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This background paper examines the variety of issues affecting access to oral health care in the United States. It considers the possibilities and challenges presented by public financing sources for dental care for low-income children and families—including Medicaid, the State Children’s Health Insurance Program, and other safety net programs—and reviews a sampling of privately funded efforts at improving oral health access. The paper illustrates some of the major barriers to dental care, particularly the shortage of dentists willing to serve low-income and uninsured patients and the overall lack of growth in the dental workforce. It also considers the changing roles of other providers, such as dental hygienists and primary care providers, in providing oral health education, preventive care, and referrals to dentists. Finally, this background paper touches on more global—or population-based—approaches to improving oral health.

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