A new report, funded by the W.K. Kellogg Foundation and the DentaQuest Institute, outlines an approach to expand efforts to make the oral health care delivery system accountable for quality and access. Although quality improvement in oral health lags behind similar efforts for overall health, these efforts are intensifying, according to the report titled “Oral Health Quality Improvement in the Era of Accountability.”

The report comes as dental expenses now rank among the highest out-of-pocket health expenditures for consumers. In 2008, they accounted for $30.7 billion, or 22.2% of total out-of-pocket health expenditures, second only to prescription medications, according to the Bureau of Labor Statistics.

The report provides an overview of current efforts and cites elements that are critical for advancing this agenda: increased use of electronic dental records and integrated health records; better measurement of oral health outcomes; new payment and incentive mechanisms; and expanded delivery of care by non-dental professionals, as well as new types of allied dental professionals.

The report outlines a number of systemic barriers that have slowed efforts to improve oral health care, including limited evidence of best practices for most dental procedures, which has led to widespread variation in clinical decisions among dentists. Also, the resport says that the government only pays for about 6% of dental care nationally and there is no large provider organization representing dental practices and patients that is pushing for improvements in care.

The report was released last week at a national meeting of oral health professionals, government leaders, consumer advocates, and others held by the Kellogg Foundation and DentaQuest Institute. The goal of the meeting was to launch a national dialogue on quality improvement and increased access to dental care.