OBJECTIVE
Dental providers are increasingly challenged in communicating with limited English proficiency (LEP) patients. Accordingly, the study’s purpose was to examine methods of communicating with LEP patients in North Carolina (NC) safety-net dental clinics as perceived by dental staff.

METHODS
An anonymous, 36-item, cross-sectional survey was distributed to representatives of 68 NC safety-net dental clinics. Question domains included: 1) perceived need for language services, 2) methods of language services provided, 2) perceptions of dental staff about dental care experiences for LEP patients, and 4) perceived legal and financial roles in providing language services.

RESULTS
Fifty-five (55) of the 68 clinics responded (81%). All clinics reported treating LEP patients, and 93% of clinics reported a need for providing language services. Many clinics used multiple methods to provide language services. Some clinics reported differences in treatment recommendations (13%), treatment provided (19%), and visit length (61%) for LEP patients. All responded that additional costs are incurred to treat LEP patients, and only 69% of responding clinics recognized legal obligations of treating LEP patients.

CONCLUSIONS
There is a reported need for language services in NC safety-net dental clinics. These services often resulted in additional cost to the dental clinic. To maintain the quality of care and to comply with legal requirements related to LEP dental patients, additional funding sources may be required to recruit multi-lingual staff, support language services in dental clinics, and provide language skills training for practicing dentists. Additionally, studies are suggested to measure LEP patient perception of the effectiveness of communication methods.