What is the Virtual Dental Home?
The Virtual Dental Home (VDH) creates a community-based oral health delivery system in which people receive preventive and simple therapeutic services in community settings where they live or receive educational, social or general health services. It utilizes the latest technology to link practitioners in the community with dentists at remote office sites.
Using the VDH system registered dental hygienists in alternative practice (RDHAP), registered dental hygienists working in public health programs (RDH) and registered dental assistants in extended functions (RDAEF) can keep people healthy in community settings by collecting diagnostic records, providing preventive procedures and interim therapeutic restorations education, and case management. Where more complex dental treatment is needed, the Virtual Dental Home connects patients with dentists in the area.
This system promotes collaboration between dentists in dental offices and these community-based dental hygienists and dental assistants. Most importantly, it brings much-needed services to individuals who might otherwise receive no care.
How does it work?
The VDH model relies on community-based practice of specially trained dental hygienists and assistants who collect dental records and provide preventive care for patients in community settings, such as schools, Head Start preschools and nursing homes. They send that information through a secure telehealth system to a dentist at a clinic or dental office who establishes a diagnosis and creates a dental treatment plan. In addition to preventive procedures, the hygienist or assistant, if directed to do so by the dentist, may provide a type of small protective filling called an "interim therapeutic restoration" (ITR), stabilizing the tooth until the dentist determines that further treatment is required. Patients who require more complex treatment that only a dentist can provide are referred and receive assistance securing a dental appointment.
The services provided in community locations include:
- Health promotion and prevention education
- Dental disease risk assessment
- Preventive procedures such as application of fluoride varnish, dental sealants and for dental hygienists, dental prophylaxis and periodontal scaling
- Placing carious teeth in a holding pattern using interim therapeutic restorations (ITR) to stabilize patients until they can be seen by a dentist for definitive care. Placing ITRs has been approved for this project by the Office of Statewide Health Planning and Development under the Health Workforce Pilot Project application #172.
- Tracking and supporting the individual's need for and compliance with recommendations for additional and follow-up dental services.
Approximately two-thirds of the patients seen in a VDH were able to receive the care they needed at the community site. This is care they most likely would not have received otherwise or would have had great difficulty getting.
Benefits and Savings
Dental disease is the No. 1 chronic disease of children — more common than obesity and asthma, and it is almost entirely preventable. For children, providing access to preventive services early in their lives inhibits the initiation of dental disease and provides a lifetime of benefits. When children are free from active dental disease, they miss fewer days of schools and are better able to learn. They also enjoy the benefits of higher-quality nutrition and experience improved self-esteem.
For elders, especially those who live in a residential facility, they benefit from receiving dental services that will keep their mouths clean and pain free. In instances where more complex care is required and a trip to the dental office is scheduled, the VDH system minimizes the number of visits required, as the patients' needs have already been assessed and the dentist is prepared to provide the required treatment.
The cost of neglect is substantial to individuals and to society. By reducing barriers to preventive and basic dental care in these vulnerable populations, the VDH model can provide long-term savings by avoiding costly procedures, emergency room visits and even hospitalizations associated with advanced dental disease.