Brenda Diamond, Director Ministry Dental Center . Patsy Mbughuni, Senior Planner CAP Services Inc. . CHALLENGE. AGENDA. Culture. Barriers to Dental Care. Effects of Oral Health on Overall Health. History of Ministry Dental Center. ID: 155131
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Providing Dental Care to Low Income Families
Brenda Diamond, Director Ministry Dental Center Patsy Mbughuni, Senior Planner CAP Services Inc.
Barriers to Dental Care
Effects of Oral Health on Overall Health
History of Ministry Dental Center
Culture is defined as learned behavior which has been socially
aquired1 1Park K. Social sciences and medicine. Park’s textbook of preventive and social medicine. 17th ed. Jabalpur India; M/ s Banarsidas Bhanot publishers: 2002: pp 459-488.
Number of people with dental Insurance?
Seen a dentist in the last 6 months for preventative care?
Children should be seen at age 2 for their first dental exam? True or False
Believe you have “soft” teeth.
Want to see a dentist but cannot.Slide4
65% of people who have dental insurance, utilize it annually.
46% with commercial insurance, have completed a yearly check up (re-care appointment). (Paid at 100%)
On average, 30% of children in Wisconsin covered by Badger Care has seen a dentist in the last year. Children should be seen by age 1.Slide5
Myths Unveiled continued
There is not such a thing as “soft” teeth. Teeth that break down easily could be a result of diet (sugar drinks), brushing habits, other oral habits such as smoking, chewing tobacco and drug therapy as well as lack of professional dental care. Fluoride and genetics do play a role in the enamel make up of your teeth.
Access to comprehensive dental care continues to be a real problem in the state of Wisconsin.
Based on utilization rates today, studies indicate there will be enough providers to cover the demand for care in the future. Should community demand increase, dental access could be constrained.Slide6
44 percent of American children will suffer from pediatric dental disease before they reach kindergarten.
73 percent of preschoolers and 48 percent of primary school age
Only 1.5 percent of 1-year-olds have had a dental office visit compared with 89 percent who have had an
. (Question of value placed on oral health)Slide7
Barriers to Seeking Care
FearEmbarrassmentExpense of non covered treatmentWork SchedulesTransportation (Reliable)Mental Health Limited providersSlide8
Commercial InsuranceCo PaymentsOut of Pocket CostsMaximum benefits reached quicklyNon-InsuredInitial $200 plus for appointmentTight Budget, no extra cash for careChronic needsPublic Assistance Programs Limited providersTravel Long distance Wait list for careChronic needsIn/Out of EligibilitySlide9
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Oral Systemic Connection
Recent scientific research suggests a very strong correlation between chronic oral infections from periodontal (gum) disease and systemic health.
Medical conditions may be complicated by bacteria from the mouth.Slide11
Cardiovascular disease - Inflammatory response to oral bacteria contributes to cardiovascular disease, heart attacks or strokes.Pulmonary Disease - People with chronic periodontal disease (10% of the general population and 50% of all seniors) are most affected by pneumonia. Improving the state of poor oral health may reduce the number of pneumonia cases and decrease patient mortality.Diabetes - 1/3 of all people with diabetes have severe periodontal disease. Untreated, periodontal disease can disrupt diabetic control. Periodontal disease may be considered a complication of diabetes.
originate from oral bacteria
lead to failure of the
evaluation before surgery
decrease the potential risk of
of all dental disease prior
cancer therapy may minimize or
the potential complicating
of preterm birth was 3 to 8 times
for mothers with periodontal
Services’ community needs
assessment 1995 and 1998 identify lack of access to medical and dental care
Head Start dental
assessments – no providers
Hospital Emergency Room visits for dental issues
Family Preservation and Support Initiative - Affordable Health Care Task
Force 1996- lack of dental careSlide13
Delta Dental of Wisconsin, Saint Michael’s Hospital, CAP Services
Each partner brought unique resources to the table:
Delta Dental: financial resources
Saint Michael’s Hospital: financial resources and management/organizational medical infrastructure
CAP Services: resource mobilization capacity, outreach to target community.
“Mission of CAP Services is to bring about a permanent increase in the ability of low-income individuals to become economically and emotionally self-sufficient.”Slide14
January 2002 - OpenSlide15
Ministry Dental Center
Mission is to continually improve the health and well being of people, especially the poor, in the communities we serve.We believe people have the right to quality dental care services that are efficient, effective and accessible. We believe care should be compassionate and delivered in a dignified and respectful manner by a culturally sensitive and highly professional team of people.Slide16
Dental Center provides comprehensive general dental care for infant, pediatric, adolescent, adult and geriatric patients.
Eligibility:Recipient of Badger Care Benefits
in Portage & Waupaca Co
patient population served is approximately
% under age 20;
% patients aged 20-59; and
% 60 and older.
% self report
SCOPE & COMPLEXITY OF PATIENT’S CARE NEEDS
most prevalent reasons patients present for dental care are:
(Oral evaluations, diagnostic imaging)
which includes scaling and polishing procedures to remove coronal plaque, calculus and stains; fluoride treatment; nutritional and dental disease counseling; tobacco counseling for the control and prevention of oral disease; oral hygiene instructions and sealant placement)
(placement of amalgam, resin fillings)
Emergency Treatment of dental pain
(Open a tooth to drain infection and/or extraction as necessary)
Limited Endodontics, Periodontics and Prosthodontics
(Root Canal Therapy, treatment of gum disease and replacement of missing teeth)Slide18
Ministry Dental is staffed by Total of 13.4 FTE.2.80 FTE Dentist. 2.4 FTE Dental Hygienists, 4.6 FTE Dental Assistants, 2.6 FTE Schedulers, and 1.0 Director. HOURS OF OPERATION:Monday 8 a.m. – 5 p.m.Tues-Thursday 8 a.m. - 6 p.m.Friday 8a.m. - 4:30 p.m.Slide19
2013 Patients Seen By CountyCountyPatients SeenPatient EncountersPeriodic ExamsNew PatientsTreatment CompletePortage 2796695014546451961Waupaca14243595711310807Other4813739041 2013 Total 426810,682220295528092012 Totals428110,227289210012798
Patients Seen in 2013
Operational PhilosophyPatients FirstStandardizationOrganizationLean-eliminate wasteSlide21
Sustainablity_Filling the GAP
United Way of Portage CountyWI Department of Health Services Dental GrantDelta Dental Anthony Family FoundationFrame Memorial Presbyterian Church
Jeregan’sManawa Telephone companyWetherbee DonationSaint Michael’s FoundationCentral Wisconsin Community Foundation
*Average Annual Deficit of $460,000Slide22
Children are seen next available appointment starting at age 9m – 1 yr.Fluoride Varnish Sealants Patient Education utilizing teach back techniquesEmergency & Restorative CareTreatment plans are completed in 90 daysOver 15,000 persons seenLow income families have dental home
Decrease decay rates in children
Decrease adult dental care needs
Increase demand for preventative recare appointments to sustain oral health.
Community awareness of the effectives of oral health on overall health
Improve overall health in the CommunitySlide24
Community Out Reach
Improving oral health in the community involves changing the community culture around oral health. (learned
behavior which has been socially
Way to impact community culture is through outreach and education.
New Moms groups
Public nurses – education in-service
Primary care, OB-GYN, Pediatric physician forums on early intervention and education.
Physicians applying fluoride varnish during well baby checks.Slide25
Back to the Mission
Mission is to continually improve the health and well being of people, especially the poor, in the communities we serve
believe people have the right to quality dental care services that are efficient, effective and accessible.
believe care should be compassionate and delivered in a dignified and respectful manner by a culturally sensitive and highly professional team of people.Slide26
Making a difference in our community !Slide27