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Mertz E, Kottek A, Werts M, Langelier M, Surdu S, Moore J. Dental Therapists in the United States: Health Equity, Advancing. Med Care 2021; 59:S441-S448. [PMID: 34524241 PMCID: PMC8428854 DOI: 10.1097/mlr.0000000000001608] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations. OBJECTIVES The objective of this study is to qualitatively examine the drivers and outcomes of the US dental therapy movement through a health equity lens, including community engagement, implementation and dissemination, and access to oral health care. METHODS The study compiled a comprehensive document library on the dental therapy movement including literature, grant documents, media and press, and gray literature. Key stakeholder interviews were conducted across the spectrum of engagement in the movement. Dedoose software was used for qualitative coding. Themes were assessed within a holistic model of oral health equity. FINDINGS Health equity is a driving force for dental therapy adoption. Community engagement has been evident in diverse statewide coalitions. National accreditation standards for education programs that can be deployed in 3 years without an advanced degree reduces educational barriers for improving workforce diversity. Safe, high-quality care, improvements in access, and patient acceptability have been well documented for DTs in practice. CONCLUSION Having firmly taken root politically, the impact of the dental therapy movement in the US, and the long-term health impacts, will depend on the path of implementation and a sustained commitment to the health equity principle.
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Affiliation(s)
- Elizabeth Mertz
- Healthforce Center, University of California, San Francisco
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA
| | - Aubri Kottek
- Healthforce Center, University of California, San Francisco
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA
| | - Miranda Werts
- Healthforce Center, University of California, San Francisco
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA
| | - Margaret Langelier
- Center for Health Workforce Studies, School of Public Health, University at Albany, State University of New York, Rensselaer, NY
| | - Simona Surdu
- Center for Health Workforce Studies, School of Public Health, University at Albany, State University of New York, Rensselaer, NY
| | - Jean Moore
- Center for Health Workforce Studies, School of Public Health, University at Albany, State University of New York, Rensselaer, NY
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Navarro Azevedo de Azeredo F, Silva Guimarães L, Azeredo A. Antunes L, Santos Antunes L. Global prevalence of dental caries in athletes with intellectual disabilities: An epidemiological systematic review and meta-analysis. SPECIAL CARE IN DENTISTRY 2018; 39:114-124. [DOI: 10.1111/scd.12349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/30/2018] [Accepted: 12/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Lívia Azeredo A. Antunes
- Postgraduate Program; School of Dentistry; Fluminense Federal University; Niterói RJ Brazil
- Department of Specific Formation; School of Dentistry; Fluminense Federal University; Nova Friburgo RJ Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program; School of Dentistry; Fluminense Federal University; Niterói RJ Brazil
- Department of Specific Formation; School of Dentistry; Fluminense Federal University; Nova Friburgo RJ Brazil
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Ishimaru M, Ono S, Yasunaga H, Matsui H, Koike S. Projected future distribution of dentists in Japan. J Public Health Dent 2016; 76:241-8. [PMID: 27037616 DOI: 10.1111/jphd.12143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 01/18/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Appropriate health policies for the supply of dentists have been an ongoing issue in many developed countries. The purpose of this study was to estimate the future distribution of dentists with different working statuses in Japan and to discuss policy implications about the supply of dentists in any country. METHODS This was a retrospective cohort study using data from the National Survey of Physicians, Dentists and Pharmacists for 1972-2012. Based on data from the 2010 and 2012 surveys, we calculated by means of a Markov model the future number of dentists with different working statuses until 2042 according to sex. RESULTS We estimated that the total number of active dentists will decrease from 2012 to 2042. The number of active dentists per 1,000 population was predicted to reach a peak in 2018, decrease by 4.2% from 2012 to 2038, and thereafter slightly increase. With regard to working status, the number of dentists with their own practices per 1,000 people was predicted to have reached a peak in 2014 and decrease by 22.0% until 2042. We estimated that the number of dentists used in dental clinics per 1,000 population will increase continuously between 2012 and 2042 by 20.0%. CONCLUSIONS Our study suggests that maintaining this supply of dentists may lead to maldistribution of their working status in the future.
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Affiliation(s)
- Miho Ishimaru
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Sachiko Ono
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Soichi Koike
- Division of Health Policy and Management, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Fernandez Rojas C, Wichrowska-Rymarek K, Pavlic A, Vinereanu A, Fabjanska K, Kaschke I, Marks LAM. Oral health needs of athletes with intellectual disability in Eastern Europe: Poland, Romania and Slovenia. Int Dent J 2015; 66:113-9. [PMID: 26601920 DOI: 10.1111/idj.12205] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aims of this study were to evaluate the oral condition and treatment needs of Special Olympics (SO) athletes from Poland, Romania and Slovenia. METHODS A cross-sectional study was performed with data collected through standardised oral screening of athletes who participated in the annual SO events held in Poland, Romania and Slovenia, between 2011 and 2012. The data were compiled and transferred to an SPSS data file for analysis using descriptive statistics. RESULTS A total of 3,545 athletes participated in the study. Among the main findings, the prevalence of untreated decay was 41% in Poland and 61% in Slovenia, whilst 70% of the Romanian athletes had signs of gingival disease and only 3.8% presented molar fissure sealants. In addition, 47% of Polish athletes were in need of urgent treatment. CONCLUSIONS Analysis of the results obtained following screening showed comparable oral health needs of athletes with intellectual disability among countries. Exploration of the oral health systems of the countries revealed similar significant co-payments and lack of incentive for dentists to treat patients with special needs. The results from Romania, Poland and Slovenia demonstrated the need for a structured system in which a special population is a target for oral-health-related education programmes and system-included preventive, restorative and maintenance interventions.
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Affiliation(s)
- Carla Fernandez Rojas
- Centre of Special Care in Dentistry, PAECOMEDIS, Ghent University Hospital, Gent, Belgium
| | - Kaja Wichrowska-Rymarek
- Special Olympics Special Smiles Poland, Department of General Dentistry, Medical University of Lodz, Lodz, Poland
| | - Alenka Pavlic
- Special Olympics Special Smiles Slovenia, Department of Paediatric and Preventive Dentistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Katarzyna Fabjanska
- Special Olympics Special Smiles Poland, Department of Conservative Dentistry and Endodontics, Medical University of Lodz, Lodz, Poland
| | - Imke Kaschke
- Special Olympics Healthy Athletes Germany, Berlin, Germany
| | - Luc A M Marks
- Centre of Special Care in Dentistry, PAECOMEDIS, Ghent University Hospital, Gent, Belgium
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Hamershock RA, Rajabiun S, Fox JE, Mofidi M, Abel SN, York JA, Kunzel C, Sanogo M, Mayfield TG. Dental Students’ HIV/AIDS-Related Knowledge, Attitudes, and Intentions: Impact of the U.S. Health Resources and Services Administration's Community-Based Dental Partnership Program. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.8.tb05781.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rose A. Hamershock
- Health and Disability Working Group; Boston University School of Public Health
| | - Serena Rajabiun
- Health and Disability Working Group; Boston University School of Public Health
| | - Jane E. Fox
- Health and Disability Working Group; Boston University School of Public Health
| | - Mahyar Mofidi
- HIV/AIDS Bureau; U.S. Health Resources and Services Administration
| | - Stephen N. Abel
- Community and Professional Initiatives; University at Buffalo School of Dental Medicine
| | - Jill A. York
- Hunterdon Endowed Chair in Dental Public Health; Department of Community Dentistry; Rutgers School of Dental Medicine
| | - Carol Kunzel
- Dental Community Health and Sociomedical Sciences; Columbia University College of Dental Medicine
| | - Moussa Sanogo
- Section of Social and Behavioral Sciences; Columbia University College of Dental Medicine
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Cartes-Velasquez RA. Exponential growth of dental schools in Chile: effects on academic, economic and workforce issues. Braz Oral Res 2013; 27:471-7. [DOI: 10.1590/s1806-83242013000600005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 08/06/2013] [Indexed: 11/22/2022] Open
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Watanabe T, Hanioka T, Yamamoto M, Haresaku S, Shimada K, Naito T. Association between perception of dentist oversupply and expectations of dentistry: a survey of dental graduates in Japan. Int Dent J 2013; 63:137-44. [PMID: 23691958 DOI: 10.1111/idj.12022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The perception that there is a surplus of dentists may be an opportunity to explore attractive career options in dentistry in Japan. METHODS A self-administered questionnaire was mailed to 2,114 graduates of a private dental school in Japan. We asked about the perception of oversupply, rated by a visual analogue scale, work environment factors, potential areas of dentistry and necessary medical subjects for their dental practice. The association of a strong perception of dentist oversupply with work environment factors, dental areas and medical subjects was examined by multivariate logistic regression analyses. RESULTS The response rate was 66%, and data from 1,203 community dentists were analysed. Most respondents (76%) perceived either a strong or very strong surplus of dentists. A very strong perception was significantly associated with work environment factors, including practising in large cities and earning the second lowest of four levels of annual income, but no further associations were found with either the number of patients treated or with the other two ranges of income. This perception was negatively associated with the number of necessary medical subjects, specifically otorhinolaryngology, but no significant association was seen with the number of potential areas of dentistry. CONCLUSIONS The negative correlation between the aspiration to acquire medical knowledge and the perception of dentist oversupply under the circumstance of the possibly excessive perception among community dentists invites further research on the benefits of teaching oral medicine to graduate entry students to build future working satisfaction.
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Affiliation(s)
- Takeshi Watanabe
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
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Ford PJ, Farah CS. Oral health therapists: what is their role in Australian health care? Int J Dent Hyg 2012; 11:22-7. [DOI: 10.1111/j.1601-5037.2012.00564.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2012] [Indexed: 11/29/2022]
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Early childhood caries and the impact of current u.s. Medicaid program: an overview. Int J Dent 2012; 2012:348237. [PMID: 22496690 PMCID: PMC3312229 DOI: 10.1155/2012/348237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/25/2011] [Indexed: 11/17/2022] Open
Abstract
Pediatric dental caries is the most common chronic disease among children. Above 40% of the U.S. children aged 2-11 years have dental caries; more than 50% of them come from low-income families. Under dental services of the Medicaid program, children enrolled in Medicaid must receive preventive dental services. However, only 1/5 of them utilize preventive dental services. The purpose of this overview is to measure the impact of Medicaid dental benefits on reducing oral health disparities among Medicaid-eligible children. This paper explains the importance of preventive dental care, children at high risk of dental caries, Medicaid dental benefits, utilization of dental preventive services by Medicaid-eligible children, dental utilization influencing factors, and outcome evaluation of Medicaid in preventing dental caries among children. In conclusion, despite the recent increase of children enrolled in Medicaid, utilizing preventive dental care is still a real challenge that faces Medicaid.
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Calache H, Hopcraft MS. Evaluation of a Pilot Bridging Program to Enable Australian Dental Therapists to Treat Adult Patients. J Dent Educ 2011. [DOI: 10.1002/j.0022-0337.2011.75.9.tb05164.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Hanny Calache
- Education, and Research; Dental Health Services Victoria; La Trobe University Victoria; Australia
| | - Matthew S. Hopcraft
- Melbourne Dental School; University of Melbourne Victoria; Research Project Support; Dental Health Services Victoria; Australia
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Garcia RI, Inge RE, Niessen L, DePaola DP. Envisioning success: the future of the oral health care delivery system in the United States. J Public Health Dent 2010; 70 Suppl 1:S58-65. [PMID: 20806476 DOI: 10.1111/j.1752-7325.2010.00185.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The elimination of oral health disparities in the US will require enhancing access to oral health care services. The workshop convened in 2009 by the Institute of Medicine on the "US Oral Health Workforce in the Coming Decade" highlighted both the current workforce's failure to meet the nation's needs as well as the promising opportunities presented by various workforce strategies to significantly enhance access and improve oral health outcomes. In this article, we have briefly reviewed and expanded on the contributions in this special issue of the Journal of Public Health Dentistry, with the goal of identifying common themes and providing a framework for evaluation. There are several key areas where change is critically needed in order to ensure successful implementation of any new workforce models. These areas include a) the public and private financing of dental care, b) the dental educational system, and c) state and federal policies.
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Affiliation(s)
- Raul I Garcia
- Health Policy & Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, 750 Albany Street, 560, 3rd floor, Boston, MA 02118, USA.
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Mertz EA, Finocchio L. Improving oral healthcare delivery systems through workforce innovations: an introduction. J Public Health Dent 2010; 70 Suppl 1:S1-5. [PMID: 20806470 DOI: 10.1111/j.1752-7325.2010.00179.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objective of this paper is to describe the purpose, rationale and key elements of the special issue, Improving Oral Healthcare Delivery Systems through Workforce Innovations. The purpose of the special issue is to further develop ideas presented at the 2009 Institute of Medicine (IOM) workshop, Sufficiency of the U.S. Oral Health Workforce in the Coming Decade. Using the IOM discussions as their starting point, the authors evaluate oral health care delivery system performance for specific populations' needs and explore the roles that the workforce can play in improving the care delivery model. The contributing articles provide a broad framework for stimulating and evaluating innovation and change in the oral health care delivery system. The articles in this special issue point to many deficits in the current oral health care delivery system and provide compelling arguments and proposals for improvements. The issues presented and solutions recommended are not entirely new, but add to a growing body of work that is of critical importance given the context of wider health care reform.
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Affiliation(s)
- Elizabeth A Mertz
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco School of Dentistry, 3333 California Street, Suite 410, San Francisco, CA 94118, USA.
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