Creating and maintaining oral health for dependent people in institutional settings.

The absolute number and percentage of the population of dependent individuals in institutional settings are growing dramatically in the United States. The current dominant office-based oral health delivery system is not adequately addressing the oral health needs of these populations and is unlikely to do so in the future. There are multiple challenges in providing oral health services for dependent people in institutional settings. To achieve improvements in the oral health of these populations, we must change the education of oral health professionals, educate staff in institutional settings about oral health, integrate oral health activities into general health and social service systems, use existing oral health professionals in new ways in community settings, develop new categories of oral health professionals, and reform oral health delivery and reimbursement systems. Developing new models of oral health services for dependent individuals in institutional settings may provide an opportunity to create a new paradigm of care based on integration of oral health services with general health and social services with an emphasis on prevention and health promotion activities.