Over the last several decades, remarkable progress has been made in addressing North Carolinians’ oral health. A look back at just one outcome measure paints a vivid picture.
More than 2,000 North Carolina students had lost all of their permanent teeth to a dental disease before graduating from high school in the early 1960s.
At the time, there was only one dentist for every 4,000 people, fewer than 100 dental hygienists practiced throughout the state, and only 15% of the population drank fluoridated water.
Today, a downward trend in dental caries in children’s and adolescents’ permanent teeth, first identified in the 1970s, has reached historic low levels.
Complete tooth loss due to dental disease has decreased dramatically in the last 50 years and has all but disappeared in upper-income groups. In short, dramatic reductions in disease burden are possible and have been accomplished for many North Carolinians.
One negative trend stands out: dental disease is now primarily concentrated in lower-income populations. This disparity in dental disease between low- and middle-income groups should come as no surprise given concurrent trends in social determinants of disease. As the population grows, it becomes older, more diverse, and more deeply divided by income.
The dental system in North Carolina is structured in such a way that a person’s ability to access care is largely determined by his or her ability to pay.
This is especially true for oral health care. In 2015, 84% of North Carolinians with dental benefits went to the dentist, compared to 61% of those without. 10 While having dental coverage is certainly preferable to not having any coverage at all, it does not guarantee access to care – or, more specifically, the care a person may require. Even with private insurance, the out-of-pocket costs for dental care can be prohibitive.
Out-of-pocket expenses for dental care are more than three times those for medical care. Dental expenses were identified as a leading contributor to medical debt in two national household surveys of low- and middle-income households with credit card debt in 2012.
Furthermore, lack of dental coverage and/or ability to pay creates even more barriers to care for rural populations, who are already hampered by a lack of dental providers.
The narrative that follows briefly describes the various entry points into the North Carolina oral health care system, as well as some of the opportunities and challenges that each presents to the patient population.
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Accessing the North Carolina Oral Health Care System
The most common setting in which the general public receives dental care is a private practice, whether as a solo practitioner or as part of a group practice.
In 2016, approximately 76% of dentists in North Carolina, or 4,566, were in private practice, with the majority of them being general practitioners, which means they typically provide a wide range of dental services.
Private practice fees are typically the highest of the care settings discussed here, which may help to explain why, nationally, private practices are largely comprised of privately insured patients.
Dental Colleges
North Carolinians can also get dental care from the University of North Carolina School of Dentistry (UNC), East Carolina University School of Dental Medicine (ECU), and community college Dental Hygiene programs throughout the state.
Through its student and faculty practice clinics, UNC provides comprehensive primary and specialty dental services. UNC also hosts the Student Health Action Coalition (SHAC), a student-led organization dedicated to providing free health care to the uninsured and underinsured.
The Dental Clinic is open on certain Wednesday nights and accepts patients through a walk-in lottery system (no appointments). Students also volunteer at several free clinics in the Triangle area.
ECU, which opened in 2011, currently offers comprehensive primary care and limited specialty care. Dental school clinics charge slightly lower fees than private dental practices, and both institutions accept most private insurance plans, as well as Medicaid and NC Health Choice.
However, receiving treatment at a dental school may incur additional costs in terms of time and travel.
If dental school is their only or best option, some patients may travel several hours to receive care. Furthermore, receiving care from student providers entails significantly longer appointment times – often two to three hours.
Nonetheless, both institutions try to overcome these obstacles by offering free or low-cost services through a variety of community outreach programs. ECU began with a focus on providing and improving oral health services for underserved North Carolinians and recruiting “My job does [provide dental insurance], but the dentist I was going to was costing me too much money to get it done.”
The state has 12 community college dental hygiene programs. These programs, in addition to training future hygienists, run dental hygiene clinics where students provide dental cleanings and other basic preventive services to the public; patients who require more extensive treatment, such as restorations and extractions, are referred to a dental office.
System of Dental Safety Net
The safety net health care system is considered the default system of care for the uninsured, Medicaid recipients, and other vulnerable populations. The system is not uniformly available throughout the country, let alone in North Carolina, and because it is funded through a variety of mechanisms, the financial viability, and sustainability of these programs can be challenging.
Safety-net dental programs face the unique challenge of providing high-quality care to the underserved while working within limited budgets. Many of these programs offer a limited range of dental services or target a specific age demographic.
North Carolina currently has approximately 133 safety net dental access points, which include local health departments, community health centers, free clinics, school-based dental programs, and mobile dental clinics.
There are 16 Community Health Centers. Federally Qualified Health Centers (FQHCs) and other health centers are non-profit healthcare organizations that serve underserved populations. They primarily serve Medicaid and uninsured people, but they also accept private insurance. Patients who are uninsured can apply for a sliding scale discount on services based on their income.
The federal grant money is then used to cover operational costs that are not covered by patient care revenue. This type of funding, however, is insufficient to meet the need for care.
Some health centers do not provide dental care, and those that do may not provide crowns/bridges, dentures, or orthodontics. North Carolina currently has 39 federally funded health centers, 25 of which offer some level of dental care at one or more clinic locations. Local Health Departments Dental programs at local health departments are similar to those at community health centers in terms of patient demographics, services provided, and fee structure.
North Carolina’s 100 health departments provide dental services through fixed clinic sites, mobile dental programs, or both. However, services are frequently restricted to children and, in rare cases, pregnant women.
Dental Programs in Schools
School-based programs give students access to dental care in a safe, convenient, and accessible setting: their school. The percentage of students enrolled in the federal free and reduced lunch program is frequently used to select schools.
This criterion assists programs in focusing on students who are more likely to have unmet health needs. Dental hygienists use portable dental equipment to provide services such as oral health screenings, education, and preventive services such as dental sealants and fluoride mouth rinse. Otherwise, students who require additional care should be directed to the nearest dentist.
The North Carolina Oral Health Section, in collaboration with local health departments, provides a significant portion of the state’s school-based dental services.
Dental Mobile Clinics
Dental services are delivered to populations in need using portable dental equipment or dental-equipped vans and buses, whether to schools, long-term care facilities, or other community settings. These mobile programs are primarily aimed at children and institutionalized seniors.
Depending on the program budget, restorative care, extractions, and other rehabilitative services may be provided.
There are currently at least 14 North Carolina-based mobile dental programs operating throughout the state. Charity dental events are typically one or two-day events held annually, semiannually, or more frequently depending on resource availability.
North Carolina Missions of Mercy (MOM) clinics and Give Kids A Smile (GKAS) events are two examples. Such initiatives rely heavily on grant funding and donations, as well as volunteer labor. For some charity events, patients will line up several hours before the clinic opens and may remain in line for several hours before receiving care; some patients may not receive care at all if the event is first-come-first-served.
While these events provide patients with care that they would not have received otherwise, they do not provide patients with a regular source of care or a dental home.
Free clinics differ from charity events in that they are usually fixed operations with a set schedule. However, due to the limited availability of volunteer dental staff, hours of operation and breadth of services provided may be irregular.
To ensure that resources are directed most effectively in meeting needs, eligibility for care is limited to uninsured individuals and, more specifically, those whose income is less than a designated Federal Poverty Level threshold – typically 200%.
Some clinics truly offer free services, while others may charge a fee based on income. Free clinics are frequently the only source of dental care for people with extremely limited financial means, such as the homeless population.
Long waitlists are not uncommon, and grant funding and donations, like at charity events, are critical to cover the cost of uncompensated care.
Dentists in North Carolina
Here’s a list of some of the dentists in North Carolina
- Alliance Dentistry
Address: 202 Davis Grove Cir Ste 102, Cary, NC 27519, United States
Website: Click here
Phone: +1 919-363-3100
- Belmont Dental
Address: 1100 Spruce St, Belmont, NC 28012, United States
Website: Click here
Phone: +1 704-825-3455
- Belmont Family Dental Care
Address: 6655 East Wilkinson Blvd, Belmont, NC 28012, United States
Website: Click here
Phone: +1 704-461-1116
- Branchview Dental Care
Address: 1020 Lee-Ann Dr NE, Concord, NC 28025, United States
Website: Click here
Phone: +1 704-795-1055
- Brookdale Dental Care
Address: 9621 Brookdale Dr Suite 200, Charlotte, NC 28215, United States
Floor 1 · Brookdale
Website: Click here
Phone: +1 704-597-7772
- Caring Dentistry
Address: 3090-A, 3090 NC-27, Lincolnton, NC 28092, United States
Website: Click here
Phone: +1 704-732-2629
- Carolina Dentistry
Address: 385 S Columbia St, Chapel Hill, NC 27514, United States
Floor 1 · University of North Carolina at Chapel Hill
Phone: +1 919-537-3737
- CarolinasDentist
Address: 620 Lillington Hwy, Spring Lake, NC 28390, United States
Located in: Spring Lake Town Center
Phone: +1 910-778-2397
- Carolina Smiles Dentistry
Address: 114 Buttercup Trail, Marble, NC 28905, United States
Website: Click here
Phone: +1 828-837-1005
- Carolina West Dental
Address: 205 Waynesville Plaza, Waynesville, NC 28786, United States
Located in: Waynesville Plaza
Website: Click here
Phone: +1 828-452-5656
- Coastal Carolina Dental Care
Address: 32 Office Park Dr, Jacksonville, NC 28546, United States
Website: Click here
Phone: +1 910-353-8200
- Dental Care of Greensboro
Address: 2733 Horse Pen Creek Rd STE 107, Greensboro, NC 27410, United States
Website: Click here
Phone: +1 336-854-9270
- Dental Care at Palladium
Address: 4008 Brian Jordan Pl Ste. 105, High Point, NC 27265, United States
Located in: Palladium Shopping Center
Phone: +1 336-822-9557
- Durham Dental Group
Address: 202 W North Carolina 54 Ste 201, Durham, NC 27713, United States
Located in: SouthPoint Crossing
Website: Click here
Phone: +1 919-322-3585
- Eastern Carolina Dental
Address: 56 Office Park Dr, Jacksonville, NC 28546, United States
Located in: Doctors Park Psychological Center
Phone: +1 910-353-4242
- Family Dental Care NC
Address: 1701 Country Club Rd, Jacksonville, NC 28546, United States
Website: Click here
Phone: +1 910-346-2345
- Fuller Dental
Address: 3450 Forestdale Dr, Burlington, NC 27215, United States
Website: Click here
Phone: +1 336-290-7401
- Goldsboro Family Dental
Address: 308 N Taylor St, Goldsboro, NC 27530, United States
Website: Click here
Phone: +1 919-735-6017
- Hudson Family Dentistry
Address: 155 Hickman Ave, Hudson, NC 28638, United States
Phone: +1 828-726-0202
- King Family Dentistry
Address: 226 Kirby Rd, King, NC 27021, United States
Phone: +1 336-983-0095
- Marion Family Dental
Address: 55 Morgan St, Marion, NC 28752, United States
Website: Click here
Phone: +1 828-652-6967
- Mills River Family Dental
Address: 3340 Boylston Hwy Suite 30, Mills River, NC 28759, United States
Website: Click here
Phone: +1 828-799-0900
- Night & Day Dental
Address: 1325 Bradford View Dr Suite 120, Cary, NC 27519, United States
Located in: Bradford Shops
Website: Click here
Phone: +1 984-465-1110
- North Hills Dentistry
Address: 3803 Computer Dr #101, Raleigh, NC 27609, United States
Website: Click here
Phone: +1 919-781-0056
- O2 Dental Group of Fayetteville
Address: 1916 Skibo Rd Suite C3, Fayetteville, NC 28314, United States
Website: Click here
Phone: +1 910-484-5141
- Park Place Dental of Durham
Address: 245 NC-54 Ste 204, Durham, NC 27713, United States
Floor 2 · SouthPoint Professional Center
Website: Click here
Phone: +1 919-484-8088
- Providence Dentistry
Address: 9804 Sandy Rock Pl Suite B, Charlotte, NC 28277, United States
Website: Click here
Phone: +1 704-846-1401
- Sauratown Dental
Address: 217 Moore Rd, King, NC 27021, United States
Phone: +1 336-983-5095
- Seaside Dentistry
Address: 1165 Cedar Point Blvd Suite P, Cedar Point, NC 28584, United States
Phone: +1 252-764-2784
- Smithfield Family Dentistry
Address: 910 S Brightleaf Blvd, Smithfield, NC 27577, United States
Website: Click here
Phone: +1 919-300-5890
- Smoky Mountain Dentistry
Address: 30 Miami Dr, Waynesville, NC 28785, United States
Website: Click here
Phone: +1 828-452-5807
- Southport Dental
Address: 621-A N Fodale Ave, Southport, NC 28461, United States
Phone: +1 910-457-5026
- Stanley Family Dentistry
Address: 400 S Hwy 27, Stanley, NC 28164, United States
Website: Click here
Phone: +1 704-263-3770
- Stapleton Dentistry
Address: 8204 Tryon Woods Dr #102, Cary, NC 27518, United States
Located in: Tryon Village
Website: Click here
Phone: +1 919-851-6161
- Sunset Dental
Address: 688 Sunset Blvd N, Sunset Beach, NC 28468, United States
Website: Click here
Phone: +1 910-575-6300
- UNC Adams School of Dentistry
Address: 385 S Columbia St, Chapel Hill, NC 27599, United States
Phone: +1 919-537-3737
- Village Dental – North Raleigh
Address: 7371 Six Forks Rd, Raleigh, NC 27615, United States
Located in: Celebration Shopping Center
Phone: +1 919-561-5721
- Waterside Dental Care
Address: 175 Cross Center Rd, Denver, NC 28037, United States
Located in: Shoppes at waterside
Website: Click here
Phone: +1 704-951-8300
- Western Carolina Family Dentistry
Address: 505 Realty St SW, Lenoir, NC 28645, United States
Website: Click here
Phone: +1 828-754-2600
- WNC Dental
Address: 3179 Sweeten Creek Rd, Asheville, NC 28803, United States
Website: Click here
Phone: +1 828-684-1288
Conclusion on the Dentists in North Carolina
Given the proportion of under insured and uninsured people in North Carolina, the current dental care system is not designed to meet the needs of a large number of people.
North Carolina must invest in long-term, sustainable strategies that enable both oral health providers to provide needed care to a greater number of people and patients to seek the care they require. Decades of experience show that we have the technical solutions and human resources to improve oral health.
As a result, this is not a scientific challenge, but rather one of leadership and political will to make oral health accessible to all. This article contains a list of some of the best dentists in North Carolina. We hope it helps.
Editor’s Picks
Chibueze Uchegbu is a certified medical physiologist with a great passion for healthy living.