The 130th Annual Meeting of APHA

Abstract #35391

Lea Nolan, MA¹, Jennel Harvey, MHSA¹, Lissette Vaquerano², Sarah Blake, MA³, Brian Kamoie, JD¹, and Jeffrey Levi, PhD¹. (1) Center for Health Services Research and Policy, George Washington University, 2021 K Street, NW Suite 800, Washington, DC 20006, 202-530-2341, lea@gwu.edu, (2) Center for Health Services Research and Policy, The George Washington University, 2021 K Street, NW Suite 800, Washington, DC 20006, (3) Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E., Room 672, Atlanta, GA 30329

This study examined six states' process of passing legislation and/or rules and regulations allowing an alternative model; and whether the alternative model created a change in the delivery system for preventive oral health care. Alternative models included: provision of preventive oral health care by dental hygienists under general supervision or unsupervised practice; and use of topical fluoride application by primary care physicians. We found that changing the law does not necessarily lead to a change in the oral health care delivery system. Rather, a combination of essential factors are required to implement an alternative oral health care model, whether or not a new public health-oriented law has been enacted: 1) dentists' support (both organized and individually); 2) reimbursement streams for providers in the alternative model; 3) state Medicaid department support; 4) a referral mechanism for treatment services; 5) the type of alternative model and the providers involved; 6) an incremental approach to changing the oral health care delivery system; 7) a need for outreach and training on the alternative model; and 8) a recognized and accepted need for the alternative model. We conclude that, thus far, public health-oriented laws and alternative models have had little to no impact on the service delivery system for preventive oral health care services for low-income children.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Understand why alternative, public health-oriented models of delivering preventive oral health care are necessary for low-income populations; and
• Identify which factors are essential to successfully implementing a public health-oriented, preventive oral health care using dental hygienists and/or primary care providers.

Keywords: Oral Health, Access to Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.