WV Volunteer Dentists Develop Community Adult Treatment Program

The Smiles for Life Adult Screening and Referral Program provides a safety net for most needed dental treatment to low income adults in the Mid-Ohio Valley Health Department (MOVHD) Region. Prior to its establishment there was not a public health program addressing adult oral health needs. The program demonstrates a true community partnership.

Smiles for Life developed after the 2009 Mission of Mercy (MOM) project that was held over two days where 1,300 adults were treated and received “most needed” dental treatment. The MOM project demonstrated the lack of dental services in the region and served to raise awareness in the community and among dental professionals. MOVHD Oral Health sought to provide a more frequent, consistent model of care with the support of the local dental community. The MOM project was supported by 138 community organizations. The Smiles for Life Adult Screening and Referral Program, part of the MOVHD Clinical Department, is the only program available in the Mid-Ohio Region that provides oral health services to low-income adults in five of the six MOVHD counties. Minnie Hamilton Health Care System, a Federally Qualified Health Center, in Calhoun County does have a full service dental clinic. Parkersburg, WV has 40 dental providers; only two accept adult Medicaid and they are Oral Surgeons. The providers limit acceptance to straight Adult Medicaid which does not include several HMO’s within the Medicaid system. WV Adult Medicaid covers emergency care and x-rays but does not allow for restorative or preventive treatment.

(1) What -The Smiles for Life Adult Dental Screening and Referral Program, initiative to provide reduced cost dental treatment to low income adults and lower the number of hospital emergency department visits for dental pain and infection. (2) Who - Local Blennerhassett Dental Society and the MOVHD (3) Where - The six county regions serviced by the MOVHD, housed in Wood County, Parkersburg, WV. The MOVHD is the only regional health department in West Virginia and is one of only two health departments in the State serving over 100,000 individuals (133,000, approximately 90,000 of which are adults over 18 years of age). (4) When - The Smiles for Life Adult Screening and Referral Program took two years to develop after the MOM project in 2009. One-on-one meetings were scheduled with area providers to gain their input on how the program would work. Once a plan for the model was developed grants were sought for funding. The passing of General Supervision and the Public Health Practice Permit for Dental Hygienists in 2008 allowed for hygienists to provide screenings and preventive services in the public health setting.

Preliminary data indicates that Smiles for Life contributes to a 14% reduction in Emergency Room visits for dental pain and infection as well as it provides a resolution for the patients’ infection. The local hospital Camden Clark Medical Center and its Emergency Departments have expressed support and appreciation for the Smiles for Life Program and now send referrals. The Smiles for Life Program provides valuable data collection for the adult population in the region. Statistics are kept on all patients screened, placed at dentists, and visits to dentists and dental hygienists. Health conditions and beverage consumption are also tracked. Usual and customary fees in addition to time spent by providers to tally volunteer hours, donation of services and treatment performed are also documented.

The Smiles for Life Program is a successful community model that could be replicated in other areas of the State or nation. It has succeeded due to the participation of the area dental providers and coordination on the part of the MOVHD. The biggest challenge has been funding and now that initial startup funding has been expended the program is working toward sustainability. Oral Health is not considered one of the ten essential Public Health services and does not currently receive any funding from WV State Government to support the Smiles for Life Program. WV Adult Medicaid covers emergency care and few providers accept it. Over the last four years of existence the program has been primarily grant funded. MOVHD will always be somewhat dependent on grants due to the low income patients being served. Recent positive changes have been instituted to increase sustainability, such as better utilizing Medicaid billing; changes in the patient fee structure; requiring pre-payment; charging a flat fee for service based on Federal Poverty Level Guidelines sliding scale; accessing West Virginia University School of Dentistry student help while on rotations; and use of AmeriCorps volunteers.