Since 2006, the American Dental Association has been deeply involved in launching their new pilot program to prepare students with dental skills— especially those already involved in hygiene or assistance coursework— to support oral disease prevention in underprivileged populations. Between reception of a large donation in 2010 and Fall 2014, the ADA trained and dispatched 34 Community Dental Health Coordinators (CDHCs) to assist their neighborhoods and surrounding areas through education and affordable access to care. Frequently, graduates return to their own communities, greatly decreasing the risk of language and/or cultural barriers. For more information regarding this developing occupation, check out the following summary.
In order to apply for state board certification, CDHCs must complete 1,872 hours of education. Instruction in this field is available at a handful of institutions including Rio Salado College, UCLA, and Temple University. The curriculum focuses on establishing 7 essential core competencies that are closely linked with students’ future responsibilities. These include:
1. Design/implement community-based programs
CDHCs understand how oral health can be promoted through community-wide measures, and work to integrate such programs— such as water fluoridation— into their sites. They collaborate often with local organizations and leaders.
2. Prioritize population/patient groups
This skill requires the ability to identify developing dental problems and devise recommendations to avoid these issues. They collaborate with dentists and create referrals for patients as necessary.
3. Provide individual preventative services
CDHCs advise community members in areas such as oral hygiene, stopping tobacco use, dietary issues, fluoride and sealant treatments, and coronal polishing. They must have a working knowledge of the benefits and potential consequences of these procedures as well as the services available through the patient’s dental plan.
4. Collect diagnostic information
This supports the coordinator’s ability to screen and assess patients, interpret their medical/dental histories, and accurately complete dental charting. They must be capable with carrying out visual examinations of teeth and tissues as well as taking X-rays.
5. Perform clinical supportive treatments
Duties in this area may range from general preparatory tasks, such as dental tray arrangement and treatment area upkeep, to more direct patient assistance, like fluoride application and administering basic life support.
6. Execute administrative tasks
CDHCs are also competent in the skills necessary to manage appointments and patient reminders, process forms (online and hardcopy), maintain supply inventories, and ensure that all practices conform to basic legal regulations.
7. Temporize cavities to prepare for restorative care
Occasionally, provisional measures are required to prevent cavities from worsening until a dentist can provide more permanent treatment. CDHCs clean out potentially harmful elements from the oral cavity and install temporary fixtures such as glass ionomers.
The program has a presence in 26 rural, urban, and Native American communities spanning 8 states (Arizona, California, Montana, Minnesota, Oklahoma, Pennsylvania, Texas, and Wisconsin). CDHCs must be flexible and able to work in a variety of settings, as they may be stationed in any number of spaces including clinics, schools, churches, and social service agencies.
CDHCs do not provide surgical aid. In the event that a community member approaches him/her with an issue that requires this type of treatment, the CDHC refers the patient to an appropriate dental practitioner and may arrange any other necessary services to enable the patient to attend their appointment, such as transportation and child care.
In October 2012, the ADA published select findings regarding the impact of CDHCs. One graduate working in a tribal community’s diabetes clinic offered services that were approximately 42.7% less expensive than comparable services offered by other dental personnel. Another CDHC stationed in a rural location generated a 1,241 increase in billable procedures.
The ADA’s formal statement concludes with an optimistic prediction for the future of these programs. As more data is gathered indicating the benefits of using this model to reach underprivileged populations, more and more colleges/universities are adapting the curriculum for their own use. Additionally, the flexibility of this program allows it to work in almost any setting so there are very few limitations on where it can be implemented. Therefore, as awareness increases, it can be expected that more institutions will offer training in this area, more altruistic dental students will choose to take this career track, and the influence of CDHCs will begin to grow throughout the country.
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