This issue's policy forum focuses on initiatives that promote oral health and on challenges the state currently faces. Commentaries discuss new practice models and trends in dental practice, dentist workforce numbers, the East Carolina University School of Dental Medicine education model, and insurance innovation in dental coverage. Several articles focus on access to oral health care in specific populations including children, adult Medicaid recipients, and people with special needs. Original articles examine reasons for tanning bed use among community college students and evaluate the effectiveness of mailed interventions to increase colon cancer screening.
The importance of oral health to overall health has become increasingly evident in the recent past. A growing body of evidence shows us that oral health is inextricably linked to overall health. Preventive oral health care and early treatment interventions have become more and more essential to obtaining and maintaining optimal overall health, yet the practice of dentistry stands apart from the practice of medicine for many complex and largely historical reasons. Nevertheless, our growing understanding of how enmeshed oral health is with overall health means that oral health is receiving more—and deserved—attention in the realms of healthy policy, preventive care, and disease treatment.
This issue of the NCMJ speaks to the assumption of this new role by dentistry. Our authors describe programs and initiatives that bring preventive services and treatment to children, underserved North Carolinians, and special needs populations; explore the capacity of the dentist workforce and the need to expand it; examine changes in how dentistry is managed; and discuss access to oral health care for all North Carolinians. Issue brief author R. Gary Rozier tells us that the oral health problems the state faces are stubborn and that their solutions depend upon the participation of dentists and dental practitioners and professionals who see the need to care for all the people of the state. The profession is aware of these persistent problems.The policies, programs, and other interventions we read about here intend to address them.
North Carolina Dental Society Executive Director M. Alec Parker calls dentistry the “last cottage industry remaining in health care.” While this is true, dentistry has quickly become a very dynamic profession that makes extensive use of technology for diagnostics and treatment, combines complex professional roles in delivery sites, and coordinates the work of multiple technicians and practitioners to provide care. Dentistry may remain tied to the cottage, but the cottage has become a very high-tech structure.
North Carolina is unique in its commitment to public health dentistry. A great asset in the state is its public, higher-education system, which now houses 2 dental schools. In the University of North Carolina-Chapel Hill, the state has a dental school that is closely linked to a school of public health. The dental and the public health schools emphasize population health in both their research and training. However, we have a relatively low number of dentists in the state, and poor oral health in certain parts of the state and in particular segments of the population persists. State policymakers have responded to these issues by supporting the new school of dental medicine at East Carolina University and giving it a special mandate to train dentists to practice in places where poor oral health and access to oral health care remain problematic.
Of last note is the current national landscape where health reform has a constant presence in the news media, the costs and performance of the US health care system are high on the political agenda, and health care makes up a large and growing part of our economy. The context used to illustrate this landscape is almost always a medical one, and oral health care is often left out of the picture. This issue of the NCMJ strives to highlight the prominence of oral health as we consider health overall, the opportunity oral health presents to make improvements in population health, and how dental professionals are significant contributors to a healthier North Carolina, and thus a healthier America.
Thomas C. Ricketts III, PhD, MPH
Editor in Chief