Oregon dental leader calls for new thinking to improve oral health

By the CDHP team

Mike Shirtcliff is a dentist who is the CEO of Advantage Dental Plan, which provides dental coverage to 195,000 Oregon Health Plan members in 35 counties. In the coming months, millions of additional children are expected to secure dental coverage through the Affordable Care Act. Although this is good news, many challenges remain. CDHP recently interviewed Shirtcliff about the challenges he sees in his state or Oregon.  This is Part II of that interview:

What is your practice doing to reach people who might otherwise not be aware of the importance of oral health?

We have hired social workers and others to conduct outreach in various counties in Oregon such as Douglas County. We look for people who are part of these communities. These social workers have the cultural competence to connect with people and start to change their attitudes about oral health.

Our ultimate goal is to have someone in every county — either a social worker or a dental hygienist — who is able to engage ordinary people and educate them about oral health.

This problem isn’t going to be solved at the dental office. It needs to be addressed in a much broader way. We need to get to parents and families long before that first dental visit. Nutrition and other factors have to be discussed. If we did a good job of this, we can move to the day when tooth decay is quite rare.

What about assessing the quality of dental care?

Yes, we need to move away from a fee-based system that incentivizes procedures without taking quality into account. Other approaches can incentivize too little care. We need to find the right balance. We would be better off if we had outcome measures in dentistry that assess the need and the quality.

An example is to think of a cavity and subsequent fillings as a failed outcome rather than a success. A successful outcome would be children without a cavity. The fewer cavities, the better the outcome. 

NOTE: The 1st part of this interview was posted on Monday, November 25.

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$38 }
Communities save $38 for every $1 spent to fluoridate public drinking water.
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