Marin County Oral Health
Oral health is a key component of overall health and well-being at all stages of life.
The biggest challenge is motivation and education - getting people to value what your teeth do for you...We try to get into the community to build trust.
- Key Informant Interview
Marin County is an affluent county in the San Francisco Bay Area with a total population of 259,358. White non-Hispanics comprise the majority of the county’s population at 72%, followed by Hispanic/Latinos at 16%, and Asians at 6%. The majority of the population in the county is between the ages of 45-64 years of age.
Barriers to Care
Only 59% of respondents to the Marin County Adult Oral Health Questionnaire reported having dental insurance. Fewer adults aged 35-44 and 65 and older reported having dental insurance than other age groups, indicating that there may be different barriers faced by different age groups.
For adult respondents, the cost of services was the most commonly reported barrier to accessing services. When asked about frequency of dental visits, more than half of respondents (64%) reported having seen a dentist within the past year.
How do Marin's Kindergarteners compare?
The Kindergarten Oral Health Assessment is an annual examination of the oral health needs of children entering their first year of school in California’s public education system.
There are clear disparities in oral health between schools and school districts in Marin. Some school districts far exceed the County
average for untreated tooth decay. For example, students in the San Rafael City Elementary School District had some of the highest rates (28%) of untreated tooth decay. San Rafael City Elementary also has one of the
highest rates of low-income students which highlights the relationship between
disparities in income and oral health.
It is worthy to note that there is a decrease in amount in returned KOHA forms, from 68%-60%. This can be in part due to the COVID-19 Pandemic of 2020 which saw a temporary unavailability in some medical services, including dental care services. While there was also a decrease in the amount of untreated decay surveyed, there could potentially be more decay experienced amount 2019-2020 kindergarteners that we're not captured due to the decrease in returned assessments.
Head Start (3-5 year olds)
Families participating in the Head Start Program are
assisted with connecting their children to a dental home and with accessing
dental exams. The percentage of children participating in the Marin Head Start
Program with a dental home has remained high since 2012.
Children aged 6-9 who
receive dental care at Federally Qualified Health Centers (FQHCs) in Marin
County received sealants at lower rates than children at FQHCs across
California. However, with the exception of Marin City Health and Wellness Center, this group of children has already reached the 2025 California
sealant target of 33%.
From 2017-2018, pregnant women in Marin County have a higher dental utilization rate (69 %) in comparison to the rest of California (44%). Within this group there are disparities in accessing dental care. Pregnant women living at or above 200% of the federal poverty level demonstrated a higher frequency of dental visits (72%) during pregnancy compared to those living between 100%-200% of the federal poverty level (54%). These are typically the working poor who may not be eligible for publicly funded care (Medi-Cal) but also may not be able to afford private dental insurance.
Dental visits can be used as a proxy for oral health status, since an annual dental visit would identify and prevent dental issues at their beginning stages. Access to dental care requires sufficient resources (e.g., dental insurance and/or personal income/wealth) to pay for dental services on a regular basis. Focus groups with low-income seniors indicated that participants faced significant barriers to accessing oral health care including transportation, financial limitations, and a lack of available Denti-Cal providers.