Dental providers in Vermont lack effective treatments, new report finds

Many Vermonters have poor or no access to dental care, and the state is losing dentist providers, according to a new report released Thursday.

Vermont Oral Health Equity Landscape ReportThe study, published by the nonprofit Voices for Vermont Children, found that over roughly the last half-decade, Vermont has been losing dentists at a faster rate than nearly any other state and has seen a decline in children’s dental health.

The state has also been slow to implement new dental procedures (noninvasive methods) that could easily and inexpensively improve the oral health of many Vermonters, according to the report.

“It’s very clear that oral health is an important component of overall systemic health,” Michelle Fay, executive director of Voices for Vermont’s Children, said in an interview. “And the system we have in place is not working.”

According to national data from the American Dental Association cited in the report, Vermont had about 60 dentists per 100,000 people in 2019; This roughly corresponds to the national rate.

The state reached this figure “after years of strong hiring and policy incentives aimed at supporting the dental workforce,” the report says. But the Covid-19 pandemic erased those gains: By 2023, Vermont had just 53 dentists per 100,000 people; This represents the steepest decline in the country, according to the report.

The number of dental hygienists working in the state also decreased by approximately 4% from 2015 to 2021, according to data cited in the report. The report notes that the number of public health dental hygienists employed by the Vermont Department of Health has decreased from five pre-Covid-19 to one currently.

The state is also having difficulty adding dental therapists, professionals who perform routine dental care, to the ranks of general practitioners. Last year the state of Vermont auditor found He said Vermont State University has failed to support a dental program even after seven years and a $2.6 million investment of public funds.

One bright spot noted in the report is Vermont Medicaid’s dental care coverage. Overall, Vermont dentists see more Medicaid patients than other states, but Medicaid reimbursement rates for dental care were mixed: reimbursement rates for adults were relatively high, while rates for children’s dental care were in the middle of the pack nationwide.

Still, Fay said it’s not easy to access dental care as a Medicaid patient. Some dentists might think, “I’ll theoretically accept a Medicaid patient,” Fay said, “but only if I haven’t filled all my slots with private pay or higher-reimbursement insurance.”

The report also notes that Vermont providers have been slow to adopt new, inexpensive and minimally invasive dental procedures. Two in particular are mentioned in the report: silver diamine fluoride and silver-modified atraumatic restorative technique, methods in which protective materials are applied to the outside of the teeth.

These procedures can have a significant impact on the dental health of Vermonters at low cost, the report states.

Voice of Vermont Children recommends that the state invest in low-cost dental facilities and procedures throughout the state, including the integration of dental facilities with primary care facilities. The state’s health department should also consider a public education campaign focused on oral health, the report says.

“The key is the need to think differently about integrating oral health into overall health and use all available treatment models to meet the needs of these communities,” Fay said.