Tooth decay is the most common chronic disease among children in the U.S. with an impact that is felt most acutely in low income, underserved areas. On average, children miss 34 million school hours annually due to emergency dental care. The authors of a recent paper in JAMA Health Forum studied the cost-effectiveness of expanding the dental workforce in underserved areas through the National Health Service Corps (NHSC) to evaluate the potential impact of having more dental practitioners providing care in those communities.
“Our analysis suggests that expanding the dental workforce through the NHSC would reduce the burden of dental caries among children in underserved areas and address disparities in the social and economic determinants of oral health,” said author Sung Choi, instructor in Oral Health Policy and Epidemiology at Harvard School of Dental Medicine.
The NHSC is a federally funded program through the Health Resources and Services Administration (HRSA) that offers scholarship and loan programs to medical and dental students who commit to serving in areas defined as Health Professional Shortage Areas (HPSA’s) after completing their education and training. Currently, nearly 20,000 medical and dental clinicians serve at NHSC-approved sites in urban, rural, and tribal communities.
There are approximately 65.8 million U.S. residents living in HPSA’s — dental HPSAs are defined by the ratio of dental professionals to the population with high needs, where dental care is in short supply. More than 10,600 dental practitioners are needed to adequately supply the over 6,300 communities considered as HPSAs.
Using a model-based economic analysis that evaluated the cost-effectiveness of expanding such a program based on data from 10,780 U.S. children, the study’s authors found that increasing annual NHSC funding for dental practitioners by 5 to 30 percent over 10 years would substantially reduce the burden of dental caries and still provide a cost savings.
“The dental professional shortage in dental HPSAs has been identified as a barrier to access to dental care. Realizing that expanding the network of dental practitioners in HPSA’s can be done cost effectively and lead to better health outcomes for children is extremely encouraging,” said Choi. “This has the potential to make a difference for our most vulnerable populations in the U.S.”
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