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Opening Up Oral Care to the Disabled
Access to dental care is a serious problem—40% of Americans are not getting the care they need, according to the American Dental Hygienists’ Association. It is estimated that one in five people in the United States has some level of disability, and that one in 10 has a severe disability.1 Disabled adults have an even tougher time receiving oral care—they have serious dental problems, underutilize dental services, and have limited access to dental care.1
The National Foundation of Dentistry for the Handicapped (NFDH), based in Denver, CO, is working toward a different future: “[Our goal is that] all individuals who are disabled, elderly or medically compromised without financial means or alternative access will receive necessary, substantive, and maintainable dental care,” according to its Web site.
“Donated Dental Services (DDS) is a program in which more than 13,000 volunteer dentists and specialists across the country donate their time and expertise to vulnerable individuals who are functionally limited in such a way that they cannot earn a living, let alone be expected to budget and pay for their dental care,” says Rob Saldaña, director of DentaCheques, NFDH.
“This includes folks who are elderly but also people who are on transplant lists, people who are medically compromised, people who have chronic mental illnesses, and various other ‘invisible’ disabilities like that,” he adds.
Transplant list patients are a priority to the NFDH, according to Mr. Saldaña. “People who are awaiting a transplant take precedence in our system. If we receive their application, they go to the top of the list immediately. For them, it is quite simply, quite clearly, a matter of life or death,” he explains.
Donated Dental Services (DDS) Program
For dentists who are looking for the satisfaction, gratification, and sheer joy of making life significantly better for a grateful and truly deserving disabled, elderly, or medically compromised person, the Donated Dental Services (DDS) program is looking for a few good men and women to answer the call. Volunteer dentists can spend just a few hours spread over the course of a few months in the comfort and convenience of their own offices providing the dental care they want to needy individuals. Laboratory work and other support services are just a quick phone call away.
The 13,000 dentists already participating in the DDS program have contributed more than $120 million in pain- relieving and dignity-restoring care for 80,000 people, and overwhelmingly characterize their experience as professionally and emotionally enriching.
Imagine the uplifting feeling of helping a medically compromised person who “prayed for God to end my life” because of unrelenting pain from dental problems. In a note to her volunteer dentist, this patient wrote, “You truly transformed my life.”
Rejoice in the gratification of enabling a young father denied the chance for a life-saving kidney transplant to be approved for the procedure after obtaining the prerequisite but unaffordable dental care he needed. Consider the satisfaction of helping a depressed reclusive woman leave her self-imposed isolation and obtain a job sampling products at a grocery store after being freed of the disabling embarrassment of seriously diseased and offensive-appearing teeth.
To put DDS participation in perspective, the commitment of just a few hours can have an enduring impact on the health and well-being of the person being helped, as well as a lasting memory for the dentist and staff. DDS was designed by dentists to work effectively and beneficially for both dentists and patients. The charitable work of volunteer dentists provides the only chance for many vulnerable people to get vitally needed care. This goal underpins one of the values of the DDS program: the essential involvement of dentists requires that they enjoy the satisfaction of participating in the program and are spared of any possible frustration. To help assure such an outcome, DDS was designed by dentists to work for dentists. It may seem counterintuitive for a humanitarian dental project to prioritize the needs and wants of participating dentists rather than the patients it serves; however, as in any volunteer service initiative, beneficiaries require benefactors. Without the latter, there wouldn’t be the former.
To that end, the features of the DDS program include:
- Assisting truly deserving people by focusing on needy disabled, elderly, and medically compromised individuals whose financial predicaments result from their functional limitations;
- Private office rather than clinic-based services because it is more convenient and efficient for dentists as well as patients;
- Reliable and appreciative patients are guaranteed as a result of DDS pre-screening applicants and arranging for transportation and other logistical considerations before referral to a volunteer dentist;
- Control of involvement by each volunteer because a referral requires a dentist’s authorization based on having first received a brief written profile about the potential patient;
- Comprehensive rather than limited treatment because that is not only in the patient’s best interest, but it provides dentists and their staffs the opportunity to develop meaningful relationships with a DDS patient and to observe first-hand the improvement in that person’s quality of life;
- Top-rate services of a coordinator who arranges volunteer specialists, laboratories, securing implants, and/or addressing any other clinical needs required for a case. DDS doesn’t tell a dentist what he or she can or cannot do; instead, our coordinators offer assistance so the dentist can complete the treatment plan that is believed to be in the patient’s best interest.
“Functionally, the only significant difference for a dentist treating a DDS patient compared with a fee-for-service patient is that the payment is emotional rather than financial. Indeed, it couldn’t be simpler—no paper, no restrictions. Volunteers do the dentistry. The program does everything else,” says Larry Coffee, DDS, president and CEO of the DDS program.
It’s All About Helping People
Mr. Saldaña recalls one patient, a retired Navy veteran, who had high blood pressure, sleep apnea, and Barrett’s disease (a pre-cancerous esophageal condition). A workplace injury had left him with degenerative disc disease, forcing him to rely on Social Security. His swollen, bleeding gums and cracked and missing teeth had to take a financial backseat to the care of his two children. Through NFDH, an oral surgeon was able to restore the patient’s oral health.
There are three eligibility requirements to receive assistance from NFDH:
- the person must be functionally limited
- the person cannot earn a living
- the availability of low-cost dental care and clinics and budgeting cannot be expected to pay for the person’s dental care.
“That leaves a little bit of discretion,” Mr. Saldaña explains. “Someone who receives a rather large Social Security income who needs a filling and a cleaning might not qualify. It could be different for someone who is recently disabled and has yet to receive any income. If that person needs a filling and a cleaning, she or he might in fact qualify because of the varying degrees in which people receive compensation from the government.”
As a non-governmental organization, NFDH is not bound by any HIPAA laws.
“It is very good for the dentists who get our patients because they know right away that we have screened them,” says Mr. Saldaña. “We request verification from the Social Security administration; we will get tax forms if necessary. We also get verification from physicians.”
Since its inception, NFDH has provided over $120 million in donated dental care to over 80,000 needy individuals, according to Mr. Saldaña.
“That was a big milestone for us. We thank all of those volunteer dentists, over 13,000 of them, and also their volunteer laboratories,” he says. “There are about 3,200 private laboratories that donated their time and expertise and materials to make anything from crowns and bridges to dentures and partials.”
DentaCheques, which Mr. Saldaña calls “the counterpart to DDS,” is the organization’s main money-raising program.
“DentaCheques is a glorified coupon book, but it is much more applicable to dentists than an entertainment book because it has a lot of things that dentists normally use and have to buy,” says Mr. Saldaña. “For instance, by buying the DentaCheques book, you get $90 off of anything you buy from major dental suppliers.”
Those participating include Henry Schein Dental (Melville, NY), Patterson Dental (St. Paul, MN), and Benco Dental Supply, (Wilkes-Barre, PA), as well as smaller ones across the country, such as Dental Health Products, Inc (New Franken, WI) and Iowa Dental Supply (Grimes, IA), he explains.
“We have offers this year from 75 major dental companies,” explains Mr. Saldaña. “There is $120 to $130 worth of supplier discounts and credits. In free products alone, there’s over $700 in the book.”
Getting the offers and rebates was designed to be a simple process, according to Mr. Saldaña.
“You simply register the book online and select your free goods. There’s no qualifying purchase; just make a few clicks and you get free products, which are anything from waterline treatment tablets, which anybody can use, to 100 free prophy angles. There are plenty of other products: gloves, masks, endodontic products, prophy products, and surgical products such as x-ray films.”
The book costs $110 and it is a tax-deductible business expense. One hundred percent of that money comes to the foundation and goes to the DDS project expansion.
“What’s really great is our 15:1 ratio,” says Mr. Saldaña. “For each dollar we raise, we leverage that into $15 of donated dental care. A really powerful point for me to tell purchasers is that their $110 DentaCheques book is actually worth over $1,650 in donated dental care.
“So quite simply, if you buy a book, someone who needs $1,650 worth of dental care will get it,” he adds. “That’s a pretty powerful situation.”
1. Bonito A. Executive summary: dental care considerations for vulnerable populations. Spec Care Dentist. 2002;22(3 Suppl):5S-10S.