Oral Health in Virginia: Trends, Disparities and Policy Implications

Dental health across the U.S. has improved steadily in recent years and most Virginians receive more frequent preventive care than the national average. But some segments of Virginia’s population have clearly been left behind in access to dental care, according to the authors, Terance Rephann and Tanya Wanchek.
Virginia has made some notable progress in improving care, and in some public policy areas such as low-income children's access and utilization, the state compares very favorably with best practices, the authors write. However, the state draws only an average "C" rating from oral health monitoring organizations.
For uninsured patients, hospital emergency room care is the only regularly available recourse for painful oral infections and trauma.
Virginia offers very limited dental services to its adults for two reasons.  First, the state Medicaid eligibility rules for adults are fairly stringent and exclude some categories of low-income individuals who would be covered in other states.  Second, Medicaid-eligible adults are generally offered only emergency services.
There is considerable evidence that improvements in oral health in underserved populations could be achieved by expanding the services offered by dental professionals other than dentists.
Rephann and Wanchek observe, "In particular, allowing hygienists to offer fluoride varnish and routine cleaning without supervision by a dentist has the potential to generate significant health improvements at low cost."  They conclude, "New models for providing dental care to needy and underserved populations should be strongly considered, as well as expanding the use of hygienists and other health professionals to make dental care more widely available to all Virginians."