Lesson 3 Accessing Dental Care: Choosing a Dentist · 2016-03-11 · Welcome to Accessing Dental Care: Choosing a Dentist, Lesson 3 of Dental Health for Individuals with Disabilities

The following presentation was originally developed for individuals and families by Achieva (a Western PA service provider). Now offered as a webcast production, ODP is providing this valuable resource to Supports Coordinators and SC Supervisors for professional development. In order to receive credit for completing this course, you need to complete all course requirements and print the certificate of achievement.

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Welcome to Accessing Dental Care: Choosing a Dentist, Lesson 3 of Dental Health for Individuals with Disabilities. Please adjust your computer volume so that it is at a comfortable listening level for you.

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Lesson 3 ‐ Accessing Dental Care: Choosing a Dentist

In lessons 1 and 2 you learned why people need to take care of their mouth. Another important part of taking care of teeth is seeing a dentist. The dentist makes sure that your teeth and gums are healthy. Sometimes you can have a problem that you don’t know about. Your dentist can find that. It may be something that they can treat. Or you may need to go to a special dentist for treatment.

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How do you find a dentist?There are a number of important things to think about when looking for a dentist. The steps to finding a dentist are on the slide.• Figure out what level of care you need.• Complete a pre‐visit form to help you figure out what level of care you need.• Answer the questions that you need to ask about level of care and other issues before

you call to make your appointment.• Know how you will pay for the visit and what insurances you have.• Find a few dentists that could work.• Call the dentists on your list to see if they will work with you.

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Your ability to tolerate dental care will determine the level of dental care you need. A pre‐visit form that you can complete with your family or team can help you decide what level of care you need.

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This slide shows you links to a dental pre‐visit form and to a webinar that will give you information about the form. You can use the Play/Pause button below the webcast to pause this presentation if you would like to download these forms now. These links will also be provided toward the end of this presentation

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The first step is to figure out what level of care you need.Level of care describes where you can get your dental care. This is affected by your needs. Ask yourself these questions:• Can you go to a regular dentist? • Do you need medication to help you be less afraid? • Do you need to be asleep for care? • Do you need a special chair?

The answers to each of these helps you figure out what level of care you need. You want to make sure that you go to a dentist that can give you the right care. Some dentists can only do basic care. Others can put people to sleep for care. So you need to find a list of dentists that can do the care that you need. Here’s how to figure out what level of care you need.

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Level 1 care is community‐based care for people who are not fearful of the dentist or who may require little or no assistance to complete their dental work. People may need some pre‐medication or local anesthesia.

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Level 2 care is community‐based care for people who may need some additional support to complete dental visits. They may need behavioral support, desensitization or some light sedation during the visit.

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Level 3 care is based in the community or in a specialty clinic and is for people who, in the past, have not had success with dental visits using level 1 or 2 care. This could be due to complex medical needs or to behaviors during dental visits. These people may need IV sedation.

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Level 4 care is for people who cannot complete dental visits in a typical community practice due to behavioral or medical complexity. People who receive level 4 care need to have their dental visits in a hospital or other specialized setting, usually under deep sedation or general anesthesia.

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The second step is to figure out how to pay for your dentist appointment.

Do you have insurance to pay for a dentist? If you said yes to this question, then you will want to use a dentist that accepts your insurance. There are many ways to find a dentist that accepts your insurance. Your insurance plan may have a list of dentists that you can pick from that accept your insurance. You will need to contact your dental insurance company to find out what dentists in your area will accept your insurance. The number to call should be on your insurance card or the information that you got when you got your insurance card. Your insurance company might also have a website that would give you the information that you need.

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There are three types of dental insurance that you might have. Commercial dental insurance is generally provided through an employer. Medical Assistance or Medicaid can be a managed care or preferred provider model where you must go to a participating dentist. It can also be fee for service where either the dentist bills your insurance company for services or you submit the dentist’s bills to the insurance company to be paid. If you have commercial dental insurance, then you must use that to pay for your dental services before Medical Assistance.

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Managed Care:If you have insurance through a health maintenance organization (HMO) or managed care organization (MCO), then you will need to use one of the dentists that work with that plan. This includes people with Medical Assistance or an Access card that live in an area where physical health insurance is provided through managed care. Use the following options.Look at the on‐line directory. Search for your Managed Care Organization (MCO). Look on the website for members. Look for dentists. Sometimes you will need to put your zip code or other information in so that the search can give you dentists in the area where you live. Call the Member Service or Customer Service number on the back of your insurance card.

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Call the Special Needs Unit (SNU) of your managed care company. For people with Medical Assistance, the information that you got about your MCO has the contact information for the SNU. Some commercial MCOs also have services for their members with special health care needs and can assist with finding a dentist. If you can’t find information about an SNU, then call the customer assistance number and they should be able to help you.

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Fee for Service:If you have Medical Assistance and live in an area where physical health is provided through fee for service or in an Access Plus county, then you should call the information number on the back of your blue and yellow Access card.

If you don’t have dental insurance, then you will need to figure out how to pay for your care. If you work, then this may not be an issue. How do you find a dentist in your local area? Try one of these ways: • Talk to your doctor• Look in the phone book or on‐line • Call the Pennsylvania Dental Society (search under PA Dental Society)• Ask a family member, friend, your case manager, care manager, service coordinator,

supports coordinator or other individual that helps you.

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If you have a limited income or do not have a way to pay for your dental care, then you need to look for a dentist that will provide free or low cost care. Sometimes this is described as using a sliding fee scale. This way you will pay what you can afford for care. One example of this would be a local community health center. These are sometimes called Federally Qualified Health Centers (FQHC). They are located in many areas. The United States Department of Health and Human Services, Health Resources Service Administration runs this program. They have a website to find a health center near you. You can also get this information from the State Health Department office nearest you.

You can also try working with your family’s dentist. Some dentists will see family members even if they don’t have an insurance plan that they accept. If your dentist is not on your health plan, then you may have to pay for your visits. You can talk to your dentist about signing up for your insurance plan. But remember they don’t have to do this.

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What do you need to know before choosing a dentist and scheduling an appointment?After your search you should have a list of at least few dentists that are in your area and might be able to work with you. Some may seem better than others. Dentists that are closer to your home might be better for you. One that is on the bus route rather than one that is harder to get to. One that you know such as one that takes care of the rest of your family. There are other things that may be important to you. Put the dentists on your list in order with the one that seems the best to you first. You may have to go more than one dentist to find the right one. Ask in advance any questions that are important to you. Use the Pre‐visit form to help.

Using the information that you filled out on the form, call the first dentist on your list. If you have never seen this dentist before, be sure to ask if they are accepting new patients. Once you know that they are accepting new patients, then ask them about any accessibility needs you have. We’ll talk about those next and in lesson 6.

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Questions to ask the dentist office before scheduling an appointment.

Do you take my insurance? This question is important because networks of providers change and the lists of dentists may change.

Do you provide the level of care that I need? If you need more than basic care, then you’ll need to ask the dental office if they can do that. This might mean asking the following questions.

Do you provide medication that helps make people calmer for appointments? Can you work with someone that takes calming medication for dentist appointments?Do you put people to sleep for dental care?

If you use a wheelchair, crutches, walker or other adaptive equipment to move around, then ask the following questions.Can your office accommodate ___________________? Put information about how you get around in the blank. For example if you use a power wheelchair, then ask questions like the following:

Can your office accommodate a power wheelchair? Will I be able to get into the office? Can I stay in my chair for the visit? Do I need to be moved into the dental chair?

If you cannot walk up stairs, then you may also want to ask whether or not there are stairs into the office.

If you do not use language or English to communicate, then ask the following questions.Is there someone that speaks my language?Is there someone that understands sign language?If your office doesn’t have anyone, then can I bring someone with me?

If you don’t talk very much or use gestures or facial expressions to communicate, then you will want to have someone with you to help you express yourself.

If this dentist seems like they can work with you, then you can schedule your appointment. If this dentist can’t accommodate your needs, then there are a couple of things that you can do. You could ask if this dentist has another site that might work better. You may need to go back to your list and try a different dentist.

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Scheduling an appointment

When you schedule your appointment, make sure that you have enough time. Think about visiting the office before the appointment if that would be helpful for you. Ask the receptionist if a visit is possible. When scheduling the time of the appointment be sure to plan time to get there so you can be there about 15 minutes before your appointment. You may need to look at the bus times to do this. Don’t schedule it when you have to be somewhere else right after your appointment. Appointments sometimes take longer than you expect. Dentists are sometimes late because of emergencies. That may mean that you may have to wait for your appointment while the dentist takes care of someone with an emergency. Remember that the dentist doesn’t know about emergencies in advance.

If you are not going to visit the office before your appointment, ask the person on the phone at the dentist’s office what to expect during the first visit. Will there be xrays? Do you have to fill out forms? You could have the forms sent to you so they could be completed before the appointment. Don’t forget to bring them with you if you do this. If you choose to visit the dentist office before your scheduled appointment, you may be able to fill out the forms then. That way they would be at the dentist’s office when you arrive. Be sure to ask where the office is and anything that would make it is easier to find.

Be sure to ask about taking your medicine before the appointment. The dentist office can tell you if there are any medications that you shouldn’t take before your appointment. As well some people have heart problems and have to take antibiotics before seeing the dentist. Be sure to talk with your doctor about this so you know whether or not you need to do this. If you take medicine to help feel calmer during dental visits, then ask the dentist when you should take this. If you are traveling alone by public transportation or driving, then you may not want to take this kind of medicine before you leave your house. You may need to plan more time if you are going to take it when you get there.

If this dentist can’t help you, then ask them for another dentist that could work or call the next dentist on your list. If you get to the end of your list without finding a dentist that can help, then contact your insurance. They may be able to work with a dentist that is not on their list to provide your care.

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Here again are the links to a dental pre‐visit form and to a webinar that will give you information about the form.

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Take‐away Message

The take away message is that there are many ways to find a dentist that can give you the right level of care for your needs. Remember if one way doesn’t work, then try another.

Remember the Take‐away and get ready for Lesson 4!

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Thank you for viewing this webcast.

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Documents

Lesson 3 Accessing Dental Care: Choosing a Dentist · 2016-03-11 · Welcome to Accessing Dental Care: Choosing a Dentist, Lesson 3 of Dental Health for Individuals with Disabilities