Yesterday, Senator Bernie Sanders (I-VT) and Rep. Elijah Cummings (D-Maryland) announced they are filing legislation to address a national crisis in dental care.

The legislation would expand comprehensive dental coverage to millions of Americans through Medicare, Medicaid, and the Veterans Administration; increase access to dental services at community health centers, school-based clinics and through mobile services; and address the underlying shortage of providers by expanding the National Health Services Corps scholarship program, among other measures.

Access to comprehensive oral health care is a dire need for more than 82 million Americans who struggle daily to access care.

In February, 2,300 Kansans lined up outside an old Wal-Mart at a makeshift dental clinic, the annual Kansas Mercy of Mission Free Dental Clinic, and were lucky enough to receive care. Thousands more were turned away. While the clinic provided some residents their first opportunity to see a dentist in years, or in some cases for the first time in their lives, it also illustrated that too many people go without regular oral health care. Missions of Mercy events and emergency rooms are too often the destination for Americans who lack access to dental care because the dental delivery system is not working.

In 2000, the first-ever Surgeon General’s report on oral health identified dental and oral disease as a “silent epidemic” that burdens some population groups throughout the country. Over the last decade, the problem has only worsened, unnecessarily claiming the life Deamonte Driver and others.

Earlier this year, Senator Bernard Sanders and the Senate Subcommittee on Primary Health and Aging issued a report, Dental Crisis in America; The Need to Expand Access, which showed:

•more than 47 million people live in places where it is difficult to access dental care •more than 130 million Americans do not have dental insurance •about 17 million low-income children see a dentist less than once a year •only 45 percent of Americans age 2 and older saw a dental provider in the past 12 months

The legislation from Sen. Sanders and Rep. Cummings also contains important policies aimed to strengthen the oral health workforce. Nearly 50 million people in the United States live in dental professional shortage areas where they cannot gain easy access to a dentist. Therefore, it is exciting to see that the legislation’s included funding for the establishment of new demonstration programs within the Department of Veterans Affairs and Defense, the Federal Bureau of Prisons, and Indian Health Service for the training and employing alternative dental health care providers, known as dental therapists. Dental therapists and other mid-level providers offer the opportunity to reduce economic and geographic barriers to dental care throughout the country. By establishing and funding pilot programs, dental therapists will be able to provide routine and preventive care to underserved populations as well as demonstrate their ability to increase access to high quality, cost effective care. Already, dental therapists are increasing access to dental care in rural and underserved communities in Alaska and Minnesota.

Sen. Sanders and Rep. Cummings deserve credit for their vision to improve access to oral health care by investing in community-based dental services at community health centers and school based health centers, seeking to provide resources for coordinated care to keep patients out of costly emergency rooms, and strengthening the workforce by exploring proven models such as dental therapists who offer culturally competent care. Their efforts to invest in an oral health system that is equipped to provide coordinated, culturally competent care in community based settings is major progress and a seismic shift away from forcing millions of Americans to rely on makeshift dental clinics or a costly emergency rooms.

— David Jordan, Dental Access Project Director