2018 Florida Mission of Mercy

By DentalPC

What happens when you need a dental cleaning, you’re experiencing tooth pain or worse? Most of our readers own dental practices or they are staff members who assist in a dental practice, which should make the entire process of going to the dentist very simple.

For most people who do not work in the world of dentistry, typically you’ll make a dental appointment and see your dentist as soon as possible, but what if it wasn’t that simple for others? Thankfully, DentalPC partners with life-changing foundations like the Florida Dental Association Foundation’s Florida Mission of Mercy (FLA-MOM) to help make this process a little easier for some of our Floridians.

What is the FLA-MOM?

The FLA-MOM is a two-day clinic which provides free dental care to the under-served and under-insured in Florida – those that would otherwise go without dental care. The FLA-MOM is a first-come, first-served event with a goal of treating 2,000 patients in two days. Every year, the FLA-MOM event is held in a different location throughout the state.

Services provided include cleanings, fillings, extractions, pediatric dentistry and limited root canal therapy.

How is DentalPC Involved?

DentalPC had the honor of sponsoring the FLA-MOM as the Presenting Benefactor for the fourth consecutive year. Clay Archer (CEO) and his team of knowledgeable technicians traveled to Fort Myers for this years big event. It was a busy couple of days in Fort Myers at the Lee Civic Center last weekend! The FLA-MOM provided 11,899 procedures to 1,906 patients with a value of more than $1.7 million!

 

Take a Walk Down Memory Lane With Us:

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Behind the Scenes: Jacob and David working hard to get all of the workstations set up!
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Day 2 in full effect … 200 veterans are about to walk in for their pre-screening.
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Veterans pre-screened, meetings done, we are locked and loaded to start seeing 2,000 patients and provide high quality dental care to those in need. It all starts bright and early at 5 a.m. and won’t stop until a little after noon on Saturday!
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Our CTO, Marty Cortines and Project Lead, Jacob!
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Of course, we have a little fun along the way! Thanks for all your hard work, Clay (CEO)!
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#DPCteam
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Last day, patients coming in.
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And just like that, it ends … 1900 patients in 2 days.

Thank you to all the volunteers who selflessly dedicated their time and skills to the 2018 FLA-MOM! We could not have done this without your help and support!

We’ll see you in Orlando for the next FLA-MOM on March 22-23, 2019.

Reprinted with permission. This article first appeared on DentalPC’s blog and can be found at http://www.dentalpc.com/2018/03/2018-florida-mission-of-mercy/.

The Smile was Free, But the Hug was Priceless

By Dr. Paul Palo

As I stood with a badly aching back and feet that felt as if they had been beaten from continuously standing for 12 hours two days straight on a concrete floor, a woman appeared and briskly walked toward me. Her look was determined and a little concerned.

First, let me explain my location: I was at the Lee County Civic Center Arena. This is where I’ve just spent three days volunteering for the Florida Dental Association Foundation’s (FDA Foundation) fourth annual Florida Mission of Mercy (FLA-MOM) dental clinic. Last weekend, me and my fellow dentists, hygienists, assistants, laboratory technicians and lay volunteers provided nearly 2,000 patients with more than $1.7 million worth of dentistry at no charge to them. Hard work? You bet it is. But worth every ache and blister.

So, back to the distressed woman who approached me. I was the lead volunteer in charge of overseeing dental triage, so I was frequently singled out by many people with questions and concerns. This young woman certainly looked concerned. She introduced herself as an advocate for a group of people staying in a drug addiction treatment facility in Naples. Dr. Leo Cullinan had arranged to bus them over to our event to take advantage of the treatment we were providing. She explained that one of her charges, a 24-year-old young woman, had come in the day before with many painful, bad teeth. It was determined that her remaining teeth were so badly decayed, none could be saved. She was taken to oral surgery where a skilled surgeon removed her remaining teeth. The caregiver’s reason for concern was because she could sense the despair in this young woman’s eyes at now not having any teeth to present herself with for future employment. I calmly explained that our clinic had no provisions to make immediate dentures, but she was not deterred. So, at this point, I brought in Dr. Cullinan to see if there were any available resources in Naples to help this young woman out. And that’s where I left her — in Dr. Cullinan’s capable hands. I moved on to other problems that needed to be solved and completely forgot about the situation.

Fast-forward 24 hours to Saturday afternoon, when I was helping break down the clinical equipment and box it up to transport out when again, who do I see but the advocate bounding straight for me — this time with a huge smile on her face.  She thanked me profusely for helping the young woman the day before, and told me that due to Dr. Cullinan’s persistence, she was fitted for a same-day denture courtesy of Dr. Reza Iranmanesh, our wonderful lead prosthodontist. “This will change her life!” she proudly exclaimed as my eyes began to mist over. She then embraced me in a wonderful heartfelt hug of thanks —  more payment than I ever expected, but so gladly accepted.

If you’re looking to help change the lives of so many in need as well as receive much more payment than you would ever get in a typical week at the office, I urge you to join us in Orlando in March 2019 for the FDA Foundation’s next FLA-MOM. It will change your life, too.

 

Dr. Palo is a member of the FDA Board of Trustees and an alternate to the American Dental Association 17th District Delegation. He is a general dentist in Winter Haven, Fla. and can be reached at ppalo@bot.floridadental.org.

 

Mid-level Providers: Why Membership in the ADA Matters

By Cesar R. Sabates, DDS, FACD, FPFA, FICD

“Access to dental care” has been a growing concern for many years. Foundations and many other individuals have frequently used the same catchphrase to propose a new provider be introduced within the dental team to meet the challenge. “Mid-level providers” (aka “dental therapists”) are being touted as the solution to this nation’s access-to-care problem. The W. K. Kellogg Foundation has committed millions of dollars to advocate and promote this “solution.”

The American Dental Association (ADA) remains steadfast in opposition to the mid-level provider. ADA Policy on the Mid-Level Provider (Trans. 2008:439) states: “Resolved, that the ADA’s position on any proposed new member of the dental team shall be an individual supervised by a dentist and be based upon a determination of need, sufficient education and training and of scope of practice that ensures the protection of the public’s oral health.”

Many who advocate for mid-level providers use the argument that “there is a shortage of dentists.” A recent report by the ADA Health Policy Institute demonstrates that the number of dentists practicing per 100,000 people today has climbed more than 4 percent from 2003 to 2013, is projected to increase by 1.5 percent from 2013 to 2018 and 2.6 percent by 2033.

However, such arguments are simply not valid. Consider an article from the ADA Health Policy Resource Center, written by authors Thomas Wall, MBA, Kamyar Nasseh, PhD and Marko Vujicic, PhD, “U.S. Dental Spending Remains Flat Through 2012.” The article contains invaluable results of extensive research and is extremely effective in countering such inaccurate claims made by others. The highly acclaimed ADA Resource Center, in doing expansive research and sharing of such important information, is yet another membership value and benefit of belonging to organized dentistry.

In spite of the ADA’s opposition to the mid-level provider, the Commission on Dental Accreditation (CODA), an independent entity recognized by the U.S. Department of Education as the national accrediting agency for dental, allied dental and advanced educational programs, adopted standards by which programs that educate mid-level providers can apply for accreditation.

To give you an idea of what the scope of practice of a mid-level “dental therapist” would be, I ask you to read the following, taken directly from a document entitled, “CODA Accreditation Standards for Dental Therapy Educational Programs.”

At a minimum, graduates must be competent in providing oral health care within the scope of dental therapy practice with supervision as defined by the state practice acts, including:

a. identification of oral and systemic conditions requiring evaluation and/or treatment by dentists, physicians or other health care providers, and managing  referrals
b. comprehensive charting of the oral cavity
c. oral health instruction and disease prevention education, including nutritional counseling and dietary analysis
d. exposing radiographic images
e. dental prophylaxis including sub-gingival scaling and/or polishing procedures
f. dispensing and administering via the oral and/or topical route non-narcotic analgesics, anti-inflammatory and antibiotic medications as prescribed by a licensed health care provider
g. applying topical preventive or prophylactic agents (i.e., fluoride), including fluoride varnish, antimicrobial agents, and pit and fissure sealants
h. pulp vitality testing
i. applying desensitizing medication or resin
j. fabricating athletic mouth guards
k. changing periodontal dressings
l. administering local anesthetic
m. simple extraction of erupted primary teeth
n. emergency palliative treatment of dental pain limited to the procedures in this section
o. preparation and placement of direct restorations in primary and permanent teeth
p. fabrication and placement of single-tooth temporary crowns
q. preparation and placement of preformed crowns on primary teeth
r. indirect and direct pulp capping on permanent teeth
s. indirect pulp capping on primary teeth
t. suture removal
u. minor adjustments and repairs on removable prostheses
v. removal of space maintainers”

All of this can be accomplished by an individual with just three years of post-secondary education! A bit alarming, wouldn’t you say? How about “m. simple extractions”? Who can define the term, “simple?” I can remember one of my oral surgery professors telling me, “Son, you can only say it’s a simple extraction once you have that tooth sitting on the bracket table.”

It is time that we all wake up! Those of you who are members of the ADA, I applaud you for your investment in your future. Those of you who are non-members I simply ask you: “What are you waiting for?!” Your profession needs you! Don’t wait until it’s too late.

In a recent commentary published in Dental Abstract, Vol. 60, Issue 1, 2015, Dr. Frank Catalanotto states that, “Organized dentistry at the state and national level has opposed virtually all efforts to expand access to care to underserved individuals. And, in many cases, the Federal Trade Commission [FTC] has stepped in to help prevent this restraint of trade. Great examples of FTC intervention in the past decade or so can be found in Alaska, Alabama, Minnesota, South Carolina, Louisiana and Florida. Dentistry PACs [political action committees] are in full battle mode. Just get a copy of ‘The Dental Workforce Cook Book,’ if you can. I have only heard about it, but have not seen it.”

With all due respect to Dr. Catalanotto, I would disagree with his statement: “Organized dentistry … has opposed virtually all efforts to expand access to care to underserved individuals.” As a past president of the Florida Dental Association (FDA), president of Florida’s Donated Dental Services, vice chair of the ADA’s Council on Access Prevention and Interprofessional Relations, and a general practitioner in private practice who has devoted most of his professional life advocating for access to the underserved, I could not be prouder of the ADA’s leadership role when it comes to advocating for “access to care.”

Please take time to look at the following publications by the ADA and the FDA Action for Dental Health initiative:

  • “Breaking Down Barriers to Oral Health for All Americans: The Community Dental Health Coordinator”
  • “Breaking Down Barriers to Oral Health for All Americans: The Role of Finance”
  • “Breaking Down Barriers to Oral Health for All Americans: The Role of Workforce”
  • “Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net”
  • “Action for Dental Health: Bringing Disease Prevention into Communities”

… just to name a few.

I am almost certain that Dr. Catalanatto meant to say that the ADA has opposed all efforts to bring in mid-level providers/dental therapists. And, if that is the case, I would agree with him!

To quote the ADA president, Dr. Maxine Feinberg: “The ADA believes it is in the best interest of the public that only dentists diagnose dental disease and perform surgical and irreversible procedures. Through Action for Dental Health, the ADA and its member dentists are implementing solutions that have been proven to help address the multiple barriers that prevent many Americans from attaining better oral health.”

The issue of access to care is a complex one. I applaud and respect the efforts of anyone and everyone attempting to eliminate the barriers that prevent all Americans from suffering needlessly from a totally preventable disease. I hope and dream that, as a profession, we can continue to work to bring about the changes needed to provide the necessary education and care to those who need it.

This article first appeared the South Florida District Dental Association’s Newsletter,  Volume 57, No. 2, Fall 2015.

Dr. Sabates can be contacted at fdacesar@gmail.com, or you can contact the FDA Governmental Affairs Office at gao@floridadental.org.

 

 

Dental Therapist False Promises Force Unfair Choice on Patients and Dentists

By Jane Grover, DDS, MPH, Director, Council on Access, Prevention and Interprofessional Relations, American Dental Association

Many challenges keep people from visiting a dentist including, lack of oral health education, cost, fear of the dentist and a belief that they don’t need care. Dental therapists have failed to show meaningful results in addressing these barriers.

A handful of states created this provider to treat underserved patients, especially in rural areas. But these patients are more likely to have complex dental disease and health issues that require the skill and training of a dentist to diagnose and treat.

Despite the best intentions of connecting dental therapists to needier rural populations, they primarily practice in metropolitan areas.

Nationally, children have seen improvements in dental access with the gap in utilization between low-income children and high-income children narrowing in 49 states.

Poor children shouldn’t be stopped from seeing a dentist by a restructured system that redirects them to providers with less training than dentists. In Michigan, 80 percent of dentists participate in Healthy Kids Dental for Medicaid enrolled children. The proposed therapist model tries to fix a system that isn’t broken, relegating disadvantaged kids to a lesser standard of care.

Dental therapists are frequently cited as making dental care more affordable. But insurers and the states pay set fees for dental procedures no matter who performs them. In spite of having introduced dental therapists seven years ago, only 43 percent of Minnesota children with Medicaid visited a dentist in the past year compared to 48 percent nationally.

These programs are too expensive to survive without subsidies and mirror the Canadian program, which failed once government subsidies ended. Instead of having another provider to drill and fill teeth we should better connect patients with a fully-trained doctor of dentistry and utilizing the existing dental workforce.

The Community Dental Health Coordinator (CDHC), a community health worker, is a better option. They provide oral health education, disease prevention, help coordinate appointments and can reduce patient no-show rates from nearly 50 percent to below 10 percent.

Increasing access to care isn’t about increasing the number of providers, it’s about providing the right care, by the right provider at the right time.


This letter was originally published in the Wall Street Journal (WSJ) on Aug. 31, 2016, in response to the the Aug. 19 article, “You Don’t Have to be a Dentist to Fill A Cavity,” which proposed dental therapists as the solution to access to care issues. Note: In most cases, the WSJ requires a subscription to access its articles online.