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.