Evidence-based Solutions for Barriers to Care

Resolution 306-2018 — Adopted
2017-18 Board of Trustees
Financial Impact
Although dental treatment has advanced markedly over the last few decades, serious barriers to dental care still exist throughout the nation. Prevalence of disease continues to persist, with nearly half of the adult population suffering from periodontal disease and 1 in 4 children under the age of five living with untreated dental caries1. Due to geographic disparities, there is a lack of availability of services resulting in over 51 million Americans living in Dental Health Professional Shortage Areas (DHPSAs) in the United States where the dentist to population ratio is an unprecedented 1:5,0004. And for a number of additional reasons, there is a severe underutilization of services, with 203 million adult Americans not regularly visiting the dentist as recorded in 20151.

Efforts have been employed nationally to reduce barriers to care, and certain measures have been proven to be more efficacious and sustainable than others.  One successful early intervention is public water fluoridation. The CDC reports water fluoridation prevents tooth decay by 50-70%2, and the ADA reports it is also a cost-effective intervention: every $1 invested in water fluoridation saves a person $38 in dental treatment costs3. Medicaid expansion, as modeled in certain states as California, Colorado, and Illinois, also show positive trends. Preliminary studies have correlated expansion with a decrease in ED dental-related visits, increase in oral health care utilization, and increase in tooth-saving procedures (e.g. RCT vs ext)4. Co-location of medical and dental services has also been proven to enhance access to oral health care. Medical-dental integration models are being used nation-wide to provide comprehensive healthcare to comprised populations in federally qualified health centers (FQHC’s). Evidence continues to support that co-location of health services produces enhanced health outcomes5.

We believe that evidence-based solutions should be utilized to maximize the efficacy of oral health care delivery and reduce barriers to care; therefore, be it
Resolved, that the American Student Dental Association supports evidenced based measures that are efficacious and sustainable in reducing barriers to care in underserved communities. These measures include, but are not limited to, early intervention, Medicaid expansion and co-location of health services.