Dental care is limited by law. The lowest class of Americans on the economic and educational scale are either unable and or unwilling to pay hundreds of dollars an hour to a state licensed dental care provider.
Is there another level of care for such people? No, there is none.
You forget also what it is like living in the hollows of West Virginia, - lack of basic services, including Dentists. Often no flouride in water (wells). Poverty that would still make most of America shudder. Educational levels that do not impact things like taking care of your teeth and gums until it is too late.