth through 18 with special healthcare needs). They include subsidized plans for people who make too much for Medicaid and full-pay options for people who don't qualify for subsidized coverage.
CHIP provides federal funding to states to subsidize health insurance for children from low-income families.
Visit the InsureKidsNow.gov website to find dentists and clinics near you who see children and accept Medicaid and CHIP.
This article originally appeared on The Daytona Beach News-Journal: Florida's dentists are avoiding rural areas. Here's where to find help
