Oral U

Closing the dental health gap

It wasn’t like we didn’t get the memo about the gap in oral healthcare in America. As far back as the Surgeon General’s report 15 years ago, we knew that quality, affordable, and accessible oral health is acutely disaggregated – read as, if you live in a middle class or high end suburban neighborhood, quality dental care is readily available when compared to neighborhoods in poor urban areas and especially for rural, place bound populations across the Nation.

Indeed, we learned from former President of the American Dental Association, Robert A. Faiella D.M.D., that there continues to be “a gap between those with good dental health and those without. Its causes are varied and complex and it will only get worse without a comprehensive set of solutions”.

Even the Federal Reserve has taken serious note of the looming public health problem – concluding in its Report on Well-Being of U.S. Households that a quarter of people surveyed did not go through with needed dental procedures or appointments because of the expense. We gleaned from a 2012 U.S. Senate Report entitled “Dental Crisis in America” that the oral health gap has led to 164 million missed work hours; 51 million hours of absences from school; poor nutrition; and a decline in overall well-being. In 2010, the American Dental Association cited that 181 million Americans did not visit a dentist which is over half of the U.S. population.

For its part, dentists and their higher ed counterparts have increased the function of other career professionals in the oral health brain chain to serve as many people as possible – read as, dental assistants and dental hygienists. Already, a number of states have by legislation or regulation broadened the permissible functions of dental assistants and dental hygienists under the direct supervision of dentists.

Problematically, the preponderance of dental schools and dental assistant and hygiene programs are located in or near metropolitan areas or collegetowns with shifting demographics. In response to this unmet need, the University of New England opened its College of Dental Medicine in 2013 to help serve rural communities in Maine. We learned from UNE Provost, James J. Koelbl D.D.S., about the College’s mission – “if we can create a dental program in Maine and recruit from rural areas, especially Maine, New Hampshire and Vermont, train them locally, get them into clinics in their fourth year, we can increase chance of them practicing here”. Clearly, UNE has set out on a bold path to close the oral health gap in the place bound communities that need it most in the northern tier of New England.

Significantly, schools offering dentistry, dental hygiene, and dental assistance have large waiting lists of qualified students. This is due in part to the fact that over the next five to ten years employment growth rates are expected to rise 12.5% for dental assistants and 19.9% for dental hygienists according to the Bureau of Labor Statistics. That said, without adding capacity to the American dental health education system, the gap is likely to continue growing beyond supply in the years ahead.

With this background in mind, we reached out to Dr. Tushar Patel D.M.D., a scholar practitioner and clinical expert, whose practice is centered in Fall River – an industrial gateway city on the south coast of Massachusetts. What we learned from Dr. Patel is that there are new opportunities for expanding community dental clinics through mission complementary partnerships with programs of dental hygiene and dental assisting typically available at community and technical colleges and secondary schools throughout the United States. Through the Akshar Dental Education Network, Dr. Patel is linking higher ed institutions with community based dental clinic programs to better serve the oral health needs of Southeastern Massachusetts.

On the opposite coast, the Herman Ostrow School of Dentistry at the University of Southern California helps serve urban areas that are in need of oral health solutions by using a mobile dental unit. Uniquely, aspiring USC dental students travel throughout California providing free dental health education and preventative care.

What this all means nationwide is that both the public and independent sectors of higher education need to consider their role in closing the oral health gap through community-based, preventive oral health education and on a near-term basis, increasing capacity for producing well educated and well trained dentists, dental hygienists, and dental assistants.

—James Martin and James E. Samels, Future Shock columnists, are authors of The Provost’s Handbook: The Role of the Chief Academic Officer (Johns Hopkins University Press, 2015). Martin is a professor of English at Mount Ida College (Mass.) and Samels is president and CEO of The Education Alliance.

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