The debate about the best way to address the access to dental care issue continues to be a topic of interest across the country. Dental schools, organized dentistry, legislators, and advocacy groups are trying all sorts of approaches "to get dentists where they are most needed."  Each week I read some new ideas about how to solve  the problem.

 

As I read articles and listen to lectures on how to deal with the access-related challenges faced by patients and dentists, the discord between these groups is concerning. Everyone seems to have the solution they are sure will take care of the problem -- and this worries me. Of all the things I have learned about access to dental care during my forty years as a dentist, it is that the problem is complex and multifaceted, and it is the responsibility of many groups. I believe such an acknowledgment is critical in dealing with this issue.

 

I feel fortunate to work in a dental school where this fundamental assumption is at the heart of our engagement in a variety of solutions. Some of our efforts are small in scope but have immediate impact, like our Give Kids a Smile events. Others, like our OHIO Project, are all-encompassing with consequences that will last decades. Recruiting  dental students from rural Ohio with the hope that they will return to practice there after graduation is another effort the college is making to improve access to care. Thanks to some help from the ADA Health Policy Institute, we have received confirmation that this strategy is working. Looking at 14 years of data related to 1,500 graduates, we can say with confidence that our students from rural areas have a significantly greater likelihood of practicing in rural areas than do their urban counterparts -- 42% versus 7%.

 

While I recognize that many additional efforts are needed to improve access to dental care in the rural parts of our state, the issue goes beyond just increasing the number of dentists in these areas. There are patient transportation issues, low household income issues, and Dental Medicaid reimbursement rates that need to be addressed so practitioners can be most effective in these communities. But getting more dentists there who can work on these problems is a good first step.  

 

As a profession, we need to continue searching for solutions that take into consideration a broad mix of conditions, and we must engage a host of stakeholders. We need to have well-defined and measurable outcomes that everyone agrees we should be striving to accomplish. We must recognize that there is no single solution and that each situation requires its own unique approach. And, we have to be creative in using human, financial, and physical resources to meet our goals. Everyone has a role in improving access to dental care!