In a series of perspective papers, report editors lay out recommendations for achieving oral health equity
NIDCR Director Rena D’Souza, DDS, PhD, along with editors of the NIH report Oral Health in America: Advances and Challenges, have authored a series of perspective papers and accompanying editorials that draw on the report’s findings to propose strategies for addressing the nation’s oral health challenges. The papers, published in four dental specialty journals, offer audience-specific recommendations for dental practitioners, educators, researchers, and public health specialists. The recommendations focus on changes needed in dental health care, education, research, and policy to adapt to a changing oral health landscape, including an older and more diverse population, new ways of delivering care, and an emerging understanding of social determinants of oral health.
“The Oral Health in America report showed that although some measures of oral health have improved over the last 20 years, there is still much work to be done,” said Dr. D’Souza. “The papers published today serve as a framework to guide our community in creating an oral health ecosystem that ensures all Americans can enjoy the benefits of good oral health.”
Improving oral health and addressing disparities must first start with advances in science and technology, write the authors of a perspective paper in the Journal of Dental Research. Innovations in high throughput “omics” technologies, data science, computational biology, and bioengineering, as well as new insights into cellular, molecular, and microbial biology, will illuminate the connections between oral and systemic health and enable personalized oral health care. Eliminating disparities will require a better understanding of the relationships among mental health, substance use disorders, and oral health, as well as other social determinants of health. Implementation research to evaluate methods for integrating basic science discoveries into evidence-based patient care is critical. Finally, the authors emphasize the need for a diverse and well-trained oral health research workforce that is adequately prepared for the scientific rigor of an evolving research landscape.
The last two decades have seen significant decreases in untreated dental caries in children, improvements in tooth retention among adults, and a slight decrease in deaths from oral and pharyngeal cancers, write the authors of a second perspective paper in the Journal of Public Health Dentistry. However, disparities in oral health and access to dental care have stubbornly persisted. To address these challenges, the authors write, new investments in disease prevention strategies are needed, including clinical interventions and efforts to remove structural barriers. The authors also call for policies to increase access to and affordability of dental care and to train dental public health specialists to be effective leaders in health policy.
Developing a robust research workforce will require, in part, that dental schools provide research training opportunities and recruit students who are interested in research, write the authors of a third perspective piece in the Journal of Dental Education. Dental school curricula should integrate basic and clinical science training, with special attention to instruction on health disparities, safe pain management, addiction science, social determinants of health, use of digital and clinical technologies such as electronic health records and teledentistry, and treatment of diverse populations and patients with complex health care needs. The authors write that dental schools should expand interprofessional education to prepare students for health care environments that integrate dental, behavioral, and medical services in non-traditional settings such as schools and community centers. Dental schools can also help remedy the underrepresentation of certain groups in the dental profession through targeted recruitment efforts and by seeking financial support for scholarships.
To create an oral health care system that meets the needs of the entire population, oral health care must be more accessible and affordable, write the authors of a fourth perspective paper in the Journal of the American Dental Association. To overcome these barriers, the authors propose, private and public insurers should include comprehensive oral health care services as an essential insurance benefit. Expanding dental coverage will increase demand for care, and workforce planning is essential to ensure an optimal number of dental providers are being trained and placed in areas with high demand. Finally, the authors call for integration of oral and medical care, including integrated electronic health records and the use of a common dental and medical diagnostic coding system.
Access the papers and their accompanying editorials below to learn more:
Journal of Dental Research
- Finding Knowledge to Improve Oral Health for All
Bruce A. Dye and Judith Albino
- Translating Science into Improved Health for All
Laurie K. McCauley, Michelle Robinson, and Rena N. D’Souza
Journal of Public Health Dentistry
- Oral health is for all of us
Judith Albino, Bruce A. Dye, and Rena N. D’Souza
- The 2021 report on oral health in America: Directions for the future of dental public health and the oral health care system
Carlos Quiñonez, Judith A. Jones, Marko Vujicic, Scott L. Tomar, and Jessica Y. Lee
Journal of Dental Education
- The decades ahead for dental education
Judith Albino, Bruce A. Dye, and Rena N. D’Souza
- Oral health in America 2021: Making a case for curricular change
Linda C. Niessen, Margherita Fontana, Robert J. Weyant, Paul S. Casamassimo, Jocelyne Feine, and Nadeem Karimbux
Journal of the American Dental Association
- Facing the future and deciding what we want oral health to become
Bruce A. Dye, Rena N. D’Souza, and Judith Albino
- Oral Health in America: Implications for dental practice
Jeffrey L. Fellows, Kathryn A. Atchison, Jeffrey Chaffin, Elisa M. Chávez, and Norman Tinanoff