When will the Access to Oral Health in Georgia Law Make a Difference to the Underserved???

After years of challenging advocacy and coalition-building across the state, a law (HB 154) was passed in 2017 to increase access to oral care in Georgia; it was enacted on January 1, 2018. This law allows Georgia licensed dentists to authorize dental hygienists that have been licensed for at least two years to provide these preventive dental services when the dentist is not present: oral assessments, prophylaxis (cleaning), sealants, and fluoride. This type of supervision by the dentist is referred to as General Supervision. Although general supervision is also permitted in private practice settings, this law is intended to benefit low-income children, special patients, and older adults, as well as anyone who is unable to access services in traditional settings. The safety-net setting sites indicated for general supervision services are Title I schools, long-term-care settings, domestic violence shelters, Federally Qualified Health Centers (FQHC's), and hospitals. These are considered to be areas where our most vulnerable populations are found. In order to assist the dental profession in transitioning safely and effectively into providing services within the community, Dr. David Reznik and Dr. Eunice Chay created a Toolkit that is available to all practitioners. Not surprisingly, change is painfully slow. The first adaptors have been private practice dentists who are able to have their dental hygienists provide these preventive services in addition to x-rays for their patients of record; patients who are already established and have had an initial exam by the dentist in that practice. This has been an easy transition, as not much has changed for the patient, other than receiving an exam by the dentist before or after dental hygiene services were rendered. What has been more challenging is the care being offered and provided in safety-net settings. This often involves the purchase of special equipment, such as mobile dental units and/or teledentistry. Plus, reimbursement is lower in these settings, whether Medicaid, Medicare, or sliding fee. Many dentists are reluctant to make the investment on a slower, lower return. Hurry up and wait... In my next blog, we will be discussing some of the pockets of change in our state... Next blog: The Access to Oral Care Crawl vs. Sprawl