NJ Dental Hygienists’ Association Assists Low-income Mothers and Children in United Way of Central Jersey Program

NJ Dental Hygienists’ Association Assists Low-income Mothers and Children in United Way of Central Jersey Program 

“Research shows that both pregnant mothers and children before age 3 need dental care. Years ago, dentists would refrain from treating these two groups, but today we know better,” said Ms Rebecca Pugh, Executive Director of the NJ Dental Hygienists’ Association (NJDHA). 

“Too many people don’t realize that oral care can prevent infection from spreading to other parts of the body. This is always important but especially so during pregnancy.” Ms Pugh and the NJDHA have been important supporters of a new program implemented by the United Way of Central Jersey (UWCJ) that reaches out to low-income, first-time mothers to educate them about preventive dental care. 

Prevention is Cheaper 

Over half of low-income children have cavities, even though they are almost 100% preventable, Source: National Health and Nutrition Examination Survey, 1999–2004, and over 40% of low-income adults have untreated decay. 

United Way knows that many low-income mothers do not seek dental care for themselves or their children because they think it will be too expensive. The risk is that delayed treatment leads to unsupportable pain that drives patients to an emergency room. The cost of emergency room care is much higher than continuing, preventive care – especially because NJ FamilyCare and sliding scale programs at Federally Qualified Health Clinics reduce the cost of care to manageable levels. 

Social Determinants of Health 

The barriers to dental care extend beyond just cost. Some people are afraid to go to the dentist because they expect to feel pain or they are unfamiliar with the procedures or the language. Lack of transportation is also a factor, and so is a cultural legacy that does not include preventive dental care. Some people just think losing your teeth is inevitable. 

“United Way wants to clear away the barriers, so that people can feel unafraid to get the care they need. That would benefit all of us because of lower cost and improved productivity,” said Gloria Aftanski, President of UWCJ. “Absenteeism, both from school and work, is a costly consequence of dental pain. It makes sense for all of us to work together to eliminate dental disease” 

Strategy Shifts for Healthcare 

The U.S. healthcare system has been provider-centric, fragmented and directed at treatment of disease. Much discussion about shifting from a volume to a value-based system has begun to orient practitioners to preventive, patient-centered care. Care that is continuous and coordinated and home-focused has been shown to lower cost vs. emergency care in the ER. 

UWCJ’s Care Coordination Program 

“If we can help mothers to adopt preventive care, we can overcome barriers to health,” said Linda Knudsen, President of the NJDHA. Everybody knows that education is a key enabler, but what type of education works best to achieve long-term behavior change? An approach termed “Care Coordination” adds a skilled person to the typical patient-provider relationship who facilitates and reinforces specific care strategies. 

The NJDHA has recommended Dental Hygienists who are willing to meet with mothers in their home to provide the knowledge, answer questions and facilitate a visit to the dentist. “Sometimes an enthusiastic, friendly voice from a trustworthy person can help build the confidence needed to take charge of your own care,” said Noora Bayoumi who is one of the Dental Hygienists providing care coordination. It’s a “peer-to-peer” approach not unlike what happens every day in “water cooler” conversations – but it’s in a private setting appropriate to private health matters. 

How do you know that you are making any difference? 

“I can see it in their eyes; I know they are engaged – they are learning,” answered Ms Luz Munera, Vice President of the NJDHA, one of the Dental Hygienists who visit low-income first-time mothers. “I was with a young mother the other day who was unaware of the importance of caring for her six month old’s baby teeth. While I ran down the list of reasons, I could tell she was shocked by the importance of preventive care for her baby’s teeth. She really appreciated it.” 

United Way’s Care Coordination initiative is a Pilot Study that tracks changes in awareness and behavior over time to see if the approach improves health, saves cost and improves patient experience. The Study is funded by the American Dental Association Foundation and the Delta Dental of NJ Foundation and is being conducted with the assistance of the Nurse Home Visitors who implement UWCJ’s Nurse-Family Partnership program. 

Care Coordination has the potential to lower cost by getting people to adopt continuous, preventive care at home that eliminates the need for trauma care in the ER. “Collaboration is the key to success,” said Ms Pugh, “and the Dental Hygienists are happy to be a part of this initiative that takes person-centered care into the community.” 

For more information about the Care Coordination Pilot study, please contact Bill Dennison at UWCJ, wdennison@uwcj.org.