Improving Access and Provision of Preventive Oral Health Care for Very Young, Poor, and Low-Income Children Through a New Interdisciplinary Partnership

Objective: The authors conducted an integrative literature review of recent studies that explored the impact of interventions implemented in the U.S. that focused on improving access to dental care for low-income and vulnerable populations. Methods: The authors conducted an integrative literature review of studies published between 2012-2018 that addressed six oral health policy spheres. 1) Community-based dental access programs; (2) Medicaid reimbursement and expansion; (3) Student loan support; (4) Oral health services in non-traditional settings and dental residency programs; (5) Programs to improve oral health literacy; and (6) Use of dental therapists. Results: The authors included 39 articles for qualitative synthesis. Numerous public health initiatives and programs exist in the US aimed at increasing access to quality oral health care. Medicaid expansion, increased Medicaid fee-for-service reimbursement rates, and state loan repayment programs have demonstrated some success in improving access among underserved populations. A diversified dental workforce, with community dental health workers and mid-level providers like dental therapists, as well as interprofessional training of nurses and primary-care physicians in oral health have also shown positive impacts in advancing health equity. Further studies are needed to understand how oral health literacy programs can affect access and utilization of dental services. Conclusions: Improvements to the oral health care safety net will require a holistic and multifaceted approach in order to reduce oral health disparities. Policy levers should work, not in isolation, but rather in complementary fashion to one another.

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Financing Oral Health Care for Low-Income Adults Living with HIV/AIDS

Public Health Reports ◽

10.1177/00333549121270s211 ◽

2012 ◽

Vol 127 (2_suppl) ◽

pp. 82-86 ◽

Cited By ~ 2

Author(s):

Helene Bednarsh ◽

David A. Reznik ◽

Carol R. Tobias

Keyword(s):

Health Care ◽

Oral Health ◽

Low Income ◽

Oral Health Care ◽

Living With Hiv ◽

Hiv Aids

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EPSDT's Role in Improving Child Vision, Hearing, and Oral Health

The Journal of Law Medicine & Ethics ◽

10.1177/1073110517703328 ◽

2017 ◽

Vol 45 (S1) ◽

pp. 65-68

Author(s):

Jane Perkins

Keyword(s):

Health Care ◽

Oral Health ◽

Health Services ◽

Low Income ◽

Children With Disabilities ◽

Health Care Coverage ◽

Low Income Children ◽

Oral Health Services

The Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit offers health care coverage specifically targeted to meet the needs to low-income children and children with disabilities. This article provides a brief overview of EPSDT and then discusses how states are working to bring vision, hearing, and oral health services to children through EPSDT.

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Disparities in Access to Oral Health Care

Annual Review of Public Health ◽

10.1146/annurev-publhealth-040119-094318 ◽

2020 ◽

Vol 41 (1) ◽

pp. 513-535 ◽

Cited By ~ 6

Author(s):

Mary E. Northridge ◽

Anjali Kumar ◽

Raghbir Kaur

Keyword(s):

Health Care ◽

Oral Health ◽

Low Income ◽

Safety Net ◽

The United States ◽

Oral Health Care ◽

Oral Diseases ◽

Patient Centered ◽

Obesity And Diabetes ◽

Centered Care

In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.

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Increasing Use of Dental Services by Children, but Many Are Unable to Secure Needed Care

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.39.1.j677kp1584657r80 ◽

2014 ◽

Vol 39 (1) ◽

pp. 9-11 ◽

Cited By ~ 3

Author(s):

HB Waldman ◽

MB Ackerman ◽

SP Perlman

Keyword(s):

Health Care ◽

Oral Health ◽

Access To Care ◽

Low Income ◽

Oral Health Care ◽

Oral Disease ◽

National Study ◽

Vulnerable Children ◽

Dental Services ◽

National Studies

National studies indicate that an increasing proportion of children are receiving needed oral health care. However, this increase is not uniform throughout all populations of youngsters. Overall national study findings regarding the use of dental services mask the fact that, a significant subset of low-income, minority, medically and developmentally compromised and socially vulnerable children continue to lack access to care and suffer significant and consequential dental and oral disease. In addition, these same children will face continued difficulties in securing needed care as they reach their early adult years.

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Interprofessional Collaboration and Smartphone Use as Promising Strategies to Improve Prenatal Oral Health Care Utilization among US Underserved Women – Results from a Qualitative Study

10.21203/rs.3.rs-17811/v1 ◽

2020 ◽

Author(s):

Lin Wang ◽

Johana Ren ◽

Kevin Fiscella ◽

Sherita Bullock ◽

Mechelle R Sanders ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Care Utilization ◽

Focus Groups ◽

Low Income ◽

Oral Health Care ◽

Mitigation Strategies ◽

Care Utilization ◽

Dissemination And Implementation ◽

Structured Interviews

Abstract Objectives: Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to use of prenatal oral health care among underserved US women.Methods: We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018-2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups, which were audio-recorded, transcribed, and analyzed for thematic content.Results: We identified individual and systemic barriers/facilitators to utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide change to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved groups. Furthermore, use of smartphones offers an innovative entry point to promote utilization of prenatal oral care at the individual level.Conclusions for practice: Low-income women face multiple, addressable barriers to receipt of oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.

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Interprofessional collaboration and smartphone use as promising strategies to improve prenatal oral health care utilization among US underserved women: results from a qualitative study

BMC Oral Health ◽

10.1186/s12903-020-01327-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lin Wang ◽

Johana Ren ◽

Kevin A. Fiscella ◽

Sherita Bullock ◽

Mechelle R. Sanders ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Care Utilization ◽

Focus Groups ◽

Low Income ◽

Oral Health Care ◽

Mitigation Strategies ◽

Care Utilization ◽

Dissemination And Implementation ◽

Underserved Women

Abstract Background Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to the use of prenatal oral health care among underserved US women. Methods We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018–2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups which were audio-recorded, transcribed, and analyzed for thematic content. Results We identified individual and systemic barriers/facilitators to the utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide changes to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved women. Moreover, smartphones have the potential to be an innovative entry point to promote utilization of prenatal oral care at the individual level. Conclusions Low-income women face multiple, addressable barriers to obtaining oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.

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