Public policies, rights, and dental health programs in the United States of America: implementation and access to care

Abstract

The purpose of the article is to identify the structure of public health policy in the United States of America (USA) and the execution of oral health programs, the means used and the population’s access to them. It is oriented towards a qualitative approach, supported by the interpretive paradigm of documents that provide information from official government sources, public health entities, federal, state, and local agencies, scientific articles, and literature on the topic. The study is categorized with a documentary-bibliographic design, the method used was analysis-synthesis. The results reveal that public health policies are formulated according to the administrative levels: federal, state, and local; however, the autonomy in each state allows defining norms appropriate to its geographical context. Access to free or low-cost medical care is conditioned by certain terms of eligibility for government plans: Medicaid and Medicare, which do not include dental care. Prevention and fluoridation services are the most common strategies applied by dental health providers. It is concluded that, in the public health policy cycle, there is cohesion between the levels of government and the actors. The lack of prioritization of dental health as a public policy is not exclusive to the USA, it is a global pattern, violating the rights to access, inequality, conditioned by the high costs of dental services. It is recommended that the dental union’s proposals for health policy reform should be promoted and visible to the whole stakeholders’ community.