UW School of Dentistry

School aiding effort to boost low-income dental health

Advantage Dental Services and the UW School of Dentistry have announced that they will launch an effort next year to improve the dental health of low-income mothers and children in Oregon.

Advantage, which is based in Oregon, will target 82,000 children and mothers enrolled in the Oregon Health Plan (OHP) in rural counties with a program designed to widen access to care and reduce delays in getting dental treatment. The program will involve not only private dentists and Advantage Clinics but will also make greater use of expanded practice permit (EPP) dental hygienists, who can practice in non-traditional settings under a dentist’s supervision. School nurses will also be enlisted in the program.

The program will begin with seven test counties: Coos, Deschutes, Douglas, Jackson-Josephine, Klamath, Morrow and Wasco. In these counties, Advantage will deploy EPP hygienists to provide screening, tooth decay risk assessment and preventive care in the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Head Start, schools and other settings. Advantage will also expand its centralized case management staff to reduce delays in getting needed care.

Children and their mothers who require care by a dentist will be referred to private dentists or Advantage clinics. The company now serves 300,000 enrollees in 150 primary care dental practices and 30 clinics. It will also provide financial incentives to staff members whose programs help reduce oral health disparities among OHP clients. Researchers will also monitor patient satisfaction and other aspects of care.

Advantage anticipates that the EPP hygienists and community teams will be able to manage the majority of children’s dental needs, with many fewer children requiring referrals to dentists. This is expected to produce significant cost reductions and improvements in oral health.

The project will be underwritten by Advantage and by a three-year, $488,434 evaluation grant from the Robert Wood Johnson Foundation of Princeton, NJ, to be administered by the School of Dentistry’s Northwest Center to Reduce Oral Health Disparities. The grant is part of the foundation’s “Reducing Health Care Disparities Through Payment and Delivery System Reform” program administered by the University of Chicago.

Advantage CEO R. Mike Shirtcliff and Northwest Center Project Director Peter Milgrom said in a joint statement, “The program will use a science-based approach to care delivery using highly trained dental hygienists working within the community and tied to Advantage clinics throughout the state, while at the same time providing incentives for professional and lay employees to focus on reducing oral health disparities among our citizens in greatest need.”

The joint proposal was the single dental care project selected in a national competition. It allows Advantage to further its mission to provide effective and efficient care to the whole community. Dr. Marshall Chin, director of the Reducing Health Care Disparities National Program Office, said, “The University of Washington/Advantage Dental Services proposal is at the cutting edge of efforts to reduce health care disparities by changing the way we deliver and pay for care. We hope it will be a successful model for the nation.”