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The Dentist is in the Details

Mobile Dentistry: Entrepreneurial Boom Spurs Debate

Mobile dentistry done right

In 1988, a regulation was passed to allow preventive treatment on patients in South Carolina schools and Nurseing homes without the direct supervision of a dentist, but it was unused until Medicaid rates were increased in 2000, due to the efforts of organized dentistry. Non-dentist providers claimed that some care was better than no care at all, especially if the dentists were not willing to provide it, but members of the dental community were understandably concerned. At a meeting in January 2001 that was attended by a large group of dentists, much of the discussion was centered on these portable, school-based services.

John Reese, DMD, of York County, S.C., called leaders of the South Carolina State Board of Dentistry, the Department of Social Services, the South Carolina Dental Association, and other agencies to find out the best way to provide the services that were desperately needed by so many children. He acquired a used RV and retrofitted it as a mobile dental clinic, obtained approval from the South Carolina State Board of Dentistry, and entered into a contract with one school district to provide complete dental care to Medicaid-eligible children in one school as a pilot program - all in less than 60 days - while continuing to operate a totally insurance-free complex comprehensive restorative and cosmetic brick-and-mortar practice.

"The pilot program was immediately successful and the school district officials asked us to expand our services to more schools. The word also got out to neighboring districts and we received more requests for our services," says Dr. Reese. He sold his practice in 2001 to practice mobile dentistry full-time and has "never looked back". Since then he has designed a custom-built, state-of-the-art mobile dental clinic. His operation now serves nine school districts in six counties in South Carolina and employs four full-time dentists, one of whom is a pediatric dentist with 25 years of experience.

Dr. Reese says that when other states were being investigated for unscrupulous and fraudulent mobile and portable dental units, South Carolina began the process of passing regulations requiring the registration of Mobile and Portable Dental Operations. Because of his unit's reputation for providing quality dental care in the mobile environment, the leadership of the South Carolina Dental Association and State Board of Dentistry asked Dr. Reese to help write the law, which passed in 2006.

Reputable mobile/portable units

When reliable mobile dental offices provide services in a state, school administrators as well as organized dentistry takes note.

According to Dr. Reese, Dental Access Carolina (the company Dr. Reese established to provide mobile dental services) is an all-around team effort. "We utilize the true team concept of dentistry by having a dentist, a hygienist, and an assistant in each mobile clinic. We have provided true comprehensive and continuing care to more than 5,500 children during more than 14,700 patient visits since our program started in 2001," says Dr. Reese. "We do everything from prophys to endodontics in our facilities - without the use of restraints or sedation.

"Increasing access to care has been the catchphrase of organized dentistry for the last few years, espeically since the Surgeon General gave a failing report because of the level of dental disease in this country and reported that the number one reason children visit the school Nursee is for dental-related pain. The ADA and the AGD talk about access to care. But access to care can't just be a mantra, we must really believe in the concept. Our program is providing access to care. One of the first things I said when addressing the South Carolina House of Delegates was that preventive care is great - but you can't correct a toothache by polishing teeth or prevent a cavity that already exists by placing a sealant. I've been diligent in making sure correct treatments are performed on our patients. I also make sure that my office's recordkeeping is impeccable. I have records on patients dating back to 2001."

Dr. Reese's mobile office only treats patients who have signed consent forms from their legal guardians. The team maintains records for every patient and they keep them in a central office location. They send written information home with each patient and provide access to patients in the event of emergencies. Dr. Reese says, "Our goal is to provide compassionate, comprehensive care to children at their schools or other central locations in a environment that fosters a true winning relationship for all who are involved: the schools, the parents, the dental team, and most importantly, the children."

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