Care Delivery Systems: Community-based Approaches

1
Care Delivery SystemsCommunity-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