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Dental Public Health Activities: Descriptive Summaries

Oral Health Across the Commonwealth

Practice Number: 24007
Submitted By: Tufts University School of Dental Medicine, Department of Public Health and Community Service
Submission Date: September 2009
Last Reviewed: February 2018
Last Updated: February 2018
Best Practice Approach Example Oral Health Across the Commonwealth
 

The Oral Health Across the Commonwealth (OHAC) program is the result of a collaborative relationship between Tufts University School of Dental Medicine’s Community Dental Program (a dental school) and the Commonwealth Mobile Oral Health Services (a private portable dental care provider).  This collaboration allows for a comprehensive care model with Tufts providing preventive services and oral health education and Commonwealth Mobile Oral Health Services providing restorative services

The goal of OHAC is to provide children in Massachusetts access to oral health care. This is accomplished by providing comprehensive dental treatment at community sites with portable dental equipment. Oral health services include dental exam and diagnosis, dental cleaning, radiographs, dental fillings, fluoride treatment, sealants, and oral health education and referral services.  Community sites include Head Start programs, preschools, public and charter school, summer camp program and Boys and Girls clubs. OHAC has increased access to dental care by bringing services to populations with significant access barriers. 

The OHAC portable dental program is co-administered by the Tufts Community Dental Program and Commonwealth Mobile Oral Health Services, both working together to deliver oral health services. Medicaid reimbursement, private insurance reimbursement, grant funding and in kind support from Tufts University School of Dental Medicine cover the cost of the program. In FY17, the OHAC program provided dental exams, dental cleanings, fluoride varnish, sealants and restorative care to over 10,000 children in the Commonwealth of Massachusetts. In addition, 220 oral health trainings were provided to 1538 teachers and staff and 151 parents.

Overall, the OHAC model is an excellent example what can be achieved through collaboration and development of public and private partnerships to reach disparate populations and improve their access to oral healthcare, thus decreasing the prevalence of oral health disease in this population.

Lessons Learned:

  • Educating public and governmental agencies is extremely important to increase awareness of access to care issues.
  • Sustainability of the OHAC program requires generating revenue from billable services and securing gap funding to cover costs of providing care to children who lack dental insurance.
  • Maximizing the use an ancillary personnel in providing preventive services as allowed by the State Dental Practice Act can have positive effect on the financial viability of the program.
  • Dental partners are critical to assure appropriate referral for procedures that cannot be provided in the school setting such as specialty services (orthodontics, oral surgery etc.)
  • An integrated electronic health can improve efficiency in billing, patient data management, and health record documentation and will lead to added incomes and better assessment of outcomes data.
  • Ongoing Communication is the key to successful partnering.
    • Each partner should have a well- defined role and business plan for sustainability. 
    • Consider playing to each other’s strengths rather than duplicating efforts. When partners share resources, everyone benefits.
    • Must have proper infrastructure to support the partnership, make sure to allot resources to administrative staff.
    • Finally, a business plan involving all partners based upon sound systems and operations, will ensure growth and sustainability.

Challenges:

  • Keeping busy during school vacation weeks and testing days. These interruptions in the schedule can affect the number of days that the program can deliver services during a school year
  • Time on learning in a school based program can affect the ability to take children out of the classroom, for instance, you may not be able to take children from a math or reading class.
  • Staff turnover at sites can affect the program as it takes time to establish new relationships with the school nurses
  • Lunch and nap schedules you may need to work around lunch and nap schedules especially at preschools and day cares.
  • Space can be a challenge and the program may be limited to non-consecutive days if another specialist uses the same space
  • Perception of the program by the community. It is helpful when starting a program to meet with community dentists and community leaders prior to starting a dental program.
  • The consent form can also be a challenge to the population being served.
    • Make sure you have all your documents translated by a reputable translation service in languages that are appropriate to your population.
    • Your informed consent is a legal document – you need it written at a level that your target population will understand.

Tips for Success:

  • Assess for all cost variables. What are the hidden costs?
  • Monitor production and collections daily; weekly; monthly – develop dashboards.
  • Assess and revise program activities as needed.
  • Assign providers to work at the top of their license – scope of practice.
  • Customize your program to fit the needs of the community.

Contact Person(s) for Inquiries:

Kathryn Dolan, RDH, MED, Director, Tufts Community Dental Programs, Tufts University School of Dental Medicine, One Kneeland Street, Boston, MA 02111, Phone: 617-291-2217, Fax: 617-636-6834, Email: kathryn.dolan@tufts.edu

Mark Doherty, DMD, MPH, CCHP, Director, Commonwealth Mobile Oral Health Services, 12 Colleen Drive, Lakeville, MA 02347, Phone: 508-958-0959, Fax: 617-288-0642, Email: mdoherty@dentaquestinstitute.org

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