THE WORLD’S richest country has toothaches in its health system.
And this is where a new dental outreach initiative in the United States has been called “revolutionary.”
It involves the Community Dental Health Coordinator or CDHC working with an emergency department physician and an oral and maxillofacial surgeon.
The team of health care providers makes up an emergency department referral model that has been successful in in rural New York state.
“The community dental health coordinators have completely changed how dental care is delivered in underserved communities,” says Dr. Laurence Pfeiffer, M.D., an oral and maxillofacial surgeon at Bassett Medical Center. “This novel pilot program has evolved into a revolutionary outreach initiative.”
“This model of proactive care has been shown to reduce health care costs by keeping patients out of the emergency department and in the dental practices where they are much better served,” says Dr. Pfeiffer.
“Despite being an essential component of primary care and preventive medicine, dental care is often overlooked,” says Dr. Lewis Britton, M.D., Director of Emergency Services at Little Falls Hospital, in a rural area of New York state.
Among patients coming to the hospital’s Emergency Department, dental complaints are common.
“The Emergency Department is far from the ideal setting to provide dental care,” Dr. Britton says. “Although we are trained to handle dental emergencies, we have limited equipment and expertise to manage the more frequent, chronic dental issues patients often present to the emergency department with. Finding a way to help these patients obtain outpatient dental services was a priority for us.”
The Community Dental Health Coordinator is one way.
And that’s Dawn Helstrom, a dental hygienist at the Bassett Medical Center.
Since graduation from the Rio Salado Community College in Tempe, Arizona, last year, she has been the Community Dental Health Coordinator at the medical center.
Ms. Helstrom, who is about to complete her fourth decade as a hygienist, also heads the hospital’s Emergency Department referral program.
Patients were overusing the Emergency Department “perhaps unnecessarily,” she says.
That’s because most were underserved and lacked a dental home, she says.
“I felt I could assist these individuals by navigating them through our complex beneficiary health system. As a hygienist, I felt I had the networking capabilities to empower them to help themselves, as well as the community as a whole.”
“When she began telling me about her interest in launching a Community Dental Health Coordinator program, I thought that Little Falls Hospital would be the ideal site,” Dr. Britton recalls.
They wanted to improve overall health care and reduce unnecessary emergency department visits.
Dr. Britton and his ER nurse managers keep records of all dental-related emergency department visits.
Those who do not have established dental care are referred to Ms. Helstrom who then reviews the medical record to determine what follow-up is necessary. Then she arranges appointments for patients.
The Community Dental Health Coordinator helps reach the most in need and connects them with dental providers, says the American Dental Association (ADA).
In 2006, the ADA set up a task force to determine how to best meet the needs of dentally underserved rural, urban and American Indian communities.
In 2009, the ADA established the Community Dental Health Coordinator or CDHC pilot program to break through the barriers that prevent people from receiving regular dental care.
By 2010, the first class of 10 CDHC students completed training in Tempe, Arizona, and Norman, Oklahoma, and began working in tribal clinics, urban and rural Federally Qualified Health Centers, Indian Health Service facilities and other settings.
The ADA is now providing technical assistance to 18 educational institutions with more than 600 graduates over the years, and 45 states have either a CDHC school program, a graduate of the program or a student in the program.
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Dr. Joseph D. Lim is the former Associate Dean of the University of the East College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
