I read with dismay the umbrella title, "Access to Care," for the three cover stories1–3 in September JADA. This focus on access to care by the American Dental Association was further brought home to me after listening to the presentations from [ADA leaders] at our Vermont State Dental Society annual meeting. It appears that organized dentistry has fallen into the political trap of focusing on access to services rather than disease prevention or "access to prevention."
Historically, the profession of dentistry has focused on a health model based on prevention. Early dental research focused on eliminating caries and discovering the etiology of periodontal disease, and continues to do so today. Unlike our brethren in the medical profession, the dental health profession has served the public by teaching—and preaching—healthy lifestyle alternatives in order to prevent dental disease.
I would challenge the ADA, at this critical juncture in health care, to put its resources into examining ways in which the dental health profession can promote disease prevention and healthier lifestyles. Shift the paradigm from how to increase the number of dentists in areas that are underserved to developing a model of utilizing dental health professionals and nurse practitioners to focus on fluoride, diet, flossing, brushing and sealants.
Partner with the American Diabetes Association and American Heart Association in working toward teaching healthy choices to our patients to reduce diabetes and heart disease through healthy eating and healthy habits, such as flossing. Refuse to focus on short-term "solutions," and instead focus on the long-term establishment of healthier lifestyles.
While this position may not result in the "quick fix" that the political and governmental entities may be pushing the ADA towards, no one could possibly suggest that the current medical model, based on treatment of disease, has improved health care and/or decreased costs over the past 20 years. As the organization representing dentists, the ADA needs to stand firm and focus on the health of our nation through access to prevention, not access to care.
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