Improving Dental Education and Training
An improved and responsive dental education system is needed to ensure that current and future generations of dental professionals can deliver quality care to diverse populations in various settings. Providing students with clinical experiences in community-based settings and with patients with complex oral health care needs improves their comfort level in caring for vulnerable and underserved populations and increases the likelihood that students will care for such populations in their future careers. Dental professional education programs should increase recruitment and support for students from underrepresented minority, lower–income, and rural populations; require student experiences in community based rotations; and recruit and retain faculty with expertise in caring for vulnerable and underserved populations. In addition, the committee recommends that HRSA dedicate Title VII funding to support these efforts as well as expand opportunities for dental residencies in community- based settings.
Reducing Financial and Administrative Barriers
Dental coverage is a major determinant of access to and utilization of oral health care. Publiclyfunded programs, such as Medicaid, and the Children’s Health Insurance Program (CHIP), are the primary sources of coverage for underserved and vulnerable individuals. Currently, all states are required to provide dental coverage for children enrolled in Medicaid and CHIP, but these same benefits are not required for adults on Medicaid. The committee concludes that dental coverage for all Medicaid beneficiaries is a critical and necessary goal. To examine the impact of expanding Medicaid coverage and determine the best implementation strategies, the committee recommends that the Centers for Medicare and Medicaid Services (CMS) fund and evaluate state-based demonstration projects. In addition, to increase provider participation in public programs, states should raise Medicaid and CHIP reimbursement rates so that beneficiaries have equitable access to services, streamline providers’ administrative processes, and increase case management for beneficiaries.
State oral health programs play an important role in monitoring and analyzing the burden of oral diseases, which is critical to planning, implementation, and evaluation of dental public health services. The committee recommends that the Centers for Disease Control and Prevention and the Maternal and Child Health Bureau collaborate with states to ensure that each state has the infrastructure and support necessary to perform core dental public health functions.
Expanding the capacity of Federally Qualified Health Centers (FQHCs) to deliver oral health care is another important way to meet the needs of vulnerable and underserved populations, as these centers are required by law to provide certain preventive oral health services. Therefore, the committee recommends that HRSA help improve the capacity of FQHCs by supporting the use of a variety of oral health care professionals and enhancing financial incentives for their recruitment and retention, providing guidance to FQHCs for best practices, and assisting FQHCs in the provision of oral health care outside of the physical facilities.
This report presents a vision for oral health care in the United States where everyone has access to quality oral health care throughout the life cycle. Realizing this vision will require numerous coordinated and sustained actions, with special attention to the distinct and varied needs of the nation’s vulnerable and underserved populations. This will require flexibility and ingenuity among leaders at the federal, state, local, and community levels acting in concert with oral health and other health care professionals. The committee’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.