Access to Dental Care for the Working Poor

By: Fatima Naqvi, Class of 2020

Communities across the United States have increased their number of “dental care events,” which are events offered to individuals who have neither dental insurance nor the means to pay for routine dental treatment. When such events occur, hundreds of people often line up for hours in order to see a dentist and receive treatment for their current pain or immediate illness. Surprisingly, while one may expect that such individuals are unemployed, many of them actually hold steady jobs; they are librarians, construction workers, postal workers, and more [2]. A main reason for their attendance at these events is that, although they have full-time jobs and incomes, these incomes fall outside of the Medicaid income range requirement [1]. Consequently, despite being active contributors to the workforce, many of these hard-working Americans, these “working poor,” are unable to secure comprehensive dental care insurance plans or pay for dental treatment out of pocket, because of current healthcare legislations. Such legislations limit dental care coverage in medical insurance plans to just children, and adults are required to attain separate dental insurance plans that require large out of pocket payments [1]. To further complicate matters, plan benefits vary by state.

This is a complex problem. Limited dental care access for the working poor is a topic discussed in journals, magazines, schools, offices, and documentaries across many medical disciplines. At Penn Dental Medicine, second year students take a course called Behavioral Sciences: Local and Global Public Health. This course provides students an opportunity to learn through lectures, seminars, and documentaries about current issues regarding dental care access. As part of the class, I have read multiple articles and have watched the PBS documentary “Dollars and Dentists,” highlighting how difficult it is for hardworking Americans to gain access to dental care on a regular basis. Issues including, student debt, limited and incomprehensive insurance plans, ill-informed health legislations, and current practices in dentistry are discussed in great detail as part of the course.

However, solutions to this problem are unclear. I believe that it is medically and scientifically incorrect to separate the oral health component from an individual’s general health. Oral health enables individuals to chew properly and attain adequate nutrition. It enables people to socially interact. Any form of pain due to teeth or other oral diseases can be very debilitating and can significantly decrease the quality of life for individuals. Therefore, I would recommend that new legislations need to be passed that recognize the importance of oral health in terms of maintaining an individual’s general health. Legislations should be created to enforce laws on private and government insurance companies to provide comprehensive dental services as part of their medical plans [1]. In addition, dental students are graduating with enormous amounts of debt, limiting their ability to practice in areas that have shortage of dentists or patient populations unable to pay for dental services. Additional repayment plans for dental students and new legislation to address the rising costs of dental schools should be created to enable dentists to accept Medicare rates and expand their scope of dental practice. Furthermore, it is completely unacceptable for individuals who are working hard to wait in lines for dental care that occurs rarely as part of community trips. Although these community trips does help patients get relief from their oral pain, most of these treatments are extractions due to limited funds and time. Comprehensive dental care is difficult to provide in these community events and people are not receiving continual dental services in order to maintain their oral health [1]. Additional community programs need to be implemented to help the working poor maintain their oral health.

Although people are gaining greater awareness of the weaknesses in our health insurance systems, particularly in relation to  dental care access, more can be done. It is imperative for dental students, current dentists, and public health professionals to work together to improve access to dental care for all individuals in the country, regardless of their ability to pay.


Hupp, James. “Dental Care for the Working Poor—We Need Answers.” Journal of Oral and Maxillofacial Surgery, vol. 75, no. 10, Oct. 2017, pp. 2033–2035., doi:

Jordan, Mary, and Kevin Sullivan. “The Painful Truth About Teeth.” The Washington Post, WP Company, 13 May 2017,

About the Author: Fatima Naqvi is currently a D2 and a contributing editor for Penn ASDA.