Oral Health Advocacy Education Impacts Future Engagement: Exploration at a Midwestern US Dental School

Purpose: With the emergence of COVID-19, and the potential inclusion of dental benefits in Medicare, it is critical that dentists are able to engage in legislative advocacy to support public oral health. Dental education has an opportunity to teach advocacy skills to future dentists, although advocacy training in predoctoral dental education has been largely ignored. The purpose of this study was to evaluate fourth-year dental student's attitudes toward advocacy, identify the type and extent of advocacy experiences during dental school, and assess their future intentions to engage in advocacy.Methods: An electronic questionnaire was administered to fourth-year dental students enrolled in their final semester at Ohio State University.Results: Forty-seven students completed the survey (43% response rate). Most (84%) respondents agreed that advocacy training should be a required experience in accreditation standards for predoctoral dental education. Over half (58%) reported seldom or no exposure to legislative and regulatory processes in oral health policy development in the curriculum. Students who participated in grassroots advocacy efforts while in dental school were more likely to contact legislators regarding dental issues (p = 0.005) or public insurance (p = 0.037), and participate in future lobbying efforts (p = 0.019). Students who contributed to PAC while in dental school were more likely to express intentions to contribute in future (p = 0.005).Conclusions: There is limited exposure to legislative advocacy in predoctoral dental education. Dental students with advocacy experience are more likely to report intentions to participate in advocacy as dentists. Dental education has a critical role in preparing future dentist-advocates.

Costing the Scale-Up of a National Primary School-Based Fluoride Varnish Program for Aboriginal Children Using Dental Assistants in Australia

There is good evidence that fluoride varnish programs are effective in preventing dental caries in children. This study aims to provide a costing for the scale-up of a child fluoride varnish program in New South Wales (NSW), Australia. Most child fluoride varnish programs are school-based, and a number of studies have examined the acceptability and cost effectiveness of using non-dental providers to apply the fluoride varnish. This paper describes the number of primary schools in Australia that could be targeted using a standard population-based risk criteria based on published data. A costing method was developed for various scenarios of school enrolment and provider types, along with potential revenue from the Child Dental Benefits Schedule (CDBS). Most of the costs of a school-based fluoride varnish program can be covered by the CDBS with assumptions of 80% child consent and 75% CDBS eligibility. While the scale-up of child fluoride varnish programs to prevent dental caries has been recommended by numerous strategic plans and reports, particularly for Aboriginal and Torres Strait Islander children, limited progress has been made. This paper concludes that using a standardized criteria for targeting schools using a combination of ICSEA and Aboriginal enrolments, and aiming at four applications a year, is feasible, and that the main costs of the program could be covered by using the CDBS.