Q&A: Dental Hygienist Opens Up for National Dental Hygiene Month

As October comes to an end, so does the national observance recognizing the need and importance of dental hygiene. For this Q&A, one of our own registered dental hygienists (RDHs) opens up about how she came to this career path and why it is invaluable to the oral health care system.

Let's dig in with Laura Skaret, RDH, BSDH | Project Manager, Safety Net Solutions | DentaQuest Institute

Q: Why did you decide to become an RDH?

A: My mom is a dental hygienist, and I got my first job at her office as a dental receptionist and then later was trained on the job to work as a dental assistant. I loved my experience as an assistant and found the work we did fascinating – including the devastating results of dental disease. I saw the cycle of dental disease first hand:  teeth would need small restorations, then larger restorations, then root canals, then crowns, and even sometimes implants. I knew I wanted to focus my career on helping patients prevent and properly manage dental disease rather than repairing the damage after it occurs.

We had a pamphlet in the office that said that enamel was far more valuable than gold (referring to a gold crown).  I found that to be such a thought-provoking and accurate concept.  It’s also similar to the old familiar adage, “an ounce of prevention is worth a pound of cure.”  That couldn’t be more true in the dental field.

Q: Why are hygienists important in the care team? 

A: Dental hygienists are patient advocates. When explaining the dental disease process to patients, I always tell them that my job is essentially to keep them out of the dentist’s chair, but I can only do so much without their buy-in.  Due to the nature of plaque biofilm, the daily care that patients do for their own mouths is far more important than the work that we do in one hour with them at the dental office. Patients go to the dental office maybe two to four times per year, however 365 days a year they are responsible for managing their own oral health.  This means our most important role is to educate and motivate our patients to improve their daily oral health habits. 

Q: What has been your greatest accomplishment or most proud moment in relation to working as an RDH?

A: I’ve realized that it’s not only what you do, but the way that you do it that can make an impact.  I always try to be very kind and compassionate to the questions and concerns of my patients. I’ve had several patients who were terrified of coming to the dental office when I first met them. Years of neglecting their mouths and avoiding the dentist would bring them to our office in a lot of pain and in need of quite a bit of dental work. In addition to using a gentle technique and local and topical anesthetics, I try to help them feel more comfortable by talking them through everything I’m doing or telling them stories to get their mind off of the situation. Sometimes it’s helpful to listen to their story to find out why they have a fear, affirm their past concern, and then assure them that won’t happen today. 

When those patients then continue to come in regularly, you know you’ve not only made a difference for their oral cavity, but for their life as well.  I had one patient who needed lengthy measures to address advanced decay and periodontal (gum) disease.  After we completed her first three visits of needed periodontal therapy, she actually sent a card to my office to thank me for helping her overcome her fear of the dentist.  With a more manageable level of fear, she was able to get the care she needed to restore her smile, which gave her back her confidence.

Q: How does your professional background impact/influence/help you in your DentaQuest Institute (DQI) role?

A: My primary role at DQI is as a project manager for Safety Net Solutions (SNS), a DentaQuest Institute program. Safety Net Solutions helps safety net dental clinics adopt targeted business management best practices.  Our focus is to ensure that these dental offices can maintain financial viability to stay open and provide access to care for the underserved. We also help ensure that they understand their capacity and can maximize access to care by optimizing their productivity.  

My previous experience of working in all areas of the dental office (receptionist, chairside with the dentist, and then also as a hygienist) means I have very comprehensive knowledge of how dental offices work, from scheduling appointments, to managing supplies and inventory, to managing the patient’s care experience, to dealing with dental equipment and instrument shortages. Basically, I can understand and relate to almost any concerns our SNS clients have.

Q: Why do you continue private practice once a week? 

A: Although you can technically keep your annual dental hygiene license “active” by simply paying the license fee each year, I want to keep it active with actual patient care, as well. Also I continue to practice because I love the work!  I love working with patients and helping them improve their oral health. I also believe this helps me stay relevant and engaged with my SNS clients and their common concerns. 

Q: What is one message you hope to impart to anyone interested in becoming an RDH?

A: Hygienists are super important members of the care team! As policy changes and we move forward with accountable care organizations and pay for performance insurance reimbursement models, I think the role dental hygienists play in preventing and managing disease will be brought even more into the forefront. When finances are attached to healthy patient outcomes, dental care teams will attach an even higher value to dental hygienists. 

Also, there is a massive shortage of dental professionals – and dentists in particular – nationwide. Maximizing the use of preventive modalities such as sealants, fluoride varnish, and silver diamine fluoride will help address access gaps where dentists are hard to come by, like rural areas.  Of course, we will never stop needing the education and skills of a dentist, but if we can reduce the demand for the skills of a dentist by reducing the dental disease burden, we can help minimize the gap in access to oral health care.  

Interested in learning more about prevention-focused dental care? Check out the DentaQuest Institute's Online Learning Center and let us know what you think! 

Congress: Protect Access to Dental Health Care

As the Senate debates health care bill proposals to transform our care delivery and financing systems, we must ensure they protect access to dental coverage for all Americans.

Over the past few years, more and more Americans have been able to access affordable dental coverage. In fact, since 2000, the percentage of children without dental coverage has been cut in half.

Medicaid has played a critical role in this progress. Dental services are considered an essential part of the Early Periodic Screening, Diagnostic and Treatment (EPSDT) program, which ensures that children receive regular dental care. Adults have also benefited in recent years, with 5.4 million adults gaining coverage through Medicaid expansion.

Other public programs have also helped. Because pediatric dental benefits are considered an essential health benefit on the exchanges, more kids have coverage. Further, many adults have selected dental coverage through the marketplaces.

As more of us gain access to coverage, we see the rate of untreated decay declining among low-income children, and research shows that costly emergency department visits for dental-related issues have declined. These improvements are in large part attributable to the fact that more people have access to dental coverage.

Over the past several months – continuing this week and for likely the near future – Congress has explored various avenues for health care reform. The value of oral health care and dental coverage cannot be overlooked in these conversations.

Let’s not overlook that tooth decay remains the most chronic condition among children, which can affect school performance and attendance.

Additionally, optimal oral health is not simply a goal in itself, but is vital to creating healthier communities. Research has shown that tooth decay can result in an elevated risk for diabetes, heart disease, and stroke. What’s more, recent studies demonstrate that treatment of gum disease can lead to better overall health management—as evidenced by lower health care costs and fewer hospitalizations—among people with common health conditions like those mentioned above or even pregnancy.

Any health care reforms must ensure dental remains a priority.

By improving access to dental coverage for low-income families in the past few years, we as a nation have made tremendous strides to

• ensure children are well-positioned for a lifetime of optimal health;  

• decrease poor quality, high-cost emergency department visits for dental-associated issues; and

• improve the oral and overall health of vulnerable populations.

We hope Congress pursues solutions that protect these improvements.

National Minority Health Month: A Thank You to Community Health Promoters

During National Minority Health Month, we’re calling attention to barriers many people must overcome to enjoy their best health, and the advocates who help them. 

One of our jobs as a leading health care organization is to help people understand what they need to do to stay healthy – and that starts with literacy.

Literacy skills are one of the strongest predictors of oral health status – stronger than age, income, employment status, education level, or racial/ethnic group.  It is estimated that at least a third of adults in the United States have limited health literacy and nearly half of all American adults - 90 million people - have difficulty understanding and using health information. Because of that, folks delay taking action, and before long, small problems become big health issues.  

Community health workers are stepping in to help people understand and navigate our health care system. It’s a very personal approach to health education. DentaQuest’s outreach team spends a lot of time in the community talking to people about oral health and explaining dental benefits and how to use them. National Minority Health Month gives us an opportunity to talk about the importance of community health workers — promotores*, or  outreach specialists. These committed team members are doing incredible work to bridge health equity across communities.

Community outreach specialists are hyper grassroots, frontline public health translators. Using the strength of their personality; personal contacts; trust; and an intimate understanding of the community’s strengths, needs and social networks, they tackle sensitive health topics, correct misinformation, and connect people with quality care.  In some parts of the United States, our certified promotores are at work in rural and urban areas at clinics, churches, workplaces, schools, and even around agricultural fields.

These outreach specialists are very important to achieving our goal of ending dental disease in children. An estimated 17 million low income children in the United States go without oral health care each year—that’s about one out of every five children. 

Outreach workers help figure out why that happens. It might be because the families don’t know they should seek dental care for the children. It could be because the caregivers don’t know where to find a dentist. And it could be that the parents simply fear going to the dentist and share that fear with their kids. Outreach workers calm fears, educate and guide caregivers, and help them navigate the complexities of our health care system. They introduce families to preventive services, and even check back to be sure treatments that are initiated get completed.

And it’s not just for children. Regular screenings and preventive education for people of all ages reduce poor health outcomes and health expenditures. Outreach specialists help adults understand systemic health – what smoking does to the body or how managing mouth disease helps control diabetes and heart disease, for instance. It’s the trusting relationship with the community that enables outreach specialists to cross the cultural divide and get people involved in disease prevention and wellness. This is a critical role, especially where language, transportation and cultural responses are barriers to health.

National Minority Health Month - with this year's theme of health equity - is an opportunity to acknowledge the dedicated work of our promotores / outreach specialists and to give thanks for their genuine servicio de corazon (service from the heart).

Thank you for all you do to advance health equity nationwide!

*Promotores de salud, also known as promotoras, is Spanish for “community health worker.” 

Building Health Literacy with Read Across America

If you’ve ever read a book with a child, you know the feeling of joy that comes from the experience, as well as how fundamental literacy is for people of any age.


So it is a source of pride that DentaQuest staff from coast to coast are joining teachers, celebrities, community members and parents in getting kids excited about reading through the National Education Association's (NEA's) Read Across America Campaign, a celebration of reading timed with the birthday of Dr. Seuss.


As health industry professionals, we have a responsibility to educate consumers so they can be active advocates for their own health. In its health literacy fact sheet, the CDC says 9 out of 10 adults struggle to understand and use health information, especially when it is unfamiliar, complex or jargon-filled. In fact, low literacy contributes to poor health outcomes, higher rates of hospital utilization, and less frequent use of preventive services, in addition to overall higher health care costs.


According to the National Center for Education Statistics, since 1993 just 53 to 58 percent of children ages 3 to 5 years read or were read to on a daily basis.


Simply reading daily with a child is important.

• Children who are read to at home have a higher success rate in school. 
• Children who read frequently develop stronger reading skills. 

As part of this year’s NEA campaign, our staff is visiting schools in:

• Columbia, S.C.; 
• Locust Hill and Richmond, Va.; 
• Lincoln, Neb.; 
• Milwaukee and Mequon, Wisc.; 
• Austin and Red Rock, Texas; 
• Doral, Fla.; 
• Snoqualmie, Wa.; 
• Anniston, Ala.; and 
• the Greater Boston area. 

We are reading one of three fun books --Throw Your Tooth on the Roof by Selby B. Beeler, The Tooth Book by Edward Miller, and Open Wide by Laurie Keller. The school’s library will also get the book to keep for future reading.

In Locust Hill #VA, Jackie wowed #HeadStart kids Middlesex Elementary with tales from The Tooth Book. #healthysmiles #READACROSSAMERICA pic.twitter.com/NU6kXJMrm4

— DentaQuest (@DentaQuest) March 1, 2017

Staff who have already visited classrooms said they felt like rock stars and oral health ambassadors. The children loved the facts we shared about their teeth, including how they should take care of their own teeth and gums.


Dental disease is the most common chronic childhood disease – and it is preventable. Introducing children to fun facts about their mouths, teeth and gums through the books we brought for Read Across America is a strong step in building the health literacy skills and disease prevention awareness that will empower this next generation of consumers to be health-knowledgeable adults.


Efforts like these will go a long way to helping us achieve our vision of being a nation where children can grow up free of dental disease.

Advocacy Efforts Encourage U.S. Treasury to Address Pediatric Dental

Earlier this month, the U.S. Department of Treasury released a proposed rule clarifying that pediatric dental benefits should be part of the calculation for marketplace tax credits. If implemented, this rule will be a major victory for low-income families in need of access to affordable dental coverage for their children.

Pediatric dental coverage is one of the 10 essential health benefits for marketplace plans that are subsidized based on income level under the Affordable Care Act (ACA).

Unfortunately, the cost of pediatric dental coverage is often not included in the total subsidy amount that roughly 85 percent of those purchasing coverage through the marketplace receive to help pay for the total cost of coverage for their family.

Without the full subsidy to cover all 10 essential health benefits promised under the ACA, many families struggle to get access to dental coverage for their children.

And Congress noticed.

A few months ago, Sen. Debbie Stabenow (D-Mich.) took the lead with a group of Senators who co-signed a letter urging the Treasury to make sure that the advanced premium tax credits under the ACA accounts for the cost of pediatric dental benefits.

The National Association of Dental Plans (NADP) and Delta Dental Plans Association (DDPA) led a coalition of organizations, including DentaQuest, to garner support for Sen. Stabenow’s efforts on this issue.

So, what’s changed for pediatric dental benefits?

The latest proposed rule ensures pediatric dental is included in the subsidy calculation for all families. 

Once finalized, this rule will mean that more families have the financial support they need to get the coverage they need to #ExpectOralHealth.

Industry advocates resoundingly supported the announcement. The American Dental Association (ADA), the Children’s Dental Health Project (CDHP), DDPA, and NADP released a joint press release applauding it.

And Sen. Stabenow said:

“For young children, early dental care is especially important, and this decision will help make dental coverage more affordable for families in Michigan and across the country.”

As policies aimed at improving access and affordability continue to evolve, it is equally critical that they are implemented effectively. We are pleased to see the Treasury Department taking steps to ensure that low-income children get access to the dental coverage they need to lead productive, healthy lives. 

As health care continues to undergo significant changes, oral health is too important to be forgotten. 

To Fill or Not to Fill: That is the Question

By Dr. Doyle Williams, Chief Dental Officer, DentaQuest

Recently, the New York Times published an article, “A Closer Look at Teeth May Mean More Fillings for Dentists,” which discussed microcavities and the different ways dental care providers treat them. A 22 year old college student who had grown up without ever having a cavity visited a dentist while at college and found out she had a cavity – in fact, multiple cavities. Somehow, in just 12 months, she went from perfect oral health to having many cavities. How can that be?

Ever new technologies make it possible for dentists to find very early stage cavities (microcavities) that can’t be seen with X-rays or the naked eye. These technologies are an effective tool in identifying early decay and allowing dentists to address it before it progresses to become a bigger and more painful problem.

The microcavities they detect are abnormalities which can be an indication of the beginnings of tooth decay. For patients who previously had perfect oral health, hearing they may have a number of cavities that need to be filled is a shock. If you are concerned that a diagnosis doesn’t match up with your prior dental history (and there has been no change in your home care or health), it is never a bad idea to get a second opinion.

Today, when dental teams catch disease in an early stage, there are more options for patients than the traditional filling. For example, dentists can watch and wait to see what happens as suggested in the article by Dr. James Bader, a research professor at the University of North Carolina School of Dentistry.

Another approach is to take preventive steps. The diagnosis of a microcavity may lead a dentist to recommend the application of sealants, a thin plastic coating applied to the teeth to protect them from the bacteria that causes dental disease and the potential for further decay.

Or, a dental health professional may attempt to help “heal” the tooth. At the DentaQuest Oral Health Center, the dental team would take steps to reduce the level of the decay-causing bacteria in the patient’s mouth, and enhance the body’s natural ability to replace minerals. So instead of placing fillings that will need to be replaced in the future, they use other measures to stop early decay, help the tooth heal, and then make it more resistant to future decay. It’s a prevention-focused approach to oral health care.

My colleague, Peter Blanchard, DDS, MBA; Director, Evidence-based Practice, DentaQuest Oral Health Center, wrote an op ed in response to the New York Times article entitled “To fill or not to fill: That is the question” which was published on DrBicuspid.com.

Finding cavities early is never a bad idea. It gives us more options to help our patients stay disease free.

What you don’t know about oral health may hurt you

By Dr. Doyle Williams, Chief Dental Officer

When people hear the phrase, “I’m in good health,” chances are they aren’t thinking about their mouths.

But you should. A regular check up with your dentist is as important as an annual physical. If you are someone who is afraid of the dentist and only make an appointment when you are in pain – think of this: regular preventive care is not painful and it will help prevent painful visits in the future. Good oral health serves much more than cosmetic purposes – it is integral to your overall good health.

Teeth, gums and oral soft tissue are all susceptible to a range of conditions and diseases, including cavities, gingivitis and oral cancer. The irony is that dental disease – cavities and gum disease – are nearly 100 percent preventable if you know what to do. It’s what you don’t know about oral health that may hurt you. That’s oral health literacy.

Culturally-competent oral health literacy is as important as seeing an oral health professional. For some, a painful tooth may be enough reason to schedule a visit with a dentist. But others may wait to see bleeding, swelling, or a fever before thinking about getting care.

That’s the challenge of oral health literacy – making sure people know how to care for their teeth and gums, making sure they know the signs for concern, and making sure they know when and where to go for help.

Here are two examples:

• The U.S. Surgeon General stressed that parents who are unfamiliar with the importance and care of their child’s primary teeth are unlikely to take appropriate action that may prevent Early Childhood Caries (ECC). That includes food choices, bedtime bottle routines, daily oral hygiene, and failure to see a health professional as the baby teeth are starting to come in.

• Recently, a 24-year old father from Cincinnati, Ohio died from a tooth infection because he could not afford his medication. When his face and mouth began to swell, the man visited the emergency room at his local hospital where he was given prescriptions for pain medication and antibiotics. Because he could not afford both medications, he only filled the prescription for the pain medication. That helped the pain but the infection continued to spread, eventually to his brain.

Knowledge is power. Everyone has a role in making sure that oral health is an integral part of their overall health.

What do you think needs to be addressed to improve America’s oral health literacy?

Building a Movement for Optimal Oral Health

By Ralph Fuccillo, President, DentaQuest Foundation

According to a recent report from the Institute of Medicine, “Millions of Americans are not receiving needed dental care services because of "persistent and systemic" barriers that limit their access to oral health care. Nearly 5 million children went without regular dental checkups in 2008 because of financial limitations. 33.3 million Americans live in an area with a shortage of dental professionals.” Improving Access to Oral Health Care for Vulnerable and Underserved Populations

Stories like this illustrate the need that drives the DentaQuest Foundation’s investments in oral health improvement at the national, state and local levels. Previously, I wrote about the DentaQuest Foundation’s support for the U.S. National Oral Health Alliance which is engaging national partners in oral health improvement goals.

People feel the pain of their inability to get needed services at the local level. So today, I am writing about the Oral Health 2014 Initiative. This new signature program of the DentaQuest Foundation is building a movement for oral health at the state and community level by supporting the work of state-based organizations that are developing effective community solutions.

When we announced the Oral Health 2014 initiative, we immediately saw a clear need and interest in community solutions for oral health across the United States. Over 200 program leaders from nearly every state joined in our Request for Proposals launch webinar in June. Seventy (70) organizations responded with their ideas. Thirty-six (36) were invited to submit a full proposal.

Today, Oral Health 2014 is taking root and moving forward in 20 states. I am enthusiastic about every one of these organizations. Each is working to build support for oral health solutions in their communities, engaging traditional and not-so-traditional partners. Oral Health 2014 is a multi-year initiative. The DentaQuest Foundation is committed to each organization’s success, providing financial and technical resources to help them move their projects forward.

This is an important moment for oral health. These 20 state organizations join the growing national movement of collaborative leaders who are aligned in their desire to address oral health disparities-- many hands working toward a common goal.

I extend the gratitude of the DentaQuest Foundation to the National Advisory Committee of leaders in community health, philanthropy, civic engagement, and members of the founding board of the U.S. National Oral Health Alliance. They provided guidance in the development of the program and the selection of grantees.

• Dr. Caswell Evans of the University of Illinois, DentaQuest Foundation Board of Directors and the U.S. National Oral Health Alliance Founding Board of Directors
• Paul Gilmer of Triana Energy and a member of the National Community Committee of the CDC Prevention Research Centers
• Dr. Leslie E. Grant of the National Dental Association and the U.S. National Oral Health Alliance Founding Board of Directors
• Marion Kane, formerly of Barr Foundation and currently on the Board of the Directors for the DentaQuest Foundation
• Dr. Dushanka Kleinman of the University of Maryland School of Public Health and the U.S. National Oral Health Alliance Founding Board of Directors
• Barbara Leonard of the Maine Health Access Foundation
• Sandra Owens Lawson of CRP Corp.
• Dr. Lindsey Robinson of the California Dental Association Foundation and the U.S. National Oral Health Alliance Founding Board of Directors, and
• Dr. Donna Shelley of New York University School of Nursing and Dentistry.

Congratulations to our new Oral Health 2014 partners! I encourage you to join them in building collaborative solutions.

The DentaQuest Foundation will continue to look for ways to support local leaders in their important work to make oral health a public health priority. We encourage every group who was interested in Oral Health 2014 to stay active as oral health advocates by contributing their talents and enthusiasm to the work of the U.S. National Oral Health Alliance which is tackling the same priority areas at the national level.

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

Keeping America’s Oral Health Safety Net Strong

Ask any American what they think about healthcare reform and, for better or worse, you’ll probably find very strong opinions about the role of government and spending.

However, backstage, away from the public debate about the new law, a quiet revolution is underway to help the 59 million Americans who go without medical care and the 100 million who have not had dental care this year, get the care they desperately need.

It’s not the individual mandate or the state health exchanges. It’s the most significant investment in primary care you’ve probably never heard of—an $11 billion commitment to community health centers and $15 billion to prevention programs. It may sound like small potatoes compared to the estimated total cost of healthcare reform--$940 billion over 10 years--but the impact will be significant, especially for those who need it the most.

These funds, reopened for debate by Congress, would double the capacity of community health centers (CHCs) from serving 20 million people a year to 40 million. As the only access point for care besides the emergency room, CHCs provide critical prenatal care, behavioral health services, primary and specialty care for 1 out of 7 uninsured individuals. By 2015, with new capacity, CHCs will serve 1 out 3 uninsured.

Healthcare reform requires that CHCs offer oral health services. This means as many as 17 million children will get to see a dentist, some for the first time ever. Currently, these children are significantly underserved because they can’t access to care to prevent tooth decay and, once they have decay, to get timely treatment.

There’s a reason why former U.S. Surgeon General David Satcher declared childhood tooth decay a “silent epidemic”. 6.5 million children have untreated dental disease, the majority of whom are from low-income households. Half of these children are estimated to go to school with mouth pain—as children who cannot eat properly or pay attention in class and do well in school.

For infants 3 years old and younger, this can mean a mouth full of diseased baby teeth that can only be treated through surgical intervention. This is followed by a life time of being at greater risk for tooth decay, because the corrosive bacteria that cause tooth decay have colonized their mouths in greater proportion.

Tooth decay not only disrupts development and educational attainment, it can also turn deadly. The 2007 death of a 14-year-old Maryland boy is a tragic reminder of how one ‘simple’ toothache can develop into an unchecked infection that can quickly spread to the brain. His death could have been prevented with a timely dental care, but, at the time, oral health services were difficult to find for families on Medicaid.

From our work as president of a foundation focused solely on oral health and as a lifelong practicing dentist in both a private practice and a community health center, we see evidence every day of how oral health disparities in underserved communities are every bit as cruel as violence, inadequate housing, or poorly performing schools.

Fortunately, dental disease is nearly 100% preventable with education, regular check-ups for prevention, and treatment. That is why we’re committing DentaQuest Foundation resources to supporting and strengthening the community care safety net for oral health. We want to make sure that greater numbers of health centers will be prepared to provide effective, high-quality oral health services to children and families. The DentaQuest Institute and its Safety Net Solutions program are joining us to make sure that happens.

It may take decades before the impact of this investment in community health centers is fully appreciated. That’s okay. Today we are thinking about the millions of children who will have greater opportunity in life because of accessible health care.

Blog post by Ralph Fuccillo and Dr. Mark Doherty.

Ralph Fuccillo is President of the DentaQuest Foundation.
Dr. Mark Doherty is Executive Director of the DentaQuest Institute. Its Safety Net Solutions Program is helping community health center dental programs become more efficient, effective and financially stable.

Eradicating Early Childhood Caries

This year, the Centers for Medicare & Medicaid Services and other experts estimate that more than 300,000 children under the age of six, many from lower-income households, will suffer from Early Childhood Caries (ECC) and require hospitalization. These young children often have a mouthful of cavities and a potentially life-threatening bacterial infection that may cause them to seek hospitalization. Another 1.5 million children are considered at risk for ECC. Hospital resources are so limited that children requiring operating room care at one of the few hospital-based dental clinics commonly wait up to six months before receiving treatment. In the meantime, parents rely on powerful antibiotics to keep the infection in check. (Not much can be done about the pain).

Early Childhood Caries can be prevented. But to do this, young parents need the right information about the oral health of their babies and toddlers in time to prevent infection. Without access to preventive education and care, children may find themselves facing rampant cavities, a hospital stay, and residual lifelong disadvantages—such as malnutrition, school absences, and missed work.

We at the DentaQuest Institute are tackling this preventable, chronic childhood disease head on. Working in partnership with researchers at Children’s Hospital Boston, we have developed a clinical protocol for treating Early Childhood Caries that works with primary care providers and parents to improve treatment in the hospital and, most importantly, at home. This program is using education and case-management to help change behavior at home and the dental office. Where this treatment plan has been used, we have been able to reduce the percentage of young children (under 60 months) with new cavities by 69 percent; reduced those who needed treatment by 55 percent; and reduced reports of children with mouth pain by 50 percent. The DentaQuest Institute is now working to expand the ECC program to 10 dental clinics across 8 states—including MA, RI, OH, NY, FL, CA, WA and NY. In many ways, Early Childhood Caries is a parable for what plagues healthcare: small problems that turn into big problems because the right information and resources weren’t available in the first place to stop the progression. Preventive health care is part of the solution, but it means nothing unless you know how to use it.

Dr. Mark Doherty, Executive Director, DentaQuest Institute and Dr. Jay Anderson, Director of Quality Improvement, DentaQuest Institute

Using Performance Measurement to Improve Oral Health and Patient Care

This week, I have the pleasure of recognizing my colleague Dr. Rob Compton, who was recently appointed to the American Dental Association’s (ADA) Dental Quality Alliance (DQA) Advisory Committee on Research and Development of Performance Measures.

Dr. Compton, vice president of quality improvement for DentaQuest, is a nationally recognized expert on evidence-based oral health care and cost management methodologies. In 1999, Dr. Compton opened DentaQuest’s model dental office in Massachusetts. Its goal has been to deliver cost-effective, appropriate dental care using scientific, evidence-based technologies and treatments that are tailored to the dental needs of each patient. Today, under the direction of Dr. Peter Blanchard, the DentaQuest Oral Health Center is a thriving multi-specialty dental office—and the American Dental Association’s Adult Preventive Practice of the Year. Disease management and patient education are at the heart of its business and clinical systems. And for patients, that means healthier mouths, keeping their teeth for life, and much less need to drill and fill. The DentaQuest Oral Health Center has become a model for other dental offices who want to emphasize disease management in patient care.

Dr. Compton has brought the same thoughtful care and attention to quality improvement for better patient outcomes to DentaQuest’s dental benefit plan designs. He has encouraged DentaQuest to cover new services once they have been shown to have real impact on slowing the progression of dental and gum disease, particularly in higher-risk patients. His appointment to this ADA committee is acknowledgement of DentaQuest’s role as a major stakeholder and subject matter expert in high quality oral health benefits that emphasize cost and quality and which lead to improved patient outcomes.

The DQA was established by the American Dental Association in 2008 at the request of the Center for Medicare and Medicaid Services (CMS) which is also a co-sponsor. Its mission is to advance performance measurement as a means to improve oral health and patient care and safety through a consensus-building process.

Bionic teeth

Losing a tooth in adulthood isn't exciting as it was when we were young. In fact, adult tooth loss has serious consequences--like difficulty chewing food or not wanting to smile at school or work. Missing teeth can also weaken the overall structure of your mouth.

In the next few years, there may be a "bionic" option for replacing lost teeth: re-growing them. We have seen the technology work in animals and we hope it will be available for commercial use in the next decade.

Scientists have discovered stem cells in baby teeth and that may put our friend the tooth fairy out of a job. In animals, scientists have used scaffolding to re-grow teeth. Work on the human genome has identified a gene that may actually re-grow a duplicate tooth in your own mouth. This technology is still maybe years away from being realized, yet there is reason to believe that stem cells from baby teeth will eventually be used to grow your own teeth for replacement. Instead of putting teeth under the pillow, parents may be sending their children’s teeth to stem cell banks for cryogenic storage.

A viable option for a lost tooth today is the dental implant. (Incidentally, November is Dental Implant Month). These replacements not only act and feel like natural teeth, but they also offer solid, non-mobile support. It may take three to six months for your new implant to feel fully functional in your own mouth following an extraction of a tooth, but dental implants restore proper chewing functions, allowing you to be able to enjoy foods you love.

Read more about tissue regeneration for teeth at http://www.popsci.com/science/article/2010-05/new-technique-uses-bodys-stem-cells-regenerate-teeth