​HOW DOES MYSMILEBUDDY SUPPORT PARADIGM SHIFTS UNDERWAY IN HEAALTH CARE?
Shift toward primary prevention to address root causes of disease by improving health behaviors
The MySmileBuddy Program supports Health-Behavioral Management of childhood caries as a complement to conventional dental care. MySmileBuddy meets the American Academy of Pediatric Dentistry’s call for “non-surgical interventions … to postpone or reduce the need for surgical treatment approaches” and use of chronic disease management approaches that include “parent engagement to facilitate and promote preventive measures while encouraging the identification and reduction of individual risk factors.” Notably conventional dental repair fails to stop disease progression and results in high relapse and retreatment rates because it does not address underlying disease determinants. Office-based child and parent education, oral hygiene instruction, and diet counseling are important first steps in prevention …but…are not sufficient to help people adopt and sustain healthy behaviors. The MySmileBuddy Program picks up where office counseling leaves off!
Shift toward addressing social determinants of health
The MySmileBuddy Program considers families’ social, economic, educational, and environmental capacities and capabilities in creating highly individualized and tailored approaches to caries prevention and management. MySmileBuddy Program coaches are trained to refer families for services that address economic, housing, employment, immigration, and food insecurities to better position families to take action to improve diet and oral hygiene behaviors.
Shift toward paying for quality, outcomes, and value
The MySmileBuddy Program supports value-based healthcare and advanced payment mechanisms by enhancing oral health quality of life, addressing caries risks, stopping disease initiation and progression, and reducing costs of restorative care. As dental care – like medical care – shifts toward alternative payment mechanisms, the Program can support pay-for-performance (P4P), episodes and bundles of care, and family and provider incentives.
Shift toward integration of clinical and public health care
The Association of State and Territorial Dental Directors suggests that childhood caries should be addressed through a combination of prevention (“addressing the disease”), treatment (“systems of care”), and “public health practices.” The MySmileBuddy Program advances these approaches by operationalizing disease prevention and management; by supporting integration with community-based education, nutrition, and health promotion services; and by targeting
at-risk subpopulations of children and their families.
Shift toward Medical-Dental Integration
The MySmileBuddy Program can be implemented in primary care medical offices to meet responsibilities outlined by physicians’ professional organizations. The American Academy of Pediatrics calls on pediatricians to “be knowledgeable about the disease process of dental caries, prevention of the disease, and interventions available to the pediatrician and the family to maintain and restore [oral] health. The American Academy of Family Physicians similarly calls on primary care physicians and nurses to “play a role in preventing oral disease and promoting oral health” by screening, counseling, and referring. The Connecticut Health Foundation’s report, “Improving Children’s Oral Health by Crossing the Medical-Dental Divide” details eight options for increasing dental care for young children, increasing involvement of medical primary care providers (PCPs), and securing the triple aim of improved patient outcomes at lower cost with improved population health.” These options build on concepts of chronic disease management that are commonly employed by physicians treating other chronic conditions like asthma, diabetes, and obesity.
Shift toward Teledentistry and community-based health care
The MySmileBuddy Program may be used for in-person counseling in community-based sites that support socially-vulnerable families like Head Start, WIC, and MIECHV (Home Visiting Programs). Our survey of 101 community-based oral health-counseling programs found that most seek to promote families’ adoption of positive health behaviors but few use established tools like MySmileBuddy to do so.
MySmileBuddy is also tailor-made for remote delivery by medical and dental personnel as well as by community health workers, nutritionists, health educators, and social workers. Delivering the MySmileBuddy Program through teledentistry supports principles of virtual dental care advanced by the American Teledentistry Association by expanding access (particularly in underserved communities), reducing costs to families associated with travel and missed work, and facilitating dentists’ outreach to high-needs communities.