Portland, OR - OHSU’s School of Dentistry is pleased to announce that the Oregon Health Authority’s Health Systems Division has approved its application to train Expanded Practice Dental Hygienists (EPDHs) to provide Interim Therapeutic Restorations (ITRs) on patients. Under the direction of Department of Community Dentistry Chair, Dr. Eli Schwarz, DDS, MPH, PhD, the pilot project will be a collaborative effort between OHSU, Capitol Dental Care and Pacific Center for Special Care, University of the Pacific Arthur A. Dugoni School of Dentistry, California, directed by Dr. Paul Glassman DDS, MA, MBA. The dental pilot project is undertaken within the framework of SB 738 on dental pilot projects enacted by the Oregon legislature during the 2011 session.
The ability of highly trained EPDHs to perform interim therapeutic restorations in a community setting will improve the oral health of underserved populations, and demonstrate the EPDH’s ability to carry out this type of care. The EPDH practitioners are excited about the chance to expand the services they can offer away from the dental office. Linda Mann, BS, RDH, EPDH, Director of Community Outreach for Capitol Dental Care, shared that, “a specially-trained dental hygienist that can fill the tooth – the fill part of the “scoop and fill” - with an interim filling, will stabilize tooth structure and abate decay until the patient sees a dentist. Allowing hygienists to work at the top of their licensure in this way expands the reach of the workforce and ultimately results in improved access to care for those with the greatest dental needs.”
The dental pilot project has been planned during a year-long process which has involved a large network of dental care stakeholders in the state assisted by the Pacific Center for Special Care. A planning grant was made available through a generous contribution from CareOregon, Kaiser Permanente, Northwest Health Foundation, Providence Health & Services, Samaritan Health Services, and The Oregon Community Foundation. The pilot program is expected to run
for 54 months and may expand to include other dental care organizations. The need is particularly great in Oregon,” according to Dr. Jeff Sulitzer, CDC’s Chief Dental Officer, “Capitol will have the chance to reduce future, more extensive dental care costs by addressing immediate dental needs in community settings.”
What is particularly innovative about the planned “ITR” pilot is its integration into the “Virtual Dental Home” - a model of care that allows the EPDH (connected with a remotely-located dentist through telehealth) to provide preventive dental care in a non-traditional setting, whether that be a school-based clinic, an assisted living facility or mental health clinic. In addition to performing an overall dental risk assessment, the EPDH takes x-rays and intra-oral photographs, which are then uploaded from a laptop to the Cloud for later assessment by the dentist, who then develops a treatment plan from this patient information. This pilot will allow the “ITR” procedure, when appropriate, to be added to the EPDH’s toolbox of preventive services available to the patient.
The parameters of the “ITR” Pilot Program required that an existing funding source be in place prior to start of the pilot. That support came from Capitol Dental Care and a 2015 OHA Telehealth Innovation grant. The grant, managed by Oregon Office for Rural Health, brought Capitol Dental Care’s telehealth team together with Dr. Glassman and Dr. Schwarz, with the goal of delivering the “Virtual Dental Home” model of care to residents of Polk County. Dr. Glassman, long considered the pioneer of the “Virtual Dental Home”, has successfully implemented this model of care in California for the last six years, and he will continue to play an integral role in training EPDHs that participate in the “ITR” pilot program.
“This is an extraordinary synergy of passion and skill coming together,” Dr. Schwarz, added. “The integration of telehealth combined with an EPDHs’ ability to deliver ITRs will change Oregon’s dental care landscape.” Currently, Oregon is in the midst of a dental health care crisis with more than 61% of its residents not having their dental care needs met.”
It is now the hope that the approved pilot project can attract additional funders that will allow it to expand its reach and collect the kind of data that can serve as the impetus for legislative change. “It’s only through a change in legislation,” according to Dr. Schwarz, “that Oregon can begin to reverse this tide and see improvement in the oral health of its citizens.”
