Conference Presentation Archives

2017 NNOHA Annual Conference

Sunday, November 12th (Pre-conference)

Your Oral Health Program: Strategies for Success

This seven-part program introduces CHC executives to the concepts necessary to build and sustain a successful dental program. These include staffing, scheduling, billing, setting fees, quality improvement and data management. A dental background and training are not necessary for this course. Created through a partnership with DentaQuest Institute’s Safety Net Solutions, this program is offered free of charge through a National Cooperative Agreement with HRSA.

Intensive Learning Session: Help I Have a One-Year-Old in My Chair

Francisco Ramos-Gomez, DDS, MS, MPH

Learn to better address the oral health of your youngest patients. Incorporate the American Academy of Pediatric Dentistry’s six steps involved in infant oral care and learn to implement a structured Caries Management by Risk Assessment (CAMBRA) protocol to improve children’s oral health. This course will discuss anticipatory guidance, behavior management, use of fluoride varnish, the establishment of a dental home, and bringing parents and caregivers into the equation for success.

Fundamentals of Leading a Health Center Oral Health Program

Lisa Kearney, DDS; Ethan Kerns, DDS; Kecia Leary, DDS, MS; Ernest Meshack-Hart, DDS, FAGD; An Nguyen, DDS, MPH; Allen Patterson, CGMA, CPA, FACMPE, MHA; Nick Pfannenstiel, DDS; Bob Russell, DDS, MPH; Tena Springer, RDH, MA; Ryan Tuscher, DDS; Scott Wolpin, DMD

Back by popular demand, NNOHA is once again offering this fundamentals course on the basics of running an effective oral health program. Topics include: Financials, Health Center Fundamentals, Leadership, Quality, Risk Management and Workforce & Staffing.

 

 

Digging Deeper -Operational Site Visits + A Look at Federal Tort Claims Act (FTCA) Guidance

Dori Bingham, BA; Mary Coffey, MBA, RN; Steve Geiermann, DDS

Is your health center dental program ready for an Operational Site Visit? Is your dental program in compliance with each of the 19 program guidelines? Do you know what the “hot button” items are for Site Surveyors? Would you be ready for an FTCA audit? Learn all of this and more. Bring your toughest questions to the experts, meet peers who have successfully completed a recent OSV and learn about the myths vs. reality when it comes to FTCA.

 

 

Digging Deeper- Using Health Center Dental Dashboards for Tracking, Measurement & Improvement

Irene Hilton, DDS, MPH; Colleen Lampron, MPH; Martin Lieberman, DDS; Tova Weiss, MBA; Sandra Garbley-Kerkovich, DDS; Isaac Zeckel, DDS, MS; Matthew Horan, DMD; Chad Lennox, MPH

This session will be an intensive, hands-on workshop guiding participants through the recently developed “Health Center Dental Dashboard User’s Guide – A Tool for High Performing Health Centers©.” This session will enable participants to apply practical measurement plans to understand current performance, identify and test opportunities for improvement, and monitor improvements over time.

Monday, November 13th

Plenary Session: Time to Think (and Act) Differently: Why We Need a New Approach to Improve Oral Health in America

Marko Vujicic, PhD, Chief Economist and Vice President of the Health Policy Institute at the American Dental Association (ADA)

The U.S. healthcare system is experiencing profound change. Oral health remains on the fringes and there has been relatively little large-scale innovation in how we pay for and deliver dental care services in the last 20 years. In a novel analysis, the ADA Health Policy Institute has assessed access to dental care in every state, including for vulnerable populations. The data tell a compelling and profound story about the true barriers to improving oral health. The data also point to solutions. The oral health community needs to take a hard look in the mirror and reassess its collective approach to improving oral health in America. It is time to think and act differently.

 

 

Silver Ion Products and Dental Caries: The Old, the New and the Ugly

Timothy Wright, DDS; Peter Milgrom, DDS, MS; Tina Sopiwnik, DMD

Though silver ion products have been around since the time of G.V. Black, they somehow fell out of favor. With the emergence of silver diamine fluoride (SDF), interest in both SDF and silver nitrate has resurfaced. Come and learn when it is appropriate to consider using these “new additions” to your medical management of caries toolkit. We will consider the indications, contraindications and current clinical evidence supporting their use. Having options can be a good thing!

 

The Endodontic Pyramid to Successful Diagnosis and Treatment

Thomas Jovicich, DMD

A hands-on and lecture course combination designed to increase the dentist’s ability to diagnose and treat endodontic patients with confidence and competence. For the last 4 years, the endodontic presentation followed by hands-on training has been one of the most valued courses offered at NNOHA. You will learn the latest proven techniques to perform successful endodontic treatment, quickly, effectively and comfortably.

Oral Health Literacy: A Secret Weapon for the Oral Health Care Delivery System

Alice Horowitz, PhD; Scott Wolpin, DMD

Why is it so difficult to get our most vulnerable patients to the dental office? Health literacy and technology are transforming health care by engaging patients in wellness, but are under-utilized by community-based dental programs. This session will provide affordable, outside of the box tips to lower no show rates, increase patient treatment completion rates and increase patient and provider satisfaction.

 

Dental Program Redesign: Laying the Ground Work

Mark Doherty, DMD, MPH, CCHP

An introduction to why the redesign of a safety net dental program is vitally important to maintaining access, creating financial sustainability and general oral health outcomes that are meaningful and documentable for the population serving this cause. This course will break down dental into 5 domains, discuss the metrics utilized to measure success in each domain, demonstrate benchmarks for metrics, discuss which metrics were achieved in 2015 in health centers, educate the learners related to strategies and action steps to maximize efficiency and effectiveness in each domain. This session is part 1 of 3 of the Dental Program Redesign series.

 

 

Understanding the Science Behind Interim Therapeutic Restorations (ITR)

Nels Ewoldsen, DDS; Ria Berger

This didactic presentation focuses on the clinical steps and documented outcomes supporting the use of glass ionomer restorative materials and atraumatic restorative treatment to control caries in children and adolescents. Clinical tips and techniques for expeditious placement of Interim Therapeutic Restorations and techniques for expeditious placement of sedative restorations by members of the dental team will be presented using clinical photography.To provide perspective and context for the value of Interim Restorative Technique (ITR) you will learn about how Healthy Smiles for Kids is successfully expanding access in non-traditional dental homes through innovative clinical care.

 

Ergonomics and Your Health

Ryan Headlee

Being a dental clinician shouldn’t be a pain in the tail, or the neck, or the back, for that matter. Yet more than half of dentists who retire early, do so due to musculoskeletal problems. Ergonomic strategies should be part of every dentist’s and hygienist’s personal wellness approach; but what do you need to know? And, how do you find the right positioning to manage the clinical treatment environment and protect your own health at the same time? This course will provide answers. The guidance and principles being presented are for every clinician.

Introduction to the Health Center Dental Dashboard

Colleen Lampron, MPH

Delta Dental of Colorado Foundation and Washington Dental Service Foundation worked with NNOHA, Health Center experts and test groups to develop the Health Center Dental Dashboard. The Dental Dashboard is a set of measures that is an optional tool for Health Centers to use as part of their quality improvement program. This session will feature an overview of the dental measures included in the dashboard, and recommendations for application at your Health Center. The session.will also provide real-life examples of how the Dental Dashboard is being used to improve performance at Health Centers across the country.

 

 

Workforce Innovation: Steps in Successful Dental Case Management

Jane Grover, DDS, MPH; Jenna Linden; Bill Donigan, DDS, MPH

How long is your waiting list? How many times have you thrown it away as your contact information is no longer relevant? Community Health Workers, as the “eyes and ears” of our medical colleagues out in the field, are ready to address the health care needs of individuals across the lifespan, from babies to pregnant women to our esteemed elders. They can bring the relevance of good overall health to the community and those living within it. Prevention and education are their tools of the trade.

Integrating oral health into that already existing case management and care coordination system will make a difference! Bringing oral health into the overall health care conversation will enhance efficiency, effectiveness, productivity and profitability (no margin, no mission). This integration will truly make a demonstrable impact within the overall health of the community, not just in the lives of individuals who have been lucky enough to “break into the system.” Presenters will address how individuals with both case management and oral health knowledge can make a measureable difference within the oral health status of the community and will share personal experiences of success in this area. Isn’t it time to leave the status quo at the door and find a new way of making a difference?

 

 

Expanding Capacity Using Telehealth

Paul Glassman, DDS, MA, MBA

The United States has entered the Era of Accountability with increased emphasis on improving population health and lowering the cost of doing so. This session will describe and explain how teleheath-connected teams and Virtual Dental Homes can help health centers expand their capacity to reach populations they serve, emphasize prevention and early intervention services and improve oral health.

Care Integration for Low-income Seniors

Karen Becerra, DDS, MPH; Vyan Nguyen, MD; Eliah Aronoff-Spencer, MD, PhD

The Gary and Mary West Senior Dental Center is a nonprofit, integrated community dental center dedicated to serving low-income seniors in downtown San Diego. The Senior Dental Center links high-quality and affordable oral healthcare with a suite of nutrition, case management and wellness services, creating a one-of-a-kind, integrated community-based system of care for older adults. This successful integration of oral health into a community based organization demonstrates how oral health can – and should – be integrated into the primary places that seniors visit.

Tuesday, November 14th

Plenary Session: The Plaque Monologues

Brian Novy, DDS, FADI, Director of Practice Improvement, DentaQuest Institute

Sometimes it seems as though our patients don’t grasp the basic concept of home care. Other times our patients with impeccable hygiene develop rampant decay and we feel helpless because we can’t figure out what’s going on. New therapies and techniques provide simple and effective ways to manage disease, but implementing them in practice is challenging, especially when you’re already busy. Everyone in the office has a role to play in making patients healthier, and it starts with a new understanding of cariology.

 

 

Annual Update on the HRSA UDS Sealant Measure

Irene Hilton, DDS, MPH; Vy Nguyen, DDS, MPH; Ramona English, DMD

A follow-up to last year’s popular session, this year’s presentation will highlight results and trends from the first two years of data collection for the HRSA Uniform Data System (UDS) Dental Sealants Measure. Best practices and work-arounds to address data collection and reporting challenges will be shared for those health centers that are not yet using the EDR vendor-developed solutions in order to more accurately and completely collect the different data elements of the measure (age, patient of record, risk status, exclusions, and sealants placed). The presentation will also describe successful strategies that health centers have developed to modify and/or implement clinical workflows that have increased the percentage of children receiving sealants.

 

 

Interprofessional Oral Health Referral Management

Sean Boynes, DMD, MS; Abigail Lauer, MS

Previous analyses have demonstrated a link between a strong referral system and increased patient satisfaction, better health outcomes, and reduced cost of care. Unfortunately, medicine and dentistry share reports of difficulties and dissatisfaction with interprofessional communication and coordination of care. This presentation will review the challenges and opportunities with creating dependable referral processes. Best practices and basic guidelines developed during a multi-state learning collaborative will be presented. In addition, findings from a large cross-sectional survey on the appraisal of interprofessional referral systems involving a cohort of medical and dental clinical providers and front office staff, senior and executive health care leadership, and patient coordinators will be described.

 

Nitrous Oxide-Oxygen Procedural Sedation: Just Breathe

Leann Keefer, RDS, MSM

Creating a positive patient experience often begins by identifying and addressing any underlying fears or anxiety regarding dental treatment. Nitrous oxide-oxygen procedural sedation is the most commonly used inhalation anesthetic in dentistry. It is a valuable component of the dental resources available to clinicians. This course will provide an overview of the history, identifying fears, anxiety, and phobias related to treatment, the clinical science of N2O/O2  application, and safety issues.

ITR Hands-on

Nels Ewoldsen, DDS, MSD

Interim Therapeutic Restorations (ITRs) are an effective means of restoring and preventing carious lesions, especially in non-traditional clinical settings.  Come and explore a “hands on” experience of placing these restorations and getting more familiar with the materials involved and the techniques to utilize them fully.  All materials will be provided and the exercise will be conducted on typodonts.

 

 

Dental Program Redesign: Digging Deeper with Data

Danielle Apostolon

This course will show participants how to use data to measure capacity, set realistic and achievable goals within the five domains of access, finance, outcomes, quality and governance. There will be a demonstration of tools created to monitor dental program success in meeting goals and perform key calculations used to identify areas in need of a redesign. By the end of the course, participants will have the ability to determine if their dental program is maximizing access, patient outcomes, revenue and providing quality care. This session is part 2 of 3 of the Dental Program Redesign series.

 

 

Oral Health and Disease in HIV/AIDS

David Reznik, DDS

It has been 36 years since the first reports of Acquired Immunodeficiency Syndrome (AIDS) were reported to the United States Centers for Disease Control and Prevention. The dental team has been an important part of HIV primary care since the early days of the epidemic when up to 80% of all HIV+ patients would present with an oral manifestation related to disease progression. Recognition of the oral manifestations of HIV infection are important tools in accessing a patient’s overall well-being as they are important indicators of disease progression for those known to be HIV positive and may provide a means of accessing the potential status of those at risk for HIV infection.

This presentation will enable the participants to accurately diagnose and manage the most common oral opportunistic infections seen in association with HIV disease and how to manage an exposure in the dental setting.  Other topics to be covered include proper dental management for people living with HIV disease, including a discussion of important lab values, and the important role of the oral healthcare team in regards to the clinical management of HIV-infected patients.

 

 

Integrated Care for Patients with Diabetes

Holly Kingsbury, MPH; Katya Mauritson, DMD, MPH; Carol Niforatos, DDS

Successful integration requires collaboration and creativity from all involved. Three partners from Colorado will describe a pilot project to integrate oral health into primary health care for patients with prediabetes and diabetes. The session will highlight the ingredients for collaboration and the roles state health departments and Primary Care Associations can play to support health centers in enhancing integrated care and will demonstrate how they can build on its existing integrated model to deliver patient-centered diabetes prevention and management.

 

 

Oral Health Care Needs of Adults with Special Needs

Malieka Johnson, DDS

Adults with special needs, such as intellectual and developmental disabilities, traumatic brain injuries, spinal cord injuries, and complex medical conditions, often face more barriers to access to dental than others. Traditional barriers to access include location, transportation, insurance, costs, personal support, and fears. Non-traditional barriers include a shortage of the number of providers, lack of provider experience and comfort, and wavering institutional support. This session will highlight a model utilized at a health center and private practice. Practicing in both sectors has allowed them to see where opportunities to increase awareness of this issue lie and to provide insight into where and how access can be improved for the adult special needs community.

 

 

Excellence in Dental Billing and Coding

Andrea Dickhaut, RDH, BSDH, MHA

Do you know what an effective revenue cycle should look like for a health center dental program?
Are you familiar with, and know how to use the newest ADA procedural codes and ICD 10 diagnostic codes?
This session will be a treasure of information to make your program healthier and an opportunity to learn how poor coding practices can create risk.

 

 

Medical and Dental Working Together at the Community Level

Patty Braun, MD, MPH

In this changing healthcare environment, collaboration will be essential to move forward. The success of your dental program will hinge upon how strong of an interdisciplinary approach to patient care is supported by your health center, both within and outside of the dental office. Come and discuss how to build, nurture and sustain such partnerships.  Imagine how both medical and dental providers within a health care system can support each other’s goals to improve overall patient health?  What role does the patient play in this collaborative relationship?  Where do the public and private sectors interface? Where will we be able to find the additional resources needed to build this infrastructure?  Leave your baggage outside the door, seek “common ground”  and you might just find your HRSA operational site visits and grant applications are stronger from such a vantage point.

 

 

A National Community Dental Education Model

Bill Piskorowski, DDS

Inadequate access to oral health care in Michigan and other regions in the US persists for a variety of reasons. The University of Michigan School of Dentistry’s Community-Based Dental Education has enhanced students’ dental education and has been increasingly incorporated into the curriculum to provide high quality and comprehensive dental care to underserved and Medicaid populations, while providing expanded practice experiences for students that influence their practice decisions upon graduation.

 

 

Maxillofacial Disease Management in the HIV + Patient

Kishore Shetty, DDS, BDS, MPA, MSc, MAGD

A specialty FQHC clinic focusing on primary care of HIV+ patients in an urban setting implemented a novel approach of team based care compromising of oral medicine specialists, nurse practitioners, general dental practitioners and dental students. The 1st phase of the program involved multi- disciplinary approach for identifying patients with a condition / lesion in the oral and maxillofacial region. The 2nd phase of the program involved diagnosis of the condition/ lesion involving surgical therapy combined with therapeutic treatment and / or referral.

Wednesday, November 15th

Plenary Session: The Future of Practical Medical/Dental Integration for FQHCs

Bob Russell, DDS, MPH, Iowa Public Health Dental Director, Chief Oral & Health Delivery Systems

Seems like health centers have been wishing for greater medical/dental integration for years now. What does a truly integrated, multi-disciplinary approach to patient care look like? How do we separate the myth from the reality whereby we leave the fluff behind and chart a course that will make this dream come true! What truly is undoable, once we have broken through the bonds of maintaining the status quo? Failure is not an option. Who are your champions and where will the virtues of true leadership take us? Buckle up! It may be a bumpy ride, but it will be worth the effort!

 

 

Meeting at the Crossroads Between Risk and Quality

Mark Doherty, DMD, MPH, CCHP

The worlds of Risk Management and Quality Management and how they relate to each other and to us as those responsible for oversight and execution of both in our Health Center Oral Health Programs is not always understood with clarity. This session will define for us the essential elements of both as they relate to our oversight and responsibility. Then, it will take a deeper dive into how the relationships between Risk Management, Continuous Quality Improvement, Quality Assurance, Federal Tort Claims Act (FTCA) Malpractice Insurance and other regulatory elements related to FQHC governance all fit together. We will visit each element in relation to policy for each and demonstrate how knowing the ways in which they do relate actually gives us a better idea of our responsibility thus enabling us to execute each of them accurately and with more confidence.

 

 

Oral pH: Understanding the Importance

Tony Hashemian, DDS

Engaging Patients in Their Own Well-Being: A continuing challenge for many clinicians is how to help patients understand the importance of their oral health and to motivate patients to actively engage in and own their self-care. Dr. Hashemian will discuss the ease and efficacy of salivary ph testing as part of patient awareness and understanding, the science that links saliva ph to both oral and systemic health and research that supports health-based text-messaging to patients. He will provide approaches and insights that draw on new ways to impact patients to facilitate patient/provider partnerships.

 

 

Developing, Implementing and Improving a School-based Sealant Program

Marty Lieberman, DDS; Matt Crespin, RDH, MPH; Mary Kate Scott; Stacy Torrance

Learn how other FQHCs started and operate successful school-based sealant programs (SBSP). Hear what works (and what didn’t work!) for other FQHCs and translate these lessons learned into creating your own plan to operate a SBSP. Several SBSP programs will be profiled, including very large programs serving thousands of children, smaller programs, programs with different staffing models and very new SBSPs. We’ll present the finances of different programs to help you understand the ideal size of a program, anticipated revenues, and costs. Find out about the common misconceptions of SBSPs and how to engage your dental providers, staff, school leaders and local community on why SBSPs meet a critical need. Learn about the recently released recommendations and tools for SBSP’s published by an expert panel convened by the Children’s Dental Health Project.

 

 

Dental Program Redesign: Digging Deeper with Best Practices and Strategies

Dori Bingham, BA

Examples of best practices and strategies will be revealed to guide participants in identifying solutions to improve all aspects of dental operations. Participants will hear how these solutions address the most common issues facing safety net dental programs and have led to many successful dental program redesigns.  As a result, participants will be able to develop an improvement plan that will lead their dental program to success in the five domains of access, finance, outcomes, quality, and governance. This session is part 3 of 3 of the Dental Program Redesign series.

Pain Management – An Alternative to Prescribing Opioids

Robert Peskin, DDS

You Won’t Feel a Thing: Dr. Peskin discusses current guidelines for pain and anxiety management during and post-clinical care. He will debunk ‘myths’ and misunderstandings about different pain management protocols, best-practices for local anesthesia use and provide practical guidance for challenging clinical situations.

Treating Tobacco Dependence

Lindsay Sailor

Screening for tobacco use and patient readiness for treatment is critical to reducing the health impact of tobacco. A variety of staff asking the right questions at every opportunity and being ready to respond greatly increases the quit rates therefore improving health outcomes. This session will provide an overview of activities and policies to implement in Health Centers that will help your organization better screen, treat, and provide follow-up care for tobacco dependence. A Michigan Health Center will share their process improvement strategies and results.

 

 

Medical and Dental Integrated Visits at Community Health Centers

Ashley Popejoy, DDS, MS

The average age at which a child first visits a dentist is well over the AAPD’s recommendation to establish a dental home by age one. Because a primary care physician is likely to have multiple visits with a child between the ages of 6 months and 3 years, one method of assisting with access to care is involving dental professionals in primary medical preventive care appointments. A two-year pilot interventional study was performed with under age 3 dental visits being completed concurrently with a patient’s well-child visit at Jordan Valley Community Health Center in Springfield, MO. During this presentation, participants will learn the areas which experienced the greatest success during this trial, the most significant barriers to integration, and the level of impact these additional services had on a low-income health center population in the Midwest.

 

 

 

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