Oral Health: Florida’s Unrecognized Public Health Crisis

COVID-19. Toxic blue-green algae. Asthma. Monkey Pox. Hardly a day goes by without a public health challenge making headlines in Florida. A growing, yet often unnoticed, public health crisis is the rotten state of many Floridians’ teeth and gums. 

Oral health problems don’t just affect an individual’s teeth. They affect our physical health as well as our self-image, emotional well-being, and even the ability to chew, speak, kiss, or smile – the very essence of our humanity. 

An epidemic five times more common than asthma

“The connection between oral health and overall health and well-being is well-documented,” stated Dr. Frank Catalanotto, founder of Floridians for Dental Access, a coalition of 60 organizations working to increase dental access in Florida. “Many systemic diseases and illnesses have been linked to tooth decay and periodontal disease,” he added.

Sometimes untreated dental problems can even cause  needless deaths. Deamonte Driver from Maryland was just 12-years old when a tooth infection travelled to his brain. Preventive care and even an $80 tooth extraction could have saved his life but his family was poor and they couldn’t find a dentist that wasn’t booked out weeks in advance. His death galvanized important reforms in his state.

Poor oral health also affects the next generation through pregnancy complications. And untreated dental pain impairs a child’s ability to learn in school. Tooth decay is considered to be an epidemic among Florida’s children that’s five times more common than asthma. More than 23% of 3rd graders in Florida have untreated cavities. 

66 of Florida’s 67 counties have designated Dental Health Professional Shortage Areas

Florida leads the nation in the number of people living in areas where there is a lack of dental care, according to the U.S. Department of Health and Human Services. On average, people who lack access to dental care have less money, fewer teeth, more cavities, and poorer overall health.

One in four Florida residents – 6 million Floridians – live in areas lacking a sufficient number of dentists (federally designated Dental Health Professional Shortage Areas).

Most dentists in Florida are concentrated in large urban counties, with very few dentists in many rural counties. Three counties – Dixie, Glades, and Lafayette – are reported to have no dentists at all. State health data show three other counties – Union, Gilchrist and Franklin – each had just one dentist. 

Not only is there a shortage of dentists, but also a great number who DO NOT accept Medicaid. Of the 11,475 dentists in Florida, fewer than one in five (18%) will accept Medicaid. Yet, 60% of Florida’s children receive Medicaid. 

The result? Only 43.1% of Florida children received any dental service in 2020, much lower than the national average (52.3%). Children who encounter the greatest barriers to receiving dental care are Medicaid recipients, those with low income, people of color and those for whom English is not their primary language.

Taxpayers Foot the Bill for Preventable Problems

In 2019, Florida hospitals charged more than $630 million for hospital emergency department   visits and actual hospital admissions related to preventable dental health issues. Florida taxpayers take the financial hit, with Medicaid paying for nearly 40% of these visits and rising health care costs.


Lower-income families spend 10 times more proportionally of their income on dental care than higher-income families.  In addition, 31% of low-income adults in Florida report that the condition of their teeth affects their ability to interview for a job, which is higher than the national average. 

Even though Florida has made some attempts to promote access to dental, such as loan forgiveness for dentists practicing in rural communities and expanded mobile dental clinics, the problems persist and are pervasive.

Roy Miller, president of American Children’s Campaign, remarked that a very knowledgeable colleague told him “philanthropy for children to visit dentists is not a health care system.” Miller went on to say, “Improving oral health is a commitment all advocates must make, across every system of care.  We are encouraged by our initial outreach to them.”