Wednesday, September 30, 2015

50 Years of Medicaid, Yet Oral Health Gaps Remain

By Steve Pollock, President and Chief Executive Officer

In 1965, Medicaid and Medicare were signed into law. At that time, there were more than 194 million people in the United States. Thirty-two million lived in poverty. America’s low-income population was in desperate need of medical coverage and the financial means to access care.

Enacting Medicaid and Medicare was the first step toward helping this largely underserved population. With the intended purpose of providing a public health insurance program for low-income people, Medicaid has made great strides in increasing access to coverage since its inception.

Medicaid Covers More People, Just Not for Dental

From the original 4 million Americans that enrolled in Medicaid to the 65 million who are enrolled today, the goal has remained the same: administer proper medical care to those with limited or scarce resources.

Policy and lawmakers alike have recognized the importance of creating an opportunity for all Americans, socioeconomic status aside, to be protected with quality medical care.

As background, Medicaid provides health coverage to non-elderly low-income parents, their children, other caretaker relatives, pregnant women, and other non-disabled adults. Most recently, Medicaid expanded to include more people under those definitions based on language in the Affordable Care Act.

While Medicaid’s accomplishments to date are something to be deeply proud of, the reality is that there is a major gap that still needs attending to: adult dental coverage.

Medicaid Members Need Dental Coverage

A few months ago, I wrote a blog post on Children’s Health Insurance Program (CHIP) funding being successfully extended for two more years. In that post, I pointed out the decision to include adult dental care coverage within Medicaid is up to each state to decide. As a result of that policy, millions of Americans are left without access to dental benefits. This still holds true, even though oral health is vital to overall health and lower health costs.

In the past decade alone, patients seeking treatment for dental pain in the ER doubled from 1.1 million to 2.1 million. And 80 percent of dental-related ER visits are caused by preventable conditions. This reality means our focus needs to be on providing preventive care that will ultimately cost three times less than ER visits, and save a lot of people from excruciating dental pain.

CHIP is a great example of how mandated dental coverage works. CHIP has been a critical source of health coverage for children and pregnant women who earn too much to qualify for Medicaid but too little to purchase private health insurance. It provides affordable medical and dental coverage to more than 8 million children across the country.

Coverage Leads to Improved Prevention

According to a report from the U.S. Department of Health and Human Services, 80 percent of CHIP enrollees saw a dentist in the past year, a number much higher in comparison to children who do not have coverage. That preventive care will ultimately save kids from future dental emergency visits, keep kids in school instead of at excessive dental appointments, and ensure more kids are pain-free and smiling. 

Moving forward, I urge legislators to rise to the challenge: let’s continue increasing access for those in need and secure adult dental coverage under Medicaid at the federal level.

Oral health is crucial to overall health and wellness, and should be recognized as so by the law. Mandating adult dental coverage is the necessary next step towards achieving improved oral health for all.

Thursday, September 17, 2015

Back to School: Advancing Oral Health in the Classroom

By Ralph Fuccillo, MA, President, DentaQuest Foundation

It’s that time of year again – the time when kids all across our country head back to school for another year of learning, growth and development. But, did you know that the classroom is also a crucial point of connection, education and even treatment when it comes to oral health?

If you are a parent, you can attest that you always have your child’s health and wellbeing on your mind, particularly in an age where fast food, lack of exercise and other issues plague the next generation. For kids, tooth decay is actually the most common childhood disease, more common than asthma. Each year, children across the United States lose approximately 52 million school hours due to dental disease. Unfortunately, this impacts low-income children disproportionately, as they face more barriers to getting much-needed, preventive dental care. It’s sometimes a challenge to find a provider that accepts their insurance, and if they are able to secure an appointment, they may have trouble getting transportation to and from the office, and their parents may not be able to take the time off from work to get them there. To drive this home, kids from low-income families have twice the untreated tooth decay compared to their higher-income counterparts.

Schools are a practical and cost-effective place and time to reach children, teach them about healthy habits and even ensure they receive the preventive oral care they need. In addition to education on healthy personal dental care, school-based oral health programs can provide a range of services from screenings to sealants to fluoride treatments. To illustrate the potential of these programs, according to a recent issue brief from the Centers for Medicaid and Medicare Services’ (CMS) Oral Health Initiative, the Centers for Disease Control and Prevention (CDC) estimated that over half of kids’ tooth decay could be prevented if half of those high-risk children participated in school sealant programs.

Think of the potential! This is why one of our Oral Health 2020 goals is centered on this important, cost-effective initiative. By 2020, we strive to have oral health education and services incorporated into the curriculum and offerings of the 10 largest school districts in the country.

To make this goal a reality, we partnered with Oral Health Colorado to develop a toolkit for local communities. The recently-launched, free Smart Mouths Smart Kids (SMSK) toolkit is available to help communities assess need for such a program in their local schools, measure feasibility of program administration and create a program that is sustainable for years to come. Its development took into account best practices and key learnings from our work to provide local stakeholders with the tools they need to make oral health a priority in local schools.

From engaging appropriate partners to understanding reimbursement methodology and building a sustainable business plan, this toolkit has everything a community needs to get started with implementing school-based oral health care – along with support at every step of the way – to help bring dental care and education to the next generation. While the toolkit is focused on Colorado communities, it’s a model that can be scaled and tailored to states across the country.  We encourage you to take a look and share with school administrators, local government leaders, and teachers, and empower your community to bring good oral health back to school this fall. 

Tuesday, September 8, 2015

Missions of Mercy: Oral Health Improvement in Motion

Guest post by Marcia Brand, Ph.D., senior advisor for national policy and programs, DentaQuest Foundation, and executive director, National Interprofessional Initiative on Oral Health

Are you familiar with Missions of Mercy?

Missions of Mercy – sometimes also called “MOMs” – provide dental services, including cleanings, fillings, oral surgery, x-rays and dentures, to people in underserved communities across the country. These services are provided free of charge by dentists and hygienists who donate their time as volunteers. By bringing free dental screenings and care to those who need it most, these missions are a crucial, hands-on way to improve the oral health of all.

I recently volunteered as a dental assistant at the Wise County Mission of Mercy in Virginia. Pat Finnerty, another senior advisor to the DentaQuest Foundation, volunteered as well, managing patient flow in the triage tent.

Southwest Virginia is an area where much of the population doesn’t have access to regular dental care and services. Would you believe that more than 47 percent of the total population of Virginia doesn’t have dental insurance? I hope this helps drive home the importance of these events.

We don't often realize the powerful impact that poor oral health has on the lives of those who cannot access oral health care. I recall one young woman, perhaps 30, who came through the triage tent at the Wise MOM. After examining her mouth, the dentist gently told her that her best option was going to be to have all of her top teeth in the front extracted. There were multiple infections and they could not be saved. He had to step awayand she began to weep. I asked her if she was afraid and she said, "No, they really do hurt me, but I can't get them pulled. I'm a bartender. If I lose my front teeth, I'll lose my job." What a terrible choice she had to make remain in pain, with multiple infectionsor lose her job. Fortunately, we were able to make arrangements for her to have her teeth extracted and get a partial denturebefore her next shift. Stories like these continue to indicate to me that we must improve access to affordable dental care for all.

The DentaQuest Foundation has participated in the Wise MOM project for 11 years. Since its start in 2000, this particular MOM has brought $15.3 million in free dental care to 19,060 patients – what an incredible impact.

This year, we partnered with the Virginia Dental Association, Virginia Commonwealth University School of Dentistry and Dental Hygiene, the Health Wagon, Remote Area Medical, Virginia Health Care Foundation and other sponsors to fund the Wise County event. Over the three days, more than 1,000 patients passed through the triage tent, resulting in a total of 1,181 exams, 177 cleanings, 1,082 x-rays, 1,569 fillings and 3,527 extractions.

For many people, MOM events are the only time all year that they are able to get care. With 69 localities throughout Virginia lacking a dental safety net provider, the MOM events are a critical stop gap that reach more than 4,000 residents annually. 

While MOMs and other similar events provide dental services to people in desperate need of oral care, they also highlight the demand for an increase in access to quality, affordable care. That is why it is the DentaQuest Foundation’s goal, by 2020, to address this unacceptable gap head on. As a part of the Oral Health 2020 goals, we hope to have at least 30 states with a comprehensive Medicaid adult dental benefit and a comprehensive adult dental benefit under Medicare. Will you join us and put oral health improvement in motion?

Wednesday, July 22, 2015

Debunking Dental Myths: How Well Do You Know Your Teeth?

By Dr. Brian NovĂ˝, Director of Practice Improvement, DentaQuest Institute

Myths are something we are exposed to every day – we hear them from our co-workers, friends and family. Everyone has heard the ones about chewing gum staying in your stomach for seven years, if swallowed, or that you should never wake a sleep walker. But, did you know there are many myths about oral care and your teeth? In this post, we’ll play a game of true or false, and cover 9 common “facts” about teeth. Can you guess what is a myth and what is true?

1.    You should floss before you brush your teeth.
This is in fact true. If you floss after you brush, there is a risk that you will wipe plaque all over your clean teeth. Ideally, you would brush, floss and then brush again.

2.    Whitening your teeth will hurt your enamel.
This is a myth. While excessive whitening can be harmful, a tiny bit of bleaching gel, like carbamide peroxide, can help kill bacteria on your teeth that can cause periodontal disease and tooth decay.

3.    Bad breath is only caused by not brushing your teeth.
Would you believe that this is false? Bad breath can be caused by a number of factors. For instance, your tonsils can collect debris causing your breath to smell. Bad breath can also be caused by more serious issues, like periodontal disease and untreated tooth decay.

4.    You should use an electronic toothbrush over a regular toothbrush.
Also a myth – a regular toothbrush can do a great job of brushing, but some patients find that an electronic toothbrush can make brushing easier. Soft toothbrushes do a better job cleaning than medium or hard bristled toothbrushes, so always select a toothbrush with soft bristles.

5.    You only need to visit your dentist only once a year.
False! Everyone needs to visit the dentist at least once a year, and some patients need to visit the dentist four times a year. You should talk with your dentist about how many times a year you should visit his or her office.

6.    Brushing bleeding gums is bad.
This is one of the biggest myths out there! If your gums are bleeding, you need to brush more carefully and floss more often. If your gums still bleed after a week of gentle thorough brushing, see your dentist to ensure everything is ok.

7.    People who get cavities simply just don’t brush their teeth.
It’s much more complicated than that – this is another myth. Cavities are caused by a bacterial infection. Brushing is an easy way to prevent some cavities but you need to encourage oral health by eating protective foods, flossing and visiting the dentist for regular check-ups. 

8.    All fillings you have in your mouth will eventually need to be replaced.
This is true! Once you have had a filling, your tooth has been weakened. There currently is no perfect filling material out there, so fillings must be maintained over your lifetime. You can help you fillings last longer by caring for them with proper home care.

9.    You should not go to the dentist when you are pregnant.
This is a very common myth. While you are pregnant, your hormone levels change which can make it easier for bacteria to cause dental infections. It is important for expecting mothers to also let their dentist know if they have any changes in their oral health, like bleeding gums. Be sure to see your dentist regularly if you are pregnant.

How did you do? Did you get all 9 right? As you can see, knowing the difference between the facts and myths surrounding dental health is important not only for your oral health, but also your overall health. Always check with your dentist if you have any questions or want to clarify any myths!

Wednesday, July 15, 2015

The importance of community water fluoridation to oral health

By John Luther, DDS, Senior Vice President, Chief Dental Officer DentaQuest and Michael Monopoli, DMD, MPH, MS, Director of Policy and Programs DentaQuest Foundation  

A recent recommendation by the U.S. Department of Health and Human Services (HHS) has brought about a resurgence of support for community water fluoridation within the oral health community.

Dentists have consistently been strong advocates for the health benefits of fluoridating public water supplies, and fluoridation is widely regarded as one of the top public health achievements of the past century. Officials from both public health organizations and professional dentistry agree that water fluoridation and fluoride toothpaste are largely responsible for the significant decline in tooth decay in the U.S. over the past several decades.

Fluoride doesn't cure or medicate -- it simply prevents. Similar to a vitamin, the right amount of fluoride in our drinking water improves resistance to tooth decay and causes us no harm. By preventing tooth decay, community water fluoridation has been shown to save money, both for families and the healthcare system.

In 2000, the U.S. Task Force on Community Preventive Services examined 21 studies and concluded that fluoridated water reduces tooth decay by a median rate of 29% among children ages 4 to 17. While children are typically cited as the beneficiaries of this protection, a 2010 study in the American Journal of Public Health (October 2010, Vol. 100:10, pp. 1980-1985) found that the fluoridated water consumed as a young child makes the loss of teeth from decay less likely 40 or 50 years later when that child is a middle-aged adult.

Recently, HHS announced the first change in the recommended amount of fluoride for public drinking water supplies in more than 50 years. The new guidelines utilize the best evidence available to clarify the amount of fluoride needed to achieve the optimal amount of tooth decay prevention.

The department gave several reasons for the change, mainly citing that Americans have more access to sources of fluoride than they did when water fluoridation was first introduced in the 1940s, but water is just one of multiple sources. Consumers also have access to fluoride toothpastes, mouth rinses, and prescription fluoride supplements, as well as fluoride applied by dental professionals.

We, along with the Centers for Disease Control and Prevention, the American Dental Association, and many other organizations, know that community water fluoridation is one of the most cost-effective means of preventing dental caries. The new recommendation, along with other current findings, strengthens our understanding of the preventive effects of fluoride on oral health and reinforces the need for communities to continue to invest in keeping fluoride in community water.

After more than 70 years of studying fluoridation in drinking water, it is clear that this practice is one of the most important health-promoting policies that a community can offer all its residents. This is especially true for those who are low-income, those with limited access to regular dental care, and those who experience health disparities firsthand. It's effective. It's safe. And it's the reason why both children and adults today have much less tooth decay than people had a generation ago.

This piece originally ran on  

Wednesday, July 8, 2015

King v. Burwell: An Historic Moment for Prioritizing Equity and Improving Health

By Steve Pollock, President and Chief Executive Officer

In late June, the U.S. Supreme Court ruled in favor of upholding an important piece of the Patient Protection and Affordable Care Act (ACA) in the King v. Burwell case. This ruling confirmed the eligibility of Americans to receive tax credits to purchase much-needed health coverage, whether they live in a state with its own insurance exchange or one operated by the federal government. This crucial ruling underscores the importance of equity – no matter where you live – when it comes to getting the care you need. King v. Burwell is a landmark decision – marking a truly unique time in our history as a country and providing healthcare to those who need it most.

The ACA is already eliminating significant barriers to dental care. Thanks to this important Supreme Court decision, it will be able to continue to bring coverage to people across the country. To help illustrate the impact of ACA already, according to the American Dental Association:

·         17.7 million adults are eligible to receive basic dental coverage through the ACA
·         4.5 million adults will gain extensive dental benefits through Medicaid
·         About 800,000 adults will gain dental benefits through the health insurance exchanges

While we cannot understate the importance of the King v. Burwell ruling and its representation of our leaders’ commitment to providing everyone – no matter your income, age or geographic location – with access to care and the ability to lead a healthy life, we still have our work cut out for us:
  1. As my colleague Dan Sheehan mentioned in a recent post about, we must improve the federal exchange so consumers can access the dental coverage they need and want.
  2. We must provide consumers with the tools they need to make coverage decisions that positively impact their oral health. This means including consumer-focused resources on to help consumers choose the right dental coverage for their families.
  3. While the ACA enables access, many are still left out of the mix. This year, on the 50th anniversary, Medicaid and Medicare need to provide for comprehensive adult dental benefits.
As I look to the future from this ruling, I am hopeful that we will increase access to healthcare and promote equity across the U.S., allowing our citizens to achieve their healthiest selves. At DentaQuest, we are committed to working with our leaders, stakeholders and local communities to achieve this goal and it is within our grasp!

Wednesday, June 24, 2015

DentaQuest Foundation goes local with its grassroots engagement strategy

By Ralph Fuccillo, President of the DentaQuest Foundation

Health outcomes have improved vastly over the past few years for many Americans, especially when it comes to infant mortality and life expectancy. However, significant health inequities still persist in this country and oral health is no exception.

According to the W.K. Kellogg Foundation, more than 50 million Americans are living in areas with insufficient dental care.Tooth decay is still the most common childhood disease. Good oral health is the gateway to a person’s overall health and wellness, so without access to care or education, preventable ailments like dental caries and gum disease can build up to become more painful and costly than necessary.

In 2015, it’s unacceptable that these inequities exist, and that people are suffering from diseases that are preventable. That’s why the DentaQuest Foundation, along with our ever-growing network of grantees and partners, has made it our mission to reach the people who do not have access to regular care due to their race, age, income, language, health literacy and geographic location. We believe everyone should have the same opportunity to live a healthy life, and with nearly 83 million people in the United States facing dental care barriers, we still have a lot of work to do. 

To drive our mission forward, we recently launched the Grassroots Engagement Strategy, a grant-making initiative supporting local, community based organizations. This initiative supports our Oral Health 2020 goal of changing the public perception of oral health - helping people realize that dental pain, tooth loss and restoration don’t have to be facts of life or just an accepted part of getting older.

We’re working to create a new social norm where people can expect oral health. If we want to #expectoralhealth, the changes we need must be driven by those most impacted when the existing systems fail. Earlier this year, we selected 20 community-based organizations in six states including Arizona, California, Florida, Michigan, Pennsylvania and Virginia, to receive two $50,000 grants over the next year. The grantee organizations range from direct service providers to civic engagement and advocacy organizations, all of which are already active in promoting health equity and the pursuit of social justice for a diverse number of populations. The grants will fund these organizations to analyze the oral health landscape in their communities, enact a plan to engage stakeholders on a local level, and ultimately improve oral health in the places where they live and work.

Network development is key to all of our grantmaking initiatives. The Grassroots Engagement Strategy now gives local change agents the opportunity to have their voices heard amongst the our growing network of state, regional and national partners. Organizations at all levels of the network - from grassroots to grasstops - will be able to learn from each other what is needed to enhance oral health, share best practices and work collaboratively to bring about significant change in oral health financing, care, community and policy systems. 

It is our hope that by working with organizations we will be able to make significant leaps in our quest to achieve oral health equity for all and meet the Oral Health 2020 goals. We’ll be sure to keep you posted and provide updates on the initiative’s progress! In the meantime, follow us on Twitter (@OralHealth2020) and like our Facebook page. Visit for more information.