Workforce Equity and Dental Health Aides in CHAP: A Scoping Review

Oral health workforce shortages are a persistent challenge throughout the United States (US), disproportionately affecting American Indian/Alaskan (AI/AN) Native communities. Shortages limit access to routine and preventive dental care across settings, contributing to oral health inequities and systemic shortfalls. The integration of additional, community-based providers is a viable means of improving access and addressing these disparities. The objective of this study was to evaluate publications focused on community-based providers within the Community Health Aide Program (CHAP) through a workforce health equity lens, with an emphasis on their role serving AI/AN populations.

Article screening, and data extraction were done independently by two reviewers. Articles and documents that: (1) examined DHAs or other community-based providers' relation to workforce or health equity; (2) were published in the last 60 years; and/or (3) were peer-reviewed, government reports, and organizational reports, published curriculum, and other dental health aide program materials were included in the analysis.

This scoping review yielded a total of 33 articles. Articles discussed recruitment (n = 10), retention (n = 6), curriculum (n = 23), and access to care (n = 24) of a range of mid-level providers. Provider types included the dental therapist (n = 28), primary DHA I and II (n = 5), expanded function DHA (n = 3), dental hygienist (n = 4), all DHAs (n = 3), or other mid-level providers generally (n = 4).

This review synthesizes previous work to increase understanding of the integration of dental health aides, through the CHAP Framework. Findings outline the key oral health workforce concepts to increase access to oral healthcare through a culturally adapted approach.