Increasing access to oral healthcare services to underserved children through a collaborative school-based program using expanded scope of practice dental hygienists and dental hygiene students: A feasibility study

Accessing oral health care is a growing problem for children in the United States. Promising oral healthcare workforce innovations are improving access to preventive oral health care. However, in most instances, these innovations do not have robust outcome data to demonstrate their impact on access to preventive oral health care. In 2012, the Robert Wood Johnson Foundation posted a call for the Systematic Screening and Assessment of Workforce Innovations in the Provision of Preventive Oral Health Services. Evaluation professionals from ICF International used the systematic screening and assessment method to identify promising, real-world workforce innovations that increase access to preventive oral health services. UMKC Miles of Smiles (MOS), a school-based preventive oral health program that utilizes expanded scope of practice dental hygienists and dental hygiene students was selected to participate in this initiative. The evaluative assessment (EA) consisted of document reviews followed by a 3-day site visit. This paper will present findings from the EA, illustrate a logic model, and address lessons learned in overcoming barriers. The EA revealed MOS has the capacity to provide restorative care onsite and is considered to be fully implemented as intended, increasing opportunities for MOS to serve as a dental home. Multiple resources, personnel and systems are required to fully implement the MOS program. The collaboration of dental hygienists, dental hygiene students, faculty, dentists and school administrators working together close the loop for comprehensive care. As MOS continues, and adapts to new circumstances, additional resources may be required which could affect the program's feasibility.