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Care Delivery Systems: Community-based Approaches

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  1. Care Delivery Systems:Community-based Approaches Michelle M. Henshaw, DDS, MPH Boston University School of Dental Medicine

  2. Current environment • Dental care segregated • Dental schools provide inadequate training in elder care • Non-dental health professionals have limited to no training in oral health • Low oral health literacy • As disability increases, focus on prevention decreases and acute care increases (oral health not valued) • Lack of financing

  3. What we need • Integration in existing care delivery systems • Additional training for dentists • Training for non-dental health professionals • Focus on social marketing • PREVENTION, PREVENTION • Partnerships, Partnerships, Partnerships

  4. Community-based Models • Volunteer dental clinics/dentists • Physician based (pediatricians) • Community-based service delivery • Preventive services • Comprehensive care

  5. Oral Health Equity Project (OHEP) Partners • Boston Public Health Commission • Boston University School of Dental Medicine • Harvard School of Dental Medicine • Tufts University School of Dental Medicine • Massachusetts College of Pharmacy and Health Sciences, Forsyth School of Dental Hygiene • Boston Housing Authority • Boston City Commission on Affairs of the Elderly

  6. OHEP • Enhance dental school curriculum • Provide preventive services to elders living in public housing • Develop network of CHCs, dental schools, private practices for treatment needs • Partner with Social Service Agencies • Train non-dental health providers • Web based tool kit (under development) • Social marketing - Watch Your Mouth • Advocacy

  7. Lessons Learned • Service learning/experiential education works in dental education • Triaging and education in community settings increases demand • Case management is vital – partnerships important

  8. Lessons Learned • Primary care MDs not ready to connect the mouth with the body • Social marketing is necessary but not sufficient • Advocacy is essential – even when Medicaid covers adult services, preventive component is not adequate for elders