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Senate hearing focuses on access to care

Washington—The U.S. Senate took testimony Feb. 29 on proposals to increase access to dental care, including a dental therapist's appeal to Congress to "do whatever you can to make it easier to improve access to care through the exploration and utilization of new types of dental providers."

The Association, though not invited to testify, submitted a statement for the hearing record and a news release welcoming the hearing "in the hope that it will spur lawmakers to address the many barriers to oral health while rejecting the suggestion that there can be a simple fix to the problems."

Sen. Bernie Sanders (I-Vt.), who convened the hearing on "Dental Crisis in America: The Need to Expand Access," questioned witnesses on whether organized dentistry "has been aggressive, stepped up to the plate and done what they have to do" to bring attention to the problem. Sen. Sanders chairs a subcommittee on primary health and aging of the Senate Committee on Health, Education, Labor and Pensions.

Responding to the question, Dr. Burton Edelstein, one of the invited witnesses, said that while he had "noticed an absence of attention to the issue," he has seen increased efforts in Association publications and communications "to bring attention to the problem. There's a tremendous increase in awareness that much more needs to be done. We can't work without the dentists. It's critical they be involved."

Other senators questioned the witnesses on delivery of care in schools and community health centers and with mobile dentistry and the effectiveness of dental therapists in increasing access to care. Sen. Barbara Mikulski (D-Md.) asked what "the American dental establishment can learn from other modalities."

Invited witnesses included Dr. Gregory Folse, president of Outreach Dentistry, Lafayette, La.; Grant Whitmer, executive director at Community Health Centers of the Rutland Region, Vt.; Christy Jo Fogarty, licensed dental hygienist and licensed dental therapist at Children's Dental Services, Farmington, Minn.; Dr. Burton Edelstein, professor of dentistry and health policy and management at Columbia University, and Shelly Gehshan, director of the Pew Children's Dental Campaign.

The Association in a statement for the hearing record cited actions in some states, including Vermont, to improve access to dental services. "It is critical to understand that addressing only one or even a few of the numerous barriers to care is the policy equivalent of bailing a very leaky boat," the statement says. "Scattershot efforts can provide some measure of relief among some populations for some time. But ultimately, we as a nation must muster the political will to address all barriers to care. Not doing so is a recipe for repeating past failures and missing opportunities to effect lasting, positive change."

The Association's statement is available online at ada.org.

In connection with the hearing, Sen. Sanders released a report that concludes, "We need to leverage the available workforce more effectively, produce more dentists and providers of dental care and, if needed, create new provider categories to ensure that everyone has access to the care they need. We need to redesign the oral health system by further integrating dental services into nontraditional settings, such as schools. We also need to prioritize preventive strategies and education which provide important health benefits to all people. The time to strengthen the oral health care system to improve oral health and overall health for millions of Americans is now."