Achieving Equity in Oral Health: A Data-driven Approach for Informing Policy Changes

Abstract

Due to the lack of access to affordable oral healthcare in outpatient settings, emergency departments (EDs) see unnecessary overuse in providing palliative care for mouth pain. Hospitals across the country are exhausting limited human and fiscal resources on patients seeking relief for non-traumatic oral conditions that could be better managed in nonhospital settings. Community dental clinics offer one strategy for easing the burden on EDs, while simultaneously reducing costs to the system, facilitating definitive care, and minimizing time away from work and home for patients. The expansion of government funding, including comprehensive adult Medicaid dental benefits, to facilitate preventive and restorative coverage for populations in need in outpatient settings would increase access to appropriate care and likely further reduce the tendency for patients to seek dental care in EDs. Targeting of specific high-risk groups (such as low-resourced or minority persons) also would help to remove barriers to care, lessen disparities in access and treatment, and improve equity in oral health in the U.S.

Oral Health in Communities and Neighborhoods (OHICAN) Pilot Project: The Burden of Poor Oral Health

“…Once people are aware, they need places to go to obtain dental care. Lack of adequate capacity to care for populations in low income and minority areas is a major issue [7,8]. Personal contact work we did to expand dental health care capacity included (1) identifying, engaging, and training non-traditional dental care providers to perform oral exams and apply fluoride when indicated; (2) training providers to be aware of the requisite steps to address oral health issues and enhance preventive oral health measures in communities (approximately 1000 non-dental healthcare professionals were educated and trained in this area); (3) educating hygienists of recent changes in licensing laws that allow their profession to provide preventive care under general supervision; (4) educating stakeholders (primarily dentists) of the implications of the changes in dental hygienists' practice laws (approximately 325 dentists were educated in this area); (5) supporting implementation efforts for the expanded role for hygienists; and (6) integrating medical and dental efforts to increase access to preventive care.…”