In California, despite hundreds of millions of dollars in state investment and decades of well-intentioned policy reforms, oral health remains one of the most significant unmet needs in our state–especially for low-income communities of color. As leaders who come from the very urban and Tribal communities our organizations serve, we understand these challenges not just through data, but through shared lived experience. From the neighborhoods of South Los Angeles to our rural Tribal lands, we see firsthand how the lack of access to oral health care impacts our families. To bridge this gap, California must embrace dental therapy as a matter of fundamental social justice.
Low-income individuals, Tribal members, and communities of color are disproportionately affected by the lack of access to oral health care. According to recent reports from UCSF’s HealthForce Center, chronic underfunding and staffing shortages in tribal health systems are directly widening the gap in oral health outcomes for Indigenous communities. African American children face untreated decay at nearly double the rate of white children (25.8% versus 13.7%).
While California boasts one of the highest dentist-to-population ratios in the nation, the distribution of care is fundamentally broken. Marginalized Black, Indigenous, People of Color (BIPOC) and Tribal communities are disproportionately trapped in dental health professional shortage areas where the supply of care cannot meet the overwhelming demand. Only 15% of dentists participate meaningfully in Medi-Cal for adults. In 2024, only 50% of children and less than 25% of adults in Medi-Cal received any dental care.
Enter the dental therapist, a true “people’s solution.”
The California Oral Health Equity Coalition (COHEC) is a grassroots, power-building movement of low-income BIPOC, Tribal, and marginalized communities demanding a seat at the policy table. For years, COHEC members have called for dental therapy because they know firsthand that the current oral health care system is failing.
Dental therapists are a time-tested solution. Dental therapists are licensed dental professionals who provide preventive and routine care, like exams, fillings, and oral health education, in communities. Working as part of a dentist-led team, they complement the roles of dental hygienists and dental assistants to help ensure that more people get the care they need, when and where they need it.
The model has been used globally for over a century and has successfully operated in the United States for 20 years, beginning with Alaska Native leaders who recognized that their communities could not wait for providers to move into remote areas. Today, dental therapists are authorized in 14 states, with research proving that the model is safe, effective, and efficient.
By integrating dental therapists into community health clinics and deploying them to schools, nursing homes, and reservations, California can meet patients where they are.
Furthermore, dental therapy presents an accessible and high-value entry point for Californians who want to enter the oral health care field but lack the time and money and eight-plus years required to become a dentist. Dental therapy opens doors for talented individuals from underserved rural and urban neighborhoods to secure stable, good-paying jobs within their own communities. It is more than just a health care solution; it is an economic engine that empowers local workforces to solve local problems.
California must commit to a robust investment in statewide resources and policies to ensure this model thrives. This includes dedicated funding for dental therapy education programs in our community colleges and CSUs, equitable reimbursement rates under Medi-Cal, and a regulatory framework that removes unnecessary barriers to practice. Without intentional statewide support, we risk leaving the potential of this workforce untapped.
Adding a dental therapist to the oral health care team is a moral imperative. It is a fiscally responsible step to reduce the burden on our emergency rooms and a necessary action to align our healthcare system with the demands of the people. California has the resources and the data; now we need the political will to listen to our communities and treat oral health care as the fundamental right.
