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Restructuring Dental Education to Facilitate Access to Oral Health Care

  • Dental Public Health (R Collins, Section Editor)
  • Published:
Current Oral Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review recent literature evaluating how current models of dental education are contributing to reducing oral health disparities in the USA. Recent innovations in dental schools’ curricula and admissions processes will be examined, as well as how oral health disparities have driven the education and subsequent expansion of the allied dental workforce.

Recent Findings

Dental school curricula and admissions changes have had minimal impact on reducing oral health disparities. Subsequently, educational innovations have resulted in the traditional duties of dentists being performed by dental therapists, advanced dental hygiene practitioners, and independent dental hygienists.

Summary

Public perception is that extended employment of allied dental professionals has resulted in improved access and delivery of dental care to underserved members of the population. Development of a diversified oral health workforce that provides team-based, inter-professional care will help decrease the oral health inequities that exist in the USA.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. National Research Council. Improving access to oral health care for vulnerable and underserved populations. National Academies Press; 2012.

  2. • Furlini L, Noushi N, Castonguay G, Allison P, Bedos C, De Souza R, et al. Assessing dental students’ readiness to treat populations that are underserved: a scoping review. J Dent Educ. 2018;82(5):483–91 This manuscript presents a scoping review on community-based dental education.

    Article  Google Scholar 

  3. Albino JE, Inglehart MR, Tedesco LA. Dental education and changing oral health care needs: disparities and demands. J Dent Educ. 2012 Jan 1;76(1):75–88.

    PubMed  Google Scholar 

  4. Formicola AJ, Bailit HL. Community-based dental education: history, current status, and future. J Dent Educ. 2012 Jan 1;76(1):98–106.

    PubMed  Google Scholar 

  5. Pipeline. Profession & Practice: Community-Based Dental Education. Released August 27, 2013. Available at: https://www.rwjf.org/en/library/research/2009/10/pipeline%2D%2Dprofession%2D%2D-practice.html. Accessed 23 July 2018.

  6. QuickStats. Prevalence of untreated dental caries in primary teeth among children aged 2–8 years, by age group and race/hispanic origin — national health and nutrition examination survey, 2011–2014. MMWR Morb Mortal Wkly Rep. 2017;66:261. https://doi.org/10.15585/mmwr.mm6609a5.

    Article  Google Scholar 

  7. Lillie-Blanton M, Brodie M, Rowland D, Altman D, McIntosh M. Race, ethnicity, and the health care system: public perceptions and experiences. Med Care Res Rev. 2000;57(1_suppl):218–35.

    Article  Google Scholar 

  8. Saha S, Shipman SA. Race-neutral versus race-conscious workforce policy to improve access to care. Health Aff. 2008 Jan;27(1):234–45.

    Article  Google Scholar 

  9. Racial and Ethnic Diversity among Dentists in the U.S. American Dental Association, Health Policy Institute Infographics. Released November 2017. Accessed 23 July 2018. Available at: https://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIgraphic_1117_6.pdf?la=en

  10. Woolfolk MW, Price SS. Efforts to increase student diversity in allied, predoctoral, and advanced dental programs in the United States: a historical perspective. J Dent Educ. 2012;76(1):51–64.

    PubMed  Google Scholar 

  11. Andersen RM, Friedman JA, Carreon DC, Bai J, Nakazono TT, Afifi A, et al. Recruitment and retention of underrepresented minority and low-income dental students: effects of the pipeline program. J Dent Educ. 2009;73(2 suppl):S238–58.

    PubMed  Google Scholar 

  12. Snyder CR, Frogner BK, Skillman SM. Facilitating racial and ethnic diversity in the health workforce. J Allied Health. 2018;47(1):58–69.

    PubMed  Google Scholar 

  13. Mertz EA, Wides CD, Kottek AM, Calvo JM, Gates PE. Underrepresented minority dentists: quantifying their numbers and characterizing the communities they serve. Health Aff. 2016;35(12):2190–9.

    Article  Google Scholar 

  14. Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666–8.

    PubMed  PubMed Central  Google Scholar 

  15. Vujicic M. Where do dental school graduates end up locating? J Am Dent Assoc. 2015;146(10):775–7.

    Article  Google Scholar 

  16. Feldman CA. Cost of dental education, student indebtedness, and our social contract. Am Dental Educ Assoc. 2014:1479–80.

  17. Bertolami CN, Berne R. Access to care: leveraging dental education. J Dent Educ. 2014 Nov 1;78(11):1481–8.

    PubMed  Google Scholar 

  18. Stafford GL, Nourzad F, Lobb WK, Beall JR. The economic costs and benefits of dental education: an empirical analysis. J Dent Educ. 2014;78(11):1497–507.

    PubMed  Google Scholar 

  19. Nicholson S, Vujicic M, Wanchek T, Ziebert A, Menezes A. The effect of education debt on dentists’ career decisions. J Am Dent Assoc. 2015;146(11):800–7.

    Article  Google Scholar 

  20. Nasseh K, Vujicic M. The relationship between education debt and career choices in professional programs: The case of dentistry. J Am Dent Assoc. 2017;148(11):825–33.

    Article  Google Scholar 

  21. Nash DA. Can dentistry have two contracts with the public? J Am Coll Dent. 2015;82(3):4–11.

    PubMed  Google Scholar 

  22. Benn DK. Professional monopoly, social covenant, and access to oral health care in the United States. J Dent Educ. 2003 Oct 1;67(10):1080–90.

    PubMed  Google Scholar 

  23. Mathu-Muju KR. Chronicling the dental therapist movement in the United States. J Public Health Dent. 2011;71(4):278–88.

    Article  Google Scholar 

  24. Mathu-Muju KR, Friedman JW, Nash DA. Current status of adding dental therapists to the oral health workforce in the United States. Curr Oral Health Rep. 2016;3(3):147–54.

    Article  Google Scholar 

  25. Commission on Dental Accreditation. Accreditation standards for dental therapy education programs. American Dental Association. 2015 February 6. Accessed 23 July 2018. Available at: http://www.ada.org/~/media/CODA/Files/dt.ashx

  26. Evans C. The principles, competencies, and curriculum for educating dental therapists: a report of the American Association of Public Health Dentistry Panel. J Public Health Dent. 2011 Mar;71:S9–19.

    Article  Google Scholar 

  27. Alaska Area 2016 Active User Population by Tribal Resolution and Federally Recognized Tribe for American Indians/Alaska Natives (AI/AN) from the Active User Population Report (B) Version 88. Accessed July 23, 2018. Available at: https://www.ihs.gov/alaska/includes/themes/responsive2017/display_objects/documents/pop_reports/TRIBE2016.pdf

  28. National Conference of State Legislatures. Federally recognized tribes. Accessed 23 July 2018. Available at: http://www.ncsl.org/research/state-tribal-institute/list-of-federal-and-state-recognized-tribes.aspx#ak

  29. Chi DL, Lenaker D, Mancl L, Dunbar M, Babb M. Dental utilization for communities served by dental therapists in Alaska’s Yukon Kuskokwim Delta: findings from an observational quantitative study. University of Washington. August 2017. Accessed July 23 2018. Available at: https://faculty.washington.edu/dchi/files/DHATFinalReport.pdf

  30. • Chi DL, Lenaker D, Mancl L, Dunbar M, Babb M. Dental therapists linked to improved dental outcomes for Alaska Native communities in the Yukon-Kuskokwim Delta. J Public Health Dent. 2018; This article demonstrates effectiveness of the community dental therapist for indigenous Alaskans.

  31. Glasrud PE, Ebertson C, Day T, Diercks R. A history of Minnesota's dental therapist legislation: or, what the heck happened up there? Minneapolis: Minnesota Dental Association; 2009.

    Google Scholar 

  32. Minnesota’s Dental Therapist Workforce. Highlights from the 2016 dental therapist survey. Minnesota Department of Health, Office of Rural Health and Primary Care. 2017, Available at: http://www.health.state.mn.us/divs/orhpc/workforce/oral/2016dtb.pdf

  33. Early Impacts of Dental Therapists in Minnesota. Minnesota Department of Health, Minnesota Board of Dentistry. Report to the Minnesota legislature. February, 2014. Available at: http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf

  34. Jacobi D, Hegelson MJ. Apple tree dental: an innovative oral health solution. J Calif Dent Assoc. 2015;43(8):453–8.

    PubMed  Google Scholar 

  35. Blue CM, Kaylor MB. Dental therapy practice patterns in Minnesota: a baseline study. Community Dent Oral Epidemiol. 2016;44(5):458–66.

    Article  Google Scholar 

  36. Vannah CE, McComas M, Taverna M, Hicks B, Wright R. Educational deficiencies recognized by independent practice dental hygienists and their suggestions for change. Am Dent Hyg Assoc. 2014;88(6):373–9.

    Google Scholar 

  37. American Dental Hygienists' Association. Transforming dental hygiene education and the profession for the 21st century. Available at: http://tenndha.com/wp-content/uploads/2015/10/ADHA-White-Paper.pdf. Chicago: American Dental Hygienists' Association; 2015.

    Google Scholar 

  38. Langelier M, Continelli T, Moore J, Baker B, Surdu S. Expanded scopes of practice for dental hygienists associated with improved oral health outcomes for adults. Health Aff. 2016;35(12):2207–15.

    Article  Google Scholar 

  39. Bell KP, Coplen AE. Evaluating the impact of expanded practice dental hygienists in Oregon: an outcomes assessment. Am Dent Hyg Assoc. 2015;89(1):17–25.

    Google Scholar 

  40. American Dental Hygienists’ Association. The history of introducing a new provider in Minnesota: A chronicle of legislative efforts. Chicago: American Dental Hygienists’ Association. Available from: https://www.adha.org/resources-docs/75113_Minnesota_Story.pdf

  41. American Dental Education Association. Vermont Governor signs dental therapy bill. Available from: http://www.adea.org/Blog.aspx?id=34695&blogid=20132

  42. State of Maine. An act to improve access to oral health care. Sec. 1.32 MRSA c. 16, sub-c. 3-C. Augusta, Maine: State of Maine; 2014. Available from: http://www.mainelegislature.org/legis/bills/bills_126th/billtexts/HP087001

  43. Lamster IB, Eaves K. A model for dental practice in the 21st century. Am J Public Health. 2011 Oct;101(10):1825–30.

    Article  Google Scholar 

  44. Nash DA, Friedman JW, Mathu-Muju KR, Robinson PG, Satur J, Moffat S, et al. A review of the global literature on dental therapists. Community Dent Oral Epidemiol. 2014;42(1):1–0.

    Article  Google Scholar 

  45. Mathu-Muju KR, Friedman JW, Nash DA. Saskatchewan's school-based dental program staffed by dental therapists: a retrospective case study. J Public Health Dent. 2017;77:78–85. https://doi.org/10.1111/jphd.12184.

    Article  PubMed  Google Scholar 

  46. Advancing Dental Care. Education and training review. National Health Service: health education England. 2018. Available at: https://www.hee.nhs.uk/sites/default/files/documents/advancing_dental_care_final.pdf

  47. Collins RJ, Friedman JW. The future of payment for dental care. Curr Oral Health Rep. 2018:1–7.

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Authors and Affiliations

  1. Division of Pediatric Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada

    Kavita R. Mathu-Muju

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  1. Kavita R. Mathu-Muju
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Correspondence to Kavita R. Mathu-Muju.

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This article is part of the Topical Collection on Dental Public Health

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Mathu-Muju, K.R. Restructuring Dental Education to Facilitate Access to Oral Health Care. Curr Oral Health Rep 5, 270–275 (2018). https://doi.org/10.1007/s40496-018-0192-0

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  • DOI: https://doi.org/10.1007/s40496-018-0192-0

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