Working With the Dental Community
Harry W. Bickel, Jr, DMD, MPH, Health Specialist, Region N-B TASC, Training & Technical Assistance Services, Bowling Green, Kentucky
"My dentists won't work with me!" cried the desperate health coordinator. The anger and frustration were apparent. "I have all of these kids to treat and no one will take them. What can I do?"
As a Head Start dental consultant for nearly twenty years, I have probably heard this complaint more than any other. As a dentist who has treated Head Start children, however, I may be able to provide some insight into the problem and come up with some possible solutions.
In understanding how to work with dentists and the dental community, it helps to understand how a dental office operates. First and foremost, a dental office is a business. Unless it is a public health clinic, it is a private business, owned by a single dentist or by a group of dentists in a partnership. The only money that comes into the business is that which is generated by the dentist (or dental hygienist) through the provision of dental services. The salary of the dentist or dentists comes out of the money that is left over after all expenses have been paid. So when you deal with a dental office, you must deal with it in the same way you deal with any other business.
Now, how to find dentists? If you are having problems, the answer is not simply to send out a form letter asking if anyone would like to participate. This is fine if you have an abundance of dentists and are just looking for a few more. It is not, however, the ideal way to interest dentists in your program. The best ways, in order of importance, to communicate with dentists are:
1) in person,Simply call the dentists and ask for a few minutes of their time so that you can explain what you want.
2) by phone, and,
3) by mail.Another, perhaps more useful, way to communicate with a dentist is through another dentist. If you have a dentist on your Health Advisory Committee that is a real advocate for your program, use this person as a liaison with other dentists. If you have practitioners that have had very good experiences with your program, let them help you find other dentists. Remember, most dentists in an area know one another.
Once you have gotten your foot in the door, be very clear about what you want. Tell the dentists how many children you would like them to see, what services you will and will not pay for, and how much you can pay. Tell them of any constraints you are operating under, such as the 45 day rule, and work out a system that is good for both parties. In-kind services and reduced fees are both necessary and desirable in a Head Start program. The bottom line, however, is that the children receive the services. Therefore, don't ask the dentists to work for free. Let them know you are a paying customer that needs the services they have to offer. Assure them that they will be paid in a timely manner and that, if they have any problems, they should come to you immediately. You might also invite them to accompany you to one of your classrooms and see the children in their own environment. This will let them know what Head Start is really about.
Be sure to bring enough children to the dental office to fill the amount of time that has been blocked out. Even if a child does not get seen, it is still a good opportunity to introduce the child to the dental office if the child has never been to one before. Then the experience will not be as frightening the next time.
If a number of children are being seen in one appointment, there should always be enough adults present to adequately supervise them. They should also be provided with appropriate activities to occupy their time. Very often the dentist may ask someone from the program to come to the treatment area to help with a child who is afraid. The remaining children cannot be left alone, nor should the staff of the dental office be asked to watch them. They are not trained to do this, and it is not their responsibility.
Once you have established a good working relationship with the dental community, nurture it. Thank the dentists for their participation and check with them occasionally to see if there is any need for improvement.
Don't forget the person at the front desk. This is who makes the appointments, not the dentist. Also, don't make unnecessary demands on the dentist's time, especially during working hours. If you ask them to talk to parents or staff, make sure you have good attendance. If you ask some of them to become members of your Health Advisory Committee, assure them that you would like their help even if they cannot always attend the meetings.
"My dentists are great! They will do anything I ask of them," said the joyful Health Coordinator with a smile. Believe it or not, I have actually heard this, too. Remember, however, it didn't happen by chance or overnight. It happened because the Health Coordinator, or someone else, took the time to make it happen.