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1 Introduction
Pages 17-40

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From page 17...
... They are also more likely to have oral diseases detected in the earlier stages and obtain restorative care as needed. In contrast, lack of access to oral health care can result in delayed diagnosis, untreated oral diseases and conditions, compromised health status, and, occasionally, even death.
From page 18...
... . For example, as of March 2011, there were 4,639 dental Health Professional Shortage Areas (HPSAs)
From page 19...
... A recent analysis of the National Survey of Children with Special Health Care Needs found that 8.9 percent of children with special health care needs were unable to obtain needed dental care (Lewis, 2009)
From page 20...
... . In addition to the federal-level strategies described above, stakeholders across the country have been encouraged to increase the resources available to meet the oral health needs of the public and take action to address the poor oral health status of vulnerable and underserved populations.
From page 21...
... The committee recognizes that, while access to care is one critical component needed to improve oral health outcomes and reduce oral health disparities, it is not an end in and of itself. Improving access will, however, help provide needed services to the millions of Americans for whom oral health care is currently out of reach.
From page 22...
... This, too, goes beyond the scope of this study. Therefore, the committee limited its examination to those issues directly related to improving access to oral health care and has sought, through the careful and thorough examination of available evidence, the best and most realistic paths to pursue.
From page 23...
... Study Approach The study committee included 15 members with expertise in dentistry and dental hygiene, dental public health, pediatric dentistry, pediatrics, family medicine, obstetrics/gynecology, health law, health policy, nursing, prenatal care, neonatal and infant health, public health, health disparities, and health finance. (See Appendix E for biographies of the committee members.)
From page 24...
... In addition, one of the committee's early tasks was to establish guiding principles, reach consensus on how to define several key terms, and to determine how to approach the task of assessing the current oral health system of care in the United States. GUIDING PRINCIPLES To guide its deliberations on improving access to oral health care among vulnerable and underserved populations, the committee began with two well-established and evidence-based principles: 1.
From page 25...
... In addition, the committee contends that the implicit goal in improving access is improving access to quality oral health care -- care that is safe, timely, effective, efficient, equitable, and patient centered (IOM, 2001)
From page 26...
... Vulnerable and Underserved The committee's charge specifically refers to improving access for vulnerable and underserved populations. These are individuals and populations that are systematically excluded from obtaining oral health care.
From page 27...
... , in which the committee was charged to consider the inclusion of dental services under national health insurance plans. At that time, the IOM found a substantial unmet need for dental care in the United States and that
From page 28...
... . The workshop speakers also reviewed workforce strategies for improving access, with a particular focus on improving children's access to oral health services, as well as opportunities to reframe the oral health delivery system with special attention to the roles of federal and state health agencies, dental educators and policy leaders, advocates, and the media.
From page 29...
... The AI/AN Oral Health Access Summit focused on the role of allied dental professionals; multidisciplinary approaches to oral health promotion and disease prevention; and the resources needed to address oral health issues among AI/AN populations (e.g., recruitment and retention of oral health professionals)
From page 30...
... . The Cost of Delay found that two-thirds of states were doing an inadequate job of ensuring that children have access to basic, preventive dental care.
From page 31...
... The W.K. Kellogg Foundation recently announced plans to invest over $16 million in the Dental Therapist Project, in Kansas, New Mexico, Ohio, Vermont, and Washington, to improve oral health access in underserved communities (W.K.
From page 32...
... Bureau of Primary Health Care (BPHC) The BPHC allocates capital and operating funds to federally funded community health centers that receive grants under §330 of the Public Health Service Act (HRSA, 2010a)
From page 33...
... Indian Health Service (IHS) The IHS is working with community partners such as Head Start; the Special Supplemental Nutrition Program for Women, Infants, and Chil dren (WIC)
From page 34...
... Finally, the chapter describes factors that differentially influence oral health status and utilization of oral health care services in the United States. Chapters 3, 4, and 5 frame the challenges and types of solutions that are typically used to improve access for vulnerable and underserved populations within the context of the resources that are currently available.
From page 35...
... 2007. American Indian and Alaska Native Oral Health Access Summit: Summary report.
From page 36...
... 2010. Doctor, my tooth hurts: The costs of incomplete dental care in the emergency room.
From page 37...
... 2011. Designated health professional shortage areas (HPSA)
From page 38...
... 2009. Dental care and children with special health care needs: A population based perspective.
From page 39...
... W.K. Kellogg Foundation supports community-led efforts in five states to increase oral health care access by adding dental therapist to the dental team.


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