For oral health care, two levels of team care may exist—first among dental professionals and second among various health care professionals. As will be discussed in Chapter 4, the federal government has a history of training dental professionals to work together more effectively. More research will be needed for understanding the dynamics of the dental team as new types of dental professionals emerge. In addition, little research exists on the interprofessional education and training of dental professionals and nondental professionals together in caring for mutual patients who have complex oral health needs (Haden et al., 2010; Hallas and Shelley, 2009; Wilder et al., 2008). In 2005, New York University created a unique partnership in which a college of nursing was located within the college of dentistry. As part of the interdisciplinary educational model, pediatric nurse practitioner students work alongside dental students to provide care in school clinics and Head Start programs (Garcia et al., 2010; Hallas and Shelley, 2009). This allows the pediatric nurse practitioner students to learn about caries risk assessment and how to apply fluoride varnish while the dental students can become more familiar with the role of the nurse in oral health.
In January 2010, the Advisory Committee on Training in Primary Care Medicine and Dentistry recommended that “training grants should provide funds to develop, implement, and evaluate training programs that promote interprofessional practice in the patient-centered medical-dental home model of care” (HHS, 2010). They also stated that “funding should support clinical sites that prepare trainees for interprofessional practice by educating medical, dental, physician assistant, and other trainees together on health care teams.”
Regulation of the health care workforce in general occurs at several levels. The primary role of the federal government is to protect consumers and promote fair competition. The state has a legitimate interest in protecting the public as well, and each state develops their own scope of practice law for each health care profession that covers such things as who may enter a profession, what types of minimal competency requirements must be satisfied for licensure, and what services they may provide. Finally, the private sector is involved in the regulation of the health care workforce in that they often offer voluntary credentialing; sometimes these types of credentials are required for licensure. For professions and occupations without licensure requirements, credentialing may be one source of information for consumers. HHS has virtually no role in the regulation of health care professions, so this discussion is to provide an overview of the issues as they relate to the overall oral health care system.