Navigational Assistance for Dental Disease

Overseen By Margaret Samuels-Kalow

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Involuntary holds, Carceral facilities, Acute mental health, IPV, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

2049 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine how different methods of sharing information can enhance dental care for patients visiting the emergency department. Researchers will compare three approaches: providing general oral health tips (general information provision), offering local dental care resources (geographic information provision), and giving additional help to connect patients with nearby dental services (navigational assistance). The trial seeks patients with unmet dental needs who live in a specific hospital area and can communicate in English or Spanish. Participants must also have a working phone number and be able to consent to the study.

As an unphased trial, this study presents a unique opportunity to contribute to improving dental care strategies in emergency settings.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that providing geographic information and navigational help is generally safe and well-received. Studies using Geographic Information Systems (GIS) have helped understand dental health needs and made accessing dental care easier. No reports indicate problems from providing geographic information alone.

For navigational help, research highlights its importance in overcoming obstacles to dental care. This often involves guiding patients through the healthcare system, which has proven helpful without causing harm. Although specific safety details aren't provided, the absence of reported issues suggests these methods are safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative methods to enhance dental care accessibility. Traditional dental care often relies on patients seeking out information independently or receiving standard advice during visits. This trial is different because it investigates the impact of providing targeted information and support. One group receives geographically-specific resources, while another also benefits from active navigational assistance, potentially making it easier for patients to access nearby oral health services and address social determinants of health. By testing these approaches, researchers hope to find out if personalized guidance can improve dental health outcomes more effectively than current practices.

What evidence suggests that this trial's treatments could be effective for improving oral health care linkage?

This trial will compare different strategies to help individuals access dental care. Participants in Arm A will receive general information about oral health resources. Arm B will provide participants with geographically-proximate oral health resources. Arm C will combine geographic information with active navigational assistance. Research has shown that knowing where dental care is available can help people overcome barriers to accessing it. Studies have found that awareness of nearby dental services increases the likelihood of receiving needed care. Additionally, having guidance, such as a dental navigator, can further assist people in successfully connecting with dental services. Programs with dental navigators have improved patient return rates and overall health outcomes. These strategies aim to make it easier for everyone, especially those facing social challenges, to find and use dental services. ^{1 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for emergency department patients with unmet oral health needs who can consent, follow study procedures, and are reachable by phone. It includes adults and children over 1 year old with a guardian present. Participants must speak English or Spanish, have an ESI of 2-5, live in the specified area, and have a working phone number.

Inclusion Criteria

I am willing to follow the study rules and can be reached by phone.

I understand and can agree to the study's procedures verbally.

I can communicate in English or Spanish.

Exclusion Criteria

Presenting for acute mental health care under evaluation for Section 12

Patients on involuntary holds

I am seeking help for issues related to intimate partner violence or after a sexual assault.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive different interventions based on their assigned arm: Arm A receives general oral health and aSDoH resources, Arm B receives geographically-proximate resources, and Arm C receives geographically-proximate resources plus navigational assistance.

12 months

Follow-up

Participants are monitored for completion of dental appointments and return visits to healthcare facilities.

12 months

What Are the Treatments Tested in This Trial?

Interventions

• General information provision
• Geographic information provision
• Navigational assistance

Trial Overview The MOLAR trial tests how different types of information affect patients' ability to access dental care. Arm A gets general oral health info handouts; Arm B receives geographically tailored info; Arm C gets the same as B plus help navigating services.

How Is the Trial Designed?

Group I: C--geographic information and navigational assistance Experimental Treatment 2 Interventions

Patients in Arm C will receive geographically-proximate oral health and aSDoH resources plus active navigational assistance.

Group II: B--geographic information Experimental Treatment 1 Intervention

Patients in Arm B will receive paper handouts with geographically-proximate oral health and aSDoH resources.

Group III: A--general information Experimental Treatment 1 Intervention

Patients in Arm A will receive paper handouts with general oral health and aSDoH resources

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

National Institute of Dental and Craniofacial Research (NIDCR)

Collaborator

Trials

312

Recruited

853,000+

Published Research Related to This Trial

A computer-assisted learning package on the oral manifestations of HIV was developed and assessed by 75 general dental practitioners (GDPs) in the UK, with 72% providing feedback on its effectiveness.

The majority of GDPs found the package to be user-friendly and more effective than traditional educational methods like videos and journals, leading to its modification and distribution for broader use in England and Wales.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computer assisted learning (CAL) of oral manifestations of HIV disease. Porter, SR., Telford, A., Chandler, K., et al.[2019]

About 51.3% of consumers with chronic health conditions reported having navigational needs when seeking health information online, indicating a significant portion would benefit from assistance in finding reliable resources.

Participants with navigational needs tended to have lower eHealth literacy and sought a wider variety of health information, suggesting that targeted support could enhance their ability to manage their health effectively online.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Consumer Use of "Dr Google": A Survey on Health Information-Seeking Behaviors and Navigational Needs. Lee, K., Hoti, K., Hughes, JD., et al.[2022]

A study involving 50 participants, including 44 dental providers and 6 oral health literacy experts, revealed that while dental providers value effective communication, they rarely use recommended techniques, relying mostly on simple language and visual aids.

Key barriers to effective communication identified include time constraints, financial incentives favoring treatment over prevention, and a lack of training and resources in oral health literacy, suggesting a need for improved support and education for dental providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California. Tseng, W., Pleasants, E., Ivey, SL., et al.[2021]

Understanding health care information, such as medication directions and physician guidance, leads to improved health outcomes for consumers.

Lack of comprehension of medical instructions can result in serious health issues, including poor management of chronic conditions like diabetes, increased hospitalizations, and medication errors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Crystal-clear communication. Kantor, A.[2008]

A network map was created to visualize the complex web of health information available online, highlighting the varying quality of sources accessed by patients and medical professionals.

This prototype map serves as a tool to help users navigate and evaluate the reliability of different consumer e-health information websites, potentially improving decision-making in healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A trend map for e-health information. Plasek, JM., Pieczkiewicz, DS.[2016]

A study involving interviews and observations revealed that while most dental patients felt satisfied with the education they received during visits, 38% still sought additional information online, indicating a gap in their knowledge needs.

Patient education accounted for a significant portion of dental visit time (29% during initial exams and 7% during routine visits), suggesting that integrating effective educational strategies into dental workflows could enhance patient understanding and care outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An initial, qualitative investigation of patient-centered education in dentistry. Clayton, M., Borromeo, C., Hess, S., et al.[2013]

Educating patients and families about oral care is crucial for improving adherence to treatment regimens and enhancing overall patient outcomes during cancer therapy.

A significant barrier to effective oral care is the lack of knowledge among health care professionals, highlighting the need for improved training in oral assessment and hygiene for oncology nurses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Educational issues in oral care. Daniel, BT., Damato, KL., Johnson, J.[2019]

A new method for organizing consumer health information was developed, which combines semantic annotation and Formal Concept Analysis, resulting in improved navigation for users seeking health information online.

This method achieved a recall increase of 36.5% in multi-topic assignment of health questions, while maintaining high precision, indicating it can effectively enhance access to quality health information without compromising accuracy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multi-topic assignment for exploratory navigation of consumer health information in NetWellness using formal concept analysis. Cui, L., Xu, R., Luo, Z., et al.[2021]

A survey of 400 Australian adults revealed that over half of the participants preferred navigational support from health professionals when searching for online health information, regardless of their self-identified need for support.

The main barriers to finding reliable online health information were the overwhelming volume of available data and inconsistencies between different sources, affecting both those who needed support and those who did not.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dr Google Is Here to Stay but Health Care Professionals Are Still Valued: An Analysis of Health Care Consumers' Internet Navigation Support Preferences. Lee, K., Hoti, K., Hughes, JD., et al.[2018]

The Information Prescription (Information Rx) Program, implemented by the American College of Physicians Foundation, enhances patient education and communication by directing patients to reliable health information on MedlinePlus, as reported in studies conducted from 2002-2005.

Physicians who use Information Rx feel they are providing a valuable service that improves patient communication and encourages patients to seek quality health information online, ultimately fostering better dialogue and understanding between doctors and patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Information Rx: Evaluation of a new informatics tool for physicians, patients, and libraries. Siegel, ER., Logan, RA., Harnsberger, RL., et al.[2020]

Citations

1. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/full/10.1111/cdoe.13015

Navigating Disparities in Dental Health—A Transit‐Based ... Based on the 2022 Medical Expenditure Panel Survey data, only 43% of the USA population had a dental visit in the past 12 months [2]. Access to ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2898058/

Geographic Information Systems (GIS) in Assessing Dental ... The present study investigated the distribution profile of dental caries and its association with areas of social deprivation at the individual and contextual ...

3. ada.org ada.org/resources/research/health-policy-institute/coverage-access-outcomes/geographic-access-to-dental-care

Geographic Access to Dental Care Click on a state in the map below to view its unique access to dental care data.

4. nature.com nature.com/articles/s41415-025-8487-8

Tackling geographic barriers to primary dental care ... To review global literature addressing geographic barriers to dental care and make recommendations for health policy and future research in relation to access.

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11619838/

Spatial-Temporal Distribution of 12-Year Periodontal Disease ... This paper presents a hybrid method for use in epidemiological studies by evaluating the spatiotemporal distribution of disease prevalence.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9954952/

School Dental Services Theoretical Model-Based on ... The study aimed to design a geographic theoretical model for school dental services (SDS) in Al-Madinah, Saudi Arabia (SA), using a geographic information ...

7. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2828397

Dental Clinic Deserts in the US: Spatial Accessibility Analysis This cross-sectional study of 205 762 US dentists found that nearly 1.7 million people in the US did not have access to dental clinics within a 30-minute drive.

8. researchgate.net researchgate.net/publication/350966512_Geographic_Information_Systems_in_Spatial_Epidemiology_Unveiling_New_Horizons_in_Dental_Public_Health

Geographic Information Systems in Spatial Epidemiology Objectives: Research on the role of environment and place in various aspects of dental public health using geographic information systems ...