Access to Care

Heidi Coggan | 07.28.2014

Access to Care

There have been profound changes in the health care system in the last decade.  Traditionally, health care delivery systems have been focused on treating acute, emergency situations rather than prevention or the chronic problems of an aging population.  In the United States, the fields of dentistry and medicine have always been traditionally separate. Recently, there has been growing evidence which points to links between oral and whole body health and this separation of fields is slowly beginning to break down.  Evidence of periodontal disease as a risk factor for systemic disease has been steadily on the incline.   Some of theses links include the relationships between oral health and cardiovascular disease, diabetes, respiratory disease⎯mainly pneumonia, Alzheimer’s disease, and dementia.  With all these new facts coming to light, it has become increasingly obvious that oral health care is necessary to an adult’s general health and quality of life. It is important that the basic oral health services be a part of the primary care.  The question is how do we do this with an aging population?

The issue of unmet dental needs among the elderly has been documented for years. As baby boomers move into retirement, this need will increase exponentially.  As this crisis continues, creative problem solving has become the answer.  Through independent dental hygiene practices, or through collaborations with local dentists, the dental hygiene community is reaching out to these vulnerable populations.

Each state has its own regulations.  For example, in California, there are Registered Dental Hygienists in Alternative Practice.  They are mid-level practitioners that can travel to alternative settings such as dental health shortage areas, nursing homes and the private homes of homebound people. They can come to you.  Alaska is another state solving their access to care issues. The Alaskan Dental Health Aide recruits students from the native Alaskan communities to train and then return to those underserved populations. They can provide a variety of services including local anesthesia and tooth extraction but only in rural villages.

There are a number of resources available in each state.  The best place to find what resources are available to you is to begin with the preventative oral health experts, your local dental hygiene society or association.  Other health organizations can be of help as well.  Some of these include the local dental association, U.S. Department of Health and Human Services (look for your local chapter to avoid confusion), and last but not least the website is extremely helpful.


Heidi Coggan, RDHAP, BS, runs Hygiene in Motion, her own dental hygiene practice in San Diego, California.  In addition to being a member of the adjunct faculty at Southwestern College, she is a member and delegate of both the ADHA and CDHA.  She also serves as the membership chair and alternate trustee of the San Diego Component of the CDHA as well as the CalHyPAC Vice Chair for the CDHA.  She can be reached at .(JavaScript must be enabled to view this email address).