Looking Ahead to Year 2

By: Linda Reiner, MPH

Salud Family Health Center
 SMILES Team

Vice President
Caring for Colorado Foundation

SMILES Dental Project® officially kicked off Year 2 of implementation on October 1, 2017!  The first year of implementation saw many successes as well as a few challenges. SMILES teams are eager to make this project a sustainable new model of care for their communities, and they are poised to make great strides toward this goal in Year 2.

We are excited to announce that Salud Family Health Center, serving the Fort Morgan area, will be joining the current sites (Dental Aid, Mountain Family Health Center, Summit Community Care Clinic, and Tri-County Health Network) in implementing the SMILES Dental Project® this fall.

Implementation Goals Include:

• Interim Therapeutic Restoration (ITR): ITR is a key component of the SMILES model in keeping patients healthy using a Virtual Dental Home (VDH). In Year 1, we found that patients referred to a physical dental clinic face significant barriers getting to that clinic for treatment. At this point, ITR has been used at two sites, allowing some patients to remain in the community sites for disease management.
•  Sustainability: Year 1 focused on establishing the community sites. In Year 2, we will shift focus to demonstrating that the SMILES model can be a long-term, sustainable solution for communities.
• Evidence-Based Guidelines: For Year 2, SMILES teams will look at care models, process flows, and demand for care to assess opportunities for improvement. The SMILES Dental Project® will provide risk-based, evidence-based care. SMILES teams will set recall schedules based on patient risk, bring low-risk patients back less frequently, and follow care protocols for high-risk patients to prevent disease and keep patients healthy. We have many tools available that are evidence-based and cost-effective. For example, recently released clinical practice guidelines for pit-and-fissure sealants confirming what oral health professionals already know: sealants are safe and effective in preventing and arresting pit-and-fissure lesions in primary and permanent molars.

With the therapeutics available today, we can make a real impact on oral health. But doing so requires a paradigm shift: dental caries is a disease that we can often manage non-surgically while working to prevent it altogether.

We are excited and encouraged to see that the SMILES model is working, and that our participating communities are embracing it. We are humbled to be able to provide much-needed care for populations that may not otherwise have access to comprehensive dental services.