The Need for CO MDI
Integrating dental hygienists into medical care teams expands access to preventive dental services within the scope of dental hygiene. It builds upon national interest in integrating all aspects of health care (medical-dental-behavioral-pharmacy-social work) into a comprehensive health care home. The American Association of Pediatric Dentistry (AAPD), the American Dental Association (ADA), and the American Academy of Pediatrics (AAP) promote bringing together the interprofessional and collaborative efforts of stakeholders to help expand access to early dental services and reduce oral health disparities (1).
The Problem: Dental Disease
Caries, or dental decay, is the most common chronic childhood health condition (1).
- If untreated, caries can lead to pain, low quality of life, missed school, emergency room visits, hospitalizations, and even death (2).
- In Colorado, like most other states, caries among low-income populations is a serious public health concern with substantial costs (3).
- Children in low-income families have double the caries rate of more economically advantaged children and are less likely to receive dental care (1).
- However, caries is largely preventable (4).
Expanding Access by Leveraging the Medical Home
Providing dental hygiene services to patients in the medical home leverages the many medical visits children have. It also offers the opportunity for comprehensive health care with a coordinated referral to a dentist.
- Only two out of three Colorado dentists participate in public insurance programs (e.g. Medicaid and the Child Health Plan Plus (CHP+)).
- Only 11.8% of children enrolled in Colorado’s Medicaid and CHP+ programs had a dental check-up by age one (a recommendation for all children), according to the 2015 Colorado Health Access Survey.
- Just one third of these publicly-insured children under six years of age had a dental exam in the previous 12 months.
- In comparison, 90% of Colorado’s publicly-insured children had at least one medical check-up by age one.
Benefits of the CO MDI Model
Offering full scope dental hygiene services in an integrated care delivery model has many benefits.
- Supports the Triple Aim of:
- Improving patient care experience (including quality and satisfaction).
- Improving the health of populations.
- Reducing the per capita cost of health care.
- Reduces barriers to accessing care including:
- Finding time to attend multiple appointments in different locations.
- Finding different medical and dental provider locations.
- Contact with those who may otherwise not receive dental care.
- Receiving medical and dental care in one visit.
- Consistent health messages across providers.
- Encourages collaboration through:
- Team-based care approaches.
- Team members working to the extent of their skills and licensure.
- Streamlining care.
- Reduces redundancies in care delivery.
- Dye BA, Thornton-Evans G. Trends in oral health by poverty status as measured by Healthy People 2010 objectives. Public health reports. 2010; 125:817-30
- Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009; 140:650-7
- Chew on This: 2012 Report on the Oral Disease Burden in Colorado. In: Environment CDoPHa, editor. 20122012
- Braun PA, Widmer-Racich K, Sevick C, Starzyk EJ, Mauritson K, Hambidge SJ. Effectiveness on Early Childhood Caries of an Oral Health Promotion Program for Medical Providers. Am J Public Health. 2017; 107:S97-S103