ADA says panels need working dentists and more should receive care

The panels are tasked with studying oral health care delivery and access.

ADA President Dr Ronald Tankersley testified before the Institute of Medicine (IOM) on March 4. He pointed out that private practice dentists represent nearly 92 percent of all professionally active dentists, and he said their input is crucial to addressing the oral health care access issue.

“I am obligated, on behalf of our members, to protest the IOM’s continuing failure to include representatives of the private practice dental community on either of its two oral health panels,” Dr Tankersley said. “We respect the experience and knowledge of the committee members, but the nation’s 167,000 private practice dentists represent some 92 percent of professionally active dentists in the United States. Without them, there can be no significant impact on access to oral health care, regardless of the delivery system.”

Dr Tankersley went on to outline the ADA’s efforts to address ways to improve access for underserved populations.

“The ADA believes that oral health depends on preventing oral disease,” he said. “The nation will never drill and fill its way out this problem. Our efforts to improve access to care have taught us that there are many contributing factors and barriers to the problem. Some are economic and others environmental. Some are direct and others indirect. Some are related to the individual and others to the provider. The ADA has been on the vanguard of advocating access solutions.”

Dr Tankersley cited the following ADA initiatives as examples:

• Designing and implementing a pilot program for its prevention-focused Community Dental Health Coordinator, a community health worker with dental skills now active in Philadelphia, rural Oklahoma and Indian tribal areas.

• Convening an Access to Dental Care Summit in 2009 for a broad range of 144 stakeholders to identify short- and long-term ways to improve oral health for underserved populations.

• Creating a Public Health Advisory Committee to provide a formal presence within the ADA to receive input on issues of public health significance.

• Convening the 2007 American Indian/Alaska Native summit to collaboratively address the unique needs of these populations.

• Implementing an initiative to address oral health needs of the vulnerable elderly, one outcome of which will be the introduction of federal legislation.

• Seeking to increase collaboration among private practice dentists and those working in federally qualified health centers and other dental safety net clinics, where about 69 percent of the dentists are members of the ADA.

• Lobbying for virtually every federal program that could effectively improve access for the dentally underserved.

“While the current dental delivery system serves most Americans well, we must work together to extend that system to the most vulnerable among us, who are at the greatest risk for developing oral disease,” Dr Tankersley said.

He said the ADA believes that there are three ways to help prevent oral disease:

1. To rebuild the public health infrastructure and expand and adequately fund safety net programs, including Medicaid.

2. To increase community-based prevention programs.

3. To improve oral health literacy.

“Our current dental public health infrastructure is insufficient to address the needs of the underserved, and the gap between needs and the ability to address those needs is growing,” Dr Tankersley said. “State and local health departments have for decades suffered a continual erosion of their dental programs due to neglect by both state and federal policymakers.”

Dr Tankersley said that a perfect example is the New York City health department, which has been forced to close a number of school-based dental clinics due to budget problems, cutting or reducing services to about 17,000 students.

Also of concern to the ADA, Dr Tankersley added, was the closed-door nature of much of the committee’s business.

“This committee cannot, through a few minutes of testimony, hear enough from those who are in the field delivering care to inform its decisions,” Dr Tankersley said. “Improving access to oral health services for underserved members of our society has been a primary goal of the ADA for years.”