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Developing an Access to Care Project – Complete Dentures for Uninsured Washtenaw County Patients
John M. Le BS and Bonita Neighbors DDS
Community Dental Center, Ann Arbor MI
University of Michigan School of Dentistry, Ann Arbor, MI
1. Patients	
  will	
  be	
  provided	
  dental	
  care	
  as	
  well	
  as	
  
follow-­‐up	
  care	
  at	
  the	
  Community	
  Dental	
  Center	
  in	
  
Ann	
  Arbor
2. Educational	
  and	
  Clinical	
  experience	
  achieved	
  for	
  
University	
  of	
  Michigan	
  School	
  of	
  Dentistry	
  Faculty	
  
and	
  Student	
  Volunteers
3. Improved	
  patient	
  quality	
  of	
  life	
  based	
  on	
  improved	
  
oral	
  functions	
  such	
  as	
  speech,	
  mastication,	
  comfort,	
  
self-­‐image,	
  and	
  social	
  interaction	
  [14,	
  15]
4. Long	
  life	
  expectancy	
  based	
  on	
  ability	
  to	
  eat	
  foods	
  
higher	
  in	
  fiber,	
  which	
  require	
  teeth	
  to	
  break	
  down.	
  
5. Improve	
  body	
  mass	
  index	
  in	
  previous	
  non-­‐denture	
  
wearers	
  [16]
6. Projected	
  decrease	
  in	
  progression	
  of	
  chronic	
  
illnesses	
  due	
  to	
  improved	
  diet	
  with	
  oral	
  function	
  [17]
7. Increase	
  oral	
  health	
  awareness	
  in	
  patients	
  will	
  help	
  
decrease	
  future	
  healthcare	
  costs	
  [18]
8. Stronger	
  partnership	
  between	
  School	
  of	
  Dentistry	
  
and	
  Participating	
  Dental	
  Laboratory
Evaluation: Improvement in quality of oral health and
function as well as patient satisfaction will be evaluated
by a survey given prior to and after treatment is
provided. In addition, patient oral and medical health
will be evaluated at periodic examinations.
The Journal of Prosthetic Dentistry estimated the need for
complete dentures in the United States will increase from
54 million in 1991 to 61 million by 2020 [1]. Even though
the rate of edentulism has decreased, the exponential
growth of the aging US population will bring with it a larger
number of edentulous patients [2]. Additionally, longer life
spans due to modern healthcare and the aging baby
boomers will double the number of Americans over the age
of 65 within the next 25 years. Therefore, approximately 71
million older adults, who will account for 20% of the US
population, may need complete dentures in 2030 [3].
It has been established that the oral health of an individual
is related to overall systemic health. Poor oral health has
been associated with increased risks for diabetes,
cardiovascular disease, and low birth weights in infants [4].
Additionally, completely edentulous people are at a higher
risk for poor nutrition, coronary artery disease, diabetes,
arthritis, and chronic residual ridge resorption [5]. The
primary concern is that although the importance of oral
health is starting to emerge, dental care remains uncovered
to individuals with the Original Medicare Plan and/or do
not qualify for Medicaid [6,7]. Additionally, in low-­‐income
populations, the eligibility for Medicaid has expanded with
the Affordable Care Act, but the acceptance of this
coverage has decreased in the existing number of available
dental providers due to low reimbursement rates [8].
Fortunately, there are currently four clinics in the county
that provide routine dental care to children and adults at a
low or no cost. These include Hope Dental Clinic,
Washtenaw Children’s Dental Clinic, University of Michigan
School of Dentistry and the Community Dental Center.
Although these public health dental clinics continually
provide high quality and affordable care to Washtenaw
County residents, there is still a large need for these types
of clinics and services for the existing underserved
communities as well as the projected 13% increase in
residents aged 65 or older by 2035 [13].
Objective: To screen, treat and provide complete dentures
to selection of fully edentulous patients with the highest
need in Washtenaw County. Faculty and student volunteers
from UMSoD will treat the patients at the Community
Dental Center (CDC) in Ann Arbor. Follow-­‐up care and
establishment of a dental home will take place at the CDC
for these patients in order to evaluate the improvement in
patient quality of life.
This service project was developed by the dental
student as a Capstone Project for the Scholars Program
in Dental Leadership at the UMSoD. The purpose of the
project is to identify a need for a specific dental service
for a subpopulation of patients in Washtenaw County.
Once identified, the services rendered will be
accomplished with the support from grant funding,
dental laboratory partnership, and dentist and dental
student volunteers. The projected outcomes of this
project is to provide an improved quality of life to the
patients, teaching experience for the faculty/dentist
volunteers, and clinical experience for the dental
students. In conclusion, we hope that this project will
help encourage additional dental students to be involved
in community outreach projects and services throughout
their dental careers.
We would like to give a special thanks the Michigan
Dental Association Foundation and Delta Dental
Foundation forthe grants supporting our project.
BACKGROUND Current	
  Situation Expected	
  Outcomes
Summary
Acknowledgements: Nancy Maier – Chief Development Officer MDAF, Ruth Kraut – Washtenaw Health Plan Program Administrator, Scott Ward – Ward Dental Laboratory, Stephen Stefanac – Associate Dean for Patient Services (UMSoD)
Washtenaw County Census Data 2010
Source: 60+ Survey of Washtenaw County 2014 administered by students from the
U of M School of Social Work.
Washtenaw Health Improvement Plan Survey 2010
Target group Target group
Patient
Selection
Funding
MDA Foundation
Delta Dental
Foundation
Partners
Ward Dental
Laboratory
Key Players
Staff, dentists, and
dental student
volunteers
Facility
CDC
Projected Outcome by the end of 2016

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MDA Table Clinics 2016_Denture Project

  • 1. Developing an Access to Care Project – Complete Dentures for Uninsured Washtenaw County Patients John M. Le BS and Bonita Neighbors DDS Community Dental Center, Ann Arbor MI University of Michigan School of Dentistry, Ann Arbor, MI 1. Patients  will  be  provided  dental  care  as  well  as   follow-­‐up  care  at  the  Community  Dental  Center  in   Ann  Arbor 2. Educational  and  Clinical  experience  achieved  for   University  of  Michigan  School  of  Dentistry  Faculty   and  Student  Volunteers 3. Improved  patient  quality  of  life  based  on  improved   oral  functions  such  as  speech,  mastication,  comfort,   self-­‐image,  and  social  interaction  [14,  15] 4. Long  life  expectancy  based  on  ability  to  eat  foods   higher  in  fiber,  which  require  teeth  to  break  down.   5. Improve  body  mass  index  in  previous  non-­‐denture   wearers  [16] 6. Projected  decrease  in  progression  of  chronic   illnesses  due  to  improved  diet  with  oral  function  [17] 7. Increase  oral  health  awareness  in  patients  will  help   decrease  future  healthcare  costs  [18] 8. Stronger  partnership  between  School  of  Dentistry   and  Participating  Dental  Laboratory Evaluation: Improvement in quality of oral health and function as well as patient satisfaction will be evaluated by a survey given prior to and after treatment is provided. In addition, patient oral and medical health will be evaluated at periodic examinations. The Journal of Prosthetic Dentistry estimated the need for complete dentures in the United States will increase from 54 million in 1991 to 61 million by 2020 [1]. Even though the rate of edentulism has decreased, the exponential growth of the aging US population will bring with it a larger number of edentulous patients [2]. Additionally, longer life spans due to modern healthcare and the aging baby boomers will double the number of Americans over the age of 65 within the next 25 years. Therefore, approximately 71 million older adults, who will account for 20% of the US population, may need complete dentures in 2030 [3]. It has been established that the oral health of an individual is related to overall systemic health. Poor oral health has been associated with increased risks for diabetes, cardiovascular disease, and low birth weights in infants [4]. Additionally, completely edentulous people are at a higher risk for poor nutrition, coronary artery disease, diabetes, arthritis, and chronic residual ridge resorption [5]. The primary concern is that although the importance of oral health is starting to emerge, dental care remains uncovered to individuals with the Original Medicare Plan and/or do not qualify for Medicaid [6,7]. Additionally, in low-­‐income populations, the eligibility for Medicaid has expanded with the Affordable Care Act, but the acceptance of this coverage has decreased in the existing number of available dental providers due to low reimbursement rates [8]. Fortunately, there are currently four clinics in the county that provide routine dental care to children and adults at a low or no cost. These include Hope Dental Clinic, Washtenaw Children’s Dental Clinic, University of Michigan School of Dentistry and the Community Dental Center. Although these public health dental clinics continually provide high quality and affordable care to Washtenaw County residents, there is still a large need for these types of clinics and services for the existing underserved communities as well as the projected 13% increase in residents aged 65 or older by 2035 [13]. Objective: To screen, treat and provide complete dentures to selection of fully edentulous patients with the highest need in Washtenaw County. Faculty and student volunteers from UMSoD will treat the patients at the Community Dental Center (CDC) in Ann Arbor. Follow-­‐up care and establishment of a dental home will take place at the CDC for these patients in order to evaluate the improvement in patient quality of life. This service project was developed by the dental student as a Capstone Project for the Scholars Program in Dental Leadership at the UMSoD. The purpose of the project is to identify a need for a specific dental service for a subpopulation of patients in Washtenaw County. Once identified, the services rendered will be accomplished with the support from grant funding, dental laboratory partnership, and dentist and dental student volunteers. The projected outcomes of this project is to provide an improved quality of life to the patients, teaching experience for the faculty/dentist volunteers, and clinical experience for the dental students. In conclusion, we hope that this project will help encourage additional dental students to be involved in community outreach projects and services throughout their dental careers. We would like to give a special thanks the Michigan Dental Association Foundation and Delta Dental Foundation forthe grants supporting our project. BACKGROUND Current  Situation Expected  Outcomes Summary Acknowledgements: Nancy Maier – Chief Development Officer MDAF, Ruth Kraut – Washtenaw Health Plan Program Administrator, Scott Ward – Ward Dental Laboratory, Stephen Stefanac – Associate Dean for Patient Services (UMSoD) Washtenaw County Census Data 2010 Source: 60+ Survey of Washtenaw County 2014 administered by students from the U of M School of Social Work. Washtenaw Health Improvement Plan Survey 2010 Target group Target group Patient Selection Funding MDA Foundation Delta Dental Foundation Partners Ward Dental Laboratory Key Players Staff, dentists, and dental student volunteers Facility CDC Projected Outcome by the end of 2016