Improving Use of Oral Health Services Among HIV+ Patients: Project TEETH

Background: Project TEETH, a 5-year HRSA-SPNS funded grant, was designed to increase the number of HIV+ patients referred to and utilizing dental services at ten Montefiore Medical Group (MMG2) sites. To accomplish this we delineate three objectives: Design and implement an integrative model of oral health (OH) care; Increase usage rates of OH services in an HIV+ population; and Using a QI orientation and the RE-AIM framework to evaluate our model of dental care with regards to reach, effectiveness, acceptance, implementation and maintenance. Methods: Three of the MMG2 sites have existing dental facilities on/near site, while seven are being serviced by mobile dental unit (MDU). Patient Navigators (PNs) have been integrated at the three sites to act as liaisons between medical care and OH services, assist with the dental appointment process and perform educational and follow-up functions. The MDU has integrated a Dental Hygienist (DH) to act as its liaison/link between medical and dental care. Results: Evaluation includes the bilingual DH and PNs conducting ³300 survey-based patient interviews. We will also conduct frequent QI-based evaluations to monitor the entire program. Currently, we have recorded 30% of patients as routinely receiving OH care off-site; 46.25% of referrals resulted in a dental appointment being made; 18.75% of patients required follow up; and 5% of patients have refused a dental appointment (n=97). Conclusion: We anticipate that the 1000+ HIV+ patients that receive primary care at the MMG2 sites will have been screened, referred, and/or received dental services by the completion of the program.