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Dental Public Health Activities: Descriptive Summaries

Oral Health Disparities Collaborative

Practice Number: 99001A
Submitted By: National Network for Oral Health Access (NNOHA)
Submission Date: February 2012
Last Reviewed: February 2012
Last Updated: February 2012
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The Oral Health Disparities Collaborative (OHDC) was launched in order to improve access to oral health services for low-income individuals in two target populations: children ages 0 to 5 and pregnant women. These two sub-populations have traditionally experienced more difficulty accessing dental care. The traditional paradigm of surgical treatment of dental caries and periodontal disease has historically utilized the majority of resources, rather than a focus on preventive care.  In addition, while medical providers are in good position to identify oral health problems and refer patients for appropriate services, few do, due to a lack of training and lack of knowledge regarding available resources and interventions. Dental care has been seen as a separate, stand-alone healthcare system.

With the recognition that caries and periodontal disease are in fact chronic diseases, improved outcomes should be achievable using the Chronic Care Model as the framework for delivery system redesign. Chronic Care Model has been used in HRSA/BPHC funded Health Centers to improve outcomes in the management of chronic diseases such as diabetes and asthma. Additionally, the OHDC placed concurrent emphasis on enhancing practice and office efficiencies to support improved access and outcomes in the targeted populations, as well as encouraging the integration of dental and medical services to make oral health a part of comprehensive primary care.

Following the Collaborative approach used in previous efforts, both medical and dental providers and staff received training in best practices and intervention approaches appropriate to the target populations. Time and resources were invested in developing infrastructure for facilitating referral and data integration between disciplines. Participants became familiar with the Model for Improvement methodology, which was used to achieve incremental improvements in delivery systems.

Through the OHDC, access the oral health care for the two target populations- children ages 0 to 5 and pregnant women was expanded and practices successfully applied techniques to maximize operational efficiencies. As a result, a foundation for fiscal sustainability was created, and a critical paradigm shift from episodic, end-stage surgical care to a disease management approach in dental practice was achieved. The successes and lessons learning from the OHDC can be utilized in future efforts towards incorporating oral health in the Patient Centered Health Home concept.

Lessons Learned:

Through the work of the OHDC pilot, it became clear that successful application of the Chronic Care model to oral health in the pilot Health Centers required transformation of every aspect of the Health Center organization. The work became an opportunity to integrate oral health within the medical, administrative and financial systems of the individual Health Centers. Traditional paradigms of how and when dental care is delivered were replaced with new organizational designs that increased access and quality of care. Teams experienced increased success as medical-dental integration increased, and were also able to make a business case for collaborative participation

Contact Person(s) for Inquiries:

Irene V. Hilton, DDS, MPH,
Dental Consultant, National Network for Oral Health Access (NNOHA)
7476 East 29th Avenue, PMB 170
Denver, CO 80238
Phone: 303-957-0635
Fax: 866-316-4995,
Email: Irene@nnoha.org

 Mitsuko Ikeda
Project Director
National Network for Oral Health Access (NNOHA),
7476 East 29th Avenue, PMB 170
Denver, CO 80238
Phone: 303-957-0635
Fax: 866-316-4995
Email: mitsuko@nnoha.org

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