Collaborative Dental Practice Targets Systemic Healthcare

Richard Gawel

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With an eye on the influence that oral care has on systemic health, ProHEALTH Care Associates has opened its first dental clinic in Lake Success, NY. During its ribbon cutting ceremony on Wednesday, April 6, its representatives emphasized the role that the practice will play in reducing the risk of heart disease, oral cancer, diabetes, and other life-threatening illnesses.

“Our physician group has almost a thousand providers now,” said Dr. David Cooper, founder and CEO of ProHEALTH Corp. “And it became clear that in order to take care of the overall aspect of all of our patients’ care, we needed to add dental as a service, knowing that a good 20% of preventable chronic illnesses can be associated with poor oral hygiene.”

ProHEALTH treats more than 800,000 patients at more than 275 locations in Long Island and the New York metropolitan area. It coordinates care among its primary, cardiology, dermatology, gastroenterology, obstetrics and gynecology, pediatrics, and other practices to improve outcomes. Dental care now will be integrated too.

“This gives us the ability, for example, for our pedodontists to work with our pediatricians,” said Norton Travis, CEO of ProHEALTH Dental. “Our periodontists and our endocrinologists can work together with respect to diabetes. We have a working relationship with each of these medical specialties.”

“A few years back, I had a patient who was a dental hygienist and she asked me if I screened patients for periodontal disease. And I said no, why? She said there are studies now that are beginning to show an association between cardiac disease and periodontal disease,” said Dr. Cliff Cooper, ProHEALTH’s chief of primary care and internal medicine.

ProHEALTH is now striving to educate all of its physicians about the importance of oral health in an effort to improve overall patient care. For example, when patients arrive at any of ProHEALTH’s facilities, staff will take a complete history including both medical and dental issues.

Oral Cancer’s Importance

Additionally, the company used the ribbon cutting to spotlight oral cancer as part of Oral Cancer Awareness Month. Unlike other cancers that are seeing decreasing rates of occurrence, oral cancer rates increasing driven largely by tobacco and alcohol use and, in growing numbers, HPV infections.

“Certainly, oral cancer is an alarming kind of situation,” said Travis. “I’m a businessperson. But having been educated on this, it is pretty frightening in terms of how much it’s on the rise, and therefore that seems to be calling out to us as something that needs to be addressed as a priority.”

During the event, members of the ProHEALTH Dental staff administered free oral cancer screenings to visitors. They used the Identafi from D, which uses white, fluorescent violet, and green-amber light to illuminate the oral cavity and reveal areas of abnormal tissue growth and increased diffuse vasculature.

“Oral cancer is killing one person every hour in the United States,” said Victor Andrade, regional manager with Henry Schein, which distributes the Identafi. “Identafi allows early detection. The human eye can only see so much, and touch can only show you so much, so we can catch it at a much earlier stage with the Identafi.”

Oral cancer is virtually undetectable with the naked eye in its earliest stages, which is why it often isn’t discovered until stage III or IV. But patients who are diagnosed then have a 43% survival rate after 5 years, reports the Oral Cancer Foundation. When it is found sooner, patients see an 80% to 90% survival rate. And, these patients are getting younger.

“Years ago, the 60-year-old male who was drinking and smoking was the prime candidate for oral cancer. That’s not the case anymore,” said Cesar Figueroa, exclusive product specialist with Henry Schein. “You’re 10 times more likely to develop oral cancer with HPV. And with the rising rates of HPV in America, it’s increasing oral cancer in general.”

“Something like 9,500 Americans die every year of oral cancer, which is totally and completely and utterly preventable,” said Stanley M. Bergman, CEO of Henry Schein. “Dentists need to understand that they should test patients and patients should ask their dentists. It’s a very easy thing for dentists to do. It can save lives.”

A Multispecialty, High-Tech Facility

In addition to these screenings, the new ProHEALTH facility offers a full suite of services under one roof, including general dentistry, pediatrics, orthodontics, endodontics, periodontics, prosthodontics, oral surgery, and implants. There are 9 doctors on staff now, with plans to add more in the near future.

“The multispecialty practice all in one location allows for much better communication among the doctors. It’s seamless. A lot of times, we just walk the patients down the hall,” said Dr. Neil Karnofky, periodontist and chief dental officer. “The patients like coming to the same facility. They are very comfortable here. We treat the entire family.”

For example, there is a separate waiting area for kids decorated with a Finding Nemo theme and outfitted with video games. Plus, two of the 12 operatories are dedicated to pediatrics with appropriate decorations and equipment including video screens for entertainment. There also are operatories for hygiene work and oral surgery.

1. ProHEALTH Dental includes 12 operatories, including 2 dedicated to pediatrics.

ProHEALTH worked with Henry Schein to design and equip the practice with state-of-the-art equipment, such as the Instrumentarium Orthopantomograph OP300, which combines advanced panoramic imaging with cephalometric, cone-beam 3-D imaging, or both. It also provides automatic dose control.

“I love my CBCT. I love treatment planning in it. I love showing it to patients. I love utilizing it. I was looking at one for years and years and thought I would never use it. It would be like an exercise-bike coat rack. Well, I put one in my office, and we use it here constantly,” said Karnofsky. “It’s fabulous for patient education. And it’s fabulous for giving you a degree of comfort when you’re working.”

2. The practice uses the Instrumentarium Orthopantomograph OP300, which combines advanced panoramic imaging with cephalometric, cone-beam 3-D imaging, or both.

“They’re also using Dentrix, which is the largest practice management software in the United States. Most dentists are on Dentrix, and they feel it empowers them better than any other software out there,” said Andrade. “They also are using Dexis software for intraoral x-rays. It manages all of the imaging within the office.”

Considering the significant hardware and software involved, Henry Schein additionally provides in-house computer technicians who collaborate with ProHEALTH’s integrated technicians on installation and maintenance.

Furthermore, Henry Schein’s team designed a sterilization room that eliminates cross-contamination. Personnel enter the room with dirty instruments and load them into sterilization units that have doors on the other side of the wall, where they can be retrieved once they are clean.

3. Designed by Henry Schein, the sterilization room features cabinets with dual doors so personnel can pick up clean equipment without encountering any contamination.

“Dentists seek Henry Schein because we are an all in one solution,” said Andrade. “I actually helped Dr. Karnofsky with setting up the correct fees for the area and negotiating all of the insurance fee schedules. We can even help negotiate a lease, for that matter.”

Looking Ahead

ProHEALTH Dental is committed to using this technology in the service of a philosophy focuses on all of the patients’ oral needs as well as their overall health. Next, the company expects to open additional offices throughout Long Island and metropolitan area during the next 12 to 24 months while maintaining that comprehensive approach.

“The patients who come in here are wowed,” said Karnofsky. “Our first signee had a very nice pediatric practice. All of her parents came in and brought their kids. They all signed up. They like the way the office presents itself. They like the way the staff adheres to their needs. And if you look around, it’s state of the art, it’s clean, and it’s efficient.”

Bergman sees an even bigger influence beyond a growing client base, though. He believes ProHEALTH Dental has an opportunity to work with its corporate counterparts and generate research showing that improved oral care can lead to improved systemic health.

4. Henry Schein CEO Stanley M. Bergman addressed discussed the connection between oral and systemic health during the grand opening.

“I think you are going to have some phenomenal data and you are going to be able to show insurance companies, the states, and the federal government that the direct correlation between good oral care and good dental care is ultimately going to reduce the costs of care,” he said. “But more importantly, we’re going to increase the quality of life in this country. This is going to be a model demonstration for public health officials.”

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