KANSAS CITY, Mo. -- Angel Gillis is "filling" some time with visits to the dental clinic at Children's Mercy Hospital. That's what happens when you have ten cavities. Her mom knows how it happened.
"Definitely not brushing, flossing is a big issue," says Krisi Cushenbery.
The Independence mom feels fortunate to find a clinic fairly close to home that takes Medicaid. Only one in ten dentists in Missouri do, according to a new report from Pew Charitable Trusts. Why so few?
"The reimbursement to the dentist is so low that the dentist basically can't cover their costs," says Dr. Robin Onikul of Children's Mercy.
Dr. Onikul points to the shortage of Medicaid providers as one reason why two-thirds of Missouri kids in the program didn't see a dentist in 2011. In Kansas, more than half didn't.
The shortage is worst in rural areas.
Dr. Onikul also says many parents don't realize their kids need check-ups starting by age 1. The Children's Mercy clinic often sees kids who haven't had visits for years -- or ever.
"They have a mouth full of decay and occasionally we have to take out permanent molars which is very sad," says Dr. Onikul.
The new report also finds Missouri and Kansas could face critical shortages of dentists in general soon. More than 40 percent are over age 55 and nearing retirement. But equally worrisome is the distribution of dentists with nearly half of Kansas counties having shortages.
Some groups are pushing for a new type of dental professional in Kansas who can provide basic care in underserved areas.
Meanwhile, Missouri will have a new dental school in Kirksville starting this fall that could eventually increase the number of dentists in the state.