Oral Health Literacy and Health Equity

By Ralph Fuccillo, DentaQuest Chief Mission Officer

Nearly nine out of ten U.S. adults find it hard to use the health information they get from their dentist or doctors’ office, in the media and even in their communities.¹

 

That is a real problem.

Limited health literacy leads people to incorrect conclusions about helpful oral health actions -- like community water fluoridation, eating a healthy diet, brushing and flossing every day, even getting regular preventive dental care visits. Limited oral health literacy is a contributor to the growing number of very young children (age 1-5) with Early Childhood Caries – aggressive dental disease –in need of repair (root canals and crowns) in operating rooms. Health literacy is something we all need to pay more attention to – as consumers, care providers, and public health advocates.

I am pleased to see that oral health literacy is gaining importance as a public health priority. Last year, I had the honor of joining a number of key national oral health leaders at the Institute of Medicine (IOM)’s Roundtable on Health Literacy. Oral health is now included on the IOM Health LiteracyRoundtable through the participation of the California Dental Association. The oral health literacy roundtable explored ways to bring oral health literacy research into oral health practice, and to do this in a way that everyone can understand. As a speaker, I had four key messages:

• The mouth is part of the body
• Cavities and gum disease are the result of a bacterial infection in the mouth
• Dental disease is preventable
• Oral health literacy is everybody’s business

As part of my presentation, I also spoke about my personal experience volunteering at a Mission of Mercy free clinic in rural Virginia. It is impossible to overstate the desperation and gratitude that I saw. I left with a different perspective on our current care delivery system. People are being left behind. People don’t have the information they need to be healthy.  

This experience motivated me to become involved in the establishment of the US National Oral Health Alliance and the DentaQuest Foundation’s multi-year Oral Health 2014 initiative. Both work to improve oral health literacy, and ultimately, the oral health of all.

In June 2012, the U.S. National Oral Health Alliance hosted a national learning event focused on Oral Health Literacy as a Pathway to Health Equity. Participants worked to develop common ground messages about oral health literacy that we can all work to achieve. I share them below because they are simple, yet so important. I hope you will consider using them in your work and your lives.

• Everyone has a stake in oral health literacy.
• Health literacy is based on genuine compassion and care. We all need a sense of empathy to meet people where they are, to listen to, learn from, and respect one another
• Prevention is the starting point for health.
• We need to use simple, clear and consistent educational messages if we are to motivate action to improve their oral health. It is important to be patient-centered and respectful of cultures, languages and customs.

1.     Kutner M, Greenberg E, Jin Y, Paulsen C. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). U.S. Department of Education. Washington, DC: National Center for Education Statistics; 2006.

Bacteria in the Mouth are Not Harmless

By John Luther, DDS, Chief Dental Officer, DentaQuest

As a dentist, one of the first things I tell new parents is not to put something that has been in your mouth into your baby’s mouth.

So you can imagine my surprise when I heard about a Swedish study, which found that babies whose parents sucked on their pacifier to cleanse it were less likely to get eczema and asthma, two conditions caused by allergic reactions. 

The study concludes that when parents suck their child's pacifier clean, they transfer some of the harmless bacteria in their mouths to their child which makes those types of allergic reactions less likely. 

Despite this study, there is significant other research that shows that not all bacteria in the mouth are harmless. 

Cavities (caries) are the result of a bacterial infection and young children can “catch” the harmful bacteria that causes cavities. While everybody has bacteria in their mouth, it’s important to try to keep these harmful bacteria from our children’s mouths during their first year or two or they become the dominant bacteria and the child could experience a lifetime of tooth decay.

Babies most often get these bacteria from a family member who has the bacteria in his/her mouth. Cavity-causing bacteria in the adult’s mouth can be transferred easily to a child’s mouth through something as harmless as testing food to be sure it isn’t too hot, sharing a spoon of ice cream, “cleaning” the pacifier that fell on the floor in your mouth, biting off a piece of apple to share with a child, even kissing. If cavity causing bacteria are transferred to the child too early, they can be dominant for life.

Tooth decay is the most common chronic disease of childhood. It is five times more common than asthma. Untreated, tooth decay can have serious, negative effects on a child’s physical and educational development. Mouth pain makes it difficult to eat a healthy diet, to learn to speak properly, and to concentrate in school. Untreated tooth decay in baby teeth can damage a child’s permanent teeth. 

We need to remember there are a lot of studies out there. Occasionally doing something helpful in one area can cause harm in another. Early tooth decay can quickly put kids at a lifelong disadvantage. Taking care to reduce the risk of transmitting cavity-causing bacteria to babies and toddlers will better position them to fight off tooth decay as they grow.

How Data Analytics Creates Value in Dental Care

By: Shaju Puthussery, Chief Analytics Officer

As components of the Affordable Care Act (ACA) go into effect, dental benefit management is keeping pace. Health plans need a dental partner that provides products and services at attractive prices, but also one with experience in commercial and government spaces, as well as on a public exchange. And perhaps most importantly, a dental benefits partner should have the ability to go beyond claims processing into deep data analytics that create cost savings – including the potential for lower premiums – as a result. This new model goes beyond claims adjudication to collaborative engagement with providers and patients. 

In  order to gain cost savings from these partnerships, plan administrators must be able to understand and predict provider and patient behaviors and then put these assessments into action. Data analytics are the key to understanding those behaviors. With the right kind and amount of data, we can build predictive models that ultimately result in better quality of care from providers and better oral health outcomes for patients. That’s a win-win under any circumstances. But add to that the ability to control costs, and you can see why data analytics are a necessity for success in the world of consumer-driven healthcare.

Not every dental benefits organization can leverage data effectively, though. To create effective predictive models, you must start with a wealth of data. DentaQuest, for instance, has access to many years of data from more than 18 million members and thousands of providers. This is where effective modeling begins, as we use external data coupled with claims pattern data and provider utilization data. 

To find out more about how data analytics creates cost savings, sign up for our America Health Insurance Plan (AHIP) webinar, titled “Health Reform Dental Mandate and What It Means to You: The Role of Data Analytics In Value-Based Healthcare.” The webinar is on Wednesday, May 8, 2013 from 2 p.m. to 3 p.m. ET and offers an opportunity to ask our on-staff experts about dental benefits, data analytics, and how to create value in the new healthcare environment. Register today by visiting http://ahip.org/Webinar/DentalMandate/.

With the changes resulting from ACA mandates, health plans are looking for ways to differentiate themselves from competitors. Integrating high-quality dental benefits into their products is an excellent way to do this and an effective strategy to retain and grow membership.