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1© 2013 Washington Dental Service Foundation

Washington Dental Service Foundation: Working Together to Improve Oral HealthLaura Smith, President & CEONorthwest Portland Area Indian Health Board Quarterly MeetingOctober 22, 2013


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


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


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: Robert Henry, DMD, MPH

Photo: ICOHP


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.


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


Addressing Oral Health Improves Health and Saves Money


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 6 years

Focused on prevention

Early intervention by age 1

Training for dental offices/clinics

Outreach & case management to families


Our Work: Oral Health in Medical SettingsGOAL: 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


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


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


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


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


Our Work: SmileMobile

Dr. Paul Phillips, Colville Dental Clinic Dental Director/Host Dentist

Sites: Lummi Hoh ColvilleSERVICES

Prevention– Educate children and their families– Risk assessment– Fluoride varnish– Sealants

Restoration Referrals for children with extensive or

special needs

Mobile dental clinic serving children 0 – 18 and pregnant women


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


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


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


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

http://www.npaihb.org/


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


Questions, Discussion, Other Ideas

Questions? Discussion? Other Ideas?

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