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ADA CDHC program instrumental in success of Arizona nonprofit

March 05, 2018

By Michelle Manchir

Community leaders
Community leaders: MiQuel McRae, left, a dental hygienist, launched a nonprofit that provides underserved children with dental hygiene services in Arizona following her graduation from the ADA-developed Community Dental Health Coordinator program. She sits with Jenna Linden, right, a hygienist and CDHC program graduate who works in Wisconsin as a clinical director at a nonprofit. The pair were part of a presentation in February during the Chicago Dental Society’s Midwinter Meeting.
Pima, Ariz. — In a crowded workshop during the Arizona Dental Hygiene Convention in 2015, MiQuel McRae couldn’t help but feel isolated when the group leader went over some facts.

Greenlee County — the sparsely populated Arizona county near where she lives  — had some of the poorest dental statistics in the state, according to the data.

“Sitting there in that beautiful convention center in the middle of urbanized Phoenix, I thought to myself, I am probably the only person in this room who even knows where that county is,” said Ms. McRae, an affiliated practice dental hygienist and Community Dental Health Coordinator.

Fast forward three years, and Ms. McRae is the director of a growing nonprofit that provides no cost dental care to elementary school students Greenlee County, which sits on the state’s southwest border and is home to about 9,000 people. Her nonprofit, Tooth B.U.D.D.S. (Bringing Understanding of Dental Disease to Schools) also serves neighboring Graham County. Both counties are federally designated health professional shortage areas.

Thankfully, Ms. McRae found a bit of hope at the same convention where she heard the grim statistics. It was there that she learned about the ADA’s Community Dental Health Coordinator program available at Rio Salado Community College in Tempe, Arizona.

“That was my answer,” she said. “I knew it would be just the ticket I needed for making a difference in my community.”

The Community Dental Health Coordinator program is an ADA-developed and trademarked curriculum that emphasizes community-based prevention, care coordination and patient navigation to connect underserved patients with a dental home. Community Dental Health Coordinators are often, though not always, dental assistants or hygienists who earn the CDHC certification at higher education institutions to work within a state dental practice act at a dental office.

Currently, 17 higher education institutions throughout the country offer the program or are preparing to offer it, often with the option of completing it online.

Map of CDHC program locations
The program, which takes about a year to complete and includes an internship or community demonstration project, aims to help bring dental care to patients in rural, urban and Native American communities an ambassador in the dental office who will help them arrange and keep appointments and understand the care they need.

Ms. McRae, who lives in Pima, Arizona, in Graham County, said she applied for the program shortly after the 2015 hygienist convention. The blueprint for Tooth B.U.D.D.S. was conceived as her final project for the certification.

She would not have had the confidence to move forward with the nonprofit without CDHC training, she said.

“The CDHC program taught me the language of the public health world and now I speak it confidently,” she said.

Tooth B.U.D.D.S. officially launched in mid-2017 when she visited Boys and Girls Club of the Gila Valley in Graham County, offering cleanings and oral health education to seven children whose guardians returned a consent form. She’d anticipated seeing more than 100 kids for the event.

“It was not a huge success, to be honest,” she said.

However, since that day, she has registered Tooth B.U.D.D.S. as a 501(c)(3) nonprofit and received tens of thousands of dollars in grants from the local United Way, the Arizona Community Foundation and other local community health programs.

She also changed her approach for getting consent forms returned and since mid-2017 has served more than 450 elementary school students with hygiene services in Greenlee and Graham counties.  

To cover more ground, Ms. McRae has recruited other hygienists who volunteer their time to assist with cleanings, oral health education and, because of the grant money, silver diamine fluoride and other preventive treatments performed within the state dental practice act.

Through the program, Ms. McRae also regularly  utilizes teledentistry technology to communicate with a local dentist, sending the X-rays of some of the students for review and referral for definitive treatment to establish a dental home.

“Teledentistry allows a hygienist like myself to go into schools, take digital X-rays and immediately send them to the dentist for review. It allows hygienists to get out into the communities and receive immediate feedback from dentists, opening up rural communities to better oral health care through the use of technology,” Ms. McRae said about her work in an interview with a local newspaper, the Eastern Arizona Courier.

The ADA and state dental societies are working with state governments and higher education institutions to create new CDHC programs throughout the country. Because of her success, Ms. McRae has visited some schools on behalf of the ADA to talk about the program and she led a webinar at the request of the American Student Dental Association.

Jonathan Vogel, a dental student at the University of Texas School of Dentistry at Houston who expects to graduate this May, said he met Ms. McRae when she spoke at an advocacy symposium he organized at the University of Texas. He said he was “awed by her success.”

“MiQuel’s work illustrates the innovative roles that CDHCs can play as a member of the allied dental team, particularly as it pertains to addressing community specific needs,” said Mr. Vogel, who is the American Student Dental Association liaison to the ADA Council on Advocacy for Access and Prevention. “The program equipped her with the knowledge and tools to recognize disparities within her community, and identify opportunities to address them. Tooth B.U.D.D.S. and the resulting increase in oral health within her community is a true testament to the success of this program.”

Ms. McRae said she hopes to expand her nonprofit to surrounding counties to reach more students.

“I’ve never loved my job more than I do now,” she said.

To find out more about the CDHC program, visit For more information about Tooth B.U.D.D.S., send an email to