A pilot program using dental hygienists to prevent cavities in children from low-income families will be developed and tested in areas of northwestern Indiana that are most in need of dental services.
Funded with a $1.3 million grant from the federal Health Resources and Services Administration, the pilot program will focus on children living in federally designated dental health professional shortage areas. If the program proves successful, it will serve as a model for expanding dental services to children in dental shortage areas in other parts of the state.
The pilot program is being led by Dr. Angeles Martinez-Mier, an associate professor and director of the IU School of Dentistry’s Division of Community Dentistry in the Department of Preventive and Community Dentistry, and Dr. James Miller, the Indiana State Department of Health’s oral health director.
The Health Resources and Services Administration is the primary federal funding agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable. The agency develops criteria to decide whether a geographic area is a health professional shortage area.
The program marks the first use of a modification made two years ago to Indiana law governing the scope of practice for dental hygienists. That change allows dentists to provide off-site supervision of dental hygienists, who may now work on their own in a public health setting to treat children with dental sealants and other primarily preventive procedures as long as a dentist has previously diagnosed a patient’s need for preventive treatment. In the past, hygienists could apply sealants only if a dentist was present.
Dental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay. Most tooth decay in children and teens occurs on these surfaces.
The program will be developed and tested in partnership with school corporations designated Title 1 (lowest income) schools in Northwest Indiana and two community health centers, IU Health La Porte Community Health and Dental Clinics and HealthLinc Community Health Centers in Valparaiso and Michigan City. Three rolling sites within a school system or systems have yet to be selected. A dentist, two hygienists and two assistants will be assigned to each of the sites.
“What we are looking at is developing a new model of practice and assessing its cost effectiveness, efficacy and sustainability,” Martinez-Mier said.
Children who participate in the program will be tracked for two years. The program will assess the total numbers of children seen by the program, the number of children with cavities, the average cost per child, the average cost per sealant and other factors.
“We now have an unequal distribution of cavities,” Martinez-Mier said. “Children who don’t have access because of economic means or other reasons have the largest number of cavities. But if we can get to them early enough, we can prevent cavities. It is imperative to do prevention. For a segment of the population, tooth decay remains an extremely serious problem.”