Abstract
Purpose: Dental diseases are almost entirely preventable, but discrepancies in access to oral healthcare limit the effectiveness of preventive interventions. Dental hygienists are strategically positioned to improve access to preventive dental procedures; however, state workforce policies determine their permitted clinical tasks.
Methods: This study cross-referenced oral healthcare service use at Federally Qualified Health Centers (FQHCs) between 2004 and 2012 with the Dental Hygiene Professional Practice Index (DHPPI), which quantifies the various aspects of state policy environments for the dental hygiene workforce. More specifically, the study used generalized linear mixed-effects models to examine the influence of state policy environment on access to dental care at 958 FQHC grantees.
Results: States with “favorable” policy environments consistently reported the highest proportion of FQHC patients accessing dental care services (18%), whereas states with “restrictive” environments reported the lowest proportion (12%).
Conclusion: A smaller proportion of FQHC patients' receive dental examinations in states with restrictive state workforce policies; state lawmakers should frame workforce policies to protect public safety without limiting the oral health workforce's ability to provide important oral health services to underserved people.
- Access to care
- dental and dental hygiene workforce models
- health services research
- legislative issues
- oral health prevention
- public health
Footnotes
Hannah L. Maxey, RDH, MPH, PhD is the director, health workforce studies and assistant professor of family medicine; Connor W. Norwood, MHA, PhD is a research associate and assistant director of health workforce research and policy; Johannah B. O'Connell, JD is a former research associate; all at the Bowen Center for Health Workforce Research and Policy, Indiana University School of Medicine, Indianapolis, IN.
Ziyue Liu, PhD is an assistant professor, Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN.
This manuscript supports the NDHRA priority area Population level: Access to care (outcomes assessment).
- Received November 17, 2016.
- Accepted May 14, 2017.
- Copyright © 2017 The American Dental Hygienists’ Association
