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Dental Public Health Activities: Descriptive Summaries

Special Smiles - Assuring Access to Dental Care for People with Mental Retardation/Developmental Disabilities in Medicaid Managed Care

Practice Number: 42003
Submitted By: Special Smiles, Ltd.
Submission Date: March 2007
Last Reviewed: March 2007
Last Updated: March 2007
Best Practice Approach Example Special Smiles - Assuring Access to Dental Care for People with Mental Retardation/Developmental Disabilities in Medicaid Managed Care
 
Lack of access to dental care is a common problem for people with Medicaid, whether they are covered by traditional fee-for-service programs or by managed care. For people with developmental disabilities who are covered by Medicaid, access to dental care is even more restricted. This situation was recognized at a 1999 state dental summit in Pennsylvania and led to a recommendation that a specialized dental clinic be established to serve Medicaid recipients with severe disabilities. The target population would be patients whose disabilities prevented having their dental care in a dentists' office due to maladaptive behaviors and physical limitations requiring sedation or general anesthesia for treatment. With the technical assistance of the state Medicaid agency, three managed care programs in the Philadelphia area contracted with a private dental practice to establish a program called Special Smiles, Ltd. This program has a hospital-based state-of-the-art outpatient dental facility and is able to provide patients full mouth rehabilitation under general anesthesia. The program maintains a recall system for continued comprehensive care establishing a dental home for patients. In addition, the Special Smiles provides education and outreach to parents, patients and direct care staff on the importance of daily oral hygiene and the need for routine professional dental care. The original program goal was to complete full oral rehabilitation for 1,000 individuals annually. Now in its sixth year, Special Smiles is meeting the goal serving approximately 1,100 patients per year at an annual program cost of approximately $1.8M. During the first 5 years of operation, Special Smiles provided 5,400 patient visits, which includes recall visits, for more than 3,500 patients.

Contact Person(s) for Inquiries:

Emilee S. Langer, MPH, Consultant, Special Smiles, Ltd., 418 N. Washington Street, Titusville, PA 16354, Phone: 814-827-3785, Email: specialsmilesltd@msn.com
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