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