Online Program

Strategies for improving access in a school-linked dental program

Monday, November 4, 2013

Robin N Miller, MPH (Candidate), RDH, BA, Division of Health Promotion and Disease Prevention, Office of Oral Health, Vermont Department of Health, Burlington, VT
Martha WH Friedman, MPH, Division of Health Promotion and Disease Prevention, Office of Oral Health, Vermont Department of Health, Burlington, VT
Garry Schaedel, MHS, Division of Health Promotion & Disease Prevention, Vermont Department of Health, Burlington, VT
Onolee LB Stephan, MPH, CHES, Community Impact, Special Olympics International, Pittsford, NY
Tooth Tutor Dental Access Program (TTDAP) is an elementary school-linked dental program connecting Medicaid-eligible children without access to dental care in the last twelve months with a dental home. In Vermont, 57.7% of children receive Medicaid dental insurance and 80% of dentists accept children's Medicaid. In 2011-2012, 32 dental hygienists (Tooth Tutors) and 112 elementary schools participated in TTDAP. The Tooth Tutors' success connecting children and dentists varied. Top reasons for not accessing care included unresponsive parents (73.19%), no follow-through (17.34%), and refused assistance (6.21%). Tooth Tutors cited dentist unavailability <1% of the cases. To improve the quality of TTDAP, Vermont Department of Health (VDH) investigated reasons some Tooth Tutors had higher success rates than others. Following a quality-improvement model, VDH analyzed the percentage of students who successfully accessed care because of TTDAP. To evaluate successful strategies, VDH conducted a survey with Tooth Tutors who reported success rates over 93% in schools with low-SES populations. The strategies they employed include integration into the school community through classroom dental education and participation in school events and committees and building rapport with children, parents, and school nurses. Historically, insurance coverage and dentist availability were believed to be principal factors limiting access to dental care. Findings from the TTDAP survey suggested that these were not issues. Rather, they highlighted the importance of parental involvement in increasing access to children's dental services. Successfully linking children to dental homes depended heavily on establishing meaningful communication and rapport with families, children, and school staff.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe successful strategies employed to increase access to dental care through the Tooth Tutor Dental Access Program.

Keyword(s): Oral Health, Child Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a public health dental hygienist at the Vermont Department of Health for over 14 years. I am currently completing my Masters in Public Health and I am an RDH. I am interested in developing strategies to engage parents in their children's oral health in order to increase the number of children accessing dental care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.