Experts warn threats to Medicaid, fluoridation could harm oral health in rural areas

Dental experts are warning that the simultaneous erosion of Medicaid and fluoridation under the Trump administration could exacerbate a crisis of rural oral health and reverse decades of progress against tooth decay, particularly for children and those who rarely see a dentist (Source: “As opposition to fluoride grows, rural America risks a new surge of tooth decay,” NPR, March 26).
 
"If you have folks with little access to professional care and no access to water fluoridation," said Steven Levy, a dentist and leading fluoride researcher at the University of Iowa, "then they are missing two of the big pillars of how to keep healthy for a lifetime."
 
Nearly 25 million Americans live in areas without enough dentists — more than twice as many as prior estimates by the federal government — according to a recent study from Harvard University that measured U.S. "dental deserts" with more depth and precision than before.
 
The ADA has estimated that only a third of dentists treat patients on Medicaid.
 
The Harvard study identified over 780 counties where more than half of the residents live in a shortage area. Of those counties, at least 230 also have mostly or completely unfluoridated public drinking water, according to a KFF Health News analysis of fluoride data published by the CDC. That means people in these areas who can't find a dentist also do not get protection for their teeth from their tap water.