Thursday, May 18, 2017

Affordable and convenient access to adequate dental care is a major public health obstacle in the United States. The U.S. greatly lags behind other industrialized nations with more than 45 million adults and children living in areas with poor access to dental care, according to a 2014 report by The Commonwealth Fund.

That’s a problem Sydney Brown is trying to solve through independent research. Brown, who graduated Saturday with a degree in interdisciplinary studies from the College of Humanities and Sciences, was honored at the Council of Undergraduate Research’s annual Posters on the Hill event in April. The competitive research conference featured the work of 60 undergraduate researchers from across the country, chosen out of hundreds of applicants to showcase their work to policymakers in Washington, D.C.

Brown and other researchers shared their findings with U.S. Sen. Mark Warner and U.S. Rep. Donald McEachin.

“It was an honor to be able to advocate for the importance of undergraduate research,” Brown said. “I also wish I could speak to more policymakers about improving access to dental care. It’s amazing how much policy impacts public health.”

Brown’s work, which earned her a place in the conference as the only student from a Virginia university this year, investigated how international models could be applied in the U.S. to improve access to dental care. Specifically, Brown researched whether the international norm of employing dental therapists — midlevel care providers who perform many of the same functions as dentists — should be implemented in the U.S. These providers aren’t as extensively trained as dentists, but have a higher level of expertise and clinical independence than U.S. dental hygienists.

Brown found midlevel providers could address issues such as the lack of dental professionals in low-income or rural areas. She said that if U.S. educational systems are adapted to train midlevel providers, efforts should be made to recruit students from low-income areas because they would be vested in giving back to their communities. Brown said the lower cost and shorter time commitment to earn a midlevel provider certification, versus a degree in dentistry, may also be an incentive to these students.   

“Midlevel providers would be beneficial because it generally takes these professionals less time and money to obtain their education than what is required by dentists. This means that more individuals could be trained, making a faster impact in dental shortage areas,” Brown said.

To learn more about how midlevel providers operate and the way in which access to adequate care impacts patients worldwide, Brown surveyed faculty in dental education programs in the Netherlands, United Kingdom, Australia, Canada and New Zealand. She found that similar to the U.S., these nations had multiple issues regarding access to healthcare. A number of patients in New Zealand and Australia have reported government assistance programs placed an emphasis on care for children and cultivating good oral hygiene at an early age, while care for adults was placed on the back burner. Like the United States, all of the surveyed nations reported that low-income and rural areas lacked dental facilities.

In order for midlevel professionals to be effective in the U.S., policymakers must rework health and educational systems to account for the country’s unique access issues, Brown said.

“Midlevel providers can work in the United States, but a system must be tailored to fit our communities,” she said. “Also, midlevel providers are helpful, but they would only be one part of the solution to a complex problem, as evidenced by dental care access issues in the countries where these professionals are employed.”

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