Who Knew? Oral Health and Diabetes

By Dr. James E. Thommes, Vice President, Clinical Management, DentaQuest

On the tails of American Diabetes Month and ahead of the New Year, we want to take a moment to raise awareness about the disease that impacts nearly 30 million children and adults across the United States. And, frankly, diabetes is an even bigger epidemic than that statistic reveals - another 86 million Americans have prediabetes and are at risk for developing type 2 diabetes.

So what’s the connection between diabetes and oral health? 

Many people don’t know that there’s actually a very direct connection between diabetes and oral health. People with diabetes may experience more severe periodontitis, otherwise known as gum disease, because diabetes lowers the body’s ability to resist infection and slows healing.

Additionally, gum disease can make diabetes more difficult to control as blood sugar levels spike throughout the body. People with diabetes can also experience thrush, a mouth infection, among other oral health issues.

The millions of Americans across the country with diabetes already have a lot to manage, but it’s important to also remember dental hygiene, since it’s so directly connected to the disease. Health care providers, advocates and other stakeholders have an important part to play when it comes to raising awareness of diabetes and its connection to oral health, along with helping diabetics manage the disease.

How can we shine the light on the connection between diabetes and oral health?

At DentaQuest, we are helping bridge the gap of understanding, and the gap between dental and overall health. One key way to achieve this is by teaching dentists to uncover possible signs of diabetes during routine dental exams. Dentists can play an important role in spotting undiagnosed diabetes and helping manage the oral health effects of the disease.  

On the other hand, if a physician spots the disease first, he or she can educate the patient about its potential impact on oral health, too, and the important steps the patient should take to maintain oral health.

Another key strategy to spotlight the connection between diabetes and oral health is through consumer education. With a new diagnosis of diabetes occurring every 19 seconds in the U.S., we also must educate consumers and raise awareness beyond American Diabetes Month.

With this in mind, we encourage you to share information about the topic including our free infographic flyer and answers to common questions about the connection between oral health. 

Taking it to the Next Level: Moving from 4 to 6

By Ralph Fuccillo, MA, President, DentaQuest Foundation

In late October, we hosted our third annual Oral Health 2020 National Network Gathering – where more than 250 partners from all 50 states came together to assess the state of oral health and to further the growth of the network and collective efforts to improve it. During our time in New Orleans, our grantees and partners were focused on challenges we still face, best practices to move the the needle on oral health, and how to better engage their local communities and enact social change.

We also heard from leaders who challenged us to think even more broadly about the national oral health movement, consider new ways to improve oral health and work collaboratively with all stakeholders. Paul Schmitz, CEO of Leading Inside Out, led an exciting discussion about collective impact and encouraging leadership from unconventional sources. Mr. Schmitz presented an interesting reframing of moments in our history where the emphasis on the actions of one leading individual allowed us to overlook the value of the collective actions by multiple people.

Dr. Camara Jones, Senior Fellow at the Satcher Health Leadership Institute, Morehouse School of Medicine, and President-Elect of the American Public Health Association, shared thoughts and learning on racism and the social determinants of health as critical components of attaining oral health equity.   Her suggestions to promote population health and prevention in the context of health equity were affirmed by the Foundation’s approach to changing systems by including all voices in the conversation. 

Many of our grantees were able to discuss their own challenges and progress with Paul and Dr. Jones, and their keynotes provided stimulating dialogue for the remainder of the event.

From exciting dialogue to crucial problem-solving, there were many important moments at the convening. But, I wanted to highlight one of my favorites. Among our partners, we debuted the updated Oral Health 2020 goals, which now include six goals aimed at eliminating oral health disparities and improving oral health across the lifespan. 

We raised the stakes by:

• Upping the target for our first goal: 85% of children will reach age five without a cavity
• And adding two new goals:

1.       Oral health will be integrated into at least 50% of emerging person-centered care models.

2.       The public perception of oral health will be improved by increasingly including it in health dialogue and public policy.

Across the lifespan and across the nation, we envision a world where oral health is valued as essential to overall health. The Oral Health for All 2020 Network has crafted a strategic roadmap that is comprehensive of all areas that impact oral health. These goals will continue to drive far-reaching impact, engage communities and shape improvements at all levels of health policy, care and access, along with financing methodologies.

The growth to six achievable goals can only happen through a network of leaders who are committed to and focused on the promise of collective impact principles and culture. We are grateful for so many dedicated partners!  

You can learn more about the work of Oral Health 2020, and our grantees and partners by visiting our website, or following us on Twitter, @OralHealth2020.

Integrating Dental and Medical Care: MORE Care, More People

By Steve Pollock, President and Chief Executive Officer, DentaQuest

It’s no secret that millions of Americans lack access to basic oral health care. According to the American Dental Association, 181 million Americans don’t visit a dentist in a given year and nearly half of people over 30 suffer from various forms of gum disease. This is a significant issue plaguing Americans across the country.

And, those who live in rural areas can experience higher rates of poverty, lower oral health education, dental provider shortages and a scarcity of dependable transportation, providing even more barriers to receiving basic dental care. This culmination of factors is creating significant gaps in our oral health care system, leaving many without services they need.

So, what is the solution?

Well, for starters, we need to prioritize medical-dental integration. Under this model, dental and primary care providers alike would take an integrated approach to diagnosis and treatment of patients.

To provide an example, primary care practices would be trained to identify and manage oral health needs for their patients, and also appropriately refer and collaborate with dental partners. Similarly, if a patient went for a routine dental check-up and showed signs or risk of diabetes, the dentist would then refer them to a primary care provider for a closer look.

By training providers in both practice worlds to conduct simple screenings and spot specific signs, we can identify and thus address health issues more quickly. And, in the healthcare system of tomorrow, a connected, efficient network can help identify and address preventable diseases earlier on, while also expanding our reach in underserved communities and improving cost efficiency.

Does medical-dental integration work?

The thinking behind this type of integrated approach is exactly how the MORE Care (Medical Oral Expanded Care) initiative came to life. MORE Care is a pilot program launched by the DentaQuest Institute that connects doctors’ offices with the resources and training to provide preventive oral health services in South Carolina. It also connects medical and dental teams to establish a referral-based system for patients.

Through these efforts, MORE Care has already been able to access rural populations, bringing them reliable, preventive care that previously was difficult to obtain.

Using a phased approach, the DentaQuest Institute, in partnership with the South Carolina Office of Rural Health and Medical University of South Carolina, is initiating pilots of this program throughout the state that build oral health into primary care, while also laying the foundation for dental care referral networks.

In its first year, we’ve worked with six rural primary care practices to collaborate on solutions, test strategies to effectively deliver preventive oral health services, communicate with dental providers and identify best practices for the future of this program.

We’ve also expanded our partnerships (working closely with the South Carolina Dental Association) to enhance the program. 

Will there be MORE Care in the future?

So far, the results are promising – we are reaching underserved patient populations with integrated care and learning lessons to help us improve the program as we look to expand it. We hope to have significant data and insights early next year to inform our efforts to grow our reach.

As all of us in healthcare search for efficient solutions that achieve high-quality results, establishing medical-dental integration programs will allow providers to deliver care to the whole person, reach a patient population in significant need, and ultimately help control healthcare costs. 

Teledentistry: Bringing Oral Care to You

By Dr. Rob Compton, DDS, President, DentaQuest Institute, and Chief Dental Officer, DentaQuest

Telemedicine, telehealth, teledentistry? Billboards are talking about the first two, advertisements are featuring them, and commercials are promoting them. Virtual health care is here, if only in its early stages. Gone are the days when seeking medical care automatically equated to travel and missed school or work. Providers and patients alike want and now can more easily access necessary, quality care virtually.

But what does an age of virtual health mean for oral health care? That third word: teledentistry.

Though largely preventable, dental caries, also known as tooth decay, remains the most common chronic disease of children ages 6 to 11 and adolescents ages 12 to 19. But the damage doesn’t stop there. Roughly 90 percent of adults over the age of 20 show some degree of tooth decay.

Untreated tooth decay can lead to other serious and long-lasting complications, including bodily infections and heart disease. This is why teledentistry is such a unique and important opportunity to improve patient care, dentists’ reach, and the oral health of all.

What better way to improve access for underserved communities than to go straight to the person? Through the use of teledentistry, members of the dental team (namely dental hygienists and assistants) are traveling to schools, community centers and nursing homes to perform routine check-ups with virtual oversight from a remote dentist.

School-based oral health screenings, routine check-ups, educational programs, and delivery of preventive care are proven methods for setting kids and adults up for success. An established relationship between a child and a dental care provider leads to:

• Improved oral health habits
• A link to the child’s family members, who otherwise may not have access to care
• Better overall health for both the child and the community at large

But how does this really play out? Let’s take a look at California. California was one of the first states to pioneer an innovative approach to using teledentistry to increase access to care. Designed to reach people in underserved areas around the state, the Virtual Dental Home program offers dental services in community settings like schools and nursing homes.

As part of this demonstration by the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry (Pacific), hygienists and assistants perform routine exams and certain services with supervision by a remote dentist responsible for setting the appropriate treatment plan. Two thirds of those served by the VDH pilots were able to receive all of their care in community settings.

In its first three years, the demonstration program will bring care to 20 communities and benefit nearly 20,000 children and adults across the state.

For every dollar spent on preventive dental services, an estimated $50 is saved on more expensive and complicated procedures, according to California Dental Association President Dr. James Stephens, who spoke about this program during a recent PBS interview.

That cost savings statistic is a great example of what states can achieve when they support preventive care and expand access to dental care. Demonstration programs are already indicating that wider adoption of models like the Virtual Dental Home will continue to break down barriers to access, ultimately resulting in more cost-effective and prevention-focused dental care. The next step for California is to work with the oral health community to encourage wider adoption of the VDH model.

This model for delivering care in the community also allows dentists to fill valuable chair time with patients in need of more comprehensive restorative services at the same time that their dental team is out in the community providing routine preventive care.

We all look forward to a future where everyone has access to all critical services, regardless of where they live. Well, that future begins now. Virtual health care is here, and is ready to bring providers to you. Let’s all work together to make this a reality.

50 Years of Medicaid, Yet Oral Health Gaps Remain

By Steve Pollock, President and Chief Executive Officer

In 1965, Medicaid and Medicare were signed into law. At that time, there were more than 194 million people in the United States. Thirty-two million lived in poverty. America’s low-income population was in desperate need of medical coverage and the financial means to access care.

Enacting Medicaid and Medicare was the first step toward helping this largely underserved population. With the intended purpose of providing a public health insurance program for low-income people, Medicaid has made great strides in increasing access to coverage since its inception.

Medicaid Covers More People, Just Not for Dental

From the original 4 million Americans that enrolled in Medicaid to the 65 million who are enrolled today, the goal has remained the same: administer proper medical care to those with limited or scarce resources.

Policy and lawmakers alike have recognized the importance of creating an opportunity for all Americans, socioeconomic status aside, to be protected with quality medical care.

As background, Medicaid provides health coverage to non-elderly low-income parents, their children, other caretaker relatives, pregnant women, and other non-disabled adults. Most recently, Medicaid expanded to include more people under those definitions based on language in the Affordable Care Act.

While Medicaid’s accomplishments to date are something to be deeply proud of, the reality is that there is a major gap that still needs attending to: adult dental coverage.

Medicaid Members Need Dental Coverage

A few months ago, I wrote a blog post on Children’s Health Insurance Program (CHIP) funding being successfully extended for two more years. In that post, I pointed out the decision to include adult dental care coverage within Medicaid is up to each state to decide. As a result of that policy, millions of Americans are left without access to dental benefits. This still holds true, even though oral health is vital to overall health and lower health costs.

In the past decade alone, patients seeking treatment for dental pain in the ER doubled from 1.1 million to 2.1 million. And 80 percent of dental-related ER visits are caused by preventable conditions. This reality means our focus needs to be on providing preventive care that will ultimately cost three times less than ER visits, and save a lot of people from excruciating dental pain.

CHIP is a great example of how mandated dental coverage works. CHIP has been a critical source of health coverage for children and pregnant women who earn too much to qualify for Medicaid but too little to purchase private health insurance. It provides affordable medical and dental coverage to more than 8 million children across the country.

Coverage Leads to Improved Prevention

According to a report from the U.S. Department of Health and Human Services, 80 percent of CHIP enrollees saw a dentist in the past year, a number much higher in comparison to children who do not have coverage. That preventive care will ultimately save kids from future dental emergency visits, keep kids in school instead of at excessive dental appointments, and ensure more kids are pain-free and smiling. 

Moving forward, I urge legislators to rise to the challenge: let’s continue increasing access for those in need and secure adult dental coverage under Medicaid at the federal level.

Oral health is crucial to overall health and wellness, and should be recognized as so by the law. Mandating adult dental coverage is the necessary next step towards achieving improved oral health for all.

Back to School: Advancing Oral Health in the Classroom

By Ralph Fuccillo, MA, President, DentaQuest Foundation

It’s that time of year again – the time when kids all across our country head back to school for another year of learning, growth and development. But, did you know that the classroom is also a crucial point of connection, education and even treatment when it comes to oral health?

If you are a parent, you can attest that you always have your child’s health and wellbeing on your mind, particularly in an age where fast food, lack of exercise and other issues plague the next generation. For kids, tooth decay is actually the most common childhood disease, more common than asthma. Each year, children across the United States lose approximately 52 million school hours due to dental disease. Unfortunately, this impacts low-income children disproportionately, as they face more barriers to getting much-needed, preventive dental care. It’s sometimes a challenge to find a provider that accepts their insurance, and if they are able to secure an appointment, they may have trouble getting transportation to and from the office, and their parents may not be able to take the time off from work to get them there. To drive this home, kids from low-income families have twice the untreated tooth decay compared to their higher-income counterparts.

Schools are a practical and cost-effective place and time to reach children, teach them about healthy habits and even ensure they receive the preventive oral care they need. In addition to education on healthy personal dental care, school-based oral health programs can provide a range of services from screenings to sealants to fluoride treatments. To illustrate the potential of these programs, according to a recent issue brief from the Centers for Medicaid and Medicare Services’ (CMS) Oral Health Initiative, the Centers for Disease Control and Prevention (CDC) estimated that over half of kids’ tooth decay could be prevented if half of those high-risk children participated in school sealant programs.

Think of the potential! This is why one of our Oral Health 2020 goals is centered on this important, cost-effective initiative. By 2020, we strive to have oral health education and services incorporated into the curriculum and offerings of the 10 largest school districts in the country.

To make this goal a reality, we partnered with Oral Health Colorado to develop a toolkit for local communities. The recently-launched, free Smart Mouths Smart Kids (SMSK) toolkit is available to help communities assess need for such a program in their local schools, measure feasibility of program administration and create a program that is sustainable for years to come. Its development took into account best practices and key learnings from our work to provide local stakeholders with the tools they need to make oral health a priority in local schools.

From engaging appropriate partners to understanding reimbursement methodology and building a sustainable business plan, this toolkit has everything a community needs to get started with implementing school-based oral health care – along with support at every step of the way – to help bring dental care and education to the next generation. While the toolkit is focused on Colorado communities, it’s a model that can be scaled and tailored to states across the country.  We encourage you to take a look and share with school administrators, local government leaders, and teachers, and empower your community to bring good oral health back to school this fall. 

Missions of Mercy: Oral Health Improvement in Motion

Guest post by Marcia Brand, Ph.D., senior advisor for national policy and programs, DentaQuest Foundation, and executive director, National Interprofessional Initiative on Oral Health

Are you familiar with Missions of Mercy?

Missions of Mercy – sometimes also called “MOMs” – provide dental services, including cleanings, fillings, oral surgery, x-rays and dentures, to people in underserved communities across the country. These services are provided free of charge by dentists and hygienists who donate their time as volunteers. By bringing free dental screenings and care to those who need it most, these missions are a crucial, hands-on way to improve the oral health of all.

I recently volunteered as a dental assistant at the Wise County Mission of Mercy in Virginia. Pat Finnerty, another senior advisor to the DentaQuest Foundation, volunteered as well, managing patient flow in the triage tent.

Southwest Virginia is an area where much of the population doesn’t have access to regular dental care and services. Would you believe that more than 47 percent of the total population of Virginia doesn’t have dental insurance? I hope this helps drive home the importance of these events.

We don't often realize the powerful impact that poor oral health has on the lives of those who cannot access oral health care. I recall one young woman, perhaps 30, who came through the triage tent at the Wise MOM. After examining her mouth, the dentist gently told her that her best option was going to be to have all of her top teeth in the front extracted. There were multiple infections and they could not be saved. He had to step away – and she began to weep. I asked her if she was afraid and she said, "No, they really do hurt me, but I can't get them pulled. I'm a bartender. If I lose my front teeth, I'll lose my job." What a terrible choice she had to make – remain in pain, with multiple infections – or lose her job. Fortunately, we were able to make arrangements for her to have her teeth extracted and get a partial denture – before her next shift. Stories like these continue to indicate to me that we must improve access to affordable dental care for all.

The DentaQuest Foundation has participated in the Wise MOM project for 11 years. Since its start in 2000, this particular MOM has brought $15.3 million in free dental care to 19,060 patients – what an incredible impact.

This year, we partnered with the Virginia Dental Association, Virginia Commonwealth University School of Dentistry and Dental Hygiene, the Health Wagon, Remote Area Medical, Virginia Health Care Foundation and other sponsors to fund the Wise County event. Over the three days, more than 1,000 patients passed through the triage tent, resulting in a total of 1,181 exams, 177 cleanings, 1,082 x-rays, 1,569 fillings and 3,527 extractions.

For many people, MOM events are the only time all year that they are able to get care. With 69 localities throughout Virginia lacking a dental safety net provider, the MOM events are a critical stop gap that reach more than 4,000 residents annually. 

While MOMs and other similar events provide dental services to people in desperate need of oral care, they also highlight the demand for an increase in access to quality, affordable care. That is why it is the DentaQuest Foundation’s goal, by 2020, to address this unacceptable gap head on. As a part of the Oral Health 2020 goals, we hope to have at least 30 states with a comprehensive Medicaid adult dental benefit and a comprehensive adult dental benefit under Medicare. Will you join us and put oral health improvement in motion?

Debunking Dental Myths: How Well Do You Know Your Teeth?

By Dr. Brian Nový, Director of Practice Improvement, DentaQuest Institute

Myths are something we are exposed to every day – we hear them from our co-workers, friends and family. Everyone has heard the ones about chewing gum staying in your stomach for seven years, if swallowed, or that you should never wake a sleep walker. But, did you know there are many myths about oral care and your teeth? In this post, we’ll play a game of true or false, and cover 9 common “facts” about teeth. Can you guess what is a myth and what is true?

1.    You should floss before you brush your teeth.

This is in fact true. If you floss after you brush, there is a risk that you will wipe plaque all over your clean teeth. Ideally, you would brush, floss and then brush again.

2.    Whitening your teeth will hurt your enamel.

This is a myth. While excessive whitening can be harmful, a tiny bit of bleaching gel, like carbamide peroxide, can help kill bacteria on your teeth that can cause periodontal disease and tooth decay.

3.    Bad breath is only caused by not brushing your teeth.

Would you believe that this is false? Bad breath can be caused by a number of factors. For instance, your tonsils can collect debris causing your breath to smell. Bad breath can also be caused by more serious issues, like periodontal disease and untreated tooth decay.

4.    You should use an electronic toothbrush over a regular toothbrush.

Also a myth – a regular toothbrush can do a great job of brushing, but some patients find that an electronic toothbrush can make brushing easier. Soft toothbrushes do a better job cleaning than medium or hard bristled toothbrushes, so always select a toothbrush with soft bristles.

5.    You only need to visit your dentist only once a year.

False! Everyone needs to visit the dentist at least once a year, and some patients need to visit the dentist four times a year. You should talk with your dentist about how many times a year you should visit his or her office.

6.    Brushing bleeding gums is bad.

This is one of the biggest myths out there! If your gums are bleeding, you need to brush more carefully and floss more often. If your gums still bleed after a week of gentle thorough brushing, see your dentist to ensure everything is ok.

7.    People who get cavities simply just don’t brush their teeth.

It’s much more complicated than that – this is another myth. Cavities are caused by a bacterial infection. Brushing is an easy way to prevent some cavities but you need to encourage oral health by eating protective foods, flossing and visiting the dentist for regular check-ups. 

8.    All fillings you have in your mouth will eventually need to be replaced.

This is true! Once you have had a filling, your tooth has been weakened. There currently is no perfect filling material out there, so fillings must be maintained over your lifetime. You can help you fillings last longer by caring for them with proper home care.

9.    You should not go to the dentist when you are pregnant.

This is a very common myth. While you are pregnant, your hormone levels change which can make it easier for bacteria to cause dental infections. It is important for expecting mothers to also let their dentist know if they have any changes in their oral health, like bleeding gums. Be sure to see your dentist regularly if you are pregnant.

How did you do? Did you get all 9 right? As you can see, knowing the difference between the facts and myths surrounding dental health is important not only for your oral health, but also your overall health. Always check with your dentist if you have any questions or want to clarify any myths!

The importance of community water fluoridation to oral health

By John Luther, DDS, Senior Vice President, Chief Dental Officer DentaQuest and Michael Monopoli, DMD, MPH, MS, Director of Policy and Programs DentaQuest Foundation  

A recent recommendation by the U.S. Department of Health and Human Services (HHS) has brought about a resurgence of support for community water fluoridation within the oral health community.

Dentists have consistently been strong advocates for the health benefits of fluoridating public water supplies, and fluoridation is widely regarded as one of the top public health achievements of the past century. Officials from both public health organizations and professional dentistry agree that water fluoridation and fluoride toothpaste are largely responsible for the significant decline in tooth decay in the U.S. over the past several decades.

Fluoride doesn't cure or medicate -- it simply prevents. Similar to a vitamin, the right amount of fluoride in our drinking water improves resistance to tooth decay and causes us no harm. By preventing tooth decay, community water fluoridation has been shown to save money, both for families and the healthcare system.

In 2000, the U.S. Task Force on Community Preventive Services examined 21 studies and concluded that fluoridated water reduces tooth decay by a median rate of 29% among children ages 4 to 17. While children are typically cited as the beneficiaries of this protection, a 2010 study in the American Journal of Public Health (October 2010, Vol. 100:10, pp. 1980-1985) found that the fluoridated water consumed as a young child makes the loss of teeth from decay less likely 40 or 50 years later when that child is a middle-aged adult.

Recently, HHS announced the first change in the recommended amount of fluoride for public drinking water supplies in more than 50 years. The new guidelines utilize the best evidence available to clarify the amount of fluoride needed to achieve the optimal amount of tooth decay prevention.

The department gave several reasons for the change, mainly citing that Americans have more access to sources of fluoride than they did when water fluoridation was first introduced in the 1940s, but water is just one of multiple sources. Consumers also have access to fluoride toothpastes, mouth rinses, and prescription fluoride supplements, as well as fluoride applied by dental professionals.

We, along with the Centers for Disease Control and Prevention, the American Dental Association, and many other organizations, know that community water fluoridation is one of the most cost-effective means of preventing dental caries. The new recommendation, along with other current findings, strengthens our understanding of the preventive effects of fluoride on oral health and reinforces the need for communities to continue to invest in keeping fluoride in community water.

After more than 70 years of studying fluoridation in drinking water, it is clear that this practice is one of the most important health-promoting policies that a community can offer all its residents. This is especially true for those who are low-income, those with limited access to regular dental care, and those who experience health disparities firsthand. It's effective. It's safe. And it's the reason why both children and adults today have much less tooth decay than people had a generation ago.

This piece originally ran on DrBicuspid.com.  

King v. Burwell: An Historic Moment for Prioritizing Equity and Improving Health

By Steve Pollock, President and Chief Executive Officer

In late June, the U.S. Supreme Court ruled in favor of upholding an important piece of the Patient Protection and Affordable Care Act (ACA) in the King v. Burwell case. This ruling confirmed the eligibility of Americans to receive tax credits to purchase much-needed health coverage, whether they live in a state with its own insurance exchange or one operated by the federal government. This crucial ruling underscores the importance of equity – no matter where you live – when it comes to getting the care you need. King v. Burwell is a landmark decision – marking a truly unique time in our history as a country and providing healthcare to those who need it most.

The ACA is already eliminating significant barriers to dental care. Thanks to this important Supreme Court decision, it will be able to continue to bring coverage to people across the country. To help illustrate the impact of ACA already, according to the American Dental Association:

·         17.7 million adults are eligible to receive basic dental coverage through the ACA

·         4.5 million adults will gain extensive dental benefits through Medicaid

·         About 800,000 adults will gain dental benefits through the health insurance exchanges

While we cannot understate the importance of the King v. Burwell ruling and its representation of our leaders’ commitment to providing everyone – no matter your income, age or geographic location – with access to care and the ability to lead a healthy life, we still have our work cut out for us:

1. As my colleague Dan Sheehan mentioned in a recent post about healthcare.gov, we must improve the federal exchange so consumers can access the dental coverage they need and want.
2. We must provide consumers with the tools they need to make coverage decisions that positively impact their oral health. This means including consumer-focused resources on healthcare.gov to help consumers choose the right dental coverage for their families.
3. While the ACA enables access, many are still left out of the mix. This year, on the 50^th anniversary, Medicaid and Medicare need to provide for comprehensive adult dental benefits.

As I look to the future from this ruling, I am hopeful that we will increase access to healthcare and promote equity across the U.S., allowing our citizens to achieve their healthiest selves. At DentaQuest, we are committed to working with our leaders, stakeholders and local communities to achieve this goal and it is within our grasp!

DentaQuest Foundation goes local with its grassroots engagement strategy

By Ralph Fuccillo, President of the DentaQuest Foundation

Health outcomes have improved vastly over the past few years for many Americans, especially when it comes to infant mortality and life expectancy. However, significant health inequities still persist in this country and oral health is no exception.

According to the W.K. Kellogg Foundation, more than 50 million Americans are living in areas with insufficient dental care.Tooth decay is still the most common childhood disease. Good oral health is the gateway to a person’s overall health and wellness, so without access to care or education, preventable ailments like dental caries and gum disease can build up to become more painful and costly than necessary.

In 2015, it’s unacceptable that these inequities exist, and that people are suffering from diseases that are preventable. That’s why the DentaQuest Foundation, along with our ever-growing network of grantees and partners, has made it our mission to reach the people who do not have access to regular care due to their race, age, income, language, health literacy and geographic location. We believe everyone should have the same opportunity to live a healthy life, and with nearly 83 million people in the United States facing dental care barriers, we still have a lot of work to do. 

To drive our mission forward, we recently launched the Grassroots Engagement Strategy, a grant-making initiative supporting local, community based organizations. This initiative supports our Oral Health 2020 goal of changing the public perception of oral health - helping people realize that dental pain, tooth loss and restoration don’t have to be facts of life or just an accepted part of getting older.

We’re working to create a new social norm where people can expect oral health. If we want to #expectoralhealth, the changes we need must be driven by those most impacted when the existing systems fail. Earlier this year, we selected 20 community-based organizations in six states including Arizona, California, Florida, Michigan, Pennsylvania and Virginia, to receive two $50,000 grants over the next year. The grantee organizations range from direct service providers to civic engagement and advocacy organizations, all of which are already active in promoting health equity and the pursuit of social justice for a diverse number of populations. The grants will fund these organizations to analyze the oral health landscape in their communities, enact a plan to engage stakeholders on a local level, and ultimately improve oral health in the places where they live and work.

Network development is key to all of our grantmaking initiatives. The Grassroots Engagement Strategy now gives local change agents the opportunity to have their voices heard amongst the our growing network of state, regional and national partners. Organizations at all levels of the network - from grassroots to grasstops - will be able to learn from each other what is needed to enhance oral health, share best practices and work collaboratively to bring about significant change in oral health financing, care, community and policy systems. 

It is our hope that by working with organizations we will be able to make significant leaps in our quest to achieve oral health equity for all and meet the Oral Health 2020 goals. We’ll be sure to keep you posted and provide updates on the initiative’s progress! In the meantime, follow us on Twitter (@OralHealth2020) and like our Facebook page. Visit www.dentaquestfoundation.org for more information.

Who's Making a Difference in Oral Health?

When you think about major improvements that have occurred in your local community, they are often due to the innovative actions and tireless dedication of key individuals. Can you think of a local leader working to improve your community? We can.

As we work across the nation to improve oral health care, access and education, we have seen outstanding leaders in local communities who are making significant strides in improving the oral health of all.

With that in mind, this year we established the DentaQuest Health Equity Hero Awards to celebrate the efforts of leaders who are working tirelessly to address health equity and providing vital care to underserved communities. This year, we recognized seven people for their work.

We’d like to tell you a little more about these outstanding heroes, why they were selected and what they are doing for their communities:

• Kevin Earle, M.B.A., M.P.H. is the executive director of the Arizona Dental Association in Phoenix, Ariz. Earle is the one of the principal organizers and supporters of the Arizona American Indian Oral Health Initiative. He is working with tribal leaders to raise awareness of oral health and bring it to the forefront of policy discussions within the community and at the state level. Earle is also a leading advocate and voice for the restoration of Medicaid dental benefits for adults in Arizona.

• Ana Palomo-Zerfas is a migrant health and community engagement program manager for the Vista Community Clinic in San Diego, Calif. In this role, she leads the clinic’s efforts to help migrant workers in San Diego County overcome cultural and linguistic barriers that make it hard for them to get health and dental care. This outreach and advocacy work connects more than 5,700 migrant workers and their families to care every year.

•  At the University of Louisville, David L. Dunn, M.D., Ph.D. is the executive vice president for health affairs. Dr. Dunn, a highly-respected transplant surgeon, has been a leading advocate for coupling dental and medical coverage to ensure enhanced overall health. Throughout his career, Dr. Dunn has pushed for innovative care delivery systems. As a health care leader in Kentucky, he strives to make quality dental care affordable for underserved communities.

• As a program manager for Prince George’s County Health Department, Debony Hughes, D.D.S, F.I.C.D., works with the dental health program to better serve Maryland residents. Not only is Dr. Hughes an important voice for oral health throughout Prince George’s County, she is also responsible for the operation of the Deamonte Driver Mobile Unit, which provides education and dental treatments to 20 Title I schools and to Head Start programs, serving more than 10,000 students in Prince George’s County. This school-based care is leading to better oral health outcomes for children and their families. 

• Rucha Kavathe, Ph.D. is a project manager for the community education and empowerment directorate at UNITED SIKHS, a United Nations-affiliated civil and human rights organization, in New York, N.Y. Dr. Kavathe is a strong advocate for health equity and social justice at UNITED SIKHS and is addressing the health challenges immigrants face as they adjust to their new surroundings, particularly when it comes to navigating the U.S. healthcare system. UNITED SIKHS is making progress within its community to reduce chronic disease and improve oral health.

• Cherae Farmer-Dixon, D.D.S., M.S.P.H., F.A.C.D. is a dean and professor at Meharry Medical College – School of Dentistry based in Nashville, Tenn. Dr. Farmer-Dixon has been training dentists who aim to serve high-need urban and rural communities for the past 25 years. She also leads research on oral health disparities, the impact of dental disease on low-income children, and inter-professional community outreach and interventions.

•  At the AIDS Interfaith Network’s (AIN) Manos Unidas, Edgar Carmona serves as the associate executive director. Carmona coordinates the Binational Health Week in North Texas, a health mobilization effort serving the Americas. He is working to educate Spanish-speaking residents on the importance of oral health, and the ways they can access dental programs and services.

The selection of our 2015 Health Equity Heroes coincides with National Minority Health Month, an effort led by the U.S. Department of Health and Human Services’ Office of Minority Health to advance health equity for racial and ethnic minorities. With that in mind, along with their award, our 2015 Health Equity Heroes also will receive a donation from our Citizenship Fund toward a non-profit of their choice that is committed to promoting health equity. DentaQuest is proud to award these heroes for their incredible work! 

My first 60 days as CEO

By Steve Pollock, President and Chief Executive Officer

I have always been committed to the mission of our organization – to improve the oral health of all. Since taking the helm at DentaQuest, I’ve spent the last two months traveling the country and hearing firsthand what our mission means to our employees, community and business partners, and state leaders. I will draw on the themes I heard throughout my time on the road to fully inform DentaQuest’s path forward:

Our employees are our strongest asset. I find myself saying this over and over again. And, during my first two months, I continue to be inspired by the passion DentaQuest employees have for the work they do and the people they serve. My commitment is to continue to fuel the passion of our employees and identify ways to strengthen our connection to the mission and each other.

Partnerships are essential. We cannot be successful without strong community, government and business partnerships. I take pride in the fact that the DentaQuest family of affiliates is thought of as a strong and collaborative partner. Whether it is engaging at the grassroots level in a community, talking to providers about opportunities for  telehealth, or collaborating with national health plans on new and innovative approaches to medical-dental integration, partnerships are necessary to improve the oral health of all. Having a strong network of collaborators strengthens the work we do, the clients we serve and the members we support.

Policymakers are looking to industry for innovative solutions. Our leaders in government are looking to industry experts to help inform policy decisions. The healthcare environment is ripe for data-driven, cost-effective solutions that achieve “The Triple Aim” of improved health for the population, better experience of care and lower per capita cost of care. DentaQuest, in collaboration with our partners, can serve a key role in ensuring that government policy supports the goal of improving the oral health of all.

Our organization has an incredible responsibility to the 23 million people we serve across the country yet I am equally aware of the 83 million people in our country who do not have access to oral care.

  

It is all of these people who drive our collective agenda and our commitment to health equity. They drive the work of the DentaQuest Foundation, and the incredible grassroots and grasstops network it helps foster. Their needs motivate the DentaQuest Institute in developing new approaches to the management – and elimination – of dental disease. They are what drive the DentaQuest Care Group to open dental clinics in chronically-underserved areas in the United States.

As I look to the future, I see great opportunity for DentaQuest to drive positive social impact. Our mission – to improve the oral health of all – remains the centerpiece of our work and we will continue to measure our success against it.

So, healthcare.gov is fixed- what’s next?

By: Dan Sheehan, SVP and CIO, DentaQuest

 

Earlier this month, Optum, the contractor with the task of fixing the well-publicized IT glitches on healthcare.gov, announced that its job was complete, the website is improved and consumers are able to more easily access the benefits they need. This is a big moment, not only for the Obama Administration and IT gurus everywhere, but also for the healthcare community as a whole.

By ensuring that healthcare.gov is a more accessible and reliable outlet for millions of Americans to review and select their healthcare benefits, all involved have brought coverage to those who need it most. While this is an exciting and important moment, we cannot let this success overshadow the continued work that must be done.

Now that the major functions of healthcare.gov are working well, government officials and their consultants must turn their attention to making healthcare.gov the most effective tool that it can be for consumers.

Specifically, when it comes to dental benefits and healthcare.gov, we still need to eliminate technological barriers for consumers seeking coverage. Healthcare.gov should:

·         Allow consumers to shop for and purchase a stand-alone dental plan regardless of whether they also purchase a medical plan.

Right now, a consumer can only access stand-alone dental plans when purchasing medical coverage. This limits crucial access to dental coverage and care for people who may already have medical benefits through an employer or other government-sponsored program like Medicare.

·         Develop support tools that will help consumers make the best decisions about the level of coverage they need for their families.

This could be as simple as including more educational information about dental coverage and the importance of dental care on healthcare.gov, to help consumers make the most informed choices about their coverage options. But it could also include the development of interactive tools that allow consumers to input information about their dental needs and get recommendations on coverage options based on what they need.

While many of these fixes will certainly require time, resources and brainpower, they are crucial steps to achieve access and improve healthcare.gov. By addressing these issues, the administrators of healthcare.gov will help remove some of the barriers that 83 million Americans face today when it comes to receiving the dental care they need.

At DentaQuest, enabling access by eliminating barriers to care is a part of our work every day, as we continue to prioritize oral health for all Americans. Tools like the new-and-improved healthcare.gov will help us reach that goal, improve access and provide care.

CHIP Passes – But There’s Still More To Be Done

By Steve Pollock, President and Chief Executive Officer

 

 

On April 14, Congress passed a bill which will ensure that eight million children across the country have continued access to health insurance by extending funding for the Children’s Health Insurance Program, or CHIP, for two more years. Just a few days later, President Obama signed the bill into law. The CHIP program has been a critical source of health coverage for children and pregnant women who earn too much to qualify for Medicaid but too little to purchase private health insurance. Without passage of this bill, CHIP funding would have expired in September, leaving millions of children and hundreds of thousands of pregnant women without access to comprehensive dental care.

 

Since its inception in 1997, CHIP has helped children receive routine dental care that they may not otherwise have had access to. To help illustrate its success, a report issued by the U.S. Department of Health and Human Services found that 80 percent of CHIP enrollees saw a dentist in the past year, a significantly higher rate of access and use of services than for children who do not have coverage.

 

Congress has done a commendable job of recognizing the need for continued funding to support children’s health insurance by passing bipartisan legislation to secure its future. This is no small feat. Health equity advocates around the country are breathing a sigh of relief knowing that the health and well-being of our children took precedence over party politics. However, for dental care, we know the battle is not yet over.

 

Did you know that 83 million Americans still face obstacles in receiving dental care each year? Nearly half of all individuals in a 2013 survey said that over the previous 12 months they or a family member delayed seeing a dentist because they could not afford the expected out-of-pocket costs. Unlike medical insurance, states are not mandated to include adult dental care coverage within Medicaid programs; it is left up to the state to decide.

 

As a result, many still do not have access to dental benefits. And that hurts families. It is difficult for dentists who treat children with Medicaid or CHIP insurance to turn away parents who have immediate oral health problems but are uninsured. Dental care contributes to a person’s health and well-being over their lifespan – childhood through retirement. Preventive care saves families and taxpayers money by avoiding more costly interventions later on.

 

Without adult dental benefits for publicly-funded insurance programs, these 83 million Americans will continue to flood emergency rooms for dental issues and contribute to the 164 million work hours missed each year due to oral health problems. And, as recent studies demonstrate, poor oral health may be increasing the cost of treating chronic diseases like diabetes, pre-term pregnancy and heart disease. By ensuring that all have equal access to dental care, we work to improve the lives of millions while reducing healthcare costs.

 

Congress took a significant bipartisan step to ensure access to dental care for children. Now, state and federal leaders must act to help eliminate barriers for adults so these 83 million Americans can get the care they need to be healthy and stay that way.