What is this toolkit?

This resource is for medical practices interested in improving patient oral health by integrating a dental hygienist into a medical care team to offer up to the full scope of dental hygiene services. The content is specific to Colorado, particularly for topics such as billing, contracting, rules and regulations, and scope of dental hygiene practice. Many parts of this toolkit are applicable across state lines, but users need to research topics specific to your state.

This is a “how-to” guide based on the experiences of the Colorado Medical-Dental Integration (CO MDI) Project. For more than five years, medical practices have integrated hygienists into a variety of practice settings across Colorado including:

Medical practices considering the CO MDI model of medical-dental can determine if the practice is ready to begin this work.

We use the terms medical-dental integration (MDI) and Colorado medical-dental integration (CO MDI) throughout the toolkit. CO MDI refers specifically to the model of MDI used in the CO MDI Project.

Startup and implementation

This toolkit outlines specific activities to support the startup and implementation phases of the CO MDI model. The startup phase includes the nuts and bolts of hiring and integrating a dental hygienist into a medical practice. We describe how to build a dental space for the hygienist to provide up to the full scope of dental hygiene services in a medical setting and reference Colorado-specific rules and regulations regarding the delivery of, and reimbursement for, dental hygiene services.

The implementation phase involves creating and implementing your clinic’s model of care. We provide examples of care delivery models that were developed and tested in the CO MDI medical practices and tools for developing and refining your own model.

Much has been learned about the CO MDI model and is offered in this toolkit. The model and tools provided here will continue to be tested and refined by CO MDI Project grantees still participating in the project.

The Delta Dental of Colorado Foundation (DDCOF) CO MDI Project Implementation Team collaborated with key stakeholders to build this toolkit. Insight came from many dental and medical practice staff who helped develop and implement various care delivery models. This toolkit continues to evolve as enhancements are identified.

What it Isn’t

This toolkit does not provide detailed information regarding current prevention and instruction best practices for oral health. It also does not discuss evidence-based best practices for clinical guidelines or dental procedures. Instead, we refer to other organizations that have published work in this area.