The dental safety net, its workforce, and policy recommendations for its enhancement

Abstract

Objective: The dental safety net includes the facilities, providers, and payment programs that support dental care for underserved populations including those individuals disadvantaged by a variety of social, economic, and health conditions. Its components-health centers, dental schools, clinics, Medicaid-oriented dental practices, free-care programs, hospital emergency rooms, and others-vary in availability, comprehensiveness, continuity, and quality. The objective of this overview is to identify options and opportunities for policy changes to enhance oral health professional workforce in the safety net.

Methods: Characteristics of the dental safety net and its components are reviewed and compared.

Results: Professionals who now staff the dental safety net are a small subset of US dental providers and few current trainees anticipate practicing in these programs. Therefore, the safety net will continue to confront workforce challenges.

Conclusions: Multifactorial policy alternatives to increase the availability of dental professionals who care of the underserved include proposed changes in dental education, licensure, scope of practice for allied dental personnel, and federal and state financing of public insurance. Also needed are local efforts to establish social norms and activities among private dentists that engage more private practitioners in care of the underserved.