Abstract
Good health requires good oral health,
yet millions of Americans lack
access to basic oral health care. In 2008, 4.6 million children—1 out of every
16 children in the United States—did not receive needed dental care because
their families could not afford it. Children are just one of the many vulner
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able and underserved populations that face persistent, systemic barriers to
accessing oral health care. While the majority of the U.S. population routinely
obtains oral health care in traditional dental practice settings, oral health care
eludes many vulnerable and underserved individuals—including racial and
ethnic minorities, people with special health care needs, older adults, preg
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nant women, populations of lower socioeconomic status, and rural popula
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tions, among others. Lack of access to oral health care contributes to profound
and enduring oral health disparities in the United States. Access is hampered
by a variety of social, cultural, economic, structural, and geographic factors,
but fortunately, opportunities exist in both the public and private sectors to
reduce barriers to care.
In 2009, the Health Resources and Services Administration (HRSA) and
the California HealthCare Foundation asked the Institute of Medicine (IOM)
and the National Research Council (NRC) to convene a committee of experts
to address access to oral health care in America for vulnerable and undeserved
populations. The committee was charged to assess the current oral health
care system, to develop a vision to improve oral health care for vulnerable and
underserved populations, and to recommend strategies to achieve the vision.