Quality oral health care is especially important for young children, not only because tooth decay is the most common chronic health problem among California’s children, but because tooth decay is the number one reason children are absent from kindergarten.1
In March 2017, Sonoma County Department of Health Services Dental Health Program was selected as one of 15 FY 2017 grantees for the California Department of Health Care Services’ Dental Transformation Initiative (DTI) Domain 4: Local Dental Pilot Projects (LDPPs) program. The grant will fund efforts to treat and prevent cavities in Sonoma County’s youngest Medi Cal-enrolled children over a four-year period.
Through the County’s pilot program, Cavity-Free Sonoma, the County Department of Health Services’ Dental Health Program (DHP) will work in collaboration with the Sonoma County Dental Health Network and other partners to make progress towards the network’s overarching goal that 75% of local five year olds are cavity-free by 2020.2 Specifically, the pilot is oriented to achieve the Centers for Medicare and Medicaid Services (CMS) “Triple Aim” in dental health for Medi-Cal eligible children age 6 and under in Sonoma County:
- Improved dental health among Medi-Cal eligible children
- Medi-Cal Dental Program cost-savings
- Improved patient experience of dental care
The DHP and its partners will achieve these outcomes through three primary activities:
- Implementation of a standardized caries risk assessment (assessment for cavities);
- Outreach and service-provision by a cadre of Community Dental Health Workers; and
- Use of a mobile application that reinforced improved dental health habits and supports consistent dental health care.
Adopting a standardized caries risk assessment will ensure that children are screened for dental decay (caries) through appropriate and frequent treatment that is standardized no matter where across the county the child receives care. This will help caregivers identify dental disease early to treat preventatively and manage decay when it occurs.
During the first year of the grant, DHP will hire and train a cadre of Community Dental Health Workers to perform the caries risk assessment, provide culturally competent care management, increase clinic capacity, and ensure that care is coordinated and consistent. The Community Dental Health Workers will be stationed at partner clinics to work directly with families and children accessing care at those locations. Recruiting Dental Health Workers from the community will ensure that children and families receive the culturally competent support they need to build skills and knowledge related to oral health and dental disease prevention.
Finally, coordinating care and increasing families’ access to information will be supported through the development and use of the Sonoma Smile mobile application. The mobile app will serve as a family’s personal dental record, and is a low-cost tool for caregivers and patients to improve oral health literacy, dental decay prevention, and disease management. For example, the app will provide dental appointment reminders and have a function for parents to track the frequency of their child’s tooth brushing. At the same time, the app will enable Community Dental Health Workers and other care providers to more efficiently access care records and treatment plan information. In addition, the app will remain in the public domain and has the potential to be scaled across the United States.
These three strategies – a standardized caries risk assessment, Community Dental Health Workers, and a mobile app – work together to improve access to and delivery of preventative oral health care. This will result in significantly less dental decay among low-income children in Sonoma County, improving their oral health while decreasing oral health costs for county providers.
More information about the DTI Domain 4 Local Dental Pilot Projects, including a list of selected projects, is available at http://www.dhcs.ca.gov/provgovpart/Pages/DTIDomain4.aspx.
1. First 5 Association of California.↩
2. See Sonoma County Dental Health Network Strategic Plan 2017-2020 for more information on the network.↩