Florida Faces Dental Care Crisis: Can Dental Therapists Bridge teh Access Gap?
Florida is grappling with a severe shortage of dental professionals, leaving nearly 6 million residents in areas designated as having a critical need for dental care. Access is so limited that residents in some counties have only a fraction of the dental providers available to those in more populated regions,sparking a debate over whether expanding the role of dental therapists could alleviate the growing “oral health crisis.”
The disparity is stark. According to recent data, 65 of Florida’s 67 counties are facing shortages. In Alachua County, residents have access to roughly 11% of the dental providers found in Miami-Dade County. While Alachua County has 206 providers, surrounding rural counties fare far worse: Levy County has just 10, Bradford has seven, and Gilchrist County only four.
“We clearly have the data that says this is a huge problem in Florida,” stated Dr.Frank Catalanotto, professor emeritus at the University of Florida College of Dentistry. “The problem is getting the political will to do something about it.” The idea of utilizing dental therapists – mid-level providers who perform preventative and restorative work under the supervision of a dentist – gained traction after a successful model was implemented in other countries. “We were looking around for another model,” he explained, “and they found these dental therapists in literature.” Following a successful pilot program in the Yukon-Kuskokwim Delta starting in 2006, 14 states have now adopted the dental therapy model. Findings from that program suggested increased treatment days with dental health aide therapists (DHATs) were linked to more preventative care and fewer extractions.
However, implementing dental therapy in Florida faces significant hurdles. “Obviously, dentists as a group are conservative, fearful of change,” Catalanotto said. “They have a monopoly on dental care.” A bill (HB 21) aimed at introducing dental therapy passed in the Florida House this year but ultimately stalled in the Senate. Catalanotto alleges the Florida Dental Association (FDA) is actively opposing the measure.
The FDA argues the issue isn’t a lack of dentists, but rather a financial one. “There really isn’t a shortage of dentists,” asserted Bertram Hughes, an FDA board member and general dentist with 35 years of experiance in Florida’s Medicaid system. “We have about 14,000 to 15,000 dentists in the state of Florida.”
Hughes contends that dentists are simply not incentivized to practice in rural areas due to low Medicaid reimbursement rates. Florida currently ranks last in the nation for Medicaid reimbursement rates for children’s dental services. While the state sets fee schedules, Managed Care Organizations frequently enough reimburse providers at rates considerably below those benchmarks. “They took the money and then never appropriated it for the dentist,” Hughes claimed. “They just put it in their pockets.” With new dentists often graduating with between $300,000 and $400,000 in student debt, practicing in rural areas becomes financially unsustainable. “If you look at the fees being offered,they’re about 20 to 22 percent of what usual and customary rates are,” Hughes said. “You can’t pay another layer of care when the numbers don’t work.”
Supporters of dental therapy counter that these providers can definitely help reduce costs and alleviate pressure on emergency rooms. Scott Darius, executive director at Florida Voices for Health, a health advocacy institution, emphasized the financial burden of untreated dental issues. Residents in areas with limited access often delay care until problems escalate, requiring costly emergency room visits.According to Floridians for Dental Access, there were 4,012 hospitalizations for nontraumatic dental conditions in 2024, resulting in $281,660,948 in hospital charges.
“We spend half a billion dollars for dental care that was completely preventable in ER settings,” Darius said. “that’s just money we’re flushing down the drain because we’re not getting people access to care.” Dental therapists, capable of performing procedures like fillings and extractions, could divert patients from emergency rooms to more affordable care settings.
Floridians for Dental Access is aiming to pass legislation by the 2026 legislative cycle. Catalanotto is optimistic, noting that eight Florida universities have expressed willingness to host dental therapy programs, which can be completed in two full-time years. “Dental therapy is not a radical idea,” Catalanotto concluded. “It’s a proven model that’s been working for decades in other states and countries. It’s about giving people access to basic care.”
