An Advanced Dental Therapist in Long-Term Care: Heather Luebben’s Case Study
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02-20-18
!1
Heather Luebben, RDH, ADT
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02-20-18
!2
The first pie shows Heather alone, the second includes another DT and DT students. "
The final two pie charts are described below within the case study.
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2015
2016
$3,122
$2,201
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02-20-18
!3
On-Site Care
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02-20-18
!4
Jayne Cernohous, DDS
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.2)#$.*':2)#6$/*$I<^$6-23%*,/-.@$2%6$>S^$:)#H#%/-H#$2%6$M^$:#)-*6*%/27E$$
Year
Provider
Days
Gross
Gross/Day
Visits
Visits/
Day
Patients
2014
Cernohous (DDS)
35
$107,954
$3,084
541
15
236
2015
Cernohous (DDS)
43
$132,142
$3,073
576
13
246
2016
Cernohous (DDS)
28
$81,927
$2,926
341
12
188
2014
Heather (ADT/RDH)
26
$57,222
$2,201
215
8
133
2015
Heather (ADT/RDH)
12
$31,546
$2,629
91
8
70
2016
Heather (ADT/RDH)
21
$65,565
$3,122
213
10
136
2014
Other DT, RDH
30
$23,345
$778
187
6
147
2015
Other DT, RDH
31
$35,072
$1,131
194
6
153
2016
Other DT, RDH
26
$26,148
$1,006
134
5
121
2014
No DT Students
n/a
n/a
n/a
n/a
n/a
n/a
2015
DT Students
6
$8,083
$1,347
19
3
17
2016
DT Students
16
$23,019
$1,439
47
3
37
2016
Other RDH
4
$2,769
$692
26
7
26
02-20-18
!5
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f72.#'#%/$*+$372,,$-*%*'#),$-,$2%$-%6-.2/*)$*+$/"#$:)-*)-/=$:72.#6$*%$,/2(-7-0-%3$/"#$
*)27$"#27/"$*+$/"-,$:*:&72/-*%@$"-3"7-3"/-%3$/"#$.2:2.-/=$*+$6#%/27$/"#)2:-,/,$/*$'##/$
/"#$)#,/*)2/-H#$%##6,$*+$7*%3B/#)'$.2)#$)#,-6#%/,E$
918+#'QN'H4"17<#4'G#7,1+'9*#$1I%-,'1,',*#'>#,#$17-'(.@#'ABCF'
=.-,'/$#R3#7,+5'I$."%4#4'I$.<#43$#-'85'01,#).$5'./'2#$"%<#''
STBU'.$')$#1,#$'<.37,'I#$'<1,#).$5'./'-#$"%<#V'
G%1)7.-,%<
Diagnostic
Gross
(count)
Diagnostic
%
Preventive
Gross
(%)
Preventive
%
Restorative
Gross
(count)
Restorative
%
Perio
Gross
(count)
Perio
%
2014
$7276"
(151)
17%
$12,064
(174)
29%
$22, 297
(116)
53%
$254"
(1)
<1%
2015
$3457"
(109)
14%
$5170 "
(68)
21%
$15,973
(76)
64%
$219"
(1)
<1%
2016
$9342"
(172)
18%
$10,308
(136)
20%
$29,901
(138)
58%
$1616"
(7)
3%
Code
Description
Count
Gross Revenue
D0120
Periodic oral evaluation-
established patient
112
$6,048
D0274a
Bitewing X-rays (four films)
23
$1,426
D0220a
Periapical (first film)
12
$348
D0230a
Periapical (each additional)
8
$216
D0210a
Intraoral x-rays complete series
3
$4,201
Diagnostic
Totals
158"
92% of dx count
$8,458"
91% of dx revenue
02-20-18
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W#-,.$1,%"#
Code
Description
Count
Gross Revenue
D1110
Prophylaxis-adult
74
$7,030
D1206
Topical application of fluoride
varnish
39
$1,755
D1110b
Prophylaxis-adult lower
11
$583
D1110c
Prophylaxis-adult, 3 month
6
$570
D1354*
Interim caries arresting
medicament application
5
$275
Preventive
Totals
135"
99% of px total
$10,213"
99% of px revenue
Code
Description
Count
Gross Revenue
D2331a
Glass ionomer - two surface,
anterior
34
$7,548
D2392a
Glass ionomer - two surface,
posterior
20
$5,200
D2391a
Glass ionomer - one surface,
posterior
21
$3,801
D2330a
Glass ionomer – one surface,
anterior
18
$2,970
D2332a
Glass ionomer – three surface,
anterior
10
$2,750
D2150
Amalgam – two surface
8
$1,352
D2160
Amalgam – three surface
6
$1,218
D2393
Resin-based composite – three
surfaces, posterior
3
$966
D2920
Re-cement or re-bond crown
3
$273
D2394
Resin-based composite – four
or more surfaces, posterior
2
$644
Restorative
Totals
125"
91% of rest. count
$26,722"
89% of rest. rev.
02-20-18
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V#32)67#,,$*+$/"#$:)*H-6#),$A"*$'2R#$&:$/"#$*%B,-/#$.7-%-.27$/#2'@$/"#$.*,/,$*+$
6#7-H#)-%3$2%6$,#//-%3$&:$/"#$'*(-7#$6#%/27$*+T-.#$2)#$/"#$,2'#E$Y*A#H#)@$
#':7*='#%/$.*,/,$+*)$2$6#%/-,/$2)#$3)#2/#)$/"2%$+*)$2$6#%/27$/"#)2:-,/E$$G::7#$!)##a,$
2H#)23#$62-7=$#':7*='#%/$.*,/$*+$/")##$!A-%$N-/-#,$'*(-7#$6#%/-,/,@$A*)R-%3$+&77$/-'#$
A-/"$+&77$(#%#T-/,@$A2,$`4><E$$!"#$.*':2)2(7#$T-3&)#$+*)$/"#$26H2%.#6$6#%/27$/"#)2:-,/$
:)*H-6-%3$.2)#$2/$/"#$\#/#)2%,$Y*'#$A2,$`S?4E$$!"#*)#/-.277=@$/"-,$-,$#C&-H27#%/$/*$2%$
2%%&27-0#6$6-++#)#%.#$*+$`5>@???$-%$#':7*='#%/$.*,/,$(#/A##%$2$6#%/-,/$2%6$2%$
26H2%.#6$6#%/27$/"#)2:-,/$A*)R-%3$>MS$.7-%-.$62=,j=#2)E$$
Q%$G::7#$!)##a,$/#2'B(2,#6$.2)#$'*6#7@$/"#$26H2%.#6$6#%/27$/"#)2:-,/$-%.)#2,#6$/"#$
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-%$/"#$\#/#)2%,$Y*'#$,#//-%3@$A"#)#$/"#$3*27$A2,$/*$:)*H-6#$/"#$'29-'&'$2'*&%/$*+$
Code
Description
Count
Gross Revenue
D4341
Periodontal scaling/root
planing- four or more teeth per
quad
4
$980
D4355
Full mouth debridement to
enable comprehensive
evaluation
2
$438
D4342
Periodontal scaling/root
planing- one to three teeth per
quad
1
$198
Periodontal
Totals
7"
100% of perio count
$1,616"
100 % of perio rev.
02-20-18
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G#7,%-,'174'H4"17<#4'G#7,1+'9*#$1I%-,O'>#,#$17-'(.@#O'H3)3-,',*$.3)*'
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!2(7#$5$A2,$.)#2/#6$&,-%3$2./&27$3)*,,$)#H#%&#$3#%#)2/#6$+*)$,#)H-.#,$:)*H-6#6$(=$
G::7#$!)##$6&)-%3$>?IS$/*$>?I4E$$W29-'&'$/"#*)#/-.27$,.*:#$*+$:)2./-.#$+*)$/"#$GU!$
#9.7&6#,$,#)H-.#,$)#,#)H#6$+*)$/"#$6#%/-,/$-%$/"#$W-%%#,*/2$:)2./-.#$2./E$$F-'-72)7=@$
'29-'&'$/"#*)#/-.27$,.*:#$*+$:)2./-.#$+*)$/"#$N_UGB2::)*H#6$6#%/27$/"#)2:-,/$
#9.7&6#,$,#)H-.#,$%*/$6#,-3%2/#6$-%$/"#$G..)#6-/2/-*%$F/2%62)6,$+*)$U#%/27$!"#)2:=$
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,/&6=$-,$6-,.&,,#6$(#7*AE$$
Month
2016
Cernohous
Gross
Cernohous
Days*
Heather Gross
Heather Days
August
$9,890
3
$12,194
4
September
$12,692
4
$11,006
4
October
$3,182
1
$6,641
2
November
$11,418
2
$5,525
2
December
$9,863
3
$3,676
1
Totals
$47,045
13
$39,042
13
Per day
averages
$3,618
$3,003
02-20-18
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A"-7#$GU!,$,.*:#$*+$:)2./-.#$-%.7&6#,$#9/)2./-%3$:#)'2%#%/$/##/"@$/"#$6#%/-,/$
:#)+*)'#6$277$#9/)2./-*%,$2/$/"#$\#/#)2%,$Y*'#E$$Q%$266-/-*%@$/"#$*%B,-/#$.2)#$/#2'$
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/"2%$'-%*)$)#:2-),$2%6$26[&,/'#%/,@$.*%,&7/2/-*%$2%6$,#62/-*%E$$Q%.7&6-%3$:#)-*6-.$
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/*$-%.7&6#$#92'-%2/-*%,@$6#%/27$/"#)2:-,/,$.*&76$6#/#)'-%#$2%6$'2%23#$/"#$
/)#2/'#%/$%##6,$*+$7*%3B/#)'$.2)#$)#,-6#%/,E$Q%$#-/"#)$.2,#@$-/$-,$7-R#7=$/"2/$/"#$
:)*H-,-*%$*+$.2)#$A-77$(#$6-,/)-(&/#6$2'*%3$/"#$*%B,-/#$.2)#$/#2'$(2,#6$&:*%$2$
H2)-#/=$*+$:)2./-.27$.*%,-6#)2/-*%,$-%.7&6-%3$,."#6&7-%3@$/-'#$*++j7#2H#$*+$2(,#%.#@$
/#)',$*+$/"#$.*772(*)2/-H#$'2% 23#'#%/$2 3)##'#%/,@$#/.EE$
Q%$/"#$G::7#$!)##$U#%/27$6#7-H#)=$'*6#7@$/"#$/"#*)#/-.$'29-'&',$2)#$*H#)B#,/-'2/#,$
(#.2&,#@$+*)$#+T-.-#%.=@$#2."$/#2'$'#'(#)$A*)R,$2/$/"#$/*:$*+$"-,$*)$"#)$7-.#%,#E$$b*)$
Apple Tree Dental
Veterans Home
All providers:
Actual Gross
revenue
MN Dual Licensed
RDH/ADT
Maximum
Theoretical
% Gross revenue
CODA Dental
Therapist
Maximum
Theoretical
% Gross revenue
2014
$188,729
87
72
2015
$207,063
82
70
2016
$204,025
85
72
02-20-18
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,#)H-.#,E$$
0.7<+3-%.7'
!"-,$.2,#$,/&6=$-77&,/)2/#,$/"2/$2$6#%/27$/"#)2:-,/$+&%./-*%-%3$A-/"-%$"#)$,.*:#$*+$
:)2./-.#$,#)H#6$2,$2$,2+#@$.*,/B#++#./-H#@$2%6$:)*6&./-H#$'#'(#)$*+$2%$*%B,-/#$.2)#$
/#2'$,#)H-%3$7*%3B/#)'$.2)#$)#,-6#%/,@$#H#%$/"*,#$A-/"$,-3%-T-.2%/$'#6-.27$%##6,$2%6$
7-'-/#6$)#,*&).#,E$
01-#'2,345'0.7,$%83,.$-$
G::7#$!)##$U#%/27m$U)E$W-."2#7$cE$Y#73#,*%@$Nh_O$U#(*)2"$c2.*(-@$f*7-.=$U-)#./*)O$L)#%62$
f)*,2@$Q%+*)'2/-*%$F=,/#',$U-)#./*)O$G::7#$!)##$U#%/27$,/2++$2%6$:2/-#%/,$
N*%,&7/2%/,m$W2)R$c&)R*H-."@$UUF@$WLG@$WYQ@$WGgUO$L2)(2)2$c$F'-/"@$f"U@$VUY@$WfYO$
With$very$special$thanks$to$Heather$Luebben$and$her$team.$
References
Mather M., Jacobson L.A., Pollard K.M., “Aging In The United States,” Population Reference
1
Bureau (December 2015). Vol. 70, No. 2
Ortman, J., Velkoff, V., Hogan, H., “An Aging Nation: The Older Population in the United
2
States,” U.S. Census Bureau (May, 2014). Available at https://www.census.gov/prod/
2014pubs/p25-1140.pdf
Elizabeth D. Kanter et al. “Trends in Prescription Drug Use Among Adults in the United States
3
from 1999-2012,” Journal of the American Medical Association, Nov 3, 2015
He, W., Larsen, L.$$"Older Americans with a Disability: 2008 - 2012" (2014), National Institute
4
on Aging, National Institutes of Health, available at https://www.census.gov/content/dam/
Census/library/publications/2014/acs/acs-29.pdf"
Nash, David A., et al. "A review of the global literature on dental therapists." Community
5
dentistry and oral epidemiology 42.1 (2014): 1-10.
02-20-18
!11
CHARITABLE TRUSTS PROVIDED FUNDING FOR THIS CASE STUDY