Impact of State Workforce Policies on Underserved Patients' Access to Dental Care: A longitudinal study

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Purpose: Dental diseases are almost entirely preventable, but discrepancies in access to oral healthcare limit the effectiveness of preventive interventions. Dental hygienists are strategically positioned to improve access to preventive dental procedures; however, state workforce policies determine their permitted clinical tasks.Methods: This study cross-referenced oral healthcare service use at Federally Qualified Health Centers (FQHCs) between 2004 and 2012 with the Dental Hygiene Professional Practice Index (DHPPI), which quantifies the various aspects of state policy environments for the dental hygiene workforce. More specifically, the study used generalized linear mixed-effects models to examine the influence of state policy environment on access to dental care at 958 FQHC grantees.Results: States with "favorable" policy environments consistently reported the highest proportion of FQHC patients accessing dental care services (18%), whereas states with "restrictive" environments reported the lowest proportion (12%).Conclusion: A smaller proportion of FQHC patients' receive dental examinations in states with restrictive state workforce policies; state lawmakers should frame workforce policies to protect public safety without limiting the oral health workforce's ability to provide important oral health services to underserved people.

Original languageEnglish (US)
Pages (from-to)26-39
Number of pages14
JournalJournal of dental hygiene : JDH
Issue number5
StatePublished - Oct 1 2017


  • Access to care
  • dental and dental hygiene workforce models
  • health services research
  • legislative issues
  • oral health prevention
  • public health

ASJC Scopus subject areas

  • Medicine(all)

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