Shelly Gehshan, M.P.P.

Pew Center on the States

When approaching solutions to oral health access, all types of professionals need to remember that change often requires a legislative process. To help legislatures make these decisions, professionals need to help the legislators sort fact from fiction, especially by countering anecdotes with evidence. Expressing beliefs or opinions is valid, but should not be presented as facts.

Another point to consider is the economic crisis that is creating a situation in which much less money is available than is needed. However, this may help foster the creation of more innovative solutions. States are especially good at being innovative when faced with insufficient budgets. Along with this creativity, though, data needs to be gathered to create an evidence base.

Two of the continuing debates in the new models of care are responsibility for restorative care and levels of supervision, much of which will need to be defined by an evidence base. As these issues are explored, more attention is needed for communication and messaging, especially in the consideration of terminology. Oral health professionals need to become more skilled at strategic messaging. For example, irreversible procedures can mean nothing to a policy maker or may imply a negative connotation that is not warranted. Communication within the professions is key to moving forward.

In conclusion, there are great grounds for optimism. Oral health stakeholders need to enter into creative partnerships and reach out to nontraditional practitioners to move forward on a number of different solutions.

Elizabeth Mertz, M.A.

Center for the Health Professions, University of California, San Francisco

Many of the solutions to improving access to oral health services require developing a framework that includes new ideas, new ways to think about old problems, and ways to reframe current problems. The health care delivery system accounts for only a very small percentage of health outcomes, yet most of the money and debate centers around that part of the equation. More attention is needed on how to affect the social and behavioral environments, but the current health care delivery system has little capacity to address those broader issues. This lends to the importance of bringing all stakeholders together to determine shared goals and outcomes in areas of financing, education, and regulation. More evidence

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