Solutions: About CDHCs
Tens of millions of Americans lack adequate access to dental care. Many of them suffer with untreated disease, and many more are at risk of disease, often because they don’t have access to preventative dental health care and education. Trouble finding a dentist often has more to do with other community factors such as poverty, geography, language and cultural barriers, availability of childcare or transportation, rather than lack of dentists able to treat patients.
In response to this lack of access to available dentists, the American Dental Association launched the Community Dental Health Coordinator (CDHC) program in 2006 to provide community-based prevention, care coordination, and patient navigation to connect people who typically do not receive care from a dentist in underserved rural, urban and Native American communities. Bringing more people into the oral health system, CDHCs are currently working in 40 states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin. More than 150 students are currently in training, and educational programs to become a CDHC are available in all 50 states.
The ADA and state dental societies are working with state governments, the higher education community and the charitable and private sectors to create new CDHC programs. We believe that training CDHCs in greater numbers could dramatically improve oral health among people whose circumstances place them at greatest risk for untreated disease.
In 2004 the ADA set up a task force to determine how to best meet the needs of dentally underserved rural, urban and American Indian settings communities.
Two years later, the ADA established the Community Dental Health Coordinator Pilot Program as one component in the effort to break through the barriers that prevent people from receiving regular dental care and enjoying optimal oral health.
The ADA invested more than $7 million in the CDHC pilot program. In 2010, that funding was bolstered by Henry Schein Cares, the charitable arm of Henry Schein, Inc., which agreed to donate approximately $860,000 in equipment to support CDHC students' education and training.
In October 2010, the first class of 10 CDHC students completed training and began working in tribal clinics, urban and rural Federally Qualified Health Centers, Indian Health Service Facilities and other settings. The eight students in the second CDHC class completed their training in fall 2011, followed by 16 students who graduated the following year.
The ADA is currently providing technical assistance to 17 educational institutions with 137 graduates in over 30 states by the end of 2017. This number should more than double within a year.
Connected to the Community
CDHCs are typically recruited from the same types of communities in which they will serve, often the actual communities in which they grew up. This all but eliminates cultural, language and other barriers that might otherwise reduce their effectiveness. Their connections to the communities help establish trust and make them role models.
By focusing on oral health education and disease prevention, the CDHC can empower people in underserved communities to manage their own oral health. When disease requires treatment, the CDHC can link patients with dentists who can provide that treatment, and can help obtain other services—such as child care or transportation—that patients may need in order to receive care.
What Community Dental Health Coordinators Are Saying
"It's rewarding at the end of each day to know I guided someone and provided hope. Guiding someone to access to care is the first thing people need to start their journey to better health". - Angela Black, 2011 CDHC graduate, University of Oklahoma-College of Dentistry
"I think the CDHC has the potential to make a real impact on so many patients' lives as a critical addition to the dental care team". - Calvin Hoops, 2011 CDHC graduate, Temple University
"I am working to improve my people's oral health". - Teresa Molina, 2012 CDHC graduate, ASDOH
Flexibility in Meeting the Needs of the Underserved
While all CDHCs have basic core competencies, their job responsibilities vary depending on the goals of the clinics and communities they serve, including:
- Increasing awareness of the importance of oral health and how to become and stay healthy, through community outreach
- Improving health outcomes by bringing at-risk patients, such as people with diabetes and the elderly, to their clinics
- Providing preventive services, such as fluoride treatments and sealants, with dentists and dental team members performing restorative and other more complex procedures as appropriate
- Improving access to care by providing assistance with establishing dental homes for people in the community
The CDHC model has been adapted to numerous community settings, including clinics, schools, HeadStart centers, institutional settings, churches, social service agencies and others.
With the educational phase of the pilot program completed, the ADA conducted a comprehensive evaluation of both the individual CDHCs' effectiveness and the degree to which they are helping increase access to dental care in their communities. Results from that evaluation are meeting and exceeding expectations. As part of the Action for Dental Health: Dentists Making a Difference Campaign, the ADA now is working to engage leaders in education and public health, as well as the private practice community in bringing CDHCs to dentally underserved communities nationwide.
"In today's changing U.S. Health care environment, community health centers will play a critical role in providing education and preventive care and in expanding access to dental and medical care for more patients. Our support of the ADA's Community Dental Health Coordinator program is an important new chapter in Henry Schein's long-term relationship with the ADA to increase access to oral health care for underserved communities across the United States". - Stanley M. Berman, Chairman and CEO of Henry Schein Inc.