A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers (original) (raw)
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A paradigm shift in models of oral health care: an example and a call to action
The consequences of oral disease are wide-ranging and can have a major impact on an indi-vidual's and that person's family's quality of life. A range of factors interact to determine a person's oral and general health. Such factors can be biological, social, economic, political, cultural, or environmental, in addition to knowledge, attitudes and behaviors. Traditional models of oral health care, however, have generally ignored these factors and instead have focused on the treatment and management of existing pathology (tertiary prevention/downstream approach). This has had no effect on the rate of hospitalization or the inequitable distribution of dental diseases. To reduce the prevalence and severity of oral diseases at the individual and population levels, holistic evidence-informed prevention-based health-promoting models of care that focus on upstream determinants of health are required. The Oral Health Program at North Richmond Community Health in the state of Victoria, Australia, has developed an innovative model of oral health care based on the following principles: health promotion, disease prevention, risk-based access to care, client-and family-centered care, team-based provision of care, multidisciplinary care, and innovation. Evaluation of this approach is currently being conducted to study the sustainability of such a model under the current public dental service funding model.
Attributes of an ideal oral health care system
Journal of Public Health Dentistry, 2010
The sense of urgency concerning the inadequacies of the current U.S. oral health care system in better preventing oral diseases, eliminating oral health disparities, and ensuring access to basic oral health services has increased in recent years. This paper sought to articulate the attributes that an ideal oral health care system would possess, which would be consistent with the principles of the leading authorities on the public's health. The authors reviewed policy statements and position papers of the World Health Organization, The Institute of Medicine, The American Public Health Association, Healthy People 2010 Objectives for the Nation, and the American Association of Public Health Dentistry. Consistent with leading public health authorities, an ideal oral health care system would be have the following attributes: integration with the rest of the health care system; emphasis on health promotion and disease prevention; monitoring of population oral health status and needs; evidence-based; effective; cost-effective; sustainable; equitable; universal; comprehensive; ethical; includes continuous quality assessment and assurance; culturally competent; and empowers communities and individuals to create conditions conducive to health. Although there are some attributes of an ideal oral health care system on which the United States has made initial strides, it falls far short in many areas. The development of an oral health care delivery system that meets the characteristics described above is possible but would require tremendous commitment and political will on the part of the American public and its elected officials to bring it to fruition.
Journal of dental …, 2003
Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty-five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty-five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.
Addressing Oral Health Inequities, Access to Care, Knowledge, and Behaviors
Preventing Chronic Disease, 2021
Oral health is essential to overall health (1), and dental public health is a field of public health and a specialized field of dentistry that focuses on improving access to oral health care and understanding the factors that contribute to improving oral health from a population health perspective (2). This collection of articles in Preventing Chronic Disease (PCD), "Oral Health Behaviors and Availability of Dental Services Among Children and Adults," features 8 articles that discuss contemporary dental public health challenges and opportunities. These include inequities in access to dental care, disparities in the prevalence of oral disease, risk behaviors related to oral disease, the relationship between oral health and chronic diseases, and the effect of the COVID-19 pandemic on oral health.
Disparities in Access to Oral Health Care
Annual Review of Public Health, 2020
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the li...
Academic Pediatrics, 2009
We examined progress in US children's oral health and dental public health infrastructure since the Healthy People 2010 Oral Health Objectives were issued. We summarize trends in the prevalence of dental caries and dental sealants on the basis of national and state-specific data. Trends in state oral health program activities, funding, and staffing were derived from annual surveys. The prevalence of dental caries in primary teeth of children aged 2-4 years increased from 18% in 1988-1994 to 24% in 1999-2004. Racial disparities persisted in that age group, with caries significantly more prevalent among non-Hispanic black and Mexican American children than among non-Hispanic white children. Caries prevalence in primary teeth of non-Hispanic white children aged 6-8 years remained unchanged, but increased among non-Hispanic black and Mexican American children. State-specific prevalence of caries among third-graders ranged from 40.6% to 72.2%. Caries in permanent teeth declined among children and adolescents, while the prevalence of dental sealants increased significantly. State oral health programs' funding and staffing remained modest, although the proportion of states with sealant programs increased 75% in 2000 to 85% in 2007 and the proportion with fluoride varnish programs increased from 13% to 53%. Progress toward improving the oral health of America during the past decade has been mixed. Greater attention to the oral health of young children is clearly needed, and child health professionals can be valuable partners in the effort. With continued high prevalence of a largely preventable disease, ongoing problems with access to basic oral health services, and increased national attention to health care reform, there is a clear need and opportunity for governments to make serious and sustained investments in dental public health.