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The University of Michigan School of Dentistry (U-M SOD) will join forces with three other Michigan-based organizations in an effort to develop a comprehensive interprofessional program to reduce the burden of childhood dental disease in Michigan. The effort is made possible by the U.S. Government’s Center for Medicare and Medicaid Innovation, which has awarded a $9.4 million grant to the Altarum Institute in Ann Arbor, MI, and collaborators including the U-M SOD, Delta Dental of Michigan and the Michigan Department of Community Health.
The grant will fund a project that will test a service delivery model with four important components. One involves direct work with primary care providers and dentists to identify children at risk. A second includes promoting evidence-based preventive care in medical settings. A third involves developing and enhancing health information technologies for referrals between dentists and pediatricians. A fourth component would implement a state-wide quality monitoring system.
Margherita Fontana, D.D.S., Ph.D., a professor in the Department of Cariology, Restorative Sciences and Endodontics, will provide her expertise and oversee U-M SOD staff and faculty involved in the project. Dr. Fontana will help evaluate and select the oral health screening approach to use as well as support the development of training materials for pediatricians. She will also help develop information and education materials for patients and their families.
In addition, Dr. Fontana will oversee a pilot clinical program that involves patients, their families and oral health care providers at Mott Children’s Health Center in Flint, MI. The Center provides oral health care services to Genesee County residents from birth through age 18 whose families fall within 200% of the federal government’s poverty guidelines (annual income of less than $47,700 for a family of four). She will also serve as a consultant in developing the statewide monitoring system, which will provide feedback to individual providers on their performance relative to their peers.
“Dental caries is an infectious, progressive but yet preventable disease,” Dr. Fontana says. “Left untreated, the disease often has broad dental, medical and quality of life consequences, especially for very young children.”
Dr. Fontana says the four organizations involved “represent a unique coalition of interested groups whose focus will be on interprofessional prevention of this disease, because prevention is always less costly, in the long run.”
While childhood dental caries is relatively inexpensive to prevent, dental decay is the most prevalent chronic condition among children in the United States and the most common unmet health care need of poor children across the country and the state. She noted that as much as 80% of caries is experienced by only 20–25% of the population, and that children from the lowest socioeconomic groups experience caries at significantly higher rates and at younger ages than their peers. The National Health and Nutrition Examination Survey (NHANES) showed that rates of early dental caries of children ages 2 to 5 increased from 24% (1988–1994) to 27% (1999–2004).