The Associated Press

CLEVELAND - Six years after the Ohio Department of Health said the biggest health care need for Ohioans was dental care, low income patients still have trouble getting proper treatment, officials say.

More than half of Ohio's 88 counties lack dental clinics that treat low income patients. Forty percent of the state's residents do not have dental insurance, according to the most recent statistics from 2000.

"There is a tremendous need," said Dr. Mark Siegal, head of the state's Bureau of Oral Health Services. "After the downturn in the economy, the one thing we know is that the one clear connection between untreated dental problems is low income."

Ohio has 47 counties with no public dental programs. Cuyahoga County, which includes Cleveland, has 17 public dental clinics.

In the last four years, the state has put $8 million into dental clinics that treat the uninsured. The money was used to either build clinics or purchase equipment for existing centers.

Dentists also are encouraged to donate their services. The Ohio Partnership To Improve Oral health through access to Needed Services, or OPTIONS, offers reduced-fee dental services through private practices.

Dr. Ronald Lemmo, president of the Ohio Dental Association, said the program was created to aid "people who are working but don't have the funds or qualify for insurance to pay for the care."

In the last fiscal year, OPTIONS dentists provided $1.1 million in treatment, said Mark Owsiany, chief executive of the Ohio Dental Association.

Adding to the problem is poor access to dental care in areas such as southeast and west-central Ohio, where the patient to dentist ratio can be as high as 5,000 to 1.

"I wouldn't say that there is a shortage of dentists in the state, but rather a maldistribution of them," Owsiany said.

Efforts by the state to lure more dentists to poorly served areas include a tuition repayment program that offers newly graduated dentists up to $20,000 per year.

Lemmo said that going to the emergency room for dental care is common among the uninsured, who are often dealing with more pressing medical matters.