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Filling a Dental Gap in Colorado

Registered dental hygienist Crystal Mecham made Colorado dental history on April 12 at Bea Underwood Elementary in Parachute.

On that Wednesday, she treated a third-grader’s decaying tooth with an Interim Therapeutic Restoration (ITR) filling.

Crystal Mecham
Crystal Mecham

Colorado joined California on June 5, 2015, becoming the second state to allow hygienists to place the ITR fillings, a method to stop decay. That’s when House Bill 15 – 1309, which allows registered dental hygienists to place ITRs, was signed into law by Gov. John Hickenlooper.

Mecham, who works for Mountain Family Health Centers, was the first hygienist in Colorado to place the filling, taking a critical step forward in filling gaps in access to dental services.

ITRs are a fundamental component of establishing virtual dental homes – a model of care that helps to bring services to Coloradans with limited access.

Children, seniors and others in need of dental care receive preventive and simple therapeutic services like the ITR fillings from trained hygienists who visit schools, family centers and job training locations. Telehealth technology links these sites to dentists, who supervise the hygienists, review digital records and make treatment decisions.

For many Coloradans, especially those in rural communities, finding a dentist can be difficult. CHI’s research on the dental workforce found seven counties in Colorado with no dental services and another 10 with two or fewer private practice dentists or dental clinics.

SMILES Dental Project, a five-year, $4.7 million investment from Caring for Colorado Foundation and the Colorado Health Foundation, is expanding the telehealth dental model in five regions across the state, including Eagle and Garfield counties served by Mountain Family Health Centers. Twelve registered dental hygienists with the SMILES Dental Project have received ITR training, which was developed following passage of HB 1309 and conducted at the Community College of Denver.

Garry Millard, Mountain Family Health Center’s dental director, called Crystal and her team “true pioneers” in creating access to oral health services. Other regions funded by the SMILES Dental Project – from Naturita to Leadville – are offering these services and may soon join Crystal and colleagues in this groundbreaking work.

Most importantly, fewer Coloradans will go without needed oral health care.