Delivering Equitable Care to Underserved Communities

Sernaet al. paid limited attention to certain public health failures that we elaborate on here toward promoting oral health and health care for all. First, at least in an aspirational sense, most dental conditions are preventable through attention to the social determinants of health, includingoral health.Consider the mission of public health to fulfill society’s interest in ensuring conditions in which people can be healthy; in a more just era, most of the dental-related visits to emergency departments by Hispanics and non-Hispanics in Florida might have been avoided through lifelong provision of sound nutrition, educational opportunities, safe neighborhoods, and high-quality primary and oral health care. Evidencebased preventive strategies, including provision of fluoridated water and enforcement of legislation supporting the wearing of seatbelts, helmets, and mouth guards, might have also been used to avoid such visits. Second, hospital emergency departments are ill equipped to handle dental problems, so many patients receive only antibiotics or pain medication, leaving their fundamental oral conditions untreated and thus likely to become exacerbated over time. Finally, although Serna et al. found that Medicaid is the primary payer for bothHispanics andnon-Hispanics who use hospital emergency departments for dental problems, the harsh reality is that Medicaid coverage alone is not sufficient to reduce barriers to highquality dental services for enrollees.