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DTA Foundation Grant Chat: Creating a Permanent Dental Home For Those With Special Needs

In a breakthrough solution, Apple Tree Dental is creating a permanent dental home for those with special needs in Minneapolis and Saint Paul, filling the gap between care that can be provided in traditional dental offices and care that can be provided in an operating room under general anesthesia. Thanks to your generous donations, a $25,000 DTA Foundation grant is helping to fund Apple Tree Dental’s Special Care Dentistry (SCD) pilot project.

Recently, we sat down with the Apple Tree Dental Development and Marketing Director Mary Larkin to find out more about the program and how others can implement a similar one.


Can you tell us a little about your program and who it is targeted to help?

Our SCD Project is based upon successful programs in Europe presented at Special Care Conferences, and provides an outpatient IV sedation option for people with special needs. It also provides routine access to preventive and restorative care and helps our patients to avoid repeated cycles of dental neglect followed by costly hospitalizations that result in the loss of teeth and declining overall health.

At Apple Tree, we serve everyone – transcending age, ability, and need – across the lifespan. Nearly 80 percent of Apple Tree’s patients are on Medicaid and have very few options for accessing dental care. Our SCD Project is perfectly poised to make a significant difference in the delivery of quality, affordable healthcare services, particularly for low-income, uninsured, and underinsured individuals in Minnesota.


How will having the DTA Foundation grant help you meet that goal?

Our ultimate goal for the SCD Project is to increase the efficiency of our Special Care Dentistry team to achieve financial sustainability for the program. DTA Foundation support is helping to provide key missing elements for our surgical suite, increasing the SCD Project’s efficiency while helping relieve pain and improve the health and welfare of people with special needs, many who have long waited to receive care.


How will this program help to improve oral health in your area?

At our Mounds View Center, where this project is taking place, the need for oral health care is enormous. Patients are booked out for six weeks for hygiene and four weeks for restorative care, while IV sedation patients must wait more than four weeks for an appointment. To address this severe need, we launched the SCD Project to fill the gap in dental care for children and adults with special needs.

Special needs children, adults, and elders with developmental, behavioral, and physical disabilities are often unable to cooperate with the dentist to receive their routine dental exams or more complex procedures. This can be for a variety of reasons, including cognitive and behavioral issues, complex medical conditions, extreme anxiety, etc. It can be very difficult for patients with special needs to find a dental office that is equipped to serve them. Many special needs patients have trouble getting into the dentist’s chair to begin with, but that is only one of many challenges that both the patient and the provider face. Unresolved issues such as this result in unmet oral health needs, including tooth decay, gum disease, infections, and even oral cancers that may go undiagnosed. These problems can lead to a loss of teeth, a decline in quality of life, and also contribute to any number of chronic medical conditions.

When patients undergo conscious IV sedation, they are still able to respond, but may sleep off and on throughout their dental appointment. This type of treatment is safer, less costly, and less traumatic for patients with special needs. In addition, the patient’s recovery time is much faster with conscious IV sedation than if they were to receive general anesthesia.


What three pieces of advice would you give others considering implementing a program like yours?

Three pieces of advice from a development and funding standpoint – first, be sure to have a solid program on which to build. Apple Tree Dental has 34 years of history serving patients with special needs in the Twin Cities area. The model on which our nonprofit is structured was not common at that time, so the founders learned a lot by trial and error. We are able to look back at our history to develop practical plans and projections for potential projects.

Second, collaboration is key. Today Apple Tree has seven Centers for Dental Health across Minnesota and has helped several nonprofits to launch programs in different parts of the nation. Each of our Centers was built in collaboration with at least one other strong partner, and usually with several partners. Nonprofits looking to replicate this program will do best if they have support not only from funders, but also from community partners, including local hospitals, other dental clinics, nursing homes, Head Starts, state and county public health departments, professional associations, and more.

Third, Apple Tree has a strong leadership team, and very dedicated dental teams and support staff. We like to say that our folks possess the “special-care gene” when it comes to providing oral health care. They are passionate about the care they provide. Due to low reimbursements and the fact that the majority of our patients are on Medicaid or Medicare, patients with special needs, low-income, or under or uninsured, we are not always able to be competitive on salary and benefits. But our staff believes in what they do each day to expand access to dental care for all people, and that foundation is what makes our programs work.


Is there anything you’d like to say to the donors who make the DTA Foundation grants possible?

Please accept Apple Tree’s sincere thanks to the DTA Foundation for supporting Apple Tree’s Special Care Dentistry Expansion Project. With this funding, we are expanding upon our mission to improve the oral health of all people, including those with special dental access needs who face barriers to care.

The SCD Project is helping people in the Greater Metro area, and beyond, avoid painful and traumatic emergency room visits and hospitalizations. Your support is helping overcome barriers to dental care for thousands of special needs patients. We will continue our work to build broad public and private support as we expand our services to meet the needs of our most vulnerable children, adults, and elders.

Once again, thanks to all of you!