5.  Summary and Recommendations

Summary

This report began by highlighting several important and related phenomena:

• A growing recognition of the inter-relatedness of oral health and general health, and the critical importance of broad access to basic dental services;
• Rising public concerns about disparities in oral health and access to care that in turn, have raised questions about the supply and training of dentists; and
• Renewed interest among State and Federal officials about the public policy aspects of dental education.

Major sections of the report provide details about changes in the production, number, characteristics and distribution of dentists that are likely to further limit the supply of dental services and exacerbate access to care issues for growing segments of the population unless Federal and State officials begin to deal with dental education as a matter of broad public policy.  Dental schools are facing substantial challenges (that some have characterized as crises) as they struggle to incorporate new information from a rapidly expanding knowledge base into already overcrowded curricula, cover the costs of clinical education, and deal with growing faculty shortages.  Rising costs of education and declining Federal and State support for dental education is contributing to growing levels of student indebtedness which, in turn, make dentists who enter the profession less likely to provide services for underserved segments of the population.   Clearly, the time has come to embark upon Federal and State strategies that address these problems in a concerted manner, based upon the fundamental public policy interests in dental education.

Recommendations

The broad strategies for Federal and State policy development to enhance dental education and advance the public’s interests in having access to safe, competent practitioners prepared to address the oral health needs of a broad range of individuals include the following.

1. Develop and maintain publicly available Federal and State data sources that adequately support workforce analyses and policy development.
2. Expand Federal and State programs that address dental student indebtedness and faculty shortages.
3. Link public support for dental education to public policy concerns (using approaches similar to those that have been adopted in the three State examples highlighted in section four).
4. Develop and support a National strategy for implementing universal dental residency (PGY-1) training in order to accelerate system changes that will better serve the public interest.

Leaders in the field of dental education, dental practice and related health policy have reached a considerable degree of consensus about what needs to be done to make dental education function in a manner that serves the longstanding fundamental interests of the public.   It remains for leaders from the public policy domain–both at the Federal and State levels–to partner with professional leaders and vested stakeholders to purposefully address dental education as an essential National resource, as a National enterprise, and as a matter of broad public policy.