Washington Dental Service Foundation: Working Together to Improve Oral Health

1. Washington Dental Service Foundation: Working Together to Improve Oral Health Laura Smith, President & CEO Northwest Portland Area Indian Health Board Quarterly Meeting October 22, 2013

2. Who We Are: WDS Foundation • Mission: To prevent oral disease and improve overall health. We do this through innovative programs and policies that produce permanent changes in the health environment so that over the long-term oral disease is prevented • We partner with agencies, organizations, tribes, and communities

3. Our Partnership With Tribes Began Here Working with Lummi to Improve Oral Health Since 2001 • Partnered with tribal leaders to fluoridate Lummi’s water supply • SmileMobile provided services at Lummi Nation School and Lummi Head Start • Cavity Free Kids training to Head Start and other early learning providers • Trained medical clinic providers to address oral health • Funding to expand Lummi Dental Clinic, install a dental chair at Lummi Nation School • Worked with local leaders to raise awareness • about oral health and connect people with • dental care

4. What We’re Working to End: Oral Disease Tooth Decay • Most common chronic disease in childhood • Nearly 40% of kindergarteners in WA have tooth decay • 77% of WA’s Native American kindergarteners have tooth decay • Nearly 1 in 4 adults in the U.S. has untreated tooth decay Periodontal Disease • 47% of U.S. adults have some form of periodontal disease (> with age) • 61% of Native American elders have periodontal disease Photo: ICOHP Photo: Robert Henry, DMD, MPH

5. Oral Disease: Good News and Bad Good News: Oral disease is almost 100% preventable Bad News: Untreated oral disease can lead to: • Pain that makes it difficult to work, pay attention in school, sleep, eat • Poor eating habits and nutrition • Reduced self-confidence and/or problems obtaining employment because of decayed or missing teeth • Complications of chronic diseases like diabetes.

6. Oral Disease Systematic Diseases • Because oral health is linked to overall health, the effects of poor oral health are felt far beyond the mouth • People with serious gum disease are 40% more likely to have a chronic condition on top of it. • Periodontal disease—correlated with a variety of conditions • Cardiovascular disease, heart disease, respiratory infections, diabetes, HIV, adverse pregnancy outcomes • Systemic diseases can have an impact on oral health • Dementia • Medications lead to dry mouth

7. Addressing Oral Health Improves Health and Saves Money

8. Our Work: Access to Baby and Child Dentistry Goal: Improve young children’s oral health – more kids getting dental care • Medicaid-eligible children birth to 6years • Focused on prevention • Early intervention by age 1 • Training for dental offices/clinics • Outreach & case management to families

9. Our Work: Oral Health in Medical Settings GOAL: Train medical providers to address oral health with all their patients: - screening - risk assessment - oral health education - fluoride varnish - referral if needed WHY? • Already doing prevention & chronic disease management for rest of body • Already looking in the mouth • Oral health—related to nutrition and medications

10. Our Work: Oral Health in Medical Settings Benefits • Catch disease early, early treatment = reduced cost of care, improved outcomes • Help patients understand the connection between poor oral health and other chronic diseases • Reduce dental-related ER visits • Reduce medical costs (e.g. savings from reduced diabetes care) • Increase access to preventive oral health care for those not receiving dental care

11. Our Work: Patients with Diabetes Goal: Improve the oral health of people with diabetes in order to help them manage their diabetes and reduce diabetic complications • Recent strong evidence that diabetics who receive oral health care have better health outcomes and significantly reduced medical costs Strategies: • Engage primary care medical providers to address oral health with diabetic patients • Partner with American Diabetes Association WA Chapter and other organizations to raise awareness • Work with interveners (community health workers, other) to educate and refer to care

12. Our Work: Pregnant Women GOAL: Improve pregnant women’s oral health to help prevent their babies from getting cavities • Prevent the spread of bacteria from mother to child • Engage mothers at a time they are especially receptive about caring for their babies Strategies: • Motivate and train dentists to serve pregnant women • Engage prenatal medical care providers in addressing oral health • Engage community based organizations in identifying and referring (WIC, home visiting) • Motivate pregnant women to demand services • Education materials/media

13. Our Work: Cavity Free Kids • Address oral health in places where children spend their time: Head Start, Child Care, Home Visiting • Train early learning providers to educate children and families about oral health and connect them with dental care

14. Our Work: SmileMobile Mobile dental clinic serving children 0 – 18 and pregnant women Sites: • Lummi • Hoh • Colville Dr. Paul Phillips, Colville Dental Clinic Dental Director/Host Dentist SERVICES • Prevention • Educate children and their families • Risk assessment • Fluoride varnish • Sealants • Restoration • Referrals for children with extensive or special needs

15. Our Work: Seniors Dry Mouth Campaign • Goals: • Raise awareness about the link between dry mouth and oral disease • Engage pharmacists and medical providers in addressing dry mouth with their patients • Strategies: • Multi-media campaign targeting consumers and their providers • Strategic partnerships with statewide and regional partners • Area Agencies on Aging • AARP • Bartell Drugs

16. Our Work: Seniors – Oral Health for Caregivers GOAL: Train caregivers to address oral health with their clients/residents home care aides adult family homes agencies/groups serving seniors meal services elder services family/kinship caregivers

17. Our Work: Fluoridation Why? Fluoridation is the single most effective public health measure to prevent tooth decay and improve oral health over a lifetime, for both children and adults - David Satchcer, MD, PhD Surgeon General (1998-2002) What we do: • Develop and distribute messages, materials, and resources about fluoridation’s benefits • Work with local communities to fluoridate water supplies and fight rollbacks • Partner with Washington Department of Health, CDC to train water engineers • Provide capital funding for fluoridation equipment, installation, etc

18. Partnerships: Northwest Tribal Dental Support Center • Partnering with the Northwest Tribal Dental Support Center: • Operating Room Diversion Collaborative – reduce the number of children going to the operating room for dental treatment • Continuing Dental Education and Networking for Tribal Dental Clinic Providers – Webinars, Prevention Coordinators Meeting, Other

19. Partnerships: Opportunities to Work Together • Trainings: • Access to Baby and Child Dentistry (ABCD) for dental clinic staff • Managing and Treating Pregnant women training for dental clinic staff • Oral Health in Medical Settings training for medical staff • Cavity Free Kids Training for Head Start, Child Care, Home Visitors • Oral Health Training for WIC staff • Community Water Fluoridation • SmileMobile • Other

20. Questions, Discussion, Other Ideas Questions? Discussion? Other Ideas?