Expanding the physician-substitute concept to oral health care practitioners

This position paper proposes the development of an intermediate level practitioner to increase access to primary oral health care and to maximize cost benefit factors. The proposal is built upon research which has demonstrated the feasibility of preparing baccalaureate hygienists to serve as the counterpart to the physician assistant or nurse practitioner. The role of the primary oral health care practitioner would involve locating underserved or non-user groups, assessing oral health needs, referring to appropriate care providers, and providing primary care traditionally provided by dentists. Promotion of the intermediate oral practitioner would require policy to halt erosion of the infrastructure of university-based dental hygiene education, the allocation of nationally funded financial incentives, and specified modifications in the current health care system.