Dentistry faces the same looming issue that the rest of the health care system faces: a growing patient population with a stymied provider population. The only solution for the medical and dental system has been to rely upon ancillary staff. In the medical field, registered nurses and certified nursing assistants are picking up the slack for physicians who cannot get through their workload. In dentistry, it falls upon dental hygienists and assistants. The American Dental Association has been tasked with finding further solutions to workforce shortages in the dental field (McKinnon, Luke, Bresch, Moss & Valachovic, 2007). As a result, the development of the Community Dental Health Coordinator (CDHC) was achieved. This position caters to underserved populations in rural and disparate communities. It is yet another position that will fill the provider gap, as it expands into the future.
Workforce shortages called for the creation of the CDHC. In 2004, there were 175,705 dentists in the United States. Only 4,500 graduate from dental school each year, so it is predicted that there will be a significant dentist shortage by 2020. The American Dental Association began studying the dental workforce in 2004 in order to enhance access to dental services. They sought to discover and reassign dentistry services that could be done by those who were not dentists. A taskforce was set up and set to the task of evaluating access to dental care by underserved populations. By 2006, the task force created two new dental professional positions to increase accessibility to dental care. The Oral Preventive Assistant (OPA) was the first position, and it enhanced the dental assistant role by adding the roles of oral health educator and preventive care giver (McKinnon et al., 2007). The other position was the CDHC.
Training for the CDHC is entirely different from that of dental assistants and dental hygienists. It involves training in the community program organizations, remote services, and service to underserved populations. Instead of private practice, which encompassed 92 percent of the workforce in 2004, CDHCs would be employees under the federally qualified community health centers (FQCHCs), Indian Health Services (HIS) and public health clinics. Private practitioners in underserved areas could also employ CDHCs. The supervision of a dentist is a requirement (McKinnon et al., 2007).
The impact CDHCs have on the community is immense when faced with scarcity among the dentistry profession. Community Dental Health Coordinators perform palliative care, limited to hand instruments only, until a dentist can diagnose and treat a condition. They also are in charge of community-based prevention and promotion programs. They collect diagnostics, perform supportive procedures, administrate and provide preventive services (McKinnon et al., 2007). They mirror the mission of the OPA but take on a more administrative role.
The history, education, and community impact of the CDHC is similar to many objectives set by health care agencies. Much like in traditional medicine, the wants and needs of dentistry are expanding as treatment options become more monetarily and technologically accessible. The options along with the increasing population have created demand that greatly exceeds the supply of dental services. The role of service providers that are not dentists is invaluable in underserved communities where accessibility is a challenge. Community Dental Health Coordinators ensure that dental services are available for every member of the community and that proper education and prevention strategies are communicated. The CDHC requires a different set of skills than other dental professionals, as it is administrative, collaborative, and could in some cases be the glue that holds a community’s dental health to a high standard.
- McKinnon, M., Luke, G., Bresch, J., Moss, M., & Valachovic, R. (2007). Emerging allied dental workforce models: Considerations for academic dental institutions. Journal of Dental Education 71(11), 1476-1491.Retrieved from http://www.allhealth.org/BriefingMaterials/JDE_association_report_Workforce_Models-1275.pdf
