Mission Hospital’s Toothbus

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In 1996, Mission's Children's Hospital identified the lack of adequate access to oral health care as an overwhelming need in the 21 mountain counties it serves. Today, we report the following accomplishments of Mission Children's Dental Program:

• Restoring health to over 5,000 children.
  • 600 children aged 7-12, attending 46 elementary schools in 10 counties receive
  • 1,500 preventative and restorative dental visits/year from 2 mobile dental clinics.
  • 1,300 very young and medically compromised children provided full mouth restoration under general anesthesia in the operating rooms of 4 hospitals each year.
  • Improved health of our patients as measured by "decayed, filled teeth" (recurrent carries); percent treatment completed; and dental hygiene IQ scores.
• Leadership to influence changes made to the NC Dental Practice Act that allowed for 1) the hospital and other non-profits to "own" a dental practice and 2) licensing dentists by reciprocity, increased Medicaid reimbursement for common procedures done for children and other recommendations of the IOM Task Force on Dental Access.
• Leadership of efforts to assure dental coverage included under NC Health Choice.
• Involved the medical community in educating and providing preventive dental treatment to young children. Co-created and piloted Smart Smiles Fluoride Varnish Program in Western North Carolina.

Informed patients are empowered to take more control over their health care.

• In addition to a toothbrush, floss aide and toothpaste each ToothBus patient receives a booklet on taking Care of Your Child's Oral Health as part of their oral hygiene education. The booklet and letters home to parents are designed to keep parents educated on the subjects of oral hygiene and tooth decay. Each child receives 45-60 minutes of hygiene education and demonstrates to the dental team that they understand proper techniques. Similar education is offered to children and parents in our OR program. The program also provides the booklet to new parents in Mission's three hospitals.

The approaches are replicable.

• Provided consultative services to NYU Dental School and the Association of State and Territorial Dental Directors (ASTDD).
• Consulted with other hospitals in North Carolina interested in starting dental programs (First Health, New Hanover and the consortium in High Point). Provided input on the viability of mobile dental services in each area.
• Influenced capacity building in the region (Health Department and non-profit dental clinics now exist in Cherokee/Clay, Graham, Macon, Jackson, Haywood, and Mitchell counties and plans are underway in Polk/Rutherford and Henderson counties. These services did not exist prior to Mission Children's Dental bringing attention to the difficulty in accessing dental care for very young, medically compromised children living in families with little income).
• Invited speaker at national and international conferences including the Surgeon Generals' Conference on Children's Oral Health; National Mobile Health Association; the International Association of Special Needs Dentistry, Illinois Oral Public Health Association and the American Public Health Association.
• Co-authored Mobile/Portable Dentistry web site as safety net options for the Association of State and Territorial Health Directors (ASTDD)

Sustainable:

The Children's Dental Program became self-sustaining after finding the balance whereby OR cases could offset the loss of revenue on the mobile units. Many programs that have heard Ms. Teutsch speak have adopted a similar approach to underwrite their dental charity care.

Individuality, culture, values of patient is respected.