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January 3, 2023
Throughout 2022, leaders of all kinds, from across the oral health community, brought forth ideas and solutions to help improve oral health in the US. Those voices, each one, are essential to creating a system that is accessible, equitable, and integrated.
In the last 12 months, they helped secure dental coverage for low-income adults in certain states, reach milestones in medical-dental integration, and promote actions to break barriers to care for people of color. They advocated, improved, and listened.
Among all those influential and important voices, these 10 quotes from CareQuest Institute blog posts, publications, and webinars stood out to us as the most compelling of 2022 — and the most hopeful for 2023:
- “I get a lot of calls to our office from people who are desperate and asking where they can get dental care. Now when I get those calls, I can tell people that they will have dental coverage under the new law, starting in January 2023.”
— Mary Backley, CEO, Maryland Dental Action Coalition
The Maryland Dental Action Coalition (MDAC) led the charge to expand dental coverage for adults on Medicaid in Maryland. In May, the state governor signed a law creating a Medicaid dental benefit for all adults.
But MDAC’s work is far from over. Now it will shift its focus to implementation, which will include working with its partners and stakeholders on a significant education and outreach campaign to make sure people know that coverage exists and help them gain access.
- “We’re trying to make a difference for people who need a voice, to service every person in this community and be an oral health champion.”
— Raydiance Swanston, health program manager, Mecklenburg County Pediatric Clinic
The Mecklenburg County Pediatric Clinic is one of 14 safety-net dental clinics across North Carolina participating in the Community Oral Health Transformation (COrHT) Initiative, forming a learning community that aims to reimagine what efficient, equitable oral health care looks like. The clinics will advance the shift toward value by embracing CareQuest Institute for Oral Health’s Three Domain Framework, which focuses on 1) tele-prevention (teledentistry), 2) minimally invasive care (nonsurgical treatment of disease), and 3) integration of oral health with overall health care.
- “The successful adoption of teledentistry depends on our industry moving to more modern, cloud-based software. Without these tools, the IT limitations will limit both the ease of adoption for the team and the user experience for the patient.”
— Nathan Suter, DDS, Chief Innovation Officer at Enable Dental
Teledentistry flourished during the COVID-19 pandemic, and it’s here to stay. Patients are embracing teledentistry, which helps ensure people do not lose access to care in a crisis and reduces costs, according to a visual report from CareQuest Institute. But how do we move forward with teledentistry? This report explores a variety of state-level barriers that stand in the way of teledentistry’s continued expansion — and offers several recommendations for leaders.
- “If we want to improve health systems, we need to invest in training a more diverse workforce. I’ve seen firsthand the experience patients have when they’re in a culturally competent environment, when they see a provider that looks like them and understands their culture.”
— Myechia Minter-Jordan, MD, MBA, CareQuest Institute President and CEO
Jordan joined the Ethics Talk podcast to discuss the AMA Journal of Ethics article “Health Equity Needs Teeth,” which she coauthored with Eleanor Fleming, PhD, DDS, MPH, and Julie Frantsve-Hawley, PhD. The article discussed the inequitable oral disease burden communities of color face, the fragmented and often biased system, and the value and urgency of moving to value-based care.
- “Roughly 90% of veterans nationwide don’t receive their dental care from the Veterans Administration (VA). These men and women put their lives on the line and they can’t even get their teeth cleaned — an effective preventative care measure.”
— Sarah A. Sherman, Director of Strategic Partnerships, Maine Bureau of Veterans’ Services (MBVS)
Veterans are more likely to experience worse dental health outcomes — higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care — compared to nonveterans. To help provide dental care to veterans who otherwise can’t afford it and don’t have dental insurance, Sherman helped form the Maine Veterans’ Dental Network (MVDN). In the future, Sherman would like to see the MDVN expand to every state.
To learn more, explore a white paper from CareQuest Institute and the American Institute of Dental Public Health (AIDPH) that recommends several actions to improve access and quality of care for veterans.
- “Silver diamine fluoride prevents new cavities more efficiently than anything we’ve ever seen before. Why wouldn’t medical teams use SDF to take control of the most prevalent disease? They can, they do, and now there is a code for health plans to compensate them for it.”
— Jeremy Horst Keeper, DDS, PhD, Director of Clinical Innovation, CareQuest Innovation Partners, a for-profit subsidiary of CareQuest Institute
In September, the American Medical Association approved a new category III CPT code for the application of silver diamine fluoride (SDF) by medical teams to stop dental decay. The addition of this code is a milestone in improving access to dental care and, ultimately, helping more people achieve better oral health. Now primary care team members will be able to apply SDF to treat cavities and be reimbursed for it. This will benefit patients by providing many new points of access for treating tooth decay.
The newly approved CPT code is expected to be inputted into code sets by electronic health records vendors in July 2023.
- “The inequities in oral health outcomes for people of color, those living in rural communities, people with disabilities, people who identify as LGBTQ, and other marginalized communities in the US are unacceptable.”
— Kaz Rafia, DDS, MBA, MPH, Chief Health Equity Officer, CareQuest Institute
In his role, Kaz spearheads strategic initiatives to foster and advance engagement and access to integrated oral health care for the underserved and underrepresented communities. Kaz also drives the organization’s efforts to elevate the integration of oral health and overall health care through the oversight of the health improvement and grantmaking teams.
- “How many more men were suffering in silence, potentially not even trying from the expectation that their needs would still go unmet even if they sought care?"
— Patrick Smith, DMD, MPH, Clinical Assistant Professor, Division of Prevention and Public Health Sciences and the Department of Pediatric Dentistry at the University of Illinois Chicago
Smith’s career has focused on raising the level of consciousness for how oral health fits into our health care system and, more specifically, better understanding community engagement in low-income, predominantly Black communities. To address these disparities, he says community programs can close the gap in care when they are appropriately resourced, given the agency to lead and innovate, integrated into the health care system, and given more consideration for their contribution to reducing health care costs.
In addition, he emphasizes the importance of developing new models to study and perfect instead of preserving a system that isn’t working for millions of people and will likely get worse. He says it could make a big difference if research and funding institutions provided the resources to develop and test out new models of care delivery that are equity-focused and not just Band-Aid solutions that support existing models.
- “This project started from a bold idea that we could reach millions of Americans who may not have access to a dentist by enlisting the greater health care workforce as partners in oral health.”
— Shenam Ticku, BDS, MPH, Instructor in Oral Health Policy and Epidemiology, Harvard School of Dental Medicine
The Center for Integration of Primary Care and Oral Health launched the 100 Million Mouths Campaign in 2020, and it is now funded by CareQuest Institute. The campaign is an initiative to designate 50 Oral Health Champions (one in each state) during the next decade to work with health profession schools and programs to integrate oral health into their primary care curricula and bridge gaps in oral health access. Champions are taught to reach out to medical and osteopathic schools; physician assistant, nurse practitioner, and midwifery schools; and pediatrics, med-peds, internal medicine, obstetrics and gynecology, and family medicine residencies.
- “We really have to switch the mindset of hospital staff from oral care as a comfort hygiene method to oral care as a therapeutic intervention. If we can do that, we can go a long way.”
— Karen Giuliano, PhD, MSN, MBA, Professor at Elaine Marieb College of Nursing, University of Massachusetts-Amherst
There’s an emerging body of evidence associating the use of comprehensive oral care with a reduction in nonventilator hospital-acquired pneumonia (NVHAP). And it’s a critically important body of evidence, as NVHAP occurs in about 1 out of every 100 hospitalized patients and is associated with longer hospital stays, hospital readmissions, and increased health care costs. Guiliano shared her comment during a webinar in September when she and a panel of experts explored the importance of the connection between healthy mouths and NVHAP. You can find the recording in our growing webinar library.