Healthcare Delivery Redesign in Action: Implementing a Public Health Dental Program to Address the Needs of Chronic Disease Patients in Bexar County, Texas

Background: It is estimated that close to 108 million people in the U.S. have no dental insurance. Oral health disparities are particularly present in economically vulnerable persons of color who are less likely to have access to oral health care services. In Bexar County, Texas, Hispanics, African-Americans, and individuals living in the Southern regions of the county are less likely to rate their oral health status good-to-excellent or report having adequate dental health coverage. To address these needs, University Health System partnered with Federally Qualified Health Centers (FQHCs) to expand dental coverage for medically and economically underserved residents.

Methods: Dental chart review audits were applied to assess dental service outcomes among the patient population. Program costs, measures, and resource utilization were captured through a database built to centralize dental procedures from partner FQHC sites.   

Results:  A total of 144 patients across 855 dental care visits began treatment over the course of the first implementation year.  A group of intervention patients (n = 78) were tracked from the beginning of their treatment. Through dental chart review, 34 patients completed their treatment with 10 (29%) demonstrating improvement in periodontal disease status by the end of first implementation year.

Conclusion: Collaborating with FQHCs was critical in identifying capacity and needed resources for providing and expanding access to dental services for chronic disease patients. Through these partnerships, timely access to dental care and level of awareness regarding the importance of oral health to overall health and well-being were achieved.