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Oral Health Capacity and Infrastructure in the States Lynn Douglas Mouden, DDS, MPH Director, Office...
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Oral Health Capacity and Infrastructure in the States
Lynn Douglas Mouden, DDS, MPHLynn Douglas Mouden, DDS, MPHDirector, Office of Oral HealthDirector, Office of Oral Health
Arkansas Department of HealthArkansas Department of Health
Immediate Past President, ASTDDImmediate Past President, ASTDD
Institute of Medicine (IOM)
Future of Public Health (Future of Public Health (1988)1988)
AssessmentAssessment
Policy DevelopmentPolicy Development
AssuranceAssurance
Guidelines forState and Territorial
Oral Health Programs
Produced by theAssociation of State and Territorial Dental
Directors (ASTDD)and Approved by the
Association of State and Territorial Health Officials (ASTHO)
Revised July 2001
Guidelines forState and Territorial
Oral Health Programs
Produced by theAssociation of State and Territorial Dental
Directors (ASTDD)and Approved by the
Association of State and Territorial Health Officials (ASTHO)
Revised July 2001
State oral health programs will be better prepared to achieve State oral health programs will be better prepared to achieve
HP 2010 Oral Health Objectives for their state and for the HP 2010 Oral Health Objectives for their state and for the
nation when they have:nation when they have:
competence in surveillancecompetence in surveillance
a full-time dental directora full-time dental director
skilled staffskilled staff
a state oral health plana state oral health plan
the support of policymakersthe support of policymakers
strong public/private partnerships and strong public/private partnerships and
community coalitionscommunity coalitions
and an ability to obtain funds for servicesand an ability to obtain funds for services
(from “Guidelines” ASTDD/ASTHO 2001)(from “Guidelines” ASTDD/ASTHO 2001)
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health Establish and maintain a state-based oral health surveillance systemsurveillance system..
Assessment on the Cheap
ArkansasArkansas 1999 and 20001999 and 2000
300 children, total cost <$1,000300 children, total cost <$1,000 (not including Director’s salary)(not including Director’s salary)
20012001 600 children, total cost <$1,000600 children, total cost <$1,000 (not including Director’s salary)(not including Director’s salary)
20032003 7,000 children, 7,000 children, totaltotal cost $27,000 cost $27,000
Obtain existing
dataAnalyze existing
data
Identify gaps
Primary data
collection
Report
Disseminate
Analyze collected
data
Update
Update
Surveillance SystemSurveillance System
Arkansas Oral Health Arkansas Oral Health Burden DocumentBurden Document
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide Provide leadershipleadership to address oral health problems. to address oral health problems.
Oral Health Leadership
Total number of State Dental DirectorsTotal number of State Dental Directors
39 Full-time39 Full-time 4 Part-time4 Part-time 6 Acting6 Acting 1 Vacant1 Vacant
Job postings: Arizona, Connecticut, Job postings: Arizona, Connecticut, Iowa, Kansas, Michigan, Oregon, South Iowa, Kansas, Michigan, Oregon, South Carolina, VermontCarolina, Vermont
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide leadership to address oral health problems.Provide leadership to address oral health problems.
Develop and maintain a Develop and maintain a state oral health improvement planstate oral health improvement plan..
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide leadership to address oral health problems.Provide leadership to address oral health problems.
Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan.
Develop and promote Develop and promote policiespolicies for better oral health and to improve health for better oral health and to improve health systems.systems.
Arkansas Policy Changes
2000 – private water source testing2000 – private water source testing
2001 – Act 715, budget cuts2001 – Act 715, budget cuts
2004 – general supervision2004 – general supervision
2004 – fluoridation mandate???2004 – fluoridation mandate???
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide leadership to address oral health problems.Provide leadership to address oral health problems.
Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan.
Develop and promote policies for better oral health and to improve health Develop and promote policies for better oral health and to improve health systems.systems.
AssuranceAssurance
Provide oral health Provide oral health communications and educationcommunications and education to policymakers and to policymakers and the public.the public.
Tobacco Prevention
and Cessation
Family Violence Prevention
Artwork and acronym used by permission of the P.A.N.D.A. CoalitionArtwork and acronym used by permission of the P.A.N.D.A. Coalitiondeveloped by Delta Dental of Missouri, copyright 1992developed by Delta Dental of Missouri, copyright 1992
P P revent revent
A A buse and buse and
N N eglecteglect through through
D D ental ental
A A warenesswareness
got teeth?got teeth? get fluoride!get fluoride!
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide leadership to address oral health problems.Provide leadership to address oral health problems.
Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan.
Develop and promote policies for better oral health and to improve health Develop and promote policies for better oral health and to improve health systems.systems.
AssuranceAssurance
Provide oral health communications and education to policymakers and Provide oral health communications and education to policymakers and the public.the public.
Build Build linkageslinkages with partners interested in reducing the burden of oral with partners interested in reducing the burden of oral diseases.diseases.
Linkages
Advisory committeesAdvisory committees
Legislative panelsLegislative panels
Faith-based organizationsFaith-based organizations
and….and….
Coalitions!
Arkansas Academy of General DentistryArkansas Academy of General DentistryArkansas Advocates for Children and FamiliesArkansas Advocates for Children and Families
Arkansas Cancer Research CenterArkansas Cancer Research CenterArkansas Center for Health ImprovementArkansas Center for Health Improvement
Arkansas Child Abuse, Rape and Domestic Violence CommissionArkansas Child Abuse, Rape and Domestic Violence Commission Arkansas Dental Assistants’ AssociationArkansas Dental Assistants’ Association
Arkansas Department of Education Office of Comprehensive Health Arkansas Department of Education Office of Comprehensive Health EducationEducation
Arkansas Department of Health, Office of Oral HealthArkansas Department of Health, Office of Oral HealthArkansas Department of Health, Office of Rural Health and Primary CareArkansas Department of Health, Office of Rural Health and Primary Care
Arkansas Department of Human ServicesArkansas Department of Human ServicesArkansas Department of Human Services, Division of Medical ServicesArkansas Department of Human Services, Division of Medical Services
Arkansas Department of Higher EducationArkansas Department of Higher EducationArkansas Foundation for Medical CareArkansas Foundation for Medical Care
Arkansas Head Start AssociationArkansas Head Start AssociationArkansas Health Care Access FoundationArkansas Health Care Access Foundation
Arkansas School Nurses AssociationArkansas School Nurses Association Arkansas State Board of Dental ExaminersArkansas State Board of Dental Examiners
Arkansas State Dental AssociationArkansas State Dental Association Arkansas State Dental Hygiene AssociationArkansas State Dental Hygiene Association
Community Dental Clinic (Ft. Smith)Community Dental Clinic (Ft. Smith)Community Health Centers of Arkansas, Inc.Community Health Centers of Arkansas, Inc.
Delta Dental Plan of ArkansasDelta Dental Plan of ArkansasDonald W. Reynolds Center on AgingDonald W. Reynolds Center on Aging
Healthy Connections, Inc.Healthy Connections, Inc. Interfaith Clinic of EldoradoInterfaith Clinic of Eldorado
Partners for Inclusive CommunitiesPartners for Inclusive CommunitiesPulaski Technical College Dental Assisting Department Pulaski Technical College Dental Assisting Department
UALR Share AmericaUALR Share America UAMS College of Public HealthUAMS College of Public Health
UAMS Dental Hygiene DepartmentUAMS Dental Hygiene DepartmentVision 2010Vision 2010
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide leadership to address oral health problems.Provide leadership to address oral health problems.
Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan.
Develop and promote policies for better oral health and to improve health Develop and promote policies for better oral health and to improve health systems.systems.
AssuranceAssurance
Provide oral health communications and education to policymakers and Provide oral health communications and education to policymakers and the public.the public.
Build linkages with partners interested in reducing the burden of oral Build linkages with partners interested in reducing the burden of oral diseases.diseases.
Integrate, coordinate, and implement Integrate, coordinate, and implement population-based interventionspopulation-based interventions..
Population-based Interventions
Ten Essential Elements to Build C & I
AssessmentAssessment
Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development
Provide leadership to address oral health problems.Provide leadership to address oral health problems.
Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan.
Develop and promote policies for better oral health and to improve health Develop and promote policies for better oral health and to improve health systems.systems.
AssuranceAssurance
Provide oral health communications and education to policymakers and Provide oral health communications and education to policymakers and the public.the public.
Build linkages with partners interested in reducing the burden of oral Build linkages with partners interested in reducing the burden of oral diseases.diseases.
Integrate, coordinate, and implement population-based interventions.Integrate, coordinate, and implement population-based interventions.
Build Build community capacitycommunity capacity to implement community-level interventions. to implement community-level interventions.
Community Capacity
Ten Essential Elements to Build C & I
AssessmentAssessment Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development Provide leadership to address oral health problems.Provide leadership to address oral health problems. Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan. Develop and promote policies for better oral health and to improve health Develop and promote policies for better oral health and to improve health
systems.systems.
AssuranceAssurance Provide oral health communications and education to policymakers and Provide oral health communications and education to policymakers and
the public.the public. Build linkages with partners interested in reducing the burden of oral Build linkages with partners interested in reducing the burden of oral
diseases.diseases. Integrate, coordinate, and implement population-based interventions.Integrate, coordinate, and implement population-based interventions. Build community capacity to implement community-level interventions.Build community capacity to implement community-level interventions. Develop Develop health systems interventionshealth systems interventions to facilitate quality dental care to facilitate quality dental care
services.services.
Health Systems Interventions
School-based health centersSchool-based health centers Head start collaborations – Head start collaborations –
forums, screening AND referralforums, screening AND referral
“ “Take Five”Take Five”
Ten Essential Elements to Build C & I
AssessmentAssessment Establish and maintain a state-based oral health surveillance system.Establish and maintain a state-based oral health surveillance system.
Policy DevelopmentPolicy Development Provide leadership to address oral health problems.Provide leadership to address oral health problems. Develop and maintain a state oral health improvement plan.Develop and maintain a state oral health improvement plan. Develop and promote policies for better oral health and to improve health Develop and promote policies for better oral health and to improve health
systems.systems.
AssuranceAssurance Provide oral health communications and education to policymakers and Provide oral health communications and education to policymakers and
the public.the public. Build linkages with partners interested in reducing the burden of oral Build linkages with partners interested in reducing the burden of oral
diseases.diseases. Integrate, coordinate, and implement population-based interventions.Integrate, coordinate, and implement population-based interventions. Build community capacity to implement community-level interventions.Build community capacity to implement community-level interventions. Develop health systems interventions to facilitate quality dental care Develop health systems interventions to facilitate quality dental care
services.services. Leverage Leverage resourcesresources to adequately fund public health functions. to adequately fund public health functions.
Resources
ASTDDASTDD HRSAHRSA
SPRANS GrantsSPRANS Grants SOHCS GrantsSOHCS Grants
RWJRWJ PipelinePipeline State Action for Oral Health Access State Action for Oral Health Access
CDCCDC Capacity and Infrastructure Capacity and Infrastructure
Cooperative AgreementsCooperative Agreements
CDC State Oral Health Program CDC State Oral Health Program Infrastructure and Capacity GrantsInfrastructure and Capacity Grants
13 Recipients13 Recipients Alaska, Arkansas, Colorado, Alaska, Arkansas, Colorado,
Illinois, Michigan, Nevada, New Illinois, Michigan, Nevada, New York, North Dakota, Oregon, Rhode York, North Dakota, Oregon, Rhode Island, South Carolina, Texas and Island, South Carolina, Texas and the Republic of Palauthe Republic of Palau
Average award ~ $200,000 / yearAverage award ~ $200,000 / year
CDC State Oral Health Program CDC State Oral Health Program Infrastructure and Capacity GrantsInfrastructure and Capacity Grants
AssessmentAssessment Surveillance SystemSurveillance System Burden DocumentBurden Document
Policy DevelopmentPolicy Development LeadershipLeadership State Oral Health PlanState Oral Health Plan Statewide Oral Health CoalitionStatewide Oral Health Coalition Systems and Policy ChangeSystems and Policy Change
AssuranceAssurance Fluoridation Program Management and PromotionFluoridation Program Management and Promotion Sealant Program ManagementSealant Program Management
National National Exposure Exposure
Oral Health in Oral Health in America: America:
A Report of the A Report of the Surgeon GeneralSurgeon General
May 2000May 2000
National Call to Action on Oral Health
A Template for Action
The The SpringboardSpringboard
Simple Physics