With dental disease a major issue in student health and school attendance – 24 percent of California school children have never seen a dentist – a bill to increase student access to dental care through remote “teledentistry” was moved to the state Senate on Feb. 6. The bill passed the Assembly with broad bipartisan support.

Assembly Bill 1174, authored by Assemblyman Raul Bocanegra, D-Pacoima, would allow dentists to receive Medi-Cal payments for supervising, via web-based sharing of X-rays and photographs, the work of hygienists and dental assistants, who would be trained to provide more expansive care in schools, Head Start centers and community settings.

The bill, which has moved to the Senate Committee on Business, Professions and Economic Development, proposes a teledentistry model based on a pilot program run by the University of the Pacific School of Dentistry. That pilot program, which has been active in communities for three years, currently provides dental care for children in school facilities in Sacramento’s Twin Rivers Unified School District and San Diego County’s National School District, as well as to preschoolers in Head Start centers in San Francisco and San Diego and other locations such as care homes for the elderly.

The model can be effective for children from low-income families who live far from a dentist who accepts Medi-Cal insurance. Teledentistry creates a team of skilled dental workers who provide care in an accessible setting, such as a school health center, who are linked by technology to an off-site dentist. The goal is to facilitate “geographically distributed, collaborative dental care” to address the limited access to oral health care that many low-income children experience, according to a report by Paul Glassman, director of community oral health at the University of the Pacific School of Dentistry.

While a “dental home” where children regularly visit a dentist is ideal, teledentistry would allow children to have a “virtual dental home,” Glassman wrote.

Dental hygienists and assistants would undergo training to expand their scope of work in two key areas: they would decide which X-rays to take for a dentist to review and they would provide interim care, which could include filling small cavities until a child is able to visit a dentist. 

The model echoes recommendations in a 2011 Institute of Medicine report that called for innovative approaches to improving access to oral health care for low-income children, families and the elderly.

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