Download - Providing Dental Care to Low Income Families
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Providing Dental Care to Low Income Families Brenda Diamond, Director Ministry Dental Center
Patsy Mbughuni, Senior Planner CAP Services Inc.
CHALLENGE
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AGENDA
• Culture• Barriers to Dental Care• Effects of Oral Health on Overall Health• History of Ministry Dental Center• Community Benefit
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CULTURE
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.
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Myths Unveiled
• 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.
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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.
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National Statistics
• 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 children have unfilled cavities
• Only 1.5 percent of 1-year-olds have had a dental office visit compared with 89 percent who have had an office-based physician visit. (Question of value placed on oral health)
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Barriers to Seeking Care
• Fear• Embarrassment• Expense of non covered
treatment• Work Schedules• Transportation
(Reliable)• Mental Health • Limited providers
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INSURANCE BARRIERS
• Commercial Insurance• Co Payments• Out of Pocket Costs• Maximum benefits reached
quickly
• Non-Insured• Initial $200 plus for
appointment• Tight Budget, no extra cash for
care• Chronic needs
• Public Assistance Programs • Limited providers• Travel Long distance • Wait list for care• Chronic needs• In/Out of Eligibility
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Smiles and laughter strengthen your immune system, boost your energy, diminish pain, and protect you from the damaging effects of stress and prevent heart disease. Both are powerful mood changers as they reduce stress hormones, release endorphins and relieve tension. Smiling releases Serotonin into your blood stream so when you smile you release feel good hormones which raise your mood and lift your spirits.
OVERALL HEALTH
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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.
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Medical Conditions
• 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.
• Orthopedic Implants
- Infections originate from oral bacteria may lead to failure of the prosthesis. Dental evaluation before surgery could decrease the potential risk of infection.• Cancer
- Elimination of all dental disease prior to cancer therapy may minimize or prevent the potential complicating effects of chemotherapy.• Fetus Development
- Risk of preterm birth was 3 to 8 times greater for mothers with periodontal disease.
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Community Challenged
• Community-wide concern• CAP 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 care
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Partnership Coalesced
• 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.”
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January 2002 - Open
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Ministry Dental Center
Our 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.
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Demographics
Ministry 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
The patient population served is approximately
40% under age 20; 52% patients aged 20-59; and 8% 60 and older.
21% self report disabled.
Ethnicity:
Caucasian 81%, Hispanic 5%, Asian 1%, Hmong 9%, African American 3%, Bi-racial 1%.
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SCOPE & COMPLEXITY OF PATIENT’S CARE NEEDS
The most prevalent reasons patients present for dental care are:• Diagnostic (Oral evaluations, diagnostic imaging)• Preventive (prophylaxis 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)
• Restorative (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)
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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.
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2013 Patients Seen By County
CountyPatients Seen
Patient Encounters
Periodic Exams
New Patients
Treatment Complete
Portage 2796 6950 1454 645 1961
Waupaca 1424 3595 711 310 807
Other 48 137 39 0 41
2013 Total 4268 10,682 2202 955 2809
2012 Totals 4281 10,227 2892 1001 2798
Patients Seen in 2013
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OPERATIONAL EFFICIENCY
Operational Philosophy Patients First Standardization Organization Lean-eliminate
waste
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Sustainablity_Filling the GAP
• United Way of Portage County
• WI Department of Health Services Dental Grant
• Delta Dental
• Anthony Family Foundation
• Frame Memorial Presbyterian Church
• Jeregan’s
• Manawa Telephone company
• Wetherbee Donation
• Saint Michael’s Foundation
• Central Wisconsin Community Foundation*Average Annual Deficit of $460,000
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COMMUNITY BENEFITS
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IMPACT TODAY• Children are seen next
available appointment starting at age 9m – 1 yr.
• Fluoride Varnish • Sealants • Patient Education utilizing
teach back techniques• Emergency & Restorative
Care• Treatment plans are
completed in 90 days• Over 15,000 persons seen• Low income families have
dental home
FUTURE IMPACT
• 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 Community
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Community Out Reach
• Improving oral health in the community involves changing the community culture around oral health. (learned behavior which has been socially acquired)
• Way to impact community culture is through outreach and education. • New Moms groups• Pregnancy Fairs• 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.
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Back to the Mission
Our 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.
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Patient Satisfaction
Making a difference in our community !
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QuestionsThank you!