It goes without saying that dentistry has evolved tremendously over the past century, and Columbia University College of Dental Medicine professors Dr. Allan J. Formicola and Dr. Ira B. Lamster believe that the dental profession needs to transition even further— by addressing the issue of the many Americans that have limited or no access to dental care as well as playing a stronger role in the primary health care system. In an editorial published in the American Journal of Public Health, Formicola and Lamster point out that the dental profession is able to offer a high level of care to 75 percent of the population—which leaves 25 percent of the population without oral care. They cite that a November 2010 U.S. Government Accountability Office (GAO) report to Congress showed that there were still 4,377 dental Health Professional Shortage Areas (HPAs) and a limited involvement of dentists treating Medicaid and Children's Health Insurance Program (CHIP) children. Formicola and Lamster state that the profession needs to ''scope up,'' or become a stronger part of the primary care workforce by screening for chronic disease in their patients. They believe dental schools should prepare graduates to do this by offering a wider range of courses that emphasize interprofessional education. Dentists can then concentrate on more complex procedures and patients, they say, and more basic procedures can be handed to midlevel providers. The topic of midlevel providers is a hot one in the dental industry, some for and others against the idea. But Formicola and Lamster believe that this is the solution to reaching the underserved population without disturbing the current private practice system. “We understand that improving the oral health of the underserved or uninsured in all 50 states and the District of Columbia is a complex problem that must carefully take into account cultural beliefs and economic factors, including the distribution of dentists,†they state. “However, we cannot hide behind those reasons for inaction, but, instead, must seize this time of health reform in the United States to improve the oral health delivery system.â€
