Policy on Workforce Issues and Delivery of Oral Health Care Services in a Dental Home

Policy statement

The American Academy of Pediatric Dentistry remains committed in its vision and mission to address the disparities between children who lack access to quality oral health care and those who benefit from such services. The AAPD believes that all infants, children, and adolescents, including those with special health care needs, deserve access to high-quality comprehensive preventive and therapeutic oral health care services provided through a dentist-directed dental home. In the delivery of all dental care, patient safety must be of paramount concern.

The AAPD encourages the greater use of an expanded dental workforce including nondentist providers under direct supervision by a dentist to help increase volume of services provided within a dental home, based upon their proven effectiveness and efficiency in a wide range of settings.4^6-48,50-53 The AAPD also supports provision of preventive oral health services by a licensed dental hygienist or nondentist provider under general supervision (ie, without the presence of the supervising dentist) following the examination, diagnosis, and treatment plan by the licensed, supervising dentist. Similarly, partnering with other health providers, especially those who most often see children during the first years of life (eg, pediatricians, family physicians, pediatric nurses), will expand efforts to improve children’s oral health.

The AAPD strongly believes in a patient- and family-centered dentist-directed oral health care model. The AAPD will continue its efforts to:

• educate families, health care providers, academicians, community leaders, and partnered governmental agencies on the benefits of early establishment of a dental home.
• forge alliances with legislative leaders that will advance the dental home concept and improve funding for delivery of oral health care services and dental education.
• expand public-private partnerships to improve the oral health of children who suffer disproportionately from oral diseases.
• encourage recruitment of qualified students from rural areas and underrepresented minorities into the dental profession.
• partner with other dental and medical organizations to study barriers to care and underutilization of available services.
• support scientific research on safe, efficacious, and sustainable models of delivery of dentistdirected pediatric oral health care that is consistent with the AAPD’s oral health policies and clinical practice guidelines. 
• embrace advancements in technology and teledentistry to increase access to and improve quality of oral health care services.

Furthermore, the AAPD encourages researchers and policy makers to consult with the AAPD and its state units in the development of pilot programs and policies that have potential for significant impact on the delivery of oral health care services for our nation’s children. Evaluation of the duration, content, and outcomes of nondentist provider training programs is needed to inform future recommendations with regard to their scope of practice.