When Regulations Block Access to Oral Health Care, Children at Risk Suffer

This brief describes a range of state-based regulations or policies that either limit or prohibit dental hygienists from sealing children’s teeth at school, or create financial burdens that work against the expansion of school sealant programs. Research and experience find that these rules and policies do not have the effect of protecting the public from unsafe dental practice, nor do they promote the efficient use of public resources. Information was compiled from interviews with state dental directors, Medicaid officials, school sealant providers, and other state-level oral health stakeholders. A questionnaire of state dental directors administered by Pew research staff in 2016 with the help of the Association of State and Territorial Dental Directors further informed the brief.
Responses from 44 state dental directors—as well as a range of other state policy stakeholders—reveal that experts in multiple states perceive a range of regulatory and policy barriers. It is beyond the scope of this report to review 50 state practice acts and related documents required to identify every state where barriers exist. Instead, this report describes the nature of the barriers and includes examples of states where Pew has confirmed they exist. The report’s appendix provides more detail on the perceptions of state dental directors.

Jane Koppelman

Pew Charitable Trusts

August 20, 2018

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