Access to dental care is about more than brushing and checkups—it’s deeply connected to where people live, what they earn, and whether basic supports are within reach. A new issue brief, ALICE and the Dental Divide in Minnesota, reveals how financial hardship and community-level factors combine to widen oral health gaps across the state, particularly in rural communities.

Released by United For ALICE in partnership with United Ways of Minnesota, the research shows a clear link between income, geography, and oral health outcomes. In Minnesota, 45% of households below the ALICE Threshold live in communities with limited proximity to dental care providers, creating a significant barrier before cost is even considered. For rural families, long travel distances, provider shortages, and limited transportation make routine dental care difficult to access.

Cost further compounds the challenge. Dental care is the top medical service people skip due to expense. In 2023, 29% of adults below the ALICE Threshold across the Midwest Census Region reported going without needed dental care because they couldn’t afford it. Even when care is available, limited dental insurance coverage leaves many households paying out of pocket. In Minnesota, 22% of adults lacked dental insurance, and 28% spent more than $500 out of pocket on dental care in 2024.

These barriers have real consequences. Last year, 13% of adults below the ALICE Threshold reported losing six or more teeth due to decay or gum disease. The divide begins early as well—while many children receive dental care, gaps in access and consistency set the stage for long-term health challenges.

“Oral health is a window into our overall health and well-being,” said Kim Brink Smith, Executive Director of United Way of 1000 Lakes. “When people postpone or forgo dental visits, it affects far more than their smiles. Basic dental care should never be a luxury—it’s a necessity for families and communities to thrive.”

The Dental Divide report underscores a critical takeaway: improving oral health requires addressing community-level factors such as provider access, insurance gaps, and transportation—especially in rural areas. With better data, communities can design targeted solutions that close gaps and strengthen health outcomes for everyone.

Explore the full findings at uwlakes.org/ALICE.

Locally, United Way of 1000 Lakes is co-leading a community effort to address these gaps in Itasca County. From bringing onsite mobile dental clinics to early education students and their families, to convening partners arhttps://uwlakes.org/alice/ound access and prevention, United Way is working to ensure oral health starts early and reaches those who need it most. These efforts also expose young people to careers in dental care and workforce opportunities close to home, helping build a stronger, more sustainable local system.

To learn more or get involved, contact Kim Brink Smith at kimberly@uwlakes.org.