@article{8b89871ed58340a793b8e753b68de2de,
title = "Disruptive innovations in dentistry",
author = "Edelstein, {Burton L.}",
note = "Funding Information: Tier 4 dental disruption borrows heavily from public health principles in seeking to change the very content of oral health care by calling on the profession to address the social, behavioral, and environmental determinants of oral health along with providing traditional dental procedures. These principles include allocating scarce resources to those with the greatest need, going upstream to prioritize prevention and disease management, addressing the full range of health determinants, and providing care within the contexts of family and community. They are reflected in the growth of accountable care organizations, patient-centered health homes, and other holistic, interdisciplinary, and outcome-oriented approaches to health care. One novel disruptive enterprise in medicine that reflects this approach is Cityblock. This primary care medical model “bring[s] together primary care, behavioral health, and social services to delivery better care for every member.” 16 It was “founded on the premise that health starts at the neighborhood level.” 17 It “aim[s] to build a new kind of care model that addresses the root causes of health” and seeks to “improve health in communities that have previously been underserved.” A dental example is Columbia University{\textquoteright}s MySmileBuddy program (funded in part by the Center for Medicare & Medicaid Innovation and the National Institutes for Health), which fields technology-assisted community health care workers into the homes of children experiencing early childhood caries. These lay health care workers engage parents in sustained adoption of healthy dietary and hygiene practices to arrest caries and reduce the need for dental repair under general anesthesia. 18 Calls for expanding dentists{\textquoteright} roles and responsibilities to include primary medical care screening and preventive guidance is an additional example of potential change in the content of care. 19-21 ",
year = "2020",
month = aug,
doi = "10.1016/j.adaj.2020.05.003",
language = "English",
volume = "151",
pages = "549--552",
journal = "Journal of the American Dental Association",
issn = "0002-8177",
publisher = "American Dental Association",
number = "8",
}