The U.S. Oral Health Workforce in the Coming Decade Workshop Summary (2009) / Chapter Skim
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4 Current Demographics and Future Trends of the Oral Health Workforce
4 Current Demographics and Future Trends of the Oral Health Workforce
Pages 23-38
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The second panel considered other members of the health care workforce who may provide oral health services including physicians and nurses, and how they interact with traditional dental professionals. The Dental Workforce Dentists Richard W
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defines dental health professional shortage areas (HPSAs) according to several factors related to access; this definition roughly approximates when the dentist-to-population ratio rises to 1 to 5,000 (HRSA, 2009a)
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Dental Hygienists Ann Battrell, M.S.D.H., RDH American Dental Hygienists' Association The oral and general health needs of the population are growing. Health care practice and education need to evolve to meet those needs, health care delivery needs to become more integrated, and health care stakeholders need to work cooperatively to identify and remove the barriers that restrict the public's access to oral health care services.
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While the heart of dental hygiene is in preven tion, many patients are in need of both prevention and treatment services. To change the ability of dental hygienists to provide needed services, many stakeholders need to be engaged, including the dental examiners.
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Dental Assistants Cathy J Roberts, CDA, EFDA, COA, CDPMA, MADAA American Dental Assistants Association At about 280,000 persons, dental assistants make up the largest part of the dental workforce (BLS, 2007a)
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Other special populations that The nondental health care workforce includes health care professionals aside from dentists, dental hygienists, and dental assistants.
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Currently, family medicine is the only area of medicine that has developed standardized competencies for oral health in residency programs. Finally, if oral health services are provided by nondental professionals, consideration is needed for how to assess the clinical quality of those services.
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Krol, M.D., M.P.H., FAAP University of Toledo Physicians may receive oral health education at many levels including during medical school, during residency training, and in continuing education programs. A 2006 survey found that two-thirds of graduating residents thought they should be performing oral health assessments on their patients (Caspary et al., 2008)
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Family physicians often provide the medical home for both children and adults. Family medicine physicians typically receive little exposure to oral health in medical school or residency and perceive oral health as an area of knowledge deficit.
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For example, in New York state, nurse practitioners can write prescriptions but are required to have a collaborative practice arrangement with a physician, meaning that there is a In 2004, the American Association of Colleges of Nursing recommended the practice doctorate to be the graduate degree for advanced practice nurses, including nurse practitioners (AACN, 2004)
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Other areas of shared interest include salivary HIV testing, diabetes screening and early intervention for periodontal disease, and elder abuse screening. Finally, the College of Nursing Family Practice was developed to provide primary care services by nurse practitioners to patients who are accessing dental services at the College of Dentistry clinics.
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Workforce Planning Several specific questions were posed regarding the workforce of d entists. In response to a question regarding the accreditation of foreign dental schools, Valachovic said that unlike international medical graduates, dental graduates must currently graduate from an American dental school to be eligible for licensure in nearly all states.
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Evidence Base Several questions were submitted regarding the evidence around direct access to dental hygienists including the effects on access and impact of financing challenges. Battrell said several models of advanced practice in dental hygiene are beginning to collect data, adding that all existing and emerging models should be uniformly examined.
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Maier said the main issue is that there is a dearth of such evidence in general, noting there are just a few items each in pediatrics and family medicine that rise to the level of the Cochrane Collaboration or the United States Preventive Task Force. Second, Maier said there is also little data on whether or how education (in general)
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. Shelley said that in her program, as a result of homebound patients requesting oral health services, nurse practitioners reached out to the dental hygiene school to send dental hygiene students out with nurse practitioners to help screen and educate patients.
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