Environmental Factors in Implementing the Dental Home for All Young Children

While the dental home concept is clearly articulated by organized dentistry and accepted as policy, its widespread adoption and implementation will require consideration of environmental factors that include: (1) the advent of social medicine, (2) expanding knowledge of caries risk and its management; (3) trends in oral health disparities and the demography that drives those disparities; (4) parents’ perceived needs for, and barriers to, dental care; (5) dentistry’s relationship to medicine as a profession; and (6) dental services capacity. Issues of cost and effectiveness will impact implementation decisions regarding how the most vulnerable children will benefit and how the medical and dental homes will coordinate. The dental home concept is clear and succinct in its definition by the American Academy of Pediatric Dentistry. That definition states, “the dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way.” This concept is intimately linked to a cluster of additional progressive policies currently being advanced by pediatric dentistry including the age one dental visit, outreach to Head Start populations, updating state Medicaid periodicity schedules, and refining clinical care through risk assessment and risk-based interventions. Benefits of the dental home are substantial and intuitive, although not yet substantiated by research, and include an increasing emphasis on prevention and disease management, advancements in tailoring care to meet individual needs, and better health outcomes at lower costs.