Community-Based Postdoctoral Dentistry Program in Special Care Dentistry: Development and Implementation

There is a growing, national need for properly trained dentists to provide special care dentistry to a transitioning, aging, and medically complex population. This study describes the implementation and initial impact of a novel academic-community intervention designed to rapidly address this critical gap in provider training and service delivery in the Dallas-Fort Worth Metroplex-.

The compromised care and hospital dentistry (CCHD) fellowship and an associated special care dentistry clinic were launched based on five core objectives. Key strategies included interdepartmental collaboration and streamlined administrative processes to facilitate rapid program startup. Evaluation tracked implementation and service outcomes (reach and workforce impact), using administrative and electronic dental record data from seven partner sites across 2020-2025.

The program demonstrated high feasibility by launching in 45 days. Maintenance was achieved through securing over $4.9 million in foundational support and implementing a novel community practice partnership model to sustain core positions. Service outcomes showed high reach, with fellows treating 8013 unduplicated patients annually. The population served was highly diverse, low-income, and 93.6% reliant on Medicaid/Medicare. Workforce impact was 100%, with all 12 graduated fellows remaining in SHCN practice and the 4 remaining fellows planning to continue serving patients with SHCN.

The CCHD model provides a replicable and scalable implementation template for academic dental centers seeking to rapidly increase specialized care capacity. Successful collaboration and streamlined administration achieved institutional stability quickly. Future assessments will focus on longitudinal patient outcomes and the cost-effectiveness of this model to further substantiate its value in mitigating oral health disparities for the SHCN population.