Band-aid solutions to the dental access crisis: Conceptually flawed--a response to Dr. David H. Smith.

Though laudable, "band-aid solutions" are inadequate to solve dental access problems. By nature, such efforts are provider-driven and not designed to match the needs of underserved populations. They do not empower patients, families, or communities or provide for ongoing care. Band-aid solutions do not ensure a workforce with the capacity or geographic distribution to meet the needs of the underserved. Neither do such solutions address systemic issues such as lack of dental insurance or the need to prioritize prevention. Such solutions do not engage other health professionals in promoting oral health. Furthermore, such solutions maintain the prevailing viewpoint that dental volunteer efforts are all that is required of the dental profession; they fail to acknowledge that a response is mandated by the social contract between dentistry and society. Finally, such an approach fails to recognize the complexity of health disparities and the broad solutions that must be advanced. In the case of children, it is possible to outline an approach to defining a basic standard of oral health care and to argue that all children should receive such care. Band-aid solutions could never ensure a population-wide distribution of care and hence are not morally defensible.