According to the American Dental Hygienists’ Association (ADHA) all people must have access to oral health care, at that, people are accountable for their own health, and it is their responsibility to make healthy choices (Burt & Eklund, 2005). The majority of the people in the United States prefer to turn to private practitioners when seeking dental care (Burt & Eklund, 2005). Healthy and employed people who are conscious about their oral health have no problem with accessibility to private care. However, 12% of American citizens live below the federally-acknowledged poverty line; millions of others are on the verge of poverty. With this in mind, it is becoming increasingly challenging for the country to provide fair access to dental care for all of the citizens. The citizens who are most at risk are those who do not possess a health insurance.
The barriers to oral health are also associated with limited education or low language skills, for instance, adults who lack language skills and cannot read, therefore, may not know that their children are entitled to free dental services (Guay, 2004). Currently, there exist a number of strategies designed to enhance access to dental care, however, most of them address single factors and overlook the big picture of the multiple factors interdependence (Guay, 2004).
Although most of the people look for easy solutions for dental access, their strategies do not always work. The most frequent argument that is put forward is that there are not enough dentists, and as the population is on the increase, the human resources are scarce. This strategy completely ignores the free marketplace. Even if the number of dentists will increase tenfold, they will seek to establish their practices only where there is adequate market support, and they will therefore concentrate in the areas which provide more economic incentives (Burt and Eklund, 2004). Some people believe that including free dental services in Medicare may enhance access to dental services. However, one needs to bear in mind that not all people entitled to Medicare experience financial barriers in obtaining dental care.
Burt and Eklund (2005) put forward a number of strategies that may enhance access to dental care, in my opinion, the strategy that needs to be studied in more details is the one calling for ‘special arrangements for special populations’ (p. 135). I believe that this particular strategy is most effective and goes beyond the simple solution suggesting an increase in the number of dentists to enhance access to dental care. When the number of dentists is measured with the population figures in a specific area, it leads to a fallacy, as the population structure may vary from place to place. For instance, the population make-up of an affluent neighborhood is not the same as the population of a poor settlement consisting of low-skilled workers, their children, or the elderly. The latter, due to lack of awareness, language skills may not know of the availability of dental access that they are eligible for. Similarly, the elderly and disabled are not able to visit a dentist on their own, and the dental care must be brought to their location. Burt and Eklund (2005) note that the elderly population in the U.S. is on the increase (p. 135). With this in mind, the strategy of special arrangements needs to be put on the agenda so that dental care may be made available for specific population groups. In addition, the strategy for special arrangements needs to be expanded and include not only the elderly or disabled, but also migrant families, low-skilled and illiterate whose awareness of the dental programs needs to be increased.
Having said that, one needs to realize that a single strategy is not capable of resolving all of the issues relating to dental care access. The workable strategy needs to be multi-fold and address a wide range of issues.
Reference List
Burt, A. B., & Eklund, S. A. (2005). Dentistry, Dental Practice, and the Community. Amsterdam, Netherlands: Elsevier.
Guay, A. H. (2004). Access to dental care: Solving the problem for underserved populations. The Journal of the American Dental Association, 135(11), 1599-1605.