Dentistry is Essential … So What Does That Mean?

On October 19, 2020, the American Dental Association’s (ADA’s) House of Delegates passed Resolution 84H-2020, which states that oral health is an integral component of systemic health. The resolution also explains that dentistry is essential health care because of its role in evaluating, diagnosing, preventing, or treating the oral diseases that can affect systemic health.

The House ratified an interim policy that was created by the ADA Board of Trustees earlier in the year as part of our efforts to advocate for dentistry and oral health during the COVID-19 pandemic.

84H-2020 Resolved, that the profession of dentistry is essential and defined as the evaluation, diagnosis, prevention and/ or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, craniomaxillary area and/or the adjacent and associated structures and their impact on the human body, provided by dentists, within the scope of their education, training and experience, in accordance with the ethics of the profession and applicable law, and be it further

Resolved, that dentistry is essential and should remain an independent health care profession that safeguards, promotes and provides care for the health of the public, which may be in collaboration with other health care professionals.

The policy statement is sound and, coupled with the ADA’s advocacy efforts, has been helpful in prioritizing dentistry to receive much-needed personal protective equipment (PPE) and securing financial help for dentists’ returning to practice. The early weeks of the pandemic—when dentistry paused, and patients were unable to access all except urgent and emergency dental care—underscored the importance of preventive and routine oral health care. The fragility of our general and oral health care infrastructure became clear to our members, our patients, the dental industry, and policy makers on the state level and in our nation’s capital.

The ADA has successfully traversed the COVID-19 pandemic. Now that our most crucial frustrations associated with the pandemic have passed and dentistry is for the most part nearing prepandemic volumes,

• Are we still essential, and what does that mean? • Is oral health care essential?

Photo: Image licensed by ingram image

• Is oral health care essential to overall health? • Is oral health care essential to everyone? • Is oral health care essential to dentists and the business of dentistry? Of course … all are true.

I see oral health care as integral to and an essential component of overall health. Conversely, I consider overall health and the many exogenous factors that contribute to it to be essential to achieving oral health.

I have heard from many upset member dentists and volunteer leaders who, despite their assertion that dentistry is “essential,” want the ADA to “swim only in our lane.” Their opinion is that if it does not happen in the mouth or in a clinical dental facility, our association should not engage in it.

Let us talk about “essential.” Dictionaries define it as “absolutely necessary” and “extremely important.” Not much room for debate there. If we apply that definition to the policy passed by the House, the essential nature of dentistry extends well beyond the mouth and into the environments, both physical and social, that exist outside our offices. If we believe what we say, we should be engaged wherever opportunities exist to improve the oral and general health care of the public.

The policy’s first resolving clause describes the broad scope of our profession and its relationship to the human body. Not mouth—body. The second resolving clause reiterates

the essential nature of our profession in safeguarding and promoting the health, not only the oral health, of the public.

The Constitution of the ADA states that “[t]he object of this Association shall be to encourage the health of the public, and promote the science and art of dentistry.”

Our mission is to “help dentists succeed and support the advancement of the health of the public.”

Our vision is “empowering the dental profession to achieve optimal health for all.”

These statements do not describe a swim lane. They talk about the entire pool. It is to our profession’s advantage to be in that pool. Our patients do not exist only in “dentistry’s lane.” There are numerous determinants that can influence a patient’s health status. Fulfilling our mission, vision, and constitutional obligations requires us to account for these factors.

The profession of dentistry—as defined by our constitution, mission, and vision—and its essential nature as codified in ADA policy is obligated to be in the pool. The opportunities are boundless. Although pitfalls are certainly present, COVID-19 has also shown us that we are skilled in defining problems and shaping solutions. Dentistry’s response to the pandemic benefitted overall public health—not only oral public health.

How do we use “essential” for the good of our profession and the patients we serve? Essential health care should be accessible for those who need it and desire it. Can we advocate to improve patient benefit options, both private and public? The need for a significant portion of “essential” oral health care can be avoided. We have every opportunity to double down on prevention. Does anyone think childhood caries is not “essential” to conquer? It should be our priority to address this through all means possible. Dentistry is as essential as medicine. Is it not an advantage for our patients, our members, and our profession to improve and normalize collaboration and integration with our medical colleagues where clear benefit exists?

“Essential” is an opportunity. There is an implied responsibility that accompanies “essential.” We have defined ourselves and our purpose. We now have to walk the walk.

Dr Daniel Klemmedson ADA President 2020-2021

JADA September 2021

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