Policy on the Role of Pediatric Dentists as Both Primary and Specialty Dental Care Providers

Purpose

The American Academy of Pediatric Dentistry (AAPD) emphasizes that health care providers and other interested third parties must recognize the dual role that pediatric dentists play in the provision of professional preventive and therapeutic oral health care, which includes both primary and specialty care services, to ensure oral health care is accessible.

Methods

This policy was developed by the Council on Clinical Affairs, adopted in 20031, and last revised in 20182. This revision was based on a review of Accreditation Standards for Advanced Specialty Training Programs in Pediatric Dentistry3 and the AAPD position paper4 on the role of pediatric dentists as primary and specialty care providers. An electronic search was conducted using the terms pediatric dentist, pediatric specialist, primary care provider, dual care provider, and specialty care provider. 

Background

The Commission on Dental Accreditation defines pediatric dentistry as “an age-related specialty that provides both primary and comprehensive preventive and therapeutic oral health needs for infants and children through adolescence, including those with special health care needs.”3 The American Dental Association3,5 and the American Academy of General Dentitry6,7 recognize the pediatric dentist as both a primary care provider and specialty care provider. The dual role of pediatric dentists is like that of pediatricians, gynecologists, and internists in medicine. Within the medical profession, clinicians and third-party payors recognize these physicians in a dual role and have designed payment plans to accommodate this situation.

The AAPD respects the rights of employers to negotiate health care benefits for their employees. If third-party payors do not recognize pediatric dentists as primary care providers, access to pediatric dentists may be restricted. When oral health care is not accessible, the health implications, effects on quality of life, and societal costs are enormous.8 For children who have reached a predetermined age and/or who may be best served by specialized oral health care providers, requiring a specialty referral to a pediatric dentist prior to evaluation may delay or prohibit the most beneficial and cost-effective care. Using National Health Interview Survey data, researchers “found that more people reported financial barriers to dental care than to any other health care, regardless of age, income level, or type of insurance.”9

Policy statement

The AAPD recognizes that infants, children, adolescents, and individuals with special health care needs have the right to quality oral health care. The AAPD encourages third-party payors to recognize pediatric dentists as both primary and specialty oral health care providers and to refrain from agerelated restrictions when a parent or referring clinician desires to utilize the services and expertise of a pediatric dentist to establish a dental home or for limited specialized care.