The Real Reason Patients Avoid the Dentist: Understanding Barriers to Dental Care
- OroMed
- Jan 8
- 5 min read
Ask almost anyone when they last saw a dentist, and you’ll hear a familiar hesitation. Not because people don’t value oral health, but because getting dental care is often harder than it should be. Time off work. Transportation. Cost. Fear. Past experiences. Separate insurance. Separate appointments. Separate buildings.
These aren’t personal failures. They’re system failures.
At OroMed, we work alongside community health centers every day, and we see this pattern clearly: when dental care is difficult to access, patients don’t just skip cleanings, they lose an essential entry point to prevention. And because of the oral systemic connection, those missed opportunities ripple far beyond the mouth.
Understanding, and removing, the barriers to dental care isn’t just about improving oral health. It’s about improving whole-person health, equity, and outcomes.
Barriers to Dental Care Are About More Than Access
When we talk about barriers to dental care, cost is usually the first thing that comes to mind. And yes, affordability matters. But the reality is far more complex and far more human.
Common barriers include:
Time: Dental visits often require separate appointments during work hours, childcare arrangements, and additional transportation.
Geography: Many communities, especially rural areas, are designated Dental Health Professional Shortage Areas.
Fear and anxiety: Dental fear is real and often rooted in past pain or trauma.
Stigma: Patients may avoid care due to embarrassment about the condition of their teeth.
Fragmented systems: Dental care lives outside the medical system, with separate insurance, records, and referrals.
According to the CDC, adults with lower incomes are significantly more likely to have untreated cavities and less likely to have seen a dentist in the past year, despite having greater health needs overall.
When these barriers stack up, dental care becomes optional, something patients intend to do “someday.” Unfortunately, health doesn’t wait.
The Oral Systemic Connection Raises the Stakes
Skipping dental care isn’t a neutral choice. The mouth is deeply connected to the rest of the body through inflammation, infection pathways, and immune response. This is what clinicians refer to as the oral systemic connection, and it changes how we should think about prevention.
Research has consistently linked poor oral health to:
Diabetes complications (gum disease can worsen glycemic control)
Cardiovascular disease (periodontal inflammation is associated with higher heart disease risk)
Pregnancy complications (including preterm birth)
Respiratory infections and aspiration pneumonia
The National Institute of Dental and Craniofacial Research underscores that oral diseases are among the most common chronic conditions and many are preventable with early intervention.
When patients face barriers to dental care, medical teams inherit the downstream effects: unstable chronic disease, more urgent visits, and preventable emergency department use.
When Barriers Push Patients to the ER
One of the clearest signals of system failure is emergency department (ED) use for dental pain. EDs are not designed to treat the root causes of oral disease, yet they’ve become a default option when barriers block preventive care.
A CareQuest Institute analysis found that non-traumatic dental conditions cost the U.S. nearly $4 billion annually in ED spending, with visits often resulting in temporary relief but no definitive treatment.
This is expensive for the system, exhausting for providers, and frustrating for patients. Most importantly, it’s avoidable.
The lesson is clear: when dental care is hard to reach, costs don’t disappear, they shift to the most expensive, least effective setting.
Why Traditional Fixes Haven’t Worked
For decades, the standard response to barriers to dental care has been to build more dental clinics or add more appointments. While important, these approaches alone haven’t closed the gap, especially in communities already stretched thin.
Why? Because they don’t address the core issue: separation.
As long as dental care remains siloed from medical care, patients must overcome extra steps to receive prevention. Each step, another appointment, another building, another form, is another opportunity for care to fall through.
This is where a new model is needed.
Removing Barriers by Redesigning the System
What if dental care didn’t require a separate visit?
What if preventive oral evaluations happened where patients already are, inside the medical visit, within the same workflow, using the same health record?
That’s the approach OroMed supports.
By integrating preventive dental evaluations into medical settings, health centers can eliminate several of the biggest barriers at once:
Time: Oral evaluations occur during existing medical visits.
Transportation: No additional trip required.
Fear: Patients engage in prevention in a familiar, trusted environment.
Fragmentation: Findings live in the same chart as medical data.
This redesign doesn’t ask patients to change their behavior. It changes the surrounding system.
What Integration Looks Like in Practice
In an integrated model, a patient might come in for a routine medical follow-up. During the visit, a brief preventive dental evaluation, often just six to ten minutes, takes place using intraoral imaging and virtual dental expertise.
Findings are documented directly into the shared medical record. If concerns arise, gum inflammation, decay, oral lesions, the care team can discuss next steps immediately.
This approach acknowledges the oral systemic connection in real time. It gives medical teams better information and gives patients prevention without extra burden.
Equity Lives in the Design
Barriers to dental care disproportionately affect the same populations community health centers are built to serve: low-income families, rural communities, older adults, and patients with chronic disease.
The American Dental Association notes that access challenges are driven not just by provider availability, but by how care is structured and delivered.
When prevention is embedded into primary care, access becomes equitable by default. Everyone who walks through the door has an opportunity for oral health assessment, not just those who can navigate a separate dental system.
This is what equity looks like in practice.
From Barriers to Better Outcomes
Removing barriers to dental care isn’t about adding complexity, it’s about simplifying care. When oral health becomes part of routine medicine:
Patients receive earlier detection.
Chronic disease management improves.
Emergency visits decrease.
Care teams gain a more complete picture of health.
Health centers strengthen preventive impact and sustainability.
Prevention works best when it’s easy. Integration makes it easy.
A Path Forward
If we want to truly reduce the barriers to dental care, we have to stop asking patients to navigate a fragmented system, and start redesigning care around how people actually live and seek help. The oral systemic connection makes one thing clear: oral health can’t remain separate from medical care if we want better outcomes, equity, and sustainability.
The path forward is integration. By bringing preventive dental evaluations into the medical visit, health centers can remove the most common barriers at once: time, transportation, fear, and access; while giving care teams the information they need to support whole-person health.
OroMed was built to make this transition simple. Our model fits into existing workflows, requires no additional staff or rooms, and expands access to preventive dental care where patients already receive medical services.
Ready to see how this works in practice? Schedule a Demo below to explore how OroMed can help your health center break down barriers, strengthen prevention, and deliver more equitable care, one visit at a time.
Comments