Protecting Precious Smiles: How States Prevent Oral Diseases and Curb Costs Wednesday, August 10, 2005 2:00 p.m. EDT

1. Protecting Precious Smiles: How States Prevent Oral Diseases and Curb Costs Wednesday, August 10, 2005 2:00 p.m. EDT Please wait. The Web conference will begin shortly. Thank you.

2. Protecting Precious Smiles: How States Prevent Oral Diseases and Curb Costs Trudi Matthews,Web conference moderator Associate Director for Health Policy, The Council of State Governments

3. CSG’s Healthy States Initiative • CSG’s Partnership: • National Black Caucus of State Legislators • National Hispanic Caucus of State Legislators • Complete information on Healthy States: www.healthystates.csg.org • Click on the Healthy States link on lower left and other resources listed • Supported by the Centers for Disease Control and Prevention (CDC)

4. Upcoming Web conferences • 5 more planned this year, including: • Immunizations Disparities • Smoking • Diabetes • HIV/AIDS and STDs Prevention Education • Cancer • 3 archived on Web site: Heart Disease & Stroke, Vaccine Safety, and School Health

5. Technical Problems? • For problems connecting to the Web, call 1.866.767.6902 • If you have any difficulty with audio or Web connections, press *0 for operator assistance

6. Please Complete Evaluation at End of Web Conference • We need your help! • Please complete the evaluation poll at the end of the Web conference

7. Today’s Speakers • Dr. Scott Presson, Team Leader for Prevention, Chief Dental Officer, Centers for Disease Control and Prevention • Dr. Lewis Lampiris, State Dental Director, state of Illinois • State Representative Tommy G. Roebuck, DDS, state of Arkansas

8. Dr. Scott Presson • Program Services Team Leader, Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, CDC • U.S. Public Health Service Commissioned Corps since 1977 • Dental degree from Ohio State University, Master of Public Health from University of North Carolina at Chapel Hill • Board-certified in dental public health

9. The Burden of Oral Diseases • Cavities, gum disease • Chronic and acute pain • Infection • Tooth loss • Estimated 28,000 +cases of oral/pharyngeal cancers in 2005 • Possible effects on chronic diseases (e.g., diabetes, heart disease) and preterm births

10. The Burden of Oral Diseases • $78 billion in expenditures for dental services in 2004 • Profound disparities exist in disease levels and receipt of care • 100+ millionAmericans lack dental insurance • Effective prevention measures underutilized

11. Consequences of Oral Disease • Lost time from school, work • Problems eating, speaking, attending to learning • Social consequences • Poor children more likely to have untreated decay • Medicaid covers children, dwindling assistance for adults

12. Children 2-4 Years Who Have Ever Had Decay in Primary Teeth, 1988-94 and 1999-2000 Percent 1999-2000 1988-94 2010 Target Female Male Total White Black Mexican American Note: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-1a

13. Total Tooth Loss, Adults Aged 65 Years & Older Behavioral Risk Factor Surveillance System (BRFSS), 1999 20% 21-25.9% 26-34.9% 35% Data unavailable

14. Early Detection of Oral and Pharyngeal Cancers: 1990-95 and 1996-2000 1996-2000 1990-95 Percent 2010 Target Female Male Total White Black Hispanic Note: Data are for Stage 1 (localized) tumors, excluding Kaposi Sarcoma tumors. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Surveillance, Epidemiology, and End Results Program, NIH, NCI. Obj. 21-6

15. Prevention Works • Water fluoridation • Dental Sealants • Other fluoride preventive products • Tobacco use prevention/cessation • Regular dental care

16. Community Water Fluoridation School-based, school-linked dental sealants

17. Current U.S. Water Fluoridation Status - 2002 • U.S. population drinking fluoridated water – 170 million • 67% of U.S. population on public water systems • Healthy People 2010 goal: 75% of U.S. population served - met by 24 states and D.C.

18. Dental Sealants Dental sealants—a plastic coating applied to the chewing surfaces of the back teeth

19. Unreliable estimate, relative standard error >30%. Dental Sealants: 1988-94 and 1999-2000 1988-94 1988-94 1999-2000 1999-2000 Percent 2010 Targets Total White Black Mexican American Total White Black Mexican American 6-11 Years 12-18 Years Note: Targets are for children 8 years and 14 years. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-8

20. CDC Oral Health Program • Strengthen the nation’s oral health infrastructure by supporting state-based programs • Enhance monitoring (surveillance) of oral diseases • Evaluate science base for prevention and provide guidance to states and community programs • Extend the use of proven strategies to prevent oral diseases • Resource for program development

21. Association of State and Territorial Dental Directors (ASTDD) • CDC Cooperative Agreement • Improve surveillance and monitoring • Develop/assist state programs • Enhance communication between states • Provide the National Oral Health Conference • Compile annual Synopses of state oral health programs • Conduct Best Practices project

22. Rhode Island Republic of Palau CDC Capacity Building States ND OR NY AK MI IL NV CO SC AR TX

23. Leadership Describe disease burden Surveillance system for oral diseases State oral health plan Statewide coalition Linkages and partnerships Program evaluation Water fluoridation Dental sealants Capacity Building Activities

24. Prevention Works • Assure state program capacity • Water fluoridation • Dental sealant programs • Other fluoride preventive products • Tobacco use prevention/cessation • Regular dental care

25. Useful Oral Health Web sites • CDC Oral Health Web site: www.cdc.gov/oralhealth/ • General information • National Oral Health Surveillance System • Water Fluoridation Reporting System • State Synopses • ASTDD Web site: www.astdd.org • General information • Member list • Best Practices

26. Dr. Lewis Lampiris • Director, Illinois Department of Public Health’s Division of Oral Health • D.D.S. from Temple University, M.P.H from the University of Illinois at Chicago School of Public Health • Practiced clinical dentistry in both the military and in private practice for close to 20 years • President, Association of State and Territorial Dental Directors

27. Why implement a comprehensive state oral health program? • Protect health and welfare of citizens – children, youth, adults, elderly, disadvantaged • States invest in oral health programs • Schools for dentists, dental hygienists • Licensing boards to assure quality services • Fluoridation of water supplies • Safety net dental clinics for disadvantaged • School based education to reach children most at risk – low income • Comprehensive program assures that these investments are made wisely

28. What does a comprehensive state oral health program do? • Evaluate and monitor oral health status • Develop policies to support oral health programs • Assure that population-based programs are available • Seek improved oral health for all populations

29. Essential elements of a comprehensive state oral health program • Leadership and expertise in oral health and public health • State oral health surveillance system • Population-based interventions for effective primary and secondary prevention of oral disease • Capacity to support community-level interventions • State oral health improvement plan

30. Impact • 11.5 million residents receive benefit of fluoridated water • 27% of 3rd grade children have at least one dental sealant • Development of statewide grassroots oral health coalition • Policy changes directed toward improving oral health

31. Promising Trends • Community water fluoridation • School based/school linked dental sealant programs • Integrating oral health with primary health • Fluoride varnish • Oral cancer

32. Arkansas State Representative Tommy G. Roebuck • Occupation : Practicing Dentist • First Elected: 2000 • Relevant Committees: • Aging, Children and Youth • Public Health, Welfare, and Labor • Public Health House Health Services subcommittee

33. Arkansas Legislation • Establishing Office of Oral Health--Act 785 • Implementation of an oral health education curriculum in K-12 classes-- Act 1216 • Water fluoridation legislation-- HB 2627

34. Arkansas Programs • Smiles: AR, U.S. Coalition • Regulatory change allowing dental hygienists to practice under the general supervision of a dentist • Oral health summit (annual meeting) result of the Coalition and the Office of Oral Health

35. Getting Legislators Involved • Get involved with Dental Community • dental society, family dentist • state dental health department • free and faith based Health Clinics • Develop coalitions similar to Arkansas and collaborate with other dental providers • Become a champion of oral health • learn about oral health and what you can do as a legislator • ask other legislators to learn more about oral health and how it impacts state and preventive oral health programs • become involved in the process to provide oral health initiatives

36. Q & A Session Instructions • Submit questions either way: • Email: Use the question box on the bottom right portion of the web page • Phone: Press *1, let the operator know you have a question. The operator will unmute your line so you can ask your question directly to the panelists.

37. CDC Program Assistance • Develop science base for program decision-making • Assist states in monitoring burden of oral diseases • Provide Web-based systems to show status and progress • Support research that tests innovative population-based preventive approaches • Strengthen and support state-based programs

38. Protecting Precious Smiles Panelists Dr. Scott Presson, Centers for Disease Control and Prevention Dr. Lewis Lampiris, Illinois Division of Oral Health, Dept. of Public Health Arkansas Representative Tommy G. Roebuck

39. This Concludes the Web Conference • Please complete the evaluation poll which will pop up on your screen • Go to www.healthystates.csg.org for complete information on Healthy States Initiative • Thanks for attending!