Challenges and Opportunities for Oral Health 

in Communities of Color 

Minority Health Perspective by Hazel Harper, DDS, MPH


Closing the Gap, Oral Health • July 1999


Oral health care poses special challenges to American communities of color. As never before, we need innovative and creative partnerships between oral health professionals, 

and the consumers and communities they serve, to transform those 

challenges into opportunities. 

The United States continues to experience a slow but profound 

shift in its demographics as communities of color increase in numbers 

and influence. The U.S. population grew by nearly 19 million people 

between 1990 and 1997, according to the U.S. Census Bureau, with 

approximately two thirds of this growth due to racial and ethnic 

minority populations. 

If this population trend continues, we would need to triple the 

number of minority dentists in our health professions workforce by 

the year 2050, according to Murdoch and Hoque, writing in a 1998 

issue of the Journal of the American College of Dentistry. But there are 

other facts and trends that should disturb us all. 

The number of dental school graduates has declined between 

1986 and 1997. Little has changed in numbers of African American 

and American Indian dental graduates in this last decade, and the 

number of Hispanic dental graduates peaked in 1990, then dropped 

significantly, according to the American Dental Association Survey 

Center. 

Some 80 percent of Medicaid eligible children—who are disproportionately minority—do not receive preventive dental services, according to a 1996 report of the HHS Inspector General. Other measures of minority oral health continue to shout for corrective action 

and greater public attention. 

Public and private insurance combined still cover just half of 

U.S. dental care expenditures, according to the National Center for 

Health Statistics. So increases in employment and socioeconomic economic status among minority populations—which still lag the U.S. 

national rates—do not automatically translate into improved dental 

coverage and access to care. 

These factors have translated into poor oral health status among 

American communities of color. 

Consumers deserve quality care. Providers deserve fair and equitable compensation. Patients and providers must always have options 

and the right to choose. Patients should have access to managed care 

organizations that provide education, outreach, preventive services, 

quality care, and a broad scope of services. Compromises in the standards of care are unacceptable. 

There is much to do. We must make a firm commitment to 

eliminating the health disparities caused by differences in education, 

employment, income, and wealth, as well as by racism and access to 

care. We must improve the ratio of minority dentists to minority 

patients by recruiting and retaining more minorities into the profession. We must encourage providers to serve in areas where they are 

needed most. We must measure the success of our health delivery 

system in terms of health outcomes and patient satisfaction rather 

than merely profit margins. We must hold up high standards of care, 

and high goals for success. And we must focus on patients’ rights, 

human rights, and civil rights. 

The National Dental Association (NDA) is dedicated to improving the oral health of all Americans, with special emphasis on the 

underserved. The NDA embraces the philosophy that health care is a 

right, not a privilege. As such, the NDA is dedicated to serving as 

advocates in the legislative arena and private sector in order to increase 

access to care in communities of color. 

The NDA’s mission is to enhance the skills of its members, recruit 

underrepresented minorities into the profession, and create opportunities for research between its members and the communities they 

serve. As an organization, the NDA knows that many of today’s concerns will follow us into the next century. 

Members of the NDA are not just clinical practitioners; they are 

active members in their communities. They can give training sessions 

on ways to prevent oral diseases, participate in career counseling programs, and assist in regional and local efforts to recruit minorities into 

health careers. 

If you need help in developing and/or carrying out a dental program, 

contact your neighborhood dentist or the NDA, 3517 16th St, NW, 

Washington, DC, 20010, 202-588-1697. Dr. Harper is past president 

of the National Dental Association.

Office of Minority Health Resource Center U.S. Department of Health and Human Services