The Virtual Dental Home (VDH), a dental care system that uses telehealth-connected teams to bring preventive and early intervention dental care to children and adults who have traditionally not received dental care, is growing in recognition and adoption across the United States. The VDH system was developed at the University of the Pacific School of Dentistry in San Francisco.[1]
A six-year proof of concept demonstration of the VDH system in California led to adoption of legislation in 2014 and regulations in 2015 that added the ability of advanced practice dental hygienists to place Interim Therapeutic Restorations and required California’s Medicaid dental program to pay for dental services without regard to whether they were delivered in-person or through the use of telehealth-connected teams. Now, VDH systems across California are using dental hygienists as the leaders of community-based teams connected to dentists who are in private offices and health center dental clinics to deliver community-based prevention and early intervention care, keep the majority of children served healthy without the need to travel to a dental office, and reduce the far reaching personal and societal consequences of untreated dental disease.
In 2015, with leadership and funding from the Caring for Colorado Foundation, Colorado became the second state in the country to adopt legislation similar to that in California and to launch a VDH demonstration program. Preliminary results from that demonstration are producing similar results to those in California. Children and adults who previously had little or no access to dental care are receiving care focused on prevention and early intervention services designed to reduce the consequences of untreated dental disease.
Now, both Oregon and Hawaii have funded demonstration projects of the VDH system of care underway and several other states are considering doing this as well. A number of additional states have adopted legislation requiring their Medicaid agencies to pay for dental services performed using teledentistry technologies. These include Minnesota, Arizona, and Missouri, and other states have this idea under consideration. In addition, the American Dental Association, in 2015 adopted a Policy Statement endorsing the use of teledentistry in dental practice.
States across the nation are watching the developments and progress of the demonstration projects in California, Colorado, Oregon, and Hawaii. It is now clear that the use of teledentistry, telehealth-connected teams, and Virtual Dental Home systems of care is going to be sweeping the nation. The only real question now is “which state is going to be last” in adopting this method of delivering dental care which is showing so much promise in reaching people who are not getting care and emphasizing prevention and early intervention.
In the longer term, many policy makers and leaders in general and oral health care companies are recognizing the potential for Virtual Dental Home to help the dental industry succeed in the “Era of Accountability” and to reach the “Triple Aim” in health care. This includes improving the experiences people have in getting health care, improving the health of the population, and lowering the cost-per-capita for doing this.
[1]. University of the Pacific School of Dentistry. The Virtual Dental Home. http://www.virtualdentalhome.org.
