The dental safety net, its workforce, and policy recommendations for its enhancement.
OBJECTIVE
The dental safety net includes the facilities, providers, and payment programs that support dental care for underserved populations including those individuals disadvantaged by a variety of social, economic, and health conditions. Its components-health centers, dental schools, clinics, Medicaid-oriented dental practices, free-care programs, hospital emergency rooms, and others-vary in availability, comprehensiveness, continuity, and quality. The objective of this overview is to identify options and opportunities for policy changes to enhance oral health professional workforce in the safety net.


METHODS
Characteristics of the dental safety net and its components are reviewed and compared.


RESULTS
Professionals who now staff the dental safety net are a small subset of US dental providers and few current trainees anticipate practicing in these programs. Therefore, the safety net will continue to confront workforce challenges.


CONCLUSIONS
Multifactorial policy alternatives to increase the availability of dental professionals who care of the underserved include proposed changes in dental education, licensure, scope of practice for allied dental personnel, and federal and state financing of public insurance. Also needed are local efforts to establish social norms and activities among private dentists that engage more private practitioners in care of the underserved.
Edelstein
Burton
B
Columbia University College of Dental Medicine, Dental Medicine-SSBS, 601W 168th Street Suite 32, New York, NY 10032, USA. ble22@columbia.edu
D003727:Dental Auxiliaries / Q000706:statistics & numerical data; D003729:Dental Care / Q000458:organization & administration*; D003740:Dental Clinics / Q000191:economics; D005380:Financing, Government; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics; D054625:Healthcare Disparities; D006801:Humans; D008484:Medicaid / Q000458:organization & administration*; D008507:Medically Underserved Area; D011636:Public Health Dentistry / Q000458:organization & administration; D017664:Uncompensated Care; D014481:United States; D035862:Vulnerable Populations; D000078329:Workforce