Oral Health Disparities Among African Americans

By Damien Cuffie, DDS, MPH

People of color and other marginalized groups in the U.S. disproportionately experience health inequities, and African Americans “bear the brunt” of influencing factors such as lack of insurance, lack of access and inferior outcomes, according to the Century Foundation.

Oral health inequities are also apparent within this scope. Though disparities in oral health are preventable, they are unfortunately prevalent among African Americans.

For example, among working-age American adults (20 to 64), untreated cavities are twice as prevalent non-Hispanic Black adults (40%) compared to non-Hispanic White adults (21%), says the Oral Health Surveillance Report by the U.S. Centers for Disease Control and Prevention (CDC). The same report reveals that for adults older than 65, untreated cavities are three times as common among non-Hispanic Black adults (28%) compared to non-Hispanic White adults of the same age (9%).

Nearly one in six Black adults (16%) reported losing at least six teeth due to tooth decay or gum disease - much higher rates than white (12%), Hispanic (9%) or Asian (3%) adults, according to a study by the CareQuest Institute for Oral Health. The same study shows that African American adults are at least 2.5 times more likely than white, Hispanic or Asian adults to visit a hospital emergency department for dental care. Such last-resort efforts can be a strong indicator that patients lack oral health insurance and/or a dental home where they can access regular, preventive care.

Prevention is integral to address disparities in the incidence of oral cancer. The National Cancer Institute notes that oral cancer mortality rates are highest death rates for cases are among non-Hispanic Black and White adults. Most oral cancer cases (about 60%) are detected when they have already reached an advanced stage, according to the Journal of Evidence-Based Dental Practice. This is another example of the need for dental homes, where practitioners can screen for oral cancer during routine checkups. Other proven approaches to oral-health protection, especially those at highest risk, include dental sealants and tap-water fluoridation, which reduce the rate of cavities, says the CDC’s Division of Oral Health.

Tackling Social Drivers of Oral Health for African Americans

Everyone deserves good health, and increasing oral health equity is integral to this vision. That includes making dental health coverage more widely available, opening or expanding practices to cover areas without dentists, and addressing barriers to care such as inadequate transportation and inflexible working hours. All these negative factors disproportionately affect poor Black and Brown Americans, says CareQuest.

Addressing the social drivers of oral health is central to DentaQuest’s mission to improve the oral health of all. For example, we encourage expanded dental office hours as just a small part of Preventistry, our work to help patients live healthier lives. Also, we regularly support grassroots projects that focus on social determinants of oral health.

We support our provider partners in delivering quality, prevention-focused dental care by providing a network that's easy to work with, simplifies administration and gets claims paid fast. Dental offices can click here to learn about joining the DentaQuest provider network.