Mobile Dental Systems Staffing
a. What are typical staffing patterns for mobile clinics?

There are innumerable variations to staffing patterns for mobile dental clinics. Ownership and budget for the program often are the deciding factors. For example, health professions schools may assign one or more dental assistants and one faculty member to supervise and support students who participate in extramural rotations on a mobile unit owned by the educational institution or by a community group. Community not-for-profits, including community health centers and hospitals, may depend partly or entirely on volunteers. Health departments may employ staff and contract with other part-time dental providers for services.

Before hiring dental staff for your program, it is essential that two tasks are completed: 1) check the dental practice act for your state to determine any practice restrictions, and 2) create a staffing plan to support the scope of care you have defined for your practice.

Staffing mix on a mobile vehicle may vary according to the age range of the patient population. Usually, as the age of the patient increases, the cost and complexity of dental care increases, requiring different provider skills. For instance, a child generally requires only preventive and restorative care or simple surgery. Yet behavioral management may require providers who have extensive experience working with young children. As children grow into adults, they begin to need more complex restorative, orthodontic, periodontal and endodontic care. Older adults often need more periodontal, prosthodontic, and oral surgery care in addition to restorative care, and may have more medical issues. As needs become more complex, liability protection expenses increase as well as expenses involved in certifying providers in emergency and other procedures.

Finding the appropriate staffing mix is essential, as is cross training of staff. Based on the scope-of-care, you may choose to have two dental assistants support one dentist or have a dental student or dental assisting student assist another student serving as the provider. Federally funded community health centers have general productivity guidance that expects a dentist can provide approximately 2,300 encounters per year and a dental hygienist can provide roughly 1,400 encounters per year; two or three dental assistants are needed to best support the providers. This assumes a full day is available for the practice of dentistry, which is often not the case in mobile clinics.

A practice exclusively for children in a state that permits expanded duties for dental hygienists and/or dental assistants, including placement of fluoride varnishes, sealants and other preventive procedures under general or no supervision, may choose to provide more appointments for preventive services using these personnel. Fewer dentists would be needed and they would focus primarily on treatment planning and providing restorative and specialty care. A practice for adults with many periodontal needs will need a dental hygienist rather than an assistant performing these services, with the assistant working with the dentist on restorative and prosthetic care and supporting any periodontal consultants. See a role description (WORD doc) for a dental assistant that serves both a mobile van and a hospital operating room.