periodontal disease to increase tooth longevity and reduce systemic secondary effects in other organ systems, and
• ORAL-B: Compare the effectiveness of the various delivery models (e.g., primary care, dental offices, schools, mobile vans) in preventing dental caries in children (IOM, 2009).
The committee concluded that much more needs to be done to improve the quality assessment and improvement efforts in oral health to answer some of the basic questions regarding improving oral health and oral health access.
The committee noted the following key findings and conclusions:
Sites of Care
• Oral health is provided in two separate systems—private offices and the safety net—neither of which function adequately for vulnerable populations.
Financing Oral Health Care
• Out-of-pocket payments account for 44 percent of dental expenditures, and dental services account for 22 percent of all out-of-pocket health care expenditures.
• High out-of-pocket costs, lack of dental coverage, and limited financial means create barriers to receiving oral health care.
• Ideally, dental coverage would be included as part of health care coverage, but the cost of doing so makes this potential merger extraordinarily challenging.
• More research is needed on the economic and social impacts of increasing coverage (both in terms of numbers of individuals as well as the breadth of services).
• More research is needed on how different financing systems and the incentives therein might affect care delivery, including provider participation, cost-effectiveness, and efficiency.
• Health care professionals from underrepresented minority groups often account for a disproportionate share of care for patients from those same populations.