Access to Dental Care and the Oral Health Safety Net

Despite improvements in the oral health of the U.S. population in the past 60 years, oral disease still affects the majority of Americans. Considerable oral health disparities exist across different segments of the population. For example, low income populations and certain racial/ethnic minority groups bear a higher burden of disease compared to the rest of the population. These inequalities are also evident in the ability to access dental care, which compounds the burden of oral disease among vulnerable populations.

This report describes the major components of the oral health safety net in Iowa. The goal of this report is provide a foundation for discussion about the impact of the Patient Protection and Affordable Care Act (ACA) on the oral health safety net. The oral health safety net has been defined as a “composite of all places, providers, and programs that deliver dental services to people disenfranchised from the predominant private dental delivery system.”

While the implementation of the ACA has the potential to improve access to oral health care, primarily through the expansion of both public (i.e., Medicaid and the Children’s Health Insurance Program-CHIP) and private (i.e., plans through the Exchanges) insurance options, it is unclear whether the current delivery system will be able to support these newly insured individuals.

This report is part of project to examine the impact of the ACA on the dental safety net, supported by a grant from the DentaQuest Foundation (Boston, MA). Other components of this project include a survey of the level of private practitioner participation in Medicaid and an analysis of FQHC dental capacity. This project is part of a broader study of the impact of the ACA on the financing and delivery of care through the health safety net in Iowa, supported by The Commonwealth Fund (New York, NY).