How can dental practices become more inclusive and accessible?

How Dental Practices Can Become More Inclusive and Accessible

Dental practices must prioritize building trust with underserved communities through culturally sensitive care, multilingual materials, diverse workforce development, and physical accessibility modifications, while expanding the dental team to include midlevel providers who can deliver preventive services in underserved areas. 1

Build Trust and Community Engagement

The foundation of inclusive dental care requires establishing genuine relationships with marginalized communities before expecting their participation:

• Engage directly with communities through face-to-face interactions at community centers, schools, and local events to build trust and address historical mistrust of healthcare systems 1
• Recruit community champions as peer educators who can promote oral health and help navigate barriers from within the community, providing them with training in oral health education, communication skills, and research ethics 1
• Involve community members as active participants in practice design and service delivery decisions, creating opportunities for feedback and demonstrating openness to modify approaches based on community input 1
• Share useful medical knowledge through educational sessions on topics chosen by the community, not just what providers think is important 1

Ensure Cultural Sensitivity and Language Access

Communication barriers represent a critical obstacle to inclusive care:

• Translate all patient materials into appropriate languages with attention to maintaining tone, level, and cultural relevance of the original content 1
• Provide materials in multiple accessible formats including video, text, phone, in-person, and social media, using plain language that avoids scientific jargon 1
• Station interpreters in dental facilities rather than relying on ad-hoc solutions—56.2% of dentists report difficulty communicating with deaf patients, and 97.8% desire dedicated interpreters 2
• Ensure design elements are legible with appropriate font size, formatting, and colors for patients with visual impairments 1, 3
• Train all dental staff to practice in culturally appropriate ways that demonstrate respect and awareness of cultural, generational, and linguistic barriers 1

Address Physical Accessibility Barriers

Architectural barriers prevent many disabled patients from accessing care:

• Modify physical infrastructure including doors, hallways, waiting rooms, and dental operatories to accommodate wheelchairs and mobility devices—37.3% of patients and 43.8% of dentists report inadequate physical access 4, 2
• Ensure safe transportation access to facilities, as 60% of dentists identify unsafe environments and transportation difficulties as geographical barriers 2
• Provide accessible dental equipment including adjustable chairs that can accommodate patients who cannot transfer from wheelchairs 4
• Design reception areas and signage that are accessible to patients with visual and mobility impairments 3

Expand the Dental Workforce

Severe workforce shortages in underserved communities (dentist-to-patient ratios of 1:2800 in some Indigenous communities versus 1:1500 nationally) require innovative solutions:

• Train and deploy midlevel dental providers such as dental therapists and expanded-function dental hygienists who can provide preventive and basic restorative services under dentist supervision 1
• Utilize dental health aide therapists (DHATs) in remote and tribal communities, as programs in Alaska have demonstrated improved access and positive reception 1
• Engage primary care providers including pediatricians, nurse practitioners, and community health nurses to provide oral health screening, fluoride varnish application, and referrals 1
• Recruit and retain Indigenous and minority dental professionals to increase representation and cultural competency in the workforce 1

Reduce Financial and Organizational Barriers

Access to care extends beyond physical presence:

• Accept Medicaid and public insurance while actively working to reduce barriers that limit acceptance of these patients 1
• Provide nondiscriminatory care to all classes of patients regardless of race, ethnicity, socioeconomic status, sexual orientation, cultural background, age, disability, or religion 1
• Consider the impact of practice changes that could make it more difficult for poorer patients to access care, and implement steps to mitigate such impacts 1
• Offer flexible scheduling including evening and weekend appointments to accommodate caregiving responsibilities and work schedules 1

Implement Multimodal Recruitment and Outreach

Reaching diverse populations requires varied approaches:

• Use proactive strategies with direct face-to-face contact at community events, fitness facilities, and schools where potential patients can ask questions and build trust 1
• Employ reactive strategies through collaboration with trusted community leaders, word-of-mouth referrals, and strategically placed materials in locations with high accessibility to diverse populations 1
• Develop culturally sensitive recruitment materials available in different languages and placed in various community locations 1
• Leverage trusted relationships as encouragement from community members, family, and friends helps build confidence and reduce distrust 1

Tailor Communication for Specific Disabilities

Different disabilities require specific communication adaptations:

• For hearing-impaired patients: Use written communication, visual aids, face the patient when speaking, and ensure adequate lighting for lip-reading 3
• For visually impaired patients: Provide verbal descriptions of procedures, allow tactile exploration of instruments when appropriate, and ensure clear verbal communication 3
• For patients with neurological impairments (aphasia, dysarthria): Allow extra time, use communication aids, speak slowly and clearly, and confirm understanding through alternative methods 3
• For patients with autism spectrum conditions: Use tailored approaches addressing specific needs and anxieties, maintain consistent routines, and minimize sensory overload 3

Common Pitfalls to Avoid

• Do not assume "one size fits all" accessibility solutions—empirical evidence shows fragmented approaches fail, and wheelchair users' voices are often missing from planning 4
• Avoid only emergency-based care models—84.5% of disabled patients only seek care on an emergency basis, indicating systemic failure in preventive access 2
• Do not rely solely on disseminating guidelines without implementation support—guideline awareness alone does not change practice behavior 1
• Recognize that patients may rate accessibility better than reality—people with disabilities gave better accessibility ratings than dentists despite objective barriers, suggesting normalization of inadequate access 2