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New Institute of Medicine report on oral health access

Kathy Reincke
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The W.K. Kellogg Foundation applauds a new report issued yesterday by the Institute of Medicine (IOM) as an important step in improving access to oral health care for vulnerable children and families. The report offers a clear roadmap for how public and private entities – including dental schools, dental professionals , government agencies, Congress, health professionals and foundations – can help ensure that every American, and especially vulnerable children and families, has access to dental care. And it is sorely needed. Millions of the nation’s most vulnerable children lack access to oral care. According to the IOM panel, the current system fails a third of the nation.

The Kellogg Foundation is particularly encouraged that the report calls for:

  • Assessing new dental workforce models as a way to expand access to oral health care; and
  • Changing state laws, including practice laws, to optimize access to oral health care and to allow remote collaboration and supervision.

The report correctly identifies the critical need to better integrate oral health into overall health. There’s a critical link between the mouth and the rest of the body that is hugely overlooked. Poor oral health can lead to a lifetime of other health issues including heart disease, stroke and diabetes. Expanding the dental workforce can increase access to oral health, and help improve oral health, especially for those who currently go without much-needed care. In Alaska, 35,000 people are now receiving dental care as a result of adding dental therapists to a dentist-led team.

Growing Momentum for New Solutions

The Kellogg Foundation has a history of support for expanding access to oral health care for vulnerable children and families. Today, communities in Kansas, New Mexico, Ohio, Vermont and Washington are working to add dental therapists to the oral health workforce to extend the reach of the dental team to provide care in places where there aren’t enough dentists to meet the need.

In addition to the Alaska program, the first class of dental therapists in Minnesota is going into the field now, and Oregon recently passed legislation allowing for midlevel provider model demonstration projects. About a dozen other states also have expressed interest in pursuing this innovative model.

According to federal estimates, the U.S. needs 9,933 new dentists to fill the current gap in care. The IOM report notes that under the Affordable Care Act, state insurance exchanges will be required to provide oral health coverage for children beginning in 2014, further straining the system. Clearly new providers must be added to the system.

The report calls for “multiple solutions that use an array of providers in a variety of settings.” Improving oral health will require a multifaceted approach and dental therapists should be part of the equation.

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