BREAKING NEWS: Improving access to oral health care for vulnerable and underserved populations

By Maria Perno Goldie, RDH, MS
This report was released July 13, 2011, about 2:00 PM EDT, after a webcast. It is a consensus report, regarding Health Services, Coverage, and Access, Children, Youth and Families, Public Health, in particular Oral Health Access to Services.

Good health requires good oral health, yet millions of Americans lack access to basic oral health care. Various factors create barriers, preventing access to care for vulnerable and underserved populations, such as children and Medicaid beneficiaries. The Health Resources and Services Administration and the California HealthCare Foundation asked the IOM and the National Research Council to assess the current oral health care system, to develop a vision for how to improve oral health care for these populations, and to recommend ways to achieve this vision. Access to oral health care across the life cycle is critical to overall health, and it will take flexibility and ingenuity among multiple stakeholders—including government leaders, oral health professionals, and others—to make this access available. To improve provider participation in public programs, states should increase Medicaid and Children’s Health Insurance Program reimbursement rates. With proper training, nondental health care professionals can acquire the skills to perform oral disease screenings and provide other preventive services. Dental schools should expand opportunities for dental students to care for patients with complex oral health care needs in community-based settings in order to improve the students’ comfort levels in caring for vulnerable and underserved populations. Finally, states should examine and amend state practice laws to allow healthcare professionals to practice to their highest level of competence. The IOM’s recommendations provide a roadmap for the important and necessary next steps to improve access to oral health care, reduce oral health disparities, and improve the oral health of the nation’s vulnerable and underserved populations.The report outlines: Vision for Oral Health Care; Integrating Oral Health Care into Overall Health Care; Creating Optimal Laws and Regulations; Improving Dental Education and Training; Reducing Financial and Administrative Barriers; Promoting Research; and Expanding Capacity. Kathy Voigt Geurink, Clinical Associate Professor, Department of Dental Hygiene, School of Health Professions, University of Texas Health Science Center, is the only dental hygienist on the Committee on Oral Health Access to Services.Regarding optimal laws and regulations, the report states that a variety of regulations and policies, such as scope of practice laws, determine who may provide oral health care, how it may be provided, and where it may be provided. While education and training standards for accreditation are set nationally, regulations defining supervision and scope of practice parameters vary widely among states and even by procedure. Therefore, the committee recommends that state legislatures amend existing state laws to maximize access to oral health care. Changes would allow professionals to practice to the full extent of their education and training in a variety of settings and facilitate technology and supervision. While not specifically stating dental hygienists, the report states: Allow allied dental professionals to practice to the full extent of their education and training; allow allied dental professionals to work in a variety of settings under evidence-supported supervision levels; and allow technology-supported remote collaboration and supervision. I presume dental hygienists are considered “allied dental professionals.”For more information, and to access the PREPUBLICATION COPY: UNCORRECTED PROOFS of the report, click on report.