Numerous coordinated and sustained actions will be needed to implement the committee’s recommendations and to achieve its vision. Therefore, the committee identifies important actions that various stakeholders can take and identifies the relevant policy levers that are most likely to produce both short-term and long-term change (see later in this chapter for a summary of key implementation strategies by actor).


After reviewing the evidence, the committee concluded the following:

1. Improving access to oral health care is a critical and necessary first step to improving oral health outcomes and reducing disparities.

2. The continued separation of oral health care from overall health care contributes to limited access to oral health care for many Americans.

3. Sources of financing for oral health care for vulnerable and underserved populations are limited and tenuous.

4. Improving access to oral health care will necessarily require multiple solutions that use an array of providers in a variety of settings.

The committee’s overall conclusions reflect the need for action to address issues of access to oral health care. If the current approaches to oral health education, financing, and regulation continue unchanged, equitable access to oral health care cannot be achieved. However, this report should not be perceived as simply a call for more spending. Investing additional money in a delivery system that is poorly designed to meet the oral health care needs of the nation’s underserved and vulnerable populations would produce limited results and would be fiscally irresponsible. Rather, the report calls for transformation through targeted investments in programs and policies that are most likely to yield the greatest impact.


While the majority of the U.S. population is able to routinely obtain oral health care in traditional dental practice settings, millions of Americans have unmet oral health needs due, in part, to major barriers in access to care. This is especially true for the nation’s vulnerable and underserved populations. The committee’s review of the evidence, as presented in this report, makes a compelling case for action. Failure to address the challenges that millions of Americans face in accessing oral health care will exacerbate the disproportionate burden of oral diseases experienced by vulnerable and underserved populations. Therefore, the committee provides a vision of

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