Leading Health Indicators Webinar: Oral Health (Part 4)

Leading Health Indicators Webinar: Oral Health (Part 4)


DR. DON WRIGHT: A follow up question from
Twitter for you, Dr. Goodman. What are examples of what the state of Maryland has done in
the past and is doing to build those better systems of prevention? DR. HARRY GOODMAN: Well, we’ve actually
come from far behind, but one of the big systems that we’re truly working on is our school-based
dental sealant programs. We really feel first of all dental sealants along with community
water fluoridation are the two evidence-based prevention strategies that is obviously known.
And while the state has done incredibly well in terms of our community water fluoridation,
we really have been lax in our school sealant projects. And that’s because for many years we didn’t
have a state oral health program to sort of develop a focus for such a statewide initiative
so they were done just on a local level. But now we’re coordinating and coalescing all
those activities and truly promoting the provision of sealants in schools. We also … something
kind of lost I guess in today’s discussion is that we developed a public health hygienist
category as a result of the Dental Action Committee recommendations. And our health departments and federally qualified
health centers and other public health entities are increasingly using this very critical
workforce to provide preventive services in schools, in Head Start programs, WIC programs
and the like. And we can only continue to increase those critical efforts, and that’s
what our plan is right now in terms of prevention. DR. DON WRIGHT: Thank you, Dr. Goodman. Our
next question was submitted from an employee at a community health center and I think Rear
Admiral Bailey, you’d be appropriate for this question. I work in a community health
center. Can you give me some direction on where we can find some oral health literacy
materials to educate our patients many of whom come only for emergencies and not for
preventive care? REAR ADMIRAL WILLIAM BAILEY: Yes. A broad
array of oral health literacy materials have been developed. CDC has resources, HRSA has
resources, Indian Health Service has resources. Maybe we can make those available somehow,
but there are a number of tools and resources related to health literacy. You know, for
the federal government there’s something called the Plain Language Act that requires
the federal government employees that are putting out any regulations and so forth to
write in plain language. Something that’s encouraging is for the
first time ever this year, the IOM round table on health literacy held the first ever day
long workshop on oral health literacy, so there is greater emphasis on oral health literacy.
There are lots and lots of resources. I’m not sure how we can make those available but
we can certainly explore the avenues, but there are many, many out there and you can
just look at some of the HHS websites, CDC, HRSA and so forth and you’ll find lots of
materials on health literacy. DR. HOWARD KOH: This is Howard Koh. I can
also add that Dr. Seiji Hayashi at HRSA has leadership in many of these oral health outreach
and education and health literacy themes, so if you want a main contact person at HRSA,
I’m going to put his name forward here. DR. HARRY GOODMAN: This is Harry Goodman,
and I want to reiterate driving people to our own website, which is http://www.healthyteethhealtykids.org
and also we have in our own backyard one of the foremost experts in oral health literacy
in Dr. Alice Horowitz who’s now at the University of Maryland at College Park School of Public
Health. DR. DON WRIGHT: Thank you. Dr. Goodman, a
very specific question from one of our listeners, where can we find the locations of the five
public health clinics in Maryland? DR. HARRY GOODMAN: The new public health clinics
were in areas that were previously noted to have no public health facilities whatsoever,
so they are really in five different counties. I can name them if you want, but those are
counties that when we first started our reforms we basically did an environmental scan of
all the jurisdictions in the state and these were found to have absolutely no public health
resource, that being not a FQAC or a local health department. And so we’ve been able now to basically
fund through state funding and through other resources as well programs in those particular
five jurisdictions. I will say that they are a combination of rural and suburban counties.
Well, actually one is actually a rural county, but they really span the type of populations
that live there. DR. DON WRIGHT: Thank you, Dr. Goodman. Rear
Admiral Bailey, I think the next question would be for you, and I think you touched
on this in one of your previous answers. Why is it important for everyone in different
areas of health care to be concerned about oral health such as medicine, dentistry and
pharmacy? REAR ADMIRAL WILLIAM BAILEY: Well, not everybody
accesses care from their dentist and we heard on the call earlier that over 100 million
people don’t have dental insurance coverage, so people are going to other types of providers
and those other types of providers can help to integrate oral health into primary health
care. There are groups now that are teaching other types of providers to conduct an assessment
and to alert patients of their oral health needs to try to refer them to the proper care
that they need. But by doing this they can also consider oral
health conditions when they assess the patient’s overall health. They can also assist in being
willing to deliver oral health preventive interventions and, you know, this increased
partnering helps to integrate health across all disciplines. There are some medications
that cause things such as gingival hyperplasia and xerostomia which is dry mouth. Xerostomia puts people at a higher risk for
tooth decay and there are a number of types of medicines such as antihypertensives and
antidepressants and antihistamines and so forth that can cause a person to have dry
mouth, so it’s important for other types of professionals to know about oral health,
and in fact, some initiatives have been launched by other types of professionals. There’s a national interprofessional initiative
for oral health that is being driven by physicians and physician assistants and nurses and pharmacists
about oral health to make sure people are more informed about oral health issues and
they’ve developed a Smiles for Life curriculum which is a nice curriculum that can be accessed
by the Internet. DR. DON WRIGHT: Thank you… REAR ADMIRAL WILLIAM BAILEY: So yeah, that’s
good. DR. DON WRIGHT: Thank you, Dr. Bailey. Another
question for you, Dr. Goodman. Has Maryland’s Office on Oral Health worked with the Maryland
Dental Action Coalition on any school-based intervention? If so, how were the schools
and communities engaged? DR. HARRY GOODMAN: Well, we’re just getting
going in that. Of course as part of our state oral health plan we work to basically include
that as a very critical part of our work with MDAC but we did work with them to actually
help co-write a proposal to the Kaiser Foundation. They received a pilot school screening grant
which they’re currently in the middle of right now to try to test efficiencies in terms
of basically providing care coordination case management to kids who were screened in schools
and then if needed refereed to the dental home. And they’re sort of piloting that connection
point between the screening and then the actual receipt of any needed follow up care, so we’ve
been pretty active on that. As I said earlier, we’re only going to continue to do more
in this particular area. It’s a really big emphasis for us.

Author: Kevin Mason

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