|
|
|
The Burden of Oral DiseaseVI. PROVISION OF DENTAL SERVICESa. Dental Workforce and CapacityThe oral health care workforce is critical to society抯 ability to
deliver high-quality dental care in the United States. Effective health
policies intended to expand access, improve quality, or constrain costs must
take into consideration the supply, distribution, preparation, and
utilization of the health workforce (see
http://bhpr.hrsa.gov/healthworkforce/reports/profiles/) b. Dental Workforce DiversityOne cause of oral health disparities is a lack of access to oral health
services among under-represented minorities. Increasing the number of dental
professionals from under-represented racial and ethnic groups is viewed as
an integral part of the solution to improving access to care [USDHHS 2000b].
Data on the race/ethnicity of dental care providers were derived from
surveys of professionally active dentists conducted by the American Dental
Association [ADA 1999]. In 1997, 1.9 percent of active dentists in the
United States identified themselves as black or African American, although
that group constituted 12.1 percent of the U.S. population. Hispanic/Latino
dentists made up 2.7 percent of U.S. dentists, compared with 10.9 percent of
the U.S. population that was Hispanic/Latino. State Health Workforce Profiles from the National Center for Health Workforce Analysis: From the American Dental Education Association (www.adea.org*):
c. Use of Dental Servicesi. General PopulationAlthough appropriate home oral health care and population-based prevention are essential, professional care is also necessary to maintain optimal dental health. Regular dental visits provide an opportunity for the early diagnosis, prevention, and treatment of oral diseases and conditions for people of all ages and for the assessment of self-care practices. Adults who do not receive regular professional care can develop oral
diseases that eventually require complex treatment and may lead to tooth
loss and health problems. People who have lost all their natural teeth are
less likely to seek periodic dental care than those with teeth, which, in
turn, decreases the likelihood of early detection of oral cancer or soft
tissue lesions from medications, medical conditions, and tobacco use, as
well as from poor-fitting or poorly maintained dentures. Persons with visits
to the dentist in the last 12 months are shown in Table XII. Table XII. Proportion of Persons Aged 2 Years and Older Who Visited a Dentist in the Previous 12 Monthsa
Table XII Sources: ii. Special PopulationsSchoolchildren / Pregnant Women (National YRBS data were collected in 2003 but have not yet been
reported. If available, include state YRBS data or other state data on
dental visits.) Schoolchildren / Pregnant Women Studies documenting the effects of hormones on the oral health of pregnant
women suggest that 25�0 percent of these women experience
gingivitis and up to 10 percent may develop more serious oral infections [Amar
& Chung 1994; Mealey 1996]. Recent evidence suggests that oral infections
such as periodontitis during pregnancy may increase the risk of preterm or
low birthweight deliveries [Offenbacher et al. 2001]. During pregnancy, a
woman may be particularly amenable to disease prevention and health
promotion interventions that could enhance her health or that of her fetus [Gaffield
et al. 2001]. d. Dental Medicaid and State Children抯 Health Insurance ProgramsMedicaid is the primary source of health care for low-income families, the elderly and disabled persons in the United States. This program became law in 1965 and is jointly funded by the federal and state governments (including the District of Columbia and the Territories) to assist states in providing medical, dental, and long-term care assistance to people who meet certain eligibility criteria. People who are not U.S. citizens can receive Medicaid only to treat a life-threatening medical emergency; eligibility is determined on the basis of state and national criteria. Dental services are a required service for most Medicaid-eligible individuals under the age of 21 years, as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Services must include, at a minimum, relief of pain and infections, restoration of teeth, and maintenance of dental health. Dental services may not be limited to emergency services for EPSDT recipients [Centers for Medicare & Medicaid Services, 2004]. Nationally, federal Medicaid expenditures for Medicaid totaled $2.3 billion
in 2003, or three percent of the $74.3 billion spent on dental services
nationally [Centers for Medicare & Medicaid Services 2004]. [EXPENDITURES e. Community and Migrant Health Centers and other State, County, and Local ProgramsCommunity Health Centers (CHCs) provide family-oriented primary and preventive health care services for people living in rural and urban medically underserved communities. CHCs exist in areas where economic, geographic, or cultural barriers limit access to primary health care. The Migrant Health Program (MHP) supports the delivery of migrant health services, serving more than 650,000 migrant and seasonal farm workers. Among other services provided, many CHCs and Migrant Health Centers provide dental care services. Healthy People 2010 objective 21� is to 揑ncrease the proportion
of local health departments and community-based health centers, including
community, migrant, and homeless health centers, that have an oral health
component� [USDHHS
2000b]. In 2002, 61 percent of local jurisdictions and health centers had an
oral health component [USDHHS 2004b]; the Healthy People 2010 target
is 75 percent. One or more documents on this Web page is available in Excel Format (XLS). You will need Microsoft Excel Viewer to view and print these documents. One or more documents on this Web page is available in Portable Document Format (PDF). You will need Acrobat Reader to view and print these documents. * Links to non-Federal organizations are
provided solely as a service to our users. Links do not constitute an
endorsement of any organization by CDC or the Federal Government, and none
should be inferred. The CDC is not responsible for the content of the individual
organization Web pages found at this link.
Date last reviewed: September 21, 2007
|
|
||||||||||||
|