In so many ways, the past year was filled with darkness, and public health dentistry was in the center of this darkness. With the exception of emergency care, dental fully shut down for a long period of time, followed by a very slow return to providing dental care. Dental offices were shuttered, staff furloughed, and patients delayed care resulting in more complex treatment plans. Dental providers struggled to find PPE to keep themselves and their patients safe, and dental benefits were reduced in Medicaid while enrollment increased by over 200,000 Coloradans. Dental providers were, understandably, fearful of going to work each day as were their patients fearful to receive care.
But in times of great darkness, innovation and optimism emerge and begin to shed light. This might happen slowly and quietly, creeping in from the outer edges of the darkness. Hygienists began providing drive through screenings and fluoride. We saw organizations such as Kids In Need of Dentistry adopt this model and provide care in the same parking lot that schools were conducting lunch distribution during remote learning. We saw organizations such as the Colorado Coalition for the Homeless expand use of teledentistry, ensuring they could still provide screenings, patient education and emergency dental diagnosis to their clients virtually.
I’ve heard time and again, let’s not go back to “normal” in a post-COVID world. Let’s keep the innovation and opportunity we identified in these trying times to rethink the dental delivery system, improve access to care and advance innovation. Impactful policy advancements related to oral health have been bright spots amid the pandemic. This past week, we saw the Colorado Senate adopt expanded scope of practice for hygienists which will make provision of innovative dental procedures and advancement of teledentistry permanent. The Joint Budget Committee voted to restore the Medicaid dental benefit to $1,500, restore funding for the Senior Dental Grant Program, and not implement the copay increase for Medicaid. Final approval of these policy issues will speak to Colorado’s commitment to oral health equity.
These bright rays of light are worthy of celebration, but we must not stop there. To advance oral health equity, we must continue to seek out, and support, innovative approaches to oral healthcare that focus on improving access and prevention. This year, we’re launching initiatives in three focus areas: Place-based access to care, Prevention, and Workforce. Each initiative is geared to improve oral health outcomes and address oral health disparities in their respective areas.
In times of darkness there must be light, and in times of challenges we can find inspiration. To me, the oral health providers working in public health settings this past year have been bright rays of light. In order to fully appreciate the resiliency and perseverance of our community partners, one needs to understand the challenges they faced. Our 2020 Evaluation Report, created by The Colorado Health Institute (CHI) as an independent evaluator, gives context to the effects of the pandemic on oral health providers in Colorado. They have been pushed and challenged and responded with innovation and commitment to patient care. They have tested and proven models that are now resulting in policy change. They have epitomized oral health equity, and all their work, and the resulting policy change they helped bring about, brings a huge smile to my face.
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