Access to dental care is an issue facing many Californians, particularly individuals with developmental disabilities and those living in rural communities. University of the Pacific's Center for Oral Health for People with Special Needs announced today the results of Access California, an innovative community-based system to address this statewide problem.
"People with disabilities have more dental problems and more difficulty accessing dental services than most other segments of the population," stated Dr. Paul Glassman, co-director of Pacific's Center for Oral Health for People with Special Needs, while testifying before the United States Senate Special Committee on Aging in September. "There is a general lack of awareness of the importance of dental health and the consequences of dental disease among general health and social service professionals and among caregivers and people with special needs."
Glassman also noted that poor oral health is correlated with coronary artery disease (some studies show four times the risk of death for people with severe periodontal disease), diabetes, premature delivery and low birth weight, failure to thrive, ischemic stroke, brain abscess, bacterial endocarditis and respiratory diseases.
With a $2 million grant from The California Endowment, the state's largest health foundation, Pacific's Center for Oral Health for People with Special Needs joined forces with the California Department of Developmental Services and eight regional centers throughout California to design and implement a community-based system of oral health care for adults and children with special needs. The community-based system is a model of care that utilizes a "dental coordinator," often a dental hygienist or dental assistant, as a new resource in designated regional centers from Sacramento to Riverside. Prior to this program, dental professionals did not exist in the regional centers.
"These dental coordinators have developed and expanded dental services in their communities, provided screening, triage and referrals to regional center consumers and promoted prevention for people with special needs, caregivers and medical and health professionals," said Christine Miller, RDH, co-director of the Center for Oral Health for People with Special Needs.
At the Sheraton Grand Hotel in Sacramento, Glassman and Miller outlined the innovative program that reached more than 5,000 individuals with special needs, many of who made their first visit to the dentist. As a result, participants experienced: 23% reduction in having problems finding dental care; 20% reduction in defective or decayed fillings or crowns; 20% reduction in the need for extractions or restorations; 16% increase in people who had their last dental visit without sedation or restraint; and 15% reduction in gum disease.
In three years, the program trained more than 8,000 caregivers, parents, social workers and health professionals through continuing education programs where they learned how to work with and treat special needs patients and prevent dental disease.
Assemblywoman Lois Wolk of the 8th District and Cliff Allenby, executive director of the California Department of Developmental Services, also addressed the audience of 100 guests which included members of the Statewide Task Force on Oral Health for People with Special Needs.
During the event, Nadine Hernandez, mother of 21-year-old Sarah who was born with Pierre-Robin syndrome and has autistic tendencies, described the impact of this community-based system on her family.
"Last year, Sarah had a crisis and was admitted to a locked psychiatric facility because her behavior became unmanageable. She was throwing herself into walls and physically hurting herself. She was just screaming constantly in pain" said Hernandez. "Sarah is non-verbal so we didn't know, and she had no way of letting us know, that she was in pain with a tooth infection."
Fortunately for Sarah, the San Gabriel/Ponoma Regional Center has a dental coordinator who was able to identify that Sarah had a dental problem and found a dentist to treat her. "They came in, they did the dental work on her, and within 24 hours, Sarah was behaving normally or what we would consider normal for her type of disability," said Hernandez.
"As a strong advocate for better access to care for underserved populations, particularly for people with developmental disabilities, I am delighted that Access California was occurring in not one, but both counties in the 8th district, the district that I serve," stated Assemblywoman Lois Wolk during the awards luncheon.
Alta Regional Center in Sacramento has two dental coordinators, and together they have reached over 900 people with disabilities, 1,700 parents, caregivers and other health professionals. The dental coordinators have also located 20 new dentists willing to treat people with special needs.
At the North Bay Regional Center in Solano County, the two dental coordinators, in addition to providing training, education, resource development, screening, triage and referral, are working collaboratively with a mobile van, reaching clients who have never had and possibly would never have had dental care.
"I believe this program's success is based on the multi-faceted roles of the dental coordinators and their ability to adapt the systems to meet the needs of each community," added Wolk. "In this era of shrinking budgets and tight economic times we need to be looking for innovative models to deal with complex health problems such as improving oral health for people with special needs."
Allenby presented awards to the dental coordinators. "The project succeeded through the innovation of a very special group of 'pioneers' who were not afraid to try something different," stated Allenby. "I congratulate the regional centers who participated in this project and I am pleased to honor them, along with the dental coordinators and other staff who were on the front lines making it happen."
"This model will continue to provide oral health services and promote prevention because system-wide changes have been made and dental coordinators have been integrated into the regional centers to work in conjunction with physicians, nurses and social workers," concluded Miller.
University of the Pacific School of Dentistry, one of the nation's premier dental schools, has served the San Francisco Bay Area for 107 years. Pacific is committed to excellence in student-centered education, patient care and research. The school's clinics, located in San Francisco, Union City and Stockton, offer quality, low-cost dental services to children and adults throughout Northern California. The Center for Oral Health for People with Special Needs was founded in 1998 and is dedicated to improving the oral health and well being of people with special needs.
