FAQ: Dental delivery system
DI and dentists providing services
Descriptive Studies of Dental Delivery and Education Systems
Analytic Studies of Dental Delivery and Education Systems
Health Policy Studies
The dental delivery system consists of public and private components. The public component primarily focuses on community level interventions to prevent dental diseases. Examples include water fluoridation, education of children and adults, and school-based dental sealant programs. The public system also finances the delivery of services to low-income groups through public insurance (e.g., Medicaid), and the direct delivery of care through publicly owned community clinics (dental safety net).
The private system is mainly dentist owned and run practices that provide personal dental services to individual patients. In the United States, 95 percent of the approximately $90 billion spent on dental care in 2007 goes to the private delivery system.
3. What are dental health policies?
The term dental health policies refers to federal and state laws and regulations that influence the public and private dental care systems. As with other health professions, most laws governing dentistry are the responsibility of the state government (e.g., licensing requirements). Federal policies mainly focus on national financing programs for special populations (e.g., the poor) and environment and occupational safety rules (e.g., disposal of amalgam).
 Bailit, H., Beazoglou, T., Demby, N., McFarland, J., Robinson, P. and Weaver, R. 2006. Dental safety net: Current capacity and potential for expansion. JADA 137(6): 807-816.
This study examines the current capacity of the safety net system to provide care to the approximately 85 million low-income Americans who have low dental utilization rates. It also assesses the capacity of the safety net system to expand in the next 10 years.
 Bailit, HL, Beazoglou, TJ, Formicola, AJ. The dental curriculum and the cost of dental education. In Brown, LJ and Meskin, LH (Eds) The Economics of Dental Education. Chicago: American Dental Association. Health Policy Center. 2004:123-124.
This study estimates the cost of dental education and shows the great variation among schools in cost per student. This variation is mainly related to the substantial variation in the hours spent in different courses among schools. The impact of different cost structures and hours of instruction on student performance on Part I and II of the National Board is also assessed. Greater investment in the basic medical sciences leads to higher Part I Board scores. This is not true for the Part II Boards.
This study examines the relationship between the money spent for dental education in a state and the availability of dental services. The best predictors of the number of dentists in a state relative to the size of the population is the per capita income of the state and the number of state residents in dental school. The presence of a dental school is much less important.
This study examines trends in the productivity of dentists for the past 50 years. Dentist productivity has increased about 1.3% per year, and it is mainly the result of larger practices with more chairs and staff.
 Bailit, HL, Beazoglou, TJ, Formicola, AJ, Tedesco, LA, Brown, LJ, and Weaver, RG. U.S. state supported dental schools: Financial projections and implications. J. Dent. Educ. 2006; . 70(3): 246-257.
This study reports on the financial challenges faced by state supported dental schools and examines the response of schools to these challenges. The impact of declining resources is assessed in terms of the quality of education and research programs. The paper concludes that without major increases in public support, the current model of clinical education may no longer be viable.
This paper examines the potential of two new clinical models of dental education to address the financial problems faced by dental schools. In the first model senior students spend most of their time providing general dental services in community clinics that are not owned or managed by dental schools. In the second model, schools reorganize dental clinics into patient-centered delivery systems modeled after private practices. In this model, faculty practice while they supervise a few residents or students. The paper concludes they both models have promise to meet more of the financial needs of dental schools and at the same time strengthen dental education and research.
This editorial examines the financial challenges facing dental education and calls for the leaders of the educational and practice communities to come together to find more effective ways of educating dental students and residents.
This paper examines the supply of dental services for the next 20 years and concludes that there is likely to be a rapid increase in supply because of new dental schools opening, the expansion of the services provided by allied dental health personnel, and the possible licensing of foreign trained dentists. However, the increase in supply will have little impact on access to care for low-income populations, because the key access barrier is not the supply of services but the capacity of low-income patients to pay for dental care in the private sector.