Institute of Medicine report

Nov. 1, 2011
Recently, the Institute of Medicine (IOM) published a report on the nation’s oral health entitled, “Improving access to oral health care ...

by Christine Nathe, RDH, MS
[email protected]

Recently, the Institute of Medicine (IOM) published a report on the nation’s oral health entitled, “Improving access to oral health care for vulnerable and underserved populations.” According to its website, “The IOM was established in 1970 by the National Academy of Sciences to secure services from eminent members of appropriate professions to examine policy matters pertaining to the health of the public. The Institute acts under the responsibility of the National Academy of Sciences to be an advisor to the federal government and, upon its own initiative, to identify issues of medical care, research, and education.”

This report presents a vision for oral health care in the United States where everyone has access to quality oral health care throughout their lives. It discusses the following areas:

  • Oral health status and utilization
  • Oral health-care workforce
  • Settings of oral health care
  • Expenditures and financing for oral health care

Of particular interest to dental hygienists, the report summarizes the difficulty many individuals have obtaining dental care because they cannot afford it. Also discussed is the low level of oral health literacy, which is endemic among the public and in other health-care professions.

The report reiterates findings from the American Dental Hygienists’ Association survey that found that 68% of dental hygienists reported finding sufficient employment somewhat or very difficult, and of those who had trouble, 80% feel there are too many dental hygienists living in their area. The IOM suggests this may be because of poor distribution of dentists, and the downturn in the economy. Also reported is the fact that less restrictive dental hygiene laws have led to greater income and employment opportunities for dental hygienists. The IOM report states that as the role of dental hygienists expands, further consideration will be needed for education preparation, which could be in the form of post-graduate education.

School-based health centers (SBHCs) are discussed and the fact that children with access to an SBHC are more likely to have seen a dentist in the past year, have improved academic performance, use primary care at increased levels while using emergency rooms less, and have increased vaccination rates. While SBHCs offer significant potential to increase access to dental care, only a small number of schools have SBHCs, and this means that dental hygienists should be working to improve these numbers. This also could benefit dental hygienists by increasing employment opportunities.

Another significant mention in the report that could impact dental hygienists is the innovations in health care settings, including telehealth technologies for increased utilization of dental hygienists in alternative settings, school-based care, and collaborations with women, infant, and children agencies (WIC) and Head Start. These are all prime settings for dental hygienists to deliver care.

The report also includes overall recommendations, which are: integrate oral health care into overall health care, create optimal laws and regulations, improve dental education and training, reduce financial and administrative barriers, promote research, and expand capacity. Detailed definitive recommendations can be accessed at

This report includes numerous sources and is a great reference for dental hygienists who want to get a broad overview of oral health in America. Additionally, the report can be used for data and information when examining issues in respective states and localities, and possible dental hygiene opportunities and solutions.

Source: Improving access to oral health care for vulnerable and underserved populations. Washington, DC: The National Academies Press.

Christine Nathe, RDH, MS, is a professor and graduate program director at the University of New Mexico, Division of Dental Hygiene, in Albuquerque, N.M. She is also the author of “Dental Public Health Research” (, which is in its third edition with Pearson. She can be reached at [email protected] or (505) 272-8147.

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