University of Washington, Rural Health Research Center, USA.
J Public Health Dent. 2010 Jun;70 Suppl 1:S49-57. doi: 10.1111/j.1752-7325.2010.00178.x.
This review identifies the challenges to oral health in rural America and describes areas of innovation in prevention, delivery of dental services, and workforce development that may improve oral health for rural populations.
This descriptive article is based on literature reviews and personal communications.
Rural populations have lower dental care utilization, higher rates of dental caries, lower rates of insurance, higher rates of poverty, less water fluoridation, fewer dentists per population, and greater distances to travel to access care than urban populations. Improving the oral health of rural populations requires practical and flexible approaches to expand and better distribute the rural oral health workforce, including approaches tailored to remote areas. Solutions that involve mass prevention/public health interventions include increasing water fluoridation, providing timely oral health education, caries risk assessment and referral, preventive services, and offering behavioral interventions such as smoking and tobacco cessation programs. Solutions that train more providers prepared to work in rural areas include recruiting students from rural areas, training students in rural locations, and providing loan repayment and scholarships. Increasing the flexibility and capacity of the oral health workforce for rural areas could be achieved by creating new roles for and new types of providers. Solutions that overcome distance barriers include mobile clinics and telehealth technology.
Rural areas need flexibility and resources to develop innovative solutions that meet their specific needs. Prevention needs to be at the front line of rural oral health care, with systematic approaches that cross health professions and health sectors.
本综述旨在确定美国农村地区的口腔健康挑战，并描述预防、牙科服务提供和劳动力发展方面的创新领域，这些领域可能会改善农村人口的口腔健康。
本文基于文献综述和个人交流。
与城市人口相比，农村人口的牙科保健利用率较低，龋齿发生率较高，保险率较低，贫困率较高，水氟化物含量较低，每人口牙医人数较少，获得医疗服务的距离较远。改善农村人口的口腔健康需要采取实用且灵活的方法来扩大和更好地分配农村口腔卫生劳动力，包括针对偏远地区的方法。涉及大规模预防/公共卫生干预的解决方案包括增加水氟化物、及时提供口腔健康教育、龋齿风险评估和转诊、预防服务以及提供行为干预，如戒烟和烟草使用计划。培训更多愿意在农村地区工作的提供者的解决方案包括从农村地区招募学生、在农村地区培训学生，以及提供贷款偿还和奖学金。通过为农村地区创造新的角色和新型提供者，可以提高农村地区口腔卫生劳动力的灵活性和能力。克服距离障碍的解决方案包括移动诊所和远程医疗技术。
农村地区需要灵活性和资源来制定满足其特定需求的创新解决方案。预防需要成为农村口腔卫生保健的第一线，采用跨卫生专业和卫生部门的系统方法。
