Join the Movement for Oral Health

By Michael Monopoli, DentaQuest Foundation Director of Policy and Programs

Dental disease isn’t usually top of mind in the national conversation about health care. However, it is a serious, chronic, infectious illness—and it is preventable. Consider this:

• Dental disease (cavities) is the most common chronic disease in children, more common than asthma.

• Every year across the United States, children miss 52 million school hours due to dental disease. Adults lose close to 164 million work hours.

• In 2010, Americans spent $106 billion on oral care.

Part of the challenge in changing the dental delivery system and expanding access is that too often, people don’t have access to continuing care in a way that maintains oral health. The DentaQuest Foundation is focused on educating people about the centrality of oral health to overall health.

Through a series of grants, the foundation is doing all it can to fix this problem and promote good oral health. Most recently, the foundation announced that five additional state/regional primary care associations (PCAs) have been selected to participate in the Strengthening the Oral Health Safety Net Initiative, a national program instituted in fall 2011 to promote oral health access at community health centers (CHCs) across the country. In total, the initiative engages 10 state/regional PCA partners to develop their capacity to provide oral health leadership and technical assistance to safety net programs in their states.

CHCs are America’s health safety net, serving 23 million patients in more than 8,000 communities. They provide preventive and primary health care services to people that face financial, geographic, language, cultural, and other barriers to receiving care. The grants will promote oral health leadership, develop oral health expertise, encourage collaboration among dental and medical programs, and advance safety net oral health needs at the state level. Each award consists of grant funds plus direct practice improvement technical assistance for safety net dental programs provided in-kind by the Safety Net Solutions team of the DentaQuest Institute, a nonprofit organization affiliated with the DentaQuest Foundation.

But, it’s the ripple effects of these initiatives that are critical. When communities work together, powerful change can happen, which is why we are excited to welcome these five new PCAs to the Strengthening the Oral Health Safety Net Initiative. Together, we can change how people respond to a preventable disease.

Why is National Diabetes Month Important to Oral Health Professionals?

Guest blog post by Dr. Linda Vidone, DentaQuest Dental Director and Periodontist

This month marks National Diabetes Month, an important month designated by the American Diabetes Association to focus the nation's attention on the issues surrounding diabetes and the many people who are impacted by the disease. During November, most efforts by health professionals surrounding Diabetes Awareness Month concentrate on nutrition, self-care, weight loss and other common methods to avoid or improve people’s management of diabetes.

While these health considerations are important, often overlooked is the strong link between oral health and diabetes. Despite research showing people with diabetes are two to three times more likely to have more destructive forms of periodontal disease than people without diabetes, caring for the mouth when treating diabetes is often disregarded by physicians, who tend to focus on other more noticeable diabetes complications.

This is particularly alarming because new data from the CDC’s National Health and Nutrition Examination Survey (NHANES), published in the August 2012 Journal of Dental Research, revealed more adults have periodontal disease than dentists originally thought.  While most surveyed dentists believed 30% of adults suffered from periodontal disease, the new data shows one out of every two American adults aged 30 and older today suffer from periodontal disease.

Here are some other surprising facts and figures from the report:

• Over 64 million Americans have some form of periodontal disease.
• In adults 65 and older, the rate of periodontal disease increases to 70 percent. 
• Rates of periodontal disease are especially high among current smokers, those living below the federal poverty level, and those with less than a high school education.

The CDC National Health and Nutrition Examination Survey will continue to watch for periodontal disease in U.S adults through the 2014. This information will guide public health policy decisions including prevention and treatment recommendations. 

As noted in the study, early detection of periodontal disease is important and your oral health care provider can help you manage diabetes impact on oral health.  If untreated, however, periodontal disease infections can lead to serious health problems.

Should you be worried?

• Are your gums puffy?
• Do you spit out blood when you brush or floss your teeth?
• Do you have bad breath? 

These are all signs of periodontal disease. Talk to your oral health care provider if you experience any of them, particularly if you have diabetes.

Most importantly, celebrate American Diabetes Month with us and spread the word to someone you know about the connection between diabetes and oral health. For more information about diabetes, visit American Diabetes Association website at http://www.diabetes.org. 

Sneaky, Spooky Snacking- Don’t Get Tricked

By Dr. Linda Vidone, Dental Director, DentaQuest

Halloween is around the corner. Between picking out costumes, jack-o-lantern carving, and stocking up on treats, it’s hard not to get excited.

In the midst of the fun and fantasy, however, it’s important to remember that Halloween is a particularly spooky time for teeth.

Candy, particularly in large amounts, contributes to tooth decay. Tooth decay occurs when the sugars in candy and other sweets mix with bacteria in the sticky plaque that constantly forms on teeth to produce acid, which can wear away enamel. Chewy, sticky treats are particularly damaging because not only are they high in sugar, but they stick to teeth and are more difficult for saliva to get rid of them. Often, it takes a gentle scrubbing with a toothbrush to remove the sticky stuff. Hard candies are tough on teeth too because kids tend to suck on them at a leisurely pace for an extended period of time. Think of it as a sugar bath for teeth.

Does this mean children shouldn't eat candy on Halloween? Of course not.

Dentists understand holiday treats are a fact of life, and don’t expect kids to completely avoid candy on Halloween. Here are some simple ways to keep you and your children safe from cavities. 

• A good, healthy meal prior to trick-or-treating may mean kids are less likely to gorge on candy.

• Enjoy the candy in moderation. Chocolate dissolves quickly in the mouth and can be eaten easily, decreasing the amount of time sugar stays in contact with teeth. Consider limiting the remainder of the stash, to a piece or two a day-- especially the sticky, gummy, candy corn and chewy choices (and that includes raisins and other sticky fruits). 

• Be sure to brush your teeth before going to bed. It is important to remove the sugars that can do damage overnight.

I see Halloween as a good opportunity to teach children about making sensible choices and taking care of their teeth. If they eat the candy, encourage them to brush (for two minutes) especially after sugary/starchy/sticky snacks --and don’t forget to floss every day too.

Happy Halloween! 

Health Plans: How Reform-Ready Are You?

By Steve Pollock, DentaQuest Chief Operating Officer

The healthcare landscape is changing fast. In little more than a year, the Affordable Care Act (ACA) will require pediatric oral services as one of 10 mandatory categories of essential health benefits. This means that 23 million children across the country who currently do not have dental coverage will begin enrolling in oral health plans in 2014.

So what are the implications of this federal mandate on health plans? What components of dental benefit plan design, both front- and back-end do you need? And how do those managing health plans implement these changes?

On Oct. 16, DentaQuest addressed these questions and more when the New York Health Plans Association (NYHPA) hosted a webinar to give its members some perspective on the topic.  Though specific to healthcare reform in New York, the webinar addressed the broad effects of pending ACA mandates and what organizations should be doing now to prepare themselves for 2014.

In New York for example, 2.4 million children are currently without dental coverage and 79,000 are expected to enroll through the state’s health insurance exchange. This is new territory for most plans. However, we are one of the few dental administrators in the nation with experience in an exchange program. Drawing on that experience, the webinar gave New York health plans information to start developing their roadmap for this aspect of healthcare reform and what to look for in a dental partner.

Among plans throughout the country, awareness of the pediatric mandate has risen during the last year from 50% to 75%, and those tasked with managing these plans are starting to make important decisions about expanding the benefits they will offer. Our research shows most health plans view the upcoming changes to healthcare as an opportunity to provide their members with new benefit options and to expand their business.

Via the webinar, participants looked for guidance to assess opportunities in their market, to identify how dental benefits might provide a competitive advantage, and how to conduct an internal assessment to determine whether their current model will support dental benefits. They reviewed the data, asked questions of Dr. Rob Compton, Bob Lynn, and Arlene Saffron, and by the end of the webinar were armed with information to build a strategy for incorporating or expanding their dental program, while also meeting the ACA’s pediatric dental mandate.

We know health plans are feeling regulatory and competitive pressures. But we view the challenges of healthcare reform as a chance to share our insights as a reform-ready partner working across the full spectrum of consumers on and off exchanges, whether group and individual, Medicaid, Medicare, CHIP, or the dual-eligible population. Oral health is an essential part of good overall health, and we know the coming year is one of great change – for the better. Are you ready? We are. Let’s talk.

Clicking in to Oral Health

By Steve Pollock, DentaQuest Chief Operating Officer

We’re always looking for better ways to share DentaQuest’s innovations and improvements in oral healthcare. Our latest step forward is DentaQuest’s new website, which integrates DentaQuest’s corporate, government and mid-Atlantic websites and microsites with state-specific information, and more. This streamlined, updated web presence allows DentaQuest to bring concise, accurate oral health information to everyone who works with us: healthcare providers, benefits administrators, clients, members and people interested in good oral health.

We know dental benefits and oral healthcare are complex matters. We also know how vitally important it is to provide the information you need, exactly when you need it. We’ve revamped DentaQuest.com to be an efficient, easy-to-understand road map to better oral healthcare and benefits administration. 

First-rate service. Clear, concise information about oral healthcare management. Educational resources that forward our mission of “Improving the oral health of all.” DentaQuest is working – every hour of every day – to keep these goals at the forefront.

Since the new site was released in August, we’ve already seen visitors to the site increase by 55 percent. We hope the new website continues to bring in new viewers as we keep making improvements to serve you better.

What do you think? Tweet us @DentaQuest.

How Do We Integrate Value into Oral Healthcare to Consistently Improve Health?

By Dr. Rob Compton, Vice President, Business Intelligence, DentaQuest

Energized by the ongoing discussion of healthcare in America, we are witnessing an unprecedented shift in the way we think about care management. 

A particularly hot topic is the definition of value within the context of healthcare. How do we determine that optimal intersection of quality and affordability? And, perhaps most importantly, how do we – whether benefits providers, healthcare professionals, or patients – integrate value into oral healthcare in a way that consistently improves the health of the individual?

We know more care doesn’t necessarily equal better care, and that preventive measures haven’t always received their due. But the old mindset of “drill and fill” is fading fast. The question now becomes: what next? If we have the opportunity to create a new paradigm for oral healthcare, what does that look like and how do we manage it?

This is a challenging time – but one full of opportunities for innovation.

One such innovation is the way we are engaging all as partners in the goal of better health. This new, collaborative approach to oral healthcare rests on a foundation of proactive partnership between dentists, patients, and benefit providers. By offering enhanced benefits for higher-risk patients, data reports and a prevention-focused incentive program for our health care providers, along with educational resources for members, we’re seeing movement to better lifelong oral health.

This approach already is playing a vital role in care management. In a Massachusetts study involving a commercial PPO program, reports were sent to participating PPO dentists that identified patients who were more vulnerable to dental disease. Using these “Patient Prevention” reports, participating dentists were rewarded for their extra efforts to provide those patients with appropriate preventive care. After 12 months, collected data show a significant increase in the percentage of higher-risk patients in the program receiving recommended preventive treatments. 

The chart above shows the one-year results of what I believe is a breakthrough system of care. Children ages 6 to 18 who have had cavities are receiving fluoride treatments at an increase of 30%. Similarly, we’ve seen a 30% increase in the number of adult patients with gum disease who are receiving periodontal cleanings every six months. 

The numbers achieved so far through this collaborative approach focused on quality and value in care embodies our mission of “Improving the oral health of all.” We know dental disease is almost completely preventable, and we’re committed to eradicating it through best practices of prevention and early treatment. I’d invite you to find out more on the DentaQuest website. 

Our Mission: To Improve the Oral Health of All

By Fay Donohue

Today is one of those days when I think I must have the best job in the world.  This morning I’ll be addressing DentaQuest employees across our entire enterprise to speak about our mission, and to kick off a day of service where we will be working in communities across the country.  And all of this we do as we recognize and celebrate our corporate mission which is to improve the oral health of all.

Our employees are all motivated to engage in meaningful work in our local communities today. In Westborough, MA and Calverton, MD, Columbia, SC, Coral Gables, FL and Mequon, Grafton and Glen Oaks, WI and in Austin, TX and Boston, MA, DentaQuest employees will work together to make a difference and support our communities. We will be helping at middle schools, Boys and Girls Clubs, Habitat for Humanity sites and food banks.

As a company we understand the importance of preventive care and need to take a leading role in increasing access to quality, affordable oral health care. This day of service demonstrates our commitment to the communities we serve and underscores our passion to support healthy communities and help others.

Our mission is at the core of everything we do and stand for here at DentaQuest. Click here for interesting facts on this dental disease. Dental disease isn’t usually top-of-mind in the national conversation about health care—but it is a serious, chronic, infectious illness—and is preventable.

• Dental disease (cavities) is the most common chronic disease in children, more common than asthma.
• Every year across the United States, children miss 52 million school hours due to dental disease, and adults lose close to 164 million work hours.
• In 2010, Americans spent $106 billion dollars in oral care.
• More than 30 million people could not get treatment, including 1 out of 5 children.

During today’s “Recommitment to our Mission Day,” we will be supporting healthy communities across the country so more children have places to play and learn, more families have food to eat and a roof over their heads. And that’s part of our mission. A nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth in good health for their entire lives. And, where every person has access to quality dental care.

Let’s Bring Back “Look Ma, No Cavities!”

By Dr. Doyle Williams

“Look Ma, no cavities!” seems to be a phrase of the past.

Recently the Australian Dental Association (ADA) suggested many Australian parents view dental problems as “the norm.” Studies revealed 60 percent of Australian parents surveyed accepted that their child would experience tooth decay, an almost entirely preventable disease, at some point in time. And Australia is not alone: tooth decay is the most common chronic illness among school-age children in the United States.

Tooth decay, the process that results in a cavity and occurs when bacteria in your mouth make acids that eat away at a tooth, can be easily be prevented by brushing and flossing twice a day, controlling harmful bacteria and maintaining a healthy diet. If tooth decay goes untreated, it can cause pain, infection, tooth loss and- in extreme cases- death in patients.

Parents have a challenging job. Instead of looking at brushing teeth as a burden, think of it as a relaxing two minutes of ‘me’ time.  Here are some ideas:

• Make brushing and flossing  a twice daily event – in the morning before you go out the door and as the last activity before going to bed
• Take your baby to the dentist by age 1 to be assessed for future cavity risk.
• Drink fluoridated tap water instead of plain bottled water.
• Cut down on sugary snacks, juices and sodas especially before bedtime.

If children sense their parents view dental problems as inevitable, they are likely to adopt the same belief and will be less likely to take pride in their oral health. Let’s take simple—but important--steps to bring back the phrase “Look Ma, no cavities!” and erase tooth decay. 

The Kids’ Healthy Mouths Campaign

By Fay Donohue and Ralph Fuccillo 

Every child deserves a healthy smile. That’s why DentaQuest is delighted to share a first look at the new Kids' Healthy Mouths campaign. DentaQuest is a partner in this exciting, new campaign developed by the Ad Council and the Partnership for Healthy Mouths, Healthy Lives, leading organizations in the field of oral health. 

                                                                         

(Video link: http://www.youtube.com/watch?v=oBfxQY8qs-E&feature=player_embedded)

The Kids’ Healthy Mouths campaign aims to educate parents and caregivers about how to improve oral health in children up to age 12 through simple, preventive strategies. Using entertaining public service announcements, the campaign highlights that it takes just two minutes of brushing twice a day to keep mouths healthy and help prevent severe tooth pain. 

With a focus on low-income and minority parents and caregivers, the Kids’ Healthy Mouths campaign offers 14 fun, two-minute videos their kids can watch while brushing, along with practical information about oral health. 

Accompanying the PSAs are 15-, 30-, and 60-second television spots, like the one above, as well as print advertising, all of which will be promoted via a wide range of media outlets.

Dental decay is the most common chronic disease of childhood. DentaQuest is driven by a mission to improve the oral health of all. Our vision is a nation free of dental disease, where no child suffers from the pain of tooth decay and where every person has access to quality dental care. 

Above is a sneak preview of the PSAs and 2-minute videos; we also encourage you to take a look at the Kids’ Healthy Mouths media materials.

We hope you will support this effort by sharing our news and these materials with your clients, friends, and colleagues.

A Celebration of Diversity: The Multicultural Oral Health Summit

Guest post by Carmen Fields, DentaQuest Foundation Associate Director National Programs       

Despite coming from different backgrounds and experiences, it was clear the hundreds of attendees at the Multicultural Oral Health Summit all shared a common vision: increased access to quality oral health services and improvement of oral health for all.

The first-ever joint convention of The Hispanic DentalAssociation (HDA), National Dental Association (NDA) and Society of American Indian Dentists (SAID) took place in sunny Boca Raton, Florida last month. I joined global health leaders, corporate partners, community leaders, foundations and others from all over the nation to discuss ways to “collectively meet the needs of a diverse population to improve oral health.”

The Summit began Friday (July 20) with a powerfully symbolic prayer by Dr. George Blue Spruce, founder of the SAID, and a posting of Latin American Flags by two dozen members of the HDA. The musical interludes during the opening program were especially refreshing, featuring a flute player from the Seminole Tribe of Florida and a gospel ensemble from the area.

I attended the Summit on behalf of the DentaQuest Foundation, which was recognized during the Summit’s opening ceremony for its ongoing support of the three multicultural dental organizations and for its commitment to improving oral health in underserved and diverse populations. I was joined by Fay Donohue, DentaQuest CEO and Foundation board member, who accepted the award. By collaborating with the HDA, NDA and SAID, the Foundation continues to help promote public policy and other initiatives to support optimal oral health for everyone.

The Foundation sponsored the Summit’s two-part President’s Symposium. The first presentation was rich and layered, with powerful presentations by University of Connecticut’s Associate Clinical Professor Sarita Arteaga, Foundation board member and Oral Health Alliance founder Caswell Evans, and Dr. Spruce. Dr. Joan Y. Reeve of Harvard Medical School was a terrific moderator, who framed the meeting as a provocative restating of the issues of health, focusing directly on dental care disparities. DentaQuest Foundation President, Ralph Fuccillo facilitated a presentation on how to improve oral health access. Take-away points from the discussions will become the basis for future messaging and an eventual strategy plan aimed to improve overall oral health care access.

While I attended many of the events at the Summit, two events in particular were unforgettable. At the Annual Women Dentists’ Awards Brunch (July 21), I had the pleasure of sitting with the founder of this symposium event, Dr. Marie Holliday of Dallas, TX, a Boston University and Tufts Dental School graduate. The group was organized to address the needs and concerns of African American female practitioners—and highlight and recognize their work. I also enjoyed The Civil Rights Luncheon, held Monday (July 23), which paid tribute to individuals who have fought for the civil rights and liberties of under-represented Americans throughout history. Orrin D. Mitchell, DDS, who helped pioneer in the fight against racial discrimination when he sought membership in the segregated Yacht club of Jacksonville, Fla. and Tom Joyner, whose syndicated radio show has been encouraging  good health (and now hopefully oral health) practices were awarded Civil Rights Awards. I was honored to be in the presence of so many distinguished leaders.

This historical event changed my perspective and made me hopeful for the future of oral health. Collectively, I have witnessed, that we can make a difference and help create brighter smiles for people of all walks of life.

Smiles for Life

Guest Post by Cindy Lord, Clinical Associate Professor and Director of the Physician Assistant Program at Quinnipiac University, and Oral Health Champion with the National Interprofessional Initiative on Oral Health. The activities of the National Interprofessional Initiative on Oral Health are made possible as a result of funding from The DentaQuest Foundation, the Washington Dental Service Foundation, and the Connecticut Health Foundation.

My “aha” moment came when I realized that physician assistants (PAs) and primary care providers can not only play an integral role in improving oral health, but that we have an obligation to do so.  Dental disease is the most common chronic disease in children, and it presents frequently in pregnant and elderly patients, yet doctors and PAs too often look beyond the mouth to the back of the throat to see if a patient’s tonsils are red or swollen or if they have post-nasal drip.

So, how do we change this? At Quinnipiac, where I am the Director of the Physician Assistant Program, we have begun to integrate oral health into our overall PA curriculum. We know that collaboration between the medical and dental professions is crucial to the overall health of every patient, so we are working with our PA students to ensure that they have a full oral health education that they can apply to their day-to-day work with patients. We want them to be able to evaluate the full health of each patient they see, and that includes the patient’s oral health, especially if they are part of a high-risk group.

We’ve been using the Smiles for Life curriculum to seamlessly include oral health into our PA training. Our PA students in their pediatric rotation do the pediatric Smiles for Life module and PA students in their internal medicine and geriatric rotation do the internal medicine and geriatric modules. While at first we received some hesitation (“oral health is for dentists!”), today our students are thrilled to be part of this important movement to make oral health part of overall health.  As part of this training, student PAs learn when to help the patients understand what they can do through education and advisory guidance and when to refer the patient to a dentist for more detailed evaluation and follow up.

As the health care system continues to evolve and change, it is our responsibility, as health care providers, to take charge of health care and use our position to encourage prevention, health literacy and the best possible overall health for all our patients.

Editor’s Note: In recognition of her work, Cindy received the Outstanding PA of the Year Award from the American Academy of Physicians Assistants. See more here: http://www.niioh.org/news. 

Dentists Pioneer Way for HIV/AIDS Patients

Currently, the AIDS 2012, the international HIV/AIDS conference, is running July 22 through 27 in Washington, DC.   

With some exceptions, dentists were among the first providers to recognize some of the physical manifestations of HIV/AIDS and come to the forefront of care for these patients.

Take for example, Dr. David Reznik, D.D.S., president of HIVDent, a nationally recognized Internet resource for people with HIV/AIDS. Dr. Reznick also serves as the Dental Director of the Southeast AIDS Education and Training Center and Director of the Oral Health Center at Infectious Disease Program of Grady Health Systems in Atlanta, Georgia.

Dr. Reznick was inspired to create HIVDent after hearing from a patient that no one would see him because of his AIDS diagnosis. Dr. Reznick immediately scheduled an appointment for him. After hearing this patient’s story, and seeing the discrimination in the dental field towards people with HIV/AIDS, Dr. Reznick was inspired to expand dental care to these patients.

Sandy Thurman, President Bill Clinton’s former AIDS czar, asked Dr. Resnik to take patients with HIV/AIDS on a sliding scale, making available dental services for this population at a lower cost. Dr. Reznick took on this initiative and provided care free of charge, working around the clock to ensure that the population was cared for.

In 1993, Dr. Reznick opened Ponce De Leon Center, the largest, most comprehensive dental clinic in Atlanta for advanced HIV/AIDS, which continues to provide care today. Dr. Reznick’s work continues today. He is constantly asking: How can I communicate oral health messages to people with so much else going on in their life? How do I gain trust?

Dr. Reznick and dentists like him brought this important issue to the forefront of the national discussion. They are now providing rapid HIV testing through saliva in dental practices to help ensure newly infected patients get care in a timely way and assure that they are not denied oral health care access.

As Dr. Reznick says, “Knowledge is power and allows us to increase understanding of those we serve. We can reach out, touch someone’s hand and make their world a little better.”

Mission of Mercy: Extending the Umbrella of Coverage

Guest post by Matthew Bond, Grants and Programs Associate, DentaQuest Foundation

Hundreds of people lined up to receive relief from toothaches, routine cleanings, extractions and more at the first annual Rhode Island Mission of Mercy (RIMOM) Free Dental Care Clinic, where I joined 600 people who volunteered their time, talent, and clinical expertise to make this event a success. The RI Mission of Mercy is one of the programs in the portfolio of grants that I manage. I was extremely grateful to have had the opportunity to see the impact of the DentaQuest Foundation’s work first hand.

I arrived early in the morning, around 4:45a.m., to a line of people wrapped around the building, already waiting for care. I spent most of the event running food and water to patients and volunteers and escorting patients from place to place. 

For each patient, getting the care they needed each meant something different.

For one woman, it meant being able to celebrate milestones with a smile. A lady shared with me that her daughter, the first in her family to graduate from college, was too embarrassed to smile in graduation pictures. After receiving the proper dental care, her daughter can now smile and celebrate one of the most important moments in her life.

For another man, it meant a sense of hope. Observing the massive line of people awaiting dental care, I overheard him say to someone else in line, “I thought I was the only one. I can’t believe it!”

What really struck me was when I was walking down the line in the pouring rain, one of the patients graciously offered me his umbrella. At first, I resisted, and he replied, “Listen, buddy I haven’t been able eat for 4 months, so if I can get that problem fixed, it doesn’t matter if I get wet.” The patients were so appreciative of the dental work they were receiving. 

All in all, 800 deserving patients received free dental services totaling over $375,000.00. Volunteers performed over 300 fillings, 450 extractions, 200 teeth cleanings, 30 root canals and 45 removable partial dentures were fabricated and inserted. 

Missions of Mercy free care clinics serve an important need in helping people who have no other options for dental care. They are a stop gap, not a solution. But we are working on it. The DentaQuest Foundation and its partners in communities across the United States are working to make sure people across America are able to get oral health education and care.

Working Together for Oral Health

By Ralph Fuccillo

In recent months, oral health has been getting considerable attention from major news outlets like ABC News, The New York Times, and the PBS Frontline program.  The emphasis of this coverage-- the inability of young Medicaid patients to get dental care, the rise in preschoolers with cavities, and the lack of dental coverage sending patients to the ER illustrates how far we still have to go to eradicate a very preventable disease.

Too many still think oral diseases are related to something not done, actions not taken.  The truth is dental disease is a chronic, infectious illness.  It is caused by bacteria and other factors. It is preventable. Working together, we can create a shared understanding of this disease among those who provide care, those who write health policies, those who finance care, and those who teach health education and prevention.

As the recent news coverage has made clear, there is a pressing need to erase disparities in access to care to improve the oral health of our nation. The good news is that people are working together to do this -- individually and collectively, in public and private partnerships, in communities, companies, and philanthropies, in health centers and dental offices, across states, and at the highest levels in government.

When communities work together, powerful change can happen. In 2007, Maryland suffered the very public death of a 12 year-old child to a dental infection that spread to his brain.  This tragedy spurred a level of action in Maryland and around the country that the oral health community had not seen previously. Thanks to the efforts of many in government and the community, the state of Maryland is now a national model of how communities can work together to ensure everyone has access to dental care.   Stakeholders in Maryland have come together and launched a $1.2 million oral health public service campaign to educate the community, and just recently Maryland Governor Martin O’Malley signed SB bills authorizing the Maryland State Department of Education to oral health literacy a component of school health education.

Maryland is just one example. There is important progress going on in many sectors.

Beginning in 2009, the U.S. Department of Health and Human Services reactivated a cross-agency focus on oral health and requested that the Institute of Medicine study the state of oral health. The resulting reports confirmed what many believed: the systems that impact oral health in America are broken. One-third of the population lives in areas where they can’t get dental care due either due to the scarcity of providers or a lack of coverage.

The new U.S. National Oral Health Alliance is using a model of collaboration across stakeholders to elevate oral health to the top of the nation’s health agenda --where it belongs. The Alliance is succeeding because people want to work together.  Its national leadership gatherings (Colloquia) have stimulated respectful and thoughtful conversations, leading to unified messages on priority issues.  The active participation of so many committed individuals working from a position of common ground offers hope that we will soon have a unified national strategy to improve oral health.

The DentaQuest Foundation, through its Oral Health 2014 Initiative, is supporting a complementary collaborative approach in 20 states.  Local leaders of the Oral health 2014 Initiative are bringing their communities together and creating new oral health champions. These champions are aligning actions in Arizona, North Dakota, Florida, Maryland, California, Colorado, Idaho, Michigan, Mississippi, New Jersey, Massachusetts, Alabama, the District of Columbia, Maine, Pennsylvania, Rhode Island, Oregon, Virginia, South Carolina and West Virginia with oral health priorities nationwide.

It’s the ripple-effects of these initiatives that are critical. People are coming together with common goals -- creating conditions where individuals and groups with different perspectives feel comfortable working together. Together, they are changing how people respond to a preventable disease.

Ralph Fuccillo is the President of the DentaQuest Foundation.

Knowledge is Power: The Alliance, Oral Health Literacy and Health Equity

By Ralph Fuccillo, 
President DentaQuest Foundation,
Founding Board Member, U.S. National Oral Health Alliance

The U.S. National Oral Health Alliance completed its Third Leadership Colloquium this June 6 and 7 in San Francisco. The conversations focused on the area of Oral Health Literacy as a pathway to health equity.

It was a little over one year ago that the Alliance was launched as a new nonprofit focused on a new way of collaborating to engage people to learn and listen together.  One year and three leadership colloquia later, the Alliance is becoming the platform its founding board envisioned -- engaging diverse stakeholders from across the U.S., finding common ground through respectful dialogue that makes it possible to identify opportunities to create solutions together for improved oral health for vulnerable populations across the United States. The Alliance has set a wonderful table. It is logical and thoughtful and it happens because we work together.

Over 120 professionals from many backgrounds participated in San Francisco. We heard memorable contributions on oral health literacy from individuals at the forefront of oral health care delivery, education, marketing, and policy development, including Dr. Francisco Ramos Gomez of UCLA School of Dentistry and the Native American Health Center; Karina Alcala, Pediatric Dental Project Manager at the Native American Health Center; Alison Cusick, Program Manager at Washington Dental Service Foundation; Dr. Man Wai Ng, of Children’s Hospital Boston and the Early Childhood Caries Collaborative; Carrie Gordon, Vice President of Government Affairs for the California Dental Association; Captain Arlene M. Lester, DDS of the Office of Minority Health, Region IV, of the U.S. Department of Health and Human Services; and Gary Price President and CEO of the Dental Trade Alliance.

Alice Horowitz, PhD, from the University of Maryland School of Public Health, one of the founders of the health literacy movement, started the meeting with a challenge: our efforts to increase quality, reduce costs and disparities, and promote health equity will not succeed unless we also include science-based oral health education appropriate to the understanding and languages of vulnerable groups. “We know how to prevent cavities with fluoride and sealants; we must use patient-centered prevention and risk-based management,” she said.

Dr. David Resnick, CEO of HIVDent and Director of Oral Health for Grady Health Services in Atlanta reflected on his life experiences at the forefront of treating patients with HIV/AIDS. The challenges of oral health literacy are often bigger than anyone in the room, but we must remember to meet people where they are, he said. David framed health literacy as a multi-dimensional concept that demands we use our minds, hearts, eyes and ears, as well as medical/dental and psychosocial knowledge. How does one communicate an oral health message to people who have so many serious issues going on in their lives? Knowledge is Power. We have to find opportunities to increase the understanding of those we serve. We can reach out with knowledge and kindness and that does make the world a better place for them.

Reflecting on their experiences around health literacy, participants at this Third Leadership Colloquium discussed what it will take to lay the groundwork in any community for health literacy, to prevent future pain and unnecessary suffering. The group then broadened its view and looked at the nation and what it will take to move the nation forward.

Unifying messages were developed at the conclusion of this Colloquium. They are being published in a colloquium summary that will be posted to the Alliance website (www.USAllianceforOralHealth.org) by the end of summer and will also be offered as a foundation for developing a national oral health plan.

ADA to support NYC Mayor Bloomberg’s Soda Ban

By Dr. Doyle Williams

Mayor Bloomberg’s recent announcement that he aims to ban the sale of sugary drinks larger than 16 ounces throughout New York City sparked a nationwide controversy as people questioned whether he was going a step too far in the fight against obesity.

While a majority of New Yorkers disagree with the ban, the American Dental Association applauded the Mayor for his bold action.

The ADA has long been an active opponent to soda consumption. In 2000, it opposed contractual agreements between schools and soda manufacturers that influence consumption patterns and promote increased access to soft drinks for students.

Sugary beverages and foods can lead to a multitude of dental problems, like cavities and gum disease, which could otherwise be prevented by practicing a healthier diet. As more children consume more soda throughout the day, it is crucial that we start to cut back on foods and habits that are harmful to our oral health.

Tobacco, Cancer and Oral Health

By Doyle Williams

Tobacco is the leading cause of preventable deaths in the United States, and unfortunately, we see the dangers of it all too often in the dentistry field.  Despite the warnings, education and community outreach, tobacco use in the US has been steady, and is increasing globally.  The Institute of Medicine is holding a workshop next week in Washington DC with health leaders from around the country to examine the impact of policies and programs to reduce tobacco use and to promote collaboration among the cancer community and others to implement strategies to eliminate tobacco use.

Oral cancer is most commonly caused by tobacco use, so to see the health community come together to discuss this issue is a promising step.  Smokeless tobacco and cigarettes contain at least 28 cancer-causing chemicals, and can cause cancers of the mouth, lip, tongue, pancreas, and even voice box, esophagus, colon and bladder.  If you’re a tobacco user, be sure to inform your dentist, so they can perform a thorough exam to check for oral cancers. But the most important thing you can do is quit.

Even if you’re not a tobacco user, be sure to ask your dentist for an oral cancer screening- it can happen to anyone!

How to Find the Right Dentist

By Dr. Doyle Williams

All too often we hear from patients that they haven’t been to the dentist in years because they weren’t able to find one they liked or trusted.

Finding the right dentist can be hard, but it’s a crucial step towards good oral health.

First, comfort plays an essential role in finding the right dentist. It’s important that a dentist makes you feel at ease so you can ask questions about your care and you trust the dentist to perform procedures.

This is especially important when looking for a pediatric dentist.  If children develop good dental habits when they’re young, they’re more likely to continue to practice good oral health later in life.

You will find dentists are either a DMD (Doctor of Dental Medicine) or DDS (Doctor of Dental Surgery). Both apply to general dentists and refer to the same training programs.

Convenience is also an important part of choosing the right dentist. If you choose a dentist who has office hours that are compatible with yours and whose location is convenient, it will be easier to make and keep appointments. For example, in Massachusetts, DentaQuest’s Oral Health Center, our model dental office, has extended hours and a staff of general dentists, pediatric dentists, periodontists, endodontists and orthodontists.

Choosing a dentist who will understand your dental benefits is also important. Check your dental benefits company’s website to find the right dentist for you in their network.

Dental diseases are almost 100% preventable; having a good dentist who is experienced in preventive care is important. If you work together with your dentist and make regular appointments, you can maintain excellent oral health.

Self-Healing Teeth

By Dr. Doyle Williams


There’s exciting news on the dental research front!  Scientists at the University of Maryland School of Dentistry have come up with a new dental filling that kills bacteria and regenerates teeth harmed by cavities.  The research team still has to finish conducting tests before the fillings are approved for general use, but this innovation sounds especially promising.

As you know from reading this blog, cavities are a bacterial infection. After your dentist drills out the infected area, there are always some residual bacteria hanging around in this non-sterile environment of the mouth. These bacteria can cause more cavities down the road (which is why dental care professionals are so adamant about having you brush and floss-- to keep your mouth as bacteria-free as is possible). The new fillings have an antibacterial ingredient that will kill the left-over bacteria. They also stimulate healing of the affected tooth which causes a new healthy layer of tooth beneath the filling. And since these new fillings are supposed to last longer than traditional fillings, they should help you keep your teeth healthier longer.

New developments like this work at the University of Maryland School of Dentistry are always exciting for us to see. They are making it possible for dental care professionals to find early decay and fix it before it progresses to become a bigger and more painful problem. Our DentaQuest Oral Health Center, is using this new scientific knowledge to help their patients to reduce the level of the decay-causing bacteria in their mouths. Instead of just placing fillings after decay has already progressed to a cavity, they use other measures, like changes in diet, fluoride varnish, healthy sugars like xylitol or protective sealants, to stop early decay, help the tooth heal without any drilling, and then make it more resistant to future decay.

DentaQuest is committed to this prevention-focused approach to better oral health.

Mothers- The Key to Good Health

By Dr. Doyle Williams

Dear Mom,

We at DentaQuest want to take a moment to recognize you for all you do for your family’s health-- and especially for oral health.  

Moms (and dads!) can be key to their children’s healthy hearts, healthy bones and healthy smiles.

Moms are often the gatekeeper to their family’s wellbeing -- making sure there are clean clothes and healthy meals. Scheduling and keeping track of all those appointments for the dentist, the doctor, and more.

There are studies that show that the choices a mother makes --from the beverages she drinks to the foods she buys and even where she keeps the family snacks -- may dramatically affect her family’s nutrition, long-term health, and risk for chronic disease.

Mom’s healthy habits are just as important for her children as they are for her.  When moms set the example for good oral health, her kids will have a good example to follow.

So, we’re extending a heartfelt thank you to all Moms because they insist that their children brush and floss twice a day-- even when they are tired and cranky, and because they drive the kids to dental appointments—even when they don’t want to go, and who are conscious about their own health, because its important to have healthy moms setting a good example for the whole family.

Happy Mother’s Day!

Oral, Head and Neck Cancer Awareness Week

By Dr. Doyle Williams

Last week was Oral, Head and Neck Cancer Awareness Week, organized by the Head and Neck Cancer Alliance.  Though we say it over and over, it can’t hurt to remind everyone again about the importance of getting screened for oral cancer.

The signs of possible oral cancer lesions in your mouth include both “raised” and “sunken” lesions, changes in coloration, hardening lesions and lesions that bleed easily. If you have any of these symptoms for more than two weeks, please see your dentist about them.

The survival rate for oral cancer is very good if it’s detected early, so don’t forget to ask your dentist for a screening at your next visit.

Silent No More

By Steve Pollock

Did you catch the ABC News with Diane Sawyer this Wednesday? There was a moving story on children’s dental health.
It was part of a new ABCNews series called, “Hidden America.” ABC says this series is about the people, places and stories of struggle and hope that are not apparent to many Americans.

This first segment was about America’s “Invisible Health Crisis” -- dental disease. It is a problem most American’s probably never think about. We know it very well.

Did you know that 16 million children did not receive even the most basic preventive dental care during 2009?

Did you know that Emergency Rooms say they are treating greater numbers of toddlers whose teeth are blackened from decay and bacteria and multiple cavities?

And it is not just low income children!

Thankfully, this story is gradually gaining momentum in the mainstream media and more people are discovering the immense impact poor dental health has on our lives.  There are other equally moving articles in The New York Times, USA Today, PBS Newshour, and Consumer Reports.

If children can be seen early and regularly and receive the benefits of fluoride varnish and sealants, much of this disease could be prevented.

Silent, invisible, and hidden are three words ABC used describe this oral health crisis.  We’re working to change that.

Is Your Health Plan “Reform Ready” for Dental?

By Dennis Leonard

If you’re with a health plan, it’s a pretty sure guess you’ve spent many hundreds of hours over the past 18 months studying the Affordable Care Act to understand how it will impact your business. I know that because we’ve spent that much time and more studying the ACA’s dental mandate for children, and how it will impact our dental benefit business and the relationships we have as the third party dental administrators for our health plan clients. The ACA requires an additional 27 million children be covered by dental insurance in 2014. Many of these children are considered “high risk” and have been without dental insurance coverage and oral care. This fact will surely impact the business of health plans across the country.

What are the implications of this mandate for health plans? What are the components of dental benefits design both on the front and back end that health plans should be aware of?

We can answer these questions. Next Tuesday, April 24th, DentaQuest will host a webinar to address the oral health implications of health care reform and advise members of America’s Health Insurance Plans (AHIP), the national trade association representing the health insurance industry, how to best manage them.

The session will guide health plan executives on reevaluating whether their health plan business is reform ready for dental, and will feature our in-house experts in dental benefits administration, market intelligence, and management of clinical outcomes with higher-risk populations.

By the end of the webinar, participants will be armed with good information to guide their strategy for incorporating dental, or expanding their dental benefits offerings while meeting the requirements of the ACA’s dental mandate for children.

This free webinar is also available to the public, so please, register here!

Association? Causality? Can’t We All Work Together for Optimal Health??

By Dr. Doyle Williams, Chief Dental Officer
Dr. Linda Vidone, Dental Director and a practicing periodontist

You probably saw this in the news: The American Heart Association (AHA) issued a “scientific statement” that there is no conclusive evidence that periodontal disease causes or increases rates of cardiovascular illness. They came to this conclusion after a 3-year analysis of some 600 studies by an expert committee, led by a dentist and a cardiologist. The statement was endorsed by the American Dental Association Council on Scientific Affairs.

Wow! For decades, dentists, periodontists and researchers have been talking about a link between gum disease and heart attacks or stroke.

The AHA statement did note that “the two disorders (periodontal disease and heart disease) share a number of common risk factors, including-- cigarette smoking, age, and diabetes mellitus.”

Here’s what the American Dental Association said about this:
Although there is research showing that gum disease is associated with several other health conditions such as heart disease, stroke and diabetes, just because the two conditions are associated with each other doesn’t mean that one causes the other.

The difference is association and cause.

Here’s our take on this.
1. Both periodontal disease and cardiovascular disease are complex conditions that are influenced by multiple factors (cigarette smoking, age, and diabetes). The two diseases develop over time.
2. There is a common element to both diseases and that is inflammation.
3. Treating moderate to severe periodontal disease to the point where the clinical signs of the disease (puffiness and bleeding) are reduced also reduces indicators of inflammation in the system (like C-reactive protein, fibrinogen and white blood cells).
4. In untreated periodontal disease, certain bacteria found in pockets around diseased teeth are very similar to bacteria found in swelling in the artery wall.
5. There are studies that show if you reduce the body’s inflammatory burden, you reduce the risk of heart attack.

Cause or Association? Does it really matter?
Periodontal disease means there is unhealthy bacteria inhabiting your gum tissue. Your mouth is a gateway to the rest of your body. Doesn’t it make sense that if you control the bacteria causing inflammation in your mouth, you are healthier overall.

Be sure to point out any puffiness or bleeding in your gums to your oral health professional and your physician.

And, don’t use this study as an excuse to slack off in your home health habits. You still have to brush and floss every day.