Overcoming barriers to quality oral healthcare

Low-income patients frequently present to U.S. community health clinics with poor oral health and problems that persist throughout the life span.

In a 2000 report, the Surgeon General identified a need for improving oral diseases in Americans and identified several risk factors for poor oral health among patients from resource-poor areas. These included tobacco use, poor dietary habits, a lack of access to healthcare and inadequate education. 

These patients typically do not present with chief complaints related to their dental health and often wish to avoid discussions related to oral hygiene or dental care. For some patients, there is a misconception that optimal dental health is unattainable and reserved only for those with health insurance. More than 10 years have passed since the Surgeon General's report, yet the challenges outlined continue to exist.

Changing the way oral health care is delivered begins with offering adequate anticipatory guidance for children, as early intervention is key in preventing worsening oral health. Clinicians should advise parents that oral hygiene should begin prior to the eruption of the child's first tooth and that adequate fluorination must be sustained thereafter.

In addition to anticipatory guidance in pediatrics, it is important for clinicians to address oral hygiene throughout the lifespan and make referrals, as appropriate. Primary health-care providers should stay up-to-date with available resources in the community to ensure that underserved patients have access to adequate oral care.

Dental providers may consider engaging in community outreach programs to provide care to patients who otherwise do not have access. Let's work together to change the perception of quality dental health in America from a status symbol to an essential component of basic health.

Leigh Montejo, MSN, FNP-BC, provides health care to underserved populations at the Metropolitan Community Health Service's Agape Clinic in Washington, North Carolina.

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