Reaffirming our commitment to oral health in rural America

As rural stakeholders from around the country take time today to celebrate Nov. 16th as National Rural Health Day, DentaQuest reaffirms its commitment to improving the oral health of residents living in rural communities. DentaQuest Institute and DentaQuest Foundation have been involved in multiple activities and initiatives in recent years that help to improve oral health access and quality of oral health care for our nation’s rural residents. 

A few of the highlights include:

• The Institute’s Medical Oral Expanded Care (MORE Care) Initiative, which focuses on the integration of oral health care into the rural primary care practice as well as the development of coordinated care networks with community dental providers, has assisted more than 20 rural primary care practices and dental providers in South Carolina, Pennsylvania, and Colorado. Based on learnings from the MORE Care initiatives in the three states, several publications were created to spread resources and knowledge to other rural communities interested in creating rural interprofessional oral health networks.
• White Paper -  “MORE Care: Narrowing the Rural Interprofessional Oral Health Gap” https://www.dentaquestinstitute.org/rural-ipp

• Rural Practice Guide – Released today – that provides practice-level guidance and practical how-to tips for rural health clinics interested in creating interprofessional oral health networks in their community: http://bit.ly/2AQ0LmR 
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• The Foundation’s support of the National Rural Health Association has enabled community health workers and other providers in Texas to be trained to integrate oral health into their outreach to residents living in colonias, Hispanic-populated communities along the U.S.-Mexico border.

• DentaQuest Foundation grantee National Conference of State Legislatures is educating policymakers on issues that challenge rural communities in their access to oral health care, developing and publishing resources that can be found on their website, here.

• Lastly, we’ve been proud to see some of our rural oral health leaders featured in The Journal of Rural Health and also NRHA’s Compendium of Rural Oral Health Best Practices.

For more information on these and other great projects being led by our Institute and Foundation teams, please visit the websites at www.dentaquestinstitute.org and www.dentaquestfoundation.org. You can also sign up for Socious, our Foundation’s online collaborative platform, to access resources and tools generated by our grantees and partners. Register here: www.oralhealth.network

‘Action for Dental Health’ in Congress

While we all paid close attention to health care in the Senate last week, the House Energy and Commerce Committee made a critical, yet mostly overlooked step to advance oral health for at-risk populations.

On July 27^th, the Committee unanimously passed HR 2422, or the Action for Dental Health Act of 2017. This bill calls for Congress to authorize additional oral health promotion and disease prevention programs to help at-risk populations struggling to obtain appropriate oral health care.

The bill points out that more than 181 million Americans will not see a dentist, but almost half of people ages 30 and older have some form of gum disease and nearly a quarter of children under age 5 already have cavities. 

As we at DentaQuest well know, caries is the most prevalent chronicdisease among children and can be prevented. What’s more, we see time and again that Americans of all ages are in desperate need of access to oral health care - Missions of Mercy like the one in Wise County, Va., is a great example. Both the Washington Post and The New York Times covered the July event, for which thousands of people come from miles away and lineup for hours and even days just to get access to dental and other services.

If this new legislation passes through Congress, the Centers for Disease Control and Prevention will award grants and collaborate with states, counties, public officials, or other stakeholders to implement a variety of initiatives.

These activities could include oral health programs that:

·         more broadly use portable/mobile dental equipment;

·         facilitate the establishment of dental homes;

·         eliminate geographic, language, cultural, or other barriers to care;

·         reduce the use of emergency departments for dental conditions; and

·         provide dental care to nursing home residents.

It is exciting to see bipartisan support for dental care initiatives that have tremendous impacts on the oral and overall health of patients. This type of work will drastically improve the health of Americans. And it has the ability to address the estimated $2.6 billion in free care that dentists currently deliver, as well as the nearly $2.1 billion spent on dental cases in hospital emergency departments – 80 percent of which could be treated in a dental office for roughly $4 million total, according to the bill.

Bipartisanship like this must continue and we urge legislators to make oral health a critical component of any health reform legislation that passes through this Congress. 

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.

Dental Health Care Needs Quality Improvement Now

The message couldn’t be clearer: The time for the dental profession to jump on the health care quality improvement (QI) bandwagon is now.

In the past quarter-century, the United States has seen medical care improve and per capita health care costs go down thanks to QI standards adapted from other industries like manufacturing. But why has the dental profession been so slow to join the game? Our recent DentaQuest Institute editorial in the July/August 2016 issue of Pediatric Dentistry provides some clues.

In our editorial, we argue that, because of QI’s effectiveness—in medicine and other fields—it is 

“...imperative that dental professionals create the culture and systems necessary to apply QI principles and activities for the benefit for our patients, the public at large, and our profession.” 

That may be easier said than done, but our own Dr. Natalia Chalmers, who heads DentaQuest Institute’s Analytics and Publication team, and her colleagues lay out a number of programs that place a heavy emphasis on QI - from DentaQuest Institute’s EarlyChildhood Caries (ECC) program and the UCLA-First 5 LA Oral Health Program to new initiatives from the American Dental Association’s Dental Quality Alliance. 

The common thread with these programs: they all work.

• Through ECC Collaborative, an effort to reduce dental caries in young children, 32 federally-qualified health centers (FQHCs) significantly improved patient outcomes after implementing a disease-management approach to QI.
• The UCLA program helped 22 local FQHCs redesign workflows based on QI models, improving diagnostic, preventive and treatment services in participating dental clinics. With the “triple aim” of improving patient experiences, improving health status, and lowering costs, the ADA’s Dental Quality Alliance seeks to help dental practices establish processes “to reliably deliver evidence-based care to every patient.”

The authors note small steps may be all that’s needed to push the profession toward QI. For example, the Plan-Do-Study-Act cycle results in a trial-and-error approach until performance improvements are realized. This practice has helped improve quality performance in industries from high-tech to higher education. There’s no reason dentistry can’t do the same.

They also understand that integrating QI into a dental practice requires considerable planning, coordination and commitment. And it takes a team for QI to take root. Dental practitioners, office staff and even patients must be invested in the process for it to work.

That said, dentists need to begin thinking now about QI at the practice level. These efforts will have an enormous impact on the way dental care is delivered. And, as the DentaQuest editorial illustrates, that’s a win-win for everyone.     

           

National Children’s Dental Health Month: Our Commitment to Improving the Oral Health of the Next Generation

By Steve Pollock, President and Chief Executive Officer, DentaQuest

This February marks the 75^th annual National Children’s Dental Health Month, bringing together dental and health leaders across the country to raise awareness of and provide tools to improve kids’ oral – and overall – health. We are working hard to address the impact of sugar consumption on children’s long-term oral health with this year’s kid-friendly Sugar Wars campaign, hosted by the American Dental Association.

To help illustrate the importance of this campaign, added sugar consumption among children across the United States accounts for 15 percent of calories every day. This is a full 5 percent higher than the recommendations from the recently-released 2015-2020 U.S. Dietary Guidelines, which indicate that added sugars should account for less than 10 percent of calories daily.

Now, think of the impact this has on their health, ranging from weight gain to nutritional deficiencies to tooth decay. Sugar helps nurture cavity-causing bacteria in the mouth. If left unchecked, sugar intake can lead to significant tooth decay.

 

Would you believe that tooth decay is the most common chronic childhood illness in the United States?

Tooth decay in kids is five times more common than asthma. Today, about 20 percent of children ages 5 to 11 have at least one untreated decayed tooth, and the percentage of children ages 5 to 19 with untreated tooth decay is actually twice as high for those from low-income families – when compared with children from higher-income households.

The implications of childhood tooth decay can carry into adolescence and even adulthood. Not only can childhood tooth decay have long-term effects linked to poor oral health, heart disease and even diabetes, but it also has a significant financial impact on our health care system. This impact can be measured in the millions of dollars we spend as a country on emergency room care for dental issues today or with the long-term financial implications of poor oral health on the treatment of those with certain chronic illnesses.

So, how do we win the Sugar Wars?

Education, access and prevention. We must be advocates for our communities and educate people about the importance of oral health and sugar intake for kids, work with leaders to increase access to care and prioritize preventive dental services that will address these issues head on.

At DentaQuest, we are committed to improving the oral health of our next generation by transforming the systems of care, finance, community and policy to achieve optimal oral health for all. We have already taken steps to achieve this vision by:

• Working with our nation’s leaders to extend funding for the Children’s Health Insurance Program (CHIP), which provides vital health coverage to kids across the country who wouldn’t otherwise have much-needed care.
•  Creating and growing the Early Childhood Caries (ECC) Collaborative, a program piloted by the DentaQuest Institute that teaches medical providers about best practices for managing and preventing tooth decay in young children.
• Encouraging our leaders to act on the Oral Health 2020 Goals, which are aggressive, industry-changing charges developed by the DentaQuest Foundation and the Oral Health 2020 national network to improve the oral health of all. Among others, we aim to:
• Eradicate dental disease in children
•  Incorporate oral health into the primary education system

Throughout the month of February and 2016, we are committed to elevating the importance of oral health in children, implementing preventive care models and improving oral health for the next generation.  

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