Lack of access in healthcare delivery: a model for using dental hygienists in a cost effective manner to help address the oral healthcare problem.

The healthcare delivery of the United States is confronted with many issues and problems. In an attempt to deal with them, the country has been engaged in a process of healthcare reform. Unfortunately, this reform has largely focused on who is going to pay, what is going to be covered, and how all of the constituencies are hopefully going to be satisfied. What have been largely unaddressed are new delivery paradigms or how the care will be distributed to the underserved. The authors attempt to seek solutions to these last two areas of concern. They spell out how the expansion of the scope of practice for dental hygienists will allow them to bridge the gaps in service and to help deliver dental coverage and elements of systemic healthcare to underserved populations. Finally, the authors provide the steps and mechanisms of how the scope of practice can be expanded. Policy and educational requirements are considered.