Hispanic Heritage Month: Highlighting two organizations committed to oral health

As part of our commitment to meeting the different oral health needs for different populations, DentaQuest learns about cultural heritage through observances like Hispanic Heritage Month, which runs through Oct. 15. It is a month-long tribute to Hispanic Americans who have so richly contributed to our society, and to the cultures, languages, and traditions passed down by their ancestors. DentaQuest is committed to improving health equity and advancing solutions that meet the needs of the many different people our plans and services touch, in part by supporting the efforts of local organizations.

While the contributions of our Oral Health 2020 network partners are as diverse as the communities and the perspectives they represent, and impactful in so many important ways, we’d like to take a moment to acknowledge two of our grantees who are working in this way to improve the public’s perception of oral health, and bringing the voice of Hispanic and Latino* communities to the table.

We know that the only way to develop targeted solutions and ultimately achieve better oral health for all is to engage those people who are most impacted. One of the goals of Oral Health 2020 is to improve the public’s perception of the value of oral health. We want everyone, not just dentists and hygienists, to recognize and understand the importance of the health of the mouth to the health of the rest of the body. With this important understanding, we will continue to mobilize communities across the country to rally together to advocate for better oral health.

In California, Vision y Compromiso is committed to improving community well-being by supporting promotores (liaisons between their communities and health and social service providers) and community health workers. Across 24 counties from Southern California to the Greater Bay Area, Vision y Compromiso’s network of promotores and community health workers is serving as a bridge for both native-born and immigrant people, and leveraging their shared language, ethnicity, culture, and experiences to reduce barriers to care and education. 

For example, together with Asian Americans Advancing Justice, Vision y Compromiso is spreading a campaign to educate individuals and families in the state on the health coverage available to anyone in the state, regardless of income or immigration status.  In just under two weeks, Vision y Compromiso will be bringing together these important stakeholders at their annual conference in Ontario, CA.

Also working on the West Coast is Latino Coalition for a Healthy California (LCHC). LCHC is one of the leading voices for Latino health in California, with a focus on initiating and advancing policies that help build healthy communities. With their ongoing work to address disparities in oral health, LCHC is focusing efforts on ensuring that affordable dental care is accessible to all Californians. 

Like Vision y Compromiso, LCHS is also working with promotores, training them to be both advocates and messengers for oral health and its social influences in Latino communities. LCHC is committed to elevating the voices of those in their communities to be heard by decision- and policymakers, in order to improve oral health at a systemic level. A recent initiative champions efforts that reduce access to sugar-sweetened beverages, which not only impact oral health, but also contribute to the disproportionately high incidence of diabetes in both adults and children in Latino communities.

We are so proud to support these and so many other amazing organizations that are working to improve the oral health of all. Please visit their websites to learn more:

Vision y Compromiso  

Latino Coalition for a Healthy California

*While “Hispanic” and “Latino” are often used and understood interchangeably, “Hispanic” focuses on Spanish-speaking origin, while “Latino” refers to people of Latin American origin.

Tooth protection: Sealants for better oral health

We in the oral health community often take it for granted that everyone understands the importance of preventive treatments when it comes to good oral health. But the reality is that everyone isn’t aware of simple, cost effective things they can do—like brushing and flossing every day and seeing your dental care provider every year. And sometimes we don’t fully appreciate how difficult it may be for some to get dental services -- and that limits their use of preventive treatments.

Prevention is important for everyone, but especially so for children. If we can keep children free from dental disease, we are giving them a strong start to a healthy life. As I’ve said here before, it is hard to do well in school or in life, when you have constant tooth pain.

Dental sealants are a very good way to prevent tooth decay in children.

For those who may not be familiar with them, dental sealants are thin plastic coatings applied to permanent molars. The sealant is applied as a liquid that is brushed onto the deep grooves of teeth by your oral healthcare professional. Sealants dry into the plastic film that provides a physical barrier to bacteria and sugar and effectively protects the pits and grooves on the biting surfaces of teeth from dental decay.

Sealants are considered a cost-effective intervention to prevent tooth decay. Consider this: the cost of applying one dental sealant is significantly less than the average cost of filling that same tooth. And when you think that a single sealant may prevent that tooth from being re-filled many times over a lifetime, it is just pennies spent for every dollar saved.

In support of sealants as a proven preventive treatment, the U.S. Department of Health and Human Services’ Healthy People 2020 set a goal of increasing the number of children who have received dental sealants on their molar teeth to 50 percent. But, despite numerous studies confirming that sealants are a cost-effective intervention, only a handful of states have reached this goal.

To help reach this national goal, the DentaQuest Institute is working with five community health center dental programs to find effective ways to increase the use of sealants for children aged 6 to 8 and adolescents 12 to 14. Those are the ages when the permanent molars erupt into the mouth. We hope the results of this Dental Sealants Initiative will help other oral health care providers make sure sealants are a standard tool in their offices for preventing cavities in children and adolescents.

We are optimistic the results of this DentaQuest Institute quality improvement initiative will increase the number of children who receive dental sealants. And that means less dental disease.

Related Posts:
· Some Good News at Massachusetts’ Medicaid Dental Program
· Healthy Smiles in Miami Dade Schools
· Washington’s Unseen Oral Health Debate
· Let’s Talk About the Oral Health of America’s Children
· Is Anyone Listening?

Prevention is Key

It was great to see the National Prevention Council’s recently released action plan for health prevention – but I couldn’t help but notice that there was no mention of the importance of oral health—at all.

Prevention is what helps us have good oral health vs. poor oral health. And prevention is all about understanding your risk factors and protective factors. This is true if you are a child or an adult.

In this Oral Health Matters blog, I try to get my readers to think about the risk factors—the things in your life which contribute to poor oral health. There are protective factors too and I’ll talk about them in another blog post. Right now, however, I’ll highlight some common risk areas. I hope you will read through them thoughtfully. If you say ‘yes’ to any of them, it is time to make an appointment with your dentist.

Common risk areas:

1. Not brushing and flossing your teeth every day – to remove food and bacteria. Making this part of your daily routine is a small change that pays big benefits.


2. Irregular visits to the dentist. I encourage visiting your dentist at least once a year. Why? Your dentist can detect early signs of trouble and help you get on track.


3. Have you had a cavity within the last 3 years? Have you lost teeth because of tooth decay or gum disease? Do you have puffy or bleeding gums, receding (shrinking) gums, or areas of the gum line where the root surface of the tooth is exposed? This could mean there may be active gum disease in your mouth. Your dental professional will want to watch you closely for this.


4. How is your health? Are you pregnant? Have you been diagnosed with diabetes? Do you use/abuse tobacco (cigarettes, pipes, cigars, chewing) or drugs? Do you regularly take prescription/over-the counter-medicines? Do you have braces or partial dentures? Are you undergoing chemotherapy or radiation therapy? Do you have an eating disorder? Do you have dry mouth? Each of these conditions puts you at higher risk for tooth decay or gum disease. Your oral health professional will help you make adjustments to keep your mouth healthy.


5. Are you a between-meal-snacker? Do you have a fondness for sugary foods? Do you drink a lot of soda or energy drinks? The sugars and acids in these foods/drinks can encourage tooth decay—especially if you let them linger in your mouth for hours. Again, your oral health professional can help you understand how to lower your risk of oral disease with things as simple as rinsing your mouth with water after eating to keep your teeth healthy.

Think about your answers to these questions and use them to start a conversation with your dentist about managing your areas of risk.

I would like to see Americans get smarter about the role of oral health in their overall health. That’s why I write this blog. When consumers have the knowledge to prevent problems and know when to seek care, they will likely be healthier. That’s why it is upsetting to me that oral health was missing from the National Prevention Council’s action plan.

I’d like to hear what you have to say on the importance of prevention. What does prevention mean to you?

Related Posts:

• Making Coverage Matter: Pew’s 50 State Report on Children’s Oral Health
• State of Oral Health In America Is Not So Good
• A New Chapter for Prevention
• Let’s Talk About the Oral Health of America’s Children
• Healthy Smiles in Miami Dade Schools

Sonrie!

Oral care in the United States is undergoing many significant changes. One of these is the exciting growth in the number of Hispanic dental practitioners and patients.

I just returned from the Hispanic Dental Association’s Annual (HDA) Roundtable in Plano, TX where I had the privilege of representing DentaQuest. HDA is a rapidly growing organization and the growth is expected to continue well into the 21st century. That’s a good thing because some experts are projecting a U.S. population that will soon be 40% Hispanic. Being able to talk to patients in a way that respects their culture and background is so important in providing the right care, at the right time, so we make a real impact.

The Hispanic Dental Association is playing a major role in building leadership for Hispanic oral health professionals during this time of change and it, like DentaQuest, is focused on prevention, treatment and education. DentaQuest and the DentaQuest Foundation are proud to support their work in improving oral health in the Hispanic population.

It was good to hear about the plans, concerns, needs and passion for dentistry among the member dentists. Several chapter presidents are DentaQuest providers. For me, this was an opportunity to explain the many facets of the DentaQuest enterprise’s commitment to improving oral health – our benefit programs, philanthropy, and clinical care improvement projects. I talked about the work we are doing to support dentists and their patients, to make participating in our networks easier, and to make sure oral health providers can deliver the best care outcomes. The dentists at the Roundtable were very interested in DentaQuest’s dental home project, our broken appointment project, and the many ways our website makes their work easier.

The dentists I met are enthusiastic champions for good oral health. They are hopeful that we will continue to support their meetings with our presence and are anxious to work with the DentaQuest Institute to improve cultural competency at the practice level. I believe that we have a very effective partnership developing. But for any effort like this to truly be successful we will need the partnership to extend to patients as well. Patients can and should play an important role. I’d like to hear from you on your thoughts.

Sip Safely

Spring and summer are a time of sports and hot, humid weather which leads to very thirsty kids. That often translates into an increase in the consumption of sugary and acidic sports drinks. These seemingly harmless liquids can actually wreak havoc on children’s teeth.

The combination of acidic components, sugars, and additives in sports drinks combine to erode the tooth’s surface, weakening the enamel that protects teeth from bacteria. The enamel erosion ultimately makes teeth more susceptible to bacteria and leads to hypersensitivity, staining, and tooth decay.

Frequent consumption of sports drinks lowers the pH in the mouth promoting the demineralization of tooth enamel. (The lower the pH, the more acidic the item.) Demineralization is caused primarily by stable acids found in acidic foods and drinks or which form as by product from bacteria feeding on starches and sugars in the mouth, especially refined sugars.

Demineralization begins at a pH level of 5.5 although under certain conditions, may even start at a higher pH. Popular sports drinks can have a pH of 2.4 and contain 5.5 tsp of sugar in a 12 oz can. So, not only does the drink have a pH that promotes demineralization, it also contains 5.5 tsp of sugar, which can independently contribute to demineralization and tooth decay.

To put the sports drink pH of 2.4 in perspective, compare it to battery acid, which has a pH of 0 and water, which has a pH of 5-7 (neutral). Shocking that a sports drink is closer on the pH scale to battery acid, than water.

Given all this, water is always the best option for everyone but the highest performing athletes who need to replenish minerals from intensive workouts.

If these facts haven’t convinced you to avoid the casual consumption of sports drinks, here are a few tips to keep in mind:

Don’t sip the drink throughout the day. - Drinking them for short periods of time means less time for the sugars and acids to erode enamel. Rinse your mouth with water when you’re done to clear away remaining acids and sugars.

Don’t swish the drink around your mouth. - That only increases the risk of erosion. Instead, use a straw so teeth aren’t immersed in or in direct contact with the sugars and acids in the beverage.

Resist the urge to brush your teeth immediately after finishing a sports drink. - Tooth enamel softens after consumption of acidic drinks, making teeth susceptible to more wear from the abrasives in toothpaste. Wait 45 minutes to an hour before brushing to give your saliva time to re-mineralize the tooth structure and neutralize the damage.

Seek regular dental care. - Tooth decay is the most common chronic childhood disease, five times more common than asthma. It’s also preventable with proper care. Your dentist can identify early signs of erosion, pinpoint the causes, and advise you on how to prevent further damage and more serious problems from occurring.

State of Oral Health in America is Not So Good

In April, the Institute of Medicine (IOM) released a report on the state of oral health in America, concluding a two year evaluation of the current oral health care system. The U.S. Department of Health and Human Services (HHS) requested and funded this report to inform its work in addressing oral health challenges across America. HHS asked the IOM to assess the current oral health system and make strategic recommendations for its future programming. HHS is the federal agency which directs many of the government’s dental delivery, research, training and other programs.

Here are highlights:

• Tooth decay continues to be a common chronic disease in the United States


• The prevalence of oral diseases pose a significant burden on the health and well-being of the American people


• Evidence shows that decay and other oral health complications may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes


• Tooth decay is a highly preventable disease


• The general public and many healthcare professionals remain unaware of oral disease risk factors and preventive approaches and they do not fully appreciate how oral health affects overall health and well-being.

The IOM recommended that HHS design an oral health initiative that addresses areas in greatest need of attention, using approaches that have the most potential for creating improvement s, and to support this effort with strong leadership, sustained interest, and the involvement of multiple stakeholders.

“The Committee on an Oral Health Initiative reaffirms that oral health is an integral part of overall health and points to many opportunities to improve the nation’s oral health,” IOM President Harvey V. Fineberg, M.D., PhD., said in the foreword to the report. “We issue this report in the hope that it will prove useful to responsible government agencies, informative to the health professions, and public, and helpful in attaining higher levels of dental health.”

The IOM report and brief are posted online at www.iom.edu/Reports/2011/Advancing-Oral-Health-in-America.aspx

Making Coverage Matter: Pew’s 50 State Report on Children’s Oral Health

On May 24th, The Pew Center on the States, with support from the DentaQuest Foundation and W.K. Kellogg Foundation, issued its second annual report, Making Coverage Matter: Pew’s 50 State Report on Children’s Oral Health.

The report reflects a concerted effort and notable improvement among many of the states during the past year, proving that system changes can yield positive results for states continuing to struggle to provide adequate oral health care for children.

This year, seven states earned ‘A’s including Alaska, Connecticut, Maine, Maryland, Massachusetts, Minnesota, and South Carolina. Of these, Maryland was the top performing state, meeting seven of eight benchmarks. In addition, 22 states improved their grades, six of which raised their grade by at least two letters.

But even ‘A’ states have work to do. In five of these seven states, most Medicaid-enrolled children went a full year without seeing a dentist. And the total underserved population of all 7 ‘A’ states is 2,854,594 people.

While this report highlights the hard work that has gone on across the country to educate the general public and policy makers about programs that reduce disease and increase access to oral health care, lack of access to dental care is still an unacceptably persistent problem. Every year, 16 million children go without dental care, placing them at great risk of getting cavities. Cavities are almost 100% preventable when children have access to prevention, education and treatment services.

Five states including Florida, Hawaii, New Jersey, Indiana, Montana, received ‘F’s from this year’s report. By adopting relatively inexpensive and cost-effective strategies, ‘F’ states could improve children’s dental health. For Florida, Hawaii and New Jersey, this is the second straight year receiving failing grades. Indiana and Montana fell from a ‘D’ to an ‘F’.

This report gets people talking about oral health—and that’s important because it serves as a continuing national call to action for all 50 states to do more to improve children's oral health.

So let’s keep talking. What do you think this report has accomplished? Have you seen any signs of change in your state? Please share your thoughts by commenting on my blog.

A copy of the report can be found on the DentaQuest Foundation’s website, www.dentaquestfoundation.org.

Maryland Dental Action Coalition Launches 5-Year Oral Health Plan

On May 17, the Maryland Dental Acton Coalition proudly presented a 5-year (2011-2015) state plan to promote the oral health of all Marylanders. The plan addresses Maryland’s most critical oral health needs and capitalizes on available resources and data.

Speaking at the celebratory launch event is The Honorable Elijah Cummings, U.S. Congress, a long time supporter of oral health access for children in Maryland and across the United States. Also speaking are Delegate Keith Haynes, Maryland General Assembly, Renee Cohen on behalf of the Honorable Ben Cardin, U.S. Congress, Josh Sharfstein, Secretary, Department of Health and Mental Hygiene, Joseph and Madeline Misero, Katrina Holt, Chair, MDAC Maryland Oral Health Plan Committee, and Beth Lowe, Chair, MDAC. Also speaking is Ralph Fuccillo, President of the DentaQuest Foundation, which provided start up grant funds to MDAC.

Maryland has become a national model in improving the oral health of its citizens over the last decade. The roots of this process go back to 2007, following the untimely death of a 12-year old Maryland child from an untreated dental infection. A statewide Dental Action Committee (DAC) was convened by John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene (DHMH), with a specific charge to make recommendations to improve access to oral health care for vulnerable (disadvantaged and/or underinsured) children.

In 2010, the DAC transitioned to the Maryland Dental Action Coalition (MDAC), an independent, broad-based partnership of individuals working to make sure progress continued on the DAC’s recommendations for improving access to oral health care for all Marylanders. Last year, MDAC hosted an Oral Health Heroes Celebration to recognize the work of these oral health pioneers.

The Maryland Dental Action Coalition and its members initiated the development of a 5-year state oral health plan and offered guidance as it was developed. The process involved many individuals in state and local government, academic institutions, professional dental organizations, private practice dentists, community-based programs, the insurance industry, advocacy groups, and others. The goals, objectives and activities in the plan will be the basis for work of the Maryland Dental Action Coalition in the years ahead specifically for:
• Access to oral health care
• Oral disease and injury prevention
• Oral health literacy and education.

With the launch of the plan comes a new phase of collaborative action to improve oral health for Marylanders. MDAC is taking inspiration from Helen Keller, who once said, “Alone we can do so little; together we can do so much!”

A copy of the Maryland Oral Health Plan will be posted to the DentaQuest Foundation website in Reports: www.dentaquestfoundation.org/resources/reports.php

Eliminating Disparities; Promoting Health Equity

Pictured:
Dr. Chester W. Douglass, Harvard University School of Dental Medicine and Harvard School of Public Health and Dr. Philip Woods, Periodontist and Reede Scholar.


Guest blog post by Ralph Fuccillo, President, DentaQuest Foundation

The DentaQuest Foundation was honored to sponsor the Reede Scholars 2nd Annual Health Equity Symposium held at Harvard Medical School on May 12, 2011. An audience of more than 75 leaders among the health professions, including community programming, health delivery systems, health plans and purchasers, large employers, government leaders, and health policy experts attended.

Reede Scholars are health care professionals (physicians, psychiatrists, psychologists and dentists) who are working from the grassroots level to the national level, in business, academia and government. This makes for a powerful network of individuals with numerous and varied talents, experiences and interests -- all focused on improving the health and well-being of underserved populations and racial/ethnic minorities.

The program is named to honor its creator and mentor, Dr. Joan Y. Reede, a pioneer in efforts to improve the representation of ethnic minorities in health services careers and founder of the Minority Health Policy Fellowship. Dr. Reede is an inspiration for thousands who seek to make a difference in the health of their communities. Reede Scholars are advancing public health goals that aim to remedy the root causes of poor health, chronic illnesses, morbidity and death and encouraging greater civic participation and support for improved health, community empowerment, and health equity.

The 2011 Health Equity Symposium explored Health Information Technology (HIT) as an approach to achieving health equity. Dr. David Blumenthal, the National Coordinator for Health Information Technology under President Barack Obama, spoke about the potential of health information technologies as a tool providers can use to better understand the socio-demographics of their patients and monitoring for disparities. Properly used, HIT has the potential to provide a rich and consistent profile of the patient to all his/her providers (medical, behavioral, oral health) not just for diagnosis but also as a point of engagement for patient education and lifestyle improvements.

Often, problems with access to dental care can be linked to the insufficient number of dental and medical provider groups with the experience and training to offer culturally competent care to the population as it is now. Investing in educational programs to diversify the student pool and provide consistent quality experiences outside of traditional clinics is nothing less than investing in the future. Sponsorship of the Reede Health Equity Symposium is one example of DentaQuest’s investments in public health dentistry, health equity and eliminating disparities.

DentaQuest shares the commitment that the return on these investments continue to add new professionals who enter public and private practice with the cultural sensitivity and training to meet the needs of the population as it is now and as it will change.

Penny Wise, Pound Foolish?

This week, two news stories caught my eye. One, in the Washington Post, was about a vote taken in the U.S. House of Representatives to repeal mandatory funding for school-based health center construction. The other, in the Worcester, MA Telegram & Gazette, recalled the days when children in Worcester received their dental care within the public school system. That ended in the late 1970s when most school dental clinics were closed. And since then, the rate of dental disease in the city’s children has been on the rise. It also doesn’t help that the city of Worcester does not fluoridate its water supply.

Across the United States, school-based health centers are becoming an important vehicle for health care delivery for all children, but especially for poor, uninsured or underinsured children. Providing health services where children spend the greatest part of their day makes sense. It eliminates the biggest impediments to getting care – such as the parent/caregiver getting time off from work, finding a provider who accepts the family’s insurance plan, and securing appropriate transportation. School-based health centers help families too, especially when the providers introduce children, siblings and the extended family to community health resources that all can use.

School-based clinics are a first line of disease prevention and eradication. When children and their caregivers know what to do to take care of teeth, and when they are able to see a dentist when something is wrong, cavities are nearly completely preventable. And when neither of the above takes place, children can end up with serious decay and infections that require emergency room care and extreme interventions. (Read about Early Childhood Caries in this blog here and here.)

Today Worcester, MA is working to establish a pathway for young at-risk children and their families to a lifetime of good oral health. Through a pilot program, 730 Head Start children and their families are learning about oral health as part of classroom activities and parent meetings. They are introduced to the dentist as a friendly, supportive adult. Parents/caregivers get a colorful “Baby Tooth Timeline” -- a growth chart which tracks age, height and weight and provides useful dental health information for the child’s first five years. The chart explains when to expect first teeth, what to do to prevent decay, and when to schedule dentist visits.

The next step is to be sure the children have connections in the community to get care when they need it. Statistically, low-income children suffer from dental disease at much greater rates than the general population. Many Head Start children are covered by Medicaid; but not all dentists accept Medicaid patients.

And, not all school-based health centers provide dental services. We think they should. As the Worcester example shows, prevention works. It would be nice if the U.S .House of Representatives would reconsider their recent vote, and instead, approve the wise investment in school-based health centers.

Dr. Mark Doherty is Executive Director of the DentaQuest institute, a not-for-profit organization focused on improving efficiency, effectiveness and quality in dental care.

Oral Cancer Facts

Since this is Oral Cancer Awareness month, I wanted to start and end the month with some thoughts on this collection of cancers. I was recently asked to talk about oral cancer on one of our local television stations and so I contacted the Oral Cancer Foundation for some information. I talked with their Director who is an oral cancer survivor of 11 years. He was a pleasant person to speak with and had lots of valuable information to share. Among his statistics:

1. 110 people every day are diagnosed with an oral cancer
2. 1 person dies every hour of every day from oral cancer
3. Anecdotally, on the oral cancer foundation survivor list, about 1/3 are under 30 years of age
4. There seems to be a correlation with the HPV virus and oral cancers
5. In 2007 oral cancers rose 11%
6. Survival rate is good if found early, but overall about a 55% survival after 5 years

The signs of possible oral cancer lesions inside your mouth include both “raised” and “sunken” lesions, changes in coloration, hardening lesions and lesions that bleed easily. These changes should have been present at least 14 days before you start to worry, and your dentist is a great place to start for a diagnosis.

Always feel free to talk to your dentist about what to watch for and ways to prevent oral cancer.