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California Dental Access Project

An Initiative to Improve the Oral Health of California's Underserved

Project Description

Recent research has shown that many Californians do not receive regular dental care. Oral diseases and other oral conditions - tooth decay, gum disease, oral cancer, and tooth loss-are among the most prevalent of all chronic health conditions. Forty-four percent of California adults had no dental insurance in 1995, and those with insurance were twice as likely as those without insurance to have visited a dentist. More than half of all California children--twice the proportion of children in other states--have untreated tooth decay. Twenty-eight percent of California children have no dental insurance--roughly twice the number of children without medical insurance. Nearly half of all preschool children and 12 percent of all high school students have never been to a dentist. These findings are of particular concern because very effective and inexpensive procedures are available that can prevent or ameliorate most oral disease.

To address these issues, The Center for the Health Professions developed and completed The California Dental Access Project. This project's goal was to examine the state of access to, and quality of, dental care in California.

Areas of focus include:

• Overviews of California's oral health care delivery system, the oral health care workforce, professional education, and dental financing (both public and private).
• Discussions of the barriers different populations encounter in accessing dental care, the populations in California disproportionately experiencing access problems, and the partnerships that will be necessary to overcome these barriers.
• In-depth analyses of policies, programs and models of care delivery that have been tried or are currently in use across the country and in different communities and health care environments.
• Descriptions of future models of dental care delivery, including an analysis of the use of individual risk assessment and the practice of evidence based dentistry
• A summary of a decade of recommendations made by local, state and national groups aimed at improving dental care delivery and practice.
• Recommendations on new and innovative models of care delivery for uninsured, low income, and Medi-Cal populations. The two strategies suggested propose a major shift in how resources are allocated to oral health activities, giving high priority to low-cost preventive activities and safety net programs that can treat existing disease.

Publications

The final project report, "Improving Oral Health Care Delivery Systems in California" may be viewed/downloaded in multiple options using Acrobat Reader:

Download full report (1.02 MB)

Download report sections:

• Cover and Detailed Table of Contents
• Executive Summary
• Chapter 1: Introduction, Purpose of the Report, Goals and Principles
• Chapter 2: Dental Care Delivery and Financing
• Chapter 3: Oral Health Care Systems - the Context for Change
• Chapter 4: The Dental Safety Net in California
• Chapter 5: Evidence-Based Dentistry
• Chapter 6: Overall Themes
• Chapter 7: Building from Existing Knowledge, Strategies and Recommendations
• Chapter 8: Recommended Strategies for Change
• Appendix 1: Summary of Recent State Medicaid / Legislative Changes
• Appendix 2: Program Interview Form
• Appendix 3: Program Interview List
• Appendix 4: Risk Assessment Model
• Appendix 5: Evaluation Tools
• Appendix 6: Summary of Previous Recommendations

This project was supported by a grant from the California HealthCare Foundation.