Alabama's Dental Crisis

Alabama is facing a shortage of dentists, with nearly half of Alabama’s counties having less than 10 dentists each – and some counties have none at all. 

Alabama has the lowest dentist per population ratio in the country. A third of these dentists are 60 years old or older, and at least half of those practice in rural Alabama – this all means the majority of rural dentists are going to be retiring soon.

Especially affected are residents in rural communities, many of whom have to drive an hour or more to reach any dental care.

Nearly half the dentists who graduate from the UAB School of Dentistry end up leaving the state to practice in states with higher insurance reimbursement rates or to enter specialty programs. “In the last several years, out of a graduating class of fifty-five from our dental school, an average of four go into rural area or small town each year,” stated pediatric dentist Dr. Richard Simpson.

On the Forefront - Pediatric Dentist Dr. Richard Simpson

Alabama-based pediatric dentist Dr. Richard Simpson, DMD, is at the forefront of dental care in the state. His practice in Tuscaloosa serves children from 17 different Alabama counties.

Since the onset of the pandemic, Dr. Simpson has been seeing pediatric patients with increased rates of tooth decay. Dr. Simpson’s practice is also overwhelmed with a constantly increasing number of new patients whose dentists retired or have stopped accepting Medicaid.

“Sometimes we have patients that are driving two hours to get to our office. That’s a burden on the family; working parents have to take off an entire day of work to get their child to the dentist because there’s no one in the area to see them,” explained Dr. Simpson.

Dr. Simpson says it is not necessarily the dentists’ fault that this is happening. “Even if they would like to [serve in rural areas], they can’t afford it,” explained Dr. Richard Simpson. “The average dentist graduating from dental school nationally has over $300,000 in debt. They need immediate income, so they are gravitating toward the large metropolitan areas, not the rural communities and to existing practices.”

“80% of all tooth decay is in 20% percent of children. We see similar scenarios in adults because of lower socio-economic status. In rural areas with decreased access to care, we see a higher disease rate. Studies show that in schools that have at least 75% of students on free or reduced lunch, those students have twice the amount of decay as children in other communities.” Simpson continued.

“We have nowhere else to send them and the waiting list at Children’s Hospital for young children that need this care or special needs kids is almost a year,” Simpson admitted. “So when they do the exam of kids that are in pain and have significant disease state, by the time they’re actually seen is 10-12 months later.”

A Solution that Empowers Rural Communities with Access to Dental Care

TelScope Telehealth System is the teledentistry tool that is capable of empowering anyone, anywhere with access to dental healthcare.

As both an oral examination device and intraoral camera, this system is designed for patients and professionals alike. It is affordable, easy to use, portable, and practical. The tool aims to bridge the gap between doctors, dentists, specialists, and patients.

TelScope is now fully integrated with Virtual Dental Care’s Teledentix app, meaning that patients can connect to a dentist virtually. For rural patients, this saves hours of driving and the hassle of scheduling an appointment. TelScope and Teledentix also limit the back-and-forth, which gives patients peace of mind, eliminates unnecessary visits, and limits further implications of untreated dental issues.

Dr. Simpson sees virtual oral healthcare through telehealth and teledentistry as one of the solutions to addressing the declining rural dental workforce. Connecting dentists and hygienists with each other and with other health care providers treating patients in remote and underserved locations serves as a workforce multiplier and lends itself to more comprehensive and patient centered care.

“I am most excited about the potential for digital triage, screening, and referrals inter-professionally (dental-dental, dental-medical, medical-medical). The ease with which a clinician can illuminate and examine the entire oral cavity and throat, capture images, and then connect and securely transmit those images with any desired mark-up and commentary can greatly enhance efficient and timely referral, improve patient satisfaction, and address the difficulties of access for rural and underserved populations. We have begun fielding TelScopes into several rural pediatric medical practices in our state, and I look forward to seeing measurable results in the near future,” said Dr. Simpson on using the device in his clinic.

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About Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service. 

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