Oral Health in America: A Report of theSurgeon General (2000) emphasized that “the public health infrastructure for oral health is insufficient to address the needs of disadvantaged groups, and the integration of oral and general health is lacking.” Healthy People 2010 oral health objective 21.17 calls for an increase in the number of state and local dental programs with public health trained directors; objective 21.14 calls for expansion of community health centers and local health departments with an oral health component; objective 1.8 calls for increasing racial and ethnic representation in health professions; and a number of infrastructure objectives (chapter 23) relate to a well-trained and competent public health workforce. Proceedings of recent workshops for dental public health residents and diplomats stress the need to develop a continuum of educational opportunities, career paths and leadership opportunities.

Many dental public health leaders will be retiring in the next ten years, and there are insufficient numbers of young professionals, especially ethnic minorities, who show interest in a dental public health career. The 1994 Future of Dental Public Health report stressed the need to ensure recruitment and professional development of qualified individuals for dental public health positions. Vacancies continue to exist in clinical, educational, policy, programmatic, and research positions. A National Call to Action to Promote Oral Health: A Public/Private Partnership Under the Leadership of the Office of the Surgeon General, released on April 29, 2003, includes one area relating to workforce that requires action: increase oral health workforce diversity, capacity, and flexibility. A number of documents, including those already mentioned, will be useful for creating recommendations for workforce development. Numerous organizations have developed workforce initiatives, but efforts have been fragmented and insufficient.

In 2000 ASTDD convened a Leadership Committee through a cooperative agreement from the HRSA Maternal and Child Health Bureau and issued an ASTDD Dental Public Health Leadership Initiative in 2002. The first goal, “Develop a sustainable plan for assuring an adequate cadre of dental public health leaders,” included action steps to convene a meeting of partners to plan collaborative strategies and outline roles, and to identify funding options for the various projects. ASTDD wrote a proposal to the Centers for Disease Control and Prevention in response to a conference grant RFP to convene a national workshop to address dental public health workforce issues in a coordinated, multi-disciplinary, collaborative fashion. ASTDD subsequently received CDC funding for the workshop, matched by funding from HRSA MCHB through the existing cooperative agreement.

The ASTDD Leadership Committee created a subcommittee to serve as the Planning Committee to oversee the workshop. Another group of 10 people, who represented potential participating organizations and agencies, agreed to serve as a Steering Committee. These committees created an invitation list of approximately 45 national organizations and federal agencies and selected workshop speakers. Three individuals from the planning committee agreed to help facilitate and record information from the workshop, while one member acted as the overall project director.

The workshop was scheduled for all day on February 26 and until noon on February 27, 2004 in Washington, DC at the Hilton Embassy Row at Dupont Circle to facilitate more representation from federal agencies and national associations during times of travel restrictions and budget

limitations, since many central offices are located there. Two HRSA MCHB funded partner organizations provided assistance with AV, registration and duplication of materials for packets. Five national organizations provided support to cover food and beverage functions.

Prior to the workshop, an organizational self-assessment was sent to all participating organizations and agencies to determine what each one was already doing related to workforce issues and what roles and resources they might want to contribute to a future collaborative endeavor. A summary of the responses was distributed at the workshop. Workshop packets contained overviews of all participating organizations as well as meeting materials. Additional resource materials, (e.g., policy papers, competency statements) were also displayed on a resource table.

Fifty-one persons representing 40 organizations and federal agencies attended the workshop. The room was set in roundtables in a crescent with an open space in the middle to facilitate discussion and viewing presentation materials. Tim Henderson from the National Council of State Legislatures served as the primary facilitator, assisted by Don Marianos, ASTDD Leadership Coordinator, and Mary Beth Kinney, formerly of the Indian Health Service, who served as recorder.

Objectives of the Workshop:

  • Assemble representatives from a variety of key stakeholders from national organizations and federal agencies
  • Increase awareness and knowledge of dental public health workforce issues
  • Brainstorm potential collaborative approaches to address the DPH workforce shortage
  • Develop a draft national action plan
  • Establish a core group to facilitate follow-up on the action plan.

Long-term outcome:

Increase capacity to recruit and retain a diverse and competent dental public health workforce that can help to reduce oral health disparities in underserved populations in the US.

The welcome and opening presentation was offered by Ms.Kneka Smith, ASTDD Leadership Chairperson, followed by Dr. Marianos giving the charge to the group. Dr. Bill Maas set the stage by reviewing current dental public health infrastructure and workforce trends. Dr. Jack Dillenburg then challenged the group to think creatively and futuristically in terms of recruiting and educating new members of the workforce. Dr. Marianos then quickly summarized the breadth of activities already occurring to try to address workforce issues.

The remainder of the day and most of the next morning was spent brainstorming and voting on objectives, action steps, and organizational players under the categories of Education, Research and Practice. Action steps were also developed for other objectives that didn’t fit under these categories or under more overarching objectives. Luncheon discussions focused on identifying which organizations might be important players in planning and creating a collaborative action plan. The group was asked to consider organizations and resources 1) external to public health, 2) external to dentistry, 3) not present at the workshop, 4) institutional policymakers, and 5) public policymakers.

On Friday morning Dr. Dushanka Kleinman, USPHS Chief Dental Officer, presented some thoughts on what next steps the group should consider that would be in line with the Surgeon General’s National Call to Action. The group then formed four workgroups that would hold teleconferences after the workshop to finish the process of developing actions plans for the areas of Education, Practice, Research and Advocacy. Once these are done, the entire action plan will be available for organizations to use. The Steering Committee will continue to meet for a few months to decide how to advance the action plan.

At the conclusion of the workshop Candace Jones, representing AAPHD, asked the group to evaluate the workshop process and outcomes, emphasizing that this was only a first step in a much broader process to develop a national collaborative action plan to enhance the dental public health workforce and infrastructure.

The entire proceedings from the conference, with detailed notes, summaries of surveys and PowerPoint presentations, are posted on the ASTDD website at under projects/leadership/workshop proceedings. As the completed action plan and other items become available, they will also be posted on the website.

Beverly Isman, RDH, MPH, ELS

Project Director

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