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Assessment of the Dental Public Health Infrastructure in the United States

Supported by the National Institute of Dental and Craniofacial Research, Contract No. 263-MD-012931.
July 2004

Executive Summary

In its narrowest definition, dental public health is one of the nine specialties of dentistry recognized by the American Dental Association Council on Dental Accreditation.  More broadly, dental public health has been defined as the "...science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts.  It is that form of dental practice which serves the community as a patient rather than the individual.  It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis."

A number of recent initiatives have highlighted the challenges facing oral health in the United States.  The Office of the US Surgeon General released its first report on oral health in America several years ago.  The major findings of that landmark report were: 1) oral diseases and disorders in and of themselves affect oral health and well-being throughout life; 2) safe and effective measures exist to prevent the most common dental diseases; 3) lifestyle behaviors that affect general health, such as tobacco use, also affect oral health as well; 4) there are profound oral health disparities among the US population; 5) more information is needed to improve America's oral health and eliminate health disparities; 6) the mouth reflects general health and well-being; 7) oral diseases and conditions are associated with other health problems; and 8) scientific research is key to further reduction in the burden of oral diseases and disorders.  The "framework for action" spelled out in the Surgeon General's Report on Oral Health highlighted the principal components of a plan to address those issues, which were:

  • Change public perceptions regarding oral health and disease so that oral health becomes an accepted component of general health.
  • Accelerate the building of the science and evidence base and apply science effectively to improve oral health.
  • Build an effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health.
  • Remove known barriers between people and oral health services.
  • Use public-private partnerships to improve the oral health of those who still suffer disproportionately from oral diseases.Another major recent initiative was the release of the Healthy People 2010 Objectives for Improving Health.  Among the focus areas included in Health People 2010 was oral health, with the overall goal being to prevent and control oral and craniofacial diseases, conditions, and injuries and to improve access to related services.  That goal was supported by 17 specific objectives that largely will require concerted dental public health action to achieve and monitor.

In addition, the American Dental Association's Future of Dentistry report adopted a vision of "Improved health and quality of life for all through optimal oral health," and laid out broad recommendations to help achieve that vision.  The seven broad recommendations were:

  1. Establish and support partnerships and alliances among dental, other health care professional, and public health organizations, as well as business and social service groups, in order to address common goals to improve oral health.
  2. Aggressively address the oral health needs of the public.
  3. Strengthen and expand dentistry's research and education capabilities.
  4. Ensure the development of a responsive, competent, diverse, and "elastic" workforce.
  5. Develop strategies to address the fiscal needs of the practice, education and research sectors of dentistry to ensure their viability and vitality.
  6. Establish a formal organization with membership consisting of the American Dental Association representing dental practice, the American Dental Education Association representing dental education, and the National Institute of Dental and Craniofacial Research and the American Association of Dental Research representing research.
  7. Utilizing the combined resources of the dental profession and dental industry, emphasis should be placed on the development of highly targeted, collaborative marketing and public relations initiatives. 

Clearly, implementing the framework outlined in The Surgeon General's Report on Oral Health in America, achieving the Healthy People 2010 Objectives for improving oral health, and realizing the vision of the Future of Dentistry report will require a viable dental public health infrastructure.  That infrastructure includes an adequate workforce, a sufficient administrative presence within health departments, adequate financial resources to implement programs, and legal authority to use personnel in an effective and cost-effective manner.  To be most effective, that dental public health workforce should be appropriately trained, should represent the diversity of America, and should be sustainable for the foreseeable future.

As a first step toward ensuring the adequacy of the dental public health infrastructure in the United States, this study sought to assess a number of its present elements.  Although it is nearly impossible to identify or measure all possible components of that infrastructure, this study did examine a number of the major areas.  Where possible, emphasis was placed on infrastructure at the state level.  It is hoped the information amassed for this project might provide useful baseline data for new initiatives that address elements of the dental public health infrastructure in the United States.

PDF file Assessment of the Dental Public Health Infrastructure in the United States (PDF File, 836KB)
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This page last updated: March 07, 2014