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Organization of Dental Care and Practice

How Dental Care is organized at the Local Level

Dental care at the local level is organized around several institutions and programs, namely local city and county governments, local foundations, nonprofit organizations, school departments, dental and dental hygiene schools, dental residency programs, and private dental practice. Local city and county governments are responsible for administering oral health prevention programs, promoting and monitoring water fluoridation, and operating clinical programs for specific populations that need limited, urgent or comprehensive dental care. Local foundations are responsible for promoting oral health across communities, though on a much smaller scale than statewide and national foundations. Nonprofit organizations are responsible for providing direct patient care through federally-qualified health centers and non-federally qualified dental clinics, while school departments are mostly responsible for operating oral disease prevention programs as well as less intensive clinical programs. Lastly, dental and dental hygiene schools and dental residency programs are responsible for promoting oral health through workforce development, clinical patient care and population-health initiatives, while private dental practitioners provide a variety of oral health services to patients at a cost.

Role of Private Practice in Access to Dental Care

Private dental practice plays an important role in ensuring an early diagnosis of oral health problems affecting community members and addressing these problems through preventive treatments as well as early intervention. Additionally, private dental practice is credited with increasing access to routine dental care for community members who are able to pay for the services. The collaboration between private dental practitioners and their professional colleagues in community-based health centers is of immense importance in enhancing access to health care for underserved individuals within the society through expanding the capacity for oral health services. Lastly, the ease of availability of private dental practitioners has been instrumental in ensuring that millions of Americans have access to preventive oral health services such as sealant applications, dental hygiene, and prophylaxis (cleanings).

Strengths and Limitations for Increasing Efficiency of Practice

In strengths, most private practice practitioners are able to provide competent dental services through appropriate diagnosis and investigations. They are also well-placed to not only monitor the health status of their patients to identify community health problems, but also to inform, educate and empower patients on oral health and hygiene. Lastly, private dental practitioners are able to link or refer their patients to needed personal health services when they are unable to provide such services. In barriers, it is evident that most dentists in private practice may be unable or unwilling to research for new innovative insights and also to mobilize community partnerships due to the profit-oriented nature of the practice. The challenges of private practice include low Medicaid reimbursement rates, excessive paperwork as well as billing and administrative complications, unequal distribution or location of private practice clinics within some states or local communities, and limited resources to address the needs of underserved populations. Lastly, in regulatory limitations, it is evident that some states do not allow private dental practitioners to assess patients teeth or apply dental sealants outside of dentists offices.

Private dental practice is different from local programs such as school-based dental sealant programs in terms of funding, policies and plans, mobilization, and patient demand issues. A school-based dental sealant program is often funded by the local government or a non-governmental organization, while private practice is self-funding and hence the services offered are relatively expensive. Additionally, the policies and plans of private practice may include profit realization, whereas those of a school-based dental sealant program may entail the provision of oral care to children from low-income families in the community. A school-based dental sealant program is more effective than private practice in terms of mobilizing community partnerships aimed at identifying and solving oral health problems. Lastly, it is evident that patient demand issues are more entrenched in private practice than in community-based programs due to the fact that the services offered by private practitioners come at a cost.

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