We deeply appreciate Dr. Solomon’s comments, sentiments and observations. Dr. Solomon accurately notes that many local directors and managers of the nation’s various disaster and emergency medicine response agencies do not appreciate the significant contribution the oral health care profession can make to infrastructure, personnel and a timely response during a disaster event. With annual changes in seasonal weather and the constant threat of a man-made disaster, it would seem that disaster managers would want to take advantage of, tap into and empower the oral health profession and its resources to provide for a robust triage and pandemic surge, recovery and reconstitution effort, when needed.
Illinois is fortunate to have forward-thinking visionaries in senior state-level positions who, without doubt, saw and defined a robust role for the oral health care profession in disaster medicine. Hesitation was present, not because of skill sets, but rather because of long-standing legal definitions of scopes of practice.
The critical leap occurred, however, when Illinois political and public health leaders perceived that dentists do perform emergency medicine. These same leaders then perceived that definitions of scope of practice were not eternally fixed as unchangeable statements and were modifiable. The Illinois State Dental Society (ISDS) through consistent and constant political will, advocated the need to change state law. ISDS gathered support from leadership within our colleague medical professions and built political support within the Illinois legislature.
Clearly, our experience reveals that the oral health profession needs to, and must constantly, justify what it can bring to the disaster medicine community. Dentistry today has a respected public perception. However, when have we, as a profession, projected to the public that we can contribute more health care than just treating caries and whitening teeth?
This is the new reality. If we cannot justify why, we will not be invited to the table. The majority of the individual health care providers who we encountered at the boots-to-the-ground level, and regardless of training, "get it." These health care providers showed, almost universally, acceptance, not resistance. Policy and planning leaders, however, have a different mission. They respond to political needs and the will of the people. They need and seek justifications, through public law, that can satisfy legal oversight.
Our experience suggests that the oral health profession needs to educate the rest of our oral health care colleagues, our fellow health care providers and the public at large to the level of care we can provide and our real place in the disaster medicine response community. Education and advocacy are key. We need to get involved and stay involved. Otherwise, our profession will become less health care–oriented and more technician-oriented.
Illinois has taken a proactive, forward-thinking position. Collaborative efforts by numerous individuals have led to a new paradigm for the oral health profession, which includes contributing to the disaster medicine and pandemic protection of the health and well-being of Illinois citizens. Many other states are looking at the Illinois model as a strategy and a way to protect their citizens. It can be done again, but it will take the whole profession to continue to advocate that this is part of the national oral health description of practice.
