I applaud my profession, and the American Dental Association, for exploring the issues related to access to dental care. Dr. Peter Milgrom and colleagues’ October JADA article, "Improving America’s Access to Care: The National Institute of Dental and Craniofacial Research Addresses Oral Health Disparities," touched on many important factors.
I suggest, however, a broader perspective is necessary to understand the true cause and effect of access to dental care. The prevailing thoughts projected in the article seem to target socioeconomic issues, which I believe to be only part of the issue, and are not likely the true fulcrum point for powerfully leveraging the factors of access to care.
I found it interesting that ethnicity was cited as though it is congruent to lower economic standing in our communities. The likely reality is that ethnicity has a much closer relationship with the cultural and educational upbringing of recent immigrants.
I was glad to see the issue of education touched on in this article, but the full weight of the importance of early interceptive dental hygiene education was not adequately prominent. More importantly, understanding a patient’s perception (whether parent or child) of the value of dental service is completely deficient in the studies.
Understanding people’s values is a much larger force, and it has a tremendous impact across all socioeconomic layers of our society. Organized dentistry has done little more than to seek ways to provide low-cost or free dental services as its answer to access to care, while it has been negligent in promoting the value of dental service across our society.
While my next comment may be perceived as anecdotal, I would caution readers to examine the reality. Recently, I was driving through a poor area in my community and noticed several homes with satellite TV dishes on the rooftops, new cars in the driveways and children playing out front in tattered clothing. This may not even be an example of an average low-income circumstance, but it does point out what is likely the greatest issue affecting access to care: a family’s values and priorities.
Our responsibility as an organization should be to review our policies on promoting the value of our services in our society. ADA, take a tip from the milk processors’ organization’s "Got Milk?" campaign. How about "Value Your Smile!"
