As a leading and innovative provider of public oral health services, Your Community Health implemented the Heal and Seal Clinic; a unique approach service delivery which:
- Is built on the fundamental principles of value based healthcare
- Is built around a team-based approach, where clinicians are empowered to work to their full scope of practice; ensuring the client is seen by the most appropriate clinician at the most appropriate time; for the most appropriate service.
- Improves engagement with clients at the point of entry to the service, often at the point of enquiry for routine oral health care services.
- Improves the timeliness of oral health education, dietary counselling and smoking cessation services; empowering clients to modify behaviours and/or seek additional support, earlier.
- Provides a mechanism for the timely assessment and escalation of clinical care according to clinical or general health and wellbeing criteria.
- Provides a mechanism for the timely provision of preventative and disease stabilisation services; whilst clients wait to access routine oral health care.
- Provides a mechanism for high risk clients to be supported with follow-up preventative services; whilst clients wait to access routine oral health care.
The team based approach to service delivery alone has enabled Your Community Health to see more clients, reduce average waiting times and reduce the number of people waiting for care; whilst ensuring client care was undertaken by the most appropriate professional, in a timely manner.
Heal & Seal Clinic model:
An initial education session is scheduled at the point in time the client registers for general dental care. This is undertaken by an Oral Health Coach (Certificate IV Dental Assistant). Following this educational session, the client is offered an optional Heal & Seal Clinic appointment with an Oral Health Therapist; whereby examination, radiographs (as indicated) and an interim treatment plan developed to stabilise active dental caries.
Where active dental caries is noted, the following management options are provided:
- Cavitated Carious Lesions: Application of Silver Diamine Fluoride (& potassium iodide precipitate where indicated) “Healing”, followed by “Sealing”/covering the lesion with an appropriate GIC. This increases the effectiveness of the SDF in addressing the caries and in most cases eliminates the need to re-apply every 6 months.
- Non-Cavitated Carious Lesions: Application of Fluoride Varnish as indicated. This is followed by 6 monthly re-application by OHC (with Fluoride Certification) for high-risk clients, under the written prescription of the OHT; until such time the client comes off the general waiting list.
- Diversion to Emergency Care (via triage) if urgent needs indicated (i.e. swelling, pain, etc.).
The aim is to stabilise the clients’ current level of oral health disease and work with them to prevent further disease and/or deterioration; whilst they wait for general care. It is envisaged that over-time, the complexity of care required in a general care setting would be significantly reduced; thus self-supporting continued resourcing and the capacity to see more people within a public dental setting.
This model is replicated within undergraduate student teaching clinics (DDS and BOH) run by Your Community Health in partnership with The University of Melbourne.
Acknowledgement: We take this opportunity to acknowledge Your Community Health for this information.