Drilling Down to the Roots of Arkansas’s Poor Oral Health

Since 2013, March 20 has been designated World Oral Health Day, an observance dedicated to raising global awareness of oral health issues. Oral disease can affect a person’s quality of life and lead to significant health problems, such as heart disease, pneumonia, and endocarditis, an infection of the inner lining of the heart chambers. Oral disease in pregnant women has also been linked to premature birth and low birth weight. Nearly 3.5 billion people worldwide have oral disease, according to the World Health Organization.

Arkansas Ranks Low in Oral Health

Surveys show Arkansas ranks low among states in oral health. The America’s Health Rankings 2024 Annual Report notes that Arkansas has the second-lowest rate of dental visits in the nation, with just 55.6% of adult Arkansans reporting that they visited a dentist or dental clinic in the past year.

According to a 2024 Arkansas Department of Health report, 69.2% of Arkansas high school students reported having visited a dentist within the past year, compared to 75.9% nationally. Among Arkansans 65 and older, 21.9% had no natural teeth, compared to 11.8% nationally. And untreated tooth decay was detected in 17.7% of Arkansas third graders.

Cost is the No. 1 barrier to dental care in the state. In a 2015 survey, 72% of Arkansas adults who had not been to a dentist in the previous 12 months cited cost as a reason, far more than the 19% who cited the second most common reason, fear of the dentist. As of 2023, more than 90% of Arkansans had health insurance, but dental insurance is much less common in the Natural State. For a 2022 study, researchers with ACHI and the Delta Dental of Arkansas Foundation reviewed insurance claims data in the Arkansas Healthcare Transparency Initiative’s All-Payer Claims Database and found that just 54% of Arkansans had evidence of dental coverage in 2019.

Even among Arkansans who have dental insurance, however, use of dental services is low. ACHI and the Delta Dental of Arkansas Foundation found that only 30% of adults and 51% of children 18 or younger used any dental services in 2019.

Access to Dental Services

The study also found that use of dental services tends to be lower in rural parts of the state, where residents may have less access to dentists. Thirty-seven percent of the state’s rural county residents visited a dentist in 2019, compared to 40% of urban county residents.

Eleven Arkansas counties had dental provider shortages as of 2019, with a shortage area defined by the Health Resources and Services Administration as a ratio of 5,000 or more residents per dentist. Arkansas’s shortage areas were in Chicot, Cleveland, Lafayette, Lawrence, Lee, Little River, Newton, Pike, Prairie, Scott, and Woodruff. Two of those counties, Cleveland and Lafayette, had no active dentist in 2019.

The study’s findings also suggest a link between lack of preventive dental care and dental emergencies. Among Arkansans with private, Medicaid, or Medicare Advantage dental insurance who sought dental care in an emergency department in 2019, over 90% had not received any preventive dental care in the previous 12 months.

Arkansas Fluoridation Program

Arkansas is ranked above most states in one metric of oral health: the percentage of its population served by communal water systems that add fluoride to the water to help prevent tooth decay. The state’s fluoridation program launched in 2011. By 2020, about 86% of Arkansas’s population, or 2.9 million people, had access to fluoridated tap water, the 20th highest percentage in the nation, according to the Centers for Disease Control and Prevention. Bills have been filed in the 2025 regular session of the Arkansas General Assembly to repeal or weaken the state’s fluoride program, however.

Improvement Efforts

One factor in Arkansas’s dental provider shortage is its lack of a dental school, but that will soon change. The Lyon College School of Dental Medicine in Little Rock is on track to welcome its first class of students in June. ACHI Interim President and CEO Craig Wilson, a Lyon alum, has written about the planned school for Talk Business & Politics.

Numerous ideas for improving oral health in the state are offered in Arkansas Oral Health Plan 2023-28, a report developed by the Arkansas Oral Health Coalition and the Arkansas Department of Health Office of Oral Health. The report provides a roadmap to better oral health through improved access to care, educational outreach, prevention efforts, and proposed policy changes. Among the latter are:

• Adding oral health screenings to the school-based health screenings that are required for students (currently limited to vision, hearing, scoliosis, and body mass index screenings).
• Empowering school nurses to apply fluoride varnish.
• Ensuring dental coverage options for special needs adults and people between coverage plans.
• Promoting universal dental coverage through Medicare.

Some dental providers in Arkansas are working to reduce barriers to care by offering free or reduced-cost services. Dr. Terry Fiddler, executive director of Arkansas Mission of Mercy, recently appeared on our podcast, Wonks at Work, to discuss his organization’s work organizing free, pop-up dental clinics around the state.

“This will be our 18th year of providing free services,” Fiddler said. Between 2007 and 2024, “we saw 27,000-plus patients and (provided) almost $18 million in free dentistry.”

The organization’s next free clinic will be April 11-12 at the Conway Expo Center.

More information about free, sliding-scale, and Medicaid dental clinics is available at FreeDental.org.