As a community oral health transformation provider, my journey has been deeply rewarding and filled with challenges and triumphs. The evolution of the Mecklenburg County Dental Clinic from a traditional care model to a value-based, integrated care approach has not only impacted our patients’ health outcomes but also reshaped the way we deliver dental care in our community.
The Shift to Value-based Care
When I began this journey, the clinic was already undergoing a transformation toward more value-based care. This approach focuses on providing comprehensive care by assessing and addressing various factors that influence a patient’s overall health, not just their oral health.1 We implemented caries risk assessments, began checking patient vitals to identify primary care needs, and started screening for social determinants of health such as food insecurity. These changes allowed us to provide referrals to primary care providers and connect patients with necessary social services.
One of the key programs that facilitated this shift was the Community Oral Health Transformation (COrHT) Initiative. A prevention-centric strategy that will improve patient outcomes, experience, and cost-efficiency was the main goal of the COrHT Initiative. Through our participation in COrHT we were able to secure additional community partners to whom we could refer patients needing specialized care. For instance, our clinic does not offer nitrous oxide for sedation, so we collaborate with other pediatric providers who can offer this service. These partnerships have been instrumental in expanding the scope of care we can offer, ensuring that our patients receive the best possible treatment, even if it means referring them to another provider.
Recruitment and Workforce Impact
An unexpected but significant outcome of our participation in COrHT was its impact on our ability to recruit new providers. Despite the ongoing workforce crisis in the dental field, the integrated, minimally invasive care approach we adopted through COrHT attracted dentists and dental hygienists from across the country. As a result, our team grew from just one-and-a-half dentists to four in the span of a year. This growth has been crucial in expanding our clinic’s capacity and improving the care we provide to our community.
Expanding Services to Meet Community Needs
One of the most exciting developments in our clinic’s transformation has been the expansion of our services to include adult dental care. Last year, we completed a feasibility study to determine the best way to scale our services to meet the needs of the entire county. With the support of COrHT and the CareQuest Institute of Oral Health, a nonprofit championing a more equitable future where every person can reach their full potential through excellent health, we gathered data and metrics that demonstrated the necessity and feasibility of this expansion to county leaders. This data-driven approach allowed us to build consensus among decision-makers and secure the resources needed to launch a mobile dental program that will serve both children and adults in our community.
The mobile clinic represents a significant step forward in making dental care more accessible and affordable. We plan to start by visiting schools, and when they are not in session, we will bring the clinic to community resource centers, engagement events, and health and wellness fairs. The mobile unit will also enable us to tackle the challenge of providing emergency care through teledentistry, ensuring that patients who cannot visit the clinic in person still receive the care they need.
The Importance of Community Engagement
Throughout this transformation, one of the most valuable lessons I’ve learned is the importance of community engagement. Participating in and engaging with the learning community that COrHT facilitated has been a tremendous support and resource. Meetings involving key players from different safety-net clinics in North Carolina allowed us to share our experiences, learn from others, and celebrate our wins and challenges. This collaborative approach has not only strengthened our clinic but has also fostered a sense of shared purpose and dedication to improving oral health outcomes across the board.
Oral Health Statistics and the Need for Change
The importance of these transformations is underscored by oral health statistics in the United States. According to the Centers for Disease Control and Prevention (CDC), nearly half of all adults aged 30 and older show signs of gum disease, and over 40% of adults report experiencing mouth pain in the last year.2 Additionally, children from low-income families are twice as likely to have untreated cavities as children from higher-income families.3 These disparities highlight the urgent need for accessible and comprehensive dental care, particularly in underserved communities.
Through our work at the clinic, we have seen firsthand the impact that value-based, integrated care can have on reducing these disparities. By addressing the social determinants of health discussed in clinical appointments by following up with case management support and collaborating with community partners, we are not only improving our patients’ oral health but also contributing to their overall well-being.
Looking Ahead
As we continue to expand our services and embrace new technologies like teledentistry, I am excited about the future of community oral health. The progress we have made would not have been possible without the support of COrHT and our community partners. Together, we are transforming oral health care into a more inclusive, accessible, and integrated system that truly meets the needs of our community.
This journey has been challenging, but it has also been incredibly fulfilling. Seeing the positive impact on our patients and knowing that we are making a difference in their lives motivates me to keep pushing forward. I am grateful for the opportunity to be part of this transformation and look forward to continuing this important work in the years to come.
Disclosure of interests
No interests were disclosed.