The Community Dental Facilitator Project: reducing barriers to dental care

This report describes an initiative developed and implemented by a low-income, urban, Canadian community to respond to their children's dental problems.

The first strategy pursued by the community was the development of the Community Dental Facilitator Project. This project facilitated children's access to existing government funding for dental treatment, and subsequently facilitated access to treatment at local dental offices. Children in need of treatment were identified by a school dental screening. The facilitation work was done by three lay workers hired from within the community who represented the community's predominant ethnic groups.

Parents revealed that barriers to dental care in local dental offices were lack of information about funding programs, language, inflexible work situation, and mistrust of bureaucracy. By the project's end, with the assistance of the facilitators, a significantly increased number of children had been enrolled for government dental benefits (P<.001). In addition to the 123 children identified at the screening as needing treatment, another 30 children "self-referred" to the program. At the end of the project's original funding period, dental appointments had been made for 68 children: 60 (48.8%) of the "screened" group, 8 (26.7%) of the "self-referred" group. One-year telephone follow-up to parents of the screened children revealed that 42 of 59 (71.1%) had completed treatment.

Barriers to dental care for low-income children go beyond economics. A community facilitation model can improve low-income children's access to existing dental services and may reduce the barriers to care for some children requiring treatment.