Suncoast Community Health Centers’ Mobile Dental Program brings dental care to the community.
The Hillsborough County nonprofit’s rolling dentist office serves low-income children who face substantial barriers to accessing quality care. Frequently, they have extensive dental decay, often with multiple abscesses, and are in constant pain, says Suncoast’s Chief Dental Officer Dr. Aura Cisneros. Because of the pain, they have trouble eating and sleeping at night, and that affects their ability to perform in school.
“We have a case of a two-year-old who needed to have 16 out of his 20 baby teeth extracted,’’ Cisneros says. “He had multiple abscesses that could have led to a life-threatening infection…Imagine, two years old, 16 teeth.”
Some Suncoast patients have Medicaid but can’t find a private dentist who takes it. So it’s like having no insurance at all, Cisneros says.
It’s a crisis of dental access and it’s a statewide problem. To address it, Cisneros supports a solution proposed by Floridians for Dental Access, a coalition founded by Dr. Frank Catalanotto, Professor Emeritus and former dean of the University of Florida College of Dentistry.
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Dr. Frank CatalanottoThe group has spent years urging the Florida Legislature to address the state’s dentist shortage and access to care issues by allowing dental therapists, licensed professionals working under the supervision of a dentist who can provide routine dental care. They can take and interpret X-rays, prepare treatment plans, fill cavities, and extract baby teeth and loose adult teeth. They can’t do root canals, implants, dentures, or permanent crowns. But for the procedures dental therapists are allowed to do, they take the same tests as dentists do, says Catalanotto.
“In the 2024 exam, they actually performed better than dentists did,” he says.
So far, 14 states have passed laws allowing licensed dental therapists and enabling them to practice under the supervision of dentists. The Florida House passed a bill in the 2025 session but it died in committee in the Florida Senate.
Scope of the problem
Statistics from Floridians for Dental Access show the magnitude of the state’s problem. Florida ranks 37th out of 50 states in the number of children who received dental health services within the previous 12 months. One in four Florida third graders has untreated cavities, the sixth worst rate in the nation.
In Hillsborough County, just 32 percent of children six and younger who are enrolled
in Medicaid had a dental visit in the previous year. For ages 7 to 20, the figure was 28 percent. In Pinellas, 27 percent of Medicaid-enrolled children six and under and 29 percent of 7 to 20-year-olds had one dental visit.
Florida ranks 42nd in the nation in access to dental care. Six million Floridians live in areas where dental services are limited or nonexistent, Catalanotto says. The statistics are from 2021, but he says the situation hasn’t changed substantially since then.
In light of those concerning numbers, Catalanotto says Floridians for Dental Access will be back for next year’s session in Tallahassee advocating for dental therapist legislation
He says in Florida and across the country, the only group opposing the effort is “organized dentistry.” Often, dentists question the quality of care.
But Catalanotto says no data exists to support that position. Every published study supports the quality, safety, and cost of seeing a dental therapist.
“It’s competition, it’s fear of the unknown,’’ Catalanotto says.
Dentists in Minnesota resisted allowing dental therapists, but the legislature passed the measure about 12 years ago. At first, private dentists refused to hire dental therapists, so most worked at community health clinics. Catalanotto says now about 50 percent of them work for dentists.
Because dental therapists are less expensive to educate and hire, “all of a sudden Medicaid becomes affordable to do in a dental practice,’’ he says.
Fluoride ban concerns
Dentists tend to agree on one thing. They expect Florida’s children will be dealing with a lot more cavities after the state ban on fluoride in drinking water begins July 1st. Among those opposed to the ban are the American Dental Association and the CareQuest Institute for Oral Health in Boston, Mass.
In an article in the Journal of the American Medical Association, Harvard School of Dental Medicine faculty members Sung Eun Choi and Dr. Lisa Simon estimated that removing fluoride from the nation’s drinking water would result in 25 million more cavities in the next five years, at a cost of $9.8 billion. Choi says it would disproportionally affect publicly insured and uninsured children “who already face a high risk of unmet dental needs.’’
Cisneros agrees.
“Water fluoridation is one of the most effective evidence-based strategies for
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Dr. Aura Cisneros preventing tooth decay, and it is particularly important for a state like Florida,” she says. “Florida has a diverse, growing population, many under-served with limited care. Fluoridated water provides a baseline.’’
People can buy fluoride supplements, such as drops to put in water. But for people who are struggling financially, if they have $5 to spend on bread and milk or fluoride drops, they’re going to choose the bread and milk, Cisneros says.
The costs of lack of access
Lack of access to dental care can lead to bacterial infections of the brain and heart. Catalanotto says that in adults, periodontal disease can result in three major health problems: low birth rate or preterm babies; trouble managing diabetes; and heart disease.
Floridians for Dental Access statistics show that 258 people in Hillsborough were hospitalized in 2021 for life-threatening infections from preventable dental conditions, at a cost of more than $11.8 million. In Pinellas that year, 153 people were hospitalized, with a cost of $7.2 million.
There are nonprofits in Hillsborough and Pinellas counties that provide dental care for people who can’t afford it. Tampa Family Health Centers and St. Pete Free Clinic are among them. But community health centers throughout the state are overwhelmed, Catalanotto says.
Suncoast Community Health Centers has six fixed locations for dental services and operates two buses that serve as mobile dental clinics, says Cisneros. They make regular visits to agencies that help the under-served communities, such as the Children’s Board Family Resource Centers in Brandon, Plant City, and Ruskin.
If dental therapists were allowed to practice, Cisneros says, they could act as a stop-gap, fixing problems like cavities before they became a life-threatening health issue.
Desperate people go to hospital emergency rooms hoping for emergency dental treatment. Figures show that 7,788 people in Hillsborough went to hospital emergency rooms seeking help in 2021, costing $26.6 million. In Pinellas, 5,197 people sought help in emergency rooms, with a cost of $21.4 million.
But it’s a myth that emergency rooms can do dental work, Catalanotto says.
“They’re required by law to see you,’’ he says. “But they can’t treat you. They give you antibiotics and pain medication and they tell you to go see a dentist tomorrow. That’s not a situation that works.’’
For more information, go to floridiansfordentalaccess.org, suncoast-chc.org and childrensboard.org.