Monday, May 9, 2016

Oral Health, Meet Eye Health

During Healthy Vision Month each May, the National Eye Institute encourages Americans to make their eye health a priority and informs them about steps they can take to protect their vision. But why are we talking about eye health on an oral health blog? 

Oral health is a critical piece to the oral health puzzle, but so is vision. Just as the mouth can be the first place to spot signs of chronic disease, so can the eyes. 

An eye exam, for example, can uncover broken or leaking blood vessels in the retina, which are an indicator of diabetes. Specifically, the capillaries that deliver blood to the retina can be broken down by a buildup of sugar in the bloodstream, and elevated blood sugar is a warning sign for diabetes that a vision provider would spot perhaps before anything else triggers a diabetes test from a primary care provider. 

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Some even suggest that identifying chronic diseases such as diabetes and hypertension at the eye doctor or dentist is more cost effective and can mean better outcomes for people who otherwise might not be diagnosed until a chronic disease has progressed or other complications develop.
Moreover, a healthy set of eyeballs means productivity and independence are within reach for much longer.

So what does the National Eye Institute encourage for healthy vision?

  • Get a comprehensive dilated eye exam.
  • Live a healthy lifestyle, including eating healthy foods, maintaining a healthy weight, managing chronic conditions, and not smoking.
  • Know your family history.
  • Use protective eye wear.
  • Wear sunglasses.

Taking these steps can help prevent vision loss or blindness, which can result from many diseases and conditions. In addition, comprehensive dilated eye exams can detect problems early, when they’re easier to treat.

DentaQuest believes in eye care as much as oral health because you cannot have improved overall health without healthy eyes and mouths. This is in part why we created eyeQuest back in 2009.

At the start of 2009, we began administering a Medicaid vision program for 40,000 people in Nevada with Amerigroup coverage. As of April 1, 2016, we now administer vision programs across 9 states for 1.6 million people!

Still need convincing that vision is important to care for the same way you care for the rest of your body? Commemorate Healthy Vision Month by pondering and sharing these fun facts:

  • 80 percent of what we learn is through our eyes.
  • Eyes are the second most complex organ after the brain.
  • An eye is composed of more than 2 million working parts.

Thursday, April 28, 2016

Beyond Your Mouth: The Social Determinants of Oral Health

April is minority health month, and there’s no better time to focus on dental health—which so profoundly affects the overall health of minorities. As the commemorative month comes to a close, consider the importance of improving the oral health of all (our mission lived each day).

“Oral health implies much more than healthy teeth. The mouth is both a cause and a reflection of individual and population health and well-being,” states a study published in BMC Oral Health. This notion reflects the fact that many of the determinants of dental health go way beyond medical factors—they are behavioral, cultural, social, and economic as well.

For example, tooth decay is a major dental health issue for the United States. And the food we eat plays an important role in this. Foods rich in sugar and carbohydrates help to form plaque acid that attacks tooth enamel. But those who live in food deserts with no access to healthy, nutrient rich food, may be forced to rely heavily on these foods in their diet.

Education also plays an important role in tooth decay. 

  • Adults aged 35–44 years with less than a high school education experience untreated tooth decay nearly three times that of adults with at least some college education.
  • In addition, adults aged 35–44 years with less than a high school education experience destructive periodontal (gum) disease nearly three times that of adults with at least some college education.
Access to fluoride is also key. 
Prior to World War II, Americans were plagued by toothache and tooth loss.  But in 1948 the National Institute of Dental and Craniofacial Research was formed and researchers began demonstrating the effectiveness of fluoride in preventing tooth decay. 

According to a Surgeon General’s report, “Community water fluoridation remains one of the great achievements of public health in the twentieth century—an inexpensive means of improving oral health that benefits all residents of a community, young and old, rich and poor alike.”

While community water fluoridation is highly recommended by nearly all public health, medical and dental organizations, some may still lack this important program. (Check your community’s status in this CDC fluoride finder.)

Dental insurance inequalities also contribute to health disparities, as preventive oral care including check-ups and regular dental cleanings are crucial. That is one reason we created the unique PreventistrySM approach, which not only fully covers most preventive services, but also helps highlight for network dentists those members at higher-risk of tooth decay.

This year’s minority health month theme is Accelerating Health Equity for the Nation. Long past just recognizing health inequalities, this theme calls us to improve our work toward health equity, in part by focusing specifically on the social determinants. 

As you continue to think about this theme—hopefully long past April—don’t forget about the intertwined importance of oral health.

Friday, March 18, 2016

World Oral Health Day: Increasing Access in the United States and Across the Globe

By Natalia I. Chalmers, DDS, PhD, DentaQuest Institute

When I talk about oral health, I refer to everything from cavities to mouth cancer to nutrition, from babies to people of all ages, from dentists to hygienists to all health professionals. And I don’t only think about America.

According to the FDI World Dental Federation (FDI), 90 percent of people worldwide will suffer from oral health problems in their lifetime. This alarming statistic underscores the need for World Oral Health Day, held annually on March 20.

This observance pushes those of us passionate about oral health to take action to reduce the incidence of dental disease, while providing a moment in time for us to elevate the issue globally. To commemorate World Oral Health Day 2016, I took a look at the global burden of untreated caries and how we stack up against our neighbors across the pond when it comes to oral health.

Global Burden of Untreated Caries

According to the World Health Organization, caries is the fourth-most expensive chronic disease to treat. While the prevalence and incidence of untreated caries remained static between 1990 and 2010, there is evidence (as noted in the Journal of Dental Research article also linked above) that the burden of untreated caries is shifting from children to adults.

Oral Health in the United States vs. United Kingdom

It is a common misconception that Americans have “better” teeth than the British, a stereotype perpetuated in the entertainment industry. However, a recent study published in the British Medical Journal shed light on the actual oral health differences between the two countries, illustrating that, in fact, the picture is more complex.

In the study, researchers looked at data from the English Adult Dental Health Survey (ADHS) and the U.S. National Health and Nutrition Examination Survey (NHANES) to analyze baseline measures, such as the number of missing teeth and oral health’s impact on daily life. The analysis yielded some of the following results:
  • U.S. adults had more missing teeth than their U.K. counterparts (an average of 7.31 to 6.97 missing teeth, respectively).
  • The impact of poor oral health on U.K. daily life was more prevalent.
  • The highest U.S. socioeconomic group had better oral health, while those in the lowest U.K. socioeconomic group had better oral health.

While these results indicate there is room for improvement in both countries, the last finding stood out to me.

Researchers in the study suggest this finding may be due to differences in how health care is funded in each country. U.K. dentistry is largely supplied by the National Health Service, while it’s largely dependent on access to dental insurance for Americans. 

Differences aside, these results point to the larger problem at hand — barriers to access in the United States.

Most Americans who fall within the lower socioeconomic category lack access to care, education, and transportation, which subsequently impacts the incidence of disease. One potential reason those with low socioeconomic status thrive in the United Kingdom is that they have resources that connect them with proper oral health care. 

This issue of access and resources is an important factor when evaluating disease causation — when we increase access, we improve oral health.

Greater Access Can Lead to Better Outcomes

So we know the burden of untreated caries is shifting from children to adults. There is evidence that the U.S.-U.K. oral health gap is not as large as we may think. Imagine what this means for our misconceptions about oral health in general across the globe.

Knowing disparities are complex, I hope this World Oral Health Day becomes the global call to increase access to oral health care for all. Let’s elevate the conversation and raise awareness: with support, access to preventive services will increase health outcomes globally and bring relief to all 90 percent of the world’s population in need.

Monday, February 22, 2016

A Million Hearts: Improving Oral Care for Healthier Hearts

By Brian B. NovĂ˝, D.D.S. F.A.D.I., Director of Practice Improvement, DentaQuest Institute

In 1964, President Lyndon B. Johnson designated February as “American Heart Month,” drawing national drew attention to heart disease, today’s number one killer in America. Heart disease claims more lives than all forms of cancer combined.

To further President Johnson’s effort and heart disease prevention overall, President Barack Obama officially launched “Million Hearts” in 2011. Aiming to prevent 1 million heart attacks and strokes by 2017, the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services co-sponsored this national initiative on behalf of the U.S. Department of Health and Human Services.

This initiative seeks to:

  • Improve access to effective care;
  • Focus clinical attention on the prevention of heart attack and stroke; and
  •  Motivate the public to lead a heart-healthy lifestyle.

What exactly is the connection between gum disease and heart disease? According to the Mayo Clinic, research suggests that the inflammation and infections associated with oral bacteria might be linked to heart disease, clogged arteries and stroke.

Prevention is necessary when combating bacteria that leads to the inflammation associated with gum and heart disease. Regularly brushing and flossing combined with bi-annual dental appointments are important steps to remove the bacteria, plaque and tartar that are detrimental to your oral – and heart – health.

As an additional step, dentists can learn to identify warning signs for heart disease and encourage patients to get screened if their mouths show signs of bacteria or inflammation during a routine cleaning or check-up.

At DentaQuest, we share many of the same goals that the Million Hearts initiative aims to achieve. Expanding access to care, stressing the importance of prevention, and improving the oral health of all are points that we live out day to day as a part of our core values.

Since the mouth is the gateway to the body, living a life with positive oral health habits can also lead to a heart and overall-healthy lifestyle. So this American Heart Month, don’t forget about the connection between oral and heart health. 

Thursday, February 18, 2016

National Children’s Dental Health Month: Our Commitment to Improving the Oral Health of the Next Generation

By Steve Pollock, President and Chief Executive Officer, DentaQuest

This February marks the 75th annual National Children’s Dental Health Month, bringing together dental and health leaders across the country to raise awareness of and provide tools to improve kids’ oral – and overall – health. We are working hard to address the impact of sugar consumption on children’s long-term oral health with this year’s kid-friendly Sugar Wars campaign, hosted by the American Dental Association.

To help illustrate the importance of this campaign, added sugar consumption among children across the United States accounts for 15 percent of calories every day. This is a full 5 percent higher than the recommendations from the recently-released 2015-2020 U.S. Dietary Guidelines, which indicate that added sugars should account for less than 10 percent of calories daily.

Now, think of the impact this has on their health, ranging from weight gain to nutritional deficiencies to tooth decay. Sugar helps nurture cavity-causing bacteria in the mouth. If left unchecked, sugar intake can lead to significant tooth decay.

Would you believe that tooth decay is the most common chronic childhood illness in the United States?

Tooth decay in kids is five times more common than asthma. Today, about 20 percent of children ages 5 to 11 have at least one untreated decayed tooth, and the percentage of children ages 5 to 19 with untreated tooth decay is actually twice as high for those from low-income families – when compared with children from higher-income households.

The implications of childhood tooth decay can carry into adolescence and even adulthood. Not only can childhood tooth decay have long-term effects linked to poor oral health, heart disease and even diabetes, but it also has a significant financial impact on our health care system. This impact can be measured in the millions of dollars we spend as a country on emergency room care for dental issues today or with the long-term financial implications of poor oral health on the treatment of those with certain chronic illnesses.

So, how do we win the Sugar Wars?

Education, access and prevention. We must be advocates for our communities and educate people about the importance of oral health and sugar intake for kids, work with leaders to increase access to care and prioritize preventive dental services that will address these issues head on.

At DentaQuest, we are committed to improving the oral health of our next generation by transforming the systems of care, finance, community and policy to achieve optimal oral health for all. We have already taken steps to achieve this vision by:
  • Working with our nation’s leaders to extend funding for the Children’s Health Insurance Program (CHIP), which provides vital health coverage to kids across the country who wouldn’t otherwise have much-needed care.
  •  Creating and growing the Early Childhood Caries (ECC) Collaborative, a program piloted by the DentaQuest Institute that teaches medical providers about best practices for managing and preventing tooth decay in young children.
  • Encouraging our leaders to act on the Oral Health 2020 Goals, which are aggressive, industry-changing charges developed by the DentaQuest Foundation and the Oral Health 2020 national network to improve the oral health of all. Among others, we aim to:
    • Eradicate dental disease in children
    •  Incorporate oral health into the primary education system
Throughout the month of February and 2016, we are committed to elevating the importance of oral health in children, implementing preventive care models and improving oral health for the next generation.  

Monday, February 1, 2016

2015 in Review: The State of Dental Care

Looking back on my first year as CEO of DentaQuest, I am in awe of the milestones we have achieved as a nation to advance oral health care and humbled by the crucial role DentaQuest has played in support of the national oral health movement. With a particular focus on expanding access to dental services, goals were met, systems were put in place and new objectives were established.

Oral Health Research Developments

The Early Childhood Caries (ECC) Collaborative, initially launched in 2008 by the DentaQuest Institute, made serious headway this past year as the third phase came to completion.

Phase III testing sites implemented disease management protocol for patients ages 6 to 60, and worked to redesign their care delivery systems to ensure every child receives a caries risk assessment.

To complement this effort, care providers began collaborating with parents to prevent and manage their child’s risk of developing caries. By reinforcing updated treatment protocols and engaging parents to change behaviors, we can positively impact a child’s risk of disease. And, to date, preliminary results have indicated positive outcomes.

Another major DentaQuest Institute development that I blogged about recently is the Medical Oral Expanded Care (MORE Care) initiative

This pilot program equips doctors’ offices with the appropriate tools to provide preventive oral health services in South Carolina, connecting medical and dental practices to establish an integrated referral-based health system. The success of this program lays the foundation for similar programs to adopt this collaborative, holistic approach to a patient’s health.

New Oral Health Goals and Conversation

At the DentaQuest Foundation, the Oral Health 2020 initiative had another successful year. During its annual convening in the fall, the Foundation unveiled new and updated Oral Health 2020 goals, refining an existing goal to raise the number of children who will reach age 5 without a cavity from 75 percent to 85 percent.

Additionally, two new goals were added, aiming to integrate oral health into at least 50 percent of emerging person-centered care models, as well as improving the public perception of the value of oral health to overall health. Transforming the national conversation, the DentaQuest Foundation is constantly looking to break barriers and insert oral health into the overall health and wellness conversation.

Across the country, the Foundation also launched its Grassroots Engagement Strategy, providing grants to support local, community-based organizations. In Arizona, California, Florida, Michigan, Pennsylvania and Virginia, the organizations are working to evaluate, integrate and provide oral health care and knowledge to immensely diverse populations.

The national movement begins at the community level, and we aim to support and enable organizations that align with our mission to advance the oral health of all.

Increased Access to Health Care

In 2015, we reached a major milestone when our vision program, eyeQuest, reached more than 1 million members. Currently in eight markets, eyeQuest offers a full line of vision and eye care services.

On the dental benefits side, we are proud to announce that we are currently serving 24 million members. As we continue to grow, we look forward to providing dental and vision care to many more people seeking high-quality, effective health solutions.

Last February marked the one-year anniversary of DentaQuest managing the Tennessee child dental Medicaid program, TennCare

Helping approximately 750,000 children, TennCare members benefit from lower costs, closer access to services and education on the importance of routine dental care. With the end of our second year quickly approaching, we are excited that we’ll soon be able to share new information about improved outcomes in Tennessee.

Across our organization, we have shared a common goal of creating partnerships to make a lasting impact on peoples’ health. As evidenced by programs such as TennCare, ECC and Oral Health 2020, establishing partnerships can lead to improved outcomes for everyone.

National Advances in Health Care

On April 16, 2015, President Obama officially extended the Children’s Health Insurance Program (CHIP) for two more years. The CHIP extension allocates approximately $20 billion over 10 years to states that help insure children in need.

By the end of 2015, a total of 31 states expanded Medicaid under the Patient Protection and Affordable Care Act (ACA), providing affordable health insurance coverage options to adults through Medicaid in addition to the Health Insurance Exchanges.

In an effort to improve the health system, states and the federal government came to the table in 2015 to advance preventive oral health care. While it will take years to realize all of the benefits of this collaboration, these are very important steps on the path to improve oral heath in our nation.

One great example is the Centers for Medicaid and Medicare Services’ approval of Medi-Cal 2020 – the federal 1115 waiver that allocates funding for crucial health care advancements in California. The Medi-Cal 2020 waiver includes a Dental Transformation Initiative to bring much-needed improvements and changes to the dental care system throughout the state.

What’s Next for 2016

Looking to the year ahead, we must continue with this momentum. Despite the significant progress made last year and the continued focus on the importance of oral health, our work has only just started. 

As an election year, 2016 will certainly be an exciting one with many changes on the horizon. We must work together to build on our successes, foster strong partnerships and grow this oral health movement. Together we can transform the systems of care, finance, policy and community to achieve optimal oral – and overall –  health at the local, regional and national levels.

Tuesday, January 19, 2016

Honoring Martin Luther King, Jr.’s Legacy in Health Care

At DentaQuest, we are motivated by the premise that oral health is a social justice issue, a motivation elevated as we recognize one of the most pivotal figures in American history, Dr. Martin Luther King, Jr.  

It seems like mere words are not enough to appropriately honor Dr. King’s passion and sacrifice in his fight for equality and acceptance for communities of color, and more broadly, for all Americans - simply, his work was nothing short of transformative. 

In one of his most well-known writings, “Letter from Birmingham Jail,” Dr. King wrote:
“We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”

Now, let’s look at just how oral health is a social justice issue. It’s unjust that people in our country live without good oral health, whether the barrier they face is that there are not enough dentists practicing in their area, they cannot get insurance coverage for dental services, the cost of necessary care is just too high, and even worse, if the barrier is based on discrimination of any kind. 

This sentiment that oral health is a right, not a privilege, is reflected in our mission: to improve the oral health of all.

At the DentaQuest Foundation, we’re funding and working with groups across the country to work to improve oral health for all people across the lifespan. This includes directly addressing the disparities we see in the oral health status of communities of color, since data shows that across the country, both children and adults of color experience dental disease at a much higher rate. 

We also know that improving oral health equity for these communities takes commitment from many stakeholders.

Our network partners at the California Pan-Ethnic Health Network (CPEHN) are working to address oral health disparities in their state by empowering communities of color to build a united and powerful voice in health advocacy. 

The foundation supported CPEHN’s recent publication of a brief on promoting equitable oral health policies for communities of color. The brief examines the causes and impact of oral health inequities on communities of color, and provides recommendations to help children and families live healthier lives. The brief addresses:

·         Improved access to and the quality of dental care

o   This means expanded dental benefits for low-income adults, higher reimbursements for dental providers, better integration of oral health into primary care, improved education and outreach on how to use insurance benefits, and improved data collection to identify and analyze oral health inequities by not just race and ethnicity, but also sexual orientation, gender identity, and language. 

·         Developing a culturally competent workforce

o   Programs should be developed to train, recruit, and retain people of color in the oral health fields. Other programs should ensure communities of color can access culturally and linguistically appropriate care. This means that beyond making translation and interpretation services available, providers also give care that bring an understanding and acknowledgement of these communities’ backgrounds, cultures, and beliefs.

In addition to addressing these issues, CPEHN also recommends supporting efforts to improve the other socioeconomic factors that contribute to poor oral health, including ways to promote sustainable career development and improve unhealthy food and environmental conditions.

We’re proud to be partners with CPEHN, and with the many other programs working collectively across the country working to promote just and fair access to oral health, for all.