How Place-Based Care Might Change Dental Care

Many older adults in the United States find it challenging to gain access to dental care [1]. This is largely because traditional dental care in the U.S. generally takes place in a private dental office or in a safety net clinic [2], both of which require some amount of travel and planning in order to receive care. Sometimes, scheduling appointments and planning for transportation must be done by a caregiver if the senior doesn’t feel fully comfortable with the complex process.

These challenges highlight the need to make oral health care accessible to seniors where they live, worship, or receive social services. This practice of providing care outside of traditional settings is referred to as “place-based care.”

Some of the benefits for place-based care is that it allows efficient use of resources, encourages community involvement, and meets the needs of seniors’ oral health needs, especially in rural settings where access to traditional private clinics is limited [3] [4].

A wide variety of place-based care models are present within the U.S. The structure of these models, and the care they provide, relies heavily on their state’s individual dental practice act, which defines requirements dentists must follow to be licensed in each state.

If you, or a loved one, are considering place-based care, here are some key questions to ask:

  • Who owns the place-based care program and how is it funded?
  • What are my financial obligations?
  • Are uninsured individuals offered the same services as insured individuals?
  • Are your providers licensed in the state where the dental services are being offered?
  • What treatments will be offered? When and where will they be provided?
  • How long will treatments take?
  • How is follow-up and urgent care handled? Who coordinates these?
  • Who can answer questions or concerns about treatment after it has been provided and how do I contact them?
  • How can I get copies of my dental records to share with future dental providers?
  • How will the information you get be shared with the residential facility?
  • Can you have a letter of reference?

[1] Dye BA, Fisher MA, Yellowitz JA, Fryar CD, Vargas CM. Receipt of dental care, dental status and workforce in U.S. nursing homes: 1997 National Nursing Home Survey. Special care in dentistry: official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry. 2007;27(5):177-86.

[2] Helgeson M, Glassman P. Oral health delivery systems for older adults and people with disabilities. Spec Care Dentist. 2013;33(4):177-89.

[3] Mueller KJ, MacKinney AC, Gutierrez M, Richgels J. Place-based policies: The road to healthy rural people and places. Columbia, MO: Rural Policy Research Institute; 2011 March 2011.

[4] Committee on the Future of Rural Health. Quality through collaboration: The future of rural health. Washington, D.C.: Institute of Medicine; 2005.