Assignment 16 (Annotated Bibliography) - Gaby Rondel

Bibliography

Bersell, Catherine H. “Access to Oral Health Care: A National Crisis and Call for Reform.” Journal of Dental Hygiene, vol. 91, 2017, jdh.adha.org/content/91/1/6/tab-article-info. 

This article talks about the different factors that influence a person’s ability to access dental care and how they impact each other. Bersell splits the factors into two categories: external barriers and internal barriers. The external barriers include prohibitive costs, inability to obtain insurance, shortage and maldistribution of dentists, low Medicaid provider participation, insufficient training, lack of interdisciplinary collaboration, inadequate financial safety nets, and a complex healthcare system. The internal barriers are low oral health literacy (the ability to understand and act upon dental health information); fear and anxiety associated with dental care; and perceptions and misconceptions about preventative oral healthcare. Bersell connects each of these barriers to poverty and low-income rates and goes into further detail on a few of them. The article also discusses several current solutions that are in place to increase access to dental health care. Bersell talks about measures the American Dental Association (ADA) and the American Dental Hygienists’ Association (ADHA) have taken. She also discusses the success of mid-level providers as well as state initiatives.

The ADHA is an organization for dental hygienists. Its position is that oral healthcare is a right of all and dental hygienists play a vital role in the solution to eliminate the barriers associated with access to dental care. Unlike the ADA, the ADHA supports the idea of a mid-level oral healthcare provider. These providers are most commonly Dental Health Aide Therapist (DHAT). DHATs are essentially a mix between a hygienist and a dentist that treat more routine problems-such as fillings, crowns, extractions, and some periodontal work- in discrete, high-need populations. The ADHA might be biased towards promoting DHATs as that is part of their position as an organization. However, the ADHA and the Journal of Dental Hygiene are research-based. Catherine Bersell is a clinical dental hygienist, researcher, and writer. She is a member of the ADHA so she might be biased towards the ADHA’s policies and positions.

This source provides a lot of useful information about the specific barriers to dental healthcare and a clear picture of measures that are currently in place to lower those barriers. I would use this as evidence for two things: 1) reasons why dental healthcare is so disproportionately bad, and 2) why the current methods in place aren’t working. Additionally, there is an anecdote that I could potentially use as an opener. 

Frakt, Austin. “How Dental Inequality Hurts Americans.” The New York Times, 19 Feb. 2018, How Dental Inequality Hurts Americans. 

This article discusses the economic implications of dental healthcare and the lack of Medicaid supported dental care. It recaps several studies (that are not available to me otherwise I would go straight to the study) that prove how a lack of dental has economic implications, specifically a person’s ability to get and maintain a job. Frakt also discusses how most of these issues and barriers are only affecting those who are eligible for Medicaid under the Affordable Care Act, and how Medicaid doesn’t- for the most part- cover dental care. Frakt also goes over the strengths and weaknesses of policies that several states have put in place in hopes of lowering barriers for Medicaid-covered patients. 

The New York Times is generally considered a reliable source, even though it does lean left on the political spectrum. Austin Frakt is the director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; an associate professor with Boston University’s School of Public Health; and an adjunct associate professor with the Harvard T.H. Chan School of Public Health. I would say that he is qualified to discuss healthcare. The goal of this article is to relay information about how Medicaid is lacking and reasons it is important to fix its policies toward dental care. 

This source discusses several studies that are not free to the public. It provides information and statistics that I could use to support my claims. Additionally, Frakt discusses several states’ policies toward Medicaid dental care; this provides a nice comparison between what is working and what is not. 

The Guardian Life Insurance Company of America. “A Comprehensive Guide to Dental Insurance.” Guardian Direct Insurance, 2020, www.guardiandirect.com/resources/articles/comprehensive-guide-dental-insurance. 

This article is an insurance company discussing dental insurance, types of dental insurance, how the dental insurance system works, why dental insurance is important, and what dental insurance covers. It also goes on to explain how one should pick their insurance plan, but this is irrelevant to my speech (even though it might be helpful in the future). This source has been especially helpful because, as a child who relies entirely on her parents for this sort of thing, I didn’t have the slightest clue as to what dental insurance covered, why it was so important, and it was such a problem to get it. This article helped me understand dental coverage and care. This article was published and written by an insurance agency. While the article could have been written in a manner that encouraged people to buy dental insurance, for the purposes of understanding how insurance works, nothing could be more reliable than an article released by an insurance agency. 

Health Policy Institute. Oral Health and Well Being in the United States, American Dental Association, 2015. 

This source is composed of seven posters that relay statistics about dental care in the United States and how American adults feel about said care. There are many diagrams, charts, and graphs each providing information about a specific topic related to dental healthcare. Most topics are split into one of three categories: household income, age, and time passed since the last dental visit. The most important of these three, for me, would be the household income section. The first graphic is the overall condition of the mouth and teeth. It shows that those with low household incomes have a worse dental condition than those with higher-income households. The jump between low-income households and middle-income households is drastic, and the jump between low and high is even worse. Problems due to the condition of mouth and teeth include dry mouth, difficulty chewing/biting, pain, avoiding smiling, embarrassment, anxiety, problems sleeping, reduction in social participation, difficulty with speech, difficulty doing daily activities, and taking days off. For every problem, low-income households were more likely to experience these problems than high-income households.

This source also provided several useful statistics: 1 in 5 low-income adults say their mouth and teeth are in poor condition and that this makes their life less satisfying; 29 percent of adults say that the appearance of mouth and teeth affects their ability to interview for a job; when asked reasons for not visiting the dentist, 59 percent of adults said cost. Finding a dentist was a close second among Medicaid patients as many dentists aren’t covered by Medicaid. 

In terms of statistics and gaining a general understanding of dental healthcare and the problems that come with it, this source has been very helpful. The infographics are very easy to read and understand. The American Dental Association is an organization for dentists focused on helping its members advance the overall oral health of patients. This organization lobbies legislators and has an agenda including funding dental research, supporting student loans and residency programs for future dentists; increased dental coverage from Medicaid and CHIP programs; reducing dental costs through insurance reform, medical liability, and health information technology; and improving public health through water fluoridation, tobacco control, and disaster planning (in reference to medical emergencies). This organization could be biased towards reform and improvement of the American system, but it is a research-based association and everything it publishes is research-based. This source is purely facts and statistics and is most likely unbiased. The goal of this source is to inform the general public. 

This source shows me, numerically, how bad American dental healthcare is. It also shows how costly dental work is and how a lack of it negatively affects a person’s life. I would use this source to put numbers behind my claims and argument. I can also take the information in the infographics and interpret it: the large gap in dental problems between low-income and high-income households shows that dental insurance is overpriced and the government needs to take action. 

“The Many Costs (Financial and Well-Being) of Poor Oral Health.” The Many Costs (Financial and Well-Being) of Poor Oral Health | University of Illinois at Chicago (UIC) College of Dentistry, University of Illinois at Chicago College of Dentistry, 6 Aug. 2019, dentistry.uic.edu/patients/oral-health-costs. 

This article covers the financial sides (barriers and the affordability gap) and costs poor dental health can have on overall health, employment, and negative impacts on children. The article also discusses treatment costs with and without dental insurance. While this article covers many of the same topics as the article from the Journal of Dental Hygiene, it takes a slightly different approach to health costs. The Bersell article was facts from studies that interviewed patients and a focus on Medicaid patients. This article is from the dentists’ perspective: what changes they notice and treatments they perform for what kind of patients (Medicaid, low-income household, children from low-income households, etc.). As well as the patterns they noticed throughout their careers. 

This article was published by the College of Dentistry at the University of Illinois. A College of Dentistry would be a great place to find dentists that have experience (professors, teachers, dental residents). As it is published by a university it is unlikely that it is biased (if there was a bias it would be toward promoting dental care). This source provided a new perspective on dental care. It also shows how costly dental work is and how a lack of it negatively affects a person’s life in many different ways. I would use this source to put numbers behind my claims and argument.