Oral Health in America: Implications for dental practice

Abstract

Background: Important, but insufficient, gains have been achieved in access to and delivery of oral health care since the 2000 US surgeon general's report on oral health in America. Access to care has increased for children and young adults, but considerable work remains to meet the oral health care needs of all people equitably. The National Institutes of Health report, Oral Health in America: Advances and Challenges, reviews the state of the US oral health care system, achievements made since 2000, and remaining challenges. In this article, the authors highlight key advances and continuing challenges regarding oral health status, access to care and the delivery system, integration of oral and systemic health, financing of oral health care, and the oral health workforce.

Results: Public insurance coverage has increased since 2000 but remains limited for many low-income, minority, and older adult populations. The oral health care workforce has expanded to include new dental specialties and allied professional models, increasing access to health promotion and preventive services. Practice gains made by women and Asian Americans have not extended to other minority demographic groups. Oral health integration models are improving access to and delivery of patient-centered care for some vulnerable populations.

Conclusions and practical implications: Coordinated policies and additional resources are needed to further improve access to care, develop dental insurance programs that reduce out-of-pocket costs to lower-income adults, and improve the integration of oral and medical health care delivery targeting a common set of patient-centered outcomes. Dental care professionals need to fully participate in meaningful and system-wide change to meet the needs of the population equitably.

Keywords: Oral Health in America; access; dental practice; disparities; insurance; integration; workforce.

Figure 1

Summary messages for dental practice. HPV: Human papillomavirus. Source: National Institutes of Health.

Figure 2

Delay or nonreceipt of needed oral health care during the past 12 months due to cost, by selected age group: United States, 2000-2018. Source: National Center for Health Statistics.