In National Minority Health Month, Oral Health for All.

By: Ralph Fuccillo, DentaQuest Chief Mission Officer; Co-chair, Health Equity Council for Region 1

We, as a nation, are committed to principles of fairness, diversity and inclusion.  Those principles guide our commitment to reject discrimination or harassment.

As a leading oral health enterprise, DentaQuest strives to honor the differences among people, especially cultural and linguistic differences, in all our interactions.  When we celebrate differences, we provide better dental benefits management for all our clients, we provide more effective resources to our community-focused work of our Foundation, and we improve the clinical care of people wherever our Institute’s programs are implemented.  DentaQuest’s mission explicitly states we are focused on improving the oral health of ALL.  In the business of oral health, it is hard to miss the fact that not everyone is included in ALL.

Recognizing that there are disparities in health care is critical to understanding how compelling our mission really is.  Think for a minute – should any child be relegated to a troubled life based on his or her lack of connection to health care?  Yet some, mostly children in communities of color and especially those who are poor, bear a greater burden of oral disease throughout their entire lives.   Health disparities make it certain that those who already carry heavy life burdens will also suffer with persistent mouth pain, diminished economic opportunities, and diminished overall life expectancy.   

That is why we applaud the National Office of Minority Health as they launch an online oral health curriculum that provides guidance on delivering culturally and linguistically appropriate services to better meet the needs of our increasingly diverse communities.  It will be an important resource for health professionals across the clinical care spectrum and a helpful addition to the work of other groups, such as  the National Interprofessional Initiative on Oral Health whose “Smiles for Life” Curriculum has been endorsed by multiple clinical care professions, and also the DentaQuest Institute’s Online Learning Center where learning modules emphasize oral disease prevention and management.

The Oral Health 2020 campaign that the DentaQuest Foundation announced earlier this year echoes the voices of people in communities who challenge all of us to “raise the bar and close the gap” in oral health inequality.  The Oral Health 2020 goal that intends to have 75% of all children reach age 5 without a cavity by 2020 doesn’t seem like much of a stretch: 70% of children across the U.S. already reach age 5 without a cavity.   As we dig deeper and look into what those numbers tell us, we find that differences across socioeconomic status, race, and ethnicity, make that 70% threshold less reliable.  We have to consider everyone – All.

We can all get behind the Oral Health 2020 campaign goals by better understanding the data and determining where disparities are greatest. We continuously promote awareness and understanding of how culturally competent literacy programs can advance the work of everyone as we focus on the importance of oral health in itself and to overall health.  We are seeking out culturally and linguistically focused community partners to work with us to reach communities where disparities persist, and collectively, we are developing strategies that will bring all children to our target goal.

We hope that 75% of ALL children reach age 5 without a cavity by 2020.   Let’s close the gap and create a country where we are proud to claim that there is equity in oral health, as we work to prevent disease and make access to care more available for those who need it.

DentaQuest Institute ECC Virtual Learning Session a Success

DentaQuest Institute launched Phase III of its Early Childhood Caries (ECC) Collaborative, which will ensure that every child aged six months to five years that visits partnering clinics receives a comprehensive caries (cavities) risk  assessment, and those who have an increased risk of developing cavities  receive the necessary care to prevent and manage oral health issues.

The ECC Collaborative, which launched in 2008, aims to eradicate ECC by educating parents and caregivers about the importance of preventive care for young children. Phase III is an 18-month initiative that builds on Phases I and II which first assessed the overall problem and needs at partnering hospital and dental clinics and then tested the proposed protocol. Now, with 33 teams participating across the country, Phase III puts the protocol into action by maintaining contact with children and their parents to ensure the children are receiving proper treatment.

The ECC Phase III Collaborative held its first virtual learning session last week, during which the Collaborative’s partners presented their progress to date, learned quality improvement skills and attended workshops about charting, scheduling, and working with patients and caregivers. The Institute chose to host the two-day session online so that participants could stay at their site and participate with other staff members who otherwise might not be able to attend an in-person meeting.

Dr. Brian Nový, director of practice improvement at DentaQuest Institute, led a session addressing the ongoing debate about fluoride. According to Dr. Nový, while the FDA considers fluoride a drug, the fluoride concentration found in toothpaste is at the optimal level for daily use. He assured attendees that if parents monitor their child’s tooth brushing through age 6, as suggested by dental professionals, they can make sure their child is using it properly and reaping the benefits. Dr. Nový also said that the warning label on toothpaste gives the wrong impression to concerned parents, as it is highly unlikely a child will ingest enough toothpaste to be considered poisonous.

Dentists use topical, localized fluoride in a very specific amount to lower disease rates in high-risk mouths. Many dentists agree that fluoride, which can decrease tooth decay by almost 50%, played a large role in reducing the amount of tooth decay in the United States.

Dr. Nový recommended that parents maintain an open line of communication with their dentist and share questions or concerns so that the dentist can help them benefit from the latest science and have the most enjoyable experience possible.

For more information on fluoride and how to use it properly, visit our Oral Health Library.

There are many resources for understanding community water fluoridation and the science behind it at http://www.ilikemyteeth.org/

Friday Dental Download: April 25, 2014

This week we are reminded of the importance of Oral Cancer Awareness Month, talk about dental insurance under the Affordable Care Act, and see a kid who is lucky enough to have the Batman logo in his mouth. Join the conversation on Twitter using #FridayDentalDL.

      1.    Obamacare and the dental industry: Part I

The Affordable Care Act declared pediatric dental insurance an essential health benefit, stating that all children under the age of 18 must be covered to combat the increasein tooth decay in American children. However, adult dental insurance was left out of the law even though more than half of US adults suffer from periodontal disease. To learn more about how to get dental coverage in your state, visit dentaquest.com.

      2.    5 things dental professionals need to know about oral cancer

April is Oral Cancer Awareness Month and this article reminds both dental professionals and patients that it’s vital to be screened for oral cancers at your biannual dental checkup. It is estimated that 42,000 Americans will be diagnosed with oral cancer this year alone. Know the symptoms of oral cancer and if you notice anything out of the ordinary in your teeth, gums, tongue or throat, schedule an appointment with your dentist immediately.

      3.    Study finds higher cavity rates in toddlers of mothers with low vitamin D

A new study found that children born towomen with low levels of vitamin D during pregnancy are more likely to develop cavities than those born to women with adequate levels of vitamin D. The flesh of fatty fish and fish liver oils are among the best sources of vitamin D. For more information on oral health during pregnancy, check out our Oral Health Library.

      4.    Boy’s tooth gap resembles Batman logo

We cracked up at this tweet by a man whose friend texted him a photo of his son whose front gap resembles the batman logo. Take a look and decide for yourself!

Friday Dental Download: April 18, 2014

This week, we learn about a new laser that could eliminate the use of drills in the dental office, discuss the need for better dental care for older Americans, and learn just how long a tooth can last. Join the conversation on Twitter using #FridayDentalDL.

1.    Dental laser from Convergent Dental gets funding, raves

The FDA approved a new laser, created by a Massachusetts-based dental technology company that could eliminate the use of needles and drills in common dental procedures such as fillings and shaving teeth to be fitted for crowns. The creator says that the laser eliminates the “fear factor” for patients, allowing them to better provide preventive dentistry.

2.    Program targets oral health of older adults

A 2013 study found that 23 percent of older adults have not seen a dental provider in five years and 70 percent do not have dental insurance. Of those seniors without dental insurance, 70 percent could not pay for a major dental procedure. Oral Health America’s Wisdom Tooth Project was created to advocate for the oral health of older Americans and educate them on the importance of good oral health. Read more about DentaQuest CEO Fay Donohue’s discussion with Oral Health America on the issue of financing oral health care for older Americans here.

3.    Q&A on Tooth Decay in Children

Dental disease is the most common chronic childhood disease, and is five times more common than asthma. This Q&A with a pediatric dentist at the University of Maryland provides information for parents and caregivers about proper oral hygiene for children and what to expect at dental checkups. For more tips on caringfor your child’s teeth, check out our Oral Health Library and our recent Q&A with Dr. Brian Novy on the best toothpaste for your teeth,

4.    How long do teeth last?

One curious reader asked and the New York Times answered: teeth can survive for many millennia. For example, in 1994, an expedition in Ethiopia found a tooth from a pre-human species that dated back 4.4 million years. The writer reports that the heavy mineralization and dense crystalline structure of tooth enamel make teethmore durable than bones.Make sure you are caring for your pearly whites- who knows where they’ll be in 4 million years!

5.    Finally, Someone Rapped About Dental Hygiene

Check out this University of North Georgia student rapping about good oral hygiene to the tune of “Ice Ice Baby.” He even reminds listeners to stay away from sugary treats. Our only recommendation: instead of telling listeners to brush “forcefully,” we suggest that they brush gently so that they do not damage their gums.

Q&A With Dr. Brian Nový

We caught up Dr. Brian Nový of the DentaQuest Institute to get the answers to some of our questions about how to determine and prevent risk.

1.    What do you think of the Justin Bieber toothbrush?

A.    “Is it ADA approved?  Then I like it.”  The ADA seal tells you the toothbrush is effective.

2.    Do you see any signs my mouth is acidic?

A.    Acidic mouths are more prone to certain diseases like caries.  Basic mouths are more prone to form tartar.

3.    Do you floss?

A.    Some people don’t need to floss.  This honest discussion improves rapport with the dentist.  They will tell you if you are one of the lucky ones to don’t need to floss… although those people aren’t as common as you’d hope.

4.    What toothpaste is best?

A.    Choose your toothpaste based on flavor.  If you like the flavor, you’re more likely to use it.  Also look for a toothpaste with the ADA Seal of Acceptance.  This means the toothpaste does what it says on the box.  If it doesn’t have the ADA seal, the claims on the box have not been evaluated by independent dental researchers who are on the ADA Council of Scientific Affairs. 

5.    Which toothbrush do you use?

A.    Many people think dentists would use an expensive electric brush, but you may be surprised to find that they use the same brush they give you after an appointment.  That’s not just a goody bag…. It contains products your oral health team thinks would benefit you best. Sometimes you get the same brush the dentist uses, other times they may recommend a specially shaped brush or even a power toothbrush.

6.    Tell me about the candy that doesn’t cause cavities.

A.     Candy containing xylitol actually fights cavities and changes the bacteria that grow in your mouth.  Now there’s a taffy for you to eat right after you brush that fights cavities.  

7.    Can I brush less?

A.     Brushing your teeth may seem tedious and inconvenient.  Your oral health team can help you find ways that make it easier for everyone.  They can tailor your oral hygiene routine to fit your unique needs. 

8.    Do I qualify for the no flossing policy?

A.     When patients bring up questions like flossing, it tells the oral health team, “This patient deserves special attention.” It may surprise you learn some recent research indicates that flossing isn’t for everyone.  This relates to the new trend in dentistry which is to practice evidence based dentistry.

9.    Why do I have cavities?

A.     Cavities are a disease that can be difficult to stop once it’s begun.  New therapies are being designed to stop the infection that causes tooth decay, and sometimes the dentist can remineralize the teeth rather than fill them. 

10. Can you put a protective coating on my teeth so I won’t get cavities?

A.     There are special varnishes that can be applied after a cleaning to help prevent cavities.  Varnishes with calcium, phosphate, protein, fluoride, and chlorhexidine allow your dentist to help your mouth remain healthy.  They can be reapplied more frequently if you need extra protection.

Friday Dental Download: April 11, 2014

This week, we hear from DentaQuest’s CEO about the need for adult dental plans on the exchanges, learn about a new teledentistry program and find out why mouthwash may be detrimental to your oral health.Join the conversation on Twitter using #FridayDentalDL.

1.       Industry: Adults Should Be Able To Buy Just Dental Plans Via Exchanges

Fay Donohue, CEO and president of DentaQuest, spoke with Inside Health Policy about the need for adult dental plans on health exchanges. Here’s an excerpt:

“Fay Donohue, president and CEO of DentaQuest, which is offering dental plans in Florida, Virginia, Texas and Maryland, was also happy to see so many adults buying family and individual coverage. "There has been a lot of focus on pediatrics, which is great, but the SADPs are able to offer adult coverage through exchanges as well and we're seeing a lot of interest in those products. DentaQuest would love it if adults who already have a medical plan could go to the federal or state-based exchange and purchase a dental plan," Donohue says. "We hope to see it happen sooner rather than later," she adds.

To learn more about dental plans on the marketplaces, visit http://www.dentaquest.com/marketplace/.

2.       When Connecting With A Dentist Doesn’t Mean An Office Visit

A new “teledentistry” program in California allows low-income patients to be treated by hygienists and dental assistants in classrooms, nursing homes and other community centers to perform basic preventive procedures on patients.If necessary, the patient is then referred to a dental office for further care. The program, called the “Virtual Dental Home Demonstration Project,” has launched in 50 locations throughout the state and is currently funded by grants and non-profits, but a bill pending before the state Legislature would expand the program statewide and require Medi-Cal to pay for procedures. This aligns with DentaQuest Foundation’s Oral Health 2020 initiative to eradicate dental disease in children by incorporating oral health into the primary education system by the year 2020. Learn more about how DentaQuest Foundation is working to achieve its goal here.

3.       Mouthwash And Poor Dental Hygiene May Up The Risk Of Oral Cancer

A recent study found that poor dental hygiene and excessive use of mouthwash containing alcohol could increase the risk of oral cancer. The article reports that 40,000 Americans are diagnosed with oral cancer each year, which resulted in 7,890 deaths last year alone. To learn more about how to recognize symptoms of oral cancer, check out our Oral Health Library.

4.       New charting system seeks to revolutionize malpractice prevention for dentists

A new charting system for dentists called the “Ideal Charting for General Dentists” (ICGD) system has been launched to minimize confusion in diagnoses and processes, as well as diminish malpractice in the industry. According to the article, the new system will update charts and progress notes without any additional effort on the dental practitioner’s part.

5.       Canadian Dentist Wants to “Own John Lennon’s DNA” and Raise Him as a Son

Dr. Michael Zuk, a Canadian dentist who bought one of John’s teeth at an auction for over $30,000 in 2011, recently stated on the British television show “Dead Famous DNA” that he’d like to use the DNA in Lennon’s tooth to clone the late musician and raise him as his own son. Whether this is actually a possibility remains to be seen, but Dr. Zuk seems pretty adamant about it, stating that he’d try cloning Lennon multiple times if necessary.

Talking to Your Dentist About Risk

By Dr. Brian Nový, DDS, FADI

We talk a lot about what you can do to reduce your risk for dental disease, like brushing and flossing, eating sugar-free candy, and scheduling regular dental check-ups. Now we thought we’d tell you what your dentist will do to identify your potential risk for dental disease. At DentaQuest, we support a specific risk assessment model called Caries Management By Risk Assessment (CAMBRA). The idea behind this assessment model is to treat each patient with the type ofcare that is best for that patient as opposed to a one-size-fits-all preventive plan.  Each patient is unique. The risk assessment allows your dentist (and the whole oral health team) to customize your “at home” self-care to your individual needs. For example, your dentist will determine if your oral health (or oral disease) is attributed to your saliva, certain bacteria, your diet, your tooth brushing technique, or any of the other factors that play a role in your specific health and/or disease. 

As part of this, your dentist should be asking you about how you take care of your mouth.  Be prepared to discuss the specific type of products you use at home, and don’t be afraid to bring your toothbrush, toothpaste, mouthwash, and floss to an appointment - your dentist can help you determine if these are appropriate products for you.  If you seem to repeatedly get cavities, you probably need a more customized plan and possibly different products. Sometimes it may mean you can simplify what you are doing at home.

A question that every dentist should be asking is, “What is your beverage of choice?”  Your dentist can tell a lot about the physiology of your mouth based on what you like to drink.  Patients who drink water usually are at lower risk of dental disease, while patients who drink coffee with cream and sugar all day are at an increased risk.  Patients who drink energy drinks or soda throughout the day are at an increased risk too. 

[Dr Nový is the Director of Practice Improvement at DentaQuest Institute, and an international thought leader in the science of dental caries management and evidence-based dentistry.]

Friday Dental Download: April 4, 2014

This week, we learn the secrets to creating a successful safety net dental program, discuss DentaQuest Foundation’s recently-launched initiative and find out what sport causes the most dental-related injuries.Join the conversation on Twitter using #FridayDentalDL.

      1.    How to create and manage a successful safety net dental program

DentaQuest Institute’s Dr. Mark Doherty was featured in DentistryIQ this week discussing key factors in the success of a safety net dental program. The DentaQuest Institute’s Safety Net Solutions program works with safety net dental programs to provide high-quality dental care. Dr. Doherty’s article highlights the importance of monitoring performance by collecting data on a variety of factors, such as no-show rate, number of visits and percentage of completed treatments. For more information on DentaQuest Institute’s Safety Net Solutions program, visit dentaquestinstitute.org.

      2.    Oral Health 2020 program seeks to end dental disease in kids

DentaQuest Foundation launched its Oral Health 2020 initiative last month, and DrBicuspid caught up with Dr. Mike Monopoli and Brian Souza to learn more about the program. The goal of Oral Health 2020 is to ultimately eradicate dental disease in children and improve oral health across the life span. DentaQuest Foundation is creating a national network of grantees, partnersand oral health advocates who are making strides in improving the oral health in their communities.

      3.    Oral Cancer Foundation sponsors Oral Cancer Awareness Month

Did you know that April is Oral Cancer Awareness Month? Oral cancer includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth. Use of tobacco is the most common cause of oral cancer, and according to the Oral Cancer Foundation, 43,250 people in the US will be newly diagnosed with oral cancer in 2014. Schedule an appointment with your dentist to get screened this month.

      4.    N.C.A.A. Players Ignore Advice on Mouth Guards, Often at Their Own Peril

      With March Madness on everyone’s minds this week, we wouldn’t be doing our jobs as oral health advocates if we didn’t warn of the dangers of playing basketball without a mouthguard. Although stars like LeBron James, Kevin Durant, Dirk Nowitzki and Stephen Curry use them, most college players go without. A 2007 study in the Journal of the American Dental Association found that men’s basketball had the highest rate of dental injury (nearly 11 injuries per 100 athletes) among all sports, yet the NCAA still has not mandated the use of mouthguards.

      5.    Study: ER visits for dental problems cost nearly $1B a year

According to a new study in the Journal of the American Dental Association, emergency department (ED) visits for dental-related problems cost nearly $3 billion between 2008 and 2010. The report also states that the majority of those seeking dental care from EDs were lower-income patients without insurance. 57% of these visits were related to dental caries, which are almost completely preventable with preventive care. To learn more about how to avoid dental caries, visit our Oral Health Library.

      6.    London skeletons reveal secrets of the Black Death

According to the Washington Post, molars taken from skeletons unearthed by work on a new London railway line are revealing secrets of the medieval Black Death, and of its victims. Scientists tested molars from the twelve skeletons and found the presence of the plague bacterium, Yersinia pestis, in several of the teeth. They think the individuals had been exposed tothe Black Death, which is thought to have killed at least 75 million people. You sure can learn a lot from a tooth!

Florida Mission of Mercy a Huge Success

By Dr. Douglas Manning, Regional Executive Director, DentaQuest Florida

Eight members of the DentaQuest Florida team volunteered along with many other dental providers and non-dental volunteers from around the state and country to support the Florida Dental Association’s Mission of Mercy (MOM) clinic in Tampa over the weekend. Over 1,600 children and adults received dental cleanings, extractions, fillings and root canals.  The event provided over $1 million of free care.

Struggles with access to affordable oral health care are a documented challenge in Florida, and events like this Mission of Mercy are one of the few options for those unable to access care. A recent study found that more than 139,000 Floridians were treated in 2012 in hospital emergency departments for oral health problems that could have been treated in a dental office or clinic, or avoided altogether with preventive oral health care.

DentaQuest would like to thank the Florida Dental Association and its Foundation for all their hard work in organizing the event.  The DentaQuest team was honored to be a part of an event that provided much needed care to so many. While we acknowledge that these Missions of Mercy free care clinics are a poor substitute for regular, ongoing oral health care, our team is ready, willing and able to participate in future events like this.