Disabled Adults Oral Health Initiative

Description

Accessing dental care in Maryland can be a difficulty for people with disabilities, as Medicaid plans in the state offer limited oral health benefits, and dentists may not be trained or have the resources to serve patients with disabilities.

Health Right funds dental care for adults with low incomes who are uninsured or underinsured. Through its Disabled Adults Oral Health Initiative, this safety net program used community health workers (CHWs) to educate and connect adults with disabilities to oral health services.

The partnering agencies included Allegany County Health Department Dental Clinic, Human Resources Development Commission, Inc. (Community Action Coalition), and facilities such as Friends Aware, Inc. that offer day programs for adults with intellectual disabilities.

The initiative was funded by the Maryland Community Health Resources Commission.

Services offered

CHWs visited agencies serving adults with disabilities and their caregivers to provide free educational presentations. These presentations covered topics such as:

• Brushing and flossing
• Eating a healthy diet
• Drinking fluoridated water
• Visiting the dentist regularly
• Finding oral health services

Results

The Disabled Adults Oral Health Initiative saw the following results:

From March 1, 2014, to August 31, 2014:

• CHWs visited 15 agencies, reaching 646 adults with disabilities and 173 staff and caregivers.
• 70 adults with disabilities received dental treatment for urgent needs (tooth extractions, fillings, cleanings, and debridement).

From September 1, 2014, to March 1, 2015:

• CHWs visited 10 sites, reaching 186 adults with disabilities and 88 staff and caregivers.
• 51 adults with disabilities received dental treatment, with 74 dental encounters.

From March 1, 2015, to August 31, 2015:

• CHWs gave 11 presentations, reaching 192 adults with disabilities and 64 staff and caregivers and distributing 409 pieces of educational material.
• 101 adults with disabilities (94 new clients) received dental treatment, with 157 dental encounters.

From September 1, 2015, to February 29, 2016:

• CHWs gave 5 presentations, reaching 60 adults with disabilities and 19 staff and caregivers.
• 67 adults with disabilities (41 new clients) received dental treatment, with 100 encounters.

Challenges

The biggest barriers to dental care include lack of money and coverage as well as transportation. CHWs provided support and advocacy for people with disabilities to overcome any and all barriers that they face. CHWs worked with these individuals to understand their dental coverage and educated them on the importance of good oral health. Additionally, CHWs also served as a liaison between organizations within the community and people with disabilities to link them to needed resources and services.

Health Right worked with an emergency department (ED) staff to help redirect those who came to the ED for a dental condition. Health Right developed flyers about their dental services but found that they weren't distributed consistently. Between March 2014 and February 2016, the ED had referred 70 people to Health Right's services, but only 7 of them had disabilities. Health Right worked on improving communications, and the ED agreed to fax patients' contact information with their consent so that Health Right could reach out to these individuals proactively.

Replication

Partner with agencies serving those with disabilities. Project coordinators found that many of these agencies and caregivers had been trying and struggling to connect their patients with dental care (due to limited finances and lack of able/willing providers) and were eager for the Disabled Adults Oral Health Initiative.

Health Right's partnership with the Allegany County Health Department allowed 3 to 4 hours of care per patient, so many patients were able to receive emergency care as well as more comprehensive care.

The National Institute of Dental and Craniofacial Research offers Dental Care Every Day – A Caregiver's Guide for professional and informal caregivers. This free publication series is not copyrighted, so viewers can reproduce it as needed. The series also features a booklet called Wheelchair Transfer: A Health Care Provider's Guide as well as booklets about care specific to those with disabilities like cerebral palsy and Down syndrome.

Contact Information

Jan Chippendale, Dental Case Manager
AHEC West
301.777.9150 Ext. 112
jchippendale@ahecwest.org