Good oral health is essential to overall health, but dental care remains the number one unmet health need for children and low-income adults in Ohio. The consequences of not having adequate dental care can be severe, including missing work or school, living with chronic pain, or even developing life-threatening infections. Webinar speakers explore how Ohio can bring affordable, high-quality oral health care to underserved communities across the state. Speakers include: - David Maywhoor, Project Director, Dental Access Now! - Dr. Edward Sterling, DDS, Diplomate, American Board of Pediatric Dentistry - Dr. Larry Hill, DDS, MPH, President, American Association for Community Dental Programs

1. Dental Access Now!
Bringing Quality Dental Care to Every Community in Ohio

2. a statewide coalition of over 480 organizations and thousands of
individual advocates.
Advocates for Ohio’s Future is…

3. Ohio should be a great place for ALL Ohioans to live
and work.
Participate in
the economy
Be healthy and sa
fe
Afford the basic
s

4. Advocate with us!
• You’ll receive a follow-up email from this webinar
• Look for “Act Now” email alerts, webinar invitations, and new resources
• Unsubscribe at any time

5. Webinar Presenters
David Maywhoor
Project Director
Dental Access Now!
Dr. Edward Sterling, DDS
Diplomate
American Board of Pediatric Dentistry
Dr. Larry Hill, DDS, MPH
President
American Association for
Community Dental Programs

6. +
Uniquely Ohio Solutions to Ohio’s
Dental Care Crisis
Advocates for Ohio’s Future
November 16, 2016
Access to Dental Care in Ohio
and New Workforce Models

7. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
UHCAN Ohio
We are a statewide consumer oriented,
advocacy organization working for high quality
and affordable health care for all Ohioans.
Improving dental access is critical to improving
overall health care delivery.

8. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Dental Access Now! has been Listening and
Planning
• What’s working
• What needs fixed
• New ideas

9. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
What’s Happening in Ohio
Ohio’s Dentist Loan Repayment (ODLR) Program
As of June 2016, 8 dentists have contracts with the
ODLR program. Doubling the program will—at
best—place a handful of dentists in underserved
areas.

10. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
What’s Happening in Ohio
According to the Ohio State Dental Board, as of August 18, 2016
there were:
7,088 Dentists (FY 2015 – 7,351)
8,377 Dental Hygienists (FY 2015 – 8,471)
August 18, 2016 Oral Health Access Supervision Permit Holders:
Dentists – 31 (FY2015 – 37)
Dental Hygienists – 98 (FY 2015 – 92)

11. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
What’s Happening in Ohio
According to the Ohio Department of Health dentists who take Medicaid
patients:
• In SFY 2012, 2,226 dentists submitted at least 1 claim for a patient covered
by Medicaid
 Only 35.6% of dentists see at least 1 patient covered by Medicaid, only
15.8% of dentists see a substantial number of patients covered by
Medicaid
Dental OPTIONS program: 12,000 patients in a 20 year span
In 2016 ODH reported that 950 dentists participated with a wait list of over 800
patients needing care.

12. Ohio’s Dental Professional Shortage
 There are 85 federally
designated dental health
professional shortage areas in
Ohio up from 59 in 2011.
 More than 1.5 million Ohioans
live in these shortage areas.
 More than 4 million children
and adult Ohioans lack dental
coverage.
Source ODH 2016

13. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Ohio Consumers Say…
Lack of transportation
More people using
Emergency Rooms for
dental care
Shortage of Medicaid
providers
Long wait lists for
OPTIONS
Free care days do not create
routine dentist patient
relationships

14. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Ohio Dentists Say…
• Medicaid rates are too low
• People won’t take care of their own teeth
• People won’t show up for appointments
• Not a shortage, but a maldistribution of dentists
• Loan repayment is working
• Dentist give plenty of free care

15. Increased Medicaid
reimbursement rates
Fewer bureaucratic
barriers
Lifting restrictions on
Dental Hygienists
More emphasis on
preventive oral self care
Expanding the dental
workforce to include
new types of
providers
For her to grow up with a healthy smile
we need…

16. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
The Dental Therapist Model
The dental therapist is a proven professional, working as part of
the dentist led team, who is trained to work under the remote
supervision of a dentist, providing some preventive dental
services, fillings, and some non-surgical extractions.

17. Recruitment
Candidates are recruited with a commitment to return to
their community to work in the dental field.
We are looking for people
who can be change agents,
who recognize that many folks
have gone without dental care
for generations.

18. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Education
• The dental therapist will be a graduate of a Commission on Dental
Accreditation approved education program.
• CODA Standard 2 –Educational Program: The dental therapy
program curriculum must be at least three academic years of full-
time instruction at post-secondary level.

19. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Education and Preceptorship
• Intensive classroom and clinical education.
• Hands-on clinical training under direct supervision of dentist
will allow the dental therapist to treat at least 150 patients by
their graduation.
• After licensure, 400 hour preceptorship directly supervised by a
licensed dentist.

20. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Licensure
The dental therapist and dental hygienist therapist
will be licensed by the Ohio Dental Board, just like
dentists and dental hygienists.

21. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Supervision
• During Education – Direct Supervision
• During 400 Hour Preceptorship – Direct Supervision
• After Standing Orders have been developed – Remote
Supervision
• Remote supervision allows the dental therapist or dental hygiene
therapist to work in a setting without the dentist being present,
using telemedicine to communicate with the dentist about patient
care.

23. A little on Minnesota Dental Therapist Program
 At August 2016 there were 64
dental therapists
 26 were Advanced Dental
Therapists
Workforce questionnaire completed
by MN Department of Health
November and December 2015. 43
out of 53 licensed dental therapists
responded.

25. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Conclusions and Recommendations
• Dental therapy workforce is growing, fulfilling statutory intent serving
uninsured and underserved patients.
• Clinics are able to decrease wait and travel time for some patients
which increases access.
• Dental therapists are practicing safely and clinics are reporting
improved quality and high patient satisfaction with their services.
• Benefits: cost savings, increased productivity, improved patient
satisfaction and lower appointment fail rates.

26. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Financial Viability – Private Practice
• In January 2012, Dr. John Powers of Main Street Dental Care in Montevideo,
Minnesota became the first private practice dentist in the United States to
hire a dental therapist.
• His practice’s share of Medicaid patients increased from 26 to 39 percent and new
patients increased by 38 percent.
• His practice’s profits increased by $23,831.
• His practice increased production by almost $300,000 and collections by $115,000.
The Pew Charitable Trusts. (2014). Expanding the dental team: Studies of two private practices.

27. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Financial Viability of the Dental Therapist – Children’s
Dental Services - MN
• Employing dental therapists for $45 an hour compared to dentists at $75 an
hour has allowed Children’s Dental Services to maintain and expand services
in the face of declining Medicaid reimbursement rates.
• Each full time dental therapist saves Children’s Dental Services $1,200 a week,
or $62,400 a year. Those savings are reinvested into the program and help to
keep the doors open.
• The dental therapists improve communications among the dental team and
free up dentists to focus on more complex procedures.

28. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Senate Bill 330 What It Does
Dental Hygienists
SB330 will expand the reach of Dental Hygienists so they are able
to provide their services to the full extent of their education,
training and licensure under general supervision of the dentist.

29. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
SB330 What It Does
Dental Therapist
SB330 will add a proven provider to the dentist-led team. A
dental therapist is educated and specially trained in a limited
number of restorative and preventive procedures including
filling cavities. By allowing dental therapists to perform a small
number of routine services, dentists are freed up to focus on
more complex cases or patients with multiple needs.

30. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
SB330 What It Does
Dental Hygienist Therapist
While we have a shortage of dentists, the same is not true for
dental hygienists. With SB330 dental hygienists will be able to
take additional education and be licensed to practice as a
hygienist and a dental therapist.
CODA Standards creates advanced standing for the dental
hygienist

31. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
SB330 what it does
Puts Providers Where They Are Needed Most.
With SB330 we ensure that the new providers are working in
communities with the greatest need. Dental therapists would be
limited to dental health professional shortage areas and with
dentists who have 20 percent or more of their patient caseload
from the Medicaid population.

32. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Why is this a good approach for OHIO?
• Care is more accessible to those who
need it most.
• Reduce cost to Hospital ED’s
• More providers whose cultural
experiences match people in need of
care.
• Strengthens the safety-net

33. UHCAN Ohio is a statewide nonprofit organization working for high quality, accessible, affordable health care for all Ohioans.
Next Steps
• Please endorse the project.
• Support passage of SB330, which changes Dental Scope
of Practice permitting Dental Therapists and Dental
Hygiene Therapists to practice in underserved areas of
Ohio.

34. Contact Information
David Maywhoor, Project Director
dmaywhoor@uhcanohio.org
614-456-0060 Ext. 225
614-738-0100 (cell)

35. • You’ll receive a follow-up email with links to video, slides and resources.
• Share information and help others become advocates:
• @DentalAccessNow
• Facebook.com/DentalAccessNow.Ohio
• @Advocates4OH
• Facebook.com/advocatesforohio
Next Steps

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