Rebuilding dental care from within: How local students are strengthening the oral health safety net

When Dr. Abby Freeman asks college students from underserved communities why they are pursuing a career in oral health, she hears similar stories.

Students at Wayne County Community College District, where Freeman is district provost for health sciences, often share that they and their family have struggled to access dental care – something they hope to change for future generations.

“Many students want to serve the communities they grew up in, particularly in neighborhoods with poor access to dental care,” she said. “When local students from underrepresented communities are trained and employed in oral health professions, they are more likely to remain in and serve those communities. This creates a cycle of reinvestment in health, education and economic development.”

The students and the Detroit-based college are working to rebuild the country’s fraying oral health safety net – the clinics, providers and public programs that deliver dental care to those who need it most.

But challenges in funding and staffing – particularly since the COVID-19 pandemic – have made it difficult for systems to keep up. And solving the problem not only means improving access to dental care, but also making sure the workforce reflects the demographics of the communities they serve.

“Across metro Detroit, we tend to see deep racial, ethnic and socioeconomic disparities in health outcomes, including oral health, for a variety of reasons that are difficult to impact like lack of dental insurance and affordability or a lack of trust in the health care system or providers,” Freeman said. “In communities where residents have historically experienced health care neglect, seeing providers who share their cultural background can significantly increase trust in care.”

Patients who trust their providers are more likely to seek preventive services, follow treatment recommendations and return for appointments.

Compared to the U.S. population, Black and Hispanic dentists remain underrepresented in the workforce, according to the American Dental Association. There’s also a wide disparity of access to dental services between urban and rural areas, with the dentist-to-population ratio in rural areas having declined steadily for the past decade.

But expanding access to care isn’t just about opening more clinics – it’s also about building teams who care deeply about patients, said Ryan Torresan, an editorial board member of the industry publication “Group Dentistry Now.” 

"A dental office is not just a place of care — it’s a pillar of the community,” he said. “The greatest impact comes when practices see themselves as part of the social fabric, serving not only those with easy access, but also those on the margins — the uninsured, the elderly, the rural and the vulnerable.”

Like many dental programs and clinics, safety net dental programs and clinics are experiencing difficulties recruiting and retaining dental professionals, said Candace Hsu Owen, senior director of education and strategic partnerships at the National Network for Oral Health Access, which serves the largest group of safety-net oral practitioners in the country.

Workforce diversity is critical for strengthening the oral health safety net – and improving health outcomes.

“There is research that shows that people have improved health outcomes and health care experiences if they receive care from people that look like them,” she said. “The safety net demonstrates that by having a diverse workforce that is culturally responsive to its patients. Many individuals working in the safety net come from that community and may share the same language and culture.”

Experts agree that repairing the safety net requires investing in education and making dental careers accessible, especially for a diverse student population.

“A lot of the barriers in the dental workforce for representation and diversity comes from the academic level,” Owen said. “There is a lot of gatekeeping that happens in higher education, especially in health professions. Allocating resources towards recruiting a diverse student population will support a future dental workforce that is representative of the population. Additionally, it’s critical that dental education programs commit to integrating social mission into their curriculum. This will create a workforce that is more culturally responsive.”

At WCCCD, the No. 1 challenge that students from underserved communities face is financial, Freeman said. They also may lack rigorous science and math preparation, which are foundational for oral health programs.

To combat that, WCCCD provides access to scholarships and grants and offers one-on-one advisory programs specially designed for students in health science programs. It offers dual-enrollment partnerships with Detroit-area schools, and it partners with K-12 schools to introduce students from diverse backgrounds to oral health careers early on.

“There is often a lack of exposure to oral health careers in communities with limited access to dental care or role models in the profession,” Freeman said. “If you don’t see these professions in your life, in your community, it’s harder to know that is an option for you.”

By Michelle Fitzgerald, Crain’s Content Studio