Today (February 22, 2011) the American Dental Association (ADA) issued a 16 page document titled Breaking Down Barriers to Oral Health for All Americans: The Role of Workforce. This can be downloaded on the ADA website at http://www.ada.org/sections/advocacy/pdfs/ada_workforce_statement.pdf
The document is intended as the first in a series of documents which will be subsequently released intended to help improve the oral health of Americans who may not currently have proper access to dental care.
In the opening of the document is a message from Raymond Gist, D.D.S. and President of the American Dental Association. In this message Dr. Gist states
“As the nation’s leading advocate for oral health, the ADA believes that we can and will reach the day when no American who needs and seeks the care that leads to good oral health will be denied. We believe that this can be accomplished by enhancing, rather than compromising a proven system of care that has served the oral health needs of generations.”
In the document it is stated
“Until a sense of value and a desire for oral health become the norm, the existing barriers will continue to block any significant progress toward improving the oral health of those who currently lack care.”
Further in the document it is stated
“Every group involved in any aspect of solving the nation’s oral health disparities latches onto the same statistics, events and trends in order to argue its case: That dental disease is the most prevalent malady affecting the nation’s children; that disadvantaged children experience a significantly greater burden of oral disease than other children, accounting for 80 percent of childhood dental disease; that a deplorably small percentage of disadvantaged children and adults see dentists regularly; that a great number of private practice dentists cannot afford to treat patients covered under Medicaid, SCHIP or similar programs; that evidence of links between chronic oral disease and non-oral disease continues to mount.”
An interesting point is made in the document about how the number of dentists in the U.S. is expected to increase from 180,000 today to roughly 200,000 in 2030 even though many earlier reports have predicted otherwise.
Another point brought up in the document is
“In the economic sense, the populations in the most common underserved settings—remote rural areas, Native American communities and inner cities—cannot support a dental practice because no one is paying adequately for their care.”
Further on in the document it says
“… dental clinics, whether government funded, private or nonprofit can have a critical role in communities that for whatever reason cannot attract sufficient private dental practices. In some communities these clinics may be the only resource available for dental care, and they often are overwhelmed. Many dentists who dedicate their careers to working in them do so out of powerful sense of social responsibility.”
A conclusion in this document is the following
“The preceding discussion takes place in a terrible context: an ongoing epidemic in the most powerful country in the world, one that corrodes lives, robs children of otherwise bright futures, aggravates chronic and expensive-to-treat medical conditions and even, as in the case of 12-year-old Deamonte Driver, kills.”
Clearly a large theme in this document is how economics prevent dentists from being able to provide adequate treatment to low income individuals and those in remote areas. They want to serve them but competitive pay does not allow for it. Other ways to approach this such as with creative and outreach approaches are discussed.
Ultimately it seems to me that what is truly needed is single-payer health care in the United States, such as what is advocated by the Physicians for a National Health Program http://pnhp.org/, although this comes with many challenges as well.
As stated in the ADA document on its own entirely seperate page
“Ultimately, education and prevention will be the linchpins in eliminating, or at least minimizing untreated dental disease.”