May 28, 2004

Latinos have access problems to dental care

There is a severe shortage of Latino dentists in California, resulting in difficulties for nearly one-third of the state’s population in accessing proper dental care, according to a study by the UCLA Center for the Study of Latino Health and Culture.

Only 4.6 percent of all dentists in California are Latino, while Latinos comprise 32.4 percent of the state’s population, the study states.

The fact that Latino dentists are found at less than one-sixth the rate of the Latino population indicates there are some major problems in the state’s education system, said David Hayes-Bautista, professor of medicine, director of the center and the study’s principal author. The issue isn’t that only Latino dentists can or should see Latino patients, but that they have been the one population of dentists that has demonstrated a willingness to work in those shortage areas, he said.

“If access to higher education had been evenly distributed across all of the state’s populations, about one-third of all dentists should have been Latino,” he said. “The fact that only one-20th of them are Latino is a symptom that educational access is not evenly distributed.”

The Latino dentist shortage also can be seen in the ratio of population per dentist. In California, there are 950 non-Latino Californians for every non-Latino dentist. For Latinos, there are 9,446 people for every Latino dentist, a ratio nearly 10 times higher.

“On a population-per-dentist basis, Latino dentists face nearly 10 times as many patients as a non-Latino dentist,” Hayes-Bautista said.

The magnitude of the shortage also can be seen if the ratio per dentist for the non-Latino population in California is applied to the Latino population. If there were one Latino dentist for every 950 Latinos, there should have been 11,544 Latino dentists, nearly one-third of the state’s total dentists. There are only 1,161 Latino dentists, 10,383 fewer than if there was parity in the state.

“If there were greater parity among dentists, the access to dental care in the underserved Latino community would be greater,” he said.

Researchers found that Latino dentists are far more likely than non-Latino dentists to locate their practices in heavily Latino areas and to speak Spanish. While any dentist can decide to practice in a shortage area and learn to speak Spanish, statistics show that most non-Latino dentists choose not to do so, while most Latino dentists do choose to do so.

“The issue is not that only Latino dentists can, or should, see Latino patients,” Hayes-Bautista said. “The issue is that Latino dentists are more than 30 times more likely than non-Latino dentists to choose to speak Spanish and practice in a heavily Latino area. If we only train a limited number of dentists every year, we have to optimize the number of graduates willing to make those two choices.”

Several options are available to begin to address the Latino dentist shortage. Increasing recruitment, admissions and retention efforts for Latino dental students is one way to increase the number of dentists practicing in shortage areas. Prior to 1970, the state’s dental schools graduated an average of two to three Latino dentists per year. Recruitment and admissions programs raised the total to a high point of 43 Latino graduates by 1982. Since then, the number has declined drastically to less than 20 per year during the 1990s.

“The fastest, most efficient way to get dentists who choose to speak Spanish into shortage areas is to increase the number of people, such as Latinos, who have demonstrated concretely their willingness to make those choices,” Hayes-Bautista said.

In addition, non-Latino dentists should be provided with incentives to learn to speak Spanish and to practice in shortage areas, he said.

“While it is important to increase the number of Latino dentists, it also is important to train non-Latino dentists in culturally effective ways of providing dental services,” Hayes-Bautista said.

Another way to increase the number of dentists serving the underserved Latino community is to consider international dental graduates as a temporary bridge, he said.

Assembly Bill 1045, authored by Assemblyman Marco Firebaugh, D-South Gate, allowed for the entry of 15 dentists trained in Mexico to practice under close supervision in rural shortage areas, Hayes-Bautista said.

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