Reaching Vulnerable Populations through Portable and Mobile Dentistry-Current and Future Opportunities
Lack of access to dental care is an ongoing problem. In 2018, the US House of Representatives
passed the Action for Dental Health Act of 2017. This act is meant to prevent dental disease,
divert dental emergencies from emergency rooms to dental offices, and reduce barriers to dental
care. Portable and mobile dentistry is a great way to achieve these goals. In a review article
published in August 2019 in the Dentistry Journal, the authors summarized the opportunities and
limitations associated with portable and mobile dentistry. 1
Portable and mobile dentistry have been shown to be particularly helpful for people that rely on
others for transportation, such as children and the elderly. Additionally, portable and mobile
dentistry has the potential to help institutionalized individuals that are medically fragile and
unable to leave the facility.
A fantastic example of a success story for pediatric patients is the St. David’s Foundation Dental
Program. This program has a fleet of nine mobile dental vans that cover 3 counties with 6 school
districts in Central Texas. The program offers free preventive and restorative dental care
delivered at the school in the van. Research has shown that children that do not receive routine
dental care are three times as likely to miss school due to dental pain than children that receive
routine dental care. Portable and mobile dentistry that delivers care to the children at school
overcome multiple barriers including transportation, parents missing work, and children missing
school due to dental pain.
Fifty thousand eight hundred eighty-one, that is the number of ER visits per year due to basic
dental complaints in the over 60 population. Sadly, 63.4% of those visits were covered by
Medicare, yet Medicare often does not cover routine dental care. The Program of All-inclusive
Care for Elderly (PACE) in Cambridge, MA is an interdisciplinary program that helps keep the
elderly out of the ER’s and nursing homes. The program collaborates with multiple disciplines of
healthcare including dental healthcare providers to come up with a care plan. This program can
utilize portable and mobile dentistry for patients to achieve optimal oral health care.
Other promising opportunities to utilize portable and mobile dentistry is to provide on-site care
for large employers. Having dental care on-site reduces the number of hours missed from the
workday. Additionally, in areas with very small populations, portable and mobile dentistry may
be more sensible than a fixed practice. There are also opportunities to provide more customized
care to some local populations. This could benefit populations with language barriers, having a
dental staff that speaks their first language can open many doors to access to care for these
populations, portable and mobile dentistry is a great option for these populations which might
otherwise feel isolated.
Portable and mobile dentistry is not without limitations. Some of the challenges include state
regulations. Fourteen states require a specific permit and have specific regulations that must be
followed for portable and mobile dentistry. For example, Arkansas charges $5000 for a mobile
clinic permit, while California charges $100 for the same permit. Some of the regulations restrict
the potential to provide care to certain populations. Louisiana requires pediatric patients to be
treated in private rooms, while Texas regulations require a parent to be present in order to bill
Medicaid. These regulations inhibit some of the potentials for portable and mobile dentistry.
Another big hurdle is the lack of availability for follow up management in the event of any
complications following treatment.
With all the benefits and limitations taken into consideration, the authors concluded “ If a dental
team can overcome the barriers of entry into this field, a highly satisfying and efficient work
environment can be established, with strong benefits of convenience to the patients they serve.
The beneficial impact of portable and mobile dentistry on health can be particularly evident in
schools serving children, in nursing homes serving the elderly, and in rural and remote
communities in which access to care remains a challenge.”
Have you worked in portable or mobile dentistry? Do you believe portable and mobile dentistry
has the potential to assist in the lack of access to care in the US? Do you think portable and
mobile dentistry programs should be easier to start up to better serve patients in need?
1. Gupta S, Hakim M, Patel D, et al.. Dent J (Basel). 2019;7(3):75. Published 2019 Aug 1.
doi:10.3390/dj7030075
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