IOM issues report on U.S. oral healthcare

The Institute of Medicine (IOM) has released its "Advancing Oral Health in America" report, which emphasizes the inextricable link between a person's oral health and overall health and also includes several recommendations for improving oral healthcare in the U.S.

In 2009, the Health Resources and Services Administration (HRSA) asked the IOM to assess the current oral healthcare sys­tem and recommend strategic actions for the U.S. Department of Health and Human Services (HHS) agencies.

Evidence shows that oral health complications may be associated with adverse pregnancy outcomes, respira­tory disease, cardiovascular disease, and diabetes.

Accessing oral healthcare is particularly difficult for certain populations, including people whose income falls below the federal poverty level, African Americans, Latinos, and children covered by Medicaid, the report noted.

Dental coverage largely determines access to oral healthcare and also predicts those who will seek it, but many people -- older adults, for example -- often do not have dental coverage. Even when individuals have dental coverage, they frequently do not receive needed services because of transportation barriers or a lack of providers who accept public insurance, among other factors, the IOM found.

The IOM's report included these organizing principles for a new oral health initiative based on what the group says are the areas in greatest need of attention, as well as approaches that have the most potential for creating improvements:

• Establish high-level accountability.
• Emphasize disease prevention and oral health promotion.
• Improve oral health literacy and cultural competence.
• Reduce oral health disparities.
• Explore new models for payment and delivery of care.
• Enhance the role of nondental healthcare professionals.
• Expand oral health research and improve data collection.
• Promote collaboration among private and public stakeholders.
• Measure progress toward short- and long-term goals and objectives.
• Advance the goals and objectives of the Healthy People 2020 initiative.

"HHS needs to have consistent messages for patients and healthcare professionals about the importance of oral health, but it is as critical for the department to have con­sistent messaging within its own organization that oral health is a priority," the report concludes. "HHS has the opportunity and responsibility to bring together different sectors to effect change in oral healthcare. There are many reasons that HHS should seize this opportunity. However, most important is that in spite of improvement, the American people continue to suffer, often silently, from avoidable and treatable oral diseases."

"Millions of Americans lack access to oral healthcare services," said Howard Koh, MD, assistant secretary for health, in a written response to the report. "This has to change."