Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers.

BACKGROUND: Poor oral health during pregnancy has significant implications across the life course, including increased risk for adverse pregnancy, birth outcomes, and the development of early childhood caries. In efforts to improve perinatal oral health in the United States, a set of national interprofessional guidelines were developed that include recommended practice behaviors for both oral health providers and prenatal providers. The purpose of this study was to examine guideline awareness, familiarity, beliefs, and practice behaviors among both provider types. METHODS: Prenatal providers and oral health providers in Florida were recruited via random and convenience sampling to complete an online survey guided by the Consolidated Framework for Implementation Research (CFIR) and the Cabana Framework. The present analysis focused on the Individuals Involved domain (CFIR), awareness and familiarity with the guidelines (Cabana Framework), confidence, and practice behaviors as recommended by prenatal oral health guidelines (assess, advise, refer, share/coordinate). Data were analyzed using chi-square tests, independent samples t-tests, Pearson correlation coefficients, and one-way analysis of variance (ANOVA) and analyses were conducted in SPSS. RESULTS: Prenatal and oral health providers did not differ significantly in their awareness of the guidelines, but awareness was significantly associated with three of the four practice behaviors for prenatal providers. Familiarity with the guidelines was significantly higher among oral health providers and was associated with all four practice behaviors for both provider types. Five out of ten oral health belief items were significantly associated with practicing the guidelines among prenatal providers, but only two among oral health providers. Confidence in performing the practice behaviors was significantly associated with guideline implementation among both groups. Years in practice was significantly associated with performing practice behaviors for prenatal providers, but not for oral health providers. CONCLUSIONS: Our findings highlight the importance of professional organizations and the role of clinical guidelines on practice behaviors. Although provider education is a key implementation strategy, organizational and policy-level system changes could also be critical in supporting practice behaviors.

Implementing a Prenatal Oral Health Program for Dental Students: Lessons Learned.

The Prenatal Oral Health Program (pOHP) was developed to educate dental students on prenatal oral health and promote access to dental care for pregnant women. Program advancement has occurred in support of quality improvement. This mixed-methods design combined quantitative data from fourth-year dental students who participated the pOHP (N = 81) and qualitative data from a student-faculty-staff focus group discussion (N = 7). Different clinical structures, appropriate leveling in the curriculum, management with a patient care coordinator, and inclusion of interprofessional learning experiences (IPE) were compared. The survey response rate was 96.4% (N = 81). Trends were noted between students who provided clinical care for a pregnant patient (31%) versus those who did not. Results indicated that an integrated clinic was preferred, though students who had treated a pOHP patient showed greater support for a standalone clinic model. Survey and focus group data agreed that pOHP should occur during the third-year dental school training; however, students with patient experience favored second-year placement. Survey and focus group data emphasize the importance of a patient care coordinator for clinical management and IPE as an essential learning element. Innovating new clinical models requires a period of evolution to determine preferred and sustainable infrastructure. Results reveal the advantages and disadvantages of various program implementation models and demonstrate that student perceptions were influenced by their clinical experiences. Study findings will inform implementation and guide other programs as they create and modify existing curricula to enhance prenatal oral health.

Retrospective Study of Prenatal and Postnatal Gaps in Oral Health Care Utilization: Medicaid Policy Implications.

OBJECTIVE: To assess the frequency and timing of dental treatment completion among pregnant and post-partum women served through the University of North Carolina at Chapel Hill (UNC-CH) Prenatal Oral Health Program (pOHP) dental clinic in the context of North Carolina (NC) dental Medicaid policies. METHODS: We completed a retrospective chart review of pregnant women referred to the program between May 2015 and May 2019. Data were collected from the time of referral until up to 2 years after their estimated due date (EDD). We assessed pre- and post-delivery dental appointment timing and dental treatment completion. RESULTS: The initial study population included 264 pregnant women. Overall, 213 patients (81%) attended at least one appointment, and 32 patients (12%) completed recommended treatments prior to their EDD. Fifty patients (19%) returned after delivery to resume dental care, with only 25 patients (10%) completing their recommended treatment plan. Women re-entered dental care at a median of 67 days (range 5-613 days) after their EDD and completed treatment at a median of 378 days (range 52-730 days) following delivery. CONCLUSIONS FOR PRACTICE: Despite dental clinic referral, most pregnant women do not complete recommended dental treatment before giving birth, and women who resumed dental care after birth demonstrated a lag-time between delivery and care completion. These findings highlight the need for extending post-pregnancy dental care coverage, which is limited under current dental Medicaid policies, posing a major public health issue for new mothers to continue oral health care.

Perinatal Oral Health Among Underserved Women: A Call to Action for North Carolina Patients, Providers and Policymakers.

INTRODUCTION: Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services. METHODS: A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014-2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data. RESULTS: Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service-less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015. DISCUSSION: Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels.

Call for ACTion: Transforming Dental Education at the University of North Carolina at Chapel Hill.

The University of North Carolina at Chapel Hill Adams School of Dentistry is developing a transformative curriculum that prepares students to enter contemporary practice. The Advocate, Clinician, and Thinker (ACT) framework will provide the basis for developing a resilient workforce capable of meeting emerging health care needs over the next 40 years.

Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: A triangulation approach.

BACKGROUND: Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. In this qualitative study, we aimed to explore barriers and facilitators influencing pregnant women's dental service utilization. METHODS: Using a triangulation approach, we included pregnant women (n = 22) from two public health centers, midwives (n = 8) and dentists (n = 12) from 12 other public centers in Tehran (Iran). Data was gathered through face-to-face semi-structured interviewing and focus group discussion methods. The analysis of qualitative data was performed using conventional content analysis with MAXQDA10 software. RESULTS: Reported barriers of dental service utilization among pregnant women were categorized under emerging themes: Lack of knowledge and misbelief, cost of dental care, physiological changes, fear and other psychological conditions, time constraint, dentists' unwillingness to accept pregnant women treatment, cultural taboos and lack of interprofessional collaboration. Solutions proposed by dentists, midwives and pregnant women to improve dental care utilization during pregnancy were categorized under three themes: Provision of knowledge, financial support and establishing supportive policies. CONCLUSIONS: Understanding perceived barriers of dental service utilization during pregnancy can serve as baseline information for planning and formulating appropriate oral health education, financial support, and legislations tailored for lower income pregnant women, midwives and dentists in countries with developing oral health care system.

A Pilot Quality Improvement Collaborative to Improve Safety Net Dental Access for Pregnant Women and Young Children.

Objectives To determine acceptability and feasibility of a quality improvement (QI) collaborative in safety net dental practices, and evaluate its effects on financial stability, access, efficiency, and care for pregnant women and young children. Methods Five safety net dental practices participated in a 15-month learning collaborative utilizing business assessments, QI training, early childhood oral health training, and prenatal oral health training. Practices collected monthly data on: net revenue, no-show rates, total encounters, and number of encounters for young children and pregnant women. We analyzed quantitative data using paired t-tests before and after the collaborative and collected supplemental qualitative feedback from clinic staff through focus groups and directed email. Results All mean measures improved, including: higher monthly revenue ($28,380-$33,102, p = 0.37), decreased no-show rate (17.7-14.3%, p = 0.11), higher monthly dental health encounters (283-328, p = 0.08), and higher monthly encounters for young children (8.8-10.5, p = 0.65), and pregnant women (2.8-9.7, p = 0.29). Results varied by practice, with some demonstrating largest increases in encounters for young children and others pregnant women. Focus group participants reported that the collaborative improved access for pregnant women and young children, and that QI methods were often new and difficult. Conclusion for practice Participation by safety net dental practices in a QI collaborative is feasible and acceptable. Individual sites saw greater improvements in different outcomes areas, based on their own structures and needs. Future efforts should focus on specific needs of each dental practice and should offer additional QI training.

Prenatal Oral Health Counseling by Primary Care Physicians: Results of a National Survey.

Objectives Limited information exists on the extent oral health is addressed in the context of prenatal care. This study sought to investigate characteristics of primary care physicians (PCP) who provide oral health counseling to pregnant women. Methods The study relied upon data from the 2013 Survey of PCP on Oral Health. Provision of oral health counseling to pregnant women (sometimes vs. rarely/never) was the primary outcome. Covariates included respondents' demographic and practice characteristics, oral health-related training, knowledge, attitudes, preparedness and clinical behaviors. The analytical strategy included bivariate tests and multivariable Poisson regression modeling, accounting for the survey design; inference was based upon marginal effects estimation. Results Two-thirds of PCP (233 out of 366 respondents) reported providing oral health counseling to pregnant women. In bivariate comparisons, female PCP, PCP with oral health-specific instruction during medical training, favorable oral health-related attitudes, behaviors, preparedness, and knowledge were more likely to provide counseling (p < 0.05). Multivariable analyses confirmed the independent associations of female gender [marginal effect = + 9.7 percentage points (p.p.); 95% confidence interval (CI) = 0.0-19.0], years in practice (- 0.4 p.p. for each added year; 95% CI = - 0.09 to 0.0), oral health continuing education (+ 13.2 p.p.; 95% CI = 2.6-23.8), preparedness (+ 23.0 p.p.; 95% CI = 16.9-29.0) and oral health counseling of adult patients with other conditions (+ 8.8 p.p.; 95% CI = 4.6-13.3) with prenatal oral health counseling. Conclusions for Practice A considerable proportion of PCP nationwide counsel pregnant patients on oral health. Provider attributes including education and preparedness appear as promising targets for interventions aimed to enhance pregnant women's oral health and care.

Using Quality Improvement Methods to Implement an Early Childhood Oral Health Initiative: A Federally Qualified Health Center Pilot Study.

OBJECTIVES: To assess the use of quality improvement (QI) methods to implement an early childhood oral health program (Baby Oral Health Program-bOHP) in four federally qualified health center (FQHC) dental clinics. STUDY DESIGN: Using a mixed-methods study design, survey responses, administrative data, QI project templates, and focus group measures were collected. Plan-Do-Study-Act (PDSA) cycles as mini-projects to improve the implementation of bOHP were examined. Data analysis included descriptive qualitative reviews and quantitative statistics at baseline, six, and 12 months following the intervention. RESULTS: Twenty-three dental team providers in one urban and three rural clinics participated. Successful QI mini-projects included shortening time period between accepted referral and patient visits, improved documentation of caregiver interview, and efficiency of the infant oral health examination. Lack of change in provider confidence was observed, regardless of years of practice (p=0.93), years of employment (p=0.39), and dental team age (p=0.85). Qualitative reviews highlighted mixed QI results related to training and limited resources invested on follow-up of QI implementation. CONCLUSIONS: A low cost, low resource pilot QI program as part of bOHP implementation showed mixed success, highlighting the critical role of training, staff committment, and leadership support to assure sustainable oral health programs in high-risk populations.

Pregnant Women's Infant Oral Health Knowledge and Beliefs: Influence of Having Given Birth and of Having a Child in the Home.

Introduction Prenatal oral health interventions can positively impact maternal and child oral health, yet limited information exists concerning how to best educate pregnant women about infant oral health. Our objective was to examine the influence of having given birth on pregnant women's infant oral health knowledge and beliefs. Methods We conducted a secondary analysis of data collected from a cross-sectional survey of pregnant women ≥18 years old attending UNC's Ultrasound Clinic. Four binomial items were categorized as infant knowledge (IK) and five rated on a Likert scale (1-5) as infant belief (IB). Overall IK and IB scores were calculated, averaging the items within each construct. Respondents were categorized into two groups: multiparous (N = 268), women having at least one previous live birth and a child between 2 and 6 years old, or nulliparous (N = 186), women with no previous live births or a child between 2 and 6 years old. Regression models for IK and IB were conducted using SAS 9.2 with maternal demographic characteristics, dental utilization, and birth history as explanatory variables (p ≤ 0.05). Results IK was affected by race (p = 0.04), mother's oral health self-rating (p = 0.0002), and birth history (p < 0.0001). On average, IK was 0.12 units higher in subjects with a history of giving birth, adjusting for explanatory variables. IB was influenced by maternal oral health beliefs (p = 0.002) and history of access to dental care (p = 0.0002). IB did not differ based on birth history (p = 0.17). Discussion The influence of birth history on pregnant women's infant oral health knowledge and beliefs can be considered in future intervention designs to maximize available resources.

WHAT ARE CANADIAN DENTAL PROFESSIONAL STUDENTS TAUGHT ABOUT INFANT, TODDLER AND PRENATAL ORAL HEALTH.

INTRODUCTION: Establishing dental homes for children at an early age is an important step toward instilling good oral health practices and changing trajectories of oral health. The purpose of this study was to determine how accredited dental and dental hygiene programs in Canada prepare students in the areas of infant, toddler and prenatal oral health. METHODS: An electronic questionnaire was sent to associate deans (academic), program directors or curriculum directors of accredited dental (n = 10) and dental hygiene (n = 39) programs. Participants were asked about infant, toddler and prenatal oral health curricula taught at their institution. Descriptive statistics and bivariate analyses were used to assess the results. A p value = 0.05 was considered significant. RESULTS: Representatives of 10 dental (100%) and 25 dental hygiene (64.1%) programs responded. All dental and 56% of dental hygiene programs recommend a first visit by 12 months. Infant and toddler oral health was noted as a component of most schools' curriculum. Barriers to teaching about or providing clinical experiences in infant and toddler oral health include lack of time, patients, program resources and finances. Most dental (70%) and dental hygiene (82.6%) programs include prenatal oral health as a component of their curriculum, yet only 40% of responding dental and 70% of dental hygiene programs reported having designated time in their curriculum for it. Barriers preventing programs from teaching or providing clinical experiences regarding prenatal oral health include lack of time and patients. CONCLUSIONS: Many, but not all dental professional programs are teaching their students about the recommended age for a first dental visit. Better adherence to national guidelines will require programs to address current barriers impeding learning about this important topic and to provide creative opportunities for students regarding prenatal and infant and toddler oral health.

Care coordination among pediatricians and dentists: a cross-sectional study of opinions of North Carolina dentists.

BACKGROUND: Care coordination between physicians and dentists remains a challenge. This study of dentists providing pediatric dental care examined their opinions about physicians' role in oral health and identified factors associated with these opinions. METHODS: North Carolina general and pediatric dentists were surveyed on their opinions of how physicians should proceed after caries risk assessment and evaluation of an 18-month-old, low risk child. We estimated two multinomial logistic regression models to examine dentists' responses to the scenario under the circumstances of an adequate and a limited dental workforce. RESULTS: Among 376 dentists, 52% of dentists indicated physicians should immediately refer this child to a dental home with an adequate dental workforce. With a limited workforce, 34% recommended immediate referral. Regression analysis indicated that with an adequate workforce guideline awareness was associated with a significantly lower relative risk of dentists' recommending the child remain in the medical home than immediate referral. CONCLUSIONS: Dentists' opinions and professional guidelines on how physicians should promote early childhood oral health differ and warrant strategies to address such inconsistencies. Without consistent guidelines and their application, there is a missed opportunity to influence provider opinions to improve access to dental care.

American Dental Education Association Compendium Entrustable Professional Activities Workgroup report.

PURPOSE: Entrustable professional activities (EPAs) are discrete clinical tasks that can be evaluated to help define readiness for independent practice in the health professions and are intended to increase trust in the dental graduate. EPAs provide a framework that bridges competencies to clinical practice. This report describes the work of the American Dental Education Association (ADEA) Compendium EPA Workgroup to develop a list of EPAs for dental education and supportive resources, including specifications and a glossary. METHODS: Preliminary work including literature and resource review, mapping of existing competencies, and review of other health professions' EPAs informed the development of our EPAs list. Workgroup members achieved consensus using a modified Delphi process. A Qualtrics survey using a validated rubric for the assessment of EPAs as described in peer-reviewed literature was used. Dental educators, including academic deans, were surveyed for feedback on the content and format of the EPAs. RESULTS: Based on findings in the literature analysis of existing EPAs and competencies in health professions, a list of EPAs was developed along with a description of specifications. The EPA workgroup (nine members from multiple institutions) used the Delphi process in receiving feedback from various experts. A list of 11 core EPAs was vetted by dental educators including academic deans (n = âˆ¼23), and the process of development was reviewed by EPAs experts outside dental education. A glossary was developed to align language. CONCLUSION: These EPAs define the scope of dental practice. This report represents Phase 1 of the EPA framework development and vetting process. Future directions will include a broader vetting of the EPA list, faculty development, and national standardized technology that support this work to optimize implementation.

Program Director Attitudes Toward Acceptance of Pediatric Dentistry Entrustable Professional Activities (EPAs).

Purpose: To acquire comments on pediatric dentistry entrustable professional activities (EPAs) from pediatric dentistry residency program directors (PDs). Methods: An electronic survey invited PDs to evaluate 16 previously developed EPAs on whether they were critical to patient safety, resident education, or both. PDs were asked to evaluate a fully developed EPA to assess structure and clarity and describe barriers to EPA. Descriptive statistics were completed. Results: Forty-one of 103 PDs completed the entire survey. Eighty-five percent (36 of 42) of PDs believed EPAs are critical to pediatric dentistry education, and 81 percent (34 of 42) believed EPAs are critical to patient safety. Eighty-one percent of PDs would likely use EPAs when available. Seventy-five percent (31 of 41) of PDs reported that they have had a resident who would have benefited from a longer duration of training. Conclusions: The majority of pediatric dentistry residency program director participants surveyed reported that entrustable professional activities are critical to patient safety and resident education. EPAs may be a valuable option for assessing residents' readiness for graduation.

A Cost-Effectiveness Analysis of Population-Level Dental Caries Prevention Strategies in US Children.

OBJECTIVE: To improve oral health disparities and outcomes among US children impacted by dental caries, there is a need to understand the cost-effectiveness of a targeted, risk-based versus universal-based approach for caries prevention. METHODS: Health and economic outcomes were simulated in a cohort of 50,000 US children aged 1-18 years, comparing current practice (CP) to risk-based-prevention (RBP) and prevention-for-all (PFA) strategies using health care sector and limited societal perspectives. Prevention included biannual oral health exams and fluoride varnish application, and one-time dental sealant placement. The primary outcome is the cost-effectiveness ratio (ICER), defined as the additional cost per quality-adjusted life year (QALY) gained when comparing each strategy to the next least costly one. RESULTS: For RBP compared to CP, the ICER was US$83,000/QALY from the health care sector perspective; for PFA compared to RBP the ICER was US$154,000/QALY. Using a limited societal perspective that includes caregiver time spent attending dental or medical setting visits, RBP compared to CP yielded a ratio of $119,000/QALY and PFA compared to RBP was $235,000/QALY. Results were most sensitive to changes in the probability of pain from an episode of dental caries, costs for prevention and restoration, and the loss in health-related quality of life due to dental caries pain. Scenario analyses evaluating a reduced intensity of prevention services yielded lower ICERs. CONCLUSION: Using a risk-based approach that identifies and targets children at increased risk for dental caries to guide the delivery of prevention services represents an economic value similar to other pediatric prevention programs.

Adoption and implementation of policies to support preventive dentistry initiatives for physicians: a national survey of Medicaid programs.

OBJECTIVES: We determined the number of state Medicaid programs adopting initiatives to support preventive dental services provision by nondental health care professionals, their perceived attributes, and implementation barriers. METHODS: We used Qualtrics to conduct a cross-sectional survey in 2008 of Medicaid dental program managers to determine organizational stage of adoption classified according to the Transtheoretical Model of Behavior Change with 3-year follow-up. We assessed perceptions of the influence of 18 initiative attributes on the decision to adopt, drawn from Roger's diffusion of innovations theory. Stage and date of adoption are presented descriptively. Attributes and barriers were analyzed by stage of adoption by using analyses of variance or χ(2) statistics. RESULTS: By 2011, 42 states had adopted a policy. Only 9 states included a comprehensive set of preventive services, the most common being fluoride varnish. Adoption was affected by perceived initiative simplicity and its compatibility with other Medicaid programs. Administrative barriers were the most common among the 15 studied. CONCLUSIONS: State Medicaid policies to reimburse nondental providers for preventive dental services are becoming widespread. Interventions are needed to ensure oral health services delivery at the practice level.

Using a change management model to develop and implement dental curricula: A case study.

Curriculum transformation is a guiding principle and driving force to continued institutional growth and innovation in oral health education. The transformation process starts from the need and desire for change to achieve the strategic goals of curriculum invocation. The design and implementation process must follow a systematic approach to ensure the oral health curricula are meeting the demands of preparing learners for their future careers and are in line with the institutional strategic goals and processes. The process of curriculum transformation needs to be carefully crafted and implemented to include all constituents and have clear and measurable outcomes to define its path and results. The University of North Carolina at Chapel Hill Adams School of Dentistry is undergoing the journey of oral health curriculum innovation and transformation. The goal of this paper is to describe the change management process using Kotter's organizational model that may apply to other schools aiming to innovate dental curricula.

Development of entrustable professional activities for post-doctorate pediatric dentistry education.

PURPOSE: To identify the core components of pediatric dentistry defining entrustable professional activities (EPAs) representing the profession. METHODS: Potential core components of pediatric dentistry and corresponding domains were identified through review of literature and existing pediatric dentistry standards. A modified Delphi technique was utilized to rate these candidate EPAs to achieve consensus around prioritized EPAs. RESULTS: Eleven participants participated in all three rounds of the Delphi. After three rounds, 16 candidate EPAs reached consensus for pediatric dentistry. Each EPA fell into one of four domains: "assessment and planning," "provision of care," "behavior guidance," and "professional development." An original candidate EPA focused on non-pharmacological behavior guidance was deemed too broad by the Delphi. This EPA was subsequently developed into three separate components on nitrous oxide analgesia, moderate sedation, and general anesthesia. CONCLUSIONS: Prioritized EPAs will help define the essential activities of the profession and provide a framework for creating assessments to ensure that graduating pediatric residents are ready for unsupervised practice.

Preparing learners to ACT as change agents: Early implementation of leadership curricula in dental education.

OBJECTIVE: Graduates of dental schools are expected to become leaders in their practices, communities, and profession. Yet, formal leadership training is underutilized in U.S. dental school curricula to help learners develop these skills. The objective of this study was to understand third- and fourth-year dental students' perceptions of their initial semester of Bell Leadership Institute training as part of the novel Advocate, Clinician, Thinker curriculum at the UNC Adams School of Dentistry. METHODS: Focus groups of 52 third- and fourth-year dental students were conducted after the completion of the first semester of leadership seminars. Session notes were transcribed, and qualitative analysis was performed to help elucidate student perceptions of the value and pertinence of the leadership seminars. RESULTS: Participants valued the opportunities to self-reflect, develop listening skills, and learn strategies to address and mitigate conflict through the leadership seminars. Perceptions of seminar length, frequency, and structure were varied. Participants also noted that explicit connections and applications of leadership topics to the field of dentistry would improve the quality of the programing. Feedback from 52 focus group participants suggests a general appreciation for curriculum-integrated leadership training. CONCLUSION: Early implementation of seminar-style leadership training in dental school curricula appears to be a productive avenue for developing critical leadership skills in dental school graduates.

Pre-doctoral dental faculty perceptions toward value-based care: An exploratory study.

OBJECTIVES: To explore pre-doctoral faculty perceptions toward implementation of value-based care (VBC) in didactic and clinical teaching. METHODS: This project was a collaborative effort between CareQuest and the University of North Carolina at Chapel Hill, Adams School of Dentistry introducing VBC to pre-doctoral dental faculty as part of a new curriculum. Following a faculty development session on VBC in June 2021, faculty and subject matter experts were invited to participate in qualitative interviews. Subject matter experts were interviewed to establish a baseline for VBC knowledge and understanding. Interviews were recorded and transcribed verbatim. Analysis was conducted by two analysts using ATLAS.ti and a thematic analysis approach. RESULTS: Six faculty and two subject matter experts participated in interviews. Although dental faculty demonstrated some understanding of VBC, they recognized that more training is required to build in-depth knowledge and implementation strategies for teaching dental students. Faculty discussed value-based concepts such as prevention-focused teaching, person-centered care, and disease management over invasive restoration of teeth, and how VBC is bringing about a paradigm shift in dentistry that needs to be reflected in dental education. They acknowledged a disconnect between VBC in didactic teaching versus clinical instruction. Those interviewed believed it would take time to shift faculty mindset and readiness to teach VBC, and continued efforts are needed at the leadership and faculty level for acceptance and implementation. CONCLUSIONS: Although dental faculty recognize that VBC can bring a shift in dental practice, more training and guidance to implement it in didactic and clinical teaching is needed.