I grew up on Medicaid, which made it possible for me to see a dentist regularly. Dental coverage was just one part of making it possible for me to grow up with healthy teeth, though. I also lived in a community with fluoridated water, my parents were able to provide healthy food, my dentist’s office was close to our house, and my dentist was Vietnamese—like me. Like a healthy body, having healthy teeth is determined by many factors, such as insurance, access to affordable and culturally-responsive care, and the social and environmental landscape in which we all live, work, and play. And not everyone has what they need to be healthy.
Colorado has substantial oral health inequities that require our attention and action. The Colorado Department of Public Health and Environment reports substantial inequities by race and income that are echoed by Pew Charitable Trust. One reason for this is that the environments in which low-income communities and communities of color reside are less conducive to healthy teeth because of our laws and policies. These neighborhoods have unhealthier foods, including more fast food and corner stores and fewer grocery stores and farmer’s markets. The lack of access to healthy and nutritious foods often leads to consumption of food that promotes dental caries.
Another environmental condition that can promote healthy teeth is the fluoridation of drinking water. Fluoridated drinking water helps stop cavities from forming, strengthens the surface of the tooth, and can potentially repair damage on the tooth’s surface; it’s the best public health prevention of tooth decay. However, there are barriers in gaining the community’s trust, especially in the immigrant community, in which they are used to not drinking local tap water because of past negative experiences. There are also distrust towards the public water systems, due to events like those in Flint, Michigan.
Other reasons for oral health inequities include a shortage of dentists in some communities, disparities in dental insurance coverage, and big societal challenges like racism and other toxic stressors. Many organizations and foundations here in Colorado are working to improve health outcomes, by bringing water fluoridation to more of our communities and funding nonprofit organizations to close gaps in health care access—by providing resources for mobile clinics, increased health screenings, and dental home models.
Today, I’m lucky to still have access to dental insurance, easily accessible dentists, healthy food, fluoridated water, and other things that keep my teeth healthy. That’s not too much to ask for all Coloradans. Together, we can (and must) ensure the health of our mouths and teeth aren’t determined by the color of our skin, how much money we make, or where we live. Our future as a state depends on it.