Oral health care access:
From the Publisher: An important, timely issue on access to oral health care. Topics include: ethics, the dental workforce, non-dental health professionals providing access to dental care for low-income and minority patients, dental health care finance, third party reimbursement for dental care and...
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2009
|
| Schriftenreihe: | The dental clinics of North America
53,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Zusammenfassung: | From the Publisher: An important, timely issue on access to oral health care. Topics include: ethics, the dental workforce, non-dental health professionals providing access to dental care for low-income and minority patients, dental health care finance, third party reimbursement for dental care and access to dental care, managing clinical risk, teledentistry, private sector response, dental insurance, improving patient retention, expanding the dental workforce through dental therapists, and much more! |
| Beschreibung: | XVI, S. [399]-615 Ill., graph. Darst. |
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Datensatz im Suchindex
| _version_ | 1804139320181784576 |
|---|---|
| adam_text | Titel: Oral health care access
Autor: Colangelo, Gary A.
Jahr: 2009
Contents
Foreword xi
Burton L Edelstein
Preface xv
Gary A. Colangelo
How Dental Care Can Preserve and Improve Oral Health 399
Clemencia M. Vargas and Oscar Arevalo
Oral health is associated with overall health, and lack of access to dental
care has consequences that go far beyond aesthetics. Most oral dis¬
eases are preventable and are relatively easy and inexpensive to address
at early stages. However, multiple barriers make dental care unreachable
for a sizable portion of the United States population, who consequently
has higher incidence and prevalence of disease. Achieving meaningful
improvements in oral health status among these groups will require a re¬
vamping of the dental infrastructure, augmenting the productivity and
skills of the dental workforce, and increasing the population s oral health
literacy.
The Dilemma of Access to Care: Symptom of a Systemic Condition 421
James T. Rule and Jos V.M. Welie
The standard ethical arguments that prescribe dentistry s involvement in
improving access to oral health care are based on the ethical principle
of social justice. The authors underwrite this principle but argue that, as
with other ethical principles, this principle alone will fail to have a practical
impact. The authors show that the issue of access is a symptom of a more
systemic problem in dentistry, namely the lack of connectedness that den¬
tists feel between themselves and their profession, their community, and
society at large. The second half of the article develops a plan for boosting
connectedness. Successful implementation should help resolve many
of the systemic problems that dentistry currently faces, including the issue
of disparities in oral health.
Dental Workforce 435
Eric S. Solomon
The dental workforce refers to the number, distribution, and character¬
istics of dentists, dental auxiliaries, and other support staff involved in
the provision of oral health care. This article reviews the changes in
the dental workforce that have taken place, especially during the last
50 years, the present status of the workforce, and projections about
the adequacy and composition of the dental workforce in the coming
years.
The Role of Non-Dental Health Professionals in Providing Access to Dental
Care for Low-Income and Minority Patients 451
Leonard A. Cohen
The disadvantaged suffer disproportionately from dental problems. These
persons are more likely to have untreated oral health problems and asso¬
ciated pain, and also are more likely to forego dental treatment even when
in pain. There has been increased emphasis on the potential role of physi¬
cians in alleviating oral health disparities, especially among children. In ad¬
dition, many adults lacking access to traditional dental services seek care
and consultation from hospital emergency departments, physicians, and
pharmacists. The delivery of oral health care services by non-dental health
professionals may assume increasing importance as the population con¬
tinues to age and becomes more diverse. This is because, in general,
the elderly and ethnic and racial minorities face significant economic bar¬
riers to accessing private dental services.
Improving Access to Oral Health Care for Children by Expanding the Dental
Workforce to Include Dental Therapists 469
David A. Nash
This article documents the disparities in oral health among children, iden¬
tifies barriers to access to care for children, describes the use of dental
therapists internationally to improve access to care for children, docu¬
ments previous efforts in the United States to train individuals other than
dentists to care for children s teeth, describes the current status of the
use of dental therapists in Alaska, justifies limiting the care given by dental
therapists to children, suggests potential economic advantages of using
dental therapists, and concludes by describing how dental therapists
could be trained and deployed in the United States to improve access to
care for children and reduce disparities in oral health.
Public Programs, Insurance, and Dental Access 485
Richard J. Manski
Disparities remain among the United States population with regard to who
receives dental treatment. This article assesses current programs de¬
signed to provide dental insurance coverage. This assessment examines
person-level use and expenditures as a function of preferences, price,
and the use of third-party coverage.
Dental Benefits Improve Access to Oral Care 505
Rene Chapin
Dental coverage provides a means to obtain oral care, which is an important
component of overall health. This article discusses the common forms of
dental health plans, the services usually covered, and their relative costs.
Managing Clinical Risk: Right Person, Right Care, Right Time 511
Council on Dental Practice, American Dental Association,
and Frank J. Graham
Dentists and the dental health care industry have a renewed interest in
clinical risk assessment, because they offer the potential to identify
a patient s clinical needs for oral health care more specifically, to maximize
prevention by early intervention, and to educate patients to become more
informed consumers of oral health care and direct resources where they
are most needed and can produce the greatest value. To realize this po¬
tential, risk assessment must be applied appropriately, and its indirect
ramifications for access to care should be considered. Several ideas for
the appropriate application of risk assessment are discussed and the ram¬
ifications for access to care are explored.
Private Sector Response to Improving Oral Health Care Access 523
Council on Access, Prevention and Interprofessional Relations,
and Lindsay A. Robinson
Despite vast improvements in the oral health status of the United States
population over the past 50 years, disparities in oral health status continue,
with certain segments of the population carrying a disproportionate dis¬
ease burden. This article attempts to describe the problem, discuss vari¬
ous frameworks for action, illustrate some solutions developed by the
private sector, and present a vision for collaborative action to improve
the health of the nation. No one sector of the health care system can re¬
solve the problem. The private sector, the public sector, and the not-for-
profit community must collaborate to improve the oral health of the nation.
Using Teledentistry to Improve Access to Dental Care for the Underserved 537
James Fricton and Hong Chen
Teledentistry is an exciting new area of dentistry that fuses electronic
health records, telecommunications technology, digital imaging, and the
Internet to link health providers in rural or remote communities. For the pa¬
tient located in underserved or remote areas, teledentistry improves ready
access to preventive dental care and teleconsultation with specialists. It al¬
lows the dentist in the nearby community to provide easier access to pre¬
ventive care to a patient who, otherwise, probably will not seek care. It
enables the specialist located many miles away to make a diagnosis and
recommend treatment options and/or referral.
Social Work in Dentistry: The CARES Model for Improving Patient Retention
and Access to Care 549
Joan M. Doris, Elaine Davis, Cynthia Du Pont, and Britt Holdaway
Social work programs in dental schools and dental clinics have been op¬
erated successfully since the 1940s, and have been documented as con¬
tributing to patients access to care and to dental education. However,
unlike medical social work, with which it has much in common, social
work in dentistry has failed to become a standard feature of dental schools
and clinics. Few of the social work initiatives that have been implemented
in dental schools have survived after initial grant funding ran out, or the in¬
stitutional supporters of the program moved on. The authors hope that the
CARES program serves as a model for the successful development of
other programs at the intersection of social work and dentistry to the ben¬
efit of both dental patients and providers.
An Introduction to Oral Health Care Reform 561
Kristen L. Hathaway
Oral health care reform is made up of several components, but access to
care is central. Health care reform will occur in some fashion at some point,
and how it will impact the entire dental sector is unclear. In the short term,
there is likely to be a dental component during the reauthorization of State
Children s Health Insurance Program in early 2009, and several federal oral
health bills are expected to be reintroduced as well. Additional public fund¬
ing for new programs and program expansions remains questionable, as
federal funding will be tight. Fiscal conservancy will be occurring in the
states as well; however, various proposals to expand dental hygienists
duties are likely, as are proposals related to student grants for dental
schools. Regardless of one s political stance, the profile of oral health
care has been elevated, offering countless opportunities for improvement
in the oral health of the nation.
Why Public Policy Matters in Improving Access to Dental Care 573
Shelly Gehshan and Andrew Snyder
The executive and legislative branches of state government have broad au¬
thority that provides the underpinning for the dental health care system.
This article describes four principal areas in which policy makers decisions
can improve children s access to dental care: (1) providing and financing
health care (ie, providing opportunities for shaping public insurance pro¬
grams like Medicaid and SCHIP); (2) regulating health providers and facili¬
ties (ie, providing levers for policy change in dental practice acts); (3)
ensuring the health of the public (ie, states choices on population-based
approaches and providing leadership in oral health); and (4) education
and training of the health workforce (ie, state support of dental education
that can ensure a dental workforce that meets the needs of the population).
Innovations to Improve Oral Health Care Access 591
Gary A. Colangelo
Improving access to oral health care requires an understanding of the so¬
cial, cultural, political, financial, and manpower factors that influence ac¬
cess. Armed with this knowledge, individuals and organizations desiring
to improve access can innovate to change public policy, garner resources,
create clinical programs, and expand public health interventions as dem¬
onstrated by the examples in this article. This article highlights past and
contemporary innovations that have improved access, or have the poten¬
tial to improve access to oral health care. These innovations are grouped
into six categories: the dental profession, public health, community-based
care delivery, oral health care funding, dental education, and evidence-
based dentistry.
Index 609
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