Position on Access to Care

Access to total health, including oral health, of the underserved has always been a high priority of the National Dental Association (NDA). The NDA is dedicated to serving as advocates, of the underserved, to elevate their health status and increase their access to care.

It is the position of the NDA that oral health care –a fundamental component of total health care-is the right of all people. Lack of access to oral health care is a critical issue in the United States due to disparities in the health care delivery system. Dental must play a vital role in the solution to eliminate these disparities and assure quality oral health care for all.

The underserved carry the burden of lack of health care. In many cases the underserved cannot receive health care because there is no dentist available in the area or there is no transportation to the available dentist or the dentist does not accept Medicaid due to the reimbursement policy. In addition lack of funds, dental insurance and unemployment affects the underserved ability to access dental care. Also, lack of health insurance for employed workers increases health disparities affecting racial and ethnic minorities disproportionately. [2]

• Increase the number of minority dentist working in underserved areas
• Increase diversity in dental, hygiene and assisting schools, to increase the number of minority mentors and role models for the underserved
  o Minority providers are more likely to serve in a minority community. [3]
• Increase the number of Loan Forgiveness Programs
• Recruit, prepare and promote minorities in leadership positions in dental health care
• Increase research in areas of access to care, disease burden of the underserved and cultural competency
• A national dental health insurance policy for all
• End discrimination-engendered access to health care.
  o This includes – but is not limited to – discrimination based on gender, race, ethnicity, socioeconomic status, sexual orientation, religion, language, age and marital status or health status.
• Make preventive oral health care services a high priority
• Eliminate licensure restrictions
• Increase the Medicaid reimbursement
• Collaborations with organizations in an effort to achieve universal access to oral health care

References
1. U.S. department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. National Institute of Dental and Craniofacial Research. Rockville. MD National Institutes of Health, 2000.
2. Medical Expenditure Panel Survey (MEPS) Highlights #7: Uninsured Workers – Demographic Characteristics (1996) at https://ndaonline.orgwww.meps.ahrq.gov/Papers/HL_99-0007/HL7.htm. Also see “Executive Summary, A Shared Destiny: Effects of Uninsurance on Individuals, Families and Communities.” Institute of Medicine. (March 2003).
3. Brotherton SE, Stoddard JJ, Tang SS. Minority and nonminority pediatricians’ care of minority and poor children. Arch Pediatr Adolesc Med. 2000;154:912-7.