As of April 1, 2009, the Catalyst Institute is renamed the DentaQuest Institute. We will have a new web address: www.DentaQuestInstitute.org. But our mail address, telephone, mission and purpose are the same. Our name change links us with the DentaQuest family of oral health companies. We share the common mission of improving oral health through dental benefit plans (DentaQuest), philanthropy (DentaQuest Foundation, formerly the Oral Health Foundation) and evidence-based research that can improve the effectiveness and efficiency of oral health care delivery systems (DentaQuest Institute). Together, we are united in our dedication to improving oral health.

Quality improvement projects start with an oral health problem or recognized need. In 2008, the Institute investigated care for children with advanced early childhood caries. For the past nine months, Director of Analytics, Dr. Alex White, has been working with co-researchers, Dr. Man Wai Ng, Chief, Department of Dentistry, Children's Hospital Boston and Dr. Dan Kane, Director of Dentistry, Saint Joseph Hospital, Providence, to test an alternative science-based approach to managing advanced caries in young children in hospital settings. This project is mid-way through the data collection phase. Preliminary data suggests reduction in operating room utilization along with reduction in new caries and oral pain at the Children's Hospital and St. Joseph's Hospital test sites.

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Current demand for Safety Net Solutions involvement proves that individualized systems change works. With the rapid growth in requests for Safety Net Solutions technical assistance services from clinics as well as public and private funders from all parts of the United States, Safety Net Solutions starts 2009 with a focused expansion of its expert advisory team.

"The potential impact that the national expansion of this program can have on the preservation, growth and viability of our nation's safety net dental practices is tremendous," said Dr. Doherty. "By increasing the number of professionals that are contributing and potentially using the Safety Net Solutions technical assistance model, and by increasing the geographic scope of our work, Safety Net Solutions will have the ability to contribute to improvements in the delivery of oral health care on a national level."

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Public and private funders are including Safety Net Solutions in their grant making because they want to ensure that grantees get to sustainable, results-oriented business practices.

Miami/Dade and Broward County, Florida
Miami/Dade County is an area of high patient need and challenging reimbursement conditions. Safety Net Solutions is collaborating with the Health Foundation of South Florida to provide practice management assessments and technical assistance to six safety net dental practices in Miami/Dade and Broward County:

• Community Smiles, a community Oral Health Safety Net dental clinic staffed by volunteers from private practice and AEGD residents;
• Care Resource, a community-based AIDS-HIV Health service organization; and
• Borinquen Health Care Center, Community Health of South Florida and Jessie Trice Community Health Center, three federally qualified health centers (FQHC).

California Safety Net Dental Programs
The California Health Care Foundation awarded a grant to Safety Net Solutions to work with five California safety net dental programs:

• County of Marin Community Health and Prevention Services;
• Clinicas de Salud Del Pueblo;
• Community Oral Health Services;
• Inland Behavioral and Health Services; and
• Vista Community Clinic.

California Pipeline Program
California's Pipeline Program is working to expand the diversity of the state's dental workforce through coursework and clinical experience that improves the dentist's ability to serve multicultural communities. All of California's dental schools are involved in this initiative. Through partnerships with Federally Qualified Health Centers throughout the state, the dental colleges are expanding the workforce and improving access to care for California's underserved populations. Dental school residents spend an average of 60 days providing dental care in community clinics, treating low-income Californians who otherwise would not have access. An estimated 89,000 low-income Californians receive dental care through the pipeline program each year. [Read about the California Pipeline Program here.]

The Pipeline Program has retained Safety Net Solutions to provide technical assistance to two Pipeline clinics: Native American Health Center in San Francisco, and the Mission Community Hospital of the UCLA dental clinic. The goal is to make sure new dentists are prepared to run clinics that balance mission and business objectives for long-term sustainability.

As an aid to Massachusetts private practice dentists who are integrating MassHealth (Medicaid) into their private practice, Safety Net Solutions has developed a comprehensive tool that simplifies administrative paperwork. The toolkit, which debuted at the Yankee Dental Congress in Boston on January 31, 2009, guides practitioners through the MassHealth program, from the enrollment application, to billing, program regulations, cost-efficient practices, to resource guides. Email kohrenberger@catalystinstitute.org to request a copy.

When discussions turn to the oral health of young children, it is difficult not to mention Burton Edelstein and his dedicated research, public policy advocacy, public speaking, and teaching. He is a valued voice on the Catalyst Institute's Advisory Committee on Quality Improvement.

Dr. Edelstein is a formidable children's oral health advocate. After 20 years of clinical private pediatric dental practice, he turned his focus to changing health policy. Dr. Edelstein's current high profile role as Founder and Board Chairman of the Children's Dental Health Project (CDHP), a non-profit policy agency committed to improving children's oral health, keeps him involved in advocacy at the highest levels of federal health policy. At CDHP, Dr. Edelstein directs the federally-funded National Oral Health Policy Center and provides technical assistance to CDC and the Maternal and Child Health Bureau on public policy and perinatal oral health issues.

At the same time, Dr. Edelstein is Chair of Social and Behavioral Sciences at Columbia University College of Dental Medicine and Professor of Health Policy and Management at the Mailman School of Public Health, where he is preparing a new generation of professionals to fight the challenges of eliminating oral disease in children. He is currently Principle Investigator on an NIH-supported Columbia University Clinical and Translational Research Award multidisciplinary project* that is also investigating management of early childhood caries.

Insight Newsletter asked Dr. Edelstein about the parallels between the Catalyst Institute's Early Childhood Caries (ECC) project and his work. "Both Catalyst Institute and Columbia want to uncover pragmatic solutions that establish a lifelong path toward oral health for our most vulnerable children," explained Dr. Edelstein. "At Columbia, our particular emphasis is the development of science-based behavioral interventions that target diet, feeding-practice, and fluoride compliance stratagems. We constantly learn from each other as we work to institutionalize disease management approaches to this all-too-common early childhood problem."

As for the policy work of CDHP, Edelstein emphasized, "Improving the oral health for all of our children requires special attention to improving programs that target children who have the greatest needs. CDHP's daily focus is its primary mission of being a voice for children and families who have no voice of their own." Most recently, CDHP was instrumental in securing a range of dental provisions in the SCHIP reauthorization that will ensure comprehensive dental coverage to millions of U.S. children.

* Improving children's oral health: Developing an informatics-assisted pharmaco-behavioral therapeutic approach to managing early childhood caries through family-centered peer-counseling.