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Dr. Huong Le, Chief Dental Officer of Asian Health Clinic in Oakland, is reaching patients in a new way. Dr. Le and her team have created a Drive-Thru pediatric oral health screening and fluoride varnish program. During these visits, parents park in front of the clinic, the clinic staff comes to the car and performs a pediatric exam, with preventive care and patient education, and then the parent and child drive away. The entire visit takes 15 minutes, and the parents and patients remain in their car the whole time. While most dental practices are finding it necessary to reduce their daily patient load, Dr. Le and her team can serve up to 27 patients in one day with the Drive-Thru, on top of the 40-60 patients they see daily for tele health visits.
A Drive-Thru exam. Photo courtesy of
Dr. Le and Asian Health Clinic, 2020.
A similar Drive-Thru program, created by Dr. Ramona English, Chief Dental Officer at Petaluma Health Center, served as inspiration for Dr. Le’s program. When the COVID-19 pandemic forced dental practices to change the way they provide care, Dr. English turned to the quality improvement (QI) skills she learned in a National Network for Oral Health Access Collaborative. She used these skills to adapt her practice’s care processes, including implementing innovative teledentistry practices and developing a Drive-Thru for treatment with SDF (silver diamine fluoride, a topical medication used to stop the progression of cavities).
Dr. English’s team needed a safe way to treat the children who they diagnosed with cavities during teledentistry exams. “Due to the quick and easy nature of the SDF application protocol, we started wondering if we could apply it in the patient’s car in a Drive-Thru type of set up. We consulted with our medical side on how they were conducting the immunization Drive-Thru and came up with a similar process. We scheduled the patients, set up a tent in front of the building, directed the patients there and a dentist and an assistant provided the SDF treatment to the patient in the back seat of their car. Everything went very smooth and we were able to adopt the change right away. There was no need to refine and test again.”
Dr. Le and her team started their teledentistry program in early March and first discussed the idea of Drive-Thru dentistry, in partnership with Asian Health Clinic’s medical department, as an integrated service with COVID-19 testing. The Clinic was receiving calls from worried parents wondering how their children could receive the state required kindergarten oral health assessment during the shelter-in-place order the city was under at that time. A Drive-Thru would provide the Clinic with a way to conduct the assessments and also treat with SDF.
Photo courtesy of
Dr. Le and Asian Health Clinic, 2020.
The plan stalled when they ran into the issue of determining where to set up the Drive-Thru. Asian Health Clinic is in Oakland’s Chinatown district, where space is at a premium, and the Clinic does not have its own parking lot. So, Dr. Le and her team got creative. “...After hearing Dr. English was doing it [a Drive-Thru program], and the calls from parents that were coming in, we reignited the idea and jumped into action…we applied to the city to have a parking space dedicated to our dental Clinic and ran with it, early in May. It’s been great, even with our very limited parking space. We make it work.”
Dr. Irene Hilton, a dual faculty member at the University of California San Francisco’s School of Medicine and School of Dentistry, was excited to see this spread of ideas. "This is what is so great about doing Collaboratives...[they are] an incubator to develop ideas and share with the community, which then puts their own spin on the idea to make it relevant to their own place and need!"
A Drive-Thru pediatric dental program has also allowed Dr. Le and her team to reach a broader audience. At the start, they planned to only see kindergarteners, performing the kindergarten oral health assessment. The team quickly realized, however, that they could provide care to a larger population. “The idea was only for kindergarteners, but now parents are asking us to apply [fluoride] varnish on their other children as well,” said Dr. Le. After residents who live on the same block as the clinic asked if they could walk up for an appointment, instead of driving, Dr. Le adapted her program to allow for that as well.
Photo courtesy of
Dr. Le and Asian Health Clinic, 2020.
By utilizing teledentistry extensively for preventive care and triaging patients, and supplementing this with Drive-thru programs, Dr. Le and Dr. English have found innovative ways to continue providing patient-centered care to children in their communities. The creativity of these doctors and their teams has helped keep children healthy, prevented Emergency Room visits, and has removed barriers to care for their patients. Thank you to these public health leaders who have thought outside the box to continue improving dental care in their communities!
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