Twickenham Family Dentistry
Dr. Brian Cook
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The Alabama Dental Divide: Why Shame, Scarcity, and Cost Keep Locals Out of the Chair

December 8, 2025
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Posted By: Dr. Brian K. Cook
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No one should feel like they can’t go to the dentist. Maybe it’s the cost of care that’s holding you back, or it’s been a long time since you’ve been to the dentist, and you’re embarrassed about how your teeth look. Perhaps the problem is that you can’t find a dentist in your area, and it isn’t feasible to travel long distances for quality care.

Whatever the reason, many Alabama residents are currently dealing with a dental divide, and this is causing serious oral health concerns for adults and children.

In this informational blog, we’ll explore how shame, scarcity, and cost are keeping locals out of the dental chair.

Who Is Affected?

A 2024 study conducted by The University of Alabama at Birmingham found some startling information regarding the scarcity of dental care in certain Alabama counties. The research indicates that many people can’t find dental care or will soon be without access to dental care in their area.

Our findings show that nine Alabama counties currently have no dentist or only one practicing dentist. Clay, Greene, and Wilcox counties have NO dentists at all, and Coosa County only has one dentist who is 60 years old and works two days a week.

This is a crisis for anyone living in those counties who needs any dental services.

The American Dental Association compared Alabama to other states in 2023, and its research found similar findings. Our findings show that the ratio of practicing dentists to state residents is the second lowest. There are only about 41 dentists for every 100,000 people, while the national average is close to 60 dentists for every 100,000 people.

Because a large number of Alabama dentists are close to retirement age and some Alabama counties have no dentists at all, some of the obstacles include the following:

  • Long wait times for treatment
  • Extended travel to get treatment
  • Lack of preventive care for vulnerable populations, including children and those with disabilities

What Does The Future Hold?

As a result of these and other startling findings, the Alabama Department of Public Health (ADPH) convened a discussion on how to improve the oral health of Alabama residents. Zachary Schulz, the ADPH faculty member for the University of Alabama at Birmingham, wrote a report aimed at educating state agencies, policymakers, and dental schools about this problem and at improving accessibility for every Alabamian.

Working with State Dental Director Tommy Johnson, DMD, Schulz wanted the report to highlight how Alabama residents, especially vulnerable populations, face significant barriers to accessing even basic dental care.

More than 43% of Alabama is rural, and in these communities, one dentist may serve up to 3,800 potential patients. And because these rural areas have higher poverty rates and lower education levels, it’s more important than ever to address these concerns.

What Causes Dental Shame and Anxiety?

Even if you have access to dental care where you live, dental shame can keep you from seeking treatment. Unfortunately, this leads to a dangerous cycle where a visible dental issue leads to feelings of shame or guilt. As a result, you avoid the dentist, which worsens the problem and increases your feelings of shame.

It’s essential to keep in mind that dentists regularly see patients with dental issues, and most dentists truly want to help you improve your oral health.

Some of the biggest causes of dental shame or anxiety are:

  • Fear of judgment — If you’re afraid your dentist will criticize your teeth and gums or judge you for not taking better care of your teeth, you may avoid making an appointment.
  • Negative experiences — If you had a painful or traumatic dental experience in the past, you might feel anxious about going back to the dentist.
  • Societal pressure — If social media and “perfect” Hollywood smiles make you feel like everyone has beautiful, white teeth, you may feel inadequate about your smile.
  • Loss of control — If you have a difficult time giving up control, undergoing dental care can lead to extreme anxiety.

No Insurance? No Problem!

At Twickenham Family Dentistry, we understand that rising dental costs and lack of insurance are both barriers to adequate care; that’s why we offer a Patient Appreciation Plan. So, if you’re self-employed, unemployed, retired, or don’t otherwise have access to dental insurance, we provide a way to receive preventive care at a predictable cost.

Here’s how it works:

For $275 per year for an individual or $585 for a family of 3 ($155 for additional members), you’ll receive the following:

  • 2 routine exams and cleanings, including x-rays and an oral cancer screening
  • 1 emergency exam and necessary x-rays
  • 30% off additional services

Other Ways to Pay

In addition to dental insurance and traditional payment methods, our Huntsville dental office offers two other ways to finance your dental care:

  • CareCredit — With a CareCredit card, you can finance your dental costs for up to 24 months with no interest. And if you need more time, they can set up fixed payments with reduced interest rates.
  • Proceed Finance — After filling out a short application form, you can choose the loan amount that works for you. Proceed Finance pays our office directly, and you can get the care you need. There are no hidden fees, and you can get a fixed interest rate.

Struggling With Dental Anxiety in Huntsville?

If previous dental experiences or fear of the unknown are keeping you from visiting the dentist, our caring team would love to speak with you! We will answer your questions, put your mind at ease, and help you get the comfortable treatment you deserve.

At Twickenham Family Dentistry, our goal is to provide efficient care in a warm, welcoming environment. We want to get to know you and your loved ones and guide them toward oral health and a smile they’ll be proud to show.

Please don’t hesitate to take the first step; give us a call at (256) 539-4079 to get started today.

We look forward to hearing from you.

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