Wednesday, December 21, 2011
Happy Holidays from all of us at DentaQuest.
View our video greeting here: DentaQuest Holiday
Friday, December 16, 2011
I just had an inspiring experience at the Institute for Healthcare Improvement’s (IHI) 23rd Annual Forum. Over 6,000 participants (yes 6,000!) converged on Orlando, Florida to focus on quality in healthcare. Over the last year, I have been working with DentaQuest Institute partners on three Quality Improvement projects in dental care – Dental Sealants for Adolescents, Early Childhood Caries (ECC), and Elimination of Dental Disease.
I wanted to attend this year’s IHI Forum because the DentaQuest Institute is gearing up for an exciting 2012 with a strong focus on quality and a prevention-focused, disease management model of care. There is a lot to be learned from the work of the Institute for Healthcare Improvement. Its successes are lessons in the kind of change management that facilitates improvements within a care system. Time and again, people that I met in sessions and around the conference said they were so happy to have people involved in dentistry at the quality table.
Maureen Bisognano, President and CEO of IHI started the two-day forum reminding us of our purpose -- we are capable of “making better care for today and a better healthcare system for tomorrow.”
With Quality Improvement, we are “acting for the individual but learning for the population.” Stories of patients and their families are important tools: “Stories,” Maureen reminded us “are first personal, then they become public, and then collective, and lastly, they become political.” There is a connecting thread: we help the individual and what we learn supports improvement for others. A compelling patient story helps grab attention today and builds the will for change. Our patient encounters help us understand the situation (patient, disease and environment) and devise better solutions. Data help us make the case to move change through the system. Quality improvement, at its core, is applying reliable new knowledge (science-based evidence) with a goal of better outcomes.
On the plane returning to Massachusetts, I sat in my seat tired but full of energy. Charlie Homer, MD, MPH, President of the National Initiative for Children’s Health Quality (NICHQ) and a national leader in improving the quality of healthcare for children, was on the same flight. Jane Taylor, EdD, an Improvement Advisor for IHI, was also on the flight. I was just a few rows behind them. It occurred to me –dentistry may be behind medicine in this quality improvement work, but we are all on the same flight, headed for the same destination… better health outcomes. And, I am thinking about the stories we will have to tell.
Tuesday, December 6, 2011
Recently, the New York Times published an article, “A Closer Look at Teeth May Mean More Fillings for Dentists,” which discussed microcavities and the different ways dental care providers treat them. A 22 year old college student who had grown up without ever having a cavity visited a dentist while at college and found out she had a cavity – in fact, multiple cavities. Somehow, in just 12 months, she went from perfect oral health to having many cavities. How can that be?
Ever new technologies make it possible for dentists to find very early stage cavities (microcavities) that can’t be seen with X-rays or the naked eye. These technologies are an effective tool in identifying early decay and allowing dentists to address it before it progresses to become a bigger and more painful problem.
The microcavities they detect are abnormalities which can be an indication of the beginnings of tooth decay. For patients who previously had perfect oral health, hearing they may have a number of cavities that need to be filled is a shock. If you are concerned that a diagnosis doesn’t match up with your prior dental history (and there has been no change in your home care or health), it is never a bad idea to get a second opinion.
Today, when dental teams catch disease in an early stage, there are more options for patients than the traditional filling. For example, dentists can watch and wait to see what happens as suggested in the article by Dr. James Bader, a research professor at the University of North Carolina School of Dentistry.
Another approach is to take preventive steps. The diagnosis of a microcavity may lead a dentist to recommend the application of sealants, a thin plastic coating applied to the teeth to protect them from the bacteria that causes dental disease and the potential for further decay.
Or, a dental health professional may attempt to help “heal” the tooth. At the DentaQuest Oral Health Center, the dental team would take steps to reduce the level of the decay-causing bacteria in the patient’s mouth, and enhance the body’s natural ability to replace minerals. So instead of placing fillings that will need to be replaced in the future, they use other measures to stop early decay, help the tooth heal, and then make it more resistant to future decay. It’s a prevention-focused approach to oral health care.
My colleague, Peter Blanchard, DDS, MBA; Director, Evidence-based Practice, DentaQuest Oral Health Center, wrote an op ed in response to the New York Times article entitled “To fill or not to fill: That is the question” which was published on DrBicuspid.com.
Finding cavities early is never a bad idea. It gives us more options to help our patients stay disease free.
Wednesday, November 23, 2011
By Dr. Mark Doherty, Executive Director, DentaQuest Institute
The DentaQuest Institute had the great honor of hosting the John Rossetti Memorial dinner at the 2011 National Primary Oral Health Conference. John was a personal friend and a great advisor to the DentaQuest Institute and its Safety Net Solutions program. He was one of the program’s first Expert Advisors – our elite faculty of experienced public health dentists who are mentoring safety net dental programs across the United States. It was a great privilege to host the memorial dinner and to endow our annual Centers of Excellence Awards with John’s name.
The John Rossetti Centers for Excellence awards recognize elite safety net dental programs of 2011– programs that displayed tremendous leadership and excellence in oral health practice management, greatly improving access to care and the oral health status of their patients. The recipients of this award provided the leadership and initiative necessary to make positive change “stick” within their dental programs.
The five 2011 Centers of Excellence partnered with Safety Net Solutions technical assistance and practice management consulting over the course of the past year. They were challenged to institute difficult changes with the goals of increasing access, promoting financial sustainability and improving oral health outcomes.
The five programs selected this year truly deserve the “Excellent” title – they have outstanding evaluation data to show that the changes they implemented have lead to measurable improvements in many areas of the dental program.
The 2011 Safety Net Solutions Centers of Excellence are:
- HealthCare Connection in Ohio
- Native American Health Center in California
- Dental Center of NorthWest Ohio
- Harbor Health in Massachusetts
- Wake Health Services in North Carolina
We commend each of these Centers for Excellence, and thank all of the safety net dental programs for being examples of sustainable dental care in their communities. I think John Rossetti would be proud of all of them.
Tuesday, November 15, 2011
By Dr. Doyle Williams, Chief Dental Officer
When people hear the phrase, “I’m in good health,” chances are they aren’t thinking about their mouths.
But you should. A regular check up with your dentist is as important as an annual physical. If you are someone who is afraid of the dentist and only make an appointment when you are in pain – think of this: regular preventive care is not painful and it will help prevent painful visits in the future. Good oral health serves much more than cosmetic purposes – it is integral to your overall good health.
Teeth, gums and oral soft tissue are all susceptible to a range of conditions and diseases, including cavities, gingivitis and oral cancer. The irony is that dental disease – cavities and gum disease – are nearly 100 percent preventable if you know what to do. It’s what you don’t know about oral health that may hurt you. That’s oral health literacy.
Culturally-competent oral health literacy is as important as seeing an oral health professional. For some, a painful tooth may be enough reason to schedule a visit with a dentist. But others may wait to see bleeding, swelling, or a fever before thinking about getting care.
That’s the challenge of oral health literacy – making sure people know how to care for their teeth and gums, making sure they know the signs for concern, and making sure they know when and where to go for help.
Here are two examples:
- The U.S. Surgeon General stressed that parents who are unfamiliar with the importance and care of their child’s primary teeth are unlikely to take appropriate action that may prevent Early Childhood Caries (ECC). That includes food choices, bedtime bottle routines, daily oral hygiene, and failure to see a health professional as the baby teeth are starting to come in.
- Recently, a 24-year old father from Cincinnati, Ohio died from a tooth infection because he could not afford his medication. When his face and mouth began to swell, the man visited the emergency room at his local hospital where he was given prescriptions for pain medication and antibiotics. Because he could not afford both medications, he only filled the prescription for the pain medication. That helped the pain but the infection continued to spread, eventually to his brain.
Friday, November 4, 2011
By Steve Pollock, President, DentaQuest
At the annual meeting of the American Public Health Association this week, the Department of Health and Human Services (HHS) announced three new categories of Leading Health Indicators for the Healthy People 2020 campaign. The good news is oral health has been identified as a Leading Health Indicator category…finally.
Healthy People 2020 identified 17 oral health goals -- from reducing the rate of dental caries in the primary and permanent teeth of children and adolescents – to increasing the number of children, adolescents and adults who use the oral healthcare system.
HHS named Oral Health a Leading Health Indicator because it is a critical health issue that, if left unaddressed, could result in future public health problems. DentaQuest could not agree more.
Everything we do is focused on our singular mission to improve oral health. Our PreventistrySM philosophy ensures a unique focus on prevention, disease management, quality care, and cost effective benefit program administration, and recognizes and supports the important provider-patient relationship in achieving good oral health. Our DentaQuest Institute isolates areas where we know there is a better way to prevent and manage oral disease, and works to make new and proven dental therapies routinely available in the dental office. Historically, new evidence-based care learnings take years to become accepted and practiced in the dental office setting, and the Institute is working to change that. Our DentaQuest Foundation is driving a grassroots movement across the nation to improve oral health with its Oral Health 2014 Initiative, awarding 20 state organizations funding and resources to reduce oral health disparities, one of the biggest cost drivers in the American health care system.
We are committed to our mission and intent on setting goals and measuring our success against them. We’re working on that. But with Healthy People 2020’s designation of oral health as a Leading Health Indicator, our ability to affect our mission takes a major step forward. With the endorsement of HHS and the power of Healthy People 2020 focused on oral health improvement, much will be done to prevent oral disease. Our population will be healthier and our state and national health care systems will see costs go down. Without good oral health, it’s impossible to enjoy good overall health.
Oral diseases are almost 100% preventable. With the right focus and resources, oral disease is one chronic health problem that we can target and eliminate – in our lifetime. I am convinced that with a coordinated system of collaboration and persistence, oral diseases can become a thing of the past.
Friday, October 28, 2011
Stories like this illustrate the need that drives the DentaQuest Foundation’s investments in oral health improvement at the national, state and local levels. Previously, I wrote about the DentaQuest Foundation’s support for the U.S. National Oral Health Alliance which is engaging national partners in oral health improvement goals.
People feel the pain of their inability to get needed services at the local level. So today, I am writing about the Oral Health 2014 Initiative. This new signature program of the DentaQuest Foundation is building a movement for oral health at the state and community level by supporting the work of state-based organizations that are developing effective community solutions.
When we announced the Oral Health 2014 initiative, we immediately saw a clear need and interest in community solutions for oral health across the United States. Over 200 program leaders from nearly every state joined in our Request for Proposals launch webinar in June. Seventy (70) organizations responded with their ideas. Thirty-six (36) were invited to submit a full proposal.
Today, Oral Health 2014 is taking root and moving forward in 20 states. I am enthusiastic about every one of these organizations. Each is working to build support for oral health solutions in their communities, engaging traditional and not-so-traditional partners. Oral Health 2014 is a multi-year initiative. The DentaQuest Foundation is committed to each organization’s success, providing financial and technical resources to help them move their projects forward.
This is an important moment for oral health. These 20 state organizations join the growing national movement of collaborative leaders who are aligned in their desire to address oral health disparities-- many hands working toward a common goal.
- Dr. Caswell Evans of the University of Illinois, DentaQuest Foundation Board of Directors and the U.S. National Oral Health Alliance Founding Board of Directors
- Paul Gilmer of Triana Energy and a member of the National Community Committee of the CDC Prevention Research Centers
- Dr. Leslie E. Grant of the National Dental Association and the U.S. National Oral Health Alliance Founding Board of Directors
- Marion Kane, formerly of Barr Foundation and currently on the Board of the Directors for the DentaQuest Foundation
- Dr. Dushanka Kleinman of the University of Maryland School of Public Health and the U.S. National Oral Health Alliance Founding Board of Directors
- Barbara Leonard of the Maine Health Access Foundation
- Sandra Owens Lawson of CRP Corp.
- Dr. Lindsey Robinson of the California Dental Association Foundation and the U.S. National Oral Health Alliance Founding Board of Directors, and
- Dr. Donna Shelley of New York University School of Nursing and Dentistry.
Congratulations to our new Oral Health 2014 partners! I encourage you to join them in building collaborative solutions.
Wednesday, October 12, 2011
Ralph Fuccillo, President, DentaQuest Foundation
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Martin Luther King Jr., 1966.
When the Martin Luther King, Jr. Memorial is dedicated in Washington, D.C. this October 16th, America will celebrate the inclusive and powerful legacy that constituted Dr. King’s overall dream for justice. This occasion has prompted me to reflect on opportunities to add a voice to this national moment of hope that keeps Dr. King’s dream alive.
Within all the memorable words of Dr. King, those spoken on the subject of health care and inequality resound in my mind most strongly. Throughout a career dedicated to prevention and public health, I have come upon too many situations where life’s odds are stacked against those in greatest need and people who are dealing with chronic illness in our communities. When I think that we have not solved “the most shocking and inhumane forms of inequality” in the 45 years since Dr. King made this claim, I know that our work is nowhere near completed.
We are moving forward with tremendous opportunities in the era of health care reform and when the value of collaboration is being recognized as a powerful method for better decision making in many sectors. I have witnessed many examples of how changes in the conditions in which people live are making a tremendous difference in reducing inequalities. These include investments to increase access to healthy fresh foods, investments in safe places to exercise and play, and investments in community supports to navigate options for health care.
The occasion to memorialize Dr. King’s legacy is an excellent one to promote effective leadership across all sectors-- business, government and philanthropy -- to create pathways for health equity. A new program of the United States Department of Health and Human Services (HHS) encourages such collaboration. The National Partnership for Action (NPA) to End Health Disparities provides opportunities to engage in Health Equity Councils in all ten regions across the United States. Each council is engaging community-based leader across health, business, philanthropy and community to move the dial on health equity through better collaboration among stakeholders and more effective use of public and private resources to reduce racial and ethnic health disparities.
No one sector can create the conditions for better health alone. It takes a cohesive and inclusive national strategy that leverages layers of public and private sector investments and creates critical partnerships. I am honored to represent oral health and philanthropy on the Region I Health Equity Council and invite others to learn more about the Councils and to get involved.
The dedication of the Martin Luther King, Jr. Memorial this month reminds our nation of its commitment to ensuring equality for all. For me it is an opportunity to highlight the important efforts of the many people and organizations working for equal access to quality health care.
Monday, October 3, 2011
Did you know that tooth decay is the most common childhood disease?
That cavities are almost 100 percent preventable when children have access to prevention, education and treatment services.
That 1/3rd of children ages 6 to 8 have untreated caries (cavity) in a permanent tooth.
That every year, 16 million children go without dental care, placing them at great risk of getting cavities or worse.
Today, on Child Health Day I would like to remind you how important your child’s dental health is to his/her wellbeing.
Please take a moment to sit down with your child today to talk about the importance of good oral health in their lives and what they can do to help keep a healthy smile.
Friday, September 30, 2011
Dr. Doyle Williams, Chief Dental Officer, DentaQuest
A public opinion survey* by Oral Health America confirmed a trend that I’ve been hearing about lately as I talk to dentists across the United States.
The survey revealed that one-third (35 percent) of people who regularly visit the dentist are going less frequently. One-half (47 percent) of larger households and households with children reduced their visits to the dentist in the past year. Families with younger children cut back more than households with slightly older children.
Regrettably, preventive dental care appears to be something that is falling through the cracks, when families are faced with managing competing needs in a challenging economy.
And that concerns me.
Dental care is the #1 unmet health care need for children and low-income adults. Cavities and gum disease are preventable. Regular dental visits are investments in long term good health. With regular visits, it is more likely that problems can be found early when dentists can help teeth “heal” without any drilling. Your oral health caregiver can show you how to protect yourself and your children from getting cavities and gum disease by helping you understand your risk factors and protective factors. You may also be told about preventive treatments, like sealants, a thin protective coating painted on the molars of the teeth of children and adolescents, to protect against cavities.
Cavities and gum disease are bacterial infections. Studies show links between gum disease and premature births, diabetes, respiratory disease, and cardiovascular disease. I was recently very saddened to read about the young father in Ohio who died from an infection that started in a wisdom tooth and spread to his brain.
Not going to the dentist means you don’t get early warning of problems or important preventive education and information to keep you from needing costly treatments later.
*Oral Health America public opinion survey sponsored by Oral Healthcare Can’t Wait and Plackers
Wednesday, September 21, 2011
By Steve Pollock, President, DentaQuest
Good dental health starts at home, and parents and caregivers are THE most important role models for their children. Oral Health America has a nice booklet, Fall for Smiles, on their website that can help families talk about good oral health. Also, from September 19-25, Trident gum is donating 5 cents to Smiles Across America® for every pack of Trident gum sold. Smiles Across America helps children who do not get regular dental visits because their families lack resources, insurance, transportation, or because of language barriers.
Make this a fall for Smiles! Brush and floss your teeth daily. Be careful about the sugars in your diet. Avoid tobacco products. And schedule a visit with your dentist.
Friday, September 9, 2011
From left to right: Pat Finnerty, DentaQuest Foundation; Bridget Hengle, DentaQuest; Felix Layne, DentaQuest; Cheryl Harris, DentaQuest; Debborah Oswalt, Virginia Health Care Foundation (ED); Waradah Eargle, DentaQuest.
Bananas and oral health? You bet they’re connected!
First let me give you some context for this story. Over 425 volunteers from Virginia and 12 states traveled to rural Western Virginia this summer to make the Wise County Mission of Mercy (MOM), sponsored by the Virginia Dental Association Foundation, and the delivery of free dental care to underserved people possible. Volunteers were dentists and hygienists as well as those not directly involved in delivering care, like me—I work in the finance department of DentaQuest.
This was my second Wise County MOM experience, and last year my role was dental hygienist assistant. This year, I was a member of the DentaQuest Virginia team responsible for distributing snacks and beverages to help sustain the hard working volunteers. This year, a dentist came to the DentaQuest snack trailer asking for a banana because his hand was cramping. The dental teams work in extremely hot tents starting at 5:30 am and continue late into the night—so one would expect hand cramping! What helps a cramping hand? The potassium found in bananas, and we didn’t have any.
I looked at the dentist and at the lines of people waiting for care and knew there was only one thing to do. Get bananas! At the nearest supermarket, I bought the entire supply of bananas -- 4 cases totaling 160lbs. There wasn’t a single banana left by the end of the day. Next year, we’ll be purchasing 500lbs of bananas for our food service effort during this three-day event.
This Missions of Mercy effort is all great work. Over three hot July days at the Wise County Fairgrounds, 1,382 patients received dental care valued at $1.5 million. This is dental care that these individuals and families—many of whom are the working poor—wouldn’t normally be able to afford. Wise County is part of the expansive and impoverished rural Appalachian Mountain area. Folks living around here are the working poor, elderly, disabled, or uninsured. When you are struggling to get food on the table, finding money to pay for dental care isn’t realistic. For this reason, the most common procedure was not cleanings or fillings, but extractions. The majority of teeth dentists saw were beyond repair. 3,575 extractions were performed.
Efforts like Missions of Mercy bring out the best in people. The desire to make a difference was contagious and didn’t stop at bananas. All kinds of folks showed up with something to offer, from food to clothes to dental services. My 14-year old daughter came with me and had the great idea to bring 150 dolls, hand-made by and donated from the North Andover Senior Center, to give to waiting children. I was so proud of her, and grateful for the opportunity to expose her to this valuable experience.
The Wise County MOM event left a dramatic impression of the unmet need for health care services. It reaffirmed the importance of having access to insured dental care, and highlighted the many different ways there are to help people.
The Virginia Dental Health Foundation started the Wise County Missions of Mercy (MOM) eleven years ago to "make caring visible." I encourage readers of this blog to get involved -- donate time, money, your voice, or your skills to help people receive vital dental care in your community. There are Missions of Mercy projects in nearly every state throughout the year.
I’m pleased to have had the opportunity to contribute in some small way to this effort. You could say that I’m bananas about MOM events. If you are interested in participating in next year’s Wise County MOM, you can find details on volunteering here.
Monday, August 29, 2011
The Boston Business Journal honored Dr. Mark Doherty, Executive Director of the DentaQuest Institute as a 2011 Health Care Champion for his work in expanding the reach of oral health care throughout Massachusett at the 2011 Champions in Health Care breakfast on August 26th.
Dr. Doherty has dedicated his career to expanding access to oral health services for low-income, underinsured and uninsured individuals in Massachusetts and across the country. During a long and illustrious career, Dr. Mark Doherty has been more than a dentist. He has also played the role of businessman, problem solver, oral health advocate, and mentor to other dentists who share his passion for improving the lives of underserved individuals.
When Dr. Doherty speaks about oral health, everyone listens, including lawmakers on Beacon Hill and Capitol Hill and federal agencies overseeing community health centers across the United States. Today, Dr. Doherty is working to create partnerships with community health center dental programs and training volunteer dentists who will mentor and coach community health center dental practice staff as they implement improvements to their practices.
Among many honors, Dr. Doherty was selected the 2011 Best Practice Management Consultant by Dr. Bicuspid readers who are dental professionals.
Wednesday, August 24, 2011
In today’s rocky economic climate, community health centers (CHCs) across the country have become the primary source of medical and dental health care for millions of people. In fact, many refer to CHCs as “America’s health safety net.”
Earlier this month, the US Department of Health and Human Services (HHS) announced awards of $28.8 million to 67 community health center programs across the country. These funds, made available by the Affordable Care Act, will help establish new health service delivery sites to care for an additional 286,000 patients.
As I stated in my last entry, CHCs provide primary health care services to 23 million individuals, most with limited financial resources; however, not all CHCs have the capacity to provide dental care. To give you a sense of the issue: more than 12 million CHC patients do not have access to dental care services.
DentaQuest Foundation has responded to this challenge with the Strengthening the Oral Health Safety Net Initiative, a $1.75 million investment to strengthen oral health delivery at CHCs across America.
But our investment alone is not enough. According to a recent statement from the American Dental Association (ADA), significant progress with the dental safety net will not occur until the nation places greater emphasis on oral health. We at the DentaQuest Foundation agree. Oral health must be part of the conversation, both at the individual, local community, and government levels.
As the ADA says, “Silence is the enemy. Let’s take the ‘silent’ out of ‘silent epidemic.’”
Wednesday, August 17, 2011
By Ralph Fuccillo, President, DentaQuest Foundation
When healthcare reform goes into effect in 2014, nearly every child in the United States will have access to dental benefits coverage, through Medicaid expansion and state exchanges, many for the first time. That is an impressive goal.
But it made us wonder how will the existing oral health care delivery system handle this dramatic volume of new individuals seeking care?
One likely source for care will be America’s health safety net of community health centers. Today, 1,250 Community Health Centers in more than 8,000 communities in 50 states and all U.S. territories provide primary health care services to 23 million individuals, most with limited financial resources. Today, not all CHCs have the capacity to provide dental care. In fact, 12 million+ community health center patients do not have access to dental care services.
Our response to this challenge is the Strengthening the Oral Health Safety Net Initiative, a $1.75 million investment to strengthen oral health delivery at community health centers across America. This Initiative is providing oral health leadership development and technical assistance to community health centers at the national, state and local levels in three ways:
1) Through a targeted investment, we are partnering with the National Association of Community Health Centers (NACHC) to build oral health leadership throughout America’s network of Federally Qualified Health Centers (FQHCs). NACHC supports its member Primary Care Associations (PCA) and their community health centers with research-based advocacy, training for health center and PCA leadership and boards, and partnerships with key stakeholders to foster the delivery of primary health care services to communities in need. NACHC will now include oral health as part of its education and advocacy work.
2) Through a very competitive Request for Proposal process, the DentaQuest Foundation invested in five state PCAs for the Strengthening the Oral Health Safety Net Initiative. Each PCA will receive funding for oral health technical assistance and leadership development to support the expansion of oral health at their member community health centers. PCAs are the state-based trade associations of health safety net organizations. They are an important partner because they provide training and continuing education, advocacy, and many other services for their member health centers.
3) Finally, up to 5 community health centers in each participating state PCA will receive direct practice improvement technical assistance to either start a new oral health program or strengthen an existing program, provided (in-kind) by the DentaQuest Institute and its Safety Net Solutions team.
We are very pleased to be working with these five PCAs in the Strengthening the Oral Health Safety Net Initiative.
- Arizona Association of Community Health Centers
- Georgia Association for Primary Health Care
- Illinois Primary Health Care Association
- Kansas Association for the Medically Underserved
- Pennsylvania Association of Community Health Centers
Their work will become a model for PCAs in other states.
Friday, August 12, 2011
Dr. Mark Doherty, Executive Director, DentaQuest Institute
This week, we lost a good friend and oral health champion with the passing of Dr. John Rossetti. John’s life was dedicated to public service and improving the lives of others. He got his first taste of community-level engagement working in rural health in Central America as one of the first “class” of Peace Corps volunteers. After graduating from dental school, he joined the U.S. Air Force and served as a Dental Officer in New Mexico and Thailand, providing dental care in the villages surrounding his base. From there, his commitment to public service lead him to join the Indian Health Service, where as the only dentist for two reservations, he learned valuable lessons in prevention, education, early intervention and restorative services. He passed these lessons along to so many peers and public health professionals throughout the years, and his guidance and tutelage made us better at what we do.
As Chief Dental Officer for the Health Resources and Services Administration, John initiated the first ever partnership between a health agency and Medicaid to address access to oral health services for children. And after ‘retiring’ in 2002, he started a new career as a consultant. It was in 2008 that I had the privilege of welcoming John as one of the DentaQuest Institute’s Safety Net Solutions program’s first Expert Advisors – our elite faculty of experienced public health dentists who are mentoring safety net dental programs across the United States.
Mentoring was in John’s soul. He loved interacting with people and connecting the dots. But more than that, he connected pulses -- helping friends share resources and ultimately have more impact both on the profession and on each other. He made us more effective and he taught us to do it with a smile. John was a genuine Pied Piper. Was there anybody more suited to the dental profession? I cannot imagine what his chair side demeanor must have been like!
John was also the ultimate diplomat. He would warn us -- not about people –always about situations to avoid or at least to consider avoiding before blundering ahead. And, when faced with thorny decisions, John always left us a gap through which we could make a graceful exit if we were not able to go where John wished. John loved to navigate or help navigate the tough situation. I actually believe he preferred the help navigate scenario because he so valued the personal relationship part of the journey. Somewhere, he learned that he could accomplish more of his mission by sharing what he had learned with us. Lucky us!
The last time I talked to John he was very sick. He refused to talk about himself and only wanted to know about me and whether I had followed-up on something he had told me I should do. And, as expected, the follow-up was related to friends. What a guy, so unselfish! Another lesson learned.
It has been an honor and privilege to share a part of this nice man’s life. Jeez! I miss John…. All of us at the DentaQuest Institute will.
Wednesday, July 27, 2011
Here’s how we know we’ve got a problem in this country when it comes to discussing oral health: A major network morning show airs a 10-minute segment with tips on how to brush your pet’s teeth.
When was the last time you can remember a TV segment with tips on how children should brush or floss their teeth – or advice on preventive measures such as sealants? It’s probably been awhile because the most common reaction from the media when the suggestion is made is: “We don’t cover dental.”
Can that really be the case in 2011, a decade after the U.S. Surgeon General declared childhood tooth decay a “silent epidemic”? Tooth decay—which is almost 100 percent preventable—is the most prevalent chronic disease in children 5 to 17 and is growing among very young children, particularly poor young children. And poor oral health is associated with severe problems such as diabetes and heart disease, so why isn’t the media talking more about oral health?
There’s a trivialization of oral health that is baffling. Maybe with all the coverage of celebrities and the fascination with teeth whitening, there is a sense that all the talk about oral health is really just cosmetic. Nothing could be further from the truth.
Congress gets it. The Affordable Care Act ensures that dental care for children is fully integrated into the law as part of the essential benefits package for children. As we move forward with health reform, it is important to remember that oral health is a critical component of the Act and should be funded and supported.
The Centers for Medicaid and Medicare gets it. The agency established new goals to increase access to dental coverage and work with states to develop an oral health action plan for 2020.
The Institute of Medicine (IOM) gets it. IOM just released a report assessing the efforts of the Department of Health and Human Services and recommending ways of enhancing and improving oral health in America and called it “The New Oral Health Initiative.”
The Pew Center on the States gets it too. Together with the Kellogg and DentaQuest Foundations, they have put out a state-by-state score card on how states are doing in providing access to oral health for their residents. This report serves another important purpose – it gets people talking about oral health—and that’s important.
What will it take to recognize that talking about oral health is a necessary first step --- for the wellbeing of children because we can help them avoid a lifetime of tooth decay and pain, but also for the health and economic wellbeing of us all? Ignoring it shouldn’t be an option.
· The State of Oral Health in America is Not so Good
· Washington’s Unseen Oral Health Debate
· Some Good News at Massachusetts’ Medicaid Dental Program
· The Silent Epidemic: Early Childhood Caries
Friday, July 22, 2011
By Ralph Fuccillo, President of the DentaQuest Foundation
I’m excited to announce that we’ve launched the first-ever Venture Fund for Oral Health.
One of the major obstacles to achieving nationwide optimal oral health is the lack of funding to bring effective solutions to scale. Developed by the DentaQuest Foundation, The Venture Fund for Oral Health is a new funding opportunity for oral health programs that have shown positive outcomes and have potential to make a large-scale impact.
The four areas that the Venture’s grants focus on include:
- Public policy that supports improved oral health
- Increased public and private funding for oral health initiatives
- Improvement in the delivery of oral health care and prevention programs
- Expanded community engagement on oral health issues
To qualify for funding, organizations must demonstrate proven past successes in one of the systems that we seek to impact – policy, funding, care, community – and a well-developed plan for expansion.
By replicating programs that have proven to be successful in reducing oral health disparities, we can improve access to oral health care and reduce oral disease for vulnerable children and their families. Knowing that tooth decay is the most prevalent chronic disease among children aged five to 17, it goes without saying that the Venture Fund for Oral Health is both critical and hopeful.
So please, spread the word! If you are part of an organization that promotes oral health or know of an organization that is eligible, encourage them to apply for one of these grants.
Monday, July 18, 2011
By Ralph Fuccillo
President, DentaQuest Foundation
During the past few years, I’ve had the opportunity to be part of an exciting, collaborative initiative that has mobilized the oral health community across the nation. What’s the initiative? The U.S. National Oral Health Alliance. The Alliance is bringing together groups with various interests and perspectives in a never-before-seen way. It is really quite remarkable.
The roots of the Alliance date back to the 2009 American Dental Association’s Access to Dental Care Summit, where more than 140 leaders in dentistry, dental education and the dental industry, as well as medical professionals, health advocates, opinion leaders, program heads, policy makers and others collectively addressed a common vision: ensuring access to care and prevention that supports optimal oral health for America’s most vulnerable children and adults...within the next five years.
With that vision came a commitment to work together to find common ground and work for shared solutions – and the Alliance was born. So far, we’ve made tremendous progress toward extending the common ground that grew from the Summit, but there is still more to be done. As the recent Institute of Medicine report points out, not enough Americans have access to dental care and nearly one-third of the population reports challenges in accessing dental care.
The Alliance continues to work toward a common purpose of improving access and oral health and welcomes all as partners.
Skeptics may say this is not possible, but having experienced the trust building and commitment of colleagues that built this new organization over the past two years, I am convinced we can fulfill the vision that many of you claimed as your own.
Visit www.usnoha.org. The first gathering, a Colloquium, is in November. Get your name on the list by joining the Alliance. Shared leadership, open minds, and the willingness to collaborate will further build on the best ideas to improve oral health for those who are most in need.
Friday, July 8, 2011
Prevention is important for everyone, but especially so for children. If we can keep children free from dental disease, we are giving them a strong start to a healthy life. As I’ve said here before, it is hard to do well in school or in life, when you have constant tooth pain.
Dental sealants are a very good way to prevent tooth decay in children.
For those who may not be familiar with them, dental sealants are thin plastic coatings applied to permanent molars. The sealant is applied as a liquid that is brushed onto the deep grooves of teeth by your oral healthcare professional. Sealants dry into the plastic film that provides a physical barrier to bacteria and sugar and effectively protects the pits and grooves on the biting surfaces of teeth from dental decay.
Sealants are considered a cost-effective intervention to prevent tooth decay. Consider this: the cost of applying one dental sealant is significantly less than the average cost of filling that same tooth. And when you think that a single sealant may prevent that tooth from being re-filled many times over a lifetime, it is just pennies spent for every dollar saved.
In support of sealants as a proven preventive treatment, the U.S. Department of Health and Human Services’ Healthy People 2020 set a goal of increasing the number of children who have received dental sealants on their molar teeth to 50 percent. But, despite numerous studies confirming that sealants are a cost-effective intervention, only a handful of states have reached this goal.
To help reach this national goal, the DentaQuest Institute is working with five community health center dental programs to find effective ways to increase the use of sealants for children aged 6 to 8 and adolescents 12 to 14. Those are the ages when the permanent molars erupt into the mouth. We hope the results of this Dental Sealants Initiative will help other oral health care providers make sure sealants are a standard tool in their offices for preventing cavities in children and adolescents.
We are optimistic the results of this DentaQuest Institute quality improvement initiative will increase the number of children who receive dental sealants. And that means less dental disease.
Wednesday, June 29, 2011
By Ralph Fuccillo, President, DentaQuest Foundation
On June 29, the DentaQuest Foundation launched the Oral Health 2014 initiative and opened the RFP. This is the biggest investment to date by the DentaQuest Foundation-- a multi-year commitment to strengthen and accelerate state, regional, and community action on behalf of better oral health. You can view the RFP on our website: www.dentaquestfoundation.org.
Our mission is to support and promote optimal oral health. To do that, we are directing our leadership and investments to oral health improvement at the national, state and local levels. These investments are strategic, multi-layered, and focused on improving systems– that is the systems that provide and finance care, enhance public policy, and help communities build and navigate available resources for better oral health.
Our Oral Health 2014 initiative supports that strategy. We are encouraging applicants to think outside-of-the-box, to engage a broad range of stakeholders – expected and unexpected, and to lead them in effectively developing a plan for change. We will be watching for the local impact of Oral Health 2014 grantee activities on the essential systems of Policy, Funding, Care, and Community throughout the life of the initiative.
The Oral Health 2014 initiative complements and supports the newly formed U.S. National Oral Health Alliance (Alliance) with engaged local partners across the United States. The DentaQuest Foundation is excited by the opportunities created by this Alliance to encourage cross-sector collaboration and involve many partners in solutions that meet the oral health needs of underserved children and adults in our communities. The Oral Health 2014 Initiative supports this work.
For more information about Oral Health 2014 and eligibility, contact Patrick Finnerty, Senior Advisor, State Oral Health Programs, firstname.lastname@example.org
For more information on the application process, contact Brenda Lavasta, Programs and Grants Associate, 617.886.1760, email@example.com
Important Dates and Deadlines
• July 22, 2011 (3 p.m. EST) Deadline for receipt of Letters of Intent (LOI).
• August 10, 2011 Applicants notified if invited to submit a full proposal for Planning Phase.
• September 9, 2011 (3 p.m. EST) Deadline for proposals for Planning Grant.
• October 14, 2011 Applicants notified of award decisions for Planning Grant.
• November 9-10, 2011 Grantee Gathering.
Monday, June 27, 2011
Prevention is what helps us have good oral health vs. poor oral health. And prevention is all about understanding your risk factors and protective factors. This is true if you are a child or an adult.
In this Oral Health Matters blog, I try to get my readers to think about the risk factors—the things in your life which contribute to poor oral health. There are protective factors too and I’ll talk about them in another blog post. Right now, however, I’ll highlight some common risk areas. I hope you will read through them thoughtfully. If you say ‘yes’ to any of them, it is time to make an appointment with your dentist.
- Not brushing and flossing your teeth every day – to remove food and bacteria. Making this part of your daily routine is a small change that pays big benefits.
- Irregular visits to the dentist. I encourage visiting your dentist at least once a year. Why? Your dentist can detect early signs of trouble and help you get on track.
- Have you had a cavity within the last 3 years? Have you lost teeth because of tooth decay or gum disease? Do you have puffy or bleeding gums, receding (shrinking) gums, or areas of the gum line where the root surface of the tooth is exposed? This could mean there may be active gum disease in your mouth. Your dental professional will want to watch you closely for this.
- How is your health? Are you pregnant? Have you been diagnosed with diabetes? Do you use/abuse tobacco (cigarettes, pipes, cigars, chewing) or drugs? Do you regularly take prescription/over-the counter-medicines? Do you have braces or partial dentures? Are you undergoing chemotherapy or radiation therapy? Do you have an eating disorder? Do you have dry mouth? Each of these conditions puts you at higher risk for tooth decay or gum disease. Your oral health professional will help you make adjustments to keep your mouth healthy.
- Are you a between-meal-snacker? Do you have a fondness for sugary foods? Do you drink a lot of soda or energy drinks? The sugars and acids in these foods/drinks can encourage tooth decay—especially if you let them linger in your mouth for hours. Again, your oral health professional can help you understand how to lower your risk of oral disease with things as simple as rinsing your mouth with water after eating to keep your teeth healthy.
I would like to see Americans get smarter about the role of oral health in their overall health. That’s why I write this blog. When consumers have the knowledge to prevent problems and know when to seek care, they will likely be healthier. That’s why it is upsetting to me that oral health was missing from the National Prevention Council’s action plan.
I’d like to hear what you have to say on the importance of prevention. What does prevention mean to you?
Thursday, June 16, 2011
I just returned from the Hispanic Dental Association’s Annual (HDA) Roundtable in Plano, TX where I had the privilege of representing DentaQuest. HDA is a rapidly growing organization and the growth is expected to continue well into the 21st century. That’s a good thing because some experts are projecting a U.S. population that will soon be 40% Hispanic. Being able to talk to patients in a way that respects their culture and background is so important in providing the right care, at the right time, so we make a real impact.
The Hispanic Dental Association is playing a major role in building leadership for Hispanic oral health professionals during this time of change and it, like DentaQuest, is focused on prevention, treatment and education. DentaQuest and the DentaQuest Foundation are proud to support their work in improving oral health in the Hispanic population.
It was good to hear about the plans, concerns, needs and passion for dentistry among the member dentists. Several chapter presidents are DentaQuest providers. For me, this was an opportunity to explain the many facets of the DentaQuest enterprise’s commitment to improving oral health – our benefit programs, philanthropy, and clinical care improvement projects. I talked about the work we are doing to support dentists and their patients, to make participating in our networks easier, and to make sure oral health providers can deliver the best care outcomes. The dentists at the Roundtable were very interested in DentaQuest’s dental home project, our broken appointment project, and the many ways our website makes their work easier.
The dentists I met are enthusiastic champions for good oral health. They are hopeful that we will continue to support their meetings with our presence and are anxious to work with the DentaQuest Institute to improve cultural competency at the practice level. I believe that we have a very effective partnership developing. But for any effort like this to truly be successful we will need the partnership to extend to patients as well. Patients can and should play an important role. I’d like to hear from you on your thoughts.
Friday, June 10, 2011
The combination of acidic components, sugars, and additives in sports drinks combine to erode the tooth’s surface, weakening the enamel that protects teeth from bacteria. The enamel erosion ultimately makes teeth more susceptible to bacteria and leads to hypersensitivity, staining, and tooth decay.
Frequent consumption of sports drinks lowers the pH in the mouth promoting the demineralization of tooth enamel. (The lower the pH, the more acidic the item.) Demineralization is caused primarily by stable acids found in acidic foods and drinks or which form as by product from bacteria feeding on starches and sugars in the mouth, especially refined sugars.
Demineralization begins at a pH level of 5.5 although under certain conditions, may even start at a higher pH. Popular sports drinks can have a pH of 2.4 and contain 5.5 tsp of sugar in a 12 oz can. So, not only does the drink have a pH that promotes demineralization, it also contains 5.5 tsp of sugar, which can independently contribute to demineralization and tooth decay.
To put the sports drink pH of 2.4 in perspective, compare it to battery acid, which has a pH of 0 and water, which has a pH of 5-7 (neutral). Shocking that a sports drink is closer on the pH scale to battery acid, than water.
Given all this, water is always the best option for everyone but the highest performing athletes who need to replenish minerals from intensive workouts.
If these facts haven’t convinced you to avoid the casual consumption of sports drinks, here are a few tips to keep in mind:
Don’t sip the drink throughout the day. - Drinking them for short periods of time means less time for the sugars and acids to erode enamel. Rinse your mouth with water when you’re done to clear away remaining acids and sugars.
Don’t swish the drink around your mouth. - That only increases the risk of erosion. Instead, use a straw so teeth aren’t immersed in or in direct contact with the sugars and acids in the beverage.
Resist the urge to brush your teeth immediately after finishing a sports drink. - Tooth enamel softens after consumption of acidic drinks, making teeth susceptible to more wear from the abrasives in toothpaste. Wait 45 minutes to an hour before brushing to give your saliva time to re-mineralize the tooth structure and neutralize the damage.
Seek regular dental care. - Tooth decay is the most common chronic childhood disease, five times more common than asthma. It’s also preventable with proper care. Your dentist can identify early signs of erosion, pinpoint the causes, and advise you on how to prevent further damage and more serious problems from occurring.
Wednesday, June 1, 2011
In April, the Institute of Medicine (IOM) released a report on the state of oral health in America, concluding a two year evaluation of the current oral health care system. The U.S. Department of Health and Human Services (HHS) requested and funded this report to inform its work in addressing oral health challenges across America. HHS asked the IOM to assess the current oral health system and make strategic recommendations for its future programming. HHS is the federal agency which directs many of the government’s dental delivery, research, training and other programs.
Here are highlights:
- Tooth decay continues to be a common chronic disease in the United States
- The prevalence of oral diseases pose a significant burden on the health and well-being of the American people
- Evidence shows that decay and other oral health complications may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes
- Tooth decay is a highly preventable disease
- The general public and many healthcare professionals remain unaware of oral disease risk factors and preventive approaches and they do not fully appreciate how oral health affects overall health and well-being.
The IOM recommended that HHS design an oral health initiative that addresses areas in greatest need of attention, using approaches that have the most potential for creating improvement s, and to support this effort with strong leadership, sustained interest, and the involvement of multiple stakeholders.
“The Committee on an Oral Health Initiative reaffirms that oral health is an integral part of overall health and points to many opportunities to improve the nation’s oral health,” IOM President Harvey V. Fineberg, M.D., PhD., said in the foreword to the report. “We issue this report in the hope that it will prove useful to responsible government agencies, informative to the health professions, and public, and helpful in attaining higher levels of dental health.”
The IOM report and brief are posted online at www.iom.edu/Reports/2011/Advancing-Oral-Health-in-America.aspx
Tuesday, May 24, 2011
The report reflects a concerted effort and notable improvement among many of the states during the past year, proving that system changes can yield positive results for states continuing to struggle to provide adequate oral health care for children.
This year, seven states earned ‘A’s including Alaska, Connecticut, Maine, Maryland, Massachusetts, Minnesota, and South Carolina. Of these, Maryland was the top performing state, meeting seven of eight benchmarks. In addition, 22 states improved their grades, six of which raised their grade by at least two letters.
But even ‘A’ states have work to do. In five of these seven states, most Medicaid-enrolled children went a full year without seeing a dentist. And the total underserved population of all 7 ‘A’ states is 2,854,594 people.
While this report highlights the hard work that has gone on across the country to educate the general public and policy makers about programs that reduce disease and increase access to oral health care, lack of access to dental care is still an unacceptably persistent problem. Every year, 16 million children go without dental care, placing them at great risk of getting cavities. Cavities are almost 100% preventable when children have access to prevention, education and treatment services.
Five states including Florida, Hawaii, New Jersey, Indiana, Montana, received ‘F’s from this year’s report. By adopting relatively inexpensive and cost-effective strategies, ‘F’ states could improve children’s dental health. For Florida, Hawaii and New Jersey, this is the second straight year receiving failing grades. Indiana and Montana fell from a ‘D’ to an ‘F’.
This report gets people talking about oral health—and that’s important because it serves as a continuing national call to action for all 50 states to do more to improve children's oral health.
So let’s keep talking. What do you think this report has accomplished? Have you seen any signs of change in your state? Please share your thoughts by commenting on my blog.
A copy of the report can be found on the DentaQuest Foundation’s website, www.dentaquestfoundation.org.
Wednesday, May 18, 2011
On May 17, the Maryland Dental Acton Coalition proudly presented a 5-year (2011-2015) state plan to promote the oral health of all Marylanders. The plan addresses Maryland’s most critical oral health needs and capitalizes on available resources and data.
Speaking at the celebratory launch event is The Honorable Elijah Cummings, U.S. Congress, a long time supporter of oral health access for children in Maryland and across the United States. Also speaking are Delegate Keith Haynes, Maryland General Assembly, Renee Cohen on behalf of the Honorable Ben Cardin, U.S. Congress, Josh Sharfstein, Secretary, Department of Health and Mental Hygiene, Joseph and Madeline Misero, Katrina Holt, Chair, MDAC Maryland Oral Health Plan Committee, and Beth Lowe, Chair, MDAC. Also speaking is Ralph Fuccillo, President of the DentaQuest Foundation, which provided start up grant funds to MDAC.
Maryland has become a national model in improving the oral health of its citizens over the last decade. The roots of this process go back to 2007, following the untimely death of a 12-year old Maryland child from an untreated dental infection. A statewide Dental Action Committee (DAC) was convened by John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene (DHMH), with a specific charge to make recommendations to improve access to oral health care for vulnerable (disadvantaged and/or underinsured) children.
In 2010, the DAC transitioned to the Maryland Dental Action Coalition (MDAC), an independent, broad-based partnership of individuals working to make sure progress continued on the DAC’s recommendations for improving access to oral health care for all Marylanders. Last year, MDAC hosted an Oral Health Heroes Celebration to recognize the work of these oral health pioneers.
The Maryland Dental Action Coalition and its members initiated the development of a 5-year state oral health plan and offered guidance as it was developed. The process involved many individuals in state and local government, academic institutions, professional dental organizations, private practice dentists, community-based programs, the insurance industry, advocacy groups, and others. The goals, objectives and activities in the plan will be the basis for work of the Maryland Dental Action Coalition in the years ahead specifically for:
• Access to oral health care
• Oral disease and injury prevention
• Oral health literacy and education.
With the launch of the plan comes a new phase of collaborative action to improve oral health for Marylanders. MDAC is taking inspiration from Helen Keller, who once said, “Alone we can do so little; together we can do so much!”
A copy of the Maryland Oral Health Plan will be posted to the DentaQuest Foundation website in Reports: www.dentaquestfoundation.org/resources/reports.php
Friday, May 13, 2011
Dr. Chester W. Douglass, Harvard University School of Dental Medicine and Harvard School of Public Health and Dr. Philip Woods, Periodontist and Reede Scholar.
Guest blog post by Ralph Fuccillo, President, DentaQuest Foundation
The DentaQuest Foundation was honored to sponsor the Reede Scholars 2nd Annual Health Equity Symposium held at Harvard Medical School on May 12, 2011. An audience of more than 75 leaders among the health professions, including community programming, health delivery systems, health plans and purchasers, large employers, government leaders, and health policy experts attended.
Reede Scholars are health care professionals (physicians, psychiatrists, psychologists and dentists) who are working from the grassroots level to the national level, in business, academia and government. This makes for a powerful network of individuals with numerous and varied talents, experiences and interests -- all focused on improving the health and well-being of underserved populations and racial/ethnic minorities.
The program is named to honor its creator and mentor, Dr. Joan Y. Reede, a pioneer in efforts to improve the representation of ethnic minorities in health services careers and founder of the Minority Health Policy Fellowship. Dr. Reede is an inspiration for thousands who seek to make a difference in the health of their communities. Reede Scholars are advancing public health goals that aim to remedy the root causes of poor health, chronic illnesses, morbidity and death and encouraging greater civic participation and support for improved health, community empowerment, and health equity.
The 2011 Health Equity Symposium explored Health Information Technology (HIT) as an approach to achieving health equity. Dr. David Blumenthal, the National Coordinator for Health Information Technology under President Barack Obama, spoke about the potential of health information technologies as a tool providers can use to better understand the socio-demographics of their patients and monitoring for disparities. Properly used, HIT has the potential to provide a rich and consistent profile of the patient to all his/her providers (medical, behavioral, oral health) not just for diagnosis but also as a point of engagement for patient education and lifestyle improvements.
Often, problems with access to dental care can be linked to the insufficient number of dental and medical provider groups with the experience and training to offer culturally competent care to the population as it is now. Investing in educational programs to diversify the student pool and provide consistent quality experiences outside of traditional clinics is nothing less than investing in the future. Sponsorship of the Reede Health Equity Symposium is one example of DentaQuest’s investments in public health dentistry, health equity and eliminating disparities.
DentaQuest shares the commitment that the return on these investments continue to add new professionals who enter public and private practice with the cultural sensitivity and training to meet the needs of the population as it is now and as it will change.