Over Six Million Floridians Are Not Smiling

By Frank Catalanotto, DMD.  

There’s nothing to smile about in Florida this February, which is National Children’s Dental Health Month. The state of children’s oral health in Florida is abysmal, indeed some would say in crisis.  The latest data clearly demonstrates that the oral health of Florida’s children is among the worst in the nation. Even worse, because oral health is directly linked to overall physical health, there most certainly will be long term consequences for many. Because children are our future, this should be concerning to everyone.

6th Worst in Nation for Unfilled Cavities- Many states conduct surveillance studies of oral health for unfilled cavities in third grade children. From the most recent data in 2017???, Florida third graders ranked 6th WORST in the nation with 25% having unfilled cavities.

2nd Worst in Nation for Medicaid Utilization, which is the number and percentage of children who received at least one dental visit in the year. In 2021 there were approximately 2.8 million infants and children up to age 20  enrolled in Florida’s Medicaid program, which means that over 1.7 million Medicaid enrolled children did not have a dental visit in 2021.


Highest Rate of Hospital Emergency Room Visits for Non-Traumatic Dental Care (- When parents have a child with dental pain or infection and they cannot afford to bring the child to a dentist, parents choose to visit a hospital emergency room (ER) which must see the patient.  

  • In 2020, Florida had the highest rate of these visits for those aged 14 and below (26.7 per 10K people) compared to all other states for whom we have 2020 data. The national rate in 2019 (the last year for which we have national data) for children aged 14 and below was 27.3.
  • Of all states for which we have data in 2020, Florida has the highest average charge for non-traumatic ER visits for children aged 0 years ($1.9K), 5 years ($2.1K), 10 years ($2.6K), and 15 years ($2.6K). These charges are 3 – 4 times higher than Maryland, which had the lowest average charges. 
  • For 2021, Florida hospitals billed  $380m558m743 for 116,980 ED visits. Most of this money is wasted dollars since the only care provided for patients is antibiotics and pain medication and the parents are advised to bring the child to dentist the next day. If the parents could not afford a dentist that day, they will not be able to afford a dentist tomorrow.

Life Threatening Child Hospitalizations for Dental infections Preventable dental issues can become life threatening, requiring hospitalization for intravenous antibiotics and pain medication. In 2021, Florida children had 165 hospitalizations for preventable dental issues and Florida hospitals billed out almost $167,327,810 million for this care.

Florida Leads the Nation in Dental Health Professional Shortage Area – almost 6 million Floridians live in communities that do not have an adequate number of dentists. Nearly all (66 out of 67) Florida counties have these shortage areas. Dental care becomes much more difficult when you must travel long distances or wait an extraordinarily long times just to be seen.

Why is good oral health in children important?

A healthy mouth is more than a pretty smile and fresh breath. Decades of scientific literature clearly document the relationship between poor oral health and dental pain in children with increased school absenteeism and poor school performance. Other data demonstrate that missing and untreated cavities can also lead to poor self-esteem in children. The way out of poverty for many poor children is education leading to better paying jobs but you cannot learn if you are in pain. 

Florida Must Solve this Oral Health Crisis

The oral health care system in Florida is broken for many children, especially those with Medicaid or from low income families or living in rural communities and those in racial and ethnic minority groups. 

Floridians for Dental Access is a bipartisan coalition of organizations and individuals working to solve Florida’s oral health crisis. We strongly support evidence-based best practices in modern dentistry and dental hygiene that increase patient health, improve affordability and safely expand access to care through choice and workforce solutions. To learn more, visit https://www.floridiansfordentalaccess.com 

About Dr. Catalanotto, DMD

Dr. Frank Catalanotto is founder and president of Floridians for Dental Access, a bipartisan coalition of more than 60 organizations and individuals actively working to solve Florida’s oral health crisis. He is also Professor in the Department of Community Dentistry and Behavioral Science at the UF College of Dentistry.  He graduated from the College of Medicine and Dentistry of New Jersey and completed a post-doctoral research fellowship in pediatric dentistry at Harvard School of Dental Medicine and Children’s Hospital Medical Center in Boston. The opinions he expresses in this commentary are his own and do not reflect the official opinions of any organization with which he is associated.