Dental public health (DPH)

Dental public health (DPH) refers to the ambitious programs, representing the joint efforts of dentists and other health care providers within a community, created to promote dental health and general awareness about strategies for maintaining healthy teeth. Although the responsibility for the care and upkeep of teeth is primarily the responsibility of the individual and is conducted between that individual and a dentist of choice, DPH programs recognize that providing leadership and expertise in a range of critical dental health issues as well as providing coordinated basic services that target those within a community who might not have access to insurance and who might, for any reason, be inclined to let dental care lapse improves the overall dental health of the community. Dental problems, such as gum disease (periodontitis), cavities, and infections, take time to develop, and the key to effective dental care is early detection and regular maintenance. By becoming a presence within a community, DPH programs seek to encourage more responsible dental care and to build a commitment to long-term dental care.

Background

The first nationwide expression of dental public health was coordinated by the American Dental Association (ADA) beginning in the early 1950s as a way to direct a national campaign to ensure communities provided fluoride in the municipal water supplies. Although many were suspicious of the government putting anything in the water supply, dental public health representatives tirelessly advocated the use of fluoride, a naturally occurring element that had been shown to dramatically decrease the number and severity of cavities by coating the teeth with a protective layering.

Between 1955 and 1970, DPH agencies were developed in cities and towns across the United States. These agencies involved the coordinated efforts of not only the dentists within the area but also a supporting staff that included dental hygienists, public and private school educators, parent groups, philanthropic organizations public service foundations, and specific advocacy groups whose wider agenda might involve dental care as well (for instance, at the time, the growing antismoking groups that also recognized the considerable danger nicotine posed for teeth). These dental public health groups were coordinated and promoted by the ADA. Initially, the groups advocated most aggressively for preventative dental health care, promoting healthy lifestyle choices and regular dental checkups. Their public service announcements were delivered through billboard advertising as well as through radio and television spots. Beginning in the 1990s, however, dental public health began to address the complex issue of health insurance. Given that effective and comprehensive dental insurance was not as widespread as effective and comprehensive health insurance, the ADA focused efforts on creating and promoting a wider health care safety net to enhance public dental care by striving specifically to include lower-income families, minority communities, and people in rural areas.

Dental Public Health Today

The twin goals of DPH—prevention and treatment—have remained remarkably consistent. That mission centers on three broad goals: first, to empower individual dentists within a community by making available to them the support network of the area’s specialists and thus to make dentistry itself a more attractive career alternative; second, to provide data, tested and reliable, about a range of dental health care issues as a way to promote awareness of matters that affect the short- and long-term care of teeth; and third, to create a community-wide network of dental care associates and, in turn, to provide a vital and real-time working infrastructure that represents a number of agencies’ cooperation when it comes to providing dental health care for a specific community.

DPH requires the cooperation of three entities, each dedicated to the specifics of dental care itself: government agencies that regulate medical practices, compile medical information and data, and investigate potential new drugs and new treatments; education groups including dental schools, professional licensing schools for hygienists and nurses, medical schools, allied nursing agencies, and vocational schools that promote dentistry; and ultimately those directly involved in the field, not only dentists but also dental assistants, hygienists, nurses, pharmacists, home health care agencies, boards of health, school administration boards, and even teachers.

DPH has had some notable successes, including the fluoride campaign, the ongoing campaign to provide through public schools dental sealant treatment to help retard cavity growth in children under twelve, efforts to sponsor cutting-edge research into developing less invasive techniques for dental treatments, national efforts to standardize initial dental protocols for new patients, the national campaign against smokeless tobacco, the campaign to promote flossing, and efforts to promote better dental care by using rotating toothbrushes. However, in 2000, the United States surgeon general lambasted the ADA for not providing sufficient and effective services.

The problems are significant. The number of dentists is shrinking—rural areas, small communities, and many inner-city neighborhoods are not served effectively. Insurance providers routinely categorize dental care as a separate and additional insurance coverage, which puts regular dental care out of the reach of many: according to the ADA, in 2015, only 35 percent of Americans see a dentist annually. Dentists see contributing their time or services to public health campaigns as distracting from their primary care responsibilities. Because most programs target children, the elderly and the homebound are routinely neglected. Because many of the DPH programs target the growing problems facing minority communities, it is significant that only about 10 percent of practicing dentists are nonwhite; white dentists may not fully understand the needs of minority groups. Finally, even if everyone who needed dental care were to seek it out, there are not enough dentist’s offices to serve that entire population.

In general, the need is too wide and the services available too narrow. Proponents of DPH now work to access public monies to better coordinate their efforts by involving health care providers and by promoting their agenda to help shape forward-looking public policy development at the state and federal levels.

Bibliography

Chestnutt, I. Dental Public Health at a Glance. Hoboken: Wiley, 2016. Print.

Daly, Blánaid, et al. Essential Dental Public Health. 2nd ed. New York: Oxford UP, 2013. Print.

"Dental Public Health." American Dental Association. Amer. Dental Assn., n.d. Web. 25 Aug. 2016.

Mason, Jill. Concepts in Dental Public Health. 2nd ed. Philadelphia: LWW, 2010. Print.

Nathe, C. Dental Public Health and Research: Contemporary Practice for the Dental Hygienist. 4th ed. New York: Pearson, 2016. Print.

Patel, Mira, and Nakul Patel. Dental Public Health: A Primer. Boca Raton: CRC, 2007. Print.

Turnock, B. Essentials of Public Health. 2nd ed. Burlington: Jones, 2011. Print.