The Dental Home Network for Children with Special Health Care Needs provides community expertise and has evolved into a telementoring study club— the future of health education.
Picture a child sitting in a dentist’s chair, the light overhead is bright, and an unfamiliar tool buzzes beside his or her ear like a bee erring too close for comfort. Even for adults, a visit to the dentist can elicit anxiety, but for children with special health care needs, these sensory experiences can be overwhelming. Many oral health care providers have limited experience and lack techniques to simultaneously manage the medical, dental, behavioral, and psychosocial aspects of oral health care for children with special health care needs.
“We tend to find that many times children struggle with access to care either because of medical issues or behavioral challenges. There aren't enough providers for all of the kids with special health care needs in Minnesota. These children need specialized procedures and adapted health care interventions to receive safe, high quality care,” explains Dr. Jeff Karp, D.M.D., M.S. pediatric dentist and Director of the Pediatric Dentistry Residency program at the School of Dentistry.
There are more than 179,000 children in Minnesota with special health care needs.
Every child deserves a healthy smile. Unfortunately, dental care is the second most common unmet health need for children with special health care needs. Oral health care is best addressed by a dental home—where all aspects of care are delivered in a comprehensive, continuously accessible, coordinated, culturally competent, interdisciplinary, and family-centered way.
“Every child should have access to a dental home. Overall health cannot happen if you do not have good oral health,” says Dr. Karp.
BREAK DOWN SILOS
Dr. Karp approached Drs. Peter Scal and Mark DeRuiter with an idea: create a health care network of professionals to collaboratively work towards combating obstacles that currently stand in the way of children receiving oral health care.
From left to right: Dr. Peter Scal, Dr. Mark DeRuiter, Dr. Jeff Karp
Together this team was able to identify early on that the problem they were dealing with went far beyond pediatric dentists, and to the full scale of health care professionals. So they put out a call to join forces. Many of the people who answered had a personal connection with children with special health care needs.
“We got people from dentistry, pediatrics, speech therapy, nursing, psychology, social work, and community providers.” said Dr. Scal, MD, MPH, and Associate Professor in the Medical School’s Department of Pediatrics.
The team began to look towards the one thing they all had in common— education.
“We found our collective strongest lever to make a change was in the realm of education,” said Dr. Scal.“Those who needed to know about this problem in providing care or moving it to a higher level of importance would all be within this category. Lots of people bring knowledge, and we need to take this into account. Rather than a hierarchical system, we should be generating conversation and bring in learners. Students come in with knowledge teachers don’t have.”
In 2016, Dr. Karp, Dr. Scal, and Dr. DeRuiter applied for a grant from the Robert Wood Johnson Foundation. They were awarded funding and became part of the first cohort in the Clinical Scholars Leadership Program, a 3-year program which provides leadership development opportunities for practitioners from diverse fields of health care working together to tackle complex health problems in their community and building a culture of health nationwide. As part of Clinical Scholars, they were able to launch a telementoring program to empower learners.
The Dental Home Network utilizes Project ECHO and Zoom-based videoconferencing for telementoring in order to connect with members and meet over video calls from any location, with the goal of creating community among providers and among rural, urban, University, and hospital settings.
“Educators have specialized knowledge, but this is inadequate. As faculty, we need to be willing to be humble and step outside the role of experts and leaders, and understand that we are one of many and this is exciting,” says Dr. Scal. “Identified student passions unleashes something great and so does taking on issues outside the classroom. When we tap into community passion and expertise, we can move ahead on solving complex problems.”
The team recently graduated from Clinical Scholars and have completed their projects’ grant funded activities. Dr. Karp looks toward the future and continuing the work of the Dental Home Network.
THE NEW NORM
Dr. Karp now facilitates SMILE ECHO, an interprofessional study club and telementoring group where attendees have the opportunity to discuss de-identified patient care cases; ask for peer support related to patient care concerns; listen to various presenters discuss best practices and new ideas in patient care; as well as networking with a varied range of clinicians and advocates. The telementoring study club offers 1.25 continuing dental education credits per month at no-cost.
It’s difficult for practitioners to meet in the middle of the day so the group holds these calls from 8 to 9:15 P.M. central time on the second Tuesday of each month, which shows just how passionate and dedicated they are. People are able to join the call from anywhere in the world and from the comfort of their own homes. Technology plays a huge role in education, and now more than ever, people are learning in new ways.
A typical monthly meeting might start with an introduction of a new topic of interest, such as individuals with unique head and neck conditions or who have sleep apnea; how best to serve a patient with sensitivity to light or noise and getting them acclimated to a clinical space ahead of an appointment. Someone presents a representative case for the group to discuss in detail. Specialists and experts weigh in to help move the presenters’ practice forward. Everyone is given an opportunity to share their experiences and resources about the topic.
Dr. Karp’s vision for this network is to see it grow not only in numbers, but in diversity of professions that are involved and more rural integration. “I welcome the chance to partner with students, residents, fellows, and early career clinicians to facilitate this group and our monthly calls. I am hopeful that SMILE ECHO becomes a part of the fabric of what we do.”
He explains, “There are a lot of opportunities and ways that we could look beyond what we consider to be traditional health care to much more collaborative and interprofessional learning networks. People want to be here, not because they’ve been told to, but because they’re passionate about the work they do and making a difference in our existing systems.”
If you are interested in learning more about SMILE ECHO or the process to join the network, please contact Dr. Jeff Karp at [email protected].