Dental Providers as Vanguard in HPV Vaccination: Policy Change is Imperative
As the healthcare landscape continues to evolve, dental professionals find their roles expanding beyond the confines of traditional oral care. Contemporary dental practices are increasingly integrating with broader health services, placing a heightened emphasis on the overall health and well-being of patients. This integration manifests in routine procedures such as blood pressure monitoring, glycemic control screening, and patient education on the interconnection between oral health and chronic diseases like diabetes, osteoporosis, and heart disease, just to name a few. Yet, there lies an untapped potential within the dental field that could profoundly impact public health - the administration of vaccines, with a particular focus on the Human Papillomavirus (HPV).
The Imperative of Vaccination
Vaccinations form the bedrock of our defense against diseases, fortifying immunity. Despite their proven efficacy, vaccination rates in the United States are on a downward trend. A study conducted in 2019 revealed that between 2009 and 2018, 27 U.S. states reported a decrease in the percentage of vaccinated children of kindergarten age. This decline is fueled by a cocktail of factors, including scientific skepticism, distrust, cost, and lack of insurance coverage, among other access-related barriers.
The Potential Role of Dentists in Vaccination
Dentists and dental hygienists are uniquely positioned to help reverse this trend. They administer injections far more frequently than their medical counterparts, and they routinely engage with patients who do not frequently visit medical providers. In 2017 alone, more than 31.1 million people in the U.S. sought care from a dentist, but not from their physician. In fact, according to the American Dental Association (ADA), “approximately 9 percent of Americans see a dentist, but not a physician, annually.” Dental visits, therefore, present a prime opportunity for vaccination.
Moreover, dentists and dental hygienists are trusted healthcare professionals who have established relationships with their patients. They are in a unique position to educate patients about the importance of vaccines, address vaccine hesitancy, and ultimately increase vaccination rates.
The role of dentists and dental hygienists in vaccination is not just theoretical. There are successful precedents of dentists and dental professionals delivering vaccinations during public health emergencies, as described below.
Dentists on the Frontlines: COVID-19 and Beyond
The COVID-19 pandemic has further highlighted the potential of dentists in the vaccination workforce. Many states, recognizing the urgency that the COVID-19 pandemic created, adopted policies, primarily through executive action, to allow dentists and other dental professionals to serve on the frontlines of vaccination efforts. This move not only expanded the vaccination workforce but also demonstrated the potential of dental professionals in public health emergencies.
In North Carolina, for instance, Executive Order 193 was enacted, allowing dentists to administer COVID-19 vaccines. This policy change was a significant step in recognizing the role dentists can play in broader public health initiatives and served as a model for other states to follow.
This is not the first-time dentists have been called upon to aid in vaccination efforts. During the H1N1 pandemic in 2009, dentists in certain states were permitted to administer vaccinations and join the pandemic's frontlines. More recently, in 2019, the Oregon state legislature approved a bill allowing dentists to prescribe and administer vaccines. Other states, including Minnesota and Illinois, permit dentists to deliver the flu vaccine.
The HPV Vaccine and Oropharyngeal Cancer
The HPV vaccine holds particular significance in the dental field. HPV is the most common sexually transmitted infection in the United States, and it significantly raises the risk of oropharyngeal cancer. In fact, according to the Centers for Disease Control and Prevention (CDC), HPV causes an estimated 70 percent of all oropharyngeal cancers. Additionally, one person dies every hour in the US due to oropharyngeal cancer!
The connection between HPV and oral health positions dental professionals as prime candidates for delivering HPV vaccinations, monitoring vaccine compliance, and providing patient education. Empowering dental professionals to provide these services would increase efficiency and vaccination rates while lowering costly oropharyngeal treatments later.
Challenges and the Call for Policy Reform
Despite the clear benefits, there are challenges to this model of dental professional-administered vaccination. The historical separation of dentistry from general medicine has led to a siloed approach to health, often undermining opportunities to promote vaccination. Practical obstacles, such as a lack of training, inadequate medical history, and payment and billing practices also present challenges.
However, these challenges are not insurmountable. With policy reform and increased dental-medical integration, dentists can play a crucial role in improving vaccination rates, particularly for HPV.
The COVID-19 pandemic has underscored the need for an all-hands-on-deck approach to public health. As we navigate this new landscape, it's time to leverage the potential of dental professionals in the vaccination workforce. By expanding the scope of dentists to administer HPV vaccinations, we can take a significant step toward cancer prevention.
Let's seize this opportunity to improve population health. It's time for states to engage in policy reform and allow dentists to administer HPV vaccinations. After all, HPV vaccination is cancer prevention.