Community Dental Team

Collaborative, competent care and health equity for all


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Integration and coordination of medical and dental health approaches to reach optimal/total health. 

Inter-professional collaboration is a driving force behind state-of-the art health care delivery. (Fried, 2014).  "Restructuring the oral health delivery system to accommodate the medically underserved will require reconfiguration of the "dental team."  To a large extent, increasing access to oral healthcare will depend upon developing inter-professional relations."


When "professional teams work collaboratively, they value one another's perspectives and contributions, they understand and appreciate true teamwork, they communicate effectively, and share an ethical code that is premised on just and high quality care."

Community Dental Team

The Community Dental Team toolbox contains information on utilization and practices pertaining to professionals working as a "Community Dental Team", to include community health workers, collaborative practice dental hygienists, dental therapists and medical/health-care colleagues.



Definition of the 21st Century Dental Team

The 21st Century Dental Team is a partnership between a team of health providers and clients using a collaborative and coordinated approach to shared decision making around health and social issues. Restructure of the traditional oral health care team will result in increased access to oral healthcare, with health equity as the goal. In the future, the formation of an interprofessional team of dental, medical, and other providers will further enhance this goal.

 

(Source: Association of State and Territorial Health Officials (ASTHO)

Team Member Roles in the 21st Century Team

Team Member Role Definitions

The illustration above depicts the inter-relationship of the professions
comprising a 21st century dental team

Dentist
The dentist is the fundamental nucleus of the professional dental team committed to leading and supporting team members toward achievement of a shared goal, which is to provide accessible comprehensive patient - centered care.

Dental Hygienist
The dental hygienist, the team's preventive oral health care specialist, reaches out to serve and empower patients to achieve optimal oral health through preventive, therapeutic and educational services. The dental hygienist practicing collaboratively in alternative settings is committed to eliminating barriers to oral health care.

Advanced Dental Therapist
This mid-level dental team member is unique, with competence in preventive, therapeutic, surgical and restorative dental services and holds a professional commitment to providing much-needed care to underserved populations.

Dental Assistant
The dental assistant being central to dental team success ensures adeptness and efficiency to the team's delivery of quality patient care, whose role and effectiveness helps expand outreach possibilities. 

Community Health Worker/Navigator
The community health worker/navigator is the dental team's trusted and most connected patient advocate effective in ensuring health care needs are met because of their close understanding of the community in which they serve.  

Administrative Staff
Office managers and administrative assistants are the dental team's organizers, budgeters, schedulers, insurance filers, and key communicators whose networking capabilities promote a clinic's ability to extend their community services.

Medical Team
Bridging professional strengths through effective collaboration leads to improved health outcomes. From physician, pharmacist, physician's assistant, nurse practitioner, nurse, nursing assistant, physical and occupational therapist, to patient care coordinator and beyond... linking systemic health to oral health requires well-connected inter-professional care. 

Click HERE for video from the Oral Health Summit II (August 2017 at Normandale Community College) of 'Moving Towards Value-Based Care: Implications for the Oral Health Workforce' presented by Margaret Langelier from the Oral Health Workforce Center (OHWFC).

The Minnesota Model: Advanced Dental Hygiene Practice Timeline

time 2


Click HERE



Collaborative Dental Hygiene Practice Coffee Talks

Coffee Talks video

Coffee Talk #1: State of the Union

Coffee Talk #2: Unravelling the Mysteries

Collaborative Practice Authorization for Dental Hygienists in Community Settings


Dental Hygiene: Collaborative Dental Hygiene Practice in Community Settings

Click HERE to download a comprehensive document that addresses the multiple aspects of Collaborative Dental Hygiene Practice in Community Settings. 
Download a collaborative agreement template (see below for the link).

   

What is collaborative dental hygiene practice?

With mounting interest from dental hygienists seeking to serve populations with limited access to preventive oral health care, state law was passed in 2001 authorizing licensed dental hygienists to provide care in community settings. Schools and older adult residences are two of many settings in which a dental hygienist (with a collaborative agreement) may use their expertise to improve and promote oral health/access to care. The progression and advancement of this model is illustrated in The Minnesota Model: Advanced Dental Hygiene Practice Timeline.

[Dentist-dental hygienist] collaborative practice is different from and greater than [dentist-dental hygienist] collaboration. Collaboration is a single, temporal event that can occur intermittently in the day to day practice of health care. Conversely, [dentist-dental hygienist] collaborative practice is a dynamic process, a commitment to interact on a professional level that empowers the participants to blend their talent, to achieve a goal that neither can do alone. (Thomson, D.J., 1995. Physicians' perceptions of nurse-physician collaborative practice. Florida Atlantic University. MSN Dissertation.) 

Forging Change as a Collaborative Practice Dental Hygienist: Click HERE for video (Whittier Clinic and Hennepin Healthcare Clinic, Minneapolis MN).


2018 Minnesota Statutes 150A.10 Allied Dental Personnel, Subd. 1a Collaborative Practice Authorization for Dental Hygienists in Community Settings

Who is a collaborative practice dental hygienist?

  • A Minnesota licensed dental hygienist who has graduated from either a two or four-year dental hygiene program and entered into a written collaborative agreement with a dentist.
  • In Minnesota, there is no official certification or credentialing required to work in this capacity. A dental hygienist working with a collaborative agreement in community settings does not carry additional credentials.
  • Effective August 2017, no additional hours of practice are required prior to a dental hygienist working in a collaborative practice community setting.
 

So You Want to be a Public Health Dental Hygienist? Working in a School Setting.
Click HERE for video (Massachusetts Department of Public Health).


So You Want to be a Public Health Dental Hygienist? Making a Difference: Serving Seniors
Click HERE for video (Massachusetts Department of Public Health).

What is a collaborative agreement and how do I obtain or develop one? 

Extending preventive and therapeutic dental care to people in need may be accomplished through the use of qualified dental hygienists who have entered a legal "collaborative agreement" with a licensed dentist. This written agreement provides protocols and authorization for services provided by a licensed dental hygienist in settings specified by law and when a dentist is not present on site.  It also includes provisions for a licensed dental assistant to provide some services when working with the dental hygienist under the collaborative agreement.

Any Minnesota dentist may enter into a collaborative agreement with a licensed Minnesota dental hygienist if all stipulations are met under Minnesota Statute 150A.10, and all agree to the terms.


Click HERE to download a collaborative agreement template developed by the Minnesota Dental Association and reviewed by the Minnesota Board of Dentistry. Each collaborative agreement is unique to the community setting in which the practice will take place.  However, the content must align with applicable laws and rules and be based on the agreement between practitioners

Dental Therapist/Advanced Dental Therapist

The Master of Science in Advanced Dental Therapy Program (MSADT) offered by the Minnesota State System is dental hygiene-based, building upon the foundation of baccalaureate dental hygiene education. Using a model that begins with a licensed dental hygienist assures that applicants are prepared with critical thinking and problem solving skills and judgment in collaboration with dentists that are necessary for advanced dental therapy practice.

Dental Therapy:

The following videos were produced by Normandale Community College.  Featured are Minnesota oral health stakeholders who describe their support for the new oral health care team member and address issues commonly raised by dentists and others who are considering inclusion of a dental therapist (DT) or advanced dental therapist (ADT) as part of their practice team.

Benefits of Dual Licensure: Dental Hygiene (DH) and Dental Therapy (DT)VIDEO

Thoughts on Dental Therapy (DT) and Advanced Dental Therapy (ADT)VIDEO

Employing a Dental Therapist (DT) or Advanced Dental Therapist (ADT)VIDEO

Alternative Settings Outside of a Traditional Dental OfficeVIDEO

Collaborative Management Agreements (DT and ADT)VIDEO



Click HERE to view An Advanced Dental Therapist in Long Term Care: Heather Luebben Case Study and video presentation.  Features a dual-licensed advanced dental therapist/dental hygienist's work as part of the care team at the Minnesota Veteran's Home, Minneapolis, MN.

 

Click HERE to view An Advanced Dental Therapist in Rural Minnesota: Jodi Hager Case Study.  Features a dual-licensed advanced dental therapist/dental hygienist's work as part of the care team at Apple Tree Dental's Madelia Center for Dental Health, Madelia Hospital in rural southern Minnesota.



This Dental Therapist is Filling a Gap in U.S. Health Care

Carol Kaufmann
July 28, 2017, TRUST MAGAZINE

This Pew Trust article (Trust magazine, July 2017) features care provided by Jodi Becker, a Minnesota dual-licensed Advanced Dental Therapist/Dental Hygienist.    

http://magazine.pewtrusts.org/en/archive/summer-2017/this-dental-therapist-is-filling-a-gap-in-us-health-care



Click HERE to access Highlights from the Approved Dental Therapy Education Standards from the American Dental Hygienists Association's Commission on Dental Accreditation (CODA). August 2015



Click HERE to access "The Origins of Minnesota's Mid-Level Dental Practitioner:  Alignment of Problem, Political and Policy Streams" published in the ADHA Journal of Dental Hygiene that explores how Minnesota came to legislate a mid-level dental practitioner to its oral health workforce and highlights the roles of issue formation, agenda setting and politics in policymaking.



Click HERE to access "Dental therapy practice patterns in Minnesota: a baseline study" by Blue, C., Kaylor, M.B. 2016




Click HERE to access "The Dental Therapist Movement in the United States: A Critique of Current Trends" published by the Journal of Public Health Dentistry. 



Dental Therapy Toolkit: A Resource for Potential Employers

Developed for the Minnesota Department of Health Office of Rural Health and Primary Care by a partnership between Normandale Community College/ Metropolitan State University, the University of Minnesota School of Dentistry, and MS Strategies. This project is part of a $45 million State Innovation Model (SIM) cooperative agreement, awarded to the Minnesota Departments of Health and Human Services in 2013 by the Centers for Medicare and Medicaid Innovation.



Hiring a Dental Therapist or Advanced Dental Therapist:  Enhancing Your Oral Health Team - Toolkit.

Developed by Normandale Community College/Metropolitan State University and the University of Minnesota School of Dentistry. The project was funded by the Otto Bremer Foundation to inform others about dental therapy and advanced dental therapy.

Community Health Workers/Navigators


Impoverished children and adults, people of color, immigrants and refugees, and many elders lack access to high-quality, affordable and culturally-competent oral care and suffer frequent, serious dental problems. Part of the solution to advancing health equity in Minnesota is integration of Community Health Workers (CHWs) into the oral health care system. 

Click HERE to view the "Success with CHWs: Oral Health Road Map", presented by the Minnesota Community Health Worker Alliance to address these challenges.


A Community Health Worker (CHW) is a frontline public health worker who has a close understanding of community needs and the persons they serve. This relationship enables the CHW to serve as a navigator or liaison between health and social services and the community to facilitate access to services and improve the quality and cultural competency of service delivery.

A CHW builds individual and community capacity through a range of activities such as outreach, community education, informal counseling, social support and advocacy.  Minnesota has six Community Health Worker educational programs.  

Community Health Worker Alliance website

Wellshare International: Minnesota Community Health Worker Peer Network               

Minnesota Department of Health- Community Health Worker (CHW)

Minnesota Department of Health- Community Health Worker Toolkit

Minnesota Department of Human Services- Community Health Worker (CHW)

Community Health Worker Integration: Issues and Options for State Health Departments

Resources Community Dental Team

Network for Public Health Law logo

Issue Brief:


Policy Options to Increase Access to Oral Health Care and Improve Oral Health by Expanding the Oral Health Workforce



ASTHOPHIWINS

Click HERE to access the Association of State and Territorial Health Officials (ASTHO) summary report of workforce data.