1. Care Delivery Systems: Community-based Approaches
Michelle M. Henshaw, DDS, MPH
Boston University School of Dental Medicine

2. Current environment Dental care segregated
Dental schools provide inadequate training in elder care
Non-dental health professionals have limited to no training in oral health
Low oral health literacy
As disability increases, focus on prevention decreases and acute care increases (oral health not valued)
Lack of financing

3. What we need Integration in existing care delivery systems
Additional training for dentists
Training for non-dental health professionals
Focus on social marketing
PREVENTION, PREVENTION
Partnerships, Partnerships, Partnerships

4. Community-based Models
Volunteer dental clinics/dentists
Physician based (pediatricians)
Community-based service delivery
Preventive services
Comprehensive care

5. Oral Health Equity Project (OHEP)
Partners
Boston Public Health Commission
Boston University School of Dental Medicine
Harvard School of Dental Medicine
Tufts University School of Dental Medicine
Massachusetts College of Pharmacy and Health Sciences, Forsyth School of Dental Hygiene
Boston Housing Authority
Boston City Commission on Affairs of the Elderly

6. OHEP Enhance dental school curriculum
Provide preventive services to elders living in public housing
Develop network of CHCs, dental schools, private practices for treatment needs
Partner with Social Service Agencies
Train non-dental health providers
Web based tool kit (under development)
Social marketing - Watch Your Mouth
Advocacy

7. Lessons Learned
Service learning/experiential education works in dental education
Triaging and education in community settings increases demand
Case management is vital – partnerships important

8. Lessons Learned
Primary care MDs not ready to connect the mouth with the body
Social marketing is necessary but not sufficient
Advocacy is essential – even when Medicaid covers adult services, preventive component is not adequate for elders