Millions in U.S. Lack Access to Dentists
Study Shows Geography, Economics, and Shortage of Dentists Limit Dental Care
Boosting Access to Dental Care continued...
"Most dentists are white men," Gehshan says. "Research shows that dental students from rural or underserved areas are more likely to go back to these areas to practice."
The committee also called on the Health Resources and Services Administration to expand opportunities for dental residencies in underserved areas.
The IOM also addressed major limitations in oral care among economically disadvantaged people receiving Medicaid. States must provide dental benefits for children enrolled in the Children's Health Insurance Program (CHIP), they are not required to provide benefits to adults.
Gehshan says while the committee members agreed that dental benefits should be available to all Medicaid recipients, the group recognized that this is not likely to happen in the current economic climate.
The committee called on federal officials to fund state-based "demonstration projects" aimed at providing dental care to adult Medicaid recipients.
In addition, the committee recommended increasing Medicaid and CHIP reimbursements and simplifying administrative practices.
"A growing number of dental professionals will not take people on these programs because reimbursements are just too low," Rivara says.
The committee called on state officials to update their dental practice regulations with the goal of doing away with restrictions that limit access to dental services.
One example cited by Gehshan involved the application of fluoride sealants that help prevent cavities.
She says 22 states still require a dentist to examine a child before a dental hygienist is allowed to apply a sealant.
New Ways to Deliver Dental Care
Gehshan says innovative ways of delivering dental services will be needed to address the shortage of dentists.
The report called for more research into new approaches to care, including the use of mobile dental vans staffed by dental hygienists or practitioners who have several years of dental training but are not dentists.
Known as dental therapists, these practitioners are the oral health equivalent of nurse practitioners.
Only two states -- Alaska and Minnesota -- license dental therapists, but at least 50 other countries allow them to practice, Gehshan says.
The American Dental Association (ADA) has come out strongly against allowing non-dentists to perform surgery.