1. 1 © 2013 Washington Dental Service Foundation 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. 2 © 2013 Washington Dental Service Foundation 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. 3 © 2013 Washington Dental Service Foundation 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. 4 © 2013 Washington Dental Service Foundation 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

5. 5 © 2013 Washington Dental Service Foundation 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. 6 © 2013 Washington Dental Service Foundation 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. 7 © 2013 Washington Dental Service Foundation Addressing Oral Health Improves Health and Saves Money

8. 8 © 2013 Washington Dental Service Foundation 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

9. 9 © 2013 Washington Dental Service Foundation 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. 10 © 2013 Washington Dental Service Foundation 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. 11 © 2013 Washington Dental Service Foundation 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. 12 © 2013 Washington Dental Service Foundation 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. 13 © 2013 Washington Dental Service Foundation 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. 14 © 2013 Washington Dental Service Foundation Our Work: SmileMobile Dr. Paul Phillips, Colville Dental Clinic Dental Director/Host Dentist Sites:  Lummi  Hoh  Colville SERVICES  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

15. 15 © 2013 Washington Dental Service Foundation 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. 16 © 2013 Washington Dental Service Foundation 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. 17 © 2013 Washington Dental Service Foundation 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. 18 © 2013 Washington Dental Service Foundation 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. 19 © 2013 Washington Dental Service Foundation 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. 20 © 2013 Washington Dental Service Foundation Questions, Discussion, Other Ideas Questions? Discussion? Other Ideas?