introduction
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Virtual
Dental
Home
paul glassman, dds, ma, mba
guest editor
Paul Glassman, dds, ma,
mba, is a professor of
Dental Practice, director
of Community Oral Health,
and director of the Pacific
Center for Special Care,
Arthur A. Dugoni School of
Dentistry in San Francisco
Conflict of Interest
Disclosure: None reported.
I
t is now widely recognized that good
oral health and access to basic dental
services are not readily available to
one-third or more of the U.S. population.1-5 These underserved populations
include low-income children and adults,
minority racial and ethnic groups, people
with disabilities and complex medical
conditions, and dependent older adults.
The reasons that many people in these
groups do not access the traditional officebased dental care system are complex, but
include issues with the cost of dental care,
the separation between dental care system
and the rest of the health care delivery
system, education of oral health and other
professionals, geographic distribution
of sources of care, language and cultural
barriers, and health literacy. The results
of these issues are profound oral health
disparities among the groups listed above.
Many people are realizing that new
and innovative strategies will be needed
to address the profound health disparities
among underserved populations. There are
currently multiple models being developed
and tested in the United States. Among
them is a model that is the theme of this
issue, the virtual dental home. This new
model of care was developed at, and is
being tested by, the Pacific Center for Special Care at the University of the Pacific,
Arthur A. Dugoni School of Dentistry. It
is based on the principles of bringing care
to places where underserved people live,
work, or receive social, educational, or
general health services; emphasizing prevention and early intervention strategies;
integrating oral health with general health,
social and educational delivery systems;
and using telehealth technologies to
connect a geographically distributed, collaborative dental team with the dentist at
the head of team-making decisions about
treatment and location of services.
The first article in this issue describes
the virtual dental home system, how it
works, and preliminary results from a
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introduction
c da j o u r n a l , vo l 4 0 , n º 7
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statewide demonstration project. The next
article is a review of the use of telehealth
technologies in the delivery of dental services. Following that is an article describing the validation of a telehealth-enabled
oral health examination. The next article
describes the scientific basis for the prevention and early intervention strategies
used in the virtual dental home system.
The final article in this series describes the
policy implications of the virtual dental
home model.
The virtual dental home system has
significant potential to improve oral
health of currently underserved populations who now experience profound
health disparities. It also has the potential to expand the scope of practice and
patient population of dentists who are
now able to interact with a geographically
expanded group of patients and direct
the activities of an expanded dental team.
Readers of the articles in this issue will
be able to increase their understanding of
this model of care as well as the potential
for other models to benefit vulnerable
and underserved patients and oral health
professionals alike.
r e f e r e nce s
1. U.S. Department of Health and Human Services, Oral Health
in America: a report of the surgeon general. Rockville, Md., U.S.
Department of Health and Human Services, National Institute
of Dental and Craniofacial Research, National Institutes of
Health, 2000.
2. The American Dental Association, Report of the Dental
Workforce Taskforce 2006, HOD Resolution 3, page 35, 2006.
3. California Dental Association, Phased strategies for
reducing the barriers to dental care in California, November
2011. http://www.cda.org/library/pdfs/access_proposal.pdf.
Accessed May 11, 2012.
4. The Institute of Medicine, Advancing oral health in America,
2011. The National Academies Press, Washington, D.C.
5. The Institute of Medicine and the National Research
Council, Improving access to oral health care for vulnerable
and underserved populations, 2011. The National Academies
Press, Washington, D.C.