Most healthcare providers are familiar with the landmark reports that suggest all populations within the United States do not access oral health care in an equitable fashion.1-4 Although dental diseases are preventable, many individuals unnecessarily suffer from dental disease and disparities exists due to lack in access to dental care services. In addition, untreated dental disease is more prevalent in individuals from lower-income households and ethnic minorities.1-3
Americans continue to underutilize preventive dental services. Data from Medical Expenditure Panel Survey (2001 through 2010) indicated that dental care utilization decreased from 41% in 2001 to 37% in 2010 for adults (age 19-64) and increased from 43% in 2001 to 46% in 2010 for children.5 Among adults, changes in insurance status, race, and income contributed to a decline in adult dental care utilization; interestingly, among children, changes in controlled factors (race, parent's education, age, income, insurance status, health status, gender, and region) did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences.5
Even in children with private dental benefits, about 43% of children aged 1-6 years do not have a single dental claim within a year.6 Reports suggest that insurance coverage increases utilization rates.7,8
Another interesting phenomenon is the increasing share of dental spending via the Medicaid program. Medicaid is the publicly funded program available to low-income populations and those with disabilities, and is financed with tax dollars. With more children qualifying for Medicaid, there has been an increase in dental care utilization within this population.9 Adults are accessing dental care as a result of Medicaid expansion within states that offer optional adult dental benefits.9 Although public financing of dental care is increasing, the private dental insurance benefits are decreasing.5
Compounding the issues of disparities and utilization is the fact oral health is an integral part of overall health. This concept of oral health effecting overall health is not new, in fact, the discipline of dental hygiene was based upon this premise.10-13 Some studies have associated periodontal diseases to heart, lung, and a number of other systemic diseases, diabetes, pneumonia, and premature, low-birth-weight babies.14 Prevention and early intervention are strategies long recognized across health disciplines as being cost-effective and minimizing or eliminating human pain and suffering. Dental hygiene science, which emphasizes disease prevention and treatment of oral infection, fits perfectly into an interprofessional model to provide comprehensive health care to all populations.
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