6th Annual New England
Rural Oral Health Conference

Improving Rural Oral Health Access
in an Environment of Diminishing Resources

Featuring Caswell Evans, DDS, MPH,
University of Illinois, Chicago College of Dentistry

Friday, September 16th, 2011
Crowne Plaza Nashua
Nashua, NH

Dentists, dental hygienists, state oral health program directors, and advocates for improved access to oral health care for New Englanders turned out in force for the RoundTable's 6th Annual Rural Oral Health Conference on Sept. 16, 2011.

Keynote speaker Dr. Caswell Evans, Jr., Associate Dean of Prevention and Sciences, University of Illinois, Chicago School of Dentistry, didn't hesitate to review new models of care that are controversial in the dental world. Although not espousing any particular new modality, Dr. Evans pounded away on the need for evidence-based models and pilot programs. "Test and evaluate new programs, based on the evidence," he counseled his listeners. A long-time educator and proponent of change, Dr. Evans most recently helped draft the July 2011 Institute of Medicine report, "Improving Access to Oral Health Care for Vulnerable and Underserved Populations." Read the summary.

Following Dr. Evans, Moderator Wendy Frosh set the stage for six panelists who told of efforts within their own states to address oral health workforce issues through alternative practice models.

• Jennifer Weirville Norton, NH Oral Health Workforce Access Strategy Work Group, with support from the Pew Endowment for Health, looked at potential workforce solutions for underserved groups. Her counsel: "Don't start over; build on what has already been started."
  
  
• Carlen Finn, Executive Director, Voices for Vermont's Children, talked about the Vermont Oral Health Care for All Project, supported by the Kellogg Foundation. The Coalition's agenda: include dental in Vermont universal health coverage; expand the successful Tooth Tutor program; add new dental practitioners to the dental team. Vermont bill H.398 authorizes and regulates the practice of dental therapy; it will be considered in 2012 legislative session.
  
  
• Dr.Bruce Tandy, DMD, CT State Dental Association, emphasized the importance of educating his group's members on new workforce models. Connecticut has succeeded in increasing the number of dentists who are willing to take Medicaid patients. CT passed legislation last year that increased scope of practice of hygienists. Dr. Tandy asked if these new models will improve utilization, which is often the major issue (not capacity.) He, too, stressed the need to take an evidence-based approach.
  
  
• Mike Saxl, Government Relations, Maine Street Solutions (a lobbying organization), noted the importance of the new University of New England dental school, set to open in 2013. The school will recruit from rural areas in hopes their graduates will return to those communities. Saxl said LD 1105, a resolution "To Study Oral Health Care in Maine and make Recommendations Regarding how to Address Maine's Oral Health Care Needs," became law in June 2011.
  
  
• Dr. Mina Paul, Chair, MA Board of Registration in Dentistry, said MA authorized public health dental hygienists in 2008; they can be reimbursed directly by Medicaid and can set up practice on their own. "EFDA" (expanded function dental assistants) legislation has passed the House and public hearings are now being held. MA dentists are being urged to take MassHealth patients, thus increasing access to care. Dr. Paul feels dental schools need to build in the ideal of community service.

In breakout sessions, physicians Hugh Silk (MA) and Amos Dienard (MN) presented practical oral health tools that can easily be adopted within a rural primary care practice. Dr. Silk and colleagues have developed a set of online oral health instructional modules – "Smiles for Life"– designed to enhance the role of primary care clinicians in the promotion of oral health for all age groups.

Lately there's been concern about the use (or perhaps over-use) of hospital Emergency Rooms for dental visits. Nancy Martin, NH Oral Health Program Manager, and epidemiologist Dr. Ludmilla Anderson recently analyzed NH hospital emergency department data for dental visits.

From the public health perspective, Alice M. Horowitz, PhD., School of Public Health, University of Maryland and a noted champion of health literacy, made the case that much needs to be done to improve oral health literacy. In her career, Dr. Horowitz has turned the spotlight on the communication gap between patient and health providers, dentists included.

A feature of the Rural Oral Health Conference each year is panel of NE State oral health directors, who report on accomplishments and efforts to improve access to services in their states.

View conference speakers' presentations below:

Collaboration and a Shared Vision of What's possible:
Keys to Increasing Access to Care
Caswell A. Evans, DDS, MPH
Associate Dean, for Prevention and Public Health Sciences
UIC College of Dentistry
Download Presentation (PDF/3.89MB)

Oral Health Workforce Forum

Emerging Oral Health Workforce Models
Wendy J. Frosh
Healthcare Management Strategies
Download Presentation (PDF/82kb)

Vermont Oral Health Care for All Project
Carlen Finn
Voices for Vermont's Children
Download Presentation (PDF/120kb)

Addressing Oral Health Workforce Dilemmas
Through Alternative Practice Models in New England
Michael Saxl
Maine Street Solutions
Download Presentation (PDF/234kb)

Breakouts

Into the Mouths of Babes: Improving Rural Oral Health Access
in an Environment of Diminishing Resources
Dr. Amos Deinard, MD, MPH
Suzanne Tessier, RDH, CDHC
Download Presentation (PDF/6.7MB)

Emergency Department Visits For Non-Traumatic
Dental Conditions New Hampshire, 2001-2008
Nancy Martin, RDH, MS
Ludmila Anderson, MD, MPH
New Hampshire Department of Health & Human Services
Division of Public Health Services
Oral Health Program
Download Presentation (PDF/918kb)

Improving Rural Oral Health:
The Case for Oral Health Literacy
Alice M. Horowitz, PhD
Download Presentation (PDF/2.29MB)

State Oral Health Director's Forum

Connecticut
Initiative: "Home by One"
Linda Ferraro
Download Presentation (PDF/231kb)

Massachusetts
Initiative: MDPH SEAL and 4510-0025
Lynn Bethel
Download Presentation (PDF/1.5MB)

Maine
Improving Access to Oral Health Services in Maine:
Systems change, planning, infrastructure and capacity-building
Judith A. Feinstein, MSPH
Director, Oral Health Program
Download Presentation (PDF/838kb)

New Hampshire
Initiatave: NACDD Grant- NH Seniors Centered on
Oral Health, Pilot Project
Nancy Martin
Download Presentation (PDF/28kb)

Rhode Island
Initiatave: RI Oral Health Mini-Residency Series
Deborah Fuller D.M.D.
Download Presentation (PDF/797kb)