The dental care industry is in equilibrium. Like the rest of the healthcare system, there are income and racial disparities we need to overcome. Even in 2018, not everyone has equal access to quality oral care. In spite of changes and improvements to dentistry, the number of adults accessing dental care has remained steady.
One view among dental industry experts is that the time for incremental change is long gone. What the industry needs are major systemic reform and disruption. The question is what changes do we need to improve oral health outcomes in the American population?
Comprehensive Dental Coverage
There was a time when dentists believed you could convince people that getting dental care is worth it. That spending out-of-pocket to prevent complications in the future is good value. The reality is that most people access dental care only if their insurance covers it. Affordability and dental coverage are the main determinants of whether a patient will accept treatment or not.
Another factor influencing people’s attitude towards dental care is public policy. Many people believe that if dental coverage is not included in public insurance programs, it must not be so important. Demand for oral care would be stimulated if dental coverage was included as a core benefit in both public and private insurance programs.
Measure Oral Health Outcomes
Other areas of healthcare are moving away from the fee for services model. The trend towards value-based care delivery is accelerating. While dentistry is not yet ready to abandon the existing frameworks, we need to start measuring oral health outcomes.
Right now, the systems are set up to measure what is done to the patient in terms of procedures, treatments, and processes. Both providers and insurance payers do not measure oral outcomes for the patient. The distinction between the two is more than semantics, there is a difference in what you’re measuring.
Dental offices maintain lists of procedures and treatments they have done to the patient – root canal treatment, filling cavities, radiographs etc. No one measures the actual outcomes which are far more important to the patient. Most people care less about the exact procedure and more about the results. Have you reduced their pain, solved a long-standing issue or reduced the risk of caries in the future?
Once we have established standards for systematically measuring oral health outcomes, it is time to tie provider fees to those outcomes. It may take a long time for the dental industry to get to that point but we have to start somewhere.
Connect Dental Care to Overall Health
At present, dental care sets in its own silo separate from the rest of the healthcare system. More often than not, the care team for a patient will not include their dentist or other oral health professional. This is unfortunate because oral health influences and is influenced by a variety of medical conditions. Poor oral hygiene can exacerbate many illnesses. Conversely, patients with a chronic illness like diabetes are more at risk for dental issues.
Dental professionals should collaborate with other doctors who are also treating the patient. For instance, a physician should not hesitate to refer their diabetic patient to a dentist because they are at a heightened risk for oral issues. Similarly, dentists would be able to make better decisions for their patients if they had access to their recent medical history. It should be a two-way street.
Some of these changes are already on the way while others are mere ideas on the horizon. But if the dental care industry hopes to improve the oral health of the American public, the change has to begin soon.
