Month: August 2021

Hannah Archer is an MPH student at UNC-Chapel Hill with a passion for public health dentistry. This summer, she worked with us at NCOHC to develop a policy brief on postpartum health benefits, while continuing to develop a research project to study the value of online resources for oral health care.

Could you tell me a bit about your career/education path prior to pursuing your current degree?

I studied Education and Biology in undergrad and was always interested in healthcare. I knew I wanted to pursue a career in dentistry, but wanted to learn more about the social components that play a role in oral health outcomes prior to starting dental school. So, I decided to apply to the Master of Public Health program at UNC Gillings. While here, I fell in love with oral health policy, and learned about NCOHC during a class I took on Dental Public Health. In August, I will begin my final year of my MPH, and recently applied to dental school in the hopes of attending dental school following my MPH.

Where are you in school, what are you studying, and why did you choose that program?

I am at the UNC Gillings School of Global Public Health studying to receive my Master of Public Health with a concentration in Health Policy. I chose this program because of the incredible opportunities at UNC, ranging from the incredible faculty, diverse peers, community-based learning experiences, and connections to organizations with a dedicated mission to improve public health.

What’s one fun fact about yourself?

I played tennis in college.

Where did you first hear about the North Carolina Oral Health Collaborative, and why did you want to pursue an internship with NCOHC?

I first heard about NCOHC when Dr. Zachary Brian spoke in two different health policy courses I was taking at UNC Gillings. His presentations were incredibly interesting and encapsulating. Even with an already established interest in oral public health, Dr. Brian made me feel inspired and driven to advocate for change. Later in the semester, I established a research project with a UNC Adams School of Dentistry professor and had the fortune to also partner with NCOHC. Given the extensive work and incredible opportunities I had over the past year to work with NCOHC, I knew there was no other place I wanted to pursue an internship and I feel incredibly fortunate to be here.

What about public health dentistry is intriguing to you?

While I aspire to have a career in dentistry and to spend time in clinical settings, I appreciate the broader focus of dental public health. I want to make an impact on dentistry at both the individual and population level. I particularly appreciate the focus of dental public health on increasing equal access to oral health care for all individuals. Through my position at NCOHC, I have seen just how significant the disparities in oral health outcomes are across the state and I aspire to make significant changes in my professional career.

Tell me a little about what you have worked on as an NCOHC intern. What do you hope to take away from the work you have been doing?

My internship revolves around two primary projects. In my first project, I am learning about public health communication by establishing a website to provide oral health information to providers and patients across North Carolina. The website includes oral health education for various populations, including pregnant mothers, children, individuals with intellectual and developmental disabilities, adults, and older adults. In the next stages of this project, I hope to provide this website to a majority of safety net clinics across NC without dental services.

In my second project, I am writing a policy advocacy paper on Senate Bill S530 that was presented to the NC General Assembly in April. The bill proposes to increase postpartum Medicaid coverage from 0 days to 1 year for North Carolina mothers.. In my policy brief, I am advocating to pass this bill so that postpartum mothers can receive both medical and dental Medicaid benefits. Through my research, I am learning a lot about the legislative process and the necessary components of advocacy (i.e., stakeholder support, lobbying, grassroots mobilization, etc.) necessary to pass a bill like this. In addition, I am learning about the social determinants of health that influence poor oral health in mothers and children, along with the significant health implications a bill like this could have.

If you could tell North Carolinians one thing you have learned that you think is important for everyone to know, what would that be?

Oral health starts before birth. I did not realize what a profound impact a mother’s oral health can have on their child, and that a child should be going to the dentist as early as one year of age. Unfortunately, the presence of oral health care and education is severely lacking in North Carolina, and this is something I hope to advocate for and address in my future dental public health career.

What’s next for you?

I just completed my applications to dental school. I hope to hear back from schools in December and I intend to pursue a residency in dental public health (and potentially pediatrics) following dental school.

A landmark piece of dentistry legislation became law in North Carolina on Friday, July 23, 2021. Senate Bill 146, sponsored by Senator Jim Perry, with a House counterpart sponsored by Representative Donny Lambeth, is a broad-reaching piece of oral health legislation that will allow North Carolina to take several steps toward a more accessible, equitable oral health care future.

There are four main parts of the legislation:

1. It codifies teledentistry in North Carolina law.
2. It allows dental hygienists with proper training and qualifications to administer local anesthesia.
3. It further aligns two existing regulatory provisions that allow dental hygienists to more efficiently work in community-based settings.
4. For the first time, it formally recognizes Federally Qualified Health Centers (FQHCs) in North Carolina statute.

All parts of the legislation went into effect when the bill was signed into law on July 23, except for the section allowing hygienists to administer local anesthesia. That portion of the bill is set to take effect on October 1, 2021.

Teledentistry is Codified in North Carolina Law

Teledentistry is an important tool in the dental professional’s toolbox. In addition to being an invaluable asset during the COVID-19 pandemic, remote care technology is a great way to expand access to patient evaluations, consultations, assessments, and education to those who may have trouble getting into a brick-and-mortar dental office.

While teledentistry has never been “illegal” in North Carolina, there have not been set standards defining its use.

Senate Bill 146 defines teledentistry, lays out the various ways it can be used, and sets standards for informed consent during remote patient encounters. It also establishes patient protections, authorizing the North Carolina State Board of Dental Examiners (NCSBDE) to take disciplinary action against dentists who allow fee-splitting or who limit a patient’s ability to file complaints or grievances when receiving teledental services.

Dental Hygienists Will Be Able to Administer Local Anesthesia

North Carolina joins 45 other states and Washington, D.C. in taking this important step.

Currently in North Carolina, dentists are the only oral health professionals authorized to administer local dental anesthesia. . Especially in public health settings — where providers routinely see high numbers of patients — the time it takes to administer local anesthesia and wait for it to take effect can create a bottleneck, limiting the dental team’s efficiency.

By allowing appropriately credentialed hygienists to perform this duty, dental teams can take steps to increase efficiency, reduce care costs, and ultimately expand their reach in treating additional patients. As mentioned above, this provision of the legislation will take effect on October 1, 2021.

To learn more about training requirements, refer to North Carolina General Statute 90-225.2. Licensed hygienists and hygienists with out-of-state certification can refer to NC General Statute 90-225.3 to find out how to become certified. Both laws can be found here.

Rules Pertaining to Public Health Hygienists and Limited Supervision Hygienists are Further Aligned

The regulatory rules within Dental Hygiene Subchapters 16W (defining what it means to be a public health hygienist) and 16Z (outlining eligibility to practice hygiene outside of direct supervision by a dentist) contained similar provisions, with a grey area where eligibility requirements were unclear. Senate Bill 146 aims to further align these provisions and the eligibility requirements that hygienists must meet to practice in limited supervision capacities.

For background, a 2020 update to Subchapter 16W allowed public health hygienists to perform preventive procedures in non-traditional settings under a written standing order from a dentist, rather than with a dentist having previously examined the patient.

Senate Bill 146 lays the groundwork for the same eligibility criteria to apply for hygienists practicing outside of direct supervision under Subchapters 16W or 16Z. For true alignment, a modification to rule 16W .0104 will need to be made.

If you would like more information to clarify 16W, 16Z, and the changes made by this recent legislation, NCOHC will be hosting informational sessions in the coming months.

Federally Qualified Health Centers are Recognized in Statute as Public Health Providers

Senate Bill 146’s passage marks the first time that Federally Qualified Health Centers (FQHCs) have been formally recognized in North Carolina law within the Dental Practice Act. While this may seem insignificant, it solves key barriers that many faced when trying to expand access to care.

When Rule 21 NCAC 16W .0104 was updated to allow public health hygienists to perform preventive procedures outside of direct supervision and based on a written standing order, FQHCs found themselves unable to efficiently take advantage of the change. Many FQHCs offer school-based oral health care services, but since their designation wasn’t clear, they were limited by legislative barriers in order to use the rule change to expand the services they offered most effectively.

Senate Bill 146 resolves this issue, identifying FQHCs as an integral component of the public health safety net.

There are many improvements for oral health access and equity contained within Senate Bill 146, and NCOHC will continue to break down all the ins and outs that you need to know. Stay up to date by joining us as a North Carolinian for Change today!