May 2019 Volume LIV Number 3

 
 
 
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Pine Dental Care: An Exemplary Dental Home Experience

March 2013 Volume XLVIX Number 2

Recently, four AAPD staff members visited with Dr. Charlie Czerepak, Dr. Nancy E. Hijjawi, Dr. Tehemina G. Richardson and their associates and employees at Pine Dental Care in Chicago. AAPD personnel work with pediatric dentists every day answering questions and offering assistance with policies and guidelines, advocacy, credentialing, insurance questions and a myriad of other issues. The office visit provided an opportunity to learn about the day-to-day activities that contribute to a well-managed pediatric dental practice.
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About Pine Dental Care

Pine Dental Care provides quality pediatric dental care to Chicago, Lincoln Park, Gold Coast, Lakeview, and the north suburban communities of Glenview, Wilmette, Northbrook, Winnetka, Glencoe, Highland Park, and Evanston and all surrounding Illinois areas.

Five Pediatric Dentists of Pine Dental Care:

Charles S. Czerepak, D.M.D, M.S. Public Policy Advocate for Illinois

Nancy E. Hijjawi, D.D.S, M.S.

She has worked with Dr. Czerepak for the past 23 years.  In fact, her entire career, as he was also her attending!

Tehemina G. Richardson, D.D.S. Allyson G. Feinstein, D.M.D. Kathryn A. Dardis, D.D.S. 

One Orthodontist:

Therese S. Galang, D.M.D., D.D.S., M.S.

 

Staff:

Mollie Buchanan, Pine Dental Office Manager

She has worked with Dr. Czerepak since January of 1987

21 Staff in total between offices

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Importance of the Dental Home

Research indicates that the oral health care of children is best managed within the context of a dental office, or "Dental Home."  According to the AAPD Policy Statement on the Dental Home, "The Dental Home is inclusive of all aspects of oral health that result from the interaction of the patient, parents, non-dental professionals and dental professionals. Establishment of the Dental

Home is initiated by the identification and interaction of these individuals, resulting in a heightened awareness of all issues impacting the patients oral health." A Dental Home is an ongoing relationship between the patient and the dentist or dental team that is coordinated/supervised by a dentist provides comprehensive, coordinated, oral health care that is continuously accessible and family-centered, is an approach to assuring that all children have access to preventative and restorative oral health care.

The benefit of dental services delivered within the context of a Dental Home is highlighted by

Paul Casamassimo and Art Nowak (2002): "Children who have a Dental Home are more likely to receive appropriate preventive and routine oral health care. Referral by the primary care physician or health provider has been recommended, based on risk assessment, as early as 6 months of age, 6 months after the first tooth erupts, and no later than 12 months of age.  Furthermore, subsequent periodicity of reappointment is based upon risk assessment. This provides time-critical opportunities to implement preventive health practices and reduce the childs risk of preventable dental/oral disease."2

Early engagement in a Dental Home can significantly reduce the cost of care as well. In fact, engagement in a Dental Home by the age of one year improves the likelihood that a child will receive more preventive services and require less treatment than those children who accessed dental services at an older age.3

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Pine Dental Care Provides a Wonderful Illustration of the Dental Home in Practice

A Dental Home should be accessible.

Pine Dental office has extra wide hallways and door ways to accommodate wheelchairs and other equipment necessary for special needs patients.  In order to make treatment more comfortable for young patients, there are multiple flat screen TVs in the office, as well as a builtin TVs on the ceiling in the patient rooms.  According to Dr. Czerepak, "Theres no need to tilt your head."  Dr. Hijjawi expressed her concern for the safety of the TV being built in to the ceiling, "We had a structural engineer come in and ensure its safety by hanging from the strut!"

A Dental Home should ensure that care is coordinated across providers.

Pine Dental has established strong relationships with the pediatrician practices in their building. The physicians and dentists regularly meet to discuss patient care and referrals, facilitating the early introduction into a Dental Home for young children and prompt referral for children in urgent need of dental care.  Dr. Irene Freeman, pediatrician at Town & Country Pediatrics notes the benefit of this relationship. "I love having a dentist across the office from me. Now, I don’t have to make a million phone calls."

Having an orthodontist onsite facilitates the coordination of care during orthodontic treatment.  Dr. Therese Galang utilizes new orthodontic technology, including Damon™ System self-ligating braces which are  low force, low friction braces, along with traditional metal appliances. Pine Dental offers a complimentary orthodontic exam and consultation for registered pediatric patients of the practice.  Once a child enters orthodontic care, Dr. Galang works with each of the dentists to provide comprehensive, team oriented orthodontic care.

 All services provided in the Dental Home should be familycentered and culturally appropriate.

At Pine Dental, patients and their families find a warm and welcoming environment.  The large waiting area has books, games and computers to interest children of all ages, from 1 to 18. Most importantly, the treatment suites are extra large to accommodate parents so they can be with their child at all times during the dental appointment.   However, the most important element in the family-centered environment is the obvious relationships that have developed between the families and the dentists and staff at Pine Dental. Front desk staff regularly step around the front counter to personally welcome patients and to assist parents with special needs patients. The dentists all know each patient and their families and take the time to learn about their life beyond the dental chair sharing and celebrating patient stories of success at school or sports.

The care provided in the Dental Home should be comprehensive and should be based on the best evidence available.

Pine Dental Cares pediatric dentists are all diplomates of the American Board of Pediatric Dentists. They have extensive experience working with children from birth to 18-years-old, including medi cally compromised and special needs children. They maintain a close affiliation with the Ann & Robert H. Lurie Childrens Hospital of Chicago where they treat their most severely compromised patients. Utilizing Evidence-Based Dentistry (EBD) is a high priority for the dentists at Pine Dental. As in every good Dental Home, EBD forms the foundation for all patient care decisions. It is so engrained in the infrastructure of the practice that the scientific literature pertaining to the development of the individual, and treatment plans are routinely shared with parents and older patients, ensuring both a collaborative clinical decision and true informed consent. According to Dr. Hijjawi, "Everything we try to do is evidence-based. In fact, we use literature to help parents understand the treatment options/decisions, as well as reference the AAPD site."

The concern for providing the best and most scientifically sound care to patients extends to the offices electronic recordkeeping system. All records are entered into the electronic system and staff regularly monitors the information to ensure quality care.  In order to ensure accuracy, all entries into the electronic dental record are completed and signed on the day of the visit. Only doctors are allowed to write into the record. The dental radiographs and photographs are stored digitally in the patients chart.

The staff also discussed the benefits of working in a group practice. The team huddles each morning to discuss patients and their respective treatment plans scheduled from six months to one year out. Additionally, at least two dentists review all X-rays and treatment plans prior to treatment.  This allows the team to learn from one another, improving the overall quality of care.

Dr. Czerepak loves to say that pediatric dentistry is the only profession that is paid in smiles. Its like being a favorite uncle or aunt every day of the year. Talking about the legacy of Pine Dental Care, he likes to quote their favorite dentist, Dr. Heber Simmons, Jr., "we just want to leave the woodpile higher than we found it."

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Photography was supplied by Horizon Photography

1    American Academy of Pediatric Dentistry. Policy on the dental home.  Reference Manual 2007-2008; 29(7):  22-23.

2    Nowak, AJ & Casamassimo, PS. The dental home:  A primary care oral health concept. Journal of the American Dental Assoc, 2002; 133(1): 93-98.

3    Savage, M, Lee, J, Kotch, J and Van, W.  Early preventive dental visits: effects on subsequent utilization and costs.  Pediatrics 2004;114;418-423.