Poor oral health reduces the economic productivity of American society by limiting participation in the workforce, as well as by increasing health care costs. This is a key finding in Oral Health in America: Implications for Dental Practice, published today online ahead of print in The Journal of the American Dental Association (JADA). The paper is a highlight of key elements of a larger report, Oral Health in America: Advances and Challenges, released by the National Institute of Dental and Craniofacial Research (NIDCR) and the National Institutes of Health (NIH).
Jeffrey L. Fellows, Ph.D., senior investigator, Kaiser Permanente Center for Health Research, Portland, Ore. is lead author of the JADA article along with four co-authors from the University of California, Los Angeles, University of the Pacific, University of Maryland, and Delta Dental of Iowa.
The article provides a sweeping assessment of changes in the state of oral health in the more than 20 years since the Surgeon General reported on oral health in 2000. According to the authors, in spite of improvements to care, there remain inequities. “Many low-income and minority adults lack dental insurance, and as a consequence seek care only for emergency needs,” the authors write.
“It is clear that the dental safety net has expanded in this country but that expansion has not yet helped everyone in need,” according to the authors of the commentary Facing the future and deciding what we want oral health to become. The commentary appears in the same issue of JADA and is co-authored by Bruce Dye, D.D.S., M.P.H., a dental epidemiologist and associate editor of JADA as well as professor and chair, Department of Community Dentistry and Population Health at the School of Dental Medicine, University of Colorado, Aurora; Rena N. D’Souza, D.D.S., Ph.D., director, National Institute of Dental and Craniofacial Research; and Judith Albino, Ph.D, professor emerita of public health, University of Colorado Anschutz Medical Campus.
Indeed, data from 2001 through 2020 show the number of people obtaining oral health care at Federally Qualified Health Centers (FQHCs) increased from 1.4 million to 5.2 million people; in 2017, one-third of these patients were younger than 18 years. Of these patients 88.5% were Medicaid or Children’s Health Insurance Program (CHIP) beneficiaries. The study authors note that in addition to improving delivery of oral health care in this country, the profession should act to shape the future of oral health, including making the case that oral care is an essential health care service.
The report considers factors affecting oral-care delivery, including the need to integrate oral and medical healthcare, improve insurance coverage and financing, and consider unmet needs in dental workforce planning. Work of both the American Dental Association’s Health Policy Institute and ADA Science & Research Institute were cited for valuable contributions of vital data and oral health research.
“While this report highlights that oral health is an integral part of overall health and the work of dentists in leading scientific advancements and clinical treatments that help improve patient health, we still have more work to do,” said Cesar R. Sabates, D.D.S., president of the American Dental Association (ADA).
The Oral Health in America report focused on three key strategies to improve oral health care in this country:
- making dental care services an essential benefit for both private and public insurance;
- incorporating dental or oral health care services demand into workforce planning; and
- increasing integration of oral and medical care delivery.
Strategies involving public and private stakeholders should be implemented to eliminate barriers and inequities in oral health care access, reduce cost, and improve both patient-centered care and oral health outcomes.
According to Dr. Sabates, the ADA challenges all health care professionals and health policy makers to raise awareness of the importance of oral disease prevention and to advocate for health care policies that will improve oral health care in the U.S. as equitably as possible.
“While I am encouraged to see the progress that has been made and applaud the recommendations for health professionals to work together in an interdisciplinary fashion there is still important work to be done to address the challenges that remain, particularly when it comes to improving health equity,” Dr. Sabates said.
“The ADA remains committed to advancing research, education, practice resources and advocacy on behalf of dental professionals and the public in order to improve oral health, particularly those facing barriers to access to care,” Dr. Sabates concluded.
