Generated by All in One SEO Pro v4.9.6.2, this is an llms-full.txt file, used by LLMs to index the site. # CareQuest Institute CareQuest Institute for Oral Health ## Posts ### [Navigating the Gray Areas of Premedication Decisions in Dentistry](https://carequest.org/blog/navigating-the-gray-areas-of-premedication-decisions-in-dentistry/) **Published:** July 6, 2026 **Author:** Caitlin Locklear **Content:** Patient premedication can be one of the biggest areas of uncertainty in dentistry when patients have complex medical histories or receive conflicting recommendations from other providers. Oral health providers must balance short-term patient safety with long-term responsible antimicrobial stewardship. These decisions elicit many questions and “what-ifs,” a reality underscored in the June 25 webinar, “Antibiotic Prophylaxis in Dental Care: Practical Guidance for Premedication Decisions,” from CareQuest Institute and the American Academy of Oral Medicine. ![](https://carequest.org/wp-content/uploads/2026/07/Antibiotic-Prophylaixs-in-Dental-Care-Webinar-Expert-Graphic_2-scaled.png)Experts from “Antibiotic Prophylaxis in Dental Care: Practical Guidance for Premedication Decisions” webinar During the one-hour session, approximately 900 dentists, dental hygienists, dental assistants, and other health professionals joined the call, asking more than 90 questions to the three experts. “Whether a clinician prescribes antibiotic prophylaxis that no longer meets evidence-based criteria, or omits it in a patient who genuinely needs it, the result is the same: compromised patient safety and meaningful medico-legal and ethical exposure,” says Jaisri R. Thoppay, BDS, MS, MBA, DABOM, MSHA, EdD(c). Below, we’ve highlighted some of the most common questions and key insights shared by the speakers. For complete recommendations and patient-specific guidance, please consult the latest clinical guidelines from the [American Dental Association (ADA)](https://www.ada.org/resources/ada-library/oral-health-topics/antibiotic-prophylaxis), [American Heart Association (AHA)](https://www.heart.org/en/health-topics/infective-endocarditis), and [American Academy of Orthopaedic Surgeons (AAOS).](https://www.aaos.org/globalassets/quality-and-practice-resources/dental/dental-2024/prevention-of-total-hip-and-knee-arthroplasty-pji-in-patients-undergoing-dental-procedures-cpg.pdf) 1. **How do I know if a patient needs antibiotic prophylaxis when they fall into a gray area not addressed by the guidelines?** Overprescribing antibiotics carries real risks and should be avoided. In gray-area cases, clinicians should consider the patient’s medical history, underlying conditions, medications, and overall risk profile. When needed, oral health providers should [collaborate with the patient’s medical team](https://carequest.org/resource/from-silos-to-synergy-integrating-oral-health-into-whole-person-care-through-interprofessional-practice/). 2. **What should oral health providers do if a physician or surgeon recommends antibiotic prophylaxis that does not align with current guidelines?** Oral health providers should have open, collaborative conversations with the patient’s physician or surgeon to discuss the current evidence and guidelines. If the medical provider continues to recommend antibiotic prophylaxis after the discussion, they should assume responsibility for prescribing the medication. 3. **Do patients with hip or knee replacements still need antibiotic prophylaxis before dental procedures?** Routine antibiotic prophylaxis is no longer recommended for otherwise healthy patients with prosthetic joint replacements. For medically complex patients, decisions should be on a case-by-case basis through collaboration with the patient’s orthopedic surgeon and care team. 4. **What if a patient forgets to take their antibiotic prophylaxis before the dental appointment?** If the pre-procedure dose is inadvertently missed, the ADA states that the recommended dose may be administered up to 2 hours after the procedure. This is intended as backup rather than routine practice. 5. **Can probiotics, prebiotics, or postbiotics reduce the risk of *C. difficile* infection after a patient takes antibiotics?** There is no strong, consistent data showing that probiotics prevent *C. difficile* infection. Probiotic products vary widely in strains, formulations, and quality, making it difficult to know which products may be effective. 6. **If a patient is immunocompromised, should they take antibiotic prophylaxis prior to dental procedures?** Guidelines do not specifically address immunocompromised hosts and the need for antibiotic prophylaxis. Clinicians should consider the underlying condition or medication causing the immunocompromised state. Diseases such as leukemia or potent immunosuppressive therapy would place patients at higher risk than those with well-controlled diabetes or low-dose corticosteroid use. Clinicians should coordinate with the patient’s medical team. *Editor’s Note: To view the full webinar, including the recording and the PowerPoint slides, visit the* [*CareQuest Institute webinar recording library.*](https://learning.carequest.org/#/online-courses/2a1a6a3f-2d09-4de0-adc6-f9440feb7b24) **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Dental Distrust and Discrimination: A Nationally Representative Perspective on LGBTQ+ Adults’ Experiences with Oral Health Care](https://carequest.org/resource/dental-distrust-and-discrimination-a-nationally-representative-perspective-on-lgbtq-adults-experiences-with-oral-health-care/) **Published:** July 21, 2026 **Author:** Lisa Sall **Content:** In this article published in *Frontiers in Oral Health*, CareQuest Institute researchers found that individuals identifying as LGBTQ+ reported significantly higher levels of both discrimination and microaggressions in dental settings compared with non-LGBTQ+ individuals. The study utilized data from the [State of Oral Health Equity in America survey](https://carequest.org/state-oral-health-equity-america-page/), a national representative survey including responses on sexual orientation and gender identity of more than 15,000 US adults. Inclusivity in research, education, and dental practice is important because experiencing discrimination and microaggressions in dental care is linked with poor oral health outcomes. The authors noted: > The findings of this study emphasize the critical need for inclusive, affirming dental practice environments in which patients of all sexual orientations and gender identities feel comfortable and accepted.” Authors also highlighted the need to integrate culturally responsive care into dental education, training, and licensure frameworks, citing a recent American Dental Education Association survey. “While many dental schools signal broad support for diversity,” they wrote, “LGBTQ+ inclusion, especially in curriculum and clinical training remains limited, inconsistent and largely informal, leaving graduates underprepared to meet the oral health needs of queer and transgender patients.” [Read the article](https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2026.1843339/full) in *Frontiers in Oral Health* (open access) **You may also be interested in:** - [Mapping the Health Divide: LGBTQIA+ Oral Health and the Role of Policy Inclusion](https://carequest.org/resource/mapping-the-health-divide-lgbtqia-oral-health-and-the-role-of-policy-inclusion/), a report featuring state-level analysis of transgender and cisgender queer people’s access to dental care, general and oral health indicators, and social drivers of health. - [Oral Health and the LGBTQ+ Community: A Snapshot of Disparities and Discrimination](https://www.carequest.org/resource-library/oral-health-and-lgbtq-community-snapshot-disparities-and-discrimination), a report examining the oral health experiences of individuals identifying as LGBTQ+. - [Caring for LGBTQ+ Patients: Five Tips and a Look at the Latest Data](https://www.carequest.org/about/blog-post/caring-lgbtq-patients-five-tips-and-look-latest-data), a blog post with practical strategies to help oral health professionals create safe and inclusive environments for patients of all identities and orientations. **Categories:** Journal Article, Resource **Tags:** Health Equity, Person-Centered Care --- ### [Examining Associations Between Medicaid Policy and Silver Diamine Fluoride Utilization](https://carequest.org/resource/examining-associations-between-medicaid-policy-and-silver-diamine-fluoride-utilization/) **Published:** July 10, 2026 **Author:** Lisa Sall **Content:** This study identified the potential role that policy could play in increasing silver diamine fluoride (SDF) utilization among Medicaid enrollees. Researchers at the Ohio State University Colleges of Dentistry and Medicine examined relationships between seven policy dimensions of the Current Dental Terminology (CDT) code D1354 and SDF utilization rates in 14 states. Reimbursement amount was the only policy dimension found to have a statistically significant association with SDF utilization, and only when accounting for the year. For example, reimbursement was associated with SDF utilization in 2022 but not in 2018. The authors observe that SDF faces stricter policies, compared to fluoride varnish and dental sealants, that do not align with American Dental Association Guidelines, writing: > This gap limits SDF’s potential to improve oral health, especially for children and patients with special health care needs. Raising reimbursement rates and easing restrictions could boost provider adoption, ensuring better access for patients.” [Read the article](https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70067) in the *Journal of Public Health Dentistry* (open access) Medicaid claims data for this analysis were made available by CareQuest Institute for Oral Health. Visit our [Health Data Exchange](https://dataexchange.carequest.org/) to access similar dental, medical, and social data. **You may also be interested in:** - [Medicaid Dental 360](https://dataexchange.carequest.org/data/9), a dashboard providing a clear, consolidated view of Medicaid dental coverage across states. - [Minimally Invasive Care in Dentistry: Healing Tooth Decay with Brush-On Therapies](https://learning.carequest.org/#/online-courses/5d7a4d33-b54c-4d65-b3b7-f50becee9b35), a self-paced course exploring several therapies, including SDF. - [Answers to 17 of Your SDF Questions](https://carequest.org/blog/answers-to-17-of-your-silver-diamine-fluoride-questions/), a blog post covering the benefits, risks, and challenges of incorporating SDF into practice. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [Becker's Hospital Review: Nearly 9.6 million Americans have sought dental care abroad: Study](https://carequest.org/in-the-news/beckers-hospital-review-nearly-9-6-million-americans-have-sought-dental-care-abroad-study/) **Published:** June 24, 2026 **Author:** Chernise Harris **Content:** Nearly 9.6 million people, or 4% of U.S. adults, have traveled outside the country for dental care, primarily seeking lower cost dental treatment, according to a new report from the CareQuest Institute for Oral Health. CareQuest released its “State of Oral Health Equity in America” report June 16 based on a survey of more than 9,300 adults in the U.S. The report includes data on adults’ knowledge and behaviors related to oral health, along with information on factors influencing oral health outcomes. [Read the full article here.](https://www.beckershospitalreview.com/quality/patient-safety-outcomes/nearly-9-6-million-americans-have-sought-dental-care-abroad-study/) **Categories:** In The News --- ### [Axios: Millions in U.S. travel abroad for cheaper dental care](https://carequest.org/in-the-news/axios-millions-in-u-s-travel-abroad-for-cheaper-dental-care/) **Published:** June 24, 2026 **Author:** Chernise Harris **Content:** Nearly 9.6 million American adults may have traveled abroad to get dental care, according to a new report from CareQuest Institute for Oral Health. [Read the full article here.](https://www.axios.com/2026/06/24/millions-travel-abroad-cheaper-dental-care) **Categories:** In The News --- ### [Becker's Dental Review: 1 year since HR 1: How the federal bill is upending oral healthcare](https://carequest.org/in-the-news/beckers-dental-review-1-year-since-hr-1-how-the-federal-bill-is-upending-oral-healthcare/) **Published:** June 23, 2026 **Author:** Chernise Harris **Content:** Nearly one year after HR 1 became law, states are confronting funding cuts and new work and eligibility requirements that threaten access to dental care under Medicaid — and industry leaders say the full impact has yet to be felt. [Read the full article here.](https://www.beckersdental.com/featured-perspectives/1-year-since-hr-1-how-the-federal-bill-is-upending-oral-healthcare/) **Categories:** In The News --- ### [CNN: This 22-year-old engineer 3D prints dentures to give low-income Americans their smiles back](https://carequest.org/in-the-news/cnn-this-22-year-old-engineer-3d-prints-dentures-to-give-low-income-americans-their-smiles-back/) **Published:** June 22, 2026 **Author:** Chernise Harris **Content:** At just 22, Connor Gibson is doing something he never dreamed possible: using his engineering skills to 3D print dentures for America’s most vulnerable people — and giving them back their sense of dignity in the process. [Read the full article here.](https://www.cnn.com/health/this-22-year-old-engineer-3d-prints-dentures-to-give-americas-poor-their-smiles-back-spc) **Categories:** In The News --- ### [It’s All Connected: How Unmet Dental Needs Can Delay Medical Treatment](https://carequest.org/resource/its-all-connected-how-unmet-dental-needs-can-delay-medical-treatment/) **Published:** June 11, 2026 **Author:** Lisa Sall **Content:** Oral health is inextricably linked to overall health in multiple ways. In some cases, the *treatment* of other health conditions — including heart disease and cancer — must be delayed because of oral health problems. Such delays can have profound health consequences. [![](https://carequest.org/wp-content/uploads/2026/06/Thumbnail_Its-All-Connected-232x300.png)](https://carequest.org/wp-content/uploads/2026/06/CareQuest-Institute_Its-All-Connected-Visual-Report_6.1.26.pdf)View visual report In this visual report, CareQuest Institute researchers found that about 15% of adults receiving one or more medical treatments (joint replacement, immunotherapy, radiation, heart surgery, or chemotherapy) had their medical care delayed by their physician due to oral health problems. Other key findings include: - Joint replacement was the most commonly delayed treatment due to oral health problems. - Younger adults are more likely to have their medical treatment delayed due to oral health problems: more than a third of adults aged 18-29 had their medical treatment delayed (36%), compared to only 6% of adults aged 60 or above. - Adults identifying as Black (non-Hispanic) reported having their medical treatment delayed in the largest percentage (31%). - Approximately one in ten adults with private dental insurance (11%) had their medical care delayed due to oral health problems, compared with 43% of adults with Medicaid dental insurance. These findings underscore the importance of equitable access to both dental and medical care; oral health is not a supplement to overall health but a prerequisite to it. The authors write: > Medical-dental integration, in which interprofessional health care teams provide whole-person care for their mutual patients, can help facilitate both communication between providers and access to dental and medical care for patients.” **You may also be interested in:** - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://carequest.org/resource/oral-systemic-interactions-and-medical-dental-integration-a-life-course-approach/), a report providing a comprehensive overview of the bidirectional nature of oral and systemic diseases across different life phases. - [From Silos to Synergy: Integrating Oral Health into Whole-Person Care Through Interprofessional Practice (IPP)](https://carequest.org/resource/from-silos-to-synergy-integrating-oral-health-into-whole-person-care-through-interprofessional-practice/), a white paper and use cases exploring IPP as a strategy to enhance patient outcomes. - [ Treating Dental Patients with Head and Neck Cancer](https://learning.carequest.org/#/online-courses/46876cd6-91b8-47ff-86fb-ec838274ab91), a self-paced course discussing pre-treatment evaluation, oral health care during treatment, and post-radiation oral care best practices. Eligible for 1 free CE credit. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [CareQuest Institute Launches National Campaign to Improve Veterans’ Oral Health](https://carequest.org/press-release/carequest-institute-launches-national-campaign-to-improve-veterans-oral-health/) **Published:** June 30, 2026 **Author:** Darren Edwards **Content:** ## Veteran-led video, coalition of supporters, and new report highlight urgent need for change **June 30, 2026 (Boston, MA)** – [CareQuest Institute for Oral Health®](https://carequest.org/) today launched a major national campaign highlighting the urgent need to improve dental care access for millions of veterans nationwide. At the center of the campaign is a [video](https://youtu.be/OjePFo2zbeA?si=2ynG3Q87mxxdoAPu) featuring the faces, voices, and experiences of real veterans, alongside a [new report](https://carequest.org/resource/its-time-to-give-all-veterans-a-good-reason-to-smile/) that shows significant disparities in access to care and oral health outcomes among veterans. The campaign has support from a broad coalition of 19 organizations across oral health, public health, academic, policy, and veterans-focused sectors. Of the more than 9 million veterans who are eligible for medical care through the Veterans Health Administration, [3 out of 4](https://news.va.gov/145117/va-improve-dental-care-access-eligible-veterans/) are ineligible for dental coverage because it’s currently limited to those with service-connected dental conditions or a 100% disability rating. Even those with coverage are not receiving the care they need. Only about [1 in 3](https://carequest.org/resource/its-time-to-give-all-veterans-a-good-reason-to-smile/) with Veterans Health Administration coverage uses their dental benefits each year. This gap in access contributes to higher rates of untreated oral disease, avoidable emergency department visits, lost productivity, and increased financial strain. “While we ask veterans to sacrifice for our country, millions return home without access to basic dental care that they need and deserve,” said **Wade Rakes, Chief Executive Officer at CareQuest Institute**. “It’s our obligation as Americans to ensure all veterans can access oral health care, which is vital to overall health and well-being. Through this campaign, we hope to elevate veterans’ voices, raise awareness about this urgent health matter, and build support for lasting solutions.” Data from CareQuest Institute’s report, [*It’s Time to Give All Veterans a Good Reason to Smile*](https://carequest.org/resource/its-time-to-give-all-veterans-a-good-reason-to-smile/), highlight significant and troubling trends impacting veterans’ health, including: - - Veterans are less likely to have dental insurance compared with nonveterans. - Veterans are more than twice as likely as nonveterans to seek dental care in an emergency department for an oral health condition. - Older US veterans are much more likely to have had at least six teeth removed than older nonveterans. The campaign brings together a coalition of leading organizations that are committed to building support and momentum for expanded dental coverage, provider access, and better integration within veterans’ care systems. Partners include: - - American Institute on Disparities in Public Health (AIDPH) - Apple Tree Dental - Everyone for Veterans - Harvard School of Dental Medicine Initiative to Integrate Oral Health and Medicine - HealthScape Advisors - Henry Schein Cares - Home Base - MATTER - National Association of Community Health Centers (NACHC) - National Network for Oral Health Access (NNOHA) - NxtCare - NYU College of Dentistry - OrisDX - PDS Health - The Primary Care Collaborative (PCC) - United Concordia Dental - University of North Carolina at Chapel Hill Adams School of Dentistry - University of Pennsylvania School of Dental Medicine - UT Health San Antonio School of Dentistry To view the campaign video and the report, visit: [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/). For more information about CareQuest Institute for Oral Health®, visit [carequest.org](http://carequest.org/). **Categories:** Press Release --- ### [New Report: Nearly 9.6 Million Adults Have Traveled Outside the US to Receive Dental Treatment](https://carequest.org/press-release/new-report-nearly-9-6-million-adults-have-traveled-outside-the-us-to-receive-dental-treatment/) **Published:** June 16, 2026 **Author:** Caitlin Locklear **Content:** ## High Costs and Access Gaps Push Americans Out of the Country for Dental Care, CareQuest Institute for Oral Health Data Shows **June 16, 2026 (Boston, MA) —** A new report from [CareQuest Institute for Oral Health®](https://carequest.org/) reveals that roughly 4% of adults — nearly 9.6 million people — have pursued dental care abroad at some point, most often to access lower-cost treatment, highlighting affordability gaps and systemic barriers in the US dental care system. The report places these findings in the broader context of dental tourism trends. According to the CDC, dental tourism is the [most prevalent form of medical tourism](https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html) among US residents. In 2019, [nearly half a million Americans traveled abroad for dental care.](https://healthcareinsider.com/medical-travel-rebounds-what-to-know#:~:text=%E2%80%9CPatients%20should%20balance%20their%20U.S.,insurance%20in%20order%20to%20visit.%E2%80%9D) In 2023, experts estimated the [global market for dental tourism at $10.9 billion](https://www.snsinsider.com/reports/dental-tourism-market-6076), and they expect this market to continue growing. In the US, approximately [69 million adults](https://carequest.org/oral-health-in-america-who-gets-left-behind/) (about 26%) do not have dental insurance, and cost remains a major barrier to accessing dental care. “No one should have to cross borders to access the dental care they need,” said **Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute for Oral Health.** “Quality, affordable oral health care should be within reach in every US community, not something people are forced to seek elsewhere. It’s a matter of equity, dignity, and a health care system that works for everyone.” A study of seven major industrial countries found that the [US ranks as the most expensive](https://wellnesspulse.com/research/smiles-across-the-g7-a-study-of-dental-care-expenses/) place to receive common dental procedures such as cleanings, extractions, fillings, crowns, and root canal treatments. Root canal treatments, for example, average $542 in Canada and $436 in France, compared with $838 in the US. The findings from the latest [State of Oral Health Equity in America (SOHEA) survey](https://carequest.org/state-oral-health-equity-america-page/) reveal: - Adults are equally likely to have traveled outside the US for dental care regardless of whether they have dental insurance or what type. - More than half (58%) say they did so because dental treatment costs are lower outside the US. - Nine percent say they traveled abroad for care because they do not have dental insurance. - Adults who reached their maximum dental benefit in the past year report traveling for dental care at some point in the past at a higher rate (7.6%) compared with adults who did not reach their maximum dental benefit in the past year (2.7%). The report also cautions that for individuals choosing to seek dental care abroad, safety should be a top priority. Although dental tourism may offer financial benefits and convenience, it also carries potential risks such as differences in safety standards, challenges in follow-up care, and limited legal recourse if complications occur. **Categories:** Press Release --- ### [Strengthening State Medicaid Adult Dental Benefits: Five Success Stories](https://carequest.org/resource/strengthening-state-medicaid-adult-dental-benefits-five-success-stories/) **Published:** December 3, 2025 **Author:** Darren Edwards **Content:** These case studies explore the policy journey of five states to strengthen their Medicaid adult dental benefits — from emergency-only to comprehensive benefits — including their challenges, strategies, and successes. Each case study includes key lessons that advocates can use to strengthen access to oral health care for low-income families, people with disabilities, and residents of rural communities in their own states. Key Insights - Data-driven talking points about cost savings and workforce productivity resonate across party lines. - Building diverse coalitions provides credibility and reinforces the connection between oral health and overall well-being. - Starting with high-need populations, like adults with disabilities, demonstrates feasibility and can help build momentum. - Provider buy-in is essential to build network capacity. [![View Kansas Case Study](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Kansas-MADB_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Kansas-Case-Study_12.2.25_FINAL.pdf)View Kansas case study [![View Maine case study](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Maine-MADB_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Maine-Case-Study_12.1.25_FINAL.pdf)View Maine case study [![View Maryland case study](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Maryland-MADB_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Maryland-Case-Study_12.2.25_FINAL.pdf)View Maryland case study [![View Utah case study](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Utah-MADB_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Utah-Case-Study_11.25.25_FINAL.pdf)View Utah case study [![View Virginia case study](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Virginia-MADB_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Virginia-Medicaid-Case-Study_FINAL.pdf)View Virginia case study **You may also be interested in:** - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows where a state’s Medicaid adult dental benefits package falls from no dental benefits to extensive benefits, helping policymakers identify areas for improvement. - [The Need for Medicaid Adult Dental Coverage Across All States](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states), a fact sheet outlining the health risks and economic consequences of Medicaid’s varying adult dental benefits across states. - [Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups), a report detailing the 21 states that offer additional dental coverage to adults who are pregnant, have developmental disabilities, or utilize long-term care. **Categories:** Resource, Tool **Tags:** Dental Coverage --- ### [Discrimination and (In)dignity in the Oral Health Care Setting and Oral Health Outcomes: A Latent Class Analysis](https://carequest.org/resource/discrimination-and-indignity-in-the-oral-health-care-setting-and-oral-health-outcomes-a-latent-class-analysis/) **Published:** December 4, 2025 **Author:** Darren Edwards **Content:** #### Research & Analytics Overview **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Dental Therapy: Expanding Access to Dental Care in Florida](https://carequest.org/resource/dental-therapy-expanding-access-to-dental-care-in-florida/) **Published:** January 21, 2026 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2026/01/Dental-Therapy-231x300.png)](https://carequest.org/wp-content/uploads/2026/01/CareQuest_FDHA_Dental-Therapy-Florida_FINAL.pdf)Read report Allowing the licensure of dental therapists will help address Florida’s provider shortage, expand access to care, and enable dentists to handle more complicated procedures. This fact sheet from CareQuest Institute and the Florida Dental Hygienists’ Association outlines how dental therapy can strengthen Florida’s dental care system — and what Florida policymakers can do to support the legislation. **Key Findings** - Florida ranks last nationally for children’s dental visits. - 65 out of 67 counties in Florida have dental provider shortages, affecting access for nearly 6 million residents. - Emergency room visits for preventable dental conditions cost Florida nearly $1 billion in 2024. **You may also be interested in:** - [Children’s Use of Emergency Departments for Non-Traumatic Dental Conditions](https://carequest.org/childrens-use-of-emergency-departments-for-non-traumatic-dental-conditions/), a report exploring the high rate of ED visits for preventable dental conditions among children in Florida. - [Dental Therapy: Examining the Misconceptions and Opportunities](https://learning.carequest.org/#/online-courses/cb7aae73-70a6-49f7-9f2c-a2fb7b460791), a webinar that discusses numerous aspects of dental therapy, including the legislative landscape, scope of practice, and real-world applications. - [Community Water Fluoridation](https://carequest.org/policy-advocacy/community-water-fluoridation/), a web page featuring facts about the safety and effectiveness of fluoride in water to prevent dental disease. **Categories:** Publication, Resource **Tags:** Access to Care, Dental Coverage --- ### [Water Fluoridation: Protecting Health and Saving Money for Nebraskans](https://carequest.org/resource/water-fluoridation-protecting-health-and-saving-money-for-nebraskans/) **Published:** January 21, 2026 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2026/01/WF2-231x300.png)](https://carequest.org/wp-content/uploads/2026/01/CareQuest_Fluoride-Nebraska_FINAL.pdf)Read report Recognized by leading public health and dental organizations as one of the most successful and cost-effective public health initiatives in history, community water fluoridation has protected Nebraska families from tooth decay for decades — making preventive dental care more affordable and accessible statewide. This fact sheet from CareQuest Institute and the Nebraska Dental Association outlines how community water fluoridation protects health and saves money for Nebraskans — and what lawmakers can do to protect what works. **Key Findings** - Decades of research and more than 7,000 studies have shown that fluoridating water at levels approved in the US is safe and effective at preventing tooth decay. - In Nebraska, 27% of adults lack dental insurance, and 7% have lost six or more teeth — problems that will get worse if fluoride is removed. - The American Dental Association estimates that eliminating fluoridation in Nebraska will cost the state $290 million over 5 years in avoidable dental expenses. **You may also be interested in:** - [Community Water Fluoridation: Proven, Safe, and Essential for Oral Health,](https://carequest.org/community-water-fluoridation-proven-safe-and-essential-for-oral-health/) a fact sheet highlighting the overwhelming benefits of community water fluoridation to prevent tooth decay and reduce health care costs. - [Fluoride: Questions Parents Ask](https://carequest.org/fluoride-questions-parents-ask/), answers from health care providers to frequently asked questions about fluoride and community water fluoridation. - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. **Categories:** Publication, Resource **Tags:** Access to Care, Health Equity --- ### [Water Fluoridation: Protecting Health and Saving Money for Louisianians](https://carequest.org/resource/water-fluoridation-protecting-health-and-saving-money-for-louisianians/) **Published:** January 21, 2026 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2026/01/WF-237x300.png)](https://carequest.org/wp-content/uploads/2026/01/CareQuest_Fluoride-Louisiana_FINAL.pdf)Read report Recognized by leading public health and dental organizations as one of the most successful and cost-effective public health initiatives in history, community water fluoridation has protected Louisiana families from tooth decay for decades — making preventive dental care more affordable and accessible statewide. This fact sheet from CareQuest Institute and the Louisiana Dental Association outlines how community water fluoridation protects health and saves money for Louisianians — and what lawmakers can do to protect what works. **Key Findings** - Decades of research and more than 7,000 studies have shown that fluoridating water at levels approved in the US is safe and effective at preventing tooth decay. - In Louisiana, 30% of adults lack dental insurance, and 12% have lost six or more teeth — problems that will get worse if fluoride is removed. - The American Dental Association estimates that eliminating fluoridation in Louisiana will cost the state $340 million over 5 years in avoidable dental expenses. **You may also be interested in:** - [Community Water Fluoridation: Proven, Safe, and Essential for Oral Health,](https://carequest.org/community-water-fluoridation-proven-safe-and-essential-for-oral-health/) a fact sheet highlighting the overwhelming benefits of community water fluoridation to prevent tooth decay and reduce health care costs. - [Fluoride: Questions Parents Ask](https://carequest.org/fluoride-questions-parents-ask/), answers from health care providers to frequently asked questions about fluoride and community water fluoridation. - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. **Categories:** Publication, Resource **Tags:** Access to Care, Health Equity --- ### [Scaling Medical-Dental Integration Nationally: Outcomes from the MORE Care Initiative](https://carequest.org/resource/scaling-medical-dental-integration-nationally-outcomes-from-the-more-care-initiative/) **Published:** March 8, 2026 **Author:** Chernise Harris **Content:** #### Research & Analytics Overview **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Mapping the Health Divide: LGBTQIA+ Oral Health and the Role of Policy Inclusion](https://carequest.org/resource/mapping-the-health-divide-lgbtqia-oral-health-and-the-role-of-policy-inclusion/) **Published:** January 29, 2026 **Author:** Lisa Sall **Content:** This report from CareQuest Institute and the American Institute of Dental Public Health provides a state-level analysis of transgender and cisgender queer people’s access to dental care, general health indicators, oral health indicators, and social drivers of health. The authors write: > The evidence presented throughout this report clearly indicates that LGBTQIA+ people, particularly transgender and queer youth, face significant and persistent barriers to achieving optimal oral, mental, and general health.” People who identify as lesbian, gay, bisexual, transgender, queer, intersex, agender/asexual, and other gender/sexual identities (LGBTQIA+) have long faced discrimination from US health care systems, including dental care. Many also encounter challenges such as financial instability and mental health issues, which can affect their oral health. [![Read report](https://carequest.org/wp-content/uploads/2026/01/Mappiing2.png)](https://carequest.org/wp-content/uploads/2026/01/CareQuest_Institute_AIDPH_Mapping-the-Health-Divide_1.7.26-1.pdf)Read report Key findings include: - States with discriminatory policies had more negative outcomes for social, mental, and oral health among transgender youth compared to states with protective policies. - Even in states with strong protections, queer patients continue to report disproportionate levels of unmet need, underscoring the reality that legal protections alone are not enough. - Queer youth, and transgender youth, in particular, in states with discriminatory policies, report lower dental utilization rates compared to states with inclusive or protective policies. - Transgender adults consistently experience the highest rates of tooth loss, especially in states with exclusionary policies. The findings in this report demonstrate that in addition to inclusive policies, care delivery systems must ensure safety, visibility, and belonging to improve health outcomes for queer patients. **You may also be interested in:** - [Oral Health and the LGBTQ+ Community: A Snapshot of Disparities and Discrimination](https://www.carequest.org/resource-library/oral-health-and-lgbtq-community-snapshot-disparities-and-discrimination), a report examining the oral health experiences of individuals identifying as LGBTQ+. - [Caring for LGBTQ+ Patients: Five Tips and a Look at the Latest Data](https://www.carequest.org/about/blog-post/caring-lgbtq-patients-five-tips-and-look-latest-data), a blog post with practical strategies to help oral health professionals create safe and inclusive environments for patients of all identities and orientations. - [Inequities Among LGBTQIA+ People of Color](https://carequest.org/inequities-among-lgbtqia-people-of-color/), a visual report finding that discrimination and oral health disparities are compounded for adults who identify as queer and transgender people of color. **Categories:** Publication, Resource **Tags:** Access to Care, Health Equity, Person-Centered Care --- ### [How Ending Water Fluoridation Would Affect Children and State Medicaid Costs](https://carequest.org/resource/how-ending-water-fluoridation-would-affect-children-and-state-medicaid-costs/) **Published:** January 29, 2026 **Author:** Lisa Sall **Content:** In this report, researchers at CareQuest Institute analyzed how ending water fluoridation would affect the well-being of children and Medicaid costs within five states: Florida, Kentucky, Louisiana, Oklahoma, and Missouri. Each of these states has legislation to ban or restrict water fluoridation, with a ban already passed in Florida. [![View visual report](https://carequest.org/wp-content/uploads/2026/01/Thumbnail_How-Ending-Water-Fluoridation_612x792-232x300.png)](https://carequest.org/wp-content/uploads/2026/01/CareQuest-Institute_How-Ending-Water-Fluoridation_1.29.26.pdf)View visual report Researchers examined Medicaid costs because children from low-income households have a greater risk of cavities compared to children from upper-income households. For families living paycheck to paycheck and for state budgets, researchers found, costs to treat additional cavities can be unaffordable. Key Findings - A water fluoridation ban in just these five states would cause more than 132,000 additional children to need cavities filled or teeth pulled, and cost state Medicaid programs nearly $40 million within three years. - Children with tooth pain are three times more likely to miss school and four times more likely to receive lower grades. - In 2023, an estimated 6 million parents/guardians reported missing approximately 38.5 million work productivity hours in the prior year due to their children’s oral pain or unplanned dental visits. After more than 7,000 studies, the overwhelming weight of scientific evidence shows that fluoride in water at levels recommended in the US is safe and effective at preventing cavities. Researchers said: > Clearly, ending fluoridation would strike a blow to children’s health, well-being, and opportunity.” **You may also be interested in:** - [2026 Community Water Fluoridation Policy Map](https://carequest.org/2026-community-water-fluoridation-policy-state-legislative-activity/), a map tracking the status of state legislation to ban, restrict, or protect water fluoridation. - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. - [Community Water Fluoridation: Proven, Safe, and Essential for Oral Health,](https://carequest.org/community-water-fluoridation-proven-safe-and-essential-for-oral-health/) a fact sheet highlighting the overwhelming benefits of community water fluoridation to prevent tooth decay and reduce health care costs. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Water Fluoridation: Protecting Health and Saving Money for Kentuckians](https://carequest.org/resource/water-fluoridation-protecting-health-and-saving-money-for-kentuckians/) **Published:** February 6, 2026 **Author:** Lisa Sall **Content:** Recognized by leading public health and dental organizations as one of the most successful and cost-effective public health initiatives in history, community water fluoridation has protected Kentucky families from tooth decay for decades — making preventive dental care more affordable and accessible statewide. [![](https://carequest.org/wp-content/uploads/2026/02/Thumbnail_Fluoride-KOHC-Kentucky_612x792-232x300.png)](https://carequest.org/wp-content/uploads/2026/03/CareQuest_KOHC_Fluoride-Kentucky_3.2.2026.pdf)Read report This fact sheet from CareQuest Institute and the Kentucky Oral Health Coalition outlines how community water fluoridation protects health and saves money for Kentuckians — and what lawmakers can do to protect what works. Key Findings - Decades of research and more than 7,000 studies have shown that fluoridating water at levels approved in the US is safe and effective at preventing tooth decay. - In Kentucky, 27% of adults do not have dental insurance, and more than one in five adults age 65 and older have lost all their natural teeth to decay or disease — problems that will get worse if fluoride is removed. - It could cost the state $19.7 million a year in increased Medicaid expenses for every 10% of Kentuckians that lose access to fluoridated water. **You may also be interested in:** - [How Ending Water Fluoridation Would Affect Children and State Medicaid Costs](https://carequest.org/how-ending-water-fluoridation-would-affect-children-and-state-medicaid-costs/), a report finding that ending water fluoridation in just five states could cause 132,000 additional children to need cavities filled or teeth pulled, and cost state Medicaid programs nearly $40 million. - [Community Water Fluoridation: Proven, Safe, and Essential for Oral Health,](https://carequest.org/community-water-fluoridation-proven-safe-and-essential-for-oral-health/) a fact sheet highlighting the overwhelming benefits of community water fluoridation to prevent tooth decay and reduce health care costs. - [Fluoride: Questions Parents Ask](https://carequest.org/fluoride-questions-parents-ask/), answers to frequently asked questions about fluoride and community water fluoridation. **Categories:** Publication, Resource **Tags:** Access to Care, Health Equity --- ### [Maxed Out: The Reality of Reaching Dental Insurance Limits](https://carequest.org/resource/maxed-out-the-reality-of-reaching-dental-insurance-limits/) **Published:** February 19, 2026 **Author:** Lisa Sall **Content:** An analysis from CareQuest Institute estimates that approximately 32 million US adults’ dental care needs will exceed their dental insurance plan’s annual maximum benefit. [![](https://carequest.org/wp-content/uploads/2026/02/Thumbnail_Maxed-Out_612x792-232x300.png)](https://carequest.org/wp-content/uploads/2026/02/CareQuest_Institute_Maxed-Out_2.12.26.pdf)View report The report draws on the 2025 State of Oral Health Equity in America survey to understand how many adult respondents reached or exceeded their annual maximum dental benefit in 2024, their sociodemographic characteristics, and how they navigated their dental treatment after reaching this maximum. Key findings include: - Of adults who reached or exceeded their maximum benefit, nearly half (46%) report that this prevented them from seeking additional dental treatment. - Eight percent of adults who exceeded their maximum dental benefit in the previous year say they traveled outside the US to receive dental care at some point in time, compared with 3% of adults who did not exceed their maximum. - The percentage of adults reaching their maximum benefit increased with age — 14% of adults aged 55 and older reached their maximum. According to the Kaiser Family Foundation, 41% of US adults have debt from medical or dental bills, disproportionally affecting individuals with lower income and people of color. “The findings underscore gaps in dental coverage that may lead to delayed or discontinued care, particularly among older adults and those with limited insurance benefits,” write the authors. **You may also be interested in:** - [Oral Health in America: Who Gets Left Behind?](https://carequest.org/oral-health-in-america-who-gets-left-behind/), findings from the latest State of Oral Health Equity in America survey that reveal both progress and gaps in access to dental care. - [Lower-Income Families Still Spend More on Dental Care](https://carequest.org/lower-income-families-still-spend-more-on-dental-care/), a visual report finding that lower-income families paid 7.4 times more out-of-pocket for dental care compared to higher-income families. - [Lifelong Oral Health: How Insurance Type Shapes Dental Care Spending](https://carequest.org/lifelong-oral-health-how-insurance-type-shapes-dental-care-spending/), a report examining differences in oral health care spending between Medicaid and commercial insurance plans. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Periodontal Therapy Among Patients with Cardiovascular Disease: Exploring Its Association with Lower Medical Spending](https://carequest.org/resource/periodontal-therapy-among-patients-with-cardiovascular-disease-exploring-its-association-with-lower-medical-spending/) **Published:** March 23, 2026 **Author:** Lisa Sall **Content:** This study by CareQuest Institute, published in the journal *Frontiers in Public Health*, found that people with cardiovascular disease (CVD) who had four or more periodontal visits had nearly 10% lower overall medical costs than those with CVD who received no periodontal care. [![](https://carequest.org/wp-content/uploads/2026/04/Thumbnail_Periodontal-Therapy_Executive-Summary_4.15.26-232x300.png)](https://carequest.org/wp-content/uploads/2026/04/CareQuest_Institute_Periodontal-Therapy_Executive-Summary_4.15.26.pdf)View plain language summary Additional findings include: - People with CVD who had one to three periodontal visits had an 8% decrease in prescription drug costs. - While 40% of adults aged 30 and above have periodontitis (gum disease), more than 80% of the patients with cardiovascular disease in this study did not receive periodontal treatment. - The observed reductions in health care costs associated with periodontal treatment could be even greater given the high incidence of periodontitis across the US population. The authors write: > These results underscore the relevance of integrating oral health into chronic disease management and indicate that greater access to periodontal care may be associated with economic and health benefits.” [Read the article](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.frontiersin.org%2Fjournals%2Fpublic-health%2Farticles%2F10.3389%2Ffpubh.2026.1741942%2Ffull&data=05%7C02%7CLSall%40carequest.org%7C8b88c50c6ddc4effd53d08de8426aca0%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C639093498812281091%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=hm42UMFS0ZCEwrZuu6ZHrNuMhOlyXyAK%2BGx3m17h4TU%3D&reserved=0) in *Frontiers in Public Health* (open access) You may also be interested in: - [The Heart of the Matter](https://carequest.org/the-heart-of-the-matter/), a visual report exploring the relationship between cardiovascular (heart) disease and periodontal (gum) disease. - [Periodontal Treatment Associated with Decreased Diabetes-Related Treatment Costs](https://carequest.org/periodontal-treatment-associated-with-decreased-diabetes-related-treatment-costs/), an article in *The Journal of the American Dental Association* finding that overall health care costs were reduced up to 14% in patients with diabetes who received periodontal treatment. - [Another Billion Reasons for a Medicare Dental Benefit](https://carequest.org/another-billion-reasons-for-a-medicare-dental-benefit/), a report finding that including periodontal treatment in Medicare could save up to $42 billion in health care costs for patients with diabetes and heart disease. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Inequities Among LGBTQIA+ People of Color](https://carequest.org/resource/inequities-among-lgbtqia-people-of-color/) **Published:** July 11, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Inequities-Among-LGBTQIA_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Inequities-Among-LGBTQIA_7.2.25.pdf)View report ## How Race and Identity Shape Oral Health Outcomes This report, based on results from CareQuest Institute’s State of Oral Health Equity in America survey, examines the oral health experiences and outcomes of adults identifying as both LGBTQIA+ and as people of color (POC). Survey results show that inequities individuals face when they belong to a sexual/gender minority and a racial/ethnic minority have a compounding effect on oral health disparities. More specifically, adults who identify as queer and transgender people of color (QTPOC) were less likely to have an annual dental visit, less likely to have a dental home, and more likely to seek dental care in an emergency department than white LGBTQIA+ adults. Adults who identified as QTPOC were also: - More likely to have experienced discrimination in a dental setting or have been denied oral health care due to discrimination. - Significantly more likely to experience at least one oral health symptom in the last year, such as toothaches and bleeding gums. - More likely to feel self-conscious or embarrassed about their oral health. The authors write: > The higher percentage of QTPOC adults who report being denied oral health care due to discrimination suggests the need for the oral health workforce to be more diverse and be more competent in providing care that is more sensitive to patients’ intersecting identities.” **You may also be interested in:** - [Caring for LGBTQ+ Patients: Five Tips and a Look at the Latest Data](https://www.carequest.org/about/blog-post/caring-lgbtq-patients-five-tips-and-look-latest-data), a blog post with practical strategies to help oral health professionals create safe and inclusive environments for patients of all identities and orientations. - [Oral Health and the LGBTQ+ Community: A Snapshot of Disparities and Discrimination](https://www.carequest.org/resource-library/oral-health-and-lgbtq-community-snapshot-disparities-and-discrimination), a report examining the oral health experiences of individuals identifying as LGBTQ+. - [Does Our Oral Health Care System Welcome Everyone?](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone), a report exploring various socioeconomic factors that continue to create barriers to equitable oral health care for millions of people in the US. **Categories:** Resource, Visual Report **Tags:** Health Equity, Person-Centered Care --- ### [Community Water Fluoridation National Opinion Poll Results](https://carequest.org/resource/community-water-fluoridation-national-opinion-poll-results/) **Published:** July 16, 2025 **Author:** Darren Edwards **Content:** [![View results](https://carequest.org/wp-content/uploads/2025/07/Thumbnail_Attitudes-about-Fluoride_0-232x300.png)](https://carequest.org/wp-content/uploads/2025/10/Attitudes-about-Fluoride_National-Survey-Results_07.17.25.pdf)View results ## Majority of Americans Support Community Water Fluoridation A national survey of US adults shows 81% either support community water fluoridation (52%) or they are not opposed to it (29%). After more than [7,000 studies](https://pubmed.ncbi.nlm.nih.gov/?term=water+fluoridation&sort=pubdate&sort_order=asc), the overwhelming weight of scientific evidence shows that fluoridating water, at levels approved in the US, is safe and effective at preventing tooth decay. Major US health organizations, including the [American Academy of Pediatrics](https://www.aap.org/en/patient-care/oral-health/fluoridation), the [Mayo Clinic](https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/keeping-childrens-teeth-healthy), and the [American Dental Association](https://www.ada.org/resources/community-initiatives/fluoride-in-water/fluoridation-faqs), also support community water fluoridation. **Additional Findings** - Only 6% of respondents think all communities should ban putting fluoride in water. - 79% of respondents believe the government should do what it can to protect and improve oral health. - Nearly all respondents (96%) trust their family doctor or pediatrician as a source to learn about fluoride in drinking water. The survey of 1,114 US adults was commissioned by CareQuest Institute and conducted online by Marketing for Change Co. between July 7 and July 9, 2025. The margin of error due to sampling is +/- 2.94%. **You may also be interested in:** - [New Study Shows Costly Consequences for States Banning Fluoride](https://www.carequest.org/about/blog-post/new-study-shows-costly-consequences-states-banning-fluoride), a blog post with authors of a study in [*JAMA Health Forum*](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2834515) summarizing their findings — ending water fluoridation could result in 25 million additional decayed teeth and nearly $10 billion in health care costs. - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. - [Winning on Water Fluoridation: Lessons from Louisiana and Connecticut](https://www.carequest.org/about/blog-post/winning-water-fluoridation-lessons-louisiana-and-connecticut), a policy expert shares key lessons from states that have defeated fluoride bans. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Perspectives and Experiences with Equitable Data Collection in Oral Health](https://carequest.org/resource/perspectives-and-experiences-with-equitable-data-collection-in-oral-health/) **Published:** July 21, 2025 **Author:** Darren Edwards **Content:** ## Moving Beyond One-Dimensional Data Collection This article, published in *BMC Oral Health*, explores how current data collection practices can perpetuate inequities by rendering some groups invisible or misrepresented. Researchers from CareQuest Institute and the University of Minnesota conducted qualitative interviews with individuals often excluded from oral health research due to race, ethnicity, language, disability, sexual orientation, and gender identity. Study participants provided suggestions to improve oral health data collection, including: - Engage in participatory research practices - Understand and respect data ownership - Build trusting relationships through collaboration and transparency - Allow participants to choose more than one option in demographic responses or write in responses The findings underscore the importance of moving beyond one-dimensional data collection and adopting methods that capture the complexity of individuals’ lived experiences. The authors write: > Data collection processes in research inform decision-making and resource allocation . . . incomplete or inequitable data can lead to potentially harmful oral health care and policy-making decisions.” [Read the article](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Frdcu.be%2FeuS6D&data=05%7C02%7CLSall%40carequest.org%7Cbe6f884717f64937985008ddbd5ac7d8%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638874919788788458%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=gTM9cULDWkhRhGfxkk9R5UvbrtW9t1m3AjHtkQ%2FSNhY%3D&reserved=0) in *BMC Oral Health* (open access) **You may also be interested in:** - [Inequities Among LGBTQIA+ People of Color: How Race and Identity Shape Oral Health Outcomes](https://www.carequest.org/resource-library/inequities-among-lgbtqia-people-color), a report examining the compounded oral health inequities individuals with intersecting identities experience. - [American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral)’, a comprehensive white paper that includes information about the importance of more accurate and inclusive data collection within Native Communities. - [Exploring Oral Health and Care Access among Adults with Disabilities](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities), a report that investigates the challenges in accessing oral health care for one-quarter of US adults that have at least one disability. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Oral Health Literacy from a Person-Centered Focus in the US](https://carequest.org/resource/oral-health-literacy-from-a-person-centered-focus-in-the-us/) **Published:** July 23, 2025 **Author:** Darren Edwards **Content:** In this article published in *BMC Oral Health*, CareQuest Institute researchers examined the existing peer-reviewed literature to determine who is most often evaluated for oral health literacy (OHL), what oral health measures and interventions are utilized, and who is responsible for improving OHL and oral health outcomes. Researchers found that OHL studies were representative of groups across the lifespan — from pregnancy to adulthood. However, studies frequently focused on only one social identity, such as being a caregiver or race/ethnicity. The authors recommend using an OHL framework, which includes identifying multiple social identities and recognizing environmental barriers, to help improve OHL. The responsibility for improving OHL is most often placed on medical and dental providers. The authors write: > Ultimately, the responsibility for improving OHL is multifactorial and includes participation and cooperation from patients, providers, communities, and health care systems.” [Read the article](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Frdcu.be%2FevUzV&data=05%7C02%7CLSall%40carequest.org%7C8294eaf79a7744f0069808ddc2e08c5e%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638880991884889048%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=qijhtcYQSR0JjjpQrGUAaZU8giAoLncZetVnRZNY6WI%3D&reserved=0) in *BMC Oral Health* (open access) **You may also be interested in:** - [The Dental Home Is Where Good Oral Health Starts](https://www.carequest.org/resource-library/dental-home-where-good-oral-health-starts), a report investigating the relationship between having a dental home and oral health outcomes. - [Oral Hygiene Home Care Practices in America](https://www.carequest.org/resource-library/oral-hygiene-home-care-practices-america), a report emphasizing that oral health care education for patients cannot be one-size-fits-all but must be person-centered. - [Social Determinants of Health Linked with Oral Health](https://www.carequest.org/resource-library/social-determinants-health-linked-oral-health), an article in *BMC Oral Health* analyzing the impact of eight structural and intermediary determinants on oral health outcomes. **Categories:** Journal Article, Resource **Tags:** Health Equity, Person-Centered Care --- ### [Medicaid Adult Dental Coverage Checker](https://carequest.org/resource/medicaid-adult-dental-coverage-checker/) **Published:** August 1, 2025 **Author:** Darren Edwards **Content:** ## **Identify Areas to Strengthen Adult Dental Benefits** The Medicaid Adult Dental Coverage Checker is an interactive tool for policymakers, administrators, and advocates to better understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping identify areas for improvement. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories. The Coverage Checker displays results that were self-reported by state Medicaid dental programs in a survey conducted in the spring of 2025. The data represent a snapshot in time and are reflective of the benefit package in place as of December 31, 2024. It’s important to note that several states have implemented new and expanded benefits for all adults in early 2025, which are not captured in the Checker. Please continue reading below for more information. The [survey](https://carequest.org/wp-content/uploads/2026/01/CareQuest_Inst_Rubric-Assessing-Medicaid-Adult-Dental-Benefits_5.15.24.pdf) mentioned above was developed in partnership with the American Dental Association Health Policy Institute (ADA HPI), Center for Health Care Strategies (CHCS), CareQuest Institute, and an advisory committee of experts in oral health care and state policy. Data visualization by Madison Vinson, MSHI and Adrianna Sonnek, MPH, Analytics & Data Insights, CareQuest Institute [Having trouble viewing the data? Click here](https://public.tableau.com/views/2024MedicaidAdultDentalCoverageCheck/CoverageChecker?:language=en-US&:sid=&:redirect=auth&:display_count=n&:origin=viz_share_link) [Click here for a tutorial](https://carequest.org/wp-content/uploads/2025/12/Medicaid-Coverage-Checker_Brief-Tutorial_2025.pdf) ***Consumer Disclaimer:** This dashboard is intended as a resource for Medicaid agencies, legislators, policymakers and advocates. It is not intended as a resource for consumers or Medicaid beneficiaries. The procedures and dental codes included and assessed in the survey — and displayed here — are intended to be representative of the hundreds of dental procedures contained in the ADA’s Current Dental Terminology code set. The sample is not exhaustive and should not be considered as constituting a complete benefits package. We encourage you to contact your state’s Medicaid agency for information regarding the Medicaid adult dental benefit.* ## **States That Have Improved Medicaid Adult Dental Benefits in 2025** **Utah** After years of expanding Medicaid adult dental benefits incrementally by population group, Utah expanded dental benefits to **all adults** effective April 1, 2025. All adult beneficiaries are now covered for exams, x-rays, cleanings, fillings, crowns, root canals, dentures, and extractions. More information can be found [here](https://medicaid.utah.gov/dental-coverage-and-plans/). This expansion was initiated in 2023 when the Utah legislature passed [Senate Bill 19](https://le.utah.gov/~2023/bills/static/SB0019.html) which directed the state to pursue federal Medicaid waivers to extend Medicaid dental care to all adults 21 years of age and over. Utah’s [1115 Waiver](https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/ut-medicaid-reform-demo-aprvl-01082025.pdf) was approved on January 8, 2025, and expanded dental benefits took effect April 1, 2025. **Learn more in the case study, [From Innovation to Impact: Utah’s Institutional Model for Medicaid Dental Expansion](https://www.carequest.org/sites/default/files/2025-11/CareQuest_Institute_Utah-Case-Study_11.25.25_FINAL_0.pdf)** **Virginia** Since [2015](https://www.dmas.virginia.gov/media/2603/medicaid-memo-released-3115.pdf), Virginia has provided comprehensive Medicaid adult dental benefits to pregnant beneficiaries. In [2021](https://www.dmas.virginia.gov/about-us/mission-and-values/state-plan/chip-state-plan-and-waiver-related-documents/), this coverage was extended from two months to 12 months postpartum. [New legislation](https://legiscan.com/VA/text/HB2539/2025) was signed into law in March 2025 that codifies the dental benefits provided to pregnant and postpartum beneficiaries. The bill — one of several this session aimed at improving maternal and child health outcomes — specifies that pregnant beneficiaries will be eligible for at least four dental visits during their pregnancy, with the possibility of additional visits recommended by a licensed dentist or obstetrician. Additionally, and for the first time since extending benefits to pregnant beneficiaries, the bill requires the Department of Medical Assistance Services to submit an annual report to the Governor and General Assembly detailing the implementation of these dental services, including the number of pregnant women who used the services, the impact on maternal and infant health outcomes, any access barriers, and recommendations for future improvements. The first such report is to be submitted by November 1, 2026, providing an opportunity to evaluate the effectiveness of the expanded dental care coverage for pregnant beneficiaries. **Learn more in the case study, [Persistence Meets Opportunity: Virginia’s Journey to Comprehensive Medicaid Adult Dental Benefits](https://www.carequest.org/sites/default/files/2025-09/CareQuest_Institute_Virginia-Medicaid-Case-Study_FINAL.pdf)** **Nevada** In 2019, the Nevada legislature passed [AB223](https://legiscan.com/NV/bill/AB223/2019) which directed the state to pursue federal Medicaid waivers to expand Medicaid dental benefits to non-pregnant adults diagnosed with diabetes. Approved on July 19, 2024, the [1115 Waiver](https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/nv-wmwb-con-adu-dia-appl-pa.pdf) will allow beneficiaries to receive a limited dental benefit package, including diagnostic and preventive, restorative, endodontic, and periodontic dental services through the provider network of selected federally qualified health centers (FQHCs) and participating Tribal Health Centers with dental clinics. The new benefits are expected to take effect later this summer. As noted in the approval letter, “this demonstration furthers the objectives of Medicaid by improving access to dental services in Nevada for certain Medicaid-enrolled adults. Through these efforts, the state will be able to test the value of improved access to oral health care on enrollee health outcomes and in controlling expenditures for a high-risk adult diabetic population in Medicaid. Nevada does not currently cover non-emergency dental benefits for its nonpregnant adult or parent population; this demonstration is a helpful tool to test the potential return on investment of providing dental benefits for this population.” **Arkansas** [New legislation](https://legiscan.com/AR/bill/SB347/2025) was signed into law in April 2025 to increase the annual benefit maximum (ABM) for adults with special needs. The ABM will be increased from $500 to $1,000 effective September 1, 2025. Additionally, the legislation increases reimbursement rates for oral and maxillofacial surgeons’ dental services, pediatric dental services, and dental services for adults with special needs. **More information can be found [here](https://humanservices.arkansas.gov/divisions-shared-services/medical-services/healthcare-programs/dental/dental-providers/#faq).** **Categories:** Dashboard, Resource **Tags:** Dental Coverage, Health Equity --- ### [Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://carequest.org/resource/medicaid-adult-dental-benefits-offered-to-specific-beneficiary-groups/) **Published:** August 6, 2025 **Author:** Darren Edwards **Content:** [![View 2025 report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits_2025_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medicaid-Adult-Dental-Benefits_2025.pdf)View 2025 report ## What does Medicaid cover for dental for adults? According to this CareQuest Institute report updated for 2025, 21 states now offer additional dental coverage to specific beneficiary groups, including pregnant and postpartum adults, adults with developmental and/or intellectual disabilities, and adults utilizing long-term care. **Additional Key Findings** - Eight states cover dental services for pregnant adults that are not provided to other adult beneficiaries. Seven states also provide these services to postpartum adults. - Nine states cover dental services for adults with intellectual or developmental disabilities that are not provided to other adult beneficiaries. - Seven states cover dental services for adults utilizing long-term care that are not provided to other adult beneficiaries. [![View 2024 report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits_2024_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medicaid-Adult-Dental-Benefits_10.9.24.pdf)View 2024 report Medicaid adult dental benefits are classified as “optional,” which means that states can limit or exclude adult dental services covered. The report includes a rubric of states offering different coverage to specific groups of adult beneficiaries within eight categories, including annual benefit maximum, diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and extraction. **You may also be interested in:** - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. - [Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage), a visual report estimating that 72 million adults in the US (27%) do not have dental insurance. [![View 2023 report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medical-Adult-Dental-Benefits_1.12.24.pdf)View 2023 report **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [The Need for Medicaid Adult Dental Coverage Across All States](https://carequest.org/resource/the-need-for-medicaid-adult-dental-coverage-across-all-states/) **Published:** August 7, 2025 **Author:** Darren Edwards **Content:** [![View resource](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_medicaid-oral-health-fact-sheet_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/medicaid-oral-health-fact-sheet_FINAL-1.pdf)View resource Medicaid is a key source of health care coverage for nearly 80 million people in the United States, providing comprehensive dental coverage for children and some adults — but only some adults. Many states offer limited or emergency-only care under Medicaid, leaving adults without the dental services they need to maintain their overall health. This fact sheet from CareQuest Institute outlines the health risks and economic consequences of Medicaid’s varying adult dental benefits across states and explains why providing comprehensive oral health coverage for all would benefit both individuals and the overall health system. The authors write: > By ensuring states provide comprehensive dental benefits for adults who rely on Medicaid for their health coverage, policymakers can improve oral health outcomes, increase employment opportunities, and reduce long-term health care spending on chronic disease management and emergency department use.” **You may also be interested in:** - [Federal Medicaid Cuts Threaten State Dental Benefits](https://www.carequest.org/resource-library/federal-medicaid-cuts-threaten-state-dental-benefits), a report examining the lessons learned in six states that eliminated Medicaid adult dental benefits in the past. - [It’s Time, Right Now, for Policy Leaders to Address America’s Oral Health Crisis](https://www.carequest.org/about/blog-post/its-time-right-now-policy-leaders-address-americas-oral-health-crisis), a blog post from our Senior Director of Policy & Advocacy outlining the policy solutions that are needed to improve oral health in the US. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows where a state’s Medicaid adult dental benefits package falls from no dental benefits to extensive benefits, helping policymakers identify areas for improvement. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Lifelong Oral Health: How Insurance Type Shapes Dental Care Spending](https://carequest.org/resource/lifelong-oral-health-how-insurance-type-shapes-dental-care-spending/) **Published:** August 25, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/08/Thumbnail_Lifelong-Oral-Health_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Lifelong-Oral-Health_FINAL.pdf)View report The cost of oral health care poses the greatest financial barrier for individuals than any other type of health care, write the authors of a new report on dental care spending from CareQuest Institute. An [interactive dashboard](https://public.tableau.com/app/profile/carequest/viz/shared/NZT623SW7) is also available for users to delve into spending by age, insurance type, and procedure. The authors write: > Given the links between oral health and overall health, determining when and how the US spends its oral health care dollars — both through Medicaid and commercial plans — is key to understanding the overall health of the nation.” The report examines oral health care spending for individuals aged 0 to 89 and evaluates differences in spending between Medicaid and commercial insurance plans. Key findings include: - Both Medicaid and commercial spending on “preventive and basic dental care” was highest for children in the first decade of life, but commercial spending in this category was consistently higher for individuals of all ages. - Commercial spending was consistently higher than Medicaid spending on “major dental care,” peaking in the first decade of life and then again around the age of 65. - Lower average spending amounts by Medicaid do not necessarily reflect fewer oral health services but a lower rate of reimbursement compared to commercial plans. **You may also be interested in:** - [Lifespan Time Trends (2019–2022)](https://public.tableau.com/shared/NZT623SW7?:display_count=n&:origin=viz_share_link), an interactive dashboard displaying average spending on oral health care by age, insurance type, and procedure. - [Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions](https://www.carequest.org/resource-library/dental-care-crisis), a report finding that costs for treating dental conditions in the ED have risen by $500 million to a total of $3.9 billion. - [The Need for Medicaid Adult Dental Coverage Across All States](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states), a fact sheet outlining the health risks and economic consequences of Medicaid’s varying adult dental benefits across states. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [Unseen Needs: The Frequency of Dental Care Received by People Living with HIV](https://carequest.org/resource/unseen-needs-the-frequency-of-dental-care-received-by-people-living-with-hiv/) **Published:** August 26, 2025 **Author:** Darren Edwards **Content:** [![Read 2025 Report](https://carequest.org/wp-content/uploads/2025/08/Thumbnail_Unseen-Needs-HIV_2025_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Unseen-Needs-HIV_Aug2025.pdf)Read 2025 Report More than 1.2 million people in the US living with human immunodeficiency virus (HIV) are significantly less likely to receive dental care compared to those without HIV, despite being at higher risk for oral health issues, according to this report from CareQuest Institute. Using 2020–2022 medical and dental claims data to compare patterns in dental utilization between individuals with and without HIV, researchers found: - Across nearly all age groups, individuals with HIV received dental treatment of any type less frequently than those without HIV. The only exception was for adults aged 65 and older. - Of those with an HIV diagnosis, 34.6% had at least one dental service, compared to 53.9% of individuals without HIV. - Periodontal care was the only treatment category where individuals with HIV had slightly higher utilization rates. Periodontal disease is more common among individuals with HIV due to weakened immune systems, making periodontal treatment particularly important. Individuals with HIV have an increased risk of oral health problems — including dry mouth, periodontal disease, and oral candidiasis (thrush) — due to a weakened immune response. In addition, those who are HIV-positive often face barriers to receiving adequate oral health care, including discrimination and stigma. [![Read 2019 Research Brief](https://carequest.org/wp-content/uploads/2025/08/CareQuest-Institute-Dental-Utilization-HIV-Research-Brief-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute-Dental-Utilization-HIV-Research-Brief.pdf)Read 2019 Research Brief These findings reinforce the importance of culturally competent, stigma-free dental care and the integration of oral health services into HIV care frameworks. **You may also be interested in:** - [Transforming Oral Health Care Through Interprofessional Education (IPE)](https://www.carequest.org/resource-library/transforming-oral-health-care-through-interprofessional-education), a white paper exploring the integration of oral health into IPE to address systemic health issues. - [Oral Health and the LGBTQ+ Community: A Snapshot of Disparities and Discrimination](https://www.carequest.org/resource-library/oral-health-and-lgbtq-community-snapshot-disparities-and-discrimination), a visual report finding that LGBTQ+ individuals have greater difficulty getting dental care and are more likely to visit a hospital emergency department for dental care. - [Does Our Oral Health Care System Welcome Everyone?](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone), a report, based on insights from our annual State of Oral Health Equity in America survey, analyzing persistent barriers to equitable oral health care. **Categories:** Resource, Visual Report **Tags:** Special Patient Care --- ### [Fluoride: Questions Parents Ask](https://carequest.org/resource/fluoride-questions-parents-ask/) **Published:** September 5, 2025 **Author:** Darren Edwards **Content:** [![Click to view Resource](https://carequest.org/wp-content/uploads/2025/09/Thumbnail_Fluoride-Questions-Parents-Ask_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_AFS_Fluoride-Questions-Parents-Ask_FINAL.pdf)Click to view Resource This resource, developed in collaboration with the American Fluoridation Society, provides answers to some of the most common questions parents ask about fluoride and fluoridation. We’ve divided it into sections to make it easier to find the answers you’re looking for. **You may also be interested in:** - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. - [New Study Shows Costly Consequences for States Banning Fluoride](https://www.carequest.org/about/blog-post/new-study-shows-costly-consequences-states-banning-fluoride), a blog post with authors of a study in JAMA Health Forum summarizing their findings — ending water fluoridation could result in 25 million additional decayed teeth and nearly $10 billion in health care costs. - [Community Water Fluoridation: How Dental Professionals Can Lead the Conversation](https://www.carequest.org/education/course/community-water-fluoridation-how-dental-professionals-can-lead-conversation/overview), a self-paced course to equip dental professionals with tools and knowledge to address patients’ questions about the safety and effectiveness of water fluoridation. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Partners in Progress: Pursuing Medical-Dental Integration in Ohio](https://carequest.org/resource/partners-in-progress-pursuing-medical-dental-integration-in-ohio/) **Published:** September 12, 2025 **Author:** Darren Edwards **Content:** [![Click to view Impact Report](https://carequest.org/wp-content/uploads/2025/09/Screenshot_17-7-2025_153247_www.carequest.org_-231x300.jpeg)](https://carequest.org/wp-content/uploads/2025/09/CareQuest_Partners-in-Progress_7.2.25_v2.pdf)Click to view Impact Report This impact report and case study explore the results of the Medical Oral Expanded Care (MORE Care®) Ohio pilot program (MORE Care OH), a two-year project designed to integrate oral health into pediatric primary care across six counties in Ohio. Led by CareQuest Institute and Oral Health Ohio, the initiative brought together seven private and health-system-affiliated practices to expand access to preventive dental services for nearly 20,000 children. Noteworthy results from the program include: - Oral health integration during well-child visits increased from less than 1% to an average of 8%, with Medicaid-covered visits reaching 10%, highlighting the growing role of medical providers in preventive oral health. - Preventive dental services rose from 30% to 34% of all dental visits, while surgical interventions declined from 16% to 12%, reflecting a shift toward minimally invasive, risk-based care. - 407 dental referrals were made by medical practices, with 34% resulting in completed visits and 83% of those referrals successfully closed through coordinated follow-up. The case study, “An Alternative Payment Model to Support Medical-Dental Integration,” takes an in-depth look at the alternative payment model (APM) tested in the MORE Care OH program. The model combined pay-for-reporting and pay-for-performance to facilitate shared goals and incentives for medical and dental providers to collaborate. The lessons learned in the report and case study offer a roadmap for scaling medical-dental integration. Together, the impact report and case study offer complementary insights: - [![Click to view Case Study](https://carequest.org/wp-content/uploads/2025/09/Thumbnail_MORE-Care_APM_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/09/CareQuest_Institute_MORE-Care_Alternative-Payment-Model_FINAL.pdf)Click to view Case Study The **impact report** focuses on measurable outcomes and system-level improvements. - The **case study** explores how the payment model supported collaboration and offers guidance for future dental APMs. **You may also be interested in:** - [Teledentistry as a Tool for Health Care Transformation](https://www.carequest.org/resource-library/teledentistry-tool-health-care-transformation), a journal article highlighting the role of technology and regulatory changes to improve access to oral health care. - [A Simple Alternative Payment Model to Incentivize Periodontal Care for Diabetes Mellitus Patients in Community Health Centers](https://www.carequest.org/resource-library/simple-alternative-payment-model-incentivize-periodontal-care-diabetes-mellitus), a tool that helps integrated care settings simulate potential cost savings by covering scaling and root planing for diabetes patients. - [Integration and Coordination to Improve the Patient Experience](https://www.carequest.org/education/course/integration-and-coordination-improve-patient-experience/overview), a self-paced, online course that explores the value of coordinated care and interprofessional collaboration to support whole-person health. Eligible for 1 free CE credit. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Oral and Mental Health During and After Pregnancy](https://carequest.org/resource/oral-and-mental-health-during-and-after-pregnancy/) **Published:** October 28, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-and-Mental-Health-During-and-After-Pregnancy_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Oral-and-Mental-Health-During-and-After-Pregnancy_11.13.24.pdf)View visual report ## The Importance of Medical-Dental-Behavioral Integration for Pregnant People Given the relationship between oral health and mental health in individuals with a pregnancy history (and across the lifespan), a report from CareQuest Institute underscores an increasing need for the integration of medical, dental, and behavioral health care. The report, based on the [State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2023), explores the links between pregnancy history, oral health, and mental health. Key findings include: - Only 4% of adults with a pregnancy history said they had received a referral to a dentist during their pregnancy. - The majority of those with a pregnancy history (85%) who see a dentist regularly rated their mental health positively, but only 69% of those who do not see a dentist regularly rated their mental health positively. - Of those who reported brushing twice a day or more, 86% rated their mental health in positive terms, compared to 72% of those who brushed less than twice per day. Medical-dental integration is essential to addressing whole-person health throughout the entire lifespan, and the pregnancy and postpartum periods are particularly important to the health of birthing parents and their newborns. **You may also be interested in:** - [Exploring the Myths and Misconceptions about Oral Health and Pregnancy](https://www.carequest.org/education/course/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy/overview), a self-paced course that discusses the most recent guidelines and research for dental care in pregnant patients. Eligible for one CE credit. - [Addressing the Role of Oral Health in Maternal Mortality and Pregnancy Outcomes](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes), a visual report that examines the worsening state of maternal and infant health in the US, and the often-overlooked connection between oral health and pregnancy outcomes. - [How Depression Is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that summarizes the growing body of research about how our emotional state is connected to oral hygiene, dental disease, and dental visits. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [The Role of Oral Health Providers in Screening and Referrals for Mpox](https://carequest.org/resource/the-role-of-oral-health-providers-in-screening-and-referrals-for-mpox/) **Published:** November 8, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Monkeypox-and-Role-Oral-Health-Providers-2024_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Monkeypox-and-the-Role-of-Oral-Health-Providers-2024-Update_FINAL.pdf)View visual report Mpox (also known as monkeypox or MPX) lesions may first appear in the mouth or on the tongue and may appear before lesions on other areas of the body. This finding means that oral health providers may be the first health care professionals to detect signs of the mpox virus in their patients, according to an updated report from CareQuest Institute. Oral health professionals, research suggests, can also play a key role in reducing the spread of this virus. Key points from the report include: - Individuals with mpox may also experience a sore throat, swollen tonsils, and difficulty swallowing, as well as fever, chills, muscle aches, headaches, fatigue, and respiratory symptoms. - Most adults are comfortable receiving health screenings from their oral health providers. Screening for the oral lesions associated with mpox is similar to other oral examinations done in a dental office and is likely to be similarly acceptable to dental patients. - Oral health providers could play an important role in educating patients about the two-dose mpox vaccine and providing appropriate referrals. In short, oral health providers are in an ideal position to screen for, detect, and educate patients about mpox and, in turn, help reduce the spread of this virus. **You may also be interested in:** - [Discussing HPV and Detecting Oral Cancer: The Role of Oral Health Providers](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers), a report summarizing what we know about HPV and oral cancer, and the role of dentists and dental hygienists in patient education and prevention of HPV. - [Missed Connections: Providers and Consumers Want More Medical-Dental Integration](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration), a report examining attitudes about the relationship between oral health and overall health and a desire to connect the siloed care delivery systems. - [Infection Control: Lessons Learned from the new ‘If Saliva Were Red’ Video](https://www.carequest.org/education/webinars/infection-control-lessons-learned-new-if-saliva-were-red-video), a recorded webinar with experts from the Association for Dental Safety who provide an overview on infection prevention and control in oral health, including strategies and equipment to reduce the risk of exposure. **Categories:** Resource, Visual Report **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Mental Health, Socioeconomic Position, and Oral Health: A Path Analysis](https://carequest.org/resource/mental-health-socioeconomic-position-and-oral-health-a-path-analysis/) **Published:** November 18, 2024 **Author:** Darren Edwards **Content:** ## How Are Oral Health and Mental Health Connected? This [peer-reviewed article in *Preventing Chronic Disease*](https://www.cdc.gov/pcd/issues/2024/24_0097.htm), a journal sponsored by the Centers for Disease Control and Prevention, examines the interrelationships between depression, oral health, and socioeconomic position based on results from a nationally representative survey of US adults. The authors, from CareQuest Institute, the University of Colorado School of Dental Medicine, and the University of Washington School of Dentistry, found that socioeconomic position — income, home ownership, employment, education, and dental insurance — is significantly associated with dental treatment seeking, toothbrushing and flossing, and mental health. These factors, in turn, are associated with self-rated oral health, including self-consciousness due to poor oral health. The authors write: > This study provides further evidence that oral health is part of overall health, and that oral health and mental health are connected in multifaceted ways, underscoring the need to find integrated and person-centered ways to treat them. The findings are based on CareQuest Institute’s annual [State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2023), the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. [**Read the article**](https://www.cdc.gov/pcd/issues/2024/24_0097.htm) **in** ***Preventing Chronic Disease*** (open access) **You may also be interested in:** - [How Depression Is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that summarizes the growing body of research about how our emotional state is connected to oral hygiene, dental disease, and dental visits. - [Dental Fear and Anxiety: Why It Exists and What Providers Can Do to Help](https://www.carequest.org/education/course/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help/overview), a self-paced course, eligible for 1 CE credit, that features dental and mental health experts explaining how dental anxiety can hinder patients from accessing care and techniques to help ease patients’ fear. - [State of Oral Health Equity in America 2024](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024), an infographic that highlights initial key findings from the annual survey. **Categories:** Journal Article, Resource **Tags:** Health Equity, Medical-Dental Integration --- ### [A Simple Alternative Payment Model to Incentivize Periodontal Care for Diabetes Mellitus Patients in Community Health Centers](https://carequest.org/resource/a-simple-alternative-payment-model-to-incentivize-periodontal-care-for-diabetes-mellitus-patients-in-community-health-centers/) **Published:** November 27, 2024 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_APM_Perio_Diabetes_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_A-Simple-Alternative-Payment-Model-_12.6.24.pdf)View report ## Managing Diabetes Costs with Oral Health This interactive tool from CareQuest Institute allows integrated care settings, such as Federally Qualified Health Centers, to input data and simulate potential cost savings from covering periodontal treatment — specifically scaling and root planing — for diabetes patients. The model demonstrates that reimbursement for scaling and root planing has the potential to reduce medical encounters and increase revenue for health centers. Andrea Clark, report author and director, health care economics, health transformation at CareQuest Institute, writes: > The incentive model proposed in this paper provides an example of a simple innovation to encourage utilization, improve outcomes, and even reduce costs. Today, only about half of state Medicaid programs cover scaling and root planing. And when it is covered, the Medicaid reimbursement rate is much less than the practice cost — factors that create a financial incentive against providing these services. [![Download tool](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_perio-diabetes-APM-tool-300x126.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Institute_Perio-Diabetes-APM-Tool_Final-1.xlsx)Download tool **You may also be interested in:** - [Periodontal Treatment Associated with Decreased Diabetes-Related Costs](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs), an article in The Journal of the American Dental Association that demonstrates cost savings up to 14% for patients with diabetes who received periodontal treatment. - [Making Connections: How a Community Clinic Is Integrating Dental and Overall Care](https://www.carequest.org/about/blog-post/making-connections-how-community-clinic-integrating-dental-and-overall-care), a blog post about how a community health center uses an integration coordinator to connect patients with diabetes to oral health care. - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a report finding that including periodontal treatment in Medicare can save up to $14.5 billion annually for patients with diabetes. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows which state Medicaid programs cover periodontal treatment, and other dental services. **Categories:** Resource, Tool **Tags:** Medical-Dental Integration, Value-Based Care --- ### [Medical-Dental-Behavioral Integration](https://carequest.org/resource/medical-dental-behavioral-integration/) **Published:** November 21, 2024 **Author:** Darren Edwards **Content:** ## Embracing Whole-Person Health in Research and Practice [![Read the editorial](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_JDR-MDI-supplement_250x325-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_JDR2024_medical-dental-behavioral-integration.pdf)Read the editorial A supplement in *JDR Clinical & Translational Research*, supported by CareQuest Institute, features nine articles that provide strong evidence for health systems to integrate oral, behavioral, and systemic health. In the accompanying editorial, authors from CareQuest Institute write: > The decades-long understanding of the links between oral, systemic, and behavioral health stands in stark contrast to the siloes in which health care continues to be provided. The authors represent providers from several aspects of health care, including oral health, primary care, nursing, and behavioral health. Their articles explore the present and future of medical, dental, and behavioral integration. - [California School Nurses’ Knowledge in Identifying Dental Conditions and Making Dental Referrals](https://journals.sagepub.com/doi/full/10.1177/23800844241273782) - [Delivery of Oral Health Services at Medical Visits through Three Medical Dental Integration Models](https://journals.sagepub.com/doi/full/10.1177/23800844241273771) - [Sub-Optimal Oral Health, Multi-morbidity and Access to Dental Care](https://journals.sagepub.com/doi/full/10.1177/23800844241273760) - [Periodontal Disease and Metabolic Control of Adults with Type 1 Diabetes Mellitus](https://journals.sagepub.com/doi/full/10.1177/23800844241273858) - [Oral Health Recovery: Randomized Evaluation of an Oral-Behavioral Health Integration Approach](https://journals.sagepub.com/doi/full/10.1177/23800844241273829) - [One Health and Oral Health: A Scoping Review to Inform Research and Challenges](https://journals.sagepub.com/doi/full/10.1177/23800844241273821) - [Toward a Comprehensive Model of Medical-Dental-Behavioral Integration](https://journals.sagepub.com/doi/full/10.1177/23800844241273836) - [System-based Intervention for Medical Providers to Improve Dental Attendance in Adult Primary Care](https://journals.sagepub.com/doi/full/10.1177/23800844241273758) - [Attitudes Toward Adolescent Mental Health Screening in a Dental Setting: A Mixed-Methods Study](https://journals.sagepub.com/doi/full/10.1177/23800844241273775) [**Read the supplement**](https://journals.sagepub.com/toc/jcta/9/1_suppl) in *JDR Clinical & Translational Research* (open access) **You may also be interested in:** - [Mental Health, Socioeconomic Position, and Oral Health: A Path Analysis](https://www.carequest.org/resource-library/mental-health-socioeconomic-position-and-oral-health-path-analysis), a journal article that explores complex relationships between socioeconomic factors, dental treatment, dental hygiene, self-rated oral health, and mental health. - [Dental Fear and Anxiety: Why It Exists and What Providers Can Do to Help](https://www.carequest.org/education/course/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help/overview), a self-paced course, eligible for 1 CE credit, that features dental and mental health experts explaining how dental anxiety can hinder patients from accessing care and techniques to help ease patients’ fear. - [Oral and Mental Health During and After Pregnancy](https://www.carequest.org/resource-library/oral-and-mental-health-during-and-after-pregnancy), a visual report that explains the importance of medical-dental-behavioral integration for the health of birthing parents and their newborns. **Categories:** Journal Article, Resource **Tags:** Medical-Dental Integration --- ### [Teledentistry as a Tool for Health Care Transformation](https://carequest.org/resource/teledentistry-as-a-tool-for-health-care-transformation/) **Published:** November 27, 2024 **Author:** Darren Edwards **Content:** An article in the North Carolina Medical Journal authored by members of the CareQuest Institute Health Transformation team highlights that teledentistry is a valuable technology tool and demonstrates how critical state-based approaches to transformation are in improving access to oral health care. The authors write: > The role that health technologies like telehealth continue to play in growing and easing access to care and enhancing communication and exchange of information cannot be overlooked.” North Carolina was a key setting for CareQuest Institute’s Community Oral Health Transformation (COrHT), which launched in July of 2022. The support from stakeholders and recent regulatory changes allowed participants to use teledentistry as a tool to address their communities’ unique needs. At the start of the initiative, only 4 of 12 participating clinics used teledentistry. By July 2023, that number had doubled to 8 clinics, driving a surge in visits — from 448 in the baseline year (July 2021–June 2022) to 1,463 during the initiative. Additional Key Takeaways: - Teledentistry demonstrably increases access to dental care, especially for preventive services. - Effective implementation requires comprehensive support, including resources, training, and infrastructure improvements. - Wider adoption depends on addressing reimbursement limitations and workforce challenges through policy adjustments. [Read the article](https://ncmedicaljournal.com/article/125137-teledentistry-as-a-tool-for-health-care-transformation) in the North Carolina Medical Journal (open access) **You may also be interested in:** - [Teledentistry and Community Learning Help Kids Get Care in North Carolina](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina), a blog post about how a Federally Qualified Health Center uses teledentistry to deliver care to more than 1,200 children in rural communities. - [Teledentistry Helps Provide the Right Care at the Right Time](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time), a research report that examines follow-up treatment and oral health outcomes for patients after a teledentistry visit. - [Teledentistry Regulation and Policy Guidance](https://www.carequest.org/resource-library/teledentistry-regulation-and-policy-guidance), a toolkit for promoting access and quality care through teledentistry. **Categories:** Journal Article, Resource **Tags:** Practice Management, Value-Based Care --- ### [Oral Health in Incarcerated Persons](https://carequest.org/resource/oral-health-in-incarcerated-persons/) **Published:** December 5, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-Health-in-Incarcerated-Persons_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Oral-Health-in-Incarcerated-Persons-FINAL.pdf)View visual report A visual report from CareQuest Institute reviews the relationship between incarceration and oral health, highlighting that 50% of incarcerated individuals had a dental problem during the time they were imprisoned. “First and foremost,” the authors write, “we must prioritize strengthening the oral health care delivery system to incarcerated people.” Despite being the only individuals in the US with a constitutional right to receive health care, incarcerated persons face numerous barriers to oral health, as do formerly incarcerated individuals. Key findings include: - When incarcerated individuals receive dental care, damaged teeth are often extracted rather than repaired, due to restrictive treatment guidelines. - In the US, formerly incarcerated individuals experience worse oral health outcomes, such as a greater likelihood of having periodontal disease, than individuals who have never been incarcerated. - For individuals with histories of substance use, untreated dental issues can reawaken addiction habits as substance use may feel like the only feasible option to eliminate pain. With an incarcerated population exceeding 1.2 million, the United States has the highest incarceration rate in the world and a system that disproportionately incarcerates individuals of color, particularly Black individuals. **You may also be interested in:** - - [Uninsured and in Need](https://www.carequest.org/resource-library/uninsured-and-need), a visual report that delves into the 68.5 million people who lack dental insurance in the US, including why they are uninsured and the effect on their health. - [State of Oral Health Equity in America 2024](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024), an infographic highlighting key findings from the largest nationally representative annual survey on the oral health of adults in the US. - [Lower-Income Families Still Spend More on Dental Care](https://www.carequest.org/resource-library/lower-income-families-still-spend-more-dental-care), an analysis of dental care spending and income reveals that poorer families paid 7 times more out-of-pocket for dental care than high-income families. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Social Determinants of Health Linked with Oral Health](https://carequest.org/resource/social-determinants-of-health-linked-with-oral-health/) **Published:** January 7, 2025 **Author:** Darren Edwards **Content:** In an article in *BMC Oral Health*, researchers from CareQuest Institute and Texas A&M University College of Dentistry analyze the impact of structural and intermediary determinants on oral health outcomes. They found that adults who experienced any of the social determinants of health (SDOH) were more likely to have poor oral health outcomes. Key findings include: - Adults who experienced any SDOHs were significantly more likely to have had at least one tooth removed. - Black adults were 67% more likely than white adults to experience tooth loss. - Adults who reported racial discrimination were 20% less likely to have visited a dentist in the last year. - Adults experiencing food insecurity or housing instability were approximately 30% less likely to report positive oral health. The authors write: > The observed disparities highlight the need for targeted policies to address the structural determinants of oral health inequality. Researchers analyzed four structural determinants (race, ethnicity, education, and income) and four intermediary determinants (housing instability, food insecurity, lack of transportation, and racial discrimination). [Read the article](https://link.springer.com/article/10.1186/s12903-024-05257-8?utm_source=rct_congratemailt&utm_medium=email&utm_campaign=oa_20241220&utm_content=10.1186%2Fs12903-024-05257-8) in *BMC Oral Health* (open access) **You may also be interested in:** - [State of Oral Health Equity in America 2024](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024), an infographic highlighting key findings from our most recent annual survey, the largest nationally representative survey on the oral health of adults in the US. - [Cost, Race, and the Persistent Challenges in Our Health System](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), a report examining discrimination and socioeconomic factors as leading contributors to oral health disparities in the US. - [Hunger Pains](https://www.carequest.org/resource-library/hunger-pains-how-food-insecurity-affects-oral-health), a report analyzing the link between oral health and food insecurity, which affects 24 million US adults. **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Health Equity --- ### [Does Our Oral Health Care System Welcome Everyone?](https://carequest.org/resource/does-our-oral-health-care-system-welcome-everyone/) **Published:** January 14, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/ThumbnaiL_SOHEA_2024_System_Welcome_Everyone_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute-State-of-Oral-Health-Equity-in-America_2024_1.6.25.pdf)View report ## Persistent Barriers to Equitable Access for All Barriers to adequate oral health care for millions of people in the US — barriers stemming from socioeconomic factors and environments that do not welcome everyone — continue to create inequities, according to CareQuest Institute’s fourth annual State of Oral Health Equity in America (SOHEA) survey. The State of Oral Health Equity in America is the largest nationally representative survey about oral health with participation from more than 9,000 adults in the US. Key findings include: - Just under one third of adults surveyed (32%) say they have not visited a dentist in the prior year, and 16% of adults do not plan to see a dentist in the coming year for routine or preventive care. Cost is the top reason for not planning a future dental visit. - One quarter of adults — 69 million people — report that they do not have any type of dental insurance. Those with a disability are least likely to have dental insurance. - Nearly half of adults say it is important to them that their dental office has a diverse workforce and that a dentist embraces their cultural preferences. - Adults identifying their race as Black (9%), two or more races (9%), or “other” (8%) were at least twice as likely to report experiencing discrimination in an oral health care setting as adults identifying as Hispanic (4%), white (3%), or Asian (1%). **You may also be interested in:** - [Social Determinants of Health Linked with Oral Health](https://www.carequest.org/resource-library/social-determinants-health-linked-oral-health), a journal article that analyzes the impact of various social determinants on oral health outcomes. - [Integration and Coordination to Improve the Patient Experience](https://www.carequest.org/education/course/integration-and-coordination-improve-patient-experience/overview), a self-paced, online course that explores care coordination and integrated care to support whole-person health. Eligible for one free CE credit. - [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2023), a series of reports that highlight key findings and insights from previous annual surveys. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [National Oral Health Data Portal](https://carequest.org/resource/national-oral-health-data-portal/) **Published:** March 1, 2025 **Author:** Darren Edwards **Content:** This updated version of the National Oral Health Data Portal consolidates more than two dozen datasets from federal and non-profit partners to examine national, state, and local trends in a single file. Designed in partnership by CareQuest Institute and the Association of State & Territorial Dental Directors, the interactive tool was created to help public health professionals, policymakers, providers, and the public find the information they need about oral health and the oral health care system in their communities. **For questions about our data dashboards, email us at .** **Designed through a partnership between:** ![](https://carequest.org/wp-content/uploads/2025/03/ASTDD-logo-300x151.jpg) ![](https://carequest.org/wp-content/uploads/2025/03/CareQuest_r_rgb_0-300x111.png) **Categories:** Dashboard, Resource **Tags:** Dental Coverage, Health Equity --- ### [Artificial Intelligence-Produced Radiographic Enhancements in Dental Clinical Care](https://carequest.org/resource/artificial-intelligence-produced-radiographic-enhancements-in-dental-clinical-care/) **Published:** March 17, 2025 **Author:** Darren Edwards **Content:** ## Provider and Patient Perspectives Can artificial intelligence (AI) facilitate dental providers’ diagnoses and educate patients about their oral health conditions? Apple Tree Dental, an innovative dental organization in Minnesota, and CareQuest Institute published an article in *Frontiers in Oral Health* that examines oral health providers’ and patients’ perspectives about the use of AI software in clinical dental care. Specifically, the study, which found positive results, focused on use of AI-enhanced radiographs in the diagnostic and patient education processes. Key findings: - Dentists and dental therapists noted that the software facilitated their diagnostic process and helped them better educate their patients about their oral health conditions. - Dental hygienists and assistants noted that the AI software added time to their workflow in terms of time needed to open the software individually for each patient. [Read the article](https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2025.1473877/full) in *Frontiers in Oral Health* **You may also be interested in:** - [Oral Mucosal Lesions 101](https://www.carequest.org/education/webinars/oral-mucosal-lesions-101-recognition-risk-assessment-and-referral), a webinar that provides practical guidance on identifying oral signs of systemic diseases. - [Managing Dental Caries: Evolving Strategies and Proven Techniques](https://www.carequest.org/education/course/managing-dental-caries-evolving-strategies-and-proven-techniques-0/overview), a self-paced course that covers screening, prevention, nonrestorative treatment, and minimally invasive care. Eligible for 1 free CE credit. - [Teledentistry as a Tool for Health Care Transformation](https://www.carequest.org/resource-library/teledentistry-tool-health-care-transformation), an article that explores the effectiveness of teledentistry to increase access to preventive dental services. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [Links Between Sugar and Dental Decay in US Children from Low-Income Families](https://carequest.org/resource/links-between-sugar-and-dental-decay-in-us-children-from-low-income-families/) **Published:** March 17, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Links-Between-Sugar-and-Dental-Decay_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/03/CareQuest_Institute_Links-Between-Sugar-and-Dental-Decay_FINAL.pdf)View report Dental caries is one of the most prevalent human diseases. And understanding the role of diet, demographics, and environmental factors in dental caries rates in children is essential to improve children’s health. To better understand these factors, CareQuest Institute conducted a systematic review of four studies to examine the link between consumption of added sugar and the incidence and prevalence of dental caries in US children from low socioeconomic backgrounds. Key findings include: - All four studies found a strong association between sugar consumption and dental caries in children from low-income families in the US. - Providers should offer nutritional counseling and motivational interviewing, which can help patients understand the harms of sugar consumption and encourage patients’ behavior change. - Community-level interventions — such as support for corner store owners committed to increasing their store inventory of healthy food — can also be helpful. The authors write: > The public health burden caused by excess sugar consumption needs to be further addressed by health providers and through policy at school, state, and national levels.” **Categories:** Publication, Resource **Tags:** Clinical Practice, Health Equity, Person-Centered Care --- ### [Exploring Oral Health and Care Access among Adults with Disabilities](https://carequest.org/resource/exploring-oral-health-and-care-access-among-adults-with-disabilities/) **Published:** May 4, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Care-Access-Adults-Disabilities_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Exploring-Oral-Health-Care-Access-Adults-Disabilities_FINAL.pdf)View report Many adults living with disabilities face considerable challenges to accessing necessary oral health care, according to findings from CareQuest Institute’s most recent State of Oral Health Equity in America (SOHEA) survey. More than one in four adults in the United States has at least one type of disability — and adults with disabilities are more likely to have worse oral health outcomes, such as untreated dental decay, missing teeth, and delayed care. Key findings include: - One quarter of adults with a disability (25%) said they delayed care, missed an appointment, or were unable to obtain needed health care, including oral health care. - Nearly a third of adults reporting a disability (30.2%) said that the dental office where they receive care does not provide them with special help and/or accommodations for their dental visit. - Adults with a disability have significantly higher odds of having visited a hospital emergency department for dental care. These findings highlight the importance of addressing social determinants of health — such as transportation options and accessible dental offices — that disproportionately affect individuals with disabilities. To improve access to oral health care for individuals with disabilities, the authors recommend: > enhancing Medicare and Medicaid coverage for adult dental care, additional training for providers in the treatment of individuals with disabilities, and integrating medical and dental care with specialty oral health care.” **You may also be interested in:** - [Caring for Individuals with Disabilities: Practical Considerations for Dental Providers](https://www.carequest.org/education/course/caring-individuals-disabilities-practical-considerations-dental-providers/overview), a self-paced course that explores different types of disabilities and ways for providers to improve access to care for individuals with disabilities. Eligible for 1 CE credit. - [Providing Equitable Care to Special Populations in North Carolina](https://www.carequest.org/about/blog-post/providing-equitable-care-special-populations-north-carolina), a blog describing how one dental practice has found innovative ways to successfully deliver dental care to patients with disabilities. - [How a Pilot Program Is Transforming Dental Care for Patients with Disabilities](https://decisionsindentistry.com/2025/02/how-a-pilot-program-is-transforming-dental-care-for-patients-with-disabilities/), an article in *Decisions in Dentistry* shares how a new pilot program at Tufts Dental Facilities is breaking barriers with home visits and telehealth to make dental care more accessible. **Categories:** Publication, Resource **Tags:** Special Patient Care --- ### [Transforming Oral Health Care Through Interprofessional Education](https://carequest.org/resource/transforming-oral-health-care-through-interprofessional-education/) **Published:** April 2, 2025 **Author:** Darren Edwards **Content:** [![View white paper](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_IPE-White-Paper_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_IPE-White-Paper_4.1.25_Final.pdf)View white paper ## A Review and Recommendations This comprehensive white paper and collection of use cases, co-authored by CareQuest Institute and 19 academic institutions, explore interprofessional education (IPE) in health care, with a particular focus on oral health. The authors find that IPE is essential to foster collaborative, patient-centered health care, writing: > By fostering collaboration among health care professionals and emphasizing the importance of oral-systemic health connections, IPE can break down traditional silos that have separated dental care from general health care.” Key takeaways include: - Integrating oral health into IPE can address systemic health issues such as diabetes, cardiovascular disease, and respiratory infections, all of which have connections to oral health. - Nearly all (96%) dental schools engage in IPE activities. Professions that collaborate with dental and dental hygiene students include behavioral health, nursing, pharmacy, primary care, and social work. - Recommendations include advocating for centralized university-wide IPE offices; fostering a culture of IPE within dental schools; and aligning IPE with workforce development and career readiness. [![View use cases](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_IPE-UseCases_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_IPE-UseCases_4.1.25_Final.pdf)View use cases For IPE to fulfill its potential, the authors note, there is a need for improved assessment tools, increased representation of oral health in IPE research, and flexible, yet standardized, implementation strategies. **You may also be interested in:** - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report that provides a comprehensive overview of the bidirectional nature of oral and systemic diseases across the lifespan. - [Medical-Dental-Behavioral Integration](https://www.carequest.org/resource-library/medical-dental-behavioral-integration), a supplement to *JDR Clinical & Translational Research*, featuring nine articles that provide strong evidence for integrated health systems. - [Missed Connections: Providers and Consumers Want More Medical-Dental Integration](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration), a visual report that examines the lack of integration between medical and oral health care and a desire for increased interprofessional collaboration. **Categories:** Publication, Resource **Tags:** Dental Coverage, Medical-Dental Integration, Person-Centered Care --- ### [Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://carequest.org/resource/out-of-pocket-a-snapshot-of-adults-dental-and-medical-care-coverage/) **Published:** May 9, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Out-of-Pocket_SOHEA2024_250c324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Out-of-Pocket_11.13.25.pdf)View report ## How many adults in the US do not have dental insurance? Approximately 72 million adults in the US (27%) do not have dental insurance — almost three times the percentage of adults who lack health insurance — according to CareQuest Institute’s latest State of Oral Health Equity in America survey. The State of Oral Health Equity in America survey is the largest annual, nationally representative survey about the oral health of adults in the US. More than 9,000 adults responded in 2024. More key findings include: - Approximately one third of Medicare (31%) and Medicaid (33%) recipients do not have dental insurance, and more than four out of five adults (83%) without health insurance also lack dental insurance. - Individuals with less education and lower incomes reported lacking dental insurance in greater percentages than those with higher levels of education and income. - Adults in the youngest (aged 18–29) and oldest (aged 60+) groups lack dental insurance in greater numbers than adults in the middle age groups (aged 30–59). These findings show the importance of expanding access to dental coverage in the US, which includes strengthening benefits in Medicare, Medicaid, and Affordable Care Act Marketplace plans. The authors write: > Given the substantial links between oral health and systemic health, lack of dental insurance can increase the risk of adverse systemic health conditions, even for those who are medically insured.” **You may also be interested in:** - [Beyond a Nice Smile](https://www.carequest.org/resource-library/beyond-nice-smile), an infographic for both patients and providers that explores the links between oral health and overall health, including heart disease, diabetes, and Alzheimer’s. - [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2023), a web page highlighting key findings and reports from previous annual surveys on the oral health of adults in the US. - [Medicaid on the Brink?](https://www.fiercehealthcare.com/payers/medicaid-brink-perspectives-23-healthcare-voices-cuts-loom) An article in *Fierce Healthcare* that shares perspectives on how cuts to Medicaid will likely increase the number of adults who lack dental coverage. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [State Oral Health Dashboard](https://carequest.org/resource/state-oral-health-dashboard/) **Published:** May 12, 2025 **Author:** Darren Edwards **Content:** ## **Data-Driven Change for an Oral Health Crisis** More than one quarter of adults in the US — [69 million people — do not have dental insurance](https://carequest.org/oral-health-in-america-who-gets-left-behind/). The inability to receive dental care is a threat to overall health. And, it costs the health care system billions every year in [treating chronic diseases](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), [lost productivity](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs), and [emergency department visits](https://www.carequest.org/ED-Use) for non-traumatic dental conditions. To improve health outcomes and reduce costs, policymakers, administrators, and advocates need data to understand access, costs, and outcomes by state. The State Oral Health Dashboard breaks down the data for 16 measures by state. **Helpful links:** [Understanding and navigating the State Oral Health Dashboard](https://carequest.org/wp-content/uploads/2025/12/State-Oral-Health-Dashboard-Instructions-2024_FINAL.pdf) [Data Quality Assessment Report](https://carequest.org/wp-content/uploads/2025/12/State-Oral-Health-Dashboard-Data-Quality-Assessment-report-2024_FINAL.pdf) **Categories:** Dashboard, Resource **Tags:** Dental Coverage, Health Equity --- ### [The Collaborative Effect: Transforming Oral Health in North Carolina](https://carequest.org/resource/the-collaborative-effect-transforming-oral-health-in-north-carolina/) **Published:** June 4, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_COrHT_The-Collaborative-Effect_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_COrHT_The-Collaborative-Effect_FINAL.pdf)View report This report evaluates the impact of a learning community comprising 14 safety-net dental practices across North Carolina with a goal to transform oral health for the 47 counties and 87,000 patients they serve. The initiative was a partnership between the North Carolina Oral Health Collaborative, the Blue Cross and Blue Shield of North Carolina Foundation, and CareQuest Institute. Noteworthy results from the community include: - Teledentistry visits increased 635% (from 402 to 2,953 visits), significantly expanding access to preventive care for underserved and rural populations. - Silver diamine fluoride applications grew by 423% (from 1,112 to 5,819 applications), reflecting a shift toward prevention and minimally invasive care. - Chronic disease screenings rose by 434% and care coordination/referrals by 563%, reflecting an emphasis on whole-person health and integrated care. Lessons and recommendations in the report offer a road map for safety-net dental practices nationwide to sustain and scale oral health transformation and achieve long-term systemic change. The authors write: > The initiative underscores that true oral health equity requires structural change: investment in infrastructure and workforce, data-informed practices, patient-centered models, and integrated care.” **You may also be interested in:** - [Teledentistry as a Tool for Health Care Transformation](https://www.carequest.org/resource-library/teledentistry-tool-health-care-transformation), a journal article highlighting the role of technology and regulatory changes to improve access to oral health care. - [A Simple Alternative Payment Model to Incentivize Periodontal Care for Diabetes Mellitus Patients in Community Health Centers](https://www.carequest.org/resource-library/simple-alternative-payment-model-incentivize-periodontal-care-diabetes-mellitus), a tool that helps integrated care settings simulate potential cost savings by covering scaling and root planning for diabetes patients. - [Integration and Coordination to Improve the Patient Experience](https://www.carequest.org/education/course/integration-and-coordination-improve-patient-experience/overview), a self-paced, online course that explores the value of coordinated care and interprofessional collaboration to support whole-person health. Eligible for 1 free CE credit. **Categories:** Publication, Resource **Tags:** Dental Coverage, Medical-Dental Integration, Minimally Invasive Care, Person-Centered Care, Value-Based Care --- ### [The Dental Home Is Where Good Oral Health Starts](https://carequest.org/resource/the-dental-home-is-where-good-oral-health-starts/) **Published:** July 1, 2025 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Dental-Home_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Dental-Home-Visual-Report_6.17.25.pdf)View visual report ## Sociodemographic Factors Associated with Having a Usual Source of Dental Care Seventy-six percent of adults report having a dental home where they receive regular dental care, according to CareQuest Institute’s 2024 State of Oral Health Equity in America survey. The goal of this visual report, which highlights the key data point, was to determine what types of dental practices US adults use as their dental homes, and the sociodemographic factors associated with the type of dental home they use. According to the report, having a dental home — a dental practice or clinic where a person has an ongoing relationship with an oral health care provider — is associated with regular dental visits and better oral health outcomes for patients, while lack of a dental home can lead to a variety of obstacles to good oral health. Additional key findings include: - Adults with dental insurance are more likely to have a dental home (85%) than those without dental insurance (62%). - The percentage of adults who have a dental home increases with income and age. - Nearly one-third (32%) of adults aged 18-29 do not have a dental home. - Younger adults and adults with lower incomes and less education are more likely to say their dental homes are dental service organizations (DSOs) and community health centers (CHCs) than private dental practices. These findings highlight the need for diverse types of dental homes to support access to care across a range of socioeconomic statuses. For those without dental homes, partnerships between hospital EDs and dental providers could facilitate more appropriate care pathways for dental emergencies and reduce the cost of care. **You may also be interested in:** - [State Oral Health Dashboard](https://www.carequest.org/state-facts), an interactive tool showing data for 16 measures of oral health access, costs, and outcomes for every state. - [Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage), a visual report analyzing dental insurance coverage in the US. - [Federal Medicaid Cuts Threaten State Dental Benefits](https://www.carequest.org/resource-library/federal-medicaid-cuts-threaten-state-dental-benefits), a publication examining lessons and consequences for states that have eliminated Medicaid adult dental benefits in the past. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Federal Medicaid Cuts Threaten State Dental Benefits](https://carequest.org/resource/federal-medicaid-cuts-threaten-state-dental-benefits/) **Published:** June 26, 2025 **Author:** Darren Edwards **Content:** [![View resource](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Impact-of-State-MADB-Cuts-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/Impact-of-State-Medicaid-Adult-Dental-Benefit-Cuts.pdf)View resource ## Lessons from Six States The Medicaid cuts Congress is debating are likely to force states to reduce or eliminate Medicaid adult dental benefits (MADBs). This publication, co-authored by CareQuest Institute, Community Catalyst, and Families USA, examines lessons and consequences from six states that have eliminated MADBs in the past. *Update: The Final Budget Reconciliation Bill passed in the House and was signed into law on July 4. It includes deep funding cuts to the Medicaid program which* [*threaten dental access for millions*](https://www.carequest.org/about/press-release/carequest-institute-raises-alarm-over-medicaid-cuts-threaten-dental-access)*.* Key Lessons Learned - In Oregon, California, Maryland, and Pennsylvania, eliminating MADBs led to increased dental ER visits and increased costs of care overall because an ER visit costs three times more than a dental visit. - In Missouri, California, and Massachusetts, MADB cuts shifted costs to Community Health Centers, straining their capacity and financial stability. - In Massachusetts, private practice dentists experienced a drop in revenue because they had provided the majority of dental care for adults with Medicaid. More than 72 million people rely on Medicaid for their health care, and it is a critical lifeline to dental care for people with disabilities, children, older adults, and families with low incomes. The authors write: > As Congress considers changes to federal Medicaid spending, the experiences from these six states offer a powerful warning: reducing or eliminating MADBs is a short-sighted decision that harms patients, burdens health systems, and ultimately costs more in the long run.” **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Veterans Need Affordable Dental Care](https://carequest.org/resource/veterans-need-affordable-dental-care/) **Published:** July 8, 2025 **Author:** Darren Edwards **Content:** [![View resource](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_veterans-oral-health-fact-sheet_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/veterans-oral-health-fact-sheet_FINAL.pdf)View resource Of the 9 million veterans who are eligible for medical care through the Veterans Health Administration, only 20% are eligible for dental benefits. This fact sheet from CareQuest Institute highlights the challenges — including the health risks and financial burdens — veterans face in accessing dental care. Policy steps to strengthen dental access for veterans include broadening dental coverage for high-risk veterans and strengthening the Community Care Network. > By addressing barriers to affordable dental care, policymakers can improve access to necessary care for veterans while reducing long-term health care costs associated with poor oral health. **You may also be interested in:** - [Oral Health Is Essential to Veteran Productivity and Well-Being](https://www.carequest.org/system/files/CareQuest_Institute_AIDPH_Oral-Health-Is-Essential-to-Veteran-Work-Productivity_3.11.24.pdf), a report exploring the lost productivity due to oral health problems experienced by 600,000 veterans in a single year. - [Veteran Oral Health: Expanding Access and Equity](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), a white paper investigating the social, structural, and individual drivers of poor oral health outcomes experienced by veterans. - [Veteran Dental Care Stimulates the Economy and Improves Overall Health](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health), a report that estimates the potential savings ($7 billion) from providing preventive dental care for veterans. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Medical Oral Expanded Care in Ohio](https://carequest.org/resource/medical-oral-expanded-care-in-ohio/) **Published:** February 7, 2024 **Author:** Darren Edwards **Content:** [![View case study](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_MORE-Care-Ohio-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/MORE-Care-Ohio-Case-Study-2.13.2024.pdf)View case study ## Improving Children’s Dental Health Tooth decay is the most common, preventable chronic disease among children in the US. And in Ohio, one out of every four children has not had an annual dental visit. CareQuest Institute and [Oral Health Ohio](https://www.oralhealthohio.org/) are collaborating on an innovative program (MORE Care™) that partners physicians and dentists to provide whole-person health care to more than 15,000 underserved children across five counties in Ohio. > MORE Care looks at the whole picture and doesn’t just break it up into slices. So now both the dental and the primary care providers approach the diagnosis and treatment of the patients together — a more integrated approach.” > > Taiwo Ngo, DDS, Toledo, OH **You may also be interested in:** - [Expanding Integration and Access for Children’s Dental Health](https://www.carequest.org/about/blog-post/expanding-integration-and-access-childrens-dental-health), a blog post that explores the importance of children’s dental health and strategies to improve medical-dental integration. - [Medical and Dental Integration: A Need for Improved Electronic Health Records](https://www.carequest.org/resource-library/medical-and-dental-integration-need-improved-electronic-health-records), a visual report that explores the barriers that dental and medical providers experience in accessing and sharing patient health information. - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report that reviews the link between oral and systemic diseases and the role of medical-dental integration (MDI) in improving access to care and health outcomes. **Categories:** Resource, Tool **Tags:** Value-Based Care --- ### [Value-Based Care Readiness Assessment](https://carequest.org/resource/value-based-care-readiness-assessment/) **Published:** February 29, 2024 **Author:** Darren Edwards **Content:** ## **Is your organization ready for value-based care and payment?** **[Take the assessment to find out](https://www.carequest.org/content/value-based-care-readiness-assessment-introduction)** The Value-Based Care (VBC) Readiness Assessment is designed to help dental and health care leadership teams evaluate organizational readiness to transition to a value-based care and payment model in dentistry. The results of the assessment will provide a snapshot of your organization’s current state and identify gaps in readiness. After completing the assessment, you will receive a “readiness score” and a learning pathway to education, resources, and tools that support your journey to value-based care. [![](https://carequest.org/wp-content/uploads/2024/02/VBCRA-screener-1200x630-1-1024x538.png)](http://https://www.carequest.org/content/value-based-care-readiness-assessment-introduction) **You may also be interested in:** - [Introduction to Value-Based Care in Oral Health: Moving from Volume to Value](https://www.carequest.org/education/course/introduction-value-based-care-oral-health-moving-volume-value/overview), a self-paced course that discusses the differences between VBC in oral health and the traditional fee-for-service model, and the benefits of VBC for patients, providers, and payors. - [Update on Alternative Payment Models in Oral Health Care](https://www.carequest.org/resource-library/update-alternative-payment-models-oral-health-care), in this journal article in *Decisions in Dentistry*, the authors find that patients in alternative payment models are more likely to receive preventive services and less likely to visit the emergency department for a dental condition. - [Value-Based Care: The Federally Qualified Health Center Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that analyzes why and how FQHCs are well positioned to lead the transformation into a value-based system. **Categories:** Resource, Tool **Tags:** Value-Based Care --- ### [Experiences with and Outcomes of Oral Health Care](https://carequest.org/resource/experiences-with-and-outcomes-of-oral-health-care/) **Published:** March 15, 2024 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Experiences-With-and-Outcomes-of-Oral-Health-Care_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Experiences-With-and-Outcomes-of-Oral-Health-Care_3.20.24_FINAL.pdf)View report ## Perspectives from Nationally Representative Data To address disparities in oral health care, it’s critical to understand how people perceive and experience the oral health care system. CareQuest Institute’s annual [State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2023) does just that, providing an in-depth look at how a nationally representative sample of adults in the US experience oral health care. This report focuses on patient experiences with value-based care, medical-dental integration, minimally invasive care, teledentistry, and discrimination in the dental setting. Overall, adults understand the significance of oral health to overall health, but they have had little experience with some of these lesser-known topics in oral health care. Key findings include: - Most adults (93%) say that oral health is at least as important to the overall health of a person as physical health. - When asked what they associate most with value when thinking about their overall health care, adults were more likely to say quality of care (46%) than out-of-pocket costs (14%) or health improvement (11%). - Only 4% of respondents said they had been referred to a primary care provider by their oral health provider, while 7% said they had received a referral to another health care professional. - When asked about choosing a new minimally invasive treatment for cavities, 36% said they would choose the new treatment, 27% would choose a filling, and 27% were unsure. - Only 4% of adults have had a teledentistry visit, but most (71%) of those adults would use this technology again if offered. > Providing integrated dental and medical care across the life span . . . can help increase access to health screenings in underserved communities and improve overall health outcomes for patients. This report emphasizes the need for patient-focused outcomes within oral health care.” **You may also be interested in:** - [State of Oral Health Equity in America 2023](https://www.carequest.org/content/state-oral-health-equity-america-2023), a web page with all the reports and key findings from our latest annual survey on oral health. - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report that provides a comprehensive overview of the bidirectional nature of oral and systemic diseases and discusses how medical-dental integration can improve access to care and health outcomes. - [An Introduction to Value-Based Care (VBC) in Oral Health: Moving from Volume to Value](https://www.carequest.org/education/course/introduction-value-based-care-oral-health-moving-volume-value/overview), a self-paced course that discusses the differences between VBC in oral health and the traditional fee-for-service model, and the benefits for patients, providers, and payors. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Minimally Invasive Care, Value-Based Care --- ### [Minor Restorations Decreased after Implementation of Sugar-Sweetened Beverage Tax](https://carequest.org/resource/minor-restorations-decreased-after-implementation-of-sugar-sweetened-beverage-tax/) **Published:** March 19, 2024 **Author:** Darren Edwards **Content:** ### Presented at the 2024 International Association for Dental, Oral, and Craniofacial Research General Session This study examined rates of minor restorations before and after the implementation of a sugar-sweetened beverage (SSB) tax in Philadelphia and Boulder, Colorado. Restorations in Philadelphia increased, while restorations in Boulder decreased following SSB tax implementation. Results suggest that an SSB tax alone does not account for changes in restorative rates. Future research should examine factors related to interactions between such taxes, demographics, and social determinants of health in changes in restoration rates. **Attachments:** [CareQuest\_Institute\_Presentation\_SugarSweetenedBeverageTax\_IADR\_2024.pdf](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Presentation_SugarSweetenedBeverageTax_IADR_2024.pdf) (298.06 KB) **Categories:** Presentation, Resource **Tags:** Health Equity --- ### [Oral Health Is Essential to Veteran Productivity and Well-Being](https://carequest.org/resource/oral-health-is-essential-to-veteran-productivity-and-well-being/) **Published:** March 19, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-Health-Essential-Veteran-Productivity_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_AIDPH_Oral-Health-Is-Essential-to-Veteran-Work-Productivity_3.11.24.pdf)View visual report Nearly 600,000 veterans reported productivity loss in the past year due to oral health problems, according to a report from CareQuest Institute and the American Institute of Dental Public Health. The report finds that lack of access to dental care leads to significant losses in productivity time and money for veterans and their employers. Other key findings include: - Veterans with urgent dental needs were approximately five times more likely to report poor functioning and work compared to veterans who needed routine dental care. - Poor oral health is linked to several chronic conditions, including heart disease. Among veterans with heart disease, the annual cost of missed workdays was four times higher for those who did not have a dental visit in the past year. - Nearly 3 million veterans felt self-conscious or embarrassed because of their teeth, mouth, or dentures, which “has profound effects on socialization and feelings of loneliness.” The authors write, “Service to country, deployment, and combat experience amplify a veteran’s risk of poor health outcomes and reduced quality of life.” Yet, 85% who are eligible for medical care through the Veteran’s Affairs Administration (VA) are not eligible for dental coverage or care. Expanding that eligibility, write the authors, is just one of several solutions to improve oral health for veterans. **You may also be interested in:** - [The Hour of Need: Productivity Time Lost Due to Urgent Oral Health Needs](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs), a visual report that explores why adults in the US miss more than 243 million hours of productivity time due to oral health problems. - [Veteran Oral Health: Expanding Access and Equity](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), a white paper that shines a light on the factors that drive poor oral health outcomes for veterans and identifies actions to improve access to and quality of care for veterans. - [Veteran Dental Care Stimulates the Economy and Improves Overall Health](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health), a visual report that examines the economic and health implications of improving access to dental care for veterans. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [Implicit Bias Among Dental Professionals: A Scoping Review](https://carequest.org/resource/implicit-bias-among-dental-professionals-a-scoping-review/) **Published:** March 27, 2024 **Author:** Darren Edwards **Content:** Presented at the 2024 International Association for Dental, Oral, and Craniofacial Research General Session This scoping review evaluated the existence of implicit bias among oral health professionals and the potential impact on patient outcomes. Findings suggest that implicit bias impacts the clinical decision-making of dental professionals, particularly among recommendations for extractions and surgery for oral cancer. Researchers recommend further study to determine how much implicit bias contributes to oral health disparities and more training on the topic within dental education and to increase workforce diversity. **Attachments:** [CareQuest\_Institute\_Poster\_Implicit\_Bias\_IADR\_3.4.24.pdf](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Poster_Implicit_Bias_IADR_3.4.24.pdf) (987.48 KB) **Categories:** Presentation, Resource **Tags:** Health Equity --- ### [An Estimated 12 Million Children and Adults Lost Medicaid Dental Insurance after the COVID-19 Public Health Emergency Expired](https://carequest.org/resource/an-estimated-12-million-children-and-adults-lost-medicaid-dental-insurance-after-the-covid-19-public-health-emergency-expired/) **Published:** April 1, 2024 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_12-Million-Lost-Medicaid_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_An-Estimated-12-Million-Children-and-Adults-Lost-Medicaid-Dental-Insurance_4.1.24_FINAL.pdf)View report New data analyses by CareQuest Institute reveal that approximately 12 million adults and children nationwide lost their dental coverage between April and September of 2023 due to Medicaid redeterminations. The public health emergency (PHE) declared during the COVID-19 pandemic included measures to prevent people from losing health insurance. However, in April of 2023, those protections ended. As a result, millions of people have been disenrolled from Medicaid, losing their medical and dental coverage. While some people have been able to find alternative sources of medical coverage, very few people have been able to reenroll in dental coverage. Key findings include: - About 12 million people were disenrolled from Medicaid coverage that included dental benefits in 2023. - Of those 12 million people, about 10 million had not enrolled in an alternative source of dental coverage as of September 2023. When the entire redetermination process is done, dental coverage losses may end up exceeding medical coverage losses, which could significantly reverse recent progress in improving access to dental care. The authors write, “The growth of Medicaid enrollment during the PHE continuous eligibility and the precipitous rise of uninsured individuals following its expiration highlight the importance of strengthening Medicaid to cover individuals who would otherwise be uninsured.” ## Impact by State Each state approached redetermination differently, creating clear differences in total Medicaid enrollment by state. In addition to national estimates, the report analyzes disenrollment rates by state. [View an interactive map with disenrollment rates by state](https://www.carequest.org/content/medicaid-redetermination-2024) **You may also be interested in:** - [Biden Administration Keeps Door Open for Oral Health Advocacy in 2024](https://www.carequest.org/about/blog-post/biden-administration-keeps-door-open-oral-health-advocacy-2024), a blog post, from CareQuest Institute’s Director of Public Policy, Melissa Burroughs, that discusses the momentum for adult dental benefits in both Medicare and Medicaid. - [Uninsured and in Need](https://www.carequest.org/resource-library/uninsured-and-need), a visual report, part of our [State of Oral Health Equity in America series](https://www.carequest.org/content/state-oral-health-equity-america-2023), that estimates more than 68 million US adults do not have dental insurance. - [Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups), a report that analyzes which states offer additional dental coverage to adults who are pregnant and postpartum, have developmental and/or intellectual disabilities, or utilize long-term care. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Poor Oral Health May Contribute to the Risk of Dementia](https://carequest.org/resource/poor-oral-health-may-contribute-to-the-risk-of-dementia/) **Published:** April 24, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Poor-Oral-Health-Dementia-Visual-Report_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Poor-Oral-Health-May-Contribute-to-the-Risk-of-Dementia-Visual-Report_4.25.24.pdf)View visual report This visual report from CareQuest Institute examines current research on the links between poor oral health and the risk of being diagnosed with Alzheimer’s disease and related dementias (ADRD). It is estimated that by 2040, the number of individuals with ADRD in the US could reach 12 million, making it critical to determine whether improvements in oral health may prevent or reduce the symptoms of this disease. ## Is there a link between oral health and dementia? Highlighted research findings include: - Adults aged 50–80 with Alzheimer’s disease have worse periodontal (gum) health than their peers without Alzheimer’s, including more plaque, more bone loss around the teeth, and more gingival bleeding. - Tooth loss from gum disease or tooth decay is linked with a higher risk of being diagnosed with ADRD. - Individuals with ADRD — including those living in long-term care facilities — are at increased risk of poor oral health, due to challenges with maintaining oral hygiene and accessing professional oral health care. - [Minimally invasive treatments](https://www.carequest.org/topics/minimally-invasive-care) may be useful to treat and prevent caries for adults with ADRD who are unable to receive care in a dental office. **You may also be interested in:** - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report that provides a comprehensive overview of the bidirectional nature of oral and systemic diseases and discusses how medical-dental integration can improve access to care and health outcomes. - [Uninsured and in Need](https://www.carequest.org/resource-library/uninsured-and-need), a report that examines why 68 million people in the US lack dental insurance, including older adults who are most likely to be uninsured. - [Minimally Invasive Care in Dentistry: Healing Tooth Decay with Brush-On Therapies](https://www.carequest.org/education/course/minimally-invasive-care-dentistry-healing-tooth-decay-brush-therapies/overview), a self-paced, online course that introduces therapies that can reduce dental anxiety and be delivered by a variety of providers. Eligible for one free CE credit. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Periodontal Treatment Associated with Decreased Diabetes-Related Treatment Costs](https://carequest.org/resource/periodontal-treatment-associated-with-decreased-diabetes-related-treatment-costs/) **Published:** June 6, 2024 **Author:** Darren Edwards **Content:** [![View summary](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Summary_Diabetes_Periodontal_Disease_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Summary_Periodontal-Treatment-Decreased-Diabetes-Costs_5.3.24.pdf)View summary ## An Analysis of Dental and Medical Claims Data In this article in *The Journal of the American Dental Association*, CareQuest Institute researchers found that overall health care costs were reduced in both Medicaid patients (14% less) and commercially insured patients (12% less) with diabetes who had received periodontal treatment within the previous two years. ## Gum Disease and Diabetes There is a well-established and bi-directional [link between diabetes and periodontal (gum) disease](https://www.carequest.org/resource-library/connection-between-oral-health-and-diabetes). Approximately 10% of the entire US population has diabetes (diagnosed or undiagnosed), and the risk of developing both diabetes and periodontal disease is increased for patients with lower socioeconomic status, such as those who receive health care coverage through Medicaid. The authors write: > “Expanding Medicaid benefits to include comprehensive periodontal treatment has the potential to reduce health care costs for patients with diabetes.” [**Read the article**](https://www.sciencedirect.com/science/article/pii/S0002817723000223) in *The Journal of the American Dental Association* (open access) **You may also be interested in:** - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a research report that finds that including periodontal treatment in Medicare has the potential to save up to $14.5 billion annually for patients with diabetes. - [The Role of Algorithms in Oral Health Care and Disease Prevention and Management](https://www.carequest.org/resource-library/role-algorithms-oral-health-care-and-disease-prevention-and-management-consumer), a research report that analyzes consumer and provider attitudes about using digital health tools to predict chronic conditions, like diabetes, and provide more personalized care. - [Integrating Diabetes Screening into Oral Health Care](https://www.carequest.org/education/webinars/integrating-diabetes-screening-oral-health-care), a recorded webinar that features oral health providers sharing the workflow they use to connect patients with diabetes to medical care. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Dental Coverage, Medical-Dental Integration --- ### [The Heart of the Matter](https://carequest.org/resource/the-heart-of-the-matter/) **Published:** June 6, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail-Heart-of-the-Matter-250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_The-Heart-of-the-Matter-Visual-Report_7.10.24.pdf)View visual report ## Links Between Cardiovascular Health and Oral Health A visual report from CareQuest Institute explores the relationship between cardiovascular (heart) disease and periodontal (gum) disease, which are both extremely common in the US. Individuals with gum disease have two to three times the risk of experiencing a heart attack, stroke, or a severe cardiovascular event. Additional key points include: - Infected and unhealthy gums can increase the risk of developing infective endocarditis (IE), particularly among individuals with existing cardiovascular issues. This issue is of particular concern for children with a heart condition. - Among children with a heart condition, about one in six have at least one sign of poor oral health. - Oral health is worse for children with a heart condition who also have an intellectual or developmental disability, live in poverty, or lack insurance. - Routine preventive dental care and regular brushing and flossing can reduce gum disease and the risk of related heart diseases. The authors write that collaboration between dental and medical providers is critical to improving health outcomes. > With heart disease remaining the leading cause of death in the US, we must continue to consider the role of our oral health in the health of our hearts. **You may also be interested in:** - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report that provides a comprehensive overview of the bidirectional nature of oral and systemic diseases and discusses how medical-dental integration can improve access to care and health outcomes. - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a report finds that including periodontal treatment in Medicare has the potential to save up to $27.8 billion annually for patients with heart disease. - [Periodontal Treatment Associated with Decreased Diabetes-Related Treatment Costs](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs), an article in *The Journal of the American Dental Association* suggests that expanding Medicaid benefits to include periodontal treatment could reduce health care costs for patients with diabetes. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Lower-Income Families Still Spend More on Dental Care](https://carequest.org/resource/lower-income-families-still-spend-more-on-dental-care/) **Published:** June 25, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Lower-Income-Families-Still-Spend-More_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Lower-Income-Families-Still-Spend-More-on-Dental-Care_5.10.24_FINAL.pdf)View visual report CareQuest Institute’s latest analysis of dental care spending and income reveals that inequities in out-of-pocket expenditures between the poorest and wealthiest families in the US have continued to grow. In 2021, the most recent data available, poorer families paid 7.4 times more in out-of-pocket expenditures for dental care compared to high-income families. Additional Key Findings - In 2007, the poorest families paid 5.5 times more than the wealthiest families in out-of-pocket expenditures for dental care. By 2021, the poorest families paid 7.4 times more for dental care. - The percentage of individuals with at least one dental visit within the prior year was substantially lower among poorer households (~25%) than wealthier ones (~55%). - When people from lower-income families can receive dental care, their households bear a disproportionate burden of out-of-pocket dental costs. - Comprehensive Medicaid adult dental benefits in all states, increased dental provider participation in Medicaid, and support for safety-net providers serving low-income patients are just a few solutions that would make dental coverage and care more accessible and affordable for low-income families. **You may also be interested in:** - [Uninsured and in Need](https://www.carequest.org/resource-library/uninsured-and-need), a visual report, part of our[ State of Oral Health Equity in America series](https://www.carequest.org/content/state-oral-health-equity-america-2023), estimates more than 68 million US adults do not have dental insurance. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. - [An Estimated 12 Million Children and Adults Lost Medicaid Dental Insurance](https://www.carequest.org/resource-library/estimated-12-million-children-and-adults-lost-medicaid-dental-insurance-after), a report that analyzes the impact on dental insurance coverage following the expiration of the COVID-19 public health emergency in 2023. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Dental Coverage National Voter Polling Results](https://carequest.org/resource/dental-coverage-national-voter-polling-results/) **Published:** July 15, 2024 **Author:** Darren Edwards **Content:** [![View presentation](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_CareQuest_OPEN_2024-Medicare-Dental-Natl-Polling-Results-300x169.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_OPEN_2024-Medicare-Dental-Natl-Polling-Results_FINAL_0.pdf)View presentation More than 9 in 10 voters nationwide (92%) support adding a dental benefit to Medicare, according to results of a new national poll commissioned by CareQuest Institute and the Oral Health Progress and Equity Network (OPEN). The findings were first presented at the 2024 OPEN Advocacy Assembly on July 17. Key findings include: - 85% of respondents who voted for Trump in both 2016 and 2020 and 99% of those who voted for the Democratic candidate in those two elections would like to see a dental benefit added to Medicare. - When ranking health care topics they find “most important,” voters rank adding dental coverage to Medicare just as highly as abortion. - Nine out of 10 voters want expanded coverage to include dental services for veterans. - 74% of voters support adding adult dental benefits to Medicaid at the state or federal level. - Additional polling was conducted in Michigan, Ohio, and Pennsylvania with results consistent with the national polling. Expanded dental coverage in Medicare, Medicaid, and for veterans is similarly popular in these key battleground states. The national polling was conducted by Marketing for Change Co. from May 29 – June 4, 2024, using a representative sample of 1,000 registered voters nationwide from the YouGov online panel. The margin of error is +/- 3.1%. Marketing for Change also conducted separate polling in Michigan (n=765), Ohio (n=761) and Pennsylvania (n=760) using the Centiment online panel between May 30 and June 13. The margin of error for those surveys was between +/- 3.54% and +/-3.55%. **You may also be interested in:** - [Dental Coverage for Seniors is Wildly Popular. Why Don’t Candidates Discuss It?](https://www.usatoday.com/story/news/health/2024/09/22/dental-insurance-medicare-popular/75054735007/), a *USA Today* article explores why the issue of dental coverage has gained little traction in health care policy despite the need among many Americans. - [Uninsured and in Need](https://www.carequest.org/resource-library/uninsured-and-need), a visual report, part of our [State of Oral Health Equity in America series](https://www.carequest.org/content/state-oral-health-equity-america-2023), estimates more than 68 million US adults do not have dental insurance. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. [![View Medicare flyer](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_medicare_handout_612x792-232x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_medicare_handout_7.16.pdf)View Medicare flyer [![View veterans flyer](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_veterans_handout_612x792-232x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_veterans_handout_7.16.pdf)View veterans flyer [![View Medicaid flyer](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_medicaid_handout__612X792-232x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_medicaid_handout_7.16.pdf)View Medicaid flyer **Categories:** Presentation, Resource **Tags:** Dental Coverage --- ### [Trauma-Informed Care in Oral Health Care](https://carequest.org/resource/trauma-informed-care-in-oral-health-care/) **Published:** August 20, 2024 **Author:** Darren Edwards **Content:** ## The Role of Dental Hygienists With half of children and two-thirds of adults in the US experiencing some type of traumatic event, oral health care providers must be able to provide compassionate, trauma-informed care, according to this article in [*The Journal of Dental Hygiene*](https://jdh.adha.org/content/98/4/50). The article, authored by CareQuest Institute researchers, examines the critical role of the dental hygienist. Even when the trauma did not occur in the dental setting, the experiences can impact a person’s oral health, write the authors. Children and adults with a trauma history are more likely to have poor oral health and increased dental care-related fear and anxiety. Experiences in the dental office may trigger negative memories or emotions for some patients with a trauma history, including: - Reclining in the dental chair - Placing a napkin around the neck - Having dental team members “hovering” over them - Not being able to speak or effectively communicate The authors write that the dental hygienist’s role is not that of a therapist, but “to make sure the patient feels heard, not rushed, and not judged for their past experiences.” > Providing trauma-informed care helps to ensure patients will feel heard and understood and increases the likelihood they will feel comfortable enough to return for regular dental care. Learn more about trauma-informed care in [*The Journal of Dental Hygiene*](https://jdh.adha.org/content/98/4/50) (open access) **You may also be interested in:** - [Understanding and Providing Trauma-Informed Oral Health Care](https://www.carequest.org/education/webinars/understanding-and-providing-trauma-informed-oral-health-care), a recorded webinar featuring experts who share strategies to sensitively interact with trauma survivors in an oral health setting. - [How Depression Is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that highlights research findings on the growing link between mental health and oral health. - [Dental Fear is Real. Providers Can Help.](https://www.carequest.org/resource-library/dental-fear-real-providers-can-help), a visual report that explores the impacts of dental fear and provides guidance and resources for dental providers to help them address dental fear in patients. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [Unlocking Value in Alternative Payment Models](https://carequest.org/resource/unlocking-value-in-alternative-payment-models/) **Published:** August 26, 2024 **Author:** Darren Edwards **Content:** ## The Power of Readily Available Information [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Unlocking-Value-APMS_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Unlocking-Value-in-Alternative-Payment-Models_FINAL.pdf)View report In the past decade, health care payment models have shifted from volume-driven, fee-for-service payments toward value-based care and payment models. These alternative payment models (APMs) hold the potential to improve quality, enhance the care experience, and reduce costs. Yet oral health is often not considered in the testing of APMs, and the dental field has been slow to adopt them on its own. A report from CareQuest Institute for Oral Health makes the case that to advance whole-person health, APMs must include oral health. The authors review public-payor APM designs in several leading states, with a focus on models that include oral health. Key points include: - Information on APMs is limited and not readily accessible. - Publicly available, high-quality, easy-to-find information is critical in payment reform efforts to fully understand the oral health landscape in APMs, to ensure that more APMs include oral health, and to learn from the successes and challenges of existing models. - A case study of Vermont provides an example that moving from fee-for-service to value-based payment takes time, but collaboration and transparency set the stage for oral health to be included in future payment and transformation efforts. **You may also be interested in:** - [Update on Alternative Payment Models in Oral Health Care](https://www.carequest.org/resource-library/update-alternative-payment-models-oral-health-care), a journal article that compares spending and service utilization of fee-for-service models to alternative payment models. - [An Introduction to Value-Based Care in Oral Health: Moving from Volume to Value](https://www.carequest.org/education/course/introduction-value-based-care-oral-health-moving-volume-value/overview), a self-paced CE course that explains how VBC can improve patient outcomes while benefiting providers and payors. - [Value-Based Care Readiness Assessment](https://www.carequest.org/content/value-based-care-readiness-assessment-introduction), a tool to help dental and health care leadership teams evaluate organizational readiness to transition to a value-based care and payment model in dentistry. **Categories:** Publication, Resource **Tags:** Medical-Dental Integration, Practice Management, Value-Based Care --- ### [State of Oral Health Equity in America 2024](https://carequest.org/resource/state-of-oral-health-equity-in-america-2024/) **Published:** September 3, 2024 **Author:** Darren Edwards **Content:** [![View infographic](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_SOHEA-2024-Survey-Key-Findings_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_SOHEA-2024-Survey-Key-Findings_Final.pdf)View infographic ## Key Findings from the 2024 Survey CareQuest Institute’s annual State of Oral Health Equity in America survey is the largest nationally representative survey focused on adults’ attitudes, experiences, and behaviors related to oral health. The 2024 survey is our largest yet, gathering responses from more than 9,000 adults in the US. This infographic highlights some initial key findings. A comprehensive report with additional findings will follow shortly, and future reports will take a deeper dive into specific outcomes and experiences. Key findings include: - More than two-thirds of adults (68%) report seeing a dentist in the prior year. - Adults earning $100K or more per year report planning to seek dental care in greater numbers (93%) than those earning less than $30K per year (73%). - Approximately 4% of adults report seeking dental care in an emergency department (ED) in the past year. - Adults with less than a high school education were nine times more likely to report seeking dental care through an ED than those with a postgraduate or professional degree. **You may also be interested in:** - [State of Oral Health Equity in America 2023](https://www.carequest.org/content/state-oral-health-equity-america-2023), a series of reports highlighting key findings and insights from the 2023 survey. - [Lower-Income Families Still Spend More on Dental Care](https://www.carequest.org/resource-library/lower-income-families-still-spend-more-dental-care), a visual report that reveals inequities in out-of-pocket expenditures between the poorest and wealthiest families in the US have continued to grow, with poorer families paying 7.4 times more out-of-pocket than wealthier families. - [A Seat at the Table, Improving Oral Health in Wisconsin](https://www.carequest.org/about/blog-post/seat-table-improving-oral-health-wisconsin), a blog post about a medical-dental integration program that engages the community and challenges negative perceptions about the difficulty for underserved populations to access dental care. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://carequest.org/resource/medicaid-adult-dental-benefits-offered-to-specific-beneficiary-groups-2/) **Published:** October 1, 2024 **Author:** Darren Edwards **Content:** [![View 2025 report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits_2025_250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medicaid-Adult-Dental-Benefits_2025-1.pdf)View 2025 report ## What does Medicaid cover for dental for adults? According to this CareQuest Institute report updated for 2025, 21 states now offer additional dental coverage to specific beneficiary groups, including pregnant and postpartum adults, adults with developmental and/or intellectual disabilities, and adults utilizing long-term care. **Additional Key Findings** - Eight states cover dental services for pregnant adults that are not provided to other adult beneficiaries. Seven states also provide these services to postpartum adults. - Nine states cover dental services for adults with intellectual or developmental disabilities that are not provided to other adult beneficiaries. - Seven states cover dental services for adults utilizing long-term care that are not provided to other adult beneficiaries. [![View 2024 report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits_2024_250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medicaid-Adult-Dental-Benefits_10.9.24-1.pdf)View 2024 report Medicaid adult dental benefits are classified as “optional,” which means that states can limit or exclude adult dental services covered. The report includes a rubric of states offering different coverage to specific groups of adult beneficiaries within eight categories, including annual benefit maximum, diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and extraction. **You may also be interested in:** - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. - [Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage), a visual report estimating that 72 million adults in the US (27%) do not have dental insurance. [![View 2023 report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits_250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medical-Adult-Dental-Benefits_1.12.24-1.pdf)View 2023 report **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [Attention to Detail: ADHD and Oral Health](https://carequest.org/resource/attention-to-detail-adhd-and-oral-health/) **Published:** October 7, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Attention-to-Detail_FINAL_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Attention-to-Detail_FINAL.pdf)View visual report ## Links Between Attention-Deficit/Hyperactivity Disorder (ADHD) and Oral Health While children with attention-deficit/hyperactivity disorder (ADHD) can be at a greater risk of poor oral health than children without ADHD, little is known about the oral health of adults with ADHD. That’s why the nationally representative, annual CareQuest Institute State of Oral Health Equity in America survey asked adults whether they had ever been diagnosed with ADHD and other questions related to their oral health. Findings suggest that adults with ADHD — nearly 9 million individuals in the US — face more risks to their oral health than adults without ADHD. Other key findings from the visual report show that more adults with ADHD: - Rated their oral health as fair/poor compared to adults without ADHD (35.5% vs. 24.9%). - Reported being embarrassed by their teeth or mouth compared to adults without ADHD (48.4% vs. 29.6%). - Reported visiting an emergency department (ED) for dental care in the prior year compared to adults without ADHD (13.0% vs. 2.3%). Researchers also noted the importance of oral health professionals being aware of the potential oral health risks associated with ADHD and collaborating with their patients to help them achieve optimal oral health. Medications used to treat ADHD, for example, may produce side effects, which can lead to increased tooth decay, gingivitis, and other oral health issues. CareQuest Institute’s annual [State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2023) is the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. **You may also be interested in:** - [Alzheimer’s Disease and the Connection to Oral Health](https://www.carequest.org/education/webinars/alzheimers-disease-and-connection-oral-health), a webinar that helps oral health teams better understand the relationship between Alzheimer’s disease, related dementias, and oral health. - [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2023), a series of reports highlighting key findings and insights from previous annual surveys. - [The Heart of the Matter: Links Between Cardiovascular Health and Oral Health](https://www.carequest.org/resource-library/heart-matter), a visual report that explores the relationship between heart disease and gum disease. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Dental Insurance Coverage and Oral Health in Battleground States](https://carequest.org/resource/dental-insurance-coverage-and-oral-health-in-battleground-states/) **Published:** October 22, 2024 **Author:** Darren Edwards **Content:** [![View Michigan report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Battle-Report-Michigan_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Michigan-Battle-Report_10.16.24_FINAL.pdf)View Michigan report ## Should Medicare and Medicaid Cover Dental Care? CareQuest Institute for Oral Health’s annual State of Oral Health Equity in America survey asked over 9,000 adults about visiting a dentist and about dental benefits included in Medicaid and Medicare. Key findings from battleground states in the 2024 election include: ### In Michigan - 67% of adults saw a dentist in the past year, and 18% of adults did not have dental coverage. - 94% of surveyed adults agree or strongly agree that Medicare should cover dental care. ### In Ohio - 67% of adults saw a dentist in the past year, and 19% of adults did not have dental coverage. - 96% of surveyed adults agree or strongly agree that Medicare should cover dental care. [![View Ohio report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Battle-Report-Ohio_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Ohio-Battle-Report_10.16.24_FINAL.pdf)View Ohio report ### In Pennsylvania - 67% of adults saw a dentist in the past year, and 26% of adults did not have dental coverage. - 94% of surveyed adults agree or strongly agree that Medicare should cover dental care. **You may also be interested in:** - [Take Action for Oral Health](https://www.carequest.org/content/take-action-oral-health), this collection of tools and resources makes it easy to engage policymakers and advocate for improved dental coverage in Medicare and Medicaid. - [Dental Coverage for Seniors is Wildly Popular. Why Don’t Candidates Discuss It?](https://www.usatoday.com/story/news/health/2024/09/22/dental-insurance-medicare-popular/75054735007/), a USA Today article explores why the issue of dental coverage has gained little traction in health care policy despite the need among many Americans. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. [![View Pennsylvania report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Battle-Report-Pennsylvania-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Pennsylvania-Battle-Report_10.16.24_FINAL.pdf)View Pennsylvania report **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Teledentistry Utilization by Oral Health Professionals and Policy Considerations](https://carequest.org/resource/teledentistry-utilization-by-oral-health-professionals-and-policy-considerations/) **Published:** October 24, 2024 **Author:** Darren Edwards **Content:** In this article in the *Journal of Public Health Dentistry*, researchers investigated why oral health professionals selected and used various types of teledentistry. They found that the majority of teledentistry visits (76%) were synchronous audio (phone call). The authors, from CareQuest Institute, MouthWatch, and Virginia Commonwealth University, explained that having multiple types of teledentistry delivery available is important to accommodate access to technology for patients and training needs for providers. Teledentistry has the potential to improve access to oral health care, the researchers added. From this one case study of a DSO in Oregon, nearly 80,000 individuals were able to connect with an oral health professional through teledentistry. Qualitative interviews with 13 oral health professionals revealed some challenges that affected teledentistry experiences, including: - Variable technical skills among staff and patients - Broadband limitations for patients - Payer limitations on reimbursement - Patient privacy considerations - Staff shortages and bottlenecks related to oral health professionals working to the top of their licenses [Read the article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12640) in the *Journal of Public Health Dentistry* (open access) **You may also be interested in:** - [Teledentistry Regulation and Policy Guidance](https://www.carequest.org/resource-library/teledentistry-regulation-and-policy-guidance), a toolkit with model teledentistry policies and rules to help improve the regulatory climate and move teledentistry forward. - [Teledentistry and Community Learning Help Kids Get Care in North Carolina](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina), a blog post about how a Federally Qualified Health Center uses teledentistry to deliver care to more than 1,200 children in rural communities. - [Dentists Perceptions about the Value of Teledentistry](https://www.carequest.org/resource-library/dentist-perceptions-about-value-teledentistry), a journal article that shares results from a survey of dentists, the majority of whom (93%) expect teledentistry to change how they practice. **Categories:** Journal Article, Resource **Tags:** Practice Management, Value-Based Care --- ### [Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States](https://carequest.org/resource/impact-of-covid-19-on-dental-care-utilization-and-oral-health-conditions-in-the-united-states/) **Published:** June 2, 2023 **Author:** Darren Edwards **Content:** In this journal article, researchers from CareQuest Institute and the Harvard School of Dental Medicine examine the impact of COVID-19 on dental care use and oral health conditions among more than 430,000 patients at Federally Qualified Health Centers (FQHCs) in 2019 and 2020. Because FQHCs serve more than 28 million patients who are publicly insured or uninsured, live in poverty, or in rural areas, they provide a critical window into the needs of vulnerable populations. ## COVID-19 Effects on Oral Health Researchers found the impact of COVID-19 was more pronounced on dental visits than medical visits. In April 2020, for example, dental care utilization decreased by nearly 81% compared to 2019 and rebounded more slowly than medical utilization. They also observed a greater demand for oral surgery and teledentistry and less demand for preventive services. As a result of COVID-19, patients received more invasive dental procedures due to delayed treatment and experienced a higher risk of psychological stress-related dental conditions, such as tooth grinding, cracked teeth, and endodontic conditions. The authors encouraged “continued support for statewide policies to expand access to oral health care and oral health promotion strategies for vulnerable populations.” [**Read the article**](https://journals.sagepub.com/doi/10.1177/23800844231165016) in *JDR Clinical & Translation Research* (subscription required) **You may also be interested in:** - [Teledentistry and Community Learning Help Kids Get Care in North Carolina](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina), a blog post that shares how an FQHC in North Carolina is using teledentistry and a mobile dental unit to increase access to care for kids in a rural community. - [The Importance of Being Ready: Lessons from Medicaid and Commercial Dental Claims Data](https://www.carequest.org/resource-library/importance-being-ready-lessons-medicaid-and-commercial-dental-claims-data), a visual report that examines dental procedure utilization during COVID-19, comparing Medicaid and commercial insurance claims. - [Value-Based Care: The Federally Qualified Health Center Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper, developed in collaboration with the National Association of Community Health Centers, that discusses how FQHCs can lead the transformation into a value-based system. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Effect of Self-Assembling Peptide P11-4 on Arrest, Cavitation, and Progression of Initial Caries Lesions](https://carequest.org/resource/effect-of-self-assembling-peptide-p11-4-on-arrest-cavitation-and-progression-of-initial-caries-lesions/) **Published:** June 13, 2023 **Author:** Darren Edwards **Content:** Systematic Review and Meta-Analysis A systematic review of self-assembling peptide P11-4, a brush-on treatment that uses a remineralization process to regenerate damaged enamel in initial caries lesions, found that the treatment successfully arrested non-cavitated caries lesions and decreased lesion size. The review, published in the *Journal of the American Dental Association*, assessed whether patients with initial caries lesions treated with P11-4 experienced more caries arrest, less cavitation, or less lesion progression compared to a randomized parallel group. ## More Minimally Invasive Dental Treatments Are Needed Untreated cavitated caries are the most common condition in the Global Burden of Disease, and more effective and simple interventions are needed to increase access to care, improve the patient experience, and lower the cost of care. The authors, including researchers from CareQuest Institute, concluded that self-assembling peptide P11-4 is a “promising treatment for initial caries lesions” in addition to silver diamine fluoride (SDF) and other minimally invasive treatments. [Read the article](https://jada.ada.org/action/showPdf?pii=S0002-8177%2823%2900189-7) in the *Journal of the American Dental Association* (open access) **You may also be interested in:** - [Minimally Invasive Care in Dentistry: Healing Tooth Decay with Brush-On Therapies](https://www.carequest.org/education/course/minimally-invasive-care-dentistry-healing-tooth-decay-brush-therapies/overview), a self-paced interactive course that introduces several therapeutic techniques for caries management. Participants can earn one free CE credit. - [Provider and Public Perceptions of Silver Diamine Fluoride (SDF)](https://www.carequest.org/resource-library/provider-and-public-perceptions-silver-diamine-fluoride-sdf), a visual report that analyzes the effectiveness and the downsides of SDF to arrest caries and prevent new lesions. - [19 Questions (and Answers) about Brush-On Dental Therapies](https://www.carequest.org/about/blog-post/19-questions-and-answers-about-brush-dental-therapies), a blog post summarizing questions and answers from a webinar with three experts in minimally invasive care, and links to additional resources about minimally invasive care. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Minimally Invasive Care --- ### [Addressing the Oral Health Needs of Hispanics in the U.S.](https://carequest.org/resource/addressing-the-oral-health-needs-of-hispanics-in-the-u-s/) **Published:** June 15, 2023 **Author:** Darren Edwards **Content:** [![View part 1](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Addressing-Oral-Health-Needs-of-Hispanics-in-US_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/HDA-CareQuest-Institute_Addressing-Oral-Health-Needs-of-Hispanics-in-US_4.26.23.pdf)View part 1 ## An Exploration of Oral Health Status, Dental Needs, Utilization of Dental Services, and Workforce Disparities in oral health that affect the most vulnerable populations in the US particularly impact Latino communities, which now represent nearly 19% of the total US population. In this comprehensive white paper and gallery report, the Hispanic Dental Association (HDA), in partnership with CareQuest Institute, identifies several key policies that can improve oral health and reduce inequalities among Hispanics in the US. The report traces the history of Hispanics/Latinos in the US, analyzes the utilization of dental services, evaluates Hispanic representation within the dental workforce, and makes recommendations for policy changes to improve health and quality of life for Hispanics/Latinos. ## Ongoing Oral Health Disparities [![View part 2](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Part-2-Addressing-Oral-Health-Needs-of-Hispanics-in-US_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/HDA-CareQuestInstitute_Part-2-Addressing-Oral-Health-Needs-of-Hispanics-in-US.pdf)View part 2 The HDA engaged with more than 63 experts in public health, dentistry, and academia to analyze the findings from multiple surveys and collaborate on recommendations to benefit Hispanic communities. Key findings include: - Family poverty level and education appear to be more sensitive than race/ethnicity in detecting inequities in dental caries (tooth decay). - On average, less than half of Hispanic children from 12 to 19 years had one or more dental sealants, with few racial/ethnic differences. - Approximately 15% of Hispanic adults aged 65 and over were edentulous (had no teeth). - Across all age groups, Hispanics reported having “excellent” or “very good” status of teeth and gums in smaller numbers than non-Hispanic whites. Policy recommendations include improved collection and disaggregation of data to understand disparities among Hispanic/Latino subgroups. The authors write, “It is essential to understand the micro-cultures within the Latino community to address behavioral patterns in oral health.” **You may also be interested in:** - [Nuestra Sonrisa Hispana: Exploring Disparities in Hispanic Oral Health](https://www.carequest.org/education/webinars/nuestra-sonrisa-hispana-exploring-disparities-hispanic-oral-health), a recorded webinar in which a panel of experts discuss how to provide better and more culturally appropriate care for Latino and Hispanic patients. - [The Glaring Scope of Racial Disparities in Oral Health](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health), a communication brief that examines the health, economic, and educational implications of the oral health disparities linked to race and ethnicity. - [Health Equity Needs Teeth](https://www.carequest.org/resource-library/health-equity-needs-teeth), an article in the *AMA Journal of Ethics* that discusses how the separation of dental care and medical care exacerbates inequities and how value-based approaches to health care can improve outcomes for everyone. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Beyond a Nice Smile](https://carequest.org/resource/beyond-a-nice-smile/) **Published:** June 20, 2023 **Author:** Darren Edwards **Content:** [![Printable version](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Beyond-A-Nice-Smile_print_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Beyond-A-Nice-Smile_print_version.pdf)Printable version ## Links Between Oral Health and Overall Health for Older Adults Oral health is about more than a pretty smile. The benefits of good oral health extend to overall health, self-esteem, and quality of life. And the risks of poor oral health can be particularly severe for older adults. This infographic, a collaboration between CareQuest Institute and the [Lunder-Dineen Massachusetts General Hospital MOTIVATE Program](https://lunderdineen.org/program/motivate-transforms-oral-health-in-long-term-care/), explains the importance of oral health for the overall health of older adults. Key points include: - Having diabetes can raise the risk of developing gum disease (periodontitis) by 86%, and individuals with diabetes have gum disease that is more severe than for people without diabetes. - Having gum disease significantly raises the risk of developing Alzheimer’s disease. - The risk of developing high blood pressure is significantly higher in adults who have lost teeth and in people with gum disease. [![Infographic for providers](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Beyond-A-Nice-Smile_Older-Adults_providers-300x194.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Beyond-A-Nice-Smile_Older-Adults_providers.pdf)Infographic for providers The infographic also includes recommendations, including more communication between physicians, dentists, and patients about the connection between oral health and overall health. **You may also be interested in:** - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a research report that finds including periodontal treatment in Medicare has the potential to save up to $42 billion annually for patients with diabetes and heart disease. - [How Depression is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that highlights the growing body of research about the link between mental health and oral health. - [The Association Between Accessing Dental Services and Nonventilator Hospital-Acquired Pneumonia (NVHAP) in Medicaid Beneficiaries](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired), a journal article which finds that patients who received periodontal therapy prior to hospitalization were less likely to be diagnosed with NVHAP, a major cause of hospital-acquired infections. [![Infographic for patients](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Beyond-A-Nice-Smile_Older-Adults_patients-386x250-1-300x194.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Beyond-A-Nice-Smile_Older-Adults_patients.pdf)Infographic for patients **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Medical and Dental Integration: A Need for Improved Electronic Health Records](https://carequest.org/resource/medical-and-dental-integration-a-need-for-improved-electronic-health-records/) **Published:** August 17, 2023 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medical-Dental-Intergration_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Medical-Dental-Intergration_8.15.23.pdf)View visual report The benefits of integrating oral health care and overall health care are well-known. However, the inability for medical and dental providers to access and contribute to shared patient records continues to be a barrier to an integrated health system. To learn about provider experiences with electronic health records (EHRs), CareQuest Institute conducted a survey of more than 100 medical and dental providers at Federally Qualified Health Centers. FQHCs were selected due to their role as innovators and early adopters of medical-dental integration. ## Barriers to an Integrated Health System Key findings from the survey highlight significant barriers to collaboration and data exchange, including: - Fewer than half (42%) of dental providers at colocated facilities can use their health center’s EHR system to enter information into patients’ medical records. - The vast majority (88%) of medical and dental providers at colocated facilities cannot revise their mutual patients’ treatment plans. - Medical providers have more access to identify medications and make referrals to outside health care providers through the EHR system than do dental providers. - All dental providers (100%) would like the ability to view their patients’ medical information. To create a truly person-centered care health system that includes co-management of oral and systemic health, medical and dental EHR integration is necessary. **You may also be interested in:** - [The Oral-Systemic Connection Across the Lifespan](https://www.carequest.org/resource-library/oral-systemic-connection-across-lifespan), an infographic that summarizes research on how dental health affects overall health from pregnancy through older adulthood. - [Missed Connections: Providers and Consumers Want More Medical-Dental Integration](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration), a visual report showing that consumers and providers understand the connection between oral health and overall health and are eager for changes to integrate the health care system. - [Cost, Race, and the Persistent Challenges in Our Oral Health System](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), a report that explores two leading contributors to oral health disparities, as uncovered by our nationally representative, annual survey on the state of oral health in the United States. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Uninsured and in Need](https://carequest.org/resource/uninsured-and-in-need/) **Published:** August 28, 2023 **Author:** Darren Edwards **Content:** ## 68.5 Million Lack Dental Insurance, More May Be Coming [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Uninsured-and-in-Need_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Uninsured-and-in-Need_8.17.23.pdf)View visual report According to the 2023 State of Oral Health Equity in America survey from CareQuest Institute, an estimated 68.5 million adults do not have dental insurance. The survey is the largest nationally representative, annual survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. Key findings from the survey reveal more detail about the ongoing inequities: - More people have dental insurance than in the previous two years. However, more than 6 million adults lost their dental coverage in the past year, primarily due to job loss. Including other household members, the number of individuals who have lost dental coverage in the past year could be as high as 15.6 million. - An additional 14 million adults may lose dental coverage under the [Medicaid redetermination](https://www.carequest.org/content/medicaid-redetermination) process that began on April 1, 2023. The total number of adults without dental insurance will continue to increase as individuals lose their Medicaid dental coverage. - Adults aged 60 years and older were most likely to lack dental insurance. - Hispanic individuals were twice as likely to have lost dental insurance in the last year than white non-Hispanic individuals. ## Dental Coverage in Medicaid and Medicare Nearly two-thirds of adults surveyed strongly agree that Medicaid and Medicare should cover dental care. This report, part of CareQuest Institute’s ongoing advocacy work, urges health care professionals, administrators, policymakers, and advocates to help increase dental coverage within Medicaid and Medicare. **You may also be interested in:** - [Medicaid Redetermination Dental Coverage](https://www.carequest.org/content/medicaid-redetermination), an analysis projecting how many people will lose their Medicaid dental benefits due to the expiration of the COVID-19 Public Health Emergency. - [Cost, Race, and the Persistent Challenges in Our Oral Health System](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), a report that summarizes key oral health disparities that persist based on findings from our 2023 State of Oral Health Equity in America survey. - [Addressing the Oral Health Needs of Hispanics in the US](https://www.carequest.org/resource-library/addressing-oral-health-needs-hispanics-us), a white paper, developed in partnership with the Hispanic Dental Association, that explores key data and makes policy recommendations to improve the oral health of Hispanics in the US. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Children’s Use of Emergency Departments for Non-Traumatic Dental Conditions](https://carequest.org/resource/childrens-use-of-emergency-departments-for-non-traumatic-dental-conditions/) **Published:** June 22, 2023 **Author:** Darren Edwards **Content:** ## Spotlight on Florida [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_FL-Pediatric-ED-Use-NTDC_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_FL-Pediatric-ED-use-NTDC.pdf)View visual report Previous reports from CareQuest Institute have analyzed why and how frequently adults visit an emergency department (ED) for dental conditions that could be best treated in a dental setting. This report is the first to explore children’s use of EDs for non-traumatic dental conditions (NTDCs), finding that Florida had the highest rate of ED visits for children and the highest average charge for these visits, compared to all other states for which data is available. Additional key findings for children in Florida include: - There were 26.7 ED visits for NTDCs per 10,000 children in Florida, compared to approximately 17 in Wisconsin and 8 in Utah. - Black boys had the highest rate of ED NTDC visits at 50.2 visits per 10,000 children. - Medicaid covered 80.6% of ED NTDC visits for children in Florida, compared to approximately 77% in Wisconsin and 56% in Utah. - Florida had the highest average charge for ED NTDC visits, ranging from $1,900 to $2,600 depending on the age of the child. Researchers found that nationally, children who visit EDs for NTDCs are more likely to be uninsured or covered by Medicaid and live in lower-income households. Children with two or more chronic health conditions are more likely to be hospitalized for NTDCs than children without a chronic health condition. The authors of the report state that reducing these costly and preventable ED visits for NTDCs is of vital importance, both for ED capacity and because oral health has far-reaching consequences for the overall health and well-being of children. **You may also be interested in:** - [Emergency Departments Are No Place for Dental Care](https://www.carequest.org/ED-Use), a web page featuring a series of research reports about adult utilization of EDs for non-traumatic dental conditions across the US and by individual states. - [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Florida](https://www.carequest.org/resource-library/adult-use-emergency-departments-non-traumatic-dental-conditions-spotlight-florida), a visual report that looks at what drives adult ED visits for dental conditions in Florida and how much it costs the state. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Cost, Race, and the Persistent Challenges in Our Oral Health System](https://carequest.org/resource/cost-race-and-the-persistent-challenges-in-our-oral-health-system/) **Published:** June 28, 2023 **Author:** Darren Edwards **Content:** Results from CareQuest Institute’s 2023 State of Oral Health Equity in America annual survey show that oral health disparities persist in the US, and that discrimination and socioeconomic factors are two leading contributors. ## Oral Health Disparities Persist [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_SOHEA2023_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute-State-of-Oral-Health-Equity-in-America_2023_5.12.2024.pdf)View report Key findings, summarized in a research report, include: - More than half of Black adults (52%) reported having lost one or more permanent teeth due to decay or gum disease, compared with 43% of all adults. - Adults earning $100,000 or more a year were much more likely to rate their oral health as excellent, very good, or good (87%), compared with 60% of those making less than $30,000 per year. - Homeownership was linked to higher rates of having a dental home, better self-rated oral health, and more regular dental visits, compared with renting or occupying a home without payment. - Among adults with a disability, 14% said they had experienced discrimination in the dental setting, and 27% said they had been denied oral health care due to discrimination. - Thirty percent of veterans did not have dental insurance, compared to 27% of individuals in the non-veteran population. The findings from this nationally representative survey of more than 5,000 adults emphasize the need to continue working toward an oral health care system that is more accessible, equitable, and integrated, including enhanced dental coverage for all adult Medicaid enrollees. **You may also be interested in:** - [Beyond a Nice Smile](https://www.carequest.org/resource-library/beyond-nice-smile), an infographic that highlights the critical links between oral health and overall health, self-esteem, and quality of life, particularly for older adults. - [Addressing the Oral Health Needs of Hispanics in the US](https://www.carequest.org/resource-library/addressing-oral-health-needs-hispanics-us), a comprehensive white paper that explores oral health status, utilization, and workforce issues impacting 19% of the total US population. - [Addressing the Role of Oral Health in Maternal Mortality and Pregnancy Outcomes](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes), a visual report that examines the worsening trend of maternal and infant health in the US, especially for people of color, and the often overlooked connection between oral health and pregnancy outcomes. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [The Oral-Systemic Connection Across the Lifespan](https://carequest.org/resource/the-oral-systemic-connection-across-the-lifespan/) **Published:** July 20, 2023 **Author:** Darren Edwards **Content:** ## How Dental Health Affects Overall Health at Every Age Across the lifespan, there is a strong connection between dental health and overall health. But the nature of that connection — the specific challenges and risks — changes over time. An infographic from CareQuest Institute summarizes research on these connections, from pregnancy through older adulthood. Key points include: - Periodontal treatment during pregnancy is linked to lower risk of infant mortality, preterm birth, and low birth weight. - Early childhood caries (cavities) and its associated pain are linked to negative impacts on play, school, sleeping, eating, and overall well-being. - Older adults with fewer than 20 teeth are more likely to experience greater overall disability and cognitive decline. [![View infographic](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-Systemic-Connection-Across-Lifespan_386x250-300x194.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Oral-Systemic-Connection-Across-Lifespan.pdf)View infographic **You may also be interested in:** - [A Cross-Sectional Analysis of Oral Health Care Spending over the Life Span in Commercial- and Medicaid-Insured Populations](https://www.carequest.org/resource-library/cross-sectional-analysis-oral-health-care-spending-over-life-span), an article in the *Journal of the American Dental Association* that features one of the most comprehensive life course analyses of spending on oral health care. - [Cost, Race, and the Persistent Challenges in Our Oral Health System](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), a report that summarizes findings from our nationally representative, annual survey on oral health takes a deep dive into factors that contribute to oral health disparities. - [Beyond a Nice Smile](https://www.carequest.org/resource-library/beyond-nice-smile), an infographic that explains the importance of oral health for the overall health of older adults. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Opioids for Acute and Chronic Pain When Receiving Psychiatric Medications](https://carequest.org/resource/opioids-for-acute-and-chronic-pain-when-receiving-psychiatric-medications/) **Published:** September 28, 2023 **Author:** Darren Edwards **Content:** A new study concludes that although health care providers have reduced opioid prescriptions for acute or chronic pain for patients at high risk for substance use disorder (SUD) — including those with mental health disorders (MHD) — opioid use for pain management has remained at consistently high levels and there’s a need to revisit and amplify pain management guidelines for providers with patients receiving antidepression and antianxiety drugs. The study, developed in collaboration between CareQuest Institute, Amrita School of Dentistry, National Library of Medicine, Health Data Analytics Institute, National Institute of Dental and Craniofacial Research, and University of Colorado School of Dental Medicine, makes it clear that many patients receiving pharmacotherapy for depression or anxiety were also receiving opioid prescriptions for pain, in spite of guidelines warning against this practice. ## Key Findings - Adults with a MHD received opioids for pain management at nearly twice the level as adults without a MHD. - Health care providers in emergency departments were 50% more likely to prescribe an opioid for dental pain to those with a MHD, while dentists were half as likely to prescribe an opioid for dental pain management. - 9.5 million US adults reported having a MHD and a substance use disorder. - The likelihood of overdose is much greater (4 to 10 times more) for individuals taking both opioids and antianxiety medications (benzodiazepines). [Read the peer-reviewed research article](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0286179) on *PLOS ONE*. (open access) **You may also be interested in:** - [How Depression Is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that highlights the growing body of research about the link between mental health and oral health. - [Opioid Overdose Deaths and Emergency Department Visits for Dental Conditions in Maryland](https://www.carequest.org/system/files/DentaQuest%20NOHC%20Opioid%20Poster_3.19.19.pdf), a poster presented at the National Oral Health Conference showing a relationship between an increase in opioid-related overdose deaths and ED visits for dental conditions. - [Emergency Departments Are No Place for Dental Care](https://www.carequest.org/ED-Use), a web page with research and resources to explain why most patient needs for dental care can be more effectively treated in a dental office than an ED. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [Hunger Pains: How Food Insecurity Affects Oral Health](https://carequest.org/resource/hunger-pains-how-food-insecurity-affects-oral-health/) **Published:** October 10, 2023 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Hunger-Pains_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Hunger-Pains_10.8.23.pdf)View report Nearly 24 million adults in the US — approximately 9% of the adult population — experience food insecurity, according to CareQuest Institute’s 2023 State of Oral Health Equity in America survey. Survey results reveal that food insecurity is linked to poorer oral health outcomes. Key findings on food insecurity from the survey — the largest in the industry focused on adults’ knowledge, attitudes, experiences, and behaviors related to oral health — include: - Black (11%) and Hispanic (10%) respondents were the most likely to worry that their food would run out before being able to afford more, whereas white respondents were the least likely (5%). - 15% of respondents aged 18-29 said they often could not afford to eat healthy, balanced meals, compared to 3% of those aged 60 years or older. - Respondents with less than a high school education were most likely to say their food often did not last before they could get more (14%), compared to just 1% of those with post-graduate study or a professional degree. - Individuals experiencing food insecurity were more likely to have poor oral health, more likely to lack dental insurance, and less likely to have visited a dentist within the past year. The high rates of food insecurity in the US have a range of detrimental health consequences, including oral health problems. The authors of this research report call on health care professionals to integrate routine questions about food intake with all patients, and to help connect patients in need to food assistance programs, especially healthy food options. The report includes a list of food assistance programs. **You may also be interested in:** - [Uninsured and in Need](https://www.carequest.org/resource-library/uninsured-and-need), a visual report that estimates more than 68 million US adults do not have dental insurance. - [Cost, Race, and the Persistent Challenges in Our Oral Health System](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), a report that summarizes findings from CareQuest Institute’s nationally representative, annual survey on oral health and takes a deep dive into factors that contribute to oral health disparities. - [The Oral-Systemic Connection Across the Lifespan](https://www.carequest.org/resource-library/oral-systemic-connection-across-lifespan), an infographic that summarizes research on the link between oral health and overall health at every age. **Categories:** Publication, Resource **Tags:** Health Equity, Medical-Dental Integration --- ### [Discrimination and Dignity Experiences in Prior Oral Care Visits Predict Racialized Oral Health Inequities Among Nationally Representative US Adults](https://carequest.org/resource/discrimination-and-dignity-experiences-in-prior-oral-care-visits-predict-racialized-oral-health-inequities-among-nationally-representative-us-adults/) **Published:** October 27, 2023 **Author:** Darren Edwards **Content:** Individuals who experience discrimination or microaggressions within oral care settings have worse oral health outcomes and are less likely to plan a preventive oral care visit in the future, according to an article in the *Journal of Racial and Ethnic Health Disparities*. The insights are based on findings from the CareQuest Institute State of Oral Health Equity in America survey, the largest nationally representative annual survey focused on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. The authors write: > The strength of the association \[between discrimination and poor oral health outcomes\], in particular, demands our scientific attention to better understand these associations and to develop practices in oral care settings to make all patients feel affirmed, supported, and valued. To improve the delivery of “culturally safe, relationship-centered care,” the authors support increased diversity in the oral care workforce and changes to CODA standards to prepare all dental students with the knowledge and skills necessary to overturn systemic oppression. [Read the article](https://link.springer.com/article/10.1007/s40615-023-01821-0) in the *Journal of Racial and Ethnic Health Disparities.* (open access) **You may also be interested in:** - [State of Oral Health Equity in America 2023](https://www.carequest.org/content/state-oral-health-equity-america-2023), a web page with key findings and reports from our latest nationally representative survey on oral health. - [Cost, Race, and the Persistent Challenges in Our Oral Health System](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), a report that takes a deep dive into factors that contribute to oral health disparities. - [Taking Action to Advance Anti-Racism in Dental Public Health](https://www.carequest.org/education/webinars/taking-action-advance-anti-racism-dental-public-health), a recorded webinar featuring a panel of experts discussing the effects of racism and discrimination and anti-racism solutions. **Categories:** Journal Article, Resource **Tags:** Health Equity, Medical-Dental Integration --- ### [Teledentistry Regulation and Policy Guidance](https://carequest.org/resource/teledentistry-regulation-and-policy-guidance/) **Published:** November 13, 2023 **Author:** Darren Edwards **Content:** [![View toolkit](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Teledentistry-Advocacy-Toolkit_Cover-238x300.gif)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Teledentistry-Advocacy-Toolkit_10.30.23.pdf)View toolkit ## A Toolkit to Promote Access and Quality Care Through Teledentistry Teledentistry offers immense potential benefits for oral health care, but to realize these benefits, appropriate policies and regulations must be in place. This document identifies primary considerations for regulators and policymakers regarding teledentistry. Key recommendations include: - Public and private entities that pay for health services must pay for covered oral health services regardless of whether they are provided through teledentistry or in person. - Teledentistry modalities include both real-time, synchronous and store-and-forward, asynchronous interactions. Payment policies should not change based on a difference in modality. - Rules about scope of practice and payment should be coordinated to ensure that providers are allowed to provide services using teledentistry modalities and can be paid for covered oral health services irrespective of whether they are provided using teledentistry methodologies or in-person encounters. These model teledentistry rules can form a basis for discussions on how to improve the regulatory climate for teledentistry moving forward. **You may also be interested in:** - [Refining the Process: Safety Net Dental Professionals’ Experiences with Teledentistry Implementation During the First Year of COVID-19](https://www.carequest.org/resource-library/refining-process-safety-net-dental-professionals-experiences-teledentistry), an article in the *Journal of Public Health Dentistry* shares key findings from interviews with 21 dental professionals about their experience with teledentistry during the first year of the pandemic — and what those professionals envision for the future of teledentistry. - [Teledentistry Helps Provide the Right Care at the Right Time](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time), a research report that examines follow-up treatment and oral health outcomes for patients after a teledentistry visit. - [Building a Teledentistry Program That Expands Access and Increases Equity](https://www.carequest.org/education/webinars/building-teledentistry-program-expands-access-and-increases-equity), a webinar recording that explores how to set up different types of teledentistry programs and shares common pitfalls to avoid. **Categories:** Resource, Tool **Tags:** Practice Management --- ### [Framework for Fiscal Impact Analysis of Managing Initial Caries Lesions with Noninvasive Therapies](https://carequest.org/resource/framework-for-fiscal-impact-analysis-of-managing-initial-caries-lesions-with-noninvasive-therapies/) **Published:** November 14, 2023 **Author:** Darren Edwards **Content:** ## Which is more cost-effective to treat initial caries lesions — traditional restoration or noninvasive therapies? A study in the *Journal of the American Dental Association* finds that several noninvasive caries therapies improve outcomes for patients and are more cost-effective for payors and clinicians. The study, co-authored by researchers at CareQuest Institute and CareQuest Innovation Partners, a for-profit subsidiary of CareQuest Institute, compares silver diamine fluoride, self-assembling peptide P11-4, and glass ionomer sealants to traditional surgical dental restorations to treat initial caries lesions. Study results showed that per-chair profitability was 4-6 times higher with noninvasive scenarios due to increased efficiencies. While 94% of US dentists report restoring initial lesions, “Noninvasive therapies provide a treatment option that empowers dental teams to heal the first signs of disease,” say the authors. ## Dental and Medical Billing Codes for Noninvasive Therapies According to the authors, clinical effectiveness and new billing codes are accelerating the trend towards noninvasive therapies and removing barriers to adoption. Billing codes mentioned in the article include: - Dental (CDT) Code: **D2991** Application of hydroxyapatite regeneration medicament. - Medical (CPT) Code: **0792T** Silver diamine fluoride for dental caries. [Read the cover article](https://jada.ada.org/article/S0002-8177(23)00414-2/fulltext) in the *Journal of the American Dental Association* (open access). **You may also be interested in:** - [Non-Invasive Caries Therapy Guide](https://www.carequest.org/content/non-invasive-caries-therapy-guide), an illustrated manual on diagnostics, preventives, and therapeutics to fight dental caries without removing tooth structure. - [Minimally Invasive Care in Dentistry, Healing Tooth Decay with Brush-On Therapies](https://www.carequest.org/education/course/minimally-invasive-care-dentistry-healing-tooth-decay-brush-therapies/overview), a self-paced online course that explains how minimally invasive therapies are effective in caries management. - [The Value of Minimally Invasive Care: A Provider’s Perspective](https://www.carequest.org/about/blog-post/value-minimally-invasive-care-providers-perspective), a blog post featuring a pediatric dentist who has long used minimally invasive techniques because they are safe, effective, and tolerated by children. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Minimally Invasive Care --- ### [Still Searching: Meeting Oral Health Needs in Rural Settings](https://carequest.org/resource/still-searching-meeting-oral-health-needs-in-rural-settings/) **Published:** November 14, 2023 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Still-Searching_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Still-Searching_11.6.23.pdf)View report Rural populations have worse oral health care access, utilization, and outcomes in comparison with their urban and suburban counterparts, according to a research report by CareQuest Institute. Key findings reveal several oral health disparities for rural residents, including: - 34% of individuals living in a rural environment rate their oral health as fair or poor, compared with 27% of urban residents and 24% of suburban residents. - Four in 10 adults living in rural environments (40%) have not visited the dentist in more than one year, compared with 35% of urban and 30% of suburban residents. A contributing factor is that 67% of rural areas are Dental Health Professional Shortage Areas. - Just over one-third of rural residents (34%) do not have dental insurance coverage, in comparison with 29% of urban and 24% of suburban residents. Employers in rural areas are less likely to offer dental insurance than employers in more populated areas. The findings are based on responses to the [2023 State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2023), the largest nationally representative, annual survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. In response to these disparities, report authors offer strategies to mitigate barriers to access and the consequent oral health burdens for approximately 46 million people who reside in rural areas. Those strategies include teledentistry, expanding dental coverage and the dental workforce, and medical-dental integration. **You may also be interested in:** - [Hunger Pains: How Food Insecurity Affects Oral Health](https://www.carequest.org/resource-library/hunger-pains-how-food-insecurity-affects-oral-health), findings from the 2023 State of Oral Health Equity in America survey reveal that food insecurity is linked to poorer oral health outcomes. - [Teledentistry Regulation and Policy Guidance](https://www.carequest.org/resource-library/teledentistry-regulation-and-policy-guidance), a toolkit with recommendations for advocates and policymakers to improve access and quality care through teledentistry. - [Uninsured and in Need: 68.5 Million Lack Dental Insurance, More May Be Coming](https://www.carequest.org/resource-library/uninsured-and-need), a report which issues a critical call to action to increase broad dental coverage in both Medicaid and Medicare. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [2023: Beyond the Screen: How Dental Providers are Using Teledentistry to Meet Patient Needs](https://carequest.org/resource/2023-beyond-the-screen-how-dental-providers-are-using-teledentistry-to-meet-patient-needs/) **Published:** November 21, 2023 **Author:** Darren Edwards **Content:** We know little about how oral health professionals are using teledentistry in day-to-day dental practice in the aftermath of a global pandemic, explained CareQuest Institute Analytics and Data Insights team Kelly Schroeder, Morgan Santoro, Paige Martin, and Eric P. Tranby in a presentation on how dental providers are using teledentistry to meet patient needs. The study concluded: Synchronous video teledentistry is not accessible for all populations or all dental clinic capacities. Policy that supports a broad spectrum of mode and type of teledentistry dental delivery is imperative for teledentistry to continue as a tool to reduce barriers to oral health care and to improve patient oral health outcomes. **Attachments:** [Teledentistry\_\_poster\_90x44\_10.20.23.pdf](https://carequest.org/wp-content/uploads/2025/10/Teledentistry__poster_90x44_10.20.23.pdf) (3.82 MB) **Categories:** Presentation, Resource **Tags:** Practice Management --- ### [2023: Safe and Dangerous Home Remedies Used for Oral Pain and Discomfort](https://carequest.org/resource/2023-safe-and-dangerous-home-remedies-used-for-oral-pain-and-discomfort/) **Published:** November 21, 2023 **Author:** Darren Edwards **Content:** Americans who do not have access to dental care or need to delay their care may resort to home remedies to alleviate mouth pain or discomfort, explained CareQuest Institute Health Sciences Specialist, Kelly Schroeder, RDH, MS, in a presentation on safe and dangerous home remedies used for oral pain and discomfort. The study concluded: Patients who do not routinely seek care from an oral health provider may be more likely to turn to home remedies that may or may not be effective for managing oral pain and discomfort. In addition, the study explains how a dental home can be an important resource when needing guidance on how to best manage dental pain or discomfort until further evaluation and follow-up care from a dental provider is possible. **Attachments:** [APHA\_Home Remedies 2023\_\_poster\_90x44\_10.10.23.pdf](https://carequest.org/wp-content/uploads/2025/10/APHA_Home-Remedies-2023__poster_90x44_10.10.23.pdf) (2.29 MB) **Categories:** Presentation, Resource **Tags:** Dental Coverage --- ### [2023: Oral Health Among Individuals Requiring Support of a Caregiver](https://carequest.org/resource/2023-oral-health-among-individuals-requiring-support-of-a-caregiver/) **Published:** November 21, 2023 **Author:** Darren Edwards **Content:** The aim of this research is to examine oral health outcomes of individuals requiring caregiver support, from the caregivers’ perspective, to assess the individual’s ability to access and utilize oral health service, explained CareQuest Institute Analytics and Data Insights team Morgan Santoro, Paige Martin, Lisa Heaton, Adrianna Sonnek, Rebecca Preston, and Eric P. Tranby in a presentation on how dental providers are using teledentistry to meet patient needs. The study concluded: Individuals under the support of a caregiver appear, based on the perspective of their caregiver, to face challenges accessing and sustaining routine dental care, with cost being the primary factor. **Attachments:** [APHA Poster\_CaregiversOralHealth (002).pdf](https://carequest.org/wp-content/uploads/2025/10/APHA-Poster_CaregiversOralHealth-002.pdf) (283.46 KB) **Categories:** Presentation, Resource **Tags:** Dental Coverage --- ### [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://carequest.org/resource/oral-systemic-interactions-and-medical-dental-integration-a-life-course-approach/) **Published:** November 28, 2023 **Author:** Darren Edwards **Content:** ## Oral Health and Overall Health Across the Lifespan This report from CareQuest Institute provides a comprehensive overview of the bidirectional nature of oral and systemic diseases across different life phases and discusses how medical-dental integration (MDI) can improve access to care, health outcomes, and health care costs. [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-Systemic-Interactions_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Oral-Systemic-Interactions_11.28.23.pdf)View report Key points include: - In addition to improving health outcomes, MDI reduces costs. For example, one study predicted that providing individuals who have diabetes and periodontitis with periodontal treatment would save each individual an average of $5,904 in health care costs. - One example of the MDI model is the integration of dental health into well-child visits (WCVs). Children who have a dental assessment during a WCV are more likely to have a preventive dental visit. However, a very small percentage of children receive a dental exam during a WCV ― less than 3%. - A major challenge for the MDI model is the infrastructure needed for sharing patient information. Some large hospital systems have shown how integrated electronic health records (EHRs) can reduce gaps in care, improve access to care, and improve patient outcomes. - Establishing integrated care models will require a shift for whole organizations ― starting with leadership buy-in, building infrastructure, and closing referral loops. To increase the success of MDI, the report recommends education for the health care workforce, changing the scope of practice for dentists, and increasing patient awareness. [![View infographic](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-Systemic-Connection-Across-Lifespan_386x250_1-300x194.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_Oral-Systemic-Connection-Across-Lifespan_1.pdf)View infographic **You may also be interested in:** - [Medical and Dental Integration: A Need for Improved Electronic Health Records](https://www.carequest.org/resource-library/medical-and-dental-integration-need-improved-electronic-health-records), a visual report that explores the barriers that dental and medical providers experience in accessing and sharing patient health information. - [Periodontal Treatment Associated with Decreased Diabetes-Related Treatment Costs](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs), an article in the *Journal of the American Dental Association* that finds overall health care costs were reduced for patients with diabetes who received periodontal treatment. - [Medical Well-Child Visits and Preventive Dental Visits](https://www.carequest.org/resource-library/medical-well-child-visits-and-preventive-dental-visits), an article in *JDR Clinical & Translational Research* that evaluates the impact of well-child visits on promoting preventive visits to the dentist. **Categories:** Publication, Resource **Tags:** Clinical Practice, Medical-Dental Integration --- ### [The Hour of Need: Productivity Time Lost Due to Urgent Oral Health Needs](https://carequest.org/resource/the-hour-of-need-productivity-time-lost-due-to-urgent-oral-health-needs/) **Published:** February 2, 2024 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Hour-of-Need_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_The-Hour-of-Need_FINAL.pdf)View visual report Adults in the US miss more than 243 million hours of productivity time each year due to oral health problems, according to findings from CareQuest Institute’s [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2023) survey. Respondents’ lost productivity time was due to their own oral health problems, or oral health problems in children and other adults in their care. ## More key findings from the research include: - Lost productivity time due to untreated dental disease costs the US an estimated $45 billion each year. - Adults missed 183 million hours of productivity time due to their own oral pain or unplanned dental visits and 60 million hours due to oral pain or dental visits of children or other adults in their care. - Missing productivity time was significantly associated with identifying as female, Hispanic, or having to travel 45 minutes or more to see a dental provider. The authors write, “. . . those with lower-paying and hourly jobs are more likely to lose more work hours due to unexpected dental visits than those in higher-paying, salaried occupations.” They recommend three solutions to mitigate the impact of oral health problems on work and school time: 1) increase the number of oral health professionals in rural areas; 2) integrate medical and dental care in collocated clinics; and 3) provide minimally invasive care to arrest dental caries in early stages. **You may also be interested in:** - [Minimally Invasive Care in Dentistry](https://www.carequest.org/education/course/minimally-invasive-care-dentistry-healing-tooth-decay-brush-therapies/overview), a self-paced, online course that explains how several brush-on therapies can be used to prevent and heal tooth decay. - [Uninsured and in Need: 68.5 Million Lack Dental Insurance, More May Be Coming](https://www.carequest.org/resource-library/uninsured-and-need), a report that issues a critical call to action to increase broad dental coverage in both Medicaid and Medicare. - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report that examines how medical-dental integration can improve access to care, health outcomes, and health care costs. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Caries Risk and Social Determinants of Health: A Big Data Report](https://carequest.org/resource/caries-risk-and-social-determinants-of-health-a-big-data-report/) **Published:** December 12, 2022 **Author:** Darren Edwards **Content:** In this study published in the [*Journal of the American Dental Association*](https://www.sciencedirect.com/science/article/pii/S0002817722006456), researchers at CareQuest Institute and the University of Colorado found that individuals living in areas with greater social deprivation had higher caries risk. Although the fact is well-known, the authors said, it is rarely examined. ## Oral Health Equity and Social Determinants The researchers analyzed the association between caries risk and social determinants of health, including the Social Deprivation Index (SDI) — a composite measure of neighborhood-level deprivation that incorporates characteristics based on income, education, housing status, and employment. Additional key findings include: - Black and Hispanic people living in areas of greater social deprivation had higher risk of caries. - Caries risk level increased with age and reached a peak at ages 49 to 64. - Men were at higher risk of caries than women. - Patients with diabetes and heart disease were at higher risk of caries. - Individuals who paid for dental care through self-pay, the Veterans Administration, or workers’ compensation had a higher caries risk compared with those with private or public insurance. This study shows the association of caries risk with higher social deprivation and reinforces the role of structural and upstream factors in oral health equity. [Read the article](https://www.sciencedirect.com/science/article/pii/S0002817722006456) in the *Journal of the American Dental Association* (open access) **You may also be interested in:** - [Caries Risk Assessment vs. Caries Risk Conversation](https://www.carequest.org/resource-library/caries-risk-assessment-vs-caries-risk-conversation), a video that demonstrates how providers can have an effective and engaging conversation with patients about caries risk. - [Voices from the Field: Dr. Patrick Smith on Oral Health Challenges for Black Men](https://www.carequest.org/about/blog-post/voices-field-dr-patrick-smith-oral-health-challenges-black-men), a blog post featuring a dentist and dental educator talking about how the oral health community can address disparities facing people of color. - [A Cross-Sectional Analysis of Oral Health Care Spending over the Life Span](https://www.carequest.org/resource-library/cross-sectional-analysis-oral-health-care-spending-over-life-span), an article in the *Journal of the American Dental Association* that demonstrates the importance of understanding and addressing the factors that impact oral health status at every stage of life. **Categories:** Journal Article, Resource **Tags:** Health Equity, Minimally Invasive Care --- ### [The Relationship Between Vaping and Oral Health](https://carequest.org/resource/the-relationship-between-vaping-and-oral-health/) **Published:** January 4, 2023 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Clearing-the-Air-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Clearing-the-Air.pdf)View visual report ## What are the health risks of vaping? Although presented as a safer alternative to tobacco, electronic cigarette (e-cigarette) use is associated with a variety of health risks. A visual report from CareQuest Institute explains the risks related to oral health. ## Vaping and Mouth Sores Oral lesions such as nicotine stomatitis (“smoker’s palate”), hairy tongue (discoloration of the tongue), and angular cheilitis (sores in the corners of the mouth) are commonly seen in the mouths of e-cigarette users. ## Vaping and Gum Disease - Individuals who use e-cigarettes are significantly more likely to report having periodontal (gum) disease compared to those who do not smoke or use other nicotine products. - E-cigarette use is linked with signs of gum disease such as increased plaque, deeper periodontal pockets around the teeth, and bone loss. - There is growing evidence that individuals who use e-cigarettes are at a higher risk for dental caries (tooth decay). ## Vaping and Oral Cancer Current evidence is limited, but researchers find environmental toxins in e-cigarettes considerably exceed federal occupational exposure limits and may place users at higher risk for oral cancer. ## Oral Health Professionals and Vaping Cessation Oral health professionals have long been involved in encouraging tobacco cessation with their patients. It is similarly important, report authors note, to discuss e-cigarette use as more evidence emerges about the health risks. Over the past 15 years, the use of e-cigarettes has increased in the United States, particularly among teenagers. In 2020, approximately 3.6 million adolescents and 9.1 million adults reported e-cigarette use. **You may also be interested in:** - [Discussing HPV and Detecting Oral Cancer: The Role of Oral Health Providers](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers), a visual report that summarizes the relationship between HPV and oral cancer, and outlines how dentists and dental hygienists can educate patients and prevent HPV. - [Missed Connections: Providers and Consumer Want More Medical-Dental Integration](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration-0), a visual report that shares findings from a nationally representative survey of consumers says that health screenings in dental offices are an underutilized opportunity for preventive care. - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a research report that analyzes Medicare data finds that including periodontal treatment in Medicare could save up to $42 billion for patients with chronic health conditions. **Categories:** Resource, Visual Report **Tags:** Clinical Practice --- ### [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on North Carolina](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-north-carolina/) **Published:** January 9, 2023 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Adult-Use-of-Emergency-Departments-NC_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Adult-Use-of-Emergency-Departments-NC_1.3.23.pdf)View visual report Millions of adults in the US lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). What drives these costly ED visits and who is most likely to make them? A new visual report from CareQuest Institute explores those questions within the state of North Carolina. ## Percentage of ED Visits for Dental Problems Is Much Higher among Uninsured Adults in North Carolina than National Average Researchers found that North Carolinians ages 25–34 enrolled in Medicaid make up nearly 21% of all ED visits for NTDCs, about half the national rate (approximately 43%). Meanwhile, uninsured adults ages 25–34 make up approximately 61% of the ED dental visits in North Carolina, compared to 34% nationally. Other findings in North Carolina include: - Adults ages 25–34 have the highest rate of ED use for NTDCs (204.1 visits per 10,000 people), while adults ages 65 and older have the lowest rate (18.5 visits per 10,000 people). - Black residents of all ages visit the ED for NTDCs at a rate more than double the rate of white residents and nearly 4.5 times more than the rate of Hispanic residents. - In 2019, the total cost of ED visits for NTDCs in North Carolina was nearly $116 million. The average charge for an ED visit for NTDCs was $1,527 in North Carolina — less than the national average at $1,872 but much more than a dental office visit at $90–$200. The visual report also covers promising solutions to expand access to care, including comprehensive adult dental coverage within Medicaid and Medicare. As of 2020, the end of the data collection period, North Carolina did not offer an extensive Medicaid adult dental benefit. Access to extensive dental benefits plays a crucial role in increasing access to and utilization of preventive care and reducing disparities in dental care visits. **You may also be interested in:** - [Emergency Departments Are No Place for Dental Care](https://www.carequest.org/content/emergency-departments-are-no-place-dental-care), a web page featuring a series of research reports about adult utilization of EDs for non-traumatic dental conditions across the US and by individual states. - [Maryland’s Successful Path to Securing Dental Coverage for Low-Income Adults](https://www.carequest.org/about/blog-post/marylands-successful-path-securing-dental-coverage-low-income-adults), a blog post that explains how leaders from the Maryland Dental Action Coalition successfully advocated for dental coverage for 800,000 adults on Medicaid. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/resource-library/medicaid-adult-dental-coverage-checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Minnesota](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-minnesota/) **Published:** January 9, 2023 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Adult-Use-of-Emergency-Departments-Minnesota_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Adult-Use-of-Emergency-Departments-Minnesota_1.3.23.pdf)View visual report Millions of adults in the US lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). What drives these costly ED visits and who is most likely to make them? A new visual report from CareQuest Institute explores those questions within the state of Minnesota. ## Who Is Most Likely to Seek Dental Care at the ED in Minnesota? Researchers found that Minnesotans ages 25–34 enrolled in Medicaid make up 45% of all ED visits for NTDCs, compared to approximately 43% nationally. While uninsured adults ages 25–34 make up approximately 20% of the ED dental visits in Minnesota, the uninsured percentage is much higher nationally at 34%. Other findings in Minnesota include: - Adults ages 25–34 have the highest rate of ED use for NTDCs (118.3 visits per 10,000 people), while adults ages 65 and older have the lowest rate (17.7 visits per 10,000 people). - Black residents of all ages visit the ED for NTDCs more than four times the rate of white and Hispanic residents, with 163.5 visits per 10,000 people - In 2019, the total cost of ED visits for NTDCs in Minnesota was more than $29 million. The average charge for an ED visit for NTDCs was $1,032 in Minnesota — less than the national average at $1,872 but much more than a dental office visit at $90–$200. The visual report also covers promising solutions to expand access to care, including comprehensive adult dental coverage within Medicaid and Medicare. As of 2020, the end of the data collection period, Minnesota did not offer an extensive Medicaid adult dental benefit. Access to extensive dental benefits plays a crucial role in increasing access to and utilization of preventive care and reducing disparities in dental care visits. **You may also be interested in:** - [Emergency Departments Are No Place for Dental Care](https://www.carequest.org/content/emergency-departments-are-no-place-dental-care), a web page featuring a series of research reports about adult utilization of EDs for non-traumatic dental conditions across the US and by individual states. - [Maryland’s Successful Path to Securing Dental Coverage for Low-Income Adults](https://www.carequest.org/about/blog-post/marylands-successful-path-securing-dental-coverage-low-income-adults), a blog post that explains how leaders from the Maryland Dental Action Coalition successfully advocated for dental coverage for 800,000 adults on Medicaid. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/resource-library/medicaid-adult-dental-coverage-checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [The Role of Algorithms in Oral Health Care and Disease Prevention and Management: Consumer and Provider Perspectives](https://carequest.org/resource/the-role-of-algorithms-in-oral-health-care-and-disease-prevention-and-management-consumer-and-provider-perspectives/) **Published:** January 27, 2023 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_The-Role-of-Algorithms_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_The-Role-of-Algorithms_FINAL.pdf)View report Consumers and providers support the use of algorithms and digital health tools to deliver more personalized, patient-centered care, according to findings in a report by CareQuest Institute. ## Using Health Data to Predict and Treat Disease The research report shares insights from surveys of consumers and providers about their attitudes toward the use of algorithms for clinical decision-making and for health insurance companies to develop benefits. Key findings include: - More than two-thirds of consumers said they support the use of algorithms if the tools help their oral health care provider and health insurance carrier provide them with more personalized care. - Most consumers said they would authorize an oral health care provider to share their medical information with other medical providers. However, fewer than one in five consumers said their oral health provider had ever given them a referral to a primary medical provider. - The majority of oral health providers agreed that algorithms and other digital tools could help them deliver higher-quality and more patient-centered care, as well as improve patients’ oral and overall health outcomes. - The majority of providers agreed that oral health providers should screen their patients for conditions like diabetes, and that an oral health visit can be an initial point of care in chronic disease prevention and management ― especially for more than 100 million individuals who visit an oral health provider but not a physician each year. Algorithms in health care are used to predict the likelihood that a patient will develop a specific medical condition, or whether a patient would benefit from a particular treatment. They have been used to predict tooth loss and dental caries (decay) in oral health care and systemic conditions like diabetes. **You may also be interested in:** - [Integrating Diabetes Screening into Oral Health](https://www.carequest.org/education/webinars/integrating-diabetes-screening-oral-health-care), a recorded webinar that discusses screening for diabetes in the dental setting, highlights patient education efforts, and shares the workflow providers developed to connect the most at-risk patients to medical services. - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a research report that demonstrates how including periodontal treatment in Medicare has the potential to save up to $14.5 billion annually for patients with diabetes and up to $27.8 billion annually for patients with heart disease. - [Missed Connections: Providers and Consumers Want More Medical-Dental Integration](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration), a report examining attitudes about the relationship between oral health and overall health and a desire to connect the siloed care delivery systems. **Categories:** Publication, Resource **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Perceptions about HPV and Oropharyngeal Cancers](https://carequest.org/resource/perceptions-about-hpv-and-oropharyngeal-cancers/) **Published:** February 15, 2023 **Author:** Darren Edwards **Content:** ## The Role of Dental Care Providers in HPV Prevention among US Adults Nearly 60% of adults are comfortable discussing HPV and the HPV vaccine with their oral health care provider, and providers have an opportunity to increase consumer knowledge about the relationship between HPV and oral cancers, according to CareQuest Institute survey results published in *The Journal of the American Dental Association*. ## HPV and Oral Cancer Prevention The article shares results from a nationally representative survey of more than 5,000 adults in the US to examine HPV vaccine knowledge and perceptions about HPV and oral health. Additional key learnings include: - 80% of adults perceived that the HPV vaccine was very or somewhat important in preventing oropharyngeal cancer. - More than one-half (56.7%) of adults had positive perceptions about dental care providers’ role in HPV education. - During the COVID-19 pandemic, due to disruption in regular and preventive care, HPV vaccination rates fell, and vaccine hesitancy rose. With rates of oral cancer on the rise, it is essential that oral health care providers engage in HPV conversations with their patients. The HPV vaccine is 90% effective at preventing HPV and related cancers, yet only 54% of adolescents aged 13 through 17 were up to date with their HPV vaccine in 2019. [**Read the article**](https://www.sciencedirect.com/science/article/pii/S0002817722007930) in *The Journal of the American Dental Association* (open access) **You may also be interested in:** - [Discussing HPV and Detecting Oral Cancer: The Role of Oral Health Providers](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers), a visual report that summarizes the relationship between HPV and oral cancer, and outlines how dentists and dental hygienists can educate patients and prevent HPV. - [Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data](https://www.carequest.org/resource-library/oral-cancer-prevalence-mortality-and-costs-medicaid-and-commercial-insurance), an article in *Cancer Epidemiology, Biomarkers and Prevention* that finds Medicaid enrollees experience higher rates of oral cancer than adults with commercial insurance. - [Monkeypox and the Role of Oral Health Providers in the Virus’s Detection and Prevention](https://www.carequest.org/resource-library/monkeypox-and-role-oral-health-providers-viruss-detection-and-prevention), a visual report that explores the early signs of the virus in the mouth. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Oral Hygiene Home Care Practices in America](https://carequest.org/resource/oral-hygiene-home-care-practices-in-america/) **Published:** February 22, 2023 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Oral-Hygiene-Home-Care-Practices_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Oral-Hygiene-Home-Care-Practices_FINAL.pdf)Read brief Results from CareQuest Institute’s nationally representative survey on oral health show that brushing and flossing frequency are correlated with other oral hygiene habits such as consuming sugary beverages and using tobacco. Key findings include: - Most adults are brushing once per day or more (94%) and flossing half as often (44%). Older adults, aged 60+, were more likely to report brushing and flossing at least once a day compared to younger adults. - More than half of males (59.3%) responded that they did not know some foods could have an impact on their teeth, compared with about two-fifths of females (39.7%). - Adults who use tobacco daily also report consuming sugary drinks and soda three to four times more than those who do not use tobacco. - Those with Medicaid dental benefits were three times more likely to report consuming more than one sugary drink per day compared to those with other insurance types. The survey results reinforce that oral health care education for patients cannot be one-size-fits-all. Oral hygiene practices and other lifestyle behaviors, such as food and beverage consumption and tobacco use, are important to consider when identifying oral health risks for individuals. Identifying these risks creates an opportunity to provide person-centered care, which can lead to better oral health outcomes and help reduce oral health inequities. **You may also be interested in:** - [How Depression Is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that highlights how an individual’s emotional state is connected to oral health, including poor oral hygiene. - [Clearing the Air: The Relationship Between Cigarette Use, Vaping, and Oral Health](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health), a visual report that explains the oral health symptoms and risks from vaping. - [MORE Care: An Evaluation of an Interprofessional Oral Health Quality Improvement Initiative](https://www.carequest.org/resource-library/more-care-evaluation-interprofessional-oral-health-quality-improvement-initiative), an article in the *Journal of Public Health Dentistry* that demonstrates improved patient outcomes from a program that integrates medical and dental care. **Categories:** Publication, Resource **Tags:** Clinical Practice --- ### [American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease'](https://carequest.org/resource/american-indian-and-alaska-native-communities-face-a-disproportionate-burden-of-oral-disease/) **Published:** March 17, 2023 **Author:** Darren Edwards **Content:** [![View white paper](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_American-Indian-and-Alaska-Native-Communities_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_American-Indian-and-Alaska-Native-Communities_5.15.23.pdf)View white paper ## Reversing Inequities Involves Challenges and Opportunities Structural racism and a lack of necessities, such as access to healthy food and adequate housing, have contributed to significant oral health disparities for American Indians and Alaska Natives (AI/AN). While some health outcomes are improving, this white paper ― a collaboration between CareQuest Institute and native-led organizations ― explores the disparities, their causes, and possible solutions. Findings are based on responses from 564 AI/AN participants in the nationally representative State of Oral Health Equity in America survey. Key points include: - The prevalence of early childhood caries in AI/AN communities is three times higher than for white children. - AI/AN adults are twice as likely to have untreated decay as the overall US population, and 83% of AI/AN adults report tooth loss, compared with 66% of the overall US population. - Three and a half times as many people who identify as AI/AN report going to the emergency department for dental care or mouth pain in the last year (13.5%) compared with those who do not identify as AI/AN (3.9%). - Researchers and funding organizations need to develop and sustain authentic partnerships with AI/AN communities and organizations to increase representation in research and funding decisions/strategies. - Culturally driven care and greater AI/AN representation in the dental workforce is needed. The number of AI/AN students applying to dental school has decreased dramatically ― from 92 in 2006 to 19 in 2021. Solutions to oral health disparities experienced by AI/AN communities, the authors write, must be grounded in diversity, equity, inclusion, and justice. The authors also recommend that accurate data collection regarding the oral health of AI/AN communities must involve clinical examination data, inclusion of AI/AN as an individual category, and the ability to choose more than one racial category in self-reported data to avoid misclassification. [View executive summary](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_AIAN-Executive-Summary_4.3.23_0.pdf) **You may also be interested in:** - [American Indian and Alaska Native Oral Health: Challenges and Opportunities](https://www.carequest.org/education/webinars/american-indian-and-alaska-native-oral-health-challenges-and-opportunities), in this recorded webinar, a panel of experts discuss findings from the white paper and share ongoing culturally and community-driven strategies — for providers, policymakers, and educators — to improve AI/AN oral health. The webinar is a collaboration between CareQuest Institute and native-led organizations. - [The Glaring Scope of Racial Disparities in Oral Health](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health), a brief that demonstrates the connections between race, ethnicity, and oral health and the implications beyond health. - [Undermining Racism: A Road to Promoting Equity in Oral Health](https://www.carequest.org/resource-library/undermining-racism-road-promoting-equity-oral-health), an article in the *Journal of Public Health Dentistry* that explains how the Oral Health Progress and Equity Network (OPEN) approaches systemic and institutional racism to address oral health inequities. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [The Non-Invasive Caries Therapy Guide](https://carequest.org/resource/the-non-invasive-caries-therapy-guide/) **Published:** April 1, 2023 **Author:** Darren Edwards **Content:** [![Download guide](https://carequest.org/wp-content/uploads/2025/12/Non-Invasive-Picture-300x200.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Non-Invasive-Caries-Therapy-Guide_071023.pdf)Download guide ## The Guide is an illustrated manual on diagnostics, preventives, and therapeutics to fight dental caries without removing tooth structure, including instructions and tips to: - Differentiate active vs. arrested caries lesions - Apply silver diamine fluoride, self-assembling peptide P11-4, and more - Perform the Hall Technique **Goals of the Guide** 1. **Increase access to care** by decreasing reliance on invasive dentistry 2. **Transform the oral health workforce** by empowering non-dentists to manage dental caries 3. **Improve clinical outcomes** by optimizing clinical technique 4. **Lower barriers** to adopting evidence-based techniques ![](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_NCTGuide_p8SAP_900x600.png) [Learn more about minimally invasive care in dentistry](https://www.carequest.org/topics/minimally-invasive-care) **Categories:** Resource, Tool **Tags:** Minimally Invasive Care --- ### [Medicaid Adult Benefits During Pregnancy and Postpartum and Birth Outcomes by State](https://carequest.org/resource/medicaid-adult-benefits-during-pregnancy-and-postpartum-and-birth-outcomes-by-state/) **Published:** April 7, 2023 **Author:** Darren Edwards **Content:** During pregnancy, oral health care is essential, yet often underutilized — especially for people enrolled in Medicaid. This dashboard provides information related to Medicaid expansion and eligibility during pregnancy and postpartum, preterm birth rates, and infant mortality rates by state. Policymakers, administrators, and advocates can use this tool to examine Medicaid expansion and eligibility in their state and ensure they are providing coverage that supports the oral health and overall health of pregnant people and their babies. For more information and policy recommendations, read the research report, [*The Role of Medicaid Adult Dental Benefits During Pregnancy and Postpartum*](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum). **Categories:** Resource, Tool **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [The Role of Medicaid Adult Dental Benefits During Pregnancy and Postpartum](https://carequest.org/resource/the-role-of-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum/) **Published:** April 9, 2023 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_The-Role-Medicaid-Adult-Dental-Benefits-During-Pregnancy_250x324-232x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_The-Role-Medicaid-Adult-Dental-Benefits-During-Pregnancy_4.10.23.pdf)View report During pregnancy, oral health care is essential, yet often underutilized. According to a report from CareQuest Institute, approximately 60–75% of pregnant people experience oral health issues that raise the likelihood of poor birth outcomes and major complications. These percentages are even higher for expecting Black women, who are 27% more likely to experience severe pregnancy complications than white women. ## Importance of Oral Health During Pregnancy The report, which includes state-specific information and insights, explains the importance of oral health during pregnancy and postpartum as well as the barriers many pregnant people face to accessing oral health care. Key points include: - Poor oral health during pregnancy has been linked to adverse birth outcomes, including preeclampsia (high blood pressure during pregnancy), preterm birth, and low-birth-weight infants. - Women enrolled in Medicaid had significantly lower odds of visiting a dentist for a cleaning during pregnancy compared with women covered by private health insurance. - Black pregnant women without dental coverage were more than 30% less likely to visit a dentist. - Less than half (44%) of pregnant persons received dental care during their pregnancy, primarily due to financial barriers. - Only one third (35%) of obstetricians and nurse midwives discussed oral health with their pregnant patients, and 77% of obstetricians reported that some patients had been “declined” treatment by dentists, although dental care during pregnancy is safe. The report recommends four specific actions that state and federal policymakers can take to address barriers to care for pregnant people; the top recommendation is to extend postpartum coverage in Medicaid from 60 days to at least 12 months. **You may also be interested in:** - [Dashboard: Medicaid Adult Dental Benefits During Pregnancy and Postpartum and Birth Outcomes by State](https://www.carequest.org/resource-library/medicaid-adult-benefits-during-pregnancy-and-postpartum-and-birth-outcomes-state), a data visualization that breaks down the information featured in this report by state. - [A Change That Can Help Address the Black Maternal Health Crisis](https://www.carequest.org/about/blog-post/change-can-help-address-black-maternal-health-crisis), a blog post from CareQuest Institute President and CEO Myechia Minter-Jordan, MD, MBA, that discusses how expanding access to oral health care before, during, and after pregnancy can change lives and bring us closer to real health equity. - [Dental Visits during Pregnancy: Pregnancy Risk Assessment Monitoring System Analysis 2012–2015](https://www.carequest.org/resource-library/dental-visits-during-pregnancy-pregnancy-risk-assessment-monitoring-system), an article in *JDR Clinical & Translation Research* exploring disparities among Black women and Medicaid-enrolled women related to dental visits during pregnancy. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Addressing the Role of Oral Health in Maternal Mortality and Pregnancy Outcomes](https://carequest.org/resource/addressing-the-role-of-oral-health-in-maternal-mortality-and-pregnancy-outcomes/) **Published:** April 28, 2023 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Addressing-the-Role-of-Oral-Health-in-Pregnancy-Outcomes-250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Addressing-the-Role-of-Oral-Health-in-Pregnancy-Outcomes-Visual-Report_4.24.23.pdf)View visual report It is an alarming trend that both maternal mortality and preterm birth rates have increased in the United States during the last three years. Even more alarming: Those rates are especially high for people of color. A visual report from CareQuest Institute examines the worsening state of maternal and infant health in the US, and the often overlooked connection between oral health and pregnancy outcomes. Key points from the report include: - In the US in 2020, 861 individuals died of pregnancy-related causes (an increase of 14% from 2019), and about 1 in 10 babies were born prematurely. - Black and American Indian/Alaska Native women are 2.9 and 2.5 times more likely, respectively, to die from pregnancy-related causes than non-Hispanic white women. - The preterm birth rate among Black women is 52% higher than the rate among all other women. - A small but significant correlation exists between periodontitis and adverse pregnancy outcomes. Maternal periodontal disease is associated with preterm birth and preeclampsia. These findings demonstrate the importance of communication between dentists and patients regarding the oral health risks during pregnancy, and the benefits of oral hygiene best practices for both maternal and infant health. **You may also be interested in:** - [The Role of Medicaid Adult Dental Benefits During Pregnancy and Postpartum](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum), a research report that recommends specific actions policymakers can take to address barriers to care for pregnant people enrolled in Medicaid. - [Dashboard: Medicaid Adult Dental Benefits During Pregnancy and Postpartum and Birth Outcomes by State](https://www.carequest.org/resource-library/medicaid-adult-benefits-during-pregnancy-and-postpartum-and-birth-outcomes-state), a data visualization that breaks down information about Medicaid expansion and eligibility for pregnant people by state. - [A Change That Can Help Address the Black Maternal Health Crisis](https://www.carequest.org/about/blog-post/change-can-help-address-black-maternal-health-crisis), a blog post from CareQuest Institute President and CEO Myechia Minter-Jordan, MD, MBA, that discusses how expanding access to oral health care before, during, and after pregnancy can change lives and bring us closer to real health equity. **Categories:** Resource, Visual Report **Tags:** Clinical Practice, Health Equity, Medical-Dental Integration --- ### [Dental Danger: Home Remedies to Avoid When Awaiting Care](https://carequest.org/resource/dental-danger-home-remedies-to-avoid-when-awaiting-care/) **Published:** May 18, 2023 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Dental-Danger_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Dental-Danger_5.19.23.pdf)View report More than half (53.8%) of adults in the US do not have consistent access to dental care and may resort to home remedies, which are not always safe. In fact, according to a visual report from CareQuest Institute, half of adults who experienced an oral health problem in the last 12 months used a home remedy for the problem. ## DIY Dental Care — Safe or Dangerous? The report, compiled from data from the State of Oral Health Equity in America survey, shares additional insights into home remedies used by consumers, including: - Those who had not had a dental visit in the last two years were 10% more likely to use dangerous home remedies than those who had a dental visit more recently. - Those who smoke used one or more dangerous home remedies twice as often as those who do not smoke. - Individuals who identified as Black (62.4%) and as two or more race/ethnicities (60.0%) reported that they used a home remedy for oral health symptoms more often than individuals identifying as white (49.5%), Hispanic (45.5%), Asian (42.9%), or “other” (47.6%). - The majority of home remedies used by survey respondents are considered safe for short-term use (75%). Unsafe home remedies included tobacco poultice, pain medication prescribed for another purpose, illegal narcotics, a needle to lance a gum abscess, aspirin powder applied to the gums, and alcohol/spirits. Having a dental home where safe and effective home care guidance is provided can prevent individuals from using unsafe home remedies. **You may also be interested in:** - [Oral Hygiene Home Care Practices in America](https://www.carequest.org/resource-library/oral-hygiene-home-care-practices-america), a research brief that examines the correlation between brushing, flossing, and other oral hygiene habits such as consuming sugary beverages and using tobacco. - [Clearing the Air: The Relationship Between Cigarette Use, Vaping, and Oral Health](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health), a visual report that explains the oral health symptoms and risks from vaping. - [Emergency Departments Are No Place for Dental Care](https://www.carequest.org/ED-Use), a web page that features a series of research reports about adult utilization of EDs for non-traumatic dental conditions across the US and by individual states. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [2022: Integration of Oral Health into Primary Care: Importance of Patients' Perceptions and Attitudes](https://carequest.org/resource/2022-integration-of-oral-health-into-primary-care-importance-of-patients-perceptions-and-attitudes/) **Published:** November 30, 2022 **Author:** Darren Edwards **Content:** MORE Care (Medical Oral Expanded Care) is an initiative of CareQuest Institute for Oral Health. Its goals are to [integrate oral health competencies](https://www.carequest.org/topics/medical-dental-integration) into primary medical care settings. In collaboration with Oral Health Ohio, this program is a pilot that operationalizes the establishment of medical-dental integration (MDI), alternative payment models (APMs), and medical-dental networking. Data surrounding this information is critical to the adoption of and sustainability of such a program. The MORE Care Ohio pilot will launch in August 2022 and will involve primary care clinics in Ohio. Patient surveys will include items on demographics and social determinants of health (SDOH). Clinical metrics will be captured regarding the number of patients with documented oral health assessments, discussions of oral health self-management goals, fluoride varnish applications, and referral to a dental provider when appropriate. Principal findings include: - Prior research by CareQuest Institute has shown that consumers and providers are both interested in increased interprofessional practice. - Results from this study will present data on the operationalization of an MDI program and patient acceptance of such a program. **Attachments:** [KSchroeder\_APHA\_Final update 11.05.2022.pptx](https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.carequest.org%2Fsystem%2Ffiles%2FKSchroeder_APHA_Final%2520update%252011.05.2022.pptx&wdOrigin=BROWSELINK) (3.48 MB) **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [The State of Sleep and Obstructive Sleep Apnea: Myths and Facts](https://carequest.org/resource/the-state-of-sleep-and-obstructive-sleep-apnea-myths-and-facts/) **Published:** May 30, 2023 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_State-of-Sleep_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest-Institute_The-State-of-Sleep-Visual-Report_5.11.23.pdf)View visual report Obstructive sleep apnea (OSA) is a common chronic health condition that can create health and job-related risks for the 30 million people who have it. A visual report from CareQuest Institute examines how the integration of oral health care with primary care and sleep medicine can improve access to OSA care, reduce sleep disparities, and save the health care system billions of dollars. ## Sleep Apnea and Dental Care The report explains why dental professionals should be concerned about sleep health, and how they can play a collaborative role in improving sleep health in their communities. Dentists (and allied dental professionals), for example, are optimally positioned to screen patients for OSA, through identifying anatomical risk factors. Key findings in the report include: - More than 1 in 10 adults have been diagnosed with OSA, but nearly 80% of adults who have OSA are undiagnosed. - While OSA is more commonly diagnosed in men, compelling evidence suggests that OSA is underdiagnosed and undertreated in women. - Sleep health is an equity issue: Black adults are more likely than white adults to experience sleep problems. Experiences of discrimination are linked to poor sleep and account for some racial differences in sleep quality. - The estimated cost burden of undiagnosed OSA for adults in the US in 2015 was nearly $150 billion. **You may also be interested in:** - [How Depression Is Linked to Oral Health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), a visual report that highlights a growing body of research, demonstrating that our emotional state is connected to our oral health. - [Understanding and Providing Trauma-Informed Oral Health Care](https://www.carequest.org/education/course/understanding-and-providing-trauma-informed-oral-health-care/overview), a self-paced course that explores how trauma history can impact engagement in oral health care and shares strategies to sensitively interact with trauma survivors. - [Dental Danger: Home Remedies to Avoid When Awaiting Care](https://www.carequest.org/resource-library/dental-danger-home-remedies-avoid-when-awaiting-care), a report that shares insights into the dental home remedies — both safe and dangerous — most frequently used by consumers. **Categories:** Resource, Visual Report **Tags:** Clinical Practice, Health Equity, Medical-Dental Integration --- ### [2022: US Adults' Perceptions about HPV Vaccination and Dental Providers' Role in HPV Prevention](https://carequest.org/resource/2022-us-adults-perceptions-about-hpv-vaccination-and-dental-providers-role-in-hpv-prevention/) **Published:** November 30, 2022 **Author:** Darren Edwards **Content:** Human Papillomavirus (HPV) is one of the most common sexually transmitted infections. Oropharyngeal cancers (OPC) are the most common cancers of all HPV cancers and can be prevented using HPV vaccines. However, HPV vaccine rates are far from Healthy People 2020 or 2030 goals. This study examined adults’ HPV vaccine knowledge and perceptions in the context of oral health. During this presentation, Megan Cloidt, DDS, MPH, shared data from CareQuest Institute for Oral Health and NORC at the University of Chicago recently nationally representative State of Oral Health Equity in America (SOHEA) survey in January-February 2022. Participants were asked about their knowledge of HPV and oral health and whether their oral health care provider ever recommended the HPV vaccine. Principal findings included: - Adults are knowledgeable about the role of HPV vaccines in preventing OPC and felt confident receiving recommendations about HPV vaccines from dental providers. - Integrating effective communication strategies with oral health providers can build patient awareness of the importance of the HPV vaccine for the prevention of OPC and other cancers. **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [2022: Screening for Diabetes in the Oral Health Care Setting: Developing a Predictive Algorithm to Identify High-Risk Patients](https://carequest.org/resource/2022-screening-for-diabetes-in-the-oral-health-care-setting-developing-a-predictive-algorithm-to-identify-high-risk-patients/) **Published:** November 30, 2022 **Author:** Darren Edwards **Content:** Approximately 2.5% of individuals with diabetes mellitus (DM) are undiagnosed. DM and periodontal disease (PD) have a suggested bidirectional relationship; those with PD have an increased risk of DM and vice versa. The goal of this study was to develop and test a predictive algorithm to identify adults at risk for DM and test their A1C levels in the dental setting. CareQuest Institute for Oral Health developed a predictive algorithm using demographics, medical and dental history to identify patients at high risk of, but not previously diagnosed with DM. Across five health centers, patients were approached to have their A1C levels tested (finger stick) during their dental appointment, primarily by dental hygienists. Patients with prediabetes (A1C = 5.7% – 6.4%) or DM (A1C > 6.5%) were referred for follow-up medical care. Patients also completed surveys about their screening experience. Principal findings include: - The predictive model was able to identify 6% of patients with previously undiagnosed DM, more than twice the estimate of undiagnosed DM in the general population. - Screening for DM in a dental setting has the promise to identify those at high risk who may not otherwise receive A1C testing. **Attachments:** [Preston\_DICP\_MedicalDentalIntegrationAPHA1031.pptx](https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.carequest.org%2Fsystem%2Ffiles%2FPreston_DICP_MedicalDentalIntegrationAPHA1031.pptx&wdOrigin=BROWSELINK) (1.27 MB) **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [2022: Consumers Experiences with and Attitudes toward Receiving Health Screenings at Dental Visits](https://carequest.org/resource/2022-consumers-experiences-with-and-attitudes-toward-receiving-health-screenings-at-dental-visits/) **Published:** November 30, 2022 **Author:** Darren Edwards **Content:** Integrating overall health screenings into dental visits ensures individuals receive both necessary dental care and important medical screenings, both which benefit patients and the overall health care system. This study examined consumers’ experiences with and attitudes toward receiving health screenings from dental providers. During this presentation, Adrianna Sonnek, MPH, shared data from CareQuest Institute for Oral Health and NORC at the University of Chicago nationally representative State of Oral Health Equity in America (SOHEA) survey in January-February 2022. Adults were asked about their experiences with and attitudes toward receiving routine health screenings in a dental office. Principal findings include: - Health screenings are not commonly done during dental visits, although most adults are comfortable with dental providers doing such screenings. - Integrating health screenings into dental visits is an important and infrequently used opportunity that can benefit patients and the overall healthcare system. **Attachments:** [SonnekAPHA Slides.pptx](https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.carequest.org%2Fsystem%2Ffiles%2FSonnekAPHA%2520Slides.pptx&wdOrigin=BROWSELINK) (1.06 MB) **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [Update on Alternative Payment Models in Oral Health Care](https://carequest.org/resource/update-on-alternative-payment-models-in-oral-health-care/) **Published:** December 6, 2022 **Author:** Darren Edwards **Content:** In this article in *Decisions in Dentistry*, CareQuest Institute researchers update a previous analysis to compare spending and service utilization of fee-for-service (FFS) models to alternative payment models (APMs) through 2019. Consistent with earlier findings, cost per patient remains lower and service utilization remains higher under APMs compared to FFS. The authors also found that patients in APMs are more likely to receive preventive services, like silver diamine fluoride and sealants, and less likely to visit the emergency department for a dental condition. The research analyzes dental care spending and utilization by Medicaid patients from ages 0 to 89. ## Fee for Service vs. Value-Based Care Rising health care costs have inspired new payment models that emphasize value and quality of care as alternatives to traditional fee-for-service models based on volume of care. Dentistry has been slower to adopt APMs compared to medicine — a recent [provider survey shows that 51% of dental providers had never heard of APMs](https://www.carequest.org/resource-library/alternative-payment-models-dentistry) — but [state Medicaid programs](https://www.dentaleconomics.com/macro-op-ed/dental-outreach/article/14282099/valuebased-payment-alignment-a-case-study-for-oral-health) have been piloting dental APMs. The authors conclude: > As awareness of, and experience with, value-based care and value-based purchasing grows in both medicine and dentistry, these trends are expected to gain momentum. It is vital that dentistry continues to adapt to shifts in payment transformation to create a more equitable, accessible, and integrated health system for everyone. [Read the article and take the CE course](https://decisionsindentistry.com/article/update-alternative-payment-models-oral-healthcare/) in *Decisions in Dentistry* **You may also be interested in:** - [An Introduction to Value-Based Care in Oral Health: Moving from Volume to Value](https://www.carequest.org/education/course/introduction-value-based-care-oral-health-moving-volume-value/overview), a self-paced CE course that explains how VBC can improve patient outcomes while benefiting providers and payors. - [Pre-Doctoral Dental Faculty Perceptions Toward Value-Based Care](https://www.carequest.org/resource-library/pre-doctoral-dental-faculty-perceptions-toward-value-based-care-exploratory-story), an article in the *Journal of Dental Education* that finds dental school faculty need more training and guidance to teach the concept of value-based care to dental students. - [Value-Based Care: The Federally Qualified Health Center Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper, developed in collaboration with the National Association of Community Health Centers, that discusses how FQHCs can lead the transformation into a value-based system. **Categories:** Journal Article, Resource **Tags:** Value-Based Care --- ### [Family Affair: A Snapshot of Oral Health Disparities and Challenges in Individuals in Households Experiencing Disability](https://carequest.org/resource/family-affair-a-snapshot-of-oral-health-disparities-and-challenges-in-individuals-in-households-experiencing-disability/) **Published:** December 7, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Family-Affair-Visual-Report_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Family-Affair-Visual-Report_FINAL.pdf)View visual report Individuals in households experiencing disability rate their oral health as fair or poor at higher rates (38%) than those not in households experiencing disability (23%), according to a report from CareQuest Institute. The report analyzes data from the annual [State of Oral Health Equity in America survey](https://www.carequest.org/SOHEA2022) and confirms the persistent disparities and challenges in accessing oral health for those with intellectual or physical disabilities. Individuals in households experiencing disabilities: - visit the dentist less frequently — 32.6% had not visited a dentist in 2 or more years compared to 19.7% in households not experiencing disability. - are more frequently denied health care or oral health care due to discrimination — more than half (52.8%) compared to 36.9% in households not experiencing disability. - are twice as likely to experience high dental anxiety (21.8%) compared to households not experiencing disability (10.6%). - visit the ED for dental care or pain 3 times more often (9.0%) compared to households not experiencing disability (3.1%). Individuals with a disability have long had higher prevalence and severity of oral disease than the general population. In 2019, the Commission on Dental Accreditation responded to recommendations by the National Council on Disability and set a requirement for dental schools to train their students in the treatment of patients with intellectual and developmental disabilities. This report reinforces the need to improve access to high-quality care for individuals in households experiencing disability. **You may also be interested in:** - [Improving Dental Care for Individuals with Intellectual and Developmental Disabilities (IDDs)](https://www.aegisdentalnetwork.com/id/2022/11/improving-dental-care-for-individuals-with-idds), an article in *Inside Dentistry* where a dentist discusses what health care providers and some state legislatures are doing to close the gap in care for those with IDDs. - [State of Oral Health Equity in America 2022](https://www.carequest.org/SOHEA2022), a collection of research reports based on results from CareQuest Institute’s annual survey that highlights ongoing disparities in access to oral health care. - [The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled), a report that finds the lack of a mandated dental benefit in Medicare significantly contributes to poor health among America’s elderly and disabled populations. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Room to Grow: An Analysis of Dental and Health Care Claims in Medicaid-Enrolled Children in Arizona](https://carequest.org/resource/room-to-grow-an-analysis-of-dental-and-health-care-claims-in-medicaid-enrolled-children-in-arizona/) **Published:** July 12, 2022 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest_Institute_Room-to-Grow-Arizona-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Room-to_Grow-Arizona_6.30.22-1.pdf)View report Arizona offers a comprehensive Medicaid dental care benefit, including assignment to a dental home, for children under 21 whose family income falls below a certain threshold. However, the state continues to lag behind the nation when it comes to children’s oral health ― more than half (52%) of Arizona’s kindergarteners have tooth decay compared to 36% nationally. A new joint study by CareQuest Institute, Arizona Oral Health Coalition, and Children’s Action Alliance examined patterns of use of medical and dental services in Arizona children enrolled in Medicaid. The study found that despite recommendations that children see a dentist by their first birthday, less than 1% of Medicaid-enrolled children had a dental claim before the age of 1. Further, only about one in four children aged 1–3 years had a dental claim. Other findings include: - Most Medicaid-enrolled children had at least one health care claim during the study period, but there were differences by age, race, and ethnicity in the use of health services. - The youngest age group (0–3 years) had the greatest percentage of major restorative dental care of all the age groups. - American Indian or Alaska Native (AI/AN) children were least likely to have a claim (48.4%), and traveled the longest distances of children in any racial group to receive health care. The authors write that “Arizona struggles with recruiting and sustaining dentists, particularly in rural and low-income areas,” with four counties lacking a pediatric dentist enrolled in the state’s Medicaid program. **You may also be interested in:** - [Webinar: Advancing Health Equity Through Dental Therapy](https://www.carequest.org/education/webinars/advancing-health-equity-through-dental-therapy), join the American Public Health Association Oral Health Section and CareQuest Institute on July 28 for a robust conversation about the benefits and concerns of expanding dental therapy, which is currently permitted in 14 states and several Tribal nations. - [Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children](https://www.carequest.org/resource-library/age-first-oral-health-examination-and-dental-treatment-needs-medicaid-enrolled), an article in *JDR Clinical & Translational Research* underscoring the importance of a child’s first dental visit before their first birthday to prevent early childhood tooth decay. - [Spotlight on Arizona: Adult Use of Emergency Departments (ED) for Non-Traumatic Dental Conditions (NTDCs)](https://www.carequest.org/resource-library/spotlight-arizona-adult-use-emergency-departments-non-traumatic-dental-conditions), a report examining who visits the ED for NTDCs in Arizona and the resulting costs of care. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a “Superutilizer”](https://carequest.org/resource/repeated-use-of-emergency-departments-for-non-traumatic-dental-conditions-factors-associated-with-being-a-superutilizer/) **Published:** July 11, 2022 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest_Institute_Repeated-Use-of-Emergency-Departments-for-Non-Traumatic-Dental-Conditions-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Repeated-Use-of-Emergency-Departments-for-Non-Traumatic-Dental-Conditions.pdf)View report Arizona offers a comprehensive Medicaid dental care benefit, including assignment to a dental home, for children under 21 whose family income falls below a certain threshold. However, the state continues to lag behind the nation when it comes to children’s oral health ― more than half (52%) of Arizona’s kindergarteners have tooth decay compared to 36% nationally. A new joint study by CareQuest Institute, Arizona Oral Health Coalition, and Children’s Action Alliance examined patterns of use of medical and dental services in Arizona children enrolled in Medicaid. The study found that despite recommendations that children see a dentist by their first birthday, less than 1% of Medicaid-enrolled children had a dental claim before the age of 1. Further, only about one in four children aged 1–3 years had a dental claim. Other findings include: - Most Medicaid-enrolled children had at least one health care claim during the study period, but there were differences by age, race, and ethnicity in the use of health services. - The youngest age group (0–3 years) had the greatest percentage of major restorative dental care of all the age groups. - American Indian or Alaska Native (AI/AN) children were least likely to have a claim (48.4%), and traveled the longest distances of children in any racial group to receive health care. The authors write that “Arizona struggles with recruiting and sustaining dentists, particularly in rural and low-income areas,” with four counties lacking a pediatric dentist enrolled in the state’s Medicaid program. **You may also be interested in:** - [Webinar: Advancing Health Equity Through Dental Therapy](https://www.carequest.org/education/webinars/advancing-health-equity-through-dental-therapy), join the American Public Health Association Oral Health Section and CareQuest Institute on July 28 for a robust conversation about the benefits and concerns of expanding dental therapy, which is currently permitted in 14 states and several Tribal nations. - [Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children](https://www.carequest.org/resource-library/age-first-oral-health-examination-and-dental-treatment-needs-medicaid-enrolled), an article in *JDR Clinical & Translational Research* underscoring the importance of a child’s first dental visit before their first birthday to prevent early childhood tooth decay. - [Spotlight on Arizona: Adult Use of Emergency Departments (ED) for Non-Traumatic Dental Conditions (NTDCs)](https://www.carequest.org/resource-library/spotlight-arizona-adult-use-emergency-departments-non-traumatic-dental-conditions), a report examining who visits the ED for NTDCs in Arizona and the resulting costs of care. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Medicare Medically Necessary Fact Sheet](https://carequest.org/resource/medicare-medically-necessary-fact-sheet/) **Published:** July 14, 2022 **Author:** Darren Edwards **Content:** [![View fact sheet](https://carequest.org/wp-content/uploads/2025/11/OH-2022-94_Medicare-Medically-Necessary-Fact-Sheet-1-249x300.png)](https://carequest.org/wp-content/uploads/2025/11/OH-2022-94_Medicare-Medically-Necessary-Fact-Sheet.pdf)View fact sheet ## Improving Medicare Dental Coverage Medically necessary dental care is oral health care that is needed to properly treat other diagnosed medical conditions. For instance, oral health care can be vital to ensuring that a person can receive a transplant, move forward with radiation therapy, get their diabetes under control, and much more. Yet, for too many Medicare enrollees, this care is unaffordable and out of reach, delaying medical care and making them even sicker. [Learn more about our advocacy work to expand adult dental benefits](https://www.carequest.org/how-we-work/policy-and-advocacy) **Categories:** Resource, Tool **Tags:** Dental Coverage --- ### [Incidence, Mortality, and Cost Trends in Nonventilator Hospital-Acquired Pneumonia in Medicaid Beneficiaries, 2015-2019](https://carequest.org/resource/incidence-mortality-and-cost-trends-in-nonventilator-hospital-acquired-pneumonia-in-medicaid-beneficiaries-2015-2019/) **Published:** July 18, 2022 **Author:** Darren Edwards **Content:** An article in the *American Journal of Infection Control*, co-authored by CareQuest Institute researchers, examines the impact of nonventilator hospital-acquired pneumonia (NVHAP) among Medicaid enrollees. 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. The authors found that the mean hospital stay was approximately $20,000 more for patients with NVHAP compared to those without. The study also found that incidence of NVHAP was higher in patients aged 45–64 and in men. While this study of Medicaid patients is not generalizable to the broader population, the findings support the need to include NVHAP in efforts to reduce hospital-acquired infections. Today, it is not included in CMS’ Hospital-Acquired Condition Reduction Program, so many hospitals do not engage in active NVHAP prevention. The authors also highlight “an emerging body of evidence associating the use of comprehensive oral care and mobility to reduce the incidence of NVHAP and findings provide additional support . . . to implement and support NVHAP prevention and education.” [Read the article](https://www.sciencedirect.com/science/article/pii/S0196655322004990) in the *American Journal of Infection Control* (open access) **You may also be interested in:** - [The Link Between Ventilator-Associated Pneumonia and the Mouth](https://www.carequest.org/resource-library/link-between-ventilator-associated-pneumonia-and-mouth), a report that explores the connection between preventive dental visits and decreased likelihood of acquiring pneumonia while on a ventilator. - [Impacts Beyond the Mouth](https://www.carequest.org/resource-library/impacts-beyond-mouth), an infographic that highlights the connection between oral health and overall health. - [A Cross-Sectional Analysis of Oral Health Care Spending Over the Life Span in Commercial- and Medicaid-Insured Populations](https://www.carequest.org/resource-library/cross-sectional-analysis-oral-health-care-spending-over-life-span), an article in the *Journal of the American Dental Association* that features one of the most comprehensive life course analyses of spending on oral health care. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Medical-Dental Integration, Practice Management --- ### [Value-Based Care: The Federally Qualified Health Center Story](https://carequest.org/resource/value-based-care-the-federally-qualified-health-center-story/) **Published:** August 2, 2022 **Author:** Darren Edwards **Content:** [![Read white paper](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Oral-Health-Value-Based-Care-FQHC-Story-White-Paper-Cover.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Oral-Health-Value-Based-Care-FQHC-Story-White-Paper.pdf)Read white paper Federally Qualified Health Centers (FQHCs) serve as a point of care for over 28 million patients annually, many of whom are uninsured, living in poverty and located in rural areas. These social determinants of health create chronic conditions, including a disproportionate burden of oral disease, within a vulnerable patient community. Facilitated by better access to technology infrastructure and coordinated primary care delivery, FQHCs have been at the forefront of providing comprehensive, person-centered health care. Shifting away from fragmented dental care provision and into a coordinated, [integrated model of health care ](https://www.carequest.org/topics/value-based-care)primes FQHCs to lead transformation into a value-based system. A series of analyses were performed using 3 data sources: the IBM Watson MarketScan Multi-State Medicaid Database, the Health Resources and Services Administration Uniform Data System and a survey of participants in a safety net technical assistance program. Data were analyzed to explore health outcomes and service provision in an FQHC population compared to non-FQHC populations. This white paper was developed in collaboration with the National Association of Community Health Centers (NACHC). A [webinar](https://www.carequest.org/education/webinars/oral-health-value-based-care-introduction-and-call-action-chcs) was also co-presented in 2020 with the National Association of Community Health Centers (NACHC), which discussed the move to value, and how community health centers are working towards positive whole health outcomes. **Categories:** Publication, Resource **Tags:** Value-Based Care --- ### [Burnout among Dental Professionals Before and During a Public Health Crisis: Causes, Consequences, and Next Steps](https://carequest.org/resource/burnout-among-dental-professionals-before-and-during-a-public-health-crisis-causes-consequences-and-next-steps/) **Published:** August 8, 2022 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest_Institute_Burnout-Among-Dental-Professionals-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Burnout-Among-Dental-Professionals_8.3.22.pdf)View report Nearly three-quarters (71%) of oral health providers said their feelings of burnout had increased since the start of the COVID-19 pandemic, according to a visual report from CareQuest Institute. To learn more about the effect of the pandemic on burnout, CareQuest Institute conducted a survey of 377 dental providers in March 2021. In general, oral health providers reported increases in burnout during the beginning of the pandemic. However, this sense of increased burnout did not impact all dental providers equally, with differences by gender, age, race, and ethnicity emerging. Key findings include: - Frequent feelings of burnout were reported most by the youngest group of providers (71% for providers aged 18–34 compared to 46% for providers aged 55 and over). - Two-thirds (66%) of female providers reported frequent feelings of burnout compared with half (50%) of male providers. - Oral health providers identifying as Hispanic were more likely (73%) to report burnout symptoms due to work compared with individuals identifying as white (63%), Asian/American Indian/Native Hawaiian/Pacific Islander (55%), or Black (35%). - Oral health providers in rural areas experienced frequent burnout at higher rates (72%) than providers in suburban/urban areas (56%). Professional burnout can lead to physical and psychological distress and is associated with higher rates of suicide among health care workers. The visual report also includes resources to help dental professionals overcome burnout. **You may also be interested in:** - [Speaking Softly and Still Being Heard](https://www.carequest.org/about/news/speaking-softly-and-still-being-heard-advice-advocating-yourself-professional-setting), a blog post from the perspective of a dental hygienist who shares advice about how to advocate for yourself in a professional setting. - [Dental Safety Net Providers’ Experiences with COVID-19 Should Inform Dental Pandemic Preparedness](https://www.carequest.org/resource-library/dental-safety-net-providers-experiences-covid-19-should-inform-dental-pandemic), an article in the *Journal of the American Dental Association* that describes providers’ experiences delivering care in the early stages of the pandemic. - [Dentist Perceptions about the Value of Teledentistry](https://www.carequest.org/resource-library/dentist-perceptions-about-value-teledentistry), a journal article showing that most dentists expect teledentistry to change how they practice with benefits including improved access to care and reduced chair time, allowing them to see more patients. **Categories:** Resource, Visual Report **Tags:** Clinical Practice --- ### [The Association Between Accessing Dental Services and Nonventilator Hospital-Acquired Pneumonia in Medicaid Beneficiaries](https://carequest.org/resource/the-association-between-accessing-dental-services-and-nonventilator-hospital-acquired-pneumonia-in-medicaid-beneficiaries/) **Published:** August 16, 2022 **Author:** Darren Edwards **Content:** A new [article](https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/association-between-accessing-dental-services-and-nonventilator-hospitalacquired-pneumonia-among-2019-medicaid-beneficiaries/3FF0BA4507652AB559620B1594B89E67), co-authored by CareQuest Institute researchers, stresses the importance of dental hygiene and treatment of gum disease to prevent nonventilator hospital-acquired pneumonia (NVHAP). Researchers found that Medicaid beneficiaries who had received a preventive dental visit within one year prior to an inpatient hospitalization were 10% less likely to be diagnosed with nonventilator hospital-acquired pneumonia (NVHAP). Patients who received periodontal therapy (scaling and root planing) six months prior to hospitalization were 30% less likely to be diagnosed with NVHAP. ## Dental Hygiene and Treatment of Gum Disease Prior to Hospitalization May Help Prevent NVHAP “Ensuring that individuals enter the hospital with a ‘clean mouth’ through regular dental care before hospitalization has the potential to lower the risk of NVHAP,” write the authors. The authors also stressed that “both elderly and younger beneficiaries are at risk for NVHAP.” NVHAP is a major cause of hospital-acquired infections, occurring in approximately 1 in 100 hospitalized patients. The estimated cost per person to treat it is $28,000–$40,000 compared to approximately $500 for periodontal therapy. However, [periodontal therapy is not covered by Medicaid in many states](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). Expanding Medicaid dental benefits to include periodontal therapy has the potential to reduce health care costs associated with NVHAP. [Read the article](https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/association-between-accessing-dental-services-and-nonventilator-hospitalacquired-pneumonia-among-2019-medicaid-beneficiaries/3FF0BA4507652AB559620B1594B89E67) in *Infection Control & Hospital Epidemiology* (open access). **You may also be interested in:** - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool to easily understand where a state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping identify areas for improvement and expansion. - [Incidence, Mortality, and Cost Trends in Nonventilator Hospital-Acquired Pneumonia in Medicaid Beneficiaries](https://www.carequest.org/resource-library/incidence-mortality-and-cost-trends-nonventilator-hospital-acquired-pneumonia), an article examining the impact of NVHAP among Medicaid enrollees. - [The Link Between Ventilator-Associated Pneumonia and the Mouth](https://www.carequest.org/resource-library/link-between-ventilator-associated-pneumonia-and-mouth), a report that explores the connection between preventive dental visits and decreased likelihood of acquiring pneumonia while on a ventilator. **Categories:** Journal Article, Resource **Tags:** Clinical Practice, Dental Coverage, Medical-Dental Integration --- ### [2022: Oral Health in Households with Disabilities](https://carequest.org/resource/2022-oral-health-in-households-with-disabilities/) **Published:** September 6, 2022 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_FL-Adult-Use-ED-NTDCs_250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_FL-HCUP-Visual-Report_9.12.22-1.pdf)View report Millions of Americans lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). What drives those costly ED visits and who is most likely to make them? A new visual report from CareQuest Institute explores those questions within the state of Florida. ## ED Visits and Lack of Adult Dental Medicaid Benefits Researchers found that among Floridians ages 25–34, those enrolled in Medicaid or who are uninsured make up more than three-quarters (78.4%) of these ED visits. As of 2020, the end of the data collection period, Florida did not offer an extensive Medicaid adult dental benefit. Other findings in Florida include: - Adults ages 25-34 have the highest rate of ED use for NTDCs (171.2 visits per 10,000 people), while adults ages 65 and older have the lowest rate (15.5 visits per 10,000 people). - Across all demographic groups, Black residents of all ages have the highest rate of ED use for NTDCs, with 146.4 visits per 10,000 people. This is more than double the rate for white residents and nearly four times higher than the rate for Hispanic residents. - In 2019, the total cost of ED visits for NTDCs in Florida was more than $400 million. The average charge for an ED visit for NTDCs was $2,657, compared to $90–$200 for a dental office visit. The report also explores reasons for ED visits and promising solutions to expand access to care. **You may also be interested in:** - [Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a “Superutilizer,”](https://www.carequest.org/resource-library/repeated-use-emergency-departments-non-traumatic-dental-conditions-factors) a research report that examines who makes repeated visits to the ED for NTDCs and why. The researchers found that superutilizers are more likely to live in states with emergency-only Medicaid adult dental benefits (Florida) compared to states with extensive Medicaid adult dental benefits (New York and Wisconsin). - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. - [A New Oral Health Outlook for 2 Million Americans](https://www.carequest.org/about/news/new-oral-health-outlook-2-million-americans), a blog post from a policy expert that breaks down which states have expanded their Medicaid adult dental benefits in the 2022 legislative sessions and what that will mean for the health of 2 million Americans. **Categories:** Presentation, Resource **Tags:** Health Equity --- ### [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Florida](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-florida/) **Published:** September 8, 2022 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_FL-Adult-Use-ED-NTDCs_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_FL-HCUP-Visual-Report_9.12.22.pdf)View report Millions of Americans lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). What drives those costly ED visits and who is most likely to make them? A new visual report from CareQuest Institute explores those questions within the state of Florida. ## ED Visits and Lack of Adult Dental Medicaid Benefits Researchers found that among Floridians ages 25–34, those enrolled in Medicaid or who are uninsured make up more than three-quarters (78.4%) of these ED visits. As of 2020, the end of the data collection period, Florida did not offer an extensive Medicaid adult dental benefit. Other findings in Florida include: - Adults ages 25-34 have the highest rate of ED use for NTDCs (171.2 visits per 10,000 people), while adults ages 65 and older have the lowest rate (15.5 visits per 10,000 people). - Across all demographic groups, Black residents of all ages have the highest rate of ED use for NTDCs, with 146.4 visits per 10,000 people. This is more than double the rate for white residents and nearly four times higher than the rate for Hispanic residents. - In 2019, the total cost of ED visits for NTDCs in Florida was more than $400 million. The average charge for an ED visit for NTDCs was $2,657, compared to $90–$200 for a dental office visit. The report also explores reasons for ED visits and promising solutions to expand access to care. **You may also be interested in:** - [Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a “Superutilizer,”](https://www.carequest.org/resource-library/repeated-use-emergency-departments-non-traumatic-dental-conditions-factors) a research report that examines who makes repeated visits to the ED for NTDCs and why. The researchers found that superutilizers are more likely to live in states with emergency-only Medicaid adult dental benefits (Florida) compared to states with extensive Medicaid adult dental benefits (New York and Wisconsin). - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. - [A New Oral Health Outlook for 2 Million Americans](https://www.carequest.org/about/news/new-oral-health-outlook-2-million-americans), a blog post from a policy expert that breaks down which states have expanded their Medicaid adult dental benefits in the 2022 legislative sessions and what that will mean for the health of 2 million Americans. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Unlocking Access to Oral Health](https://carequest.org/resource/unlocking-access-to-oral-health/) **Published:** September 19, 2022 **Author:** Darren Edwards **Content:** ## An event hosted by *The Hill* and sponsored by CareQuest Institute for Oral Health A healthy mouth is essential for a healthy body. Yet, access to adult oral health care is inconsistent or inaccessible for millions of low-income adults enrolled in Medicaid across the country. Can the federal government do more to support states and ensure access to quality oral health care for millions of low-income people in the US? Can prioritizing oral health lead to reduced medical costs and better outcomes? Watch a recording of the event to hear policymakers, health care experts, and advocates discuss the progress made and what more can be done to improve oral health nationwide. Speakers include: - **Cheryl Lee-Butler, DDS**, President, National Dental Association - **Frederick Isasi**, Executive Director, Families USA - **Rep. Jan Schakowsky (D-IL)**, Member, Committee on Energy & Commerce - **Marko Vujicic, PhD**, Chief Economist & Vice President, American Dental Association Health Policy Institute - **Mary C. Backley**, Chief Executive Officer, Maryland Dental Action Coalition (MDAC) - **Mahak Kalra, MPH**, Chief Policy & Advocacy Officer, Kentucky Youth Advocates & Kentucky Oral Health Coalition - **Kaz Rafia, DDS, MBA, MPH,** Chief Health Equity Officer, CareQuest Institute for Oral Health Related Resource: - The **[Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker)** is an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping identify areas for improvement and expansion. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories. **Categories:** Resource, Video **Tags:** Dental Coverage --- ### [Discussing HPV and Detecting Oral Cancer: The Role of Oral Health Providers](https://carequest.org/resource/discussing-hpv-and-detecting-oral-cancer-the-role-of-oral-health-providers/) **Published:** September 22, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest_Institute_Discussing-HPV-Detecting-Oral-Cancer_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Discussing-HPV-Detecting-Oral-Cancer.pdf)View visual report Human papillomavirus (HPV) causes 70% of mouth and throat cancers, which are mostly preventable through the HPV vaccine. A visual report from CareQuest Institute summarizes what we know about the relationship between HPV and oral cancer, and outlines the role that dentists and dental hygienists can play in educating patients and preventing HPV through vaccinations. ## Dentists and Dental Hygienists Can Help Prevent HPV and Oral Cancer The authors write that “adolescents with a dental visit were significantly more likely to have received an HPV vaccination.” Furthermore, 12.5% of the adolescents who visited the dentist but were unvaccinated for HPV did not have a medical visit. This finding emphasizes the opportunity for oral health providers to educate adolescent patients and their caregivers about preventing HPV and related cancers. Other findings include: - There has been an estimated four- to fivefold increase in the number of cancers of the mouth and throat during the last 10 years in the US. - The HPV vaccine can prevent more than 90% of the six types of cancer caused by HPV, including cancers of the mouth and throat. - More than half (54.1%) of adults surveyed believe that oral health care providers are qualified to educate patients about the HPV vaccine. However, only 5% of adults say that an oral health provider has ever discussed the HPV vaccine with them. The visual report also includes links to resources for oral health providers who are interested in discussing HPV and HPV vaccinations. **You may also be interested in:** - [Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data](https://www.carequest.org/resource-library/oral-cancer-prevalence-mortality-and-costs-medicaid-and-commercial-insurance), an article in *Cancer, Epidemiology, Biomarkers & Prevention* showing that Medicaid enrollees experience higher rates of oral and throat cancer compared to commercially insured adults. - [A Vaccine Can Prevent Throat Cancer](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer), a visual report that shares key facts about human papillomavirus (HPV). - [Identifying the Utility of Dental Providers in Human Papillomavirus Prevention Efforts: Results from the National Health and Nutrition Examination Survey 2015–2018](https://www.carequest.org/resource-library/identifying-utility-dental-providers-human-papillomavirus-prevention), an article in the *Journal of Adolescent Health* that highlights the importance of utilizing dental providers in HPV primary prevention efforts. **Categories:** Resource, Visual Report **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Pre-Doctoral Dental Faculty Perceptions Toward Value-Based Care: An Exploratory Story](https://carequest.org/resource/pre-doctoral-dental-faculty-perceptions-toward-value-based-care-an-exploratory-story/) **Published:** September 29, 2022 **Author:** Darren Edwards **Content:** [Value-based care](https://www.carequest.org/topics/value-based-care) (VBC) is a new concept in dentistry, and moving to VBC models will require work and support in dental education, according to a new article in the *[Journal of Dental Education](https://onlinelibrary.wiley.com/doi/10.1002/jdd.13110)*. The article, authored by researchers at CareQuest Institute and the University of North Carolina at Chapel Hill, Adams School of Dentistry, found that dental school faculty have some understanding of VBC, but more training and guidance is needed to prepare faculty to teach the concept to dental students. Researchers interviewed dental school faculty to establish a baseline of their knowledge of VBC and to understand what they need to educate dental students about VBC. The authors write: > #### “If dental graduates are to be ready to emphasize health outcomes and be part of a value-based system, dental curricula must include a focus on these components. Teaching VBC is a paradigm shift from traditional dental curricula focused on clinical skills . . . “ Faculty and subject matter experts interviewed said that a change in teaching to include VBC will need support from clinical faculty and institutional leadership. [Read the article](https://onlinelibrary.wiley.com/doi/10.1002/jdd.13110) in the *Journal of Dental Education* (subscription required) **You may also be interested in:** - [Exploring Connections to Value-Based Care in Dental Education](https://www.carequest.org/resource-library/2022-exploring-connections-value-based-care-dental-education), a poster presentation at the 2022 National Oral Health Conference examines results from a survey of dental school deans about current VBC approaches and designs. Sixty-five percent of respondents said that VBC was not currently included in didactic curriculum. - [An Introduction to Value-Based Care — in Five Minutes](https://www.carequest.org/about/news/introduction-value-based-care-five-minutes), a blog post that provides a basic understanding of VBC and compares a traditional dental care model to a VBC model. - [Value-Based Care: The Federally Qualified Health Center Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper, developed in collaboration with the National Association of Community Health Centers (NACHC), that discusses how FQHCs can lead the transformation into a value-based system. **Categories:** Publication, Resource **Tags:** Value-Based Care --- ### [Another Billion Reasons for a Medicare Dental Benefit](https://carequest.org/resource/another-billion-reasons-for-a-medicare-dental-benefit/) **Published:** September 30, 2022 **Author:** Darren Edwards **Content:** [![](https://carequest.org/wp-content/uploads/2022/09/Another-Billion-Reasons.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Another-Billion-Reasons-Medicare.pdf)View report In an analysis of Medicare beneficiary data, CareQuest Institute researchers find that including periodontal treatment in Medicare has the potential to save up to $14.5 billion annually for patients with diabetes and up to $27.8 billion annually for patients with heart disease. ## Why add dental to Medicare? Periodontal disease is linked to several chronic health conditions, including diabetes and heart disease, and improving periodontal health can improve outcomes for those with diabetes and heart disease. At the stage of life when these chronic conditions become more common — that is, for older adults — access to oral health care often drastically decreases in the United States. Medicare does not include dental benefits, and dental coverage varies within Medicare Advantage plans. Key findings from the analysis include: - Estimated health care cost savings are between $3.6 billion and $14.5 billion per year for older adults with diabetes enrolled in Medicare or Medicare Advantage. - Estimated cost savings are between $6.9 billion and $27.8 billion per year for older adults with at least one heart condition enrolled in Medicare or Medicare Advantage. - Greater use of periodontal treatment results in greater estimated savings. Therefore, the analysis concludes, adding dental coverage to Medicare has the potential to save the health care system billions of dollars per year in care for patients with diabetes and/or heart disease alone. **You may also be interested in:** - [A Snapshot of the 76.5 Million Americans Without Dental Insurance](https://www.carequest.org/resource-library/snapshot-765-million-americans-without-dental-insurance), a visual report revealing that of all Americans, Medicare beneficiaries have the largest unmet need for dental coverage. - [Impacts Beyond the Mouth](https://www.carequest.org/resource-library/impacts-beyond-mouth), an infographic highlighting the connection between oral health and overall health. - [National Survey Finds Broad, Bipartisan Support for Medicare Dental Coverage](https://www.carequest.org/about/news/national-survey-finds-broad-bipartisan-support-medicare-dental-coverage), a news article highlighting that more than three-quarters of American voters surveyed support adding dental coverage to Medicare. **Categories:** Publication, Resource **Tags:** Dental Coverage, Medical-Dental Integration --- ### [The Importance of Being Ready: Lessons from Medicaid and Commercial Dental Claims Data](https://carequest.org/resource/the-importance-of-being-ready-lessons-from-medicaid-and-commercial-dental-claims-data/) **Published:** October 19, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2022/10/Importance-of-Being-Ready.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Importance-Of-Being-Ready_9.30.22.pdf)View the visual report What lessons can we learn from examining dental procedure utilization during the COVID-19 pandemic? A visual report from CareQuest Institute examines that question, using Medicaid and commercial insurance claims data to find differences in trends by age and insurance type that can inform future planning for providers and dental offices. ## Procedures to Resolve Pain Spiked When looking at procedures as a proportion of overall outpatient encounters, procedures aimed at resolving pain spiked in April 2020 compared to April 2019, but the procedures differed based on insurance type. Oral surgery procedures (e.g. extractions) increased significantly in April 2020, especially for [individuals covered by Medicaid insurance](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage). The authors wrote, “As many states’ Medicaid programs cover extractions as part of their emergency coverage, oral health providers may have relied more on this type of procedure in emergency situations during the early days of the pandemic.” Meanwhile, endodontic procedures increased more for individuals with commercial insurance in April 2020, suggesting that “oral health providers may have chosen to address some dental emergencies using endodontic procedures rather than extractions, particularly for patients with commercial insurance.” Other key findings include: - Dental encounters began declining in February 2020, dropping to their lowest point in April 2020, returning to near-2019 levels by June 2020, and remaining relatively stable through the rest of 2020. - Procedures related to preventing disease and fixing minor problems decreased precipitously in the early days of the pandemic. According to the authors, “These findings suggest that dental providers were following guidance to limit elective treatments and focus on emergent care.” They also noted a need for the oral health profession to maintain a state of emergency readiness to be able to provide consistent care in the face of future public health emergencies. **You may also be interested in:** - [Dental Safety Net Providers’ Experiences with COVID-19 Should Inform Dental Pandemic Preparedness](https://www.carequest.org/resource-library/dental-safety-net-providers-experiences-covid-19-should-inform-dental-pandemic), an article in the *Journal of the American Dental Association* that shares experiences from dental safety net providers about delivering care in the early stages of the pandemic. - [Burnout among Dental Professionals Before and During a Public Health Crises: Causes, Consequences, and Next Steps](https://www.carequest.org/resource-library/burnout-among-dental-professionals-and-during-public-health-crisis-causes), a survey of dental providers that explores differences in increased levels of provider burnout at the beginning of COVID-19. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers and advocates to easily understand where a state’s Medicaid adult dental benefits package falls from no dental benefits to extensive benefits, helping identify areas for improvement and expansion. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity, Practice Management --- ### [Estimation of Oral Disease Burden from Claims and Self-Reported Data](https://carequest.org/resource/estimation-of-oral-disease-burden-from-claims-and-self-reported-data/) **Published:** October 24, 2022 **Author:** Darren Edwards **Content:** Claims data can be used to estimate burden of dental disease for a population who receives dental care, according to researchers from CareQuest Institute and Marquette University School of Dentistry in an article in the *Journal of Public Health Dentistry*. Typically, oral disease burden is estimated through epidemiological surveys, which can be costly and time-consuming. In this study, researchers compared Medicaid and commercial claims data with survey data to estimate burden of oral disease. The authors note several advantages to using claims data for this purpose. Claims data: - contain the entire universe of treatment-related data among enrollees who sought care, - is available in real-time, - is collected as part of standard business processes and does not require additional costs and effort to obtain, and - may provide a better estimate of disease due to the larger datasets. Using claims data for this purpose does have limitations because they only capture data on individuals who sought and received dental care. The authors write that claims data and survey data allow complementary estimates of disease burden, saying, “Survey data remain useful in estimating burden of disease especially when information from individuals who are not able to access \[care\] is critical.” **[Read the article](https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.12550)** in the *Journal of Public Health Dentistry* (subscription required) **You may also be interested in:** - [The Importance of Being Ready: Lessons from Medicaid and Commercial Dental Claims Data](https://www.carequest.org/resource-library/importance-being-ready-lessons-medicaid-and-commercial-dental-claims-data), a visual report that examines trends in dental procedure utilization during the COVID-19 pandemic to inform future emergency planning for providers and dental offices. - [A Cross-Sectional Analysis of Oral Health Care Spending over the Life Span in Commercial- and Medicaid-Insured Populations](https://www.carequest.org/resource-library/cross-sectional-analysis-oral-health-care-spending-over-life-span), an article in the *Journal of the American Dental Association* that demonstrates the importance of understanding the factors that impact oral health status at every stage of life. - [Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data](https://www.carequest.org/resource-library/oral-cancer-prevalence-mortality-and-costs-medicaid-and-commercial-insurance), an article in *Cancer Epidemiology, Biomarkers & Prevention* that concludes that Medicaid enrollees experienced higher oral cancer and throat cancer incidence, prevalence, and mortality compared with commercially insured adults. **Categories:** Journal Article, Resource **Tags:** Practice Management --- ### [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Colorado](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-colorado/) **Published:** November 1, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Adult-Use-of-Emergency-Departments-Colorado_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Adult-Use-of-Emergency-Departments-Colorado_FINAL.pdf)View visual report Millions of Americans lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). What drives these costly ED visits and who is most likely to make them? A new visual report from CareQuest Institute explores those questions within the state of Colorado. ## Percentage of Adults on Medicaid Visiting the ED for Dental Problems in Colorado Is Above National Average Researchers found that Coloradoans ages 25–34 enrolled in Medicaid make up 59% of all ED visits for NTDCs, compared to approximately 43% nationally. While uninsured adults ages 25–34 make up approximately 17% of the ED dental visits in Colorado, the uninsured percentage is twice as much nationally at 34%. Other findings in Colorado include: - Adults ages 25–34 have the highest rate of ED use for NTDCs (61 visits per 10,000 people) while adults ages 65 and older have the lowest rate (16.2 visits per 10,000 people). - Across all demographic groups, Black residents of all ages have the highest rate of ED use for NTDCs, with 88 visits per 10,000 people. This is nearly three times the rate for white and Hispanic residents. - In 2019, the total cost of ED visits for NTDCs in Colorado was more than $68 million. The average charge for an ED visit for NTDCs was $3,604 in Colorado. This is nearly two times more than the national average charge for a visit to the ED for a dental problem ($1,872), and 18 times more than a dentist office visit for dental pain at $200. The report also explores reasons for ED visits and promising solutions to expand access to care. **You may also be interested in:** - [Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a “Superutilizer,”](https://www.carequest.org/resource-library/repeated-use-emergency-departments-non-traumatic-dental-conditions-factors) a research report that examines who makes repeated visits to the ED for NTDCs and why. The researchers found that superutilizers are more likely to live in states with emergency-only Medicaid adult dental benefits (e.g., Florida) compared to states with extensive Medicaid adult dental benefits (e.g., New York and Wisconsin). - [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Florida](https://www.carequest.org/resource-library/adult-use-emergency-departments-non-traumatic-dental-conditions-spotlight-florida), a report that breaks down the data for what drives costly ED visits for dental conditions in Florida and who is most likely to make those visits. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/resource-library/medicaid-adult-dental-coverage-checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Kentucky](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-kentucky/) **Published:** November 4, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Adult-Use-of-Emergency-Departments-Kentucky_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_Adult-Use-of-Emergency-Departments-Kentucky_10.31.22.pdf)View visual report Millions of Americans lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). What drives these costly ED visits and who is most likely to make them? A new visual report from CareQuest Institute explores those questions within the state of Kentucky. ## Percentage of Adults on Medicaid Visiting the ED for Dental Pain in Kentucky Is Above National Average Researchers found that Kentuckians ages 25–34 enrolled in Medicaid make up 65% of all ED visits for NTDCs, compared to approximately 43% nationally. While uninsured adults ages 25–34 make up approximately 17% of the ED dental visits in Kentucky, the uninsured percentage is twice as much nationally at 34%. Other findings in Kentucky include: - Adults ages 25–34 have the highest rate of ED use for NTDCs (153.2 visits per 10,000 people), while adults ages 65 and older have the lowest rate (14.5 visits per 10,000 people). - Across all demographic groups, Black residents of all ages have the highest rate of ED use for NTDCs with 108.5 visits per 10,000 people. This is more than 1.5 times the rate for white residents, and nearly three times the rate for Hispanic residents. - In 2019, the total cost of ED visits for NTDCs in Kentucky was more than $44 million. The average charge for an ED visit for NTDCs was $1,598 in Kentucky — less than the national average at $1,872 but much more than a dental office visit at $90–$200. As of 2020, the end of the data collection period, Kentucky did not offer an extensive Medicaid adult dental benefit. In October 2022, Governor Andy Beshear announced that the state will expand dental care for all Medicaid-enrolled adults effective January 2023. The expanded coverage will include preventive and restorative dental care. This is a giant step toward improving access to care and creating an equitable oral health system for the people of Kentucky. **You may also be interested in:** - [Emergency Departments Are No Place for Dental Care](https://www.carequest.org/content/emergency-departments-are-no-place-dental-care), a web page featuring a series of research about adult utilization of EDs for non-traumatic dental conditions across the US and by individual states. - [Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Florida](https://www.carequest.org/resource-library/adult-use-emergency-departments-non-traumatic-dental-conditions-spotlight-florida), a report that breaks down the data for what drives costly ED visits for dental conditions in Florida and who is most likely to make those visits. - [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/resource-library/medicaid-adult-dental-coverage-checker), an interactive tool that shows where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping policymakers and advocates identify areas for improvement. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Refining the Process: Safety Net Dental Professionals’ Experiences with Teledentistry Implementation During the First Year of COVID-19](https://carequest.org/resource/refining-the-process-safety-net-dental-professionals-experiences-with-teledentistry-implementation-during-the-first-year-of-covid-19/) **Published:** November 18, 2022 **Author:** Darren Edwards **Content:** “During the first 2 months of the COVID-19 pandemic, teledentistry use increased by 60 times,” according to CareQuest Institute researchers in a new article in the *Journal of Public Health Dentistry*. The article shares key findings from interviews with 21 dental professionals about their experience with teledentistry during the first year of the pandemic — and what those professionals envision for the future of teledentistry. Three common themes emerged from the interviews: ##### Logistical and equity considerations: Reimbursement, physical space, and some patients’ exclusion from technology shaped adoption of teledentistry. > “It just did not seem to be adopted well by our patients. There were some issues about how we will generate income out of using teledentistry. \[Patients\] think they are just calling in and getting a prescription. They do not think they should be charged. Is Medicaid going to pay for it or not?” ##### Team-based factors: Some team members preferred face-to-face patient treatment while others appreciated that teledentistry allowed them to continue treating patients safely by limiting the number of team members on site. > “We found \[their model\] to be very beneficial, a great new access point for our patients with the asynchronous telehealth. We plan to keep it and boost it and help it grow even after COVID. We wanted to have as many people working from home at that time as we possibly could.” ##### Future of teledentistry is undetermined: While some providers were skeptical about the diagnostic and treatment capabilities of teledentistry, others felt that demand would grow over time. > “As people have gotten used to that and telemedicine and telehealth in general, I think that demand for that is only going to grow. Once you let the genie out . . . you are not going to get it back in the bottle.” The authors conclude that the likelihood of future pandemics makes it necessary for teledentistry to be part of a strategy to plan for dental public health emergencies. [**Read the article**](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12547) in the *Journal of Public Health Dentistry* (subscription required) **You may also be interested in:** - [Dental Safety Net Providers’ Experiences with COVID-19 Should Inform Dental Pandemic Preparedness](https://www.carequest.org/resource-library/dental-safety-net-providers-experiences-covid-19-should-inform-dental-pandemic), an article in the *Journal of the American Dental Association* that shares lessons learned among dental safety net providers while delivering care in the early stages of the pandemic. - [Teledentistry Helps Provide the Right Care at the Right Time](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time), a report examining oral health outcomes for patients following a teledentistry visit. - [The Importance of Being Ready: Lessons from Medicaid and Commercial Dental Claims Data](https://www.carequest.org/resource-library/importance-being-ready-lessons-medicaid-and-commercial-dental-claims-data), a visual report that analyzes patterns of dental procedure utilization during the COVID-19 pandemic to inform future planning for dental practices. **Categories:** Journal Article, Resource **Tags:** Practice Management --- ### [Improving the Oral Health of Rural Veterans](https://carequest.org/resource/improving-the-oral-health-of-rural-veterans/) **Published:** November 28, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Improving-the-Oral-Health-of-Rural-Veterans_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_AIDPH_Improving-the-Oral-Health-of-Rural-Veterans_11.29.22.pdf)View visual report Accessing routine dental care is challenging for many veterans — only 15% are eligible for dental care through the Veterans Health Administration (VHA). It’s even harder for veterans living in rural communities, according to a report from the American Institute of Dental Public Health (AIDPH) and CareQuest Institute. Key findings from the report show that rural veterans are: - more likely to rate their dental health as “poor” (35.5%) compared with urban veterans (28.5%) - less likely to qualify for dental care coverage through the VHA (49.3% said did not qualify) compared with urban veterans (39.6% said did not qualify) - more likely to have or need dentures (39.8%) compared with urban veterans (23%) - paying higher out-of-pocket costs for dental care compared with urban veterans Veterans are disproportionately concentrated in rural areas, so it is essential to understand and find solutions for these inequities. The report recommends several steps, including expanding eligibility for dental care through the VHA, shifting to value-based care models in dentistry, improving data collection, and expanding the use of telehealth. **You may also be interested in:** - [Veteran Oral Health: Expanding Access and Equity](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), a white paper co-authored by AIDPH and CareQuest Institute that explores what drives worse oral health outcomes for veterans and how to improve access to quality care. - [Veteran Dental Care Stimulates the Economy and Improves Overall Health](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health), a visual report that examines the economic and health implications of improving access to dental care for veterans. - [Veteran Oral Health Data Dashboards](https://public.tableau.com/app/profile/carequest/viz/VeteranOralHealthDashboards/LandingPage), publicly available dashboards that allow advocates to analyze available data about veteran health outcomes for their state. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [2022: Data and Storytelling: Supporting Equitable Access to Care for Veterans](https://carequest.org/resource/2022-data-and-storytelling-supporting-equitable-access-to-care-for-veterans/) **Published:** November 30, 2022 **Author:** Darren Edwards **Content:** Learning objectives: - Evaluate the current landscape and drivers of veteran oral health - Understand the impact and context surrounding inadequate access to veteran oral health - Identify opportunities to [improve veteran oral health](https://www.carequest.org/topics/expanding-access) using data-driven tools resources **Attachments:** [Ghimire\_APHApresentation.pptx](https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.carequest.org%2Fsystem%2Ffiles%2FGhimire_APHApresentation.pptx&wdOrigin=BROWSELINK) (4.76 MB) **Categories:** Presentation, Resource **Tags:** Dental Coverage --- ### [Missed Connections: Providers and Consumers Want More Medical-Dental Integration](https://carequest.org/resource/missed-connections-providers-and-consumers-want-more-medical-dental-integration/) **Published:** February 24, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Missed-Connections-Providers-and-Consumers-Want-More-Medical-Dental-Integration-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Missed-Connections-Providers-and-Consumers-Want-More-Medical-Dental-Integration_FINAL.pdf)View visual report We know that oral health and overall health are inextricably linked. But despite this connection, dental care is still largely siloed from medical care. A visual report from CareQuest Institute examines attitudes regarding the relationship between oral health and overall health, based on national surveys of oral health consumers and providers. Both consumers and dental providers described a lack of integration between medical and oral health care, and a desire for increased interprofessional collaboration. Some illuminating findings: - 63% of adults say their primary medical doctor “never” or “rarely” asks about their oral health. - While only one third (34%) of oral health providers say they currently screen patients for diabetes, more than half (51%) would be more willing to screen if they had better tools to identify those at risk for diabetes. - 30% of adults would be more likely to seek dental care if their dentist and doctor were located in the same place. The survey results showed that both consumers and providers understand the connection between oral health and overall health and are eager for changes to the system. **You may also be interested in:** - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration), a web page with resources about treating the whole person and building bridges between medical care and dental care. - [“How Do You Not Include Dental Care in Overall Health?”](https://www.carequest.org/about/news/how-do-you-not-include-dental-care-overall-health), in this blog post, Nathan Fletcher, DDS, discusses how adding dental coverage to Medicare would improve overall health and reduce health care costs. - [The Connection Between Oral Health and Diabetes](https://www.carequest.org/resource-library/connection-between-oral-health-and-diabetes), in this video, Mark Deutchman, MD, explains how diagnosing and treating periodontal disease can help patients with their diabetic care. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Many Older Adults Delayed Dental Care During the Pandemic](https://carequest.org/resource/many-older-adults-delayed-dental-care-during-the-pandemic/) **Published:** March 15, 2022 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_-Many-Older-Adults-Delayed-Dental-Care-During-Pandemic-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_-Many-Older-Adults-Delayed-Dental-Care-During-Pandemic.pdf)Read report Older adults in the United States have long faced barriers to accessing dental care, including cost, lack of dental coverage, and inadequate transportation. The COVID-19 pandemic added to these obstacles. To learn more about these challenges, CareQuest Institute analyzed responses from three surveys of Medicare participants conducted by federal health officials. The analysis, summarized in a research brief, shows that the pandemic led to delays in health care, especially dental care, for older adults. Key findings include: - In summer 2020, one in five Medicare participants (21%), or 13 million people, delayed some form of health care due to the disruption caused by COVID-19. - Nearly 44% of those who delayed health care put off dental care (5.7 million people) — a higher rate than for any other type of care. - Patterns in delaying dental care differed by race and ethnicity. Between summer and fall of 2020, the percentage of Medicare participants who delayed dental care continued to increase among Black participants but declined among white and Hispanic participants. The authors write that postponing care will likely result in a spike in diagnoses of oral disease among older adults, which may be more severe and therefore, more difficult and costly to treat. The brief explores the repercussions of delayed care and potential solutions. **You may also be interested in:** - [Why We (Still) Need to Add Dental to Medicare](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare), a brief that synthesizes research about the lack of dental coverage in Medicare, the impact, and a possible pathway forward. - [The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled), a report that compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. - [A Snapshot of the 76.5 Million Americans Without Dental Insurance](https://www.carequest.org/system/files/CareQuest_Institute_A%20Snapshot%20of%20the%2076.5%20Million%20Americans%20Without%20Dental%20Insurance_Visual%20Report.pdf), a visual report which shows that Medicare beneficiaries have the largest unmet need for dental coverage. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Veteran Dental Care Stimulates the Economy and Improves Overall Health](https://carequest.org/resource/veteran-dental-care-stimulates-the-economy-and-improves-overall-health/) **Published:** April 8, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest-Institute_AIDPH_Veteran-Dental-Care-Stimulates-Economy-Improves-Overall-Health-229x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute_AIDPH__Veteran-Dental-Care-Stimulates-Economy-Improves-Overall-Health_RGB_5.3.22.pdf)View visual report A visual report from CareQuest Institute and the [American Institute of Dental Public Health](https://aidph.org/veteran-oral-health/) examines the economic and health implications of improving access to dental care for veterans, a group that has higher rates of tooth decay and gum disease than nonveterans. In a survey of more than 2,000 veterans, nearly one-third rated their dental health as “poor” and more than half said they could not see a dentist due to cost. According to the report, approximately 1.1 million veterans spend at least $2,000 out of pocket each year on dental costs — a projected cost of more than $2.2 billion annually. The authors write that “chronic health conditions like diabetes and heart disease can be effectively managed through routine access to dental care.” They estimate more than $7 billion could be saved by managing chronic health conditions and reducing emergency department visits for dental care among veterans. The authors also write that when veterans do get dental care, it helps to stimulate local economies — particularly in rural communities, “where the average rural dentist creates five full-time equivalent local jobs and $340,000 in labor income.” **You may also be interested in:** - [Veteran Oral Health: Expanding Access and Equity](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), this white paper shines a light on the factors that drive poor oral health outcomes for veterans and identifies actions to improve access to and quality of care for veterans. - [Centering Veteran Voices](https://www.carequest.org/about/news/centering-veteran-voices-takeaways-transforming-veteran-oral-health-colloquium), a blog that highlights takeaways from the Transforming Veteran Oral Health Colloquium held in February 2022. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [Americans Are Still Not Getting the Dental Care They Need](https://carequest.org/resource/americans-are-still-not-getting-the-dental-care-they-need/) **Published:** April 18, 2022 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Americans-Are-Still-Not-Getting-Dental-Care-They-Need-250x324_0-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Americans-Are-Still-Not-Getting-Dental-Care-They-Need_3.pdf)View report Two years into the COVID-19 pandemic, how are Americans faring in terms of oral health? In 2022, CareQuest Institute conducted the second annual State of Oral Health Equity in America survey ― a nationally representative survey of nearly 6,000 adults to study knowledge, attitudes, experiences, and behaviors related to oral health. This report is the first in a series of upcoming reports that will summarize the findings. Responses to the 2022 survey reveal that while some aspects of oral health have rebounded since the earlier stage of the pandemic, several inequities persist. Key findings include: - More than half of adults (55%) reported some type of oral health problem. - More than half of adults with an oral health problem did not seek care, and one-quarter of them did not seek care because they could not afford it. - In both 2021 and 2022, the most frequently cited dental problems were: toothache (23% in 2021 and 2022); cracked or broken teeth (20%; 18%); swollen or bleeding gums (18%; 17%); and frequent dry mouth (15%; 17%). - For those who had not seen an oral health provider in the last two years, 27% cited cost as a reason, 18% cited the COVID-19 pandemic, and 11% said they had no reason to go. - The report also recommends solutions to increase access to care, such as expanding Medicaid adult dental benefits, teledentistry, and expanding the reach of the oral health care workforce. **You may also be interested in:** - [Why We Created the Oral Health Equity in America Survey ― and What We Found](https://www.carequest.org/about/news/why-we-created-oral-health-equity-america-survey-and-what-we-found), this blog post provides additional insights and early findings from CareQuest Institute’s annual survey of adults’ knowledge, attitudes, experiences, and behaviors related to oral health. - [Recent Trends in Hospital Emergency Department (ED) Visits](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions), a visual report which looks at the rate, characteristics of patients, and overall costs of visits to hospital EDs for nontraumatic dental conditions. - [Many Older Adults Delayed Dental Care During the Pandemic](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic), a research brief which explores the repercussions of nearly 6 million older adults delaying dental care during the pandemic and potential solutions. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data](https://carequest.org/resource/oral-cancer-prevalence-mortality-and-costs-in-medicaid-and-commercial-insurance-claims-data/) **Published:** April 26, 2022 **Author:** Darren Edwards **Content:** A new journal article, co-authored by CareQuest Institute researchers, concludes that Medicaid enrollees experienced higher oral cancer and throat cancer incidence, prevalence, and mortality compared with commercially insured adults. The article is based on a study that compared all cases (prevalence) and new cases (incidence) of oral and throat cancers among approximately 38,000 Medicaid enrollees and approximately 27,000 individuals with commercial medical insurance. Researchers found that total cancer treatment costs were higher for those with commercial insurance and that cases of oral and throat cancers were lower among adults who had seen a dentist within the prior year. The authors observed that “individuals with infrequent dental visits are often diagnosed with oral cancer at later stages,” which significantly reduces the five-year survival rate. Older white males who used tobacco or alcohol or had HIV/AIDS were more likely to be at risk for oral and throat cancers. [Read the full article](https://aacrjournals.org/cebp/article/31/9/1849/708747/Oral-Cancer-Prevalence-Mortality-and-Costs-in) in the journal, *Cancer Epidemiology, Biomarkers & Prevention* (open access). **You may also be interested in:** - [A Primary Care Provider’s Role in Oral Cancer Screenings](https://www.carequest.org/resource-library/primary-care-providers-role-oral-cancer-screenings), a video featuring family medicine physician Mark Deutchman, MD, discussing the importance of screening patients for oral cancer. - [A Vaccine Can Prevent Throat Cancer](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer), a visual report that shares key facts about human papillomavirus (HPV), which causes 70% of throat cancers. - [Identifying the Utility of Dental Providers in Human Papillomavirus Prevention Efforts: Results from the National Health and Nutrition Examination Survey 2015–2018](https://www.carequest.org/resource-library/identifying-utility-dental-providers-human-papillomavirus-prevention), a journal article which highlights the importance of utilizing dental providers in HPV primary prevention efforts. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [Evaluating Trust in the Patient-Dentist Relationship: A Mixed-Method Study](https://carequest.org/resource/evaluating-trust-in-the-patient-dentist-relationship-a-mixed-method-study/) **Published:** May 2, 2022 **Author:** Darren Edwards **Content:** A new study from CareQuest Institute and the University of Colorado School of Dental Medicine, the first to use the Dental Trust Scale (DTS) in the United States, found that dental trust was significantly higher in patients who have a regular dentist and said they have excellent general health. Researchers administered the questionnaire to 150 white, Black, and Hispanic study participants and interviewed 7 dentists to understand both dentist and patient perspectives on trust in the patient-provider relationship. Additional findings include: - Communication is key to building trust between dentists and patients. - Prioritizing the “best interest of the patient,” listening to patient concerns, and understanding patients’ beliefs and cultures are critical to open communication and building trust between dentists and patients. - COVID-19 posed unique challenges for dentists to build and sustain relationships with patients. While this study was focused on the Denver Metro area and is not generalizable to the US population, it offers insights for dentists to build trust with patients. **[Read the article](https://journals.sagepub.com/eprint/PHA6VEF3YAZKTN8D4NE4/full)** in *JDR Clinical & Translational Research* **You may also be interested in:** - [Dental Fear and Anxiety: Why It Exists and What Providers Can Do to Help](https://www.carequest.org/education/webinars/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help), a free webinar on May 5 at 1 p.m. ET that will explore the science behind dental fear and potential solutions to prevent it in patients. - [Dental Fear is Real. Providers Can Help.,](https://www.carequest.org/resource-library/dental-fear-real-providers-can-help) a visual report that explores the impacts of dental fear and provides guidance for dental providers to help address fear in patients. - [Using Motivational Interviewing in Dentistry Video Series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), a series of videos that highlight skills and techniques dentists can use to engage with patients and build trust and collaboration. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [2022: Exploring Connections to Value-Based Care in Dental Education](https://carequest.org/resource/2022-exploring-connections-to-value-based-care-in-dental-education/) **Published:** May 17, 2022 **Author:** Darren Edwards **Content:** Although value-based care remains a new topic area for schools of dentistry, the opportunity to shift the mindset of new clinicians toward new approaches and embrace the future is promising. During a poster presentation, CareQuest Institute Value-Based Care Director Rebekah Mathews shared results from a study examining the results of a survey disseminated to clinical deans at dental schools evaluating current [value-based care approaches](https://www.carequest.org/topics/value-based-care) and designs. The study found that: - 65% of respondents acknowledged value-based care was not currently included in didactic curriculum. - Almost 25% of schools are considering value-based care within their dental clinics. - While VBC is not yet broadly adopted within dental schools, many acknowledge the opportunity to align with VBC concepts when considering patient care and student experience. **Attachments:** [National Oral Health Conference 2022 ](https://carequest.org/wp-content/uploads/2025/11/NOHC-2022-VBC-in-Dental-Education-poster_48x36_4.5.22.pdf "NOHC-2022 VBC in Dental Education poster_48x36_4.5.22.pdf")(474.46 KB) **Categories:** Presentation, Resource **Tags:** Value-Based Care --- ### [2022: Diabetes Treatment Costs Decrease after Periodontal Therapy: Medicaid and Commercial Claims Data](https://carequest.org/resource/2022-diabetes-treatment-costs-decrease-after-periodontal-therapy-medicaid-and-commercial-claims-data/) **Published:** May 17, 2022 **Author:** Darren Edwards **Content:** A healthy mouth is vital to a diabetes management program. During this poster presentation, CareQuest Institute Research and Analytics Manager Madhuli Thakkar-Samtani shared data from a recent study examining the relationship between periodontal treatment and diabetic medical costs in both commercial Medicaid claims data. Principal findings included: - Receiving periodontal therapy reduced overall health care costs for patients with diabetes in both Medicaid and commercial claims data. - Expanding programs that provide health care coverage to those with lower socioeconomic status, such as Medicaid and Medicare, to include comprehensive periodontal treatment has the potential to reduce overall health care costs for individuals with diabetes. **Attachments:** [National Oral Health Conference 2022 ](https://www.carequest.org/system/files/Samtani_NOHC-2022%20poster_48x36_3.31.22.pdf "Samtani_NOHC-2022 poster_48x36_3.31.22.pdf")(489.29 KB) **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [2022: Interpretation of Ambiguous Dental Scenarios by Severity of Dental Anxiety](https://carequest.org/resource/2022-interpretation-of-ambiguous-dental-scenarios-by-severity-of-dental-anxiety/) **Published:** May 17, 2022 **Author:** Darren Edwards **Content:** Dental anxiety poses a significant barrier to adequate oral health care for 5-15% of adults, explained CareQuest Institute Science Writer Lisa Heaton in a presentation on dental anxiety. Heaton provided results from a recent study analyzing how dentally anxious individuals compare to those with lower dental anxiety when interpreting ambiguous dental scenarios. The study concluded: - Dentally anxious respondents used words related to anxiety as a greater proportion of their overall words. Less anxious individuals more often describe concerns about the cost of treatment. - While dentally anxious individuals were more likely to use terms like “worried” and “scared,” less anxious individuals were more likely to use words like “cost” and “money.” **Attachments:** [National Oral Health Conference 2022 ](https://www.carequest.org/system/files/Heaton%20et%20al%202022%20NOHC%20poster_48x36_4.8.22REV.pdf "Heaton et al 2022 NOHC poster_48x36_4.8.22REV.pdf")(67.75 KB) **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [Dentist Perceptions about the Value of Teledentistry](https://carequest.org/resource/dentist-perceptions-about-the-value-of-teledentistry/) **Published:** May 17, 2022 **Author:** Darren Edwards **Content:** This article, by researchers at CareQuest Institute and the University of Colorado School of Dental Medicine, shows that nearly one-quarter of dentists surveyed are [using teledentistry ](https://www.carequest.org/topics/teledentistry)and 93% expect teledentistry to lead to a long-term change in how they practice. The [article shares results from a survey](https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-022-02208-z) of nearly 3,000 dentists and in-depth interviews with 10 dentists. This study is one of the few to look at dentists’ perspectives about using teledentistry. Other key findings from the survey: - Nearly one-quarter (23%) of dentists surveyed are using teledentistry. - 11% planned on [using teledentistry](https://www.carequest.org/topics/teledentistry) in the future. - Younger dentists and those who treat a higher percentage (> 50%) of Medicaid patients were more likely to use teledentistry. There were notable differences in perspectives between early and late adopters of teledentistry. Early adopters said teledentistry is a valuable tool to improve access to care and reduce chair time, allowing them to see more patients. Late adopters were concerned about quality of care and the ethics of charging patients for teledentistry. All early adopters were practicing in states with regulations and reimbursement policies that supported teledentistry, and the authors said that the sustainability of these measures will be pivotal for the growth of teledentistry. [Read the article in *BMC Oral Health*](https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-022-02208-z) (open access) **You may also be interested in:** - [Teledentistry Helps Provide the Right Care at the Right Time](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time), a research report that examines follow-up treatment and oral health outcomes for patients after a teledentistry visit. - [Teledentistry: Opportunities for Expanding the Capacity and Reach of the Oral Health Care System](https://www.carequest.org/resource-library/teledentistry-opportunities-expanding-capacity-and-reach-oral-health-ca-1), a report by the [Association of State and Territorial Dental Directors](https://www.astdd.org/) (ASTDD) and CareQuest Institute that provides a framework to identify opportunities and strategies to incorporate teledentistry into oral health delivery systems. - [Building a Teledentistry Program That Expands Access and Increases Equity](https://www.carequest.org/education/webinars/building-teledentistry-program-expands-access-and-increases-equity), a webinar that explores how to set up different types of teledentistry programs and shares common pitfalls to avoid. **Categories:** Journal Article, Resource **Tags:** Practice Management, Value-Based Care --- ### [2022: Oral Health Integration: Attitudes on Medical-Dental Collaboration](https://carequest.org/resource/2022-oral-health-integration-attitudes-on-medical-dental-collaboration/) **Published:** May 17, 2022 **Author:** Darren Edwards **Content:** [Medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) encourages providers to create comprehensive care plans for the whole person. CareQuest Institute Research Analyst Adrianna Sonnek further explained [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) through the lens of our State of Oral Health Equity in America survey. The nationally representative, probability-based survey of adult consumer attitudes, experiences, and behaviors on oral health sheds light on the inextricable link between oral health and overall health. Sonnek shared several results about the connections between oral health and overall health: - 96% of consumers acknowledged the connection between health of the mouth and the rest of the body. - 45% of responding oral health providers reported “rarely” integrating care with clinicians outside of dentistry. - More than 90% of oral health providers surveyed agree that dietary habits should be assessed in all patients. **Attachments:** [National Oral Health Conference 2022 ](https://carequest.org/wp-content/uploads/2025/11/SonnekNOHC.pptx "SonnekNOHC.pptx")(1.33 MB) **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [How Depression Is Linked to Oral Health](https://carequest.org/resource/how-depression-is-linked-to-oral-health/) **Published:** May 24, 2022 **Author:** Darren Edwards **Content:** ## Eight Findings on the Growing Link Between Mental Health and Oral Health [![View visual report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_How-Depression-is-Linked-to-Oral-Health-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_How-Depression-is-Linked-to-Oral-Health_5.23.22.pdf)View visual report A growing body of research, highlighted in this visual report, shows that our emotional state is connected to our oral health. For example, depression can be linked to poor oral hygiene, fewer dental visits, and other oral health problems. Key findings from CareQuest Institute and the scientific literature include: - Adults with depression report both brushing and flossing their teeth less often than those without depression. - Adults with [poor mental health](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) (including depression) are more likely to have one or more unmet oral health need and are less likely to seek care for these needs than those with better mental health. - Depression is linked to higher levels of dental caries (decay). - Scores on measures of depression are higher in individuals with a temporomandibular disorder (TMD)—that is, chronic pain in the face and jaw—compared to those without a TMD. **You may also be interested in:** - [Three Resources That Explore the Connection Between Oral Health and Mental Health](https://www.carequest.org/about/news/three-resources-explore-connection-between-oral-health-and-mental-health), a blog post that summarizes facts and findings about the links between oral and mental health. - [Association Between Mental Health and Oral Health Status and Care Utilization](https://www.carequest.org/resource-library/association-between-mental-health-and-oral-health-status-and-care-utilization), an article in *Frontiers in Oral Health* that presents findings from the first study to evaluate the relationship between oral health and mental health during the pandemic. - [Dental Fear is Real. Providers Can Help.](https://www.carequest.org/resource-library/dental-fear-real-providers-can-help), a visual report that explores the impacts of dental fear and provides guidance and resources for dental providers to help them address dental fear in patients. **Categories:** Resource, Visual Report **Tags:** Clinical Practice --- ### [Recent Trends in Hospital Emergency Department Visits for Non-Traumatic Dental Conditions](https://carequest.org/resource/recent-trends-in-hospital-emergency-department-visits-for-non-traumatic-dental-conditions/) **Published:** June 9, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_Recent-Trends-in-Hospital-ED-Visits_6.7.22-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Recent-Trends-in-Hospital-ED-Visits_6.7.22_FINAL.pdf)View visual report An updated visual report from CareQuest Institute finds that in 2019, there were 1.8 million hospital emergency department (ED) visits for non-traumatic dental conditions (NTDCs), which cost $3.4 billion to treat. Hospital ED visits for NTDCs can divert critical resources and create added stress for ED personnel. Moreover, most hospitals lack the ability to provide appropriate care for NTDCs, and the typical cost of such ED visits is much higher than a patient receiving care from a dental provider. In this publication, an update from a 2020 report, CareQuest Institute researchers found: - Since 2014, average annual charges associated with ED visits for NTDCs have increased by 62%, while the rate of ED visits for NTDCs has continued to decrease. - Patients most likely to visit the ED for an NTDC are 25-34 years old, uninsured or have Medicaid coverage, live in a rural area, or have an income below $48,000 per year. - Black individuals were 44% more likely to visit an ED for NTDCs compared with white individuals. These trends reflect changes and growing inequities in Americans’ access to dental care. **You may also be interested in:** - [A Systematic Review of Dental-Related Emergency Department Visits Among Medicaid Beneficiaries](https://www.carequest.org/resource-library/systematic-review-dental-related-emergency-department-visits-among-medicaid), an article in the *Journal of Public Health Dentistry* takes an in-depth look at the incidence of dental-related ED visits for Medicaid enrollees compared to those with other types of insurance. - [Americans Are Still Not Getting the Dental Care They Need](https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need), the first in a series of reports from our annual State of Oral Health Equity in America 2022 survey, this publication explores persistent inequities in the nation’s oral health. - [Webinar: How’s America’s Oral Health? Barriers to Care, Common Problems, and Ongoing Inequity](https://www.carequest.org/education/webinars/hows-americas-oral-health-barriers-care-common-problems-and-ongoing-inequity), a webinar recording that explores the State of Oral Health Equity in America 2022 survey with three researchers and a leading oral health advocate. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Undermining Racism: A Road to Promoting Equity in Oral Health](https://carequest.org/resource/undermining-racism-a-road-to-promoting-equity-in-oral-health/) **Published:** June 22, 2022 **Author:** Darren Edwards **Content:** A new article in the *Journal of Public Health Dentistry* (JPHD) explains how the Oral Health Progress and Equity Network (OPEN) approaches systemic and institutional racism to [address oral health inequities](https://www.carequest.org/topics/health-equity). The article is included in **JPHD**’s special issue about anti-racism in dental public health. Co-authors, Michael Monopoli, CareQuest Institute’s vice president for grant strategy, and Ifetayo B. Johnson, OPEN’s executive director, write, “Oral health serves as a central focus for the network, but it is the alignment between equity and social justice that ignites and binds the network’s work.” Through [our grantmaking strategy](https://www.carequest.org/how-we-work/grantmaking), CareQuest Institute has supported the development of [OPEN](https://openoralhealth.org/) as a systems change network. The authors write, “OPEN’s response to racism is to treat the word ‘network’ as a verb rather than a noun.” [Read the article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12511) in the *Journal of Public Health Dentistry* (open access) [Read JPHD’s special issue](https://onlinelibrary.wiley.com/toc/17527325/2022/82/S1), Anti-Racism in Dental Public Health: Engaging Science, Education, Policy, and Practice ****You may also be interested in:**** - [Webinar: How’s America’s Oral Health? Barriers to Care, Common Problems, and Ongoing Inequity,](https://www.carequest.org/education/webinars/hows-americas-oral-health-barriers-care-common-problems-and-ongoing-inequity) watch this recorded webinar that features OPEN Network Executive Director Ifetayo Johnson. - [Taking Action on Racism: An Inside Look at a Special Issue](https://www.carequest.org/about/news/taking-action-racism-inside-look-special-issue), in an interview about the JPHD issue on anti-racism, guest editors Eleanor Fleming, PhD, DDS, MPH, FICD, and Julie Reynolds, DDS, MS, discuss the origins of the publication and its action-oriented goals. - [Advancing Equity Through Oral Health Fund](https://www.carequest.org/how-we-work/grantmaking/advancing-equity-through-oral-health-fund), learn more about how CareQuest Institute drives oral health transformation and supports efforts to dismantle unjust structures through grantmaking. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Oral Health and the LGBTQ+ Community: A Snapshot of Disparities and Discrimination](https://carequest.org/resource/oral-health-and-the-lgbtq-community-a-snapshot-of-disparities-and-discrimination/) **Published:** June 28, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest_Institute_Oral-Health-and-the-LGBTQ-Community-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Oral-Health-and-the-LGBTQ-Community_0.pdf)View visual report CareQuest Institute examined the experiences of individuals identifying as LGBTQ+ regarding their oral health, access to dental care, and experiences with discrimination. Key findings from our nationally representative survey focused on oral health show that LGBTQ+ individuals, when compared to non-LGBTQ+ individuals, were: - 77% more likely to have visited a hospital emergency department for dental care within the past year. - 58% more likely to say it would be difficult to get care from a dentist if their mouth or teeth were causing pain or discomfort. - 45% more likely to say they felt self-conscious or embarrassed because of their teeth, mouth, or dentures. These results confirm that LGBTQ+ individuals encounter distinctive oral health challenges that need to be addressed. **You may also be interested in:** - [Webinar: Becoming an Ally ― Creating an Inclusive Environment for LGBTQ+ Patients](https://www.carequest.org/education/webinars/becoming-ally-creating-inclusive-environment-lgbtq-patients), register for this June 30 webinar to learn what oral health providers can do to create more inclusive care settings for patients of all genders and sexualities. - [State of Oral Health Equity in America 2022](https://www.carequest.org/content/state-oral-health-equity-america-2022), a page that includes all the latest research based on the largest nationally representative survey focused on knowledge, attitudes, experiences, and behaviors related to oral health in the US. - [Evaluating Trust in the Patient-Dentist Relationship](https://www.carequest.org/resource-library/evaluating-trust-patient-dentist-relationship-mixed-method-study), a journal article, co-authored by CareQuest Institute and the University of Colorado School of Dental Medicine, exploring the primary factors that build trust between dentists and their patients. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [The Glaring Scope of Racial Disparities in Oral Health](https://carequest.org/resource/the-glaring-scope-of-racial-disparities-in-oral-health/) **Published:** July 7, 2022 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_CareQuest_Institute_Glaring-Scope-of-Racial-Disparities-in-Oral-Health-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Glaring-Scope-of-Racial-Disparities-in-Oral-Health.pdf)Read brief CareQuest Institute surveys of both US consumers and health care providers reveal a stark reality that race and ethnicity are closely linked with the health of an individual’s mouth and their livelihood. A communication brief from CareQuest Institute shines a light on these disparities, summarizing key findings from our 2021 and 2022 [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2022) surveys and numerous other sources. The authors write, “With these and other data, the oral health community has the opportunity to leverage the heightened awareness of disparities to take action to eliminate them and advance health equity.” Key insights from the research include: - Nearly 1 in 6 Black adults (16%) reported having lost at least six teeth due to tooth decay or gum disease. This degree of tooth loss is much higher than the proportions among adults who are white (12%), Hispanic (9%), or Asian (3%). - Black (17%) and Hispanic (16%) adults were more likely than white adults (14%) to say they had felt “self-conscious or embarrassed because of \[their\] teeth, mouth, or dentures” either very often or fairly often over the past year. - Black (9%), Asian (5%), and Hispanic (4%) adults were more likely than white adults (2%) to believe they “did not get a job” because of their teeth, mouth, or dentures. - Black adults were at least 2.5 times more likely than white, Hispanic, or Asian adults to have visited a hospital emergency department for dental care. The brief also examines the economic and educational implications of these disparities, challenges for providers of color, and the importance of expanding oral health coverage through Medicaid and Medicare. The authors urge oral health professionals to “learn about and acknowledge the history of racism in the US while confronting misconceptions they might have about race.” **You may also be interested in:** - [Webinar: Taking Action to Advance Anti-Racism in Dental Public Health](https://www.carequest.org/education/webinars/taking-action-advance-anti-racism-dental-public-health), a recorded webinar featuring a distinguished panel of experts discussing what the dental community can do to find anti-racist solutions for its industry. - [Americans Are Still Not Getting the Dental Care They Need](https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need), the first in a series of reports summarizing key findings from our nationally representative survey in 2022 of nearly 6,000 adults about their oral health. - [Taking Action on Racism: An Inside Look at a Special Issue](https://www.carequest.org/about/news/taking-action-racism-inside-look-special-issue), an interview with Julie Reynolds, DDS, MS, and Eleanor Fleming, PhD, DDS, MPH, FICD, guest editors of a special *Journal of Public Health Dentistry*, examining anti-racist solutions in dental public health. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Association Between Mental Health and Oral Health Status and Care Utilization](https://carequest.org/resource/association-between-mental-health-and-oral-health-status-and-care-utilization/) **Published:** February 10, 2022 **Author:** Darren Edwards **Content:** A new study from CareQuest Institute is the first to evaluate the [relationship between oral health and mental health](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) during the COVID-19 pandemic. Based on a nationally representative survey of adults in the US, the study found that adults who reported poor mental health were: - More likely to be facing financial and emotional hardships - More likely to have had COVID-19 - Three times more likely to rate their oral health as poor - More likely to have one or more unmet oral health needs “Evidence suggests that individuals who have experienced a mental health disorder underutilize dental services,” write the authors. Potential reasons for underutilization include lack of income and health insurance, dental fear, shame, and low self-esteem. Models of care are needed to promote oral health utilization by individuals with [mental health problems](https://www.carequest.org/resource-library/how-depression-linked-oral-health). [Read the article](https://www.frontiersin.org/articles/10.3389/froh.2021.732882/full?utm_source=F-NTF&utm_medium=EMLX&utm_campaign=PRD_FEOPS_20170000_ARTICLE) in *Frontiers in Oral Health* **You may also be interested in:** - [Dental Fear is Real. Providers Can Help.](https://www.carequest.org/resource-library/dental-fear-real-providers-can-help), a visual report that explores the impacts of dental fear and provides guidance and resources for dental providers to help them address dental fear in patients. - [The Connection Between Oral Health and Mental Health](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health), a research brief that explores the link between poor mental health status, dental fear, and delayed dental care. - [State of Oral Health Equity in America 2021](https://www.carequest.org/state-of-oral-health-equity-america-2021), a nationally representative, annual survey of consumer and patient attitudes, experiences, and behaviors on oral health. **Categories:** Journal Article, Resource **Tags:** Medical-Dental Integration --- ### [Patient Portals: Patient Perspectives and Opportunities for Practices](https://carequest.org/resource/patient-portals-patient-perspectives-and-opportunities-for-practices/) **Published:** January 31, 2022 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_Patient-Portals-Patient-Perspectives-and-Opportunities-for-Practices-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Patient-Portals-Patient-Perspectives-and-Opportunities-for-Practices.pdf)View visual report How do dental patients feel about having secure online access to their oral health information through patient portals? Do they want the ability to share their dental information with their medical providers and potentially access education and appointment information? A new visual report from CareQuest Institute, based on a nationally representative survey, shows that patients have positive perceptions of patient portals. Key findings include: - 2 out of 3 adults are interested in receiving their dental records through a portal. - More than 4 out of 5 adults want their dental records shared with medical providers electronically. - Adults with insurance are more likely to be very satisfied (63%) with their medical portal experience compared to those without insurance (45%). - Satisfaction with medical portal experience does not change across residence location — approximately 6 in 10 adults in suburban, urban, and rural locations say they are very satisfied. These responses suggest that patients see value in this type of electronic communication and that portals can give dental providers new opportunities to engage with and educate patients. **You may also be interested in:** - [Taking a Community-Based Approach to Care Coordination](https://www.carequest.org/education/webinars/taking-community-based-approach-care-coordination), a webinar about oral health care coordination featuring the work of Children Now and their Medical Dental Referral and Navigation (MDRAN) system, which facilitates and tracks dental referrals to improve dental care for children in California. - [Improving Care Coordination Between Oral and Medical Providers](https://www.carequest.org/resource-library/improving-care-coordination-between-oral-and-medical-providers), a video that explains why care coordination between dentistry and other health disciplines is essential and how it can lead to delivering the best care possible to patients. - [Dental Data Exchange Implementation Guides](https://www.carequest.org/resource-library/dental-data-exchange-hl7-implementation-guides), two publications designed to facilitate care coordination and create best practices for electronic exchange of patient data between dental and medical professionals. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Dental Safety Net Providers’ Experiences with COVID-19 Should Inform Dental Pandemic Preparedness](https://carequest.org/resource/dental-safety-net-providers-experiences-with-covid-19-should-inform-dental-pandemic-preparedness/) **Published:** February 10, 2022 **Author:** Darren Edwards **Content:** Researchers from CareQuest Institute contributed to this study about dental safety net providers’ self-described experiences delivering care in the early stages of the pandemic. Uncertainty about the COVID-19 virus caused a significant decline in dental service delivery and illuminated the need to bolster public health emergency preparedness and response (PHEPR) in dentistry. Federally Qualified Health Centers (FQHCs) are important sites for studying PHEPR because they serve more than 5 million patients who have experienced a greater proportion of COVID-19 infections and unmet dental needs due to pandemic-driven delays in care. Common themes and lessons learned among dental safety net providers in the first year of the COVID-19 pandemic include: - Unpredictability of the virus caused concern, but it also deepened collaboration to help providers through a challenging time. - Service delivery prioritized safety, flexibility, and respect for patient and provider autonomy. - Stronger infection control and telehealth are pandemic-driven changes that will likely be long-lasting. [Read the article](https://www.sciencedirect.com/science/article/pii/S0002817721007108) in the *Journal of the American Dental Association* Learn more about the unique experiences of FQHCs during the COVID-19 pandemic in a companion essay [“Dental Safety Net Providers’ Perspectives on Adapting Service Delivery During the Onset of the COVID-19 Pandemic.”](https://pages.ada.org/en/covidmonograph/dental-safety-net-providers-perspectives-on-adapting-service-delivery-during-the-onset-of-the-covid-19-pandemic-dr.-sarah-e.-raskin-and-colleagues) Co-authored by CareQuest Institute, the essay is part of a monograph on the JADA+ website documenting COVID-19’s impact on dentistry. The authors share quotations from in-depth interviews to tell the story in providers’ own words about how they adapted to the crisis. **You may also be interested in:** - [COVID-19 & Oral Health](https://www.carequest.org/topics/covid-19-and-oral-health), this web page provides an overview and resources about how the oral health industry responded to the pandemic. - [Voices from the Field: Dr. Matthew Horan on Distributing Vaccines and Medical-Dental Integration](https://www.carequest.org/about/news/voices-field-dr-matthew-horan-distributing-vaccines-and-medical-dental-integration), in this interview, Dr. Horan, executive director of dental services at an FQHC, shares his perspective on how the COVID-19 pandemic has changed dentistry and what’s next for the industry. - [A Coming Surge in Oral Health Treatment Needs](https://www.carequest.org/system/files/CareQuest-Institute-Coming-Surge-Oral-Health-Treatment-Needs-Report-1.pdf), a research report investigating several pandemic-related developments that have the potential to create a spike in oral disease among adults. **Categories:** Journal Article, Resource **Tags:** Practice Management --- ### [Teledentistry Helps Provide the Right Care at the Right Time](https://carequest.org/resource/teledentistry-helps-provide-the-right-care-at-the-right-time/) **Published:** February 14, 2022 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_Teledentistry-Helps-Provide-the-Right-Care-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Teledentistry-Helps-Provide-the-Right-Care.pdf)Read report Early in the COVID-19 pandemic, [dental providers turned to teledentistry](https://www.carequest.org/topics/teledentistry) to triage and communicate with patients. While teledentistry was thought to improve access and reduce costs, research on it was limited — especially on the types of follow-up treatments provided after a teledentistry visit. To address this gap, CareQuest Institute researchers examined data on oral health outcomes for patients after a teledentistry visit at oral health centers in Oregon and Washington. Key findings include: - 6 out of 10 individuals who had a teledentistry visit subsequently had a problem-focused evaluation at their next in-person visit. - Teledentistry visits were, on average, less expensive ($99 per visit) than in-person visits ($114 per visit). - Teledentistry was more often used by individuals living in rural areas (13%) compared to those living in suburban (10%) or urban (6%) locations. Beyond the pandemic, teledentistry holds great promise to increase access to care. Providers can use the modality to enable comprehensive, risk-based, and integrated care that improves quality at a lower cost. **You may also be interested in:** - [Oral Health Professionals Are Ready to Accept Teledentistry](https://www.carequest.org/resource-library/oral-health-professionals-are-ready-accept-teledentistry), a report featuring survey results which show that providers are open to teledentistry, and that it can play a crucial role in increasing access to care and improving quality of care. - [Teledentistry: Opportunities for Expanding the Capacity and Reach of the Oral Health Care System](https://www.carequest.org/resource-library/teledentistry-opportunities-expanding-capacity-and-reach-oral-health-ca-1), a report by the [Association of State and Territorial Dental Directors](https://www.astdd.org/) (ASTDD) and CareQuest Institute that provides a framework to identify opportunities and strategies to incorporate teledentistry into oral health delivery systems. - [Why Teledentistry Isn’t a Fad](https://www.carequest.org/about/news/voices-field-dr-scott-howell-why-teledentistry-isnt-fad), a blog post featuring Scott Howell, DMD, MPH, that provides advice for organizations getting started on a teledentistry program. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Spotlight on Arizona: Adult Use of Emergency Departments for Non-Traumatic Dental Conditions](https://carequest.org/resource/spotlight-on-arizona-adult-use-of-emergency-departments-for-non-traumatic-dental-conditions/) **Published:** October 1, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2021/10/CareQuest_Institute_Spotlight-On-Arizona-Adult-Use-of-Emergency-Departments-for-Non-Traum-Thumbnail-231x300.png)](https://carequest.org/wp-content/uploads/2021/10/CareQuest_Institute_Spotlight-On-Arizona-Adult-Use-of-Emergency-Departments-for-Non-Traumatic-Dental-Conditions.pdf)View visual report When people lack access to regular dental care, they often resort to visiting hospital emergency departments (EDs) for care — visits that are often costly and fail to address the underlying condition. This ineffective and inefficient system is not new, but the COVID-19 pandemic has highlighted and exacerbated it. At a time when ED capacity is strained, reducing preventable dental visits in these settings is of vital importance. This visual report from CareQuest Institute for Oral Health, based on data from the Healthcare Cost and Utilization Project (HCUP), focuses on ED visits for non-traumatic dental conditions (NTDC) in Arizona. Key findings include: - In Arizona, adults ages 25 – 34 have the highest rate of ED use for NTDC, with about 95 visits per 10,000 people. - Black residents in Arizona have the highest rate of ED use for NTDC, nearly three times higher than the rate for white residents and for Hispanic residents. - Adults enrolled in Medicaid (61.4%) or who were uninsured (15.7%) made nearly 8 in 10 ED visits for NTDCs among patients ages 21 – 64. The visual report also touches on promising solutions to expand access to care. **You may also be interested in:** - [Financial Impact of Emergency Department Visits for Dental Conditions in Maryland: An Update](https://www.carequest.org/resource-library/financial-impact-emergency-department-visits-dental-conditions-maryland-update), a report that underscores why expanding dental benefits to Medicaid participants is an opportunity to reduce ED visits for non-traumatic dental conditions. - [Recent Trends in Hospital Emergency Department Visits](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits), an infographic that shows patients who visit hospital EDs for non-traumatic dental conditions can divert critical resources and create added stress for ED personnel. - [Emergency and Urgent Dental Visits Among Medicaid Enrollees from 2013 to 2017](https://www.carequest.org/resource-library/emergency-and-urgent-dental-visits-among-medicaid-enrollees-2013-2017-0), a report to better understand the frequency of dental emergencies and the procedures performed during those emergency visits. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [More Than Meets the Eye: Oral Health, Eye Health, and Overall Health](https://carequest.org/resource/more-than-meets-the-eye-oral-health-eye-health-and-overall-health/) **Published:** October 1, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_More-than-Meets-the-Eye-Oral-Health-Eye-Health-and-Overall-Health-thumbnail-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_More-than-Meets-the-Eye-Oral-Health-Eye-Health-and-Overall-Health.pdf)View visual report An estimated 12 million Americans over age 40 live with some type of visual impairment, a number that is projected to increase as the population ages. And that number, many of those patients, will deal with health issues beyond the eye. To start, visual impairments have been linked with diminished oral health. Systemic causes of visual impairment, such as diabetes and heart disease, are also associated with poor oral health outcomes in addition to compromising overall health. Knowledge of these links is key for clinicians to diagnose, educate, and treat high-risk individuals. This visual report from CareQuest Institute for Oral Health reviews the links between oral health, eye health, and overall health. Key points include: - Periodontal disease is associated with increased risk of developing glaucoma. - Patients with diabetes have a significantly increased risk of developing glaucoma. - Disabled and aging populations are more predisposed to oral issues and ocular diseases. The visual report also includes recommendations for clinicians and policymakers to meet this growing public health need. **You may also be interested in:** - [Dental Data Exchange: HL7® Implementation Guides](https://www.carequest.org/resource-library/dental-data-exchange-hl7r-implementation-guides), a publication that is designed to facilitate care coordination and create best practices for electronic exchange of patient data between dental and medical professionals. - [Impacts Beyond the Mouth](https://www.carequest.org/resource-library/impacts-beyond-mouth), an infographic that highlights several examples of why oral health is about much more than a smile. - [The Wicked Problem of the Oral Health Care System](https://www.carequest.org/resource-library/wicked-problem-oral-health-care-system), a special edition of the *Journal of Public Health Dentistry* that outlines how Health IT systems need to be interoperable and coordinated to allow sharing of health records across all disciplines and providers to coordinate care. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [MORE Care: An Evaluation of an Interprofessional Oral Health Quality Improvement Initiative](https://carequest.org/resource/more-care-an-evaluation-of-an-interprofessional-oral-health-quality-improvement-initiative/) **Published:** October 6, 2021 **Author:** Darren Edwards **Content:** The Medical Oral Expanded Care (MORE Care) initiative focused on integration oral health into primary care practices in four states (South Carolina, Pennsylvania, Colorado, and Oregon). This paper describes the initiative’s collaborative methodology and assesses its outcomes. Key findings drawn from the work that started in 2015 and ended in 2020: - The percentage of pediatric patients receiving fluoride varnish increased from 25% to 40%. - The percentage of pediatric patients with self-management goals reviewed increased from 25% to 62%. - The percentage of pediatric patients with oral health risk assessments completed increased from 47% to 77%. This analysis, published in the *Journal of Public Health Dentistry*, demonstrated that MORE Care is effective in creating a structure for integrating oral health care into primary care practices. [View the article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12407) **You may also be interested in:** - [Medical Oral Expanded Care (MORE Care)](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that explores how and why community health centers are often well-positioned to adopt value-based care. **Categories:** Journal Article, Resource **Tags:** Medical-Dental Integration --- ### [Understanding Value in Oral Health: The Oral Health Value-Based Care Symposium](https://carequest.org/resource/understanding-value-in-oral-health-the-oral-health-value-based-care-symposium/) **Published:** October 6, 2021 **Author:** Darren Edwards **Content:** The implementation of value-based care in oral health brings both opportunities and challenges. This article describes a symposium, convened in December 2019, at which subject matter experts discussed this topic. The article describes the symposium process and methodology and summarizes themes that emerged. Key points include: - Attendees of the symposium predicted that value-based would claim a large portion of market share in oral health care within the next 10 years. - While participants had broad agreement about the current state and future ideal state, there was less consensus on the specific actions needed to close the gap between the two. - In a post-symposium survey, attendees did not believe that the COVID-19 pandemic would delay or negatively affect the adoption of value-based care and expected that it could instead accelerate its adoption. In sum, the oral health community has momentum to move toward value-based care, but more research and analysis are necessary to determine how to execute this delivery model. **[View the Article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12402)** **You may also be interested in:** - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that explores how and why community health centers are often well-positioned to adopt value-based care. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. **Categories:** Journal Article, Resource **Tags:** Value-Based Care --- ### [The Wicked Problem of the Oral Health Care System: An Introduction](https://carequest.org/resource/the-wicked-problem-of-the-oral-health-care-system-an-introduction/) **Published:** October 6, 2021 **Author:** Darren Edwards **Content:** A “wicked problem” is one that has complex causes, is interconnected with other problems, and is difficult to describe. There is not one solution to the problem; instead, there are multiple approaches that collectively can foster change in a positive direction. The oral health system fits this description. Addressing the wicked problem of the oral health system requires rethinking the entire system while acknowledging that the problem is complex, heterogeneous, and influenced by multiple factors. This editorial, an introduction to a special issue of the *Journal of Public Health Dentistry*, explains why the oral health system is a wicked problem and explores opportunities for addressing different aspects of it. The editorial identifies three major areas for transformation: - Care transformation - Data and analytic transformation - Payment transformation that includes alternative payment models The article also mentions several more specific initiatives underway to facilitate these transformations. [**View the article**](https://onlinelibrary.wiley.com/doi/full/10.1111/jphd.12424) **You may also be interested in:** - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that explores how and why community health centers are often well-positioned to adopt value-based care. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/learn/online-learning-center/resource-library/three-domain-framework), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Exploring the Wicked Problem of the Oral Health Care System](https://www.carequest.org/resource-library/wicked-problem-oral-health-care-system), the first in a series of webinar recordings that shares perspectives on and poses potential solutions to the wicked problem of the oral health system. **Categories:** Journal Article, Resource **Tags:** Value-Based Care --- ### [Time Is on the Side of Change in Dentistry](https://carequest.org/resource/time-is-on-the-side-of-change-in-dentistry/) **Published:** October 6, 2021 **Author:** Darren Edwards **Content:** The COVID-19 pandemic has exposed the inadequacies of the current dental operating model. In the wake of the pandemic, the field of dentistry faces an imperative to reconfigure the organization, financing, and delivery of oral health care. This paper in the *Journal of Public Health Dentistry* provides an overview of a new model, the Three Domain Framework, which uses emerging technology and transformative care methodology to facilitate care delivery and improve outcomes. - *Domain One* builds an accessible, convenient, evidence-based virtual framework for oral health care centered on disease prevention and whole-person health. - *Domain Two* focuses on minimally invasive care that reverses or slows early disease stages using a program of collaborative decision-making with patients. - *Domain Three* introduces personalized oral health care based on risk stratification, medical-dental integration, and safe surgical intervention. The paper describes each of these domains in detail and explains how we can create an environment that will sustain this approach. **[View the article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12418)** **You may also be interested in:** - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical Oral Expanded Care (MORE Care)](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. **Categories:** Journal Article, Resource **Tags:** Medical-Dental Integration, Value-Based Care --- ### [Achieving Health Equity Through Oral Health Value-Based Care: A Funder’s Perspective](https://carequest.org/resource/achieving-health-equity-through-oral-health-value-based-care-a-funders-perspective/) **Published:** October 6, 2021 **Author:** Darren Edwards **Content:** There are significant racial disparities in oral health outcomes, mirroring overall health disparities. Funders and grantmakers have the opportunity to support systemic redesign of the oral health system in a way that contributes to reducing these disparities. This article describes grantmaking efforts of CareQuest Institute for Oral Health (which formerly funded grants as the DentaQuest Partnership for Oral Health Advancement). Through its 2020 request for proposals process, CareQuest Institute invested more than $3.5 million across 27 states to support deep community partnerships, policy and regulatory change, and transformation within the dental safety net. Investments include: - Emerging, innovative, and not-yet-tested models of care - Convening diverse, multidisciplinary partners - Supporting new voices, especially those in communities of color or that have been historically excluded The article also describes some of the specific partnerships that CareQuest Institute forged and the initiatives grantees implemented. **[View the article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12411)** **You may also be interested in:** - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefit-toolkit-advocates), a toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits but expand them as well. - [Equity and Community Engagement in Statewide Oral Health Policy Advocacy](https://www.carequest.org/resource-library/equity-and-community-engagement-statewide-oral-health-policy-advocacy), a report provides a roadmap — including key data and recommendations — that will help build partnerships that promote sustainable, equity-informed, community-driven advocacy. - CareQuest Institute’s [grant application process](https://www.carequest.org/how-we-work/grantmaking/apply). **Categories:** Journal Article, Resource **Tags:** Health Equity, Medical-Dental Integration --- ### [A Cross-Sectional Analysis of Oral Health Care Spending over the Life Span in Commercial- and Medicaid-Insured Populations](https://carequest.org/resource/a-cross-sectional-analysis-of-oral-health-care-spending-over-the-life-span-in-commercial-and-medicaid-insured-populations/) **Published:** November 11, 2021 **Author:** Darren Edwards **Content:** ![](https://carequest.org/wp-content/uploads/2021/11/Feb2022JADACoverLifeSpan-224x300.png)An article from CareQuest Institute researchers in the *Journal of the American Dental Association* features one of the most comprehensive life course analyses of spending on oral health care. Using data from more than 31 million Medicaid claims and more than 45 million commercial or Medicare supplemental claims, the analysis shows the complexities of the current dental service environment and a lack of equitable access to oral health care. The findings demonstrate the importance of understanding and addressing the factors that impact oral health status at every stage of life and the impact of oral health status on overall health, mental health, and life trajectory. Key findings include: - Oral health care use rate and spending are lower during the first four years of life and in young adulthood than in other periods of life. - Stark differences in timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. - Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. “Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the life span,” the authors write in the conclusion, “as opposed to policy development that is precipitated by short-term political and financial dynamics.” **[View the article](https://jada.ada.org/article/S0002-8177(21)00486-4/fulltext)** You may also be interested in: - [Determinants of Tooth Loss in a Medicaid Adult Population](https://www.carequest.org/resource-library/determinants-tooth-loss-medicaid-adult-population), an article that examines the determinants of tooth loss in a Medicaid-enrolled population using claims data from 2016-2018. - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways), a visual report that shows how cuts could harm job growth and increase costs. - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefit-toolkit-advocates), a toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits but strengthen them as well. **Categories:** Journal Article, Resource **Tags:** Dental Coverage --- ### [Why We (Still) Need to Add Dental to Medicare](https://carequest.org/resource/why-we-still-need-to-add-dental-to-medicare/) **Published:** November 15, 2021 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Why-We-Still-Need-to-Add-Dental-to-Medicare-239x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Why-We-Still-Need-to-Add-Dental-to-Medicare.pdf)Read brief ***Note:*** *Soon before this communication brief was published, Congressional negotiators announced that their social spending proposal was being trimmed to allow hearing coverage in Medicare but not dental or vision benefits. Whatever direction this debate takes, oral health leaders and advocates for older adults can make a difference by talking with their elected officials and underscoring why oral health coverage is so crucial.* For older adults, the need for dental care is particularly acute, because aging increases the risks for oral health problems. Yet standard Medicare does not include routine dental coverage. A communications brief from CareQuest Institute synthesizes results from several surveys and studies to reveal the extent of this ongoing problem. Key points include: - 1 in 4 adults aged 65 and older (25%) said they had not received dental care in more than two years, well before the COVID-19 pandemic began. - Older adults were two-and-a-half times more likely to cite the cost of care than COVID-19 as the primary reason why they did not receive oral health services during the past two years. - During the last year, 7 in 10 Black Medicare participants and 6 in 10 Hispanic enrollees did not see a dental provider. Roughly 1 in 5 rural seniors have not seen a dentist in over five years. The brief also explores the impact of this lack of access and a possible pathway forward. You may also be interested in: - [The Push to Add Dental Coverage to Medicare](https://www.carequest.org/resource-library/push-add-dental-coverage-medicare), a report based on a nationally representative survey of 5,320 adults showing a strong consensus that a dental benefit should be added to all Medicare plans. - [The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled), a report that compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. - [Dental Insurance Is Out of Reach for Many](https://www.carequest.org/resource-library/dental-insurance-out-reach-many), a visual report that reveals that millions of Americans lost their insurance during the COVID-19 pandemic, and that access to care is distributed unequally among races and income groups. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Veteran Oral Health: Expanding Access and Equity](https://carequest.org/resource/veteran-oral-health-expanding-access-and-equity/) **Published:** December 13, 2021 **Author:** Darren Edwards **Content:** ## Inequity in Veteran Dental Care [![Read white paper](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Veteran-Oral-Health-cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Veteran-Oral-Health.pdf)Read white paper Roughly 19 million veterans live in the US, comprising about 6% of the total population. Those veterans are more likely to experience worse oral health outcomes — higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care — compared to nonveterans. A forward-thinking white paper from CareQuest Institute and the [American Institute of Dental Public Health (AIDPH)](https://aidph.org/veteran-oral-health/) aims to shine a light on the social, structural, and individual drivers of these outcomes. The paper is a result of convening many stakeholders across veteran organizations and oral health to review gaps in access for veterans and explore ways to address them. An evaluation of the landscape found: - 42% of veterans reported having had gum treatment or bone loss around their teeth, which is a significantly higher proportion than reported by nonveterans (27%). - Roughly 2 in 5 veterans described their oral health as fair or poor. This extrapolates to 8 million veterans with deficient oral health. - Nearly 24% of veterans live in rural areas, where consistent access to care can be challenging. The paper identifies several strategic recommendations to improve access to and quality of care, including: - Expanding eligibility criteria for veterans to receive oral health services - Expanding the role of Federally Qualified Health Centers and rural health clinics - Advancing medical-dental integration in veteran health care You may also be interested in: - [Oral Health Is Essential to Veteran Productivity and Well-Being](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being), a report that finds nearly 600,000 veterans experienced work productivity loss in the past year due to oral health problems and examines the impact on veterans and their employers. - [Veteran Dental Care Stimulates the Economy and Improves Overall Health](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health), a visual report that examines the economic and health implications of improving access to dental care for veterans. - [Advancing Equity Through Oral Health Fund](https://www.carequest.org/how-we-work/grantmaking/advancing-equity-through-oral-health-fund), an overview of CareQuest Institute’s grantmaking portfolio that aligns with strategies to equitably advance systems change at the local, state, and national level. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Dental Fear Is Real. Providers Can Help.](https://carequest.org/resource/dental-fear-is-real-providers-can-help/) **Published:** December 6, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Dental-Fear-Is-Real-Thumbnail-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Dental-Fear-Is-Real-Providers-Can-Help.pdf)View visual report Many people feel so anxious about visiting the dentist that it interferes with receiving care — a reality that can have significant health implications. This visual report from CareQuest Institute, based on results from a 2021 survey of 5,320 adults, explores the impacts of dental fear and how it varies by demographic groups. Key findings include: - Hispanic adults were more than two times more likely to report dental fear compared with white adults. Black and Asian adults were also more likely to report dental fear than white adults. - 60% of adults who reported experiencing dental fear at their last dental appointment were female. - Nearly 3% of adults reported that at their last dental appointment, they were “so frightened and nervous” that it either made the dental treatment difficult or the treatment didn’t succeed. The report also provides guidance and resources for dental providers to help them address dental fear in patients, highlighting practices such as building trust through good communication and providing clear information about procedures. **You may also be interested in:** - [Survey Suggests Optimism on Teledentistry Experience & Access](https://www.carequest.org/resource-library/new-survey-suggests-optimism-about-teledentistry-experience-and-access), a report explaining that patients who had experiences with teledentistry had positive feedback, and that many who had never had a virtual visit were willing to try it. - [A Dental Provider’s Role in Supporting Patients with Diabetes](https://www.carequest.org/resource-library/dental-providers-role-supporting-patients-diabetes), a video that explains how dental providers can play a key role in diabetes management. - [A Patient Guide to Visiting the Dentist](https://www.carequest.org/resource-library/patient-guide-visiting-dentist), an infographic that dentists can use to prepare patients for the steps they and their dentist may take before, during, and after a dental appointment in the era of COVID-19. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [2021: Oral Health Information Technology Virtual Convening](https://carequest.org/resource/2021-oral-health-information-technology-virtual-convening/) **Published:** December 7, 2021 **Author:** Darren Edwards **Content:** State-Based Strategies for Dental Data Exchange and Care Coordination Care coordination is essential to providing patients with the best possible care — the right care, at the right time, in the right place. Ensuring that all providers caring for a given patient have access to the same information and can communicate seamlessly with one another is vital to transforming the health system. Health information exchange can reduce costs and improve care by eliminating inefficacies, connecting providers, and increasing transparency by bridging gaps in existing health systems. In this interactive session, panelists discussed activities, goals, and strategies aimed at incorporating dental health information into state health information technology roadmaps, health information exchanges (HIEs), and quality measurement. The objective of the session was to provide information on the WHY and HOW from the perspective of state-level entities. Watch the recording of this session if you are interested in innovative solutions and best practices to move coordinated care forward in your state. **Categories:** Presentation, Resource **Tags:** Medical-Dental Integration --- ### [Improving Care Coordination Between Oral and Medical Providers](https://carequest.org/resource/improving-care-coordination-between-oral-and-medical-providers/) **Published:** December 14, 2021 **Author:** Darren Edwards **Content:** Care coordination between dentistry and other health disciplines is essential to making sure that providers get the right information at the right time to deliver the best care possible to patients. But getting that coordination right is complex and challenging. It involves communication and information exchange by providers, payors, patients, and systems to help guide the delivery of safe. What’s more, dentistry is still fairly new to electronic health records and is playing catch up and integrate into the medical system. At CareQuest Institute for Oral Health, our [Care Coordination and Interoperability](https://www.carequest.org/topics/care-coordination-and-interoperability) initiatives are actively working with health information technology tools and experts to improve the way we collect, share, and use health data. Our goal is for providers to have a clear picture of a patient’s health so they can make the right clinical decisions in collaboration with the patient in the chair. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [Identifying the Utility of Dental Providers in Human Papillomavirus Prevention Efforts: Results from the National Health and Nutrition Examination Survey 2015–2018](https://carequest.org/resource/identifying-the-utility-of-dental-providers-in-human-papillomavirus-prevention-efforts-results-from-the-national-health-and-nutrition-examination-survey-2015-2018/) **Published:** December 15, 2021 **Author:** Darren Edwards **Content:** Human papillomavirus (HPV) is a common infection that causes all cervical cancers and 70% of oropharyngeal cancers. HPV vaccines are available and effective — they have the potential to prevent 90% of HPV-related cancers. However, only half of adolescents ages 13–17 are vaccinated. The primary aim of this study was to determine the prevalence of HPV unvaccinated adolescents and young adults who had a dental visit, including those who did not have a medical visit. The findings highlight the importance of utilizing dental providers in HPV primary prevention efforts, including counseling, primary care referral, and vaccine administration. **Key findings include:** - Having a dental visit in the last year increased the odds of being vaccinated for HPV. - Dentists see a significant number of adolescents and young adults who are unvaccinated for HPV and could serve as an access point for HPV vaccine delivery. - The authors estimate that more than 3.6 million adolescents and young adults who do not see a medical provider could potentially access the HPV vaccine from their dentist. [**Read the article abstract**](https://www.jahonline.org/article/S1054-139X(21)00556-5/fulltext#secsectitle0010) (subscription required to access full text) **You may also be interested in:** [Dental Providers Offer a Key Access Point for COVID-19 Booster Shots](https://www.carequest.org/resource-library/dental-providers-offer-key-access-point-covid-19-booster-shots), a research brief drawn from a survey of almost 400 dentists that highlights the role dentists can play in administering COVID-19 vaccines and boosters. [Mouths Matter More Than You Know](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know-0), a research brief about the link between oral health and overall health, outlining how tooth decay, gum disease, and more can have an impact on diabetes, respiratory health, and blood pressure. [System Transformation: A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a framework to create a new model in dentistry that is accessible, equitable, and integrated. **Categories:** Journal Article, Resource **Tags:** Medical-Dental Integration --- ### [Teledentistry: Opportunities for Expanding the Capacity and Reach of the Oral Health Care System](https://carequest.org/resource/teledentistry-opportunities-for-expanding-the-capacity-and-reach-of-the-oral-health-care-system/) **Published:** December 15, 2021 **Author:** Darren Edwards **Content:** Teledentistry is a tool that has been used for several decades with the potential to transform oral health care delivery. It can improve oral health by helping to reduce barriers that have kept people from accessing oral health care, such as cost, time, distance, and availability of providers. A [new Best Practice Approach Report](https://www.astdd.org/bestpractices/teledentistry-bpar-2021-final.pdf?utm_source=carequest&utm_medium=report_page&utm_campaign=astdd_best_practices_teledentistry), a collaboration between the [Association of State and Territorial Dental Directors](https://www.astdd.org/) (ASTDD) and CareQuest Institute, provides a framework for states and territories to identify opportunities and strategies to incorporate teledentistry into their oral health delivery systems. The report addresses four key issues for a pathway to expanding teledentistry: 1. Increase awareness 2. Support policies that allow teledentistry to be used to its fullest potential 3. Develop reimbursement policies for services provided with teledentistry that are on par with in-person payment policies 4. Ensure training and technical support is available to those who want to use teledentistry [View the report](https://www.astdd.org/bestpractices/teledentistry-bpar-2021-final.pdf). **You may also be interested in:** - [Teledentistry](https://www.carequest.org/topics/teledentistry), this web page provides an overview and resources about the utilization and benefits of teledentistry. - [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money), a report that explores dental service utilization patterns and rate of return following teledentistry visits. **Categories:** Journal Article, Resource **Tags:** Practice Management --- ### [Health Equity Needs Teeth](https://carequest.org/resource/health-equity-needs-teeth/) **Published:** January 5, 2022 **Author:** Darren Edwards **Content:** People who are poor or members of communities of color face inequitable oral disease burden. And continued separation of dental care from medical care exacerbates these inequities, creating difficult choices involving pain, payment options, and inadequate care in emergency departments. A new [peer-reviewed article](https://journalofethics.ama-assn.org/article/health-equity-needs-teeth/2022-01) in the *AMA Journal of Ethics*, part of an issue about inequity along the medical/dental divide, highlights how value-based approaches to health care can improve outcomes for everyone. “Clinicians, payers, communities, policymakers, employers, and other decision makers must collectively decide to promote justice,” write the authors. “An integrated system of medicine and oral health care must bring attention to disparities and build policy, practice, and research solutions to support equity.” **The authors share a vision for a reimagined, more equitable health care system that:** - integrates medical and dental services - focuses on prevention rather than disease management - reimburses providers based on quality of care and patient outcomes - invests in training a more diverse health care workforce Read the full [article](https://journalofethics.ama-assn.org/article/health-equity-needs-teeth/2022-01). Listen to the [*AMA Ethics Talk* podcast interview](https://journalofethics.ama-assn.org/podcast/author-interview-health-equity-needs-teeth) with co-author Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. **You may also be interested in:** - [Veteran Oral Health: Expanding Access and Equity](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), a white paper that explores gaps in oral health care access for veterans and ways to address them. - [Oral Disease Is Common. Access to Care Is Not.](https://www.carequest.org/resource-library/oral-disease-common-access-care-not), a visual report, based on a survey of 5,320 adults, that illustrates how oral health care is inequitably distributed among Americans. - [Equity and Community Engagement in Statewide Oral Health Advocacy](https://www.carequest.org/resource-library/equity-and-community-engagement-statewide-oral-health-policy-advocacy), a research report that provides a roadmap — including key data and recommendations — to help build partnerships that promote sustainable, equity-informed, community-driven advocacy. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children](https://carequest.org/resource/age-of-first-oral-health-examination-and-dental-treatment-needs-of-medicaid-enrolled-children/) **Published:** January 10, 2022 **Author:** Darren Edwards **Content:** CareQuest Institute researchers contributed to this article — published in the December 2021 issue of *JDR Clinical & Translational Research* — that underscores the importance of a child’s first dental visit before their first birthday to prevent early childhood caries, the most prevalent disease of childhood. “Primary care providers have an important role in preventing dental caries in children through oral health examination and referrals to dentists and pediatric dentists,” write the authors. “Grouping initial oral health examinations with well-child visits can serve as a pipeline to oral health care.” **Key takeaways from the article, which is based on a study of 2.41 million Medicaid-enrolled children, include:** - The American Dental Association, American Academy of Pediatrics, and American Academy of Pediatric Dentistry all recommend that children have their first oral health examination by no later than 12 months of age. - On average, most children had their first oral health exam at age 3. - Children who had their first oral health exam at age 3 or 4 had a higher probability of requiring more extensive dental treatment. - More training is needed in dental schools to equip general dentists to treat young children. Read the [article](https://journals.sagepub.com/doi/10.1177/23800844211057793). (subscription required to access full text) **You may also be interested in:** - [Pediatric Primary Care and Oral Health](https://www.carequest.org/resource-library/pediatric-primary-care-and-oral-health), a research brief that evaluates oral health services provided in medical well-child visits and the need for greater integration of oral health in primary care to prevent dental disease. - [Association Between First Oral Examination Characteristics and Dental Treatment Needs in Privately Insured Children](https://www.carequest.org/resource-library/association-between-first-oral-examination-characteristics-and-dental-treatment), an article in *The Journal of the American Dental Association* explaining that the high proportion of children requiring restorative treatment and late age at first dental screening indicate a need to educate providers about oral health guidelines for pediatric patients. - [Trends in Adolescent Dental Care Use](https://www.carequest.org/resource-library/trends-adolescent-dental-care-use), a report highlighting the importance of oral health care in adolescents and how schools and primary care providers can help adolescent patients establish a dental home. **Categories:** Journal Article, Resource **Tags:** Medical-Dental Integration --- ### [The Impact of Underutilization of Preventive Dental Care by Adult Medicaid Participants](https://carequest.org/resource/the-impact-of-underutilization-of-preventive-dental-care-by-adult-medicaid-participants/) **Published:** January 11, 2022 **Author:** Darren Edwards **Content:** In this article published in *BMC Oral Health*, CareQuest Institute researchers examined the existing peer-reviewed literature to determine who is most often evaluated for oral health literacy (OHL), what oral health measures and interventions are utilized, and who is responsible for improving OHL and oral health outcomes. Researchers found that OHL studies were representative of groups across the lifespan — from pregnancy to adulthood. However, studies frequently focused on only one social identity, such as being a caregiver or race/ethnicity. The authors recommend using an OHL framework, which includes identifying multiple social identities and recognizing environmental barriers, to help improve OHL. The responsibility for improving OHL is most often placed on medical and dental providers. The authors write: > Ultimately, the responsibility for improving OHL is multifactorial and includes participation and cooperation from patients, providers, communities, and health care systems.” [Read the article](https://link.springer.com/epdf/10.1186/s12903-025-06472-7?sharing_token=D0IEIqvL0BrMu4ZtIXBBGG_BpE1tBhCbnbw3BuzI2RPREpdRll4t5-PQj-VKh1DS544abfrXZLwNSzpSXTlURoR10p3YY5qVi8yKvfAPQkwK5zI_UnQbDdgZaI19HdblM2CXPuJyhtt69z-iY8NvSPz5sa0qePapOBpLMjXs6QQ%3D) in *BMC Oral Health* (open access) **You may also be interested in:** - [The Dental Home Is Where Good Oral Health Starts](https://www.carequest.org/resource-library/dental-home-where-good-oral-health-starts), a report investigating the relationship between having a dental home and oral health outcomes. - [Oral Hygiene Home Care Practices in America](https://www.carequest.org/resource-library/oral-hygiene-home-care-practices-america), a report emphasizing that oral health care education for patients cannot be one-size-fits-all but must be person-centered. - [Social Determinants of Health Linked with Oral Health](https://www.carequest.org/resource-library/social-determinants-health-linked-oral-health), an article in *BMC Oral Health* analyzing the impact of eight structural and intermediary determinants on oral health outcomes. **Categories:** Journal Article, Resource **Tags:** Dental Coverage --- ### [Oral Health Professionals Are Ready to Accept Teledentistry](https://carequest.org/resource/oral-health-professionals-are-ready-to-accept-teledentistry/) **Published:** January 24, 2022 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_Oral-Health-Professionals-Are-Ready-to-Accept-Teledentistry-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Oral-Health-Professionals-Are-Ready-to-Accept-Teledentistry.pdf)Read report During the COVID-19 pandemic, many oral health providers incorporated teledentistry into their practices. What successes and challenges did they uncover? How have their perceptions of teledentistry evolved? To find out, CareQuest Institute conducted a series of three surveys of dental team members from Advantage Dental Oral Health Center in Oregon and Washington. These surveys explored how attitudes toward teledentistry changed over the course of six months as providers gained experience with virtual workflows and new software within the practices. Before implementation, nearly a third (32%) of respondents thought that the quality of care given to patients would decrease with the use of teledentistry. Following six months of teledentistry implementation: - More than three-quarters (76%) of respondents believed that utilizing a teledentistry platform increased access to care for patients. - Approximately half of respondents agreed that utilizing a teledentistry platform increased patient satisfaction (51%) and helped shorten patient wait times to get an appointment (47%). - Almost 85% of respondents said dentistry was ready to accept teledentistry as a care delivery method. The survey results show that providers are open to teledentistry, and that it can play a crucial role in increasing access to care and improving quality of care. **You may also be interested in:** - [Teledentistry: Opportunities for Expanding the Capacity and Reach of the Oral Health Care System](https://www.carequest.org/resource-library/teledentistry-opportunities-expanding-capacity-and-reach-oral-health-ca-1), a report by the [Association of State and Territorial Dental Directors](https://www.astdd.org/) (ASTDD) and CareQuest Institute provides a framework to identify opportunities and strategies to incorporate teledentistry into oral health delivery systems. - [Pandemic Drives Dental Provider Confidence in Telehealth](https://www.carequest.org/resource-library/pandemic-drives-dental-provider-confidence-telehealth), a research report that provides insight into utilization of teledentistry during the pandemic as well as opportunities for growth beyond the pandemic. - [Teledentistry: Removing Barriers and Moving Toward Implementation](https://www.carequest.org/resource-library/teledentistry-removing-barriers-and-moving-toward-implementation), a visual report that explores the landscape, barriers, potential solutions, and action steps related to teledentistry. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Large-Scale Dental Data Collection: Lessons Learned and Opportunities Gained](https://carequest.org/resource/large-scale-dental-data-collection-lessons-learned-and-opportunities-gained/) **Published:** January 25, 2022 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_Large-Scale-Dental-Data-Collection-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Large-Scale-Dental-Data-Collection.pdf)Read report The Community Oral Health Transformation (COrHT) Learning Community, an improvement initiative organized by CareQuest Institute, supports the transformation of the oral health care delivery system from a fee-for-service model to a prevention and value-based care model. Within the initiative, 10 community health centers in Ohio and Arizona collected clinical and operational data to improve care in their local settings. What can we learn from those data collection efforts? A new report highlights several key lessons, including: - EHR data from dental clinics provides unique opportunities to better understand comprehensive health care. - To improve data quality and timeliness, implementing [dental data exchange standards, such as Health Level Seven (HL7®)](https://www.carequest.org/resource-library/dental-data-exchange-hl7-implementation-guides), can be beneficial. - Appropriate incentives need to be in place to ensure that clinics succeed in providing high-quality and timely data extracts. **You may also be interested in:** - [Dental Data Exchange: HL7® Implementation Guides](https://www.carequest.org/resource-library/dental-data-exchange-hl7-implementation-guides), these publications, co-created by health care thought leaders, are designed to facilitate care coordination and create best practices for electronic exchange of patient data between dental and medical professionals. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry focused on teleprevention, minimally invasive care, and integrated and personalized care. - [Community Oral Health Transformation](https://www.carequest.org/how-we-work/health-improvement-programs/corht) (COrHT), an initiative that serves as a learning community to advance medical-dental integration and value-based oral health care. **Categories:** Publication, Resource **Tags:** Value-Based Care --- ### [A Learning Community That Aims to Change Oral Health](https://carequest.org/resource/a-learning-community-that-aims-to-change-oral-health/) **Published:** September 10, 2021 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-A-Learning-Community-Aims-to-Change-Oral-Health-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-A-Learning-Community-Aims-to-Change-Oral-Health.pdf)Read report In response to the COVID-19 pandemic, CareQuest Institute for Oral Health worked with its partners to launch an innovative educational collaboration. The COVID-19 Oral Health Recovery and Transformation (COHRT) Learning Community brought together Federally Qualified Health Centers (FQHCs) in Massachusetts to make systemic changes to their delivery of oral health care. The goal was not just to respond to the pandemic but also to begin the process of long-term transformation in oral health. A new report from CareQuest Institute describes the COHRT Learning Community and its outcomes. Key findings include: - There was a steady increase in caries risk assessments (CRAs) at the FQHCs over the course of the learning community, from a total of 275 in June 2020 to 1365 in Nov. 2020. - By the end of the learning community, 75% of participants agreed or strongly agreed that the traditional dentistry model will need to significantly transform in the next five years. - Seven of the eight participating FQHCs reported that they were confident or extremely confident in their ability to use primary and secondary interventions. This new report also includes information on the transformation of the learning community to a larger initiative: the Community Oral Health Transformation (COrHT) Initiative, which will continue to expand across the country. **You may also be interested in:** - [How the COrHT Initiative Is Transforming Health Care](https://www.youtube.com/watch?v=qdTF-Q7EE8Y), a video that highlights how organizations like the Dimock Center, a Federally Qualified Health Center in Roxbury, found new ways to provide person-centered care that will last long after the pandemic recedes. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - Learning more about the [Community Oral Health Transformation (COrHT) Initiative](https://www.carequest.org/how-we-work/health-improvement-programs/corht). **Categories:** Publication, Resource **Tags:** Health Equity, Value-Based Care --- ### [Expanding Dental Benefits Is Good for States.*](https://carequest.org/resource/expanding-dental-benefits-is-good-for-states/) **Published:** September 14, 2021 **Author:** Darren Edwards **Content:** **\*Just Ask Colorado.** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Expanding-Dental-Benefits-is-Good-for-States_Report_Cover-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Expanding-Dental-Benefits-is-Good-for-States.-Just-Ask-Colorado_Research-Report.pdf)Read report Colorado was one of the states that chose to expand Medicaid adult dental benefits under the Affordable Care Act. As of 2014, adults members could receive up to $1,000 annually toward the cost of dental services. In 2019, the cap was raised to $1,500. The new benefit covered procedures such as dental exams, crowns, partial dentures, and root canals. A new report from CareQuest Institute for Oral Health describes a study of the [impact of Medicaid expansion](https://www.carequest.org/topics/adult-dental-benefit) in Colorado, focused on one safety-net provider. Key findings include: - After expansion, the total number of adult Medicaid patients seen at the site increased by almost 350%. - Between 2013 and 2016, the site saw a 51% increase in tooth-saving procedures (e.g., restoration, endodontic and periodontal treatments) and a 22% decrease in extractions. - Tooth-saving procedures increased in all ethnicities and all ages above 21 years. Overall, in Colorado, the dental community has embraced the [adult Medicaid benefit](https://www.carequest.org/topics/adult-dental-benefit), which has improved the oral health of patients who previously lacked adequate access to care. You may also be interested in: - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways), a visual report that shows how cuts could harm job growth and increase costs. - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefit-toolkit-advocates), a toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits but expand them as well. - [Emergency and Urgent Dental Visits Among Medicaid Enrollees from 2013 to 2017](https://www.carequest.org/resource-library/emergency-and-urgent-dental-visits-among-medicaid-enrollees-2013-2017-0), a report to better understand the frequency of dental emergencies and the procedures performed during those emergency visits. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Association Between First Oral Examination Characteristics and Dental Treatment Needs in Privately Insured Children](https://carequest.org/resource/association-between-first-oral-examination-characteristics-and-dental-treatment-needs-in-privately-insured-children/) **Published:** September 14, 2021 **Author:** Darren Edwards **Content:** An article published in *The Journal of the American Dental Association* concluded that the high proportion of children requiring restorative treatment and late age at first dental screening indicate there’s a need to invest in educating general dentists, medical students, and pediatricians about oral health guidelines for pediatric patients. The authors of this study, which included de-identified claims data from 706,636 privately insured children aged 0 – 6, sought to determine how provider type and age at first dental examination are associated with caries experience among children in the United States. A total of 21% of the population required restorative treatment and the average age at first dental examination was 3.6 years. Early childhood caries remains the most common, preventable infectious disease among children in the United States. [Click here to view the article](https://jada.ada.org/article/S0002-8177(21)00344-5/fulltext) (subscription required) **You may also be interested in:** - [Pediatric Primary Care and Oral Health](https://www.carequest.org/resource-library/pediatric-primary-care-and-oral-health), a research brief that evaluates oral health services being provided in medical well-child visits and the need for greater integration of oral health in primary care to help facilitate early intervention and the prevention of dental disease. - [School Dental Programs Face Stiff Challenges,](https://www.carequest.org/resource-library/school-dental-programs-face-stiff-challenges) a report that highlights how COVID-19 pandemic has exacerbated access to health care outside of school, as school closures have limited the ability for children to receive basic preventative care. - [Adolescent Dental Care Utilization](https://www.carequest.org/resource-library/trends-adolescent-dental-care-use), a report that explores dental care utilization among Medicaid-enrolled and commercial-insured adolescents. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [A Snapshot of the 76.5 Million Americans Without Dental Insurance](https://carequest.org/resource/a-snapshot-of-the-76-5-million-americans-without-dental-insurance/) **Published:** September 15, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_A-Snapshot-of-the-76.5-Million-Americans-Without-Dental-Insurance_Visual-Report-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_A-Snapshot-of-the-76.5-Million-Americans-Without-Dental-Insurance_Visual-Report.pdf)View visual report The risk of oral health problems increases with age — and older populations are more likely to lack coverage when they need it most. This combination is leading to a surge in oral health care needs among adults aged 60 and over. A new visual report from CareQuest Institute for Oral Health reveals that of all Americans, Medicare beneficiaries have the largest unmet need for dental coverage. Other key findings include: - An estimated 76.5 million adults do not have dental insurance. - Adults aged 60 and over were most likely to lack dental insurance. - A quarter of all respondents with Medicare reported that their current dental coverage is insufficient to maintain their oral health. This visual report, based on a recent CareQuest Institute survey, also illuminates a path forward, noting that most Americans support adding comprehensive dental benefits to both Medicare and Medicaid programs. **You may also be interested in:** - [Expanding Dental Benefits Is Good for States\*](https://www.carequest.org/resource-library/expanding-dental-benefits-good-states), a report that describes a study of the impact of Medicaid expansion in Colorado. - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways), a visual report that shows how cuts could harm job growth and increase costs. - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefit-toolkit-advocates), a toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits but expand them as well. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [The Push to Add Dental Coverage to Medicare](https://carequest.org/resource/the-push-to-add-dental-coverage-to-medicare/) **Published:** September 15, 2021 **Author:** Darren Edwards **Content:** [![Read the brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Push-To-Add-Dental-Coverage-to-Medicare_Research-Brief-Cover-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Push-To-Add-Dental-Coverage-to-Medicare_Research-Brief.pdf)Read the brief The US population is aging, which means the number of Medicare beneficiaries is growing. Yet Medicare does not include a dental benefit, leaving millions of older adults without adequate oral health coverage or care. A new CareQuest Institute for Oral Health report, based on a nationally representative survey of 5,320 adults, shows a strong consensus that a dental benefit should be added to all Medicare plans. Key findings include: - Nearly all of those surveyed (94%) supported adding a dental benefit to Medicare. - Adding a dental benefit to Medicare has wide support from all political parties, medical and dental insurance groups, and consumers of all races. - Those with unmet oral health needs are more likely to express interest in adding a dental benefit to Medicare. The survey, conducted early in 2021, examined consumer attitudes, experiences, and behaviors related to oral health. You may also be interested in: - [Dental Insurance Is Out of Reach for Many](https://www.carequest.org/resource-library/dental-insurance-out-reach-many), a visual report that explores Americans’ of lack access to dental care, and the loss of insurance for many during the COVID-19 pandemic. - [Oral Disease Is Common. Access to Care Is Not.,](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) a visual report that illustrates how oral health care is inequitably distributed among Americans. - [The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled), a report that compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Dental Data Exchange: HL7® Implementation Guides](https://carequest.org/resource/dental-data-exchange-hl7-implementation-guides/) **Published:** September 16, 2021 **Author:** Darren Edwards **Content:** As part of the Dental Data Exchange Project, CareQuest Institute for Oral Health helped develop the first implementation guides to bridge the communication gap between primary care and oral health care. National partners and thought leaders, including representatives from the Department of Defense, the American Dental Association (ADA), and the Federal Electronic Health Record Modernization (FEHRM) Program Office, collaborated on the guides, which include critical information for electronic dental health information (EHI) coordination. Historically, oral and primary care providers if they communicated at all about a patient, would do it by paper and email attachments, which creates additional work and a fragmented referral process. (Prior to this guide, only the medical profession had standards built for data exchange.) These new publications, the [Health Level Seven® (HL7) CDA®](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=579) and FHIR® implementation guides, are designed to facilitate care coordination and create best practices for electronic exchange of patient data between dental and medical professionals. This exchange of information will support interprofessional practice, population health management, and value-based care. The guides offer standards that include data models, defined data items and their corresponding code and value sets, and leverages the [Reference Core Data Set for Communication Among Dental and Other Health Information Systems](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fcatalog.ada.org%2Fcatalog%2Fansiada-standard-no-1084-reference-core-data-set-for-communication-among-dental-and-other-health-d-62745&data=04%7C01%7Ccstrang%40carequest.org%7C220a15ee7776486f9f8708d9b69b8dcf%7Cb5014925e83f4fb6a482eb9184fe1c81%7C0%7C0%7C637741601483554092%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=vn90GRqjQxr0dyIKGPjRCdIl1r0rqA8TeUGDlJXFmCE%3D&reserved=0) from the American Dental Association. They were informed by several projects including CareQuest Institute’s Medical Oral Expanded Care (MORE Care™) initiative, which integrates oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers. View the [Implementation Guide: HL7® CDA® R2 Implementation Guide: Dental Data Exchange, Release 1, STU 1 – US Realm](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=579) View the [FHIR® Implementation Guide](http://hl7.org/fhir/us/dental-data-exchange/STU1/) You might also be interested in: - [The Wicked Problem of the Oral Health Care System](https://www.carequest.org/education/resource-library/wicked-problem-oral-health-care-system), a special edition of the *Journal of Public Health Dentistry* that outlines how Health IT systems need to be interoperable and coordinated to allow sharing of health records across all disciplines and providers to coordinate care. - [Care Coordination in a Community Health Center with Integrated Scheduling and Electronic Health Records](https://www.carequest.org/resource-library/care-coordination-community-health-center-integrated-scheduling-and-electronic), a case study that illustrates how individuals may interact with the health care system and demonstrates effective communication between providers. - [A Geriatric Patient with Oral Health Issues Moves Through the Health System](https://www.carequest.org/education/resource-library/geriatric-patient-oral-health-issues-moves-through-health-system)*,* a case study that illustrates how a geriatric patient may engage with the health care system and highlights the importance of oral health information exchange. **Categories:** Resource, Tool **Tags:** Medical-Dental Integration --- ### [A Dental Provider's Role in Supporting Patients with Diabetes](https://carequest.org/resource/a-dental-providers-role-in-supporting-patients-with-diabetes/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Sean Boynes, DMD, MS, vice president of health improvement at CareQuest Institute, explains how dental providers can play a key role in diabetes management. To do so, they need to understand the disease as well as how oral disease affects overall systemic well-being. Dental providers can help lay the groundwork for better health and better behavioral choices. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Clinical Practice, Medical-Dental Integration --- ### [The Importance of Oral Health During Pregnancy](https://carequest.org/resource/the-importance-of-oral-health-during-pregnancy/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** The oral health of the mother is the best predictor of the oral health of the child. If the mother has poor oral hygiene, a poor diet, and a high bacterial load, that will get passed on to the child. Periodontal disease is also associated with poor pregnancy outcomes, including pre-term labor and preeclampsia. This video featuring Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, delves into the reasons that oral health during pregnancy is crucial for both mother and baby. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Clinical Practice, Medical-Dental Integration --- ### [The Connection Between Oral Health and Diabetes](https://carequest.org/resource/the-connection-between-oral-health-and-diabetes/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, explains the connection between oral health and diabetes. When diabetic patients have good oral health, it’s easier to control their blood sugars. Diagnosing and treating periodontal disease can help patients with their diabetic care. In short, improving oral health improves diabetic control. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Getting Started with Oral Health Integration in Primary Care](https://carequest.org/resource/getting-started-with-oral-health-integration-in-primary-care/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, offers advice for integrating oral health into primary care. The first step is getting educated. Resources are available to learn about the connection between oral health and systemic health, oral health in pregnancy, and other key topics. Another important step: talking to the administrative staff in your practice to enable them to understand the importance of oral health. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [How Dental Practice Acts Impact Interprofessional Practice](https://carequest.org/resource/how-dental-practice-acts-impact-interprofessional-practice/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** This video explains how the scope of practice and state regulations can affect efforts to transition dentistry from a surgical care model to a primary care dental model. One state may have a promising approach that could apply in others, but it may be difficult to replicate if regulations differ. States need to be open to changing regulations to enable dental providers to offer the best possible care. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [Getting Started with Integration and Coordination of Physical Health in a Dental Setting](https://carequest.org/resource/getting-started-with-integration-and-coordination-of-physical-health-in-a-dental-setting/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** Change is always difficult, and dental providers might feel daunted by the prospect of medical-dental integration. In this video, Sean Boynes, DMD, MS, advises dental providers not to take on too much. Instead of thinking you need to do it all, ask yourself: What’s the next thing you can do [to improve patient care quality](https://www.carequest.org/topics/medical-dental-integration)? You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [Defining Interoperability](https://carequest.org/resource/defining-interoperability/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** What is interoperability? It’s an umbrella term for ensuring that different systems and software applications are able to communicate and understand shared data. This video explains the different layers of interoperability and the overall goal, which is to best serve patients at the point of care. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [The Oral-Systemic Connection and Why It's Important for Dental Professionals](https://carequest.org/resource/the-oral-systemic-connection-and-why-its-important-for-dental-professionals/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Sean Boynes, DMD, MS, vice president of health improvement at CareQuest Institute, explains why it’s important to recognize that the mouth is part of the body. If you’re a dental provider trying to treat periodontal disease in someone who is diabetic or has cardiovascular disease, for example, you can’t treat those conditions separately. Simply put, a disease in the mouth affects the rest of our systemic wellbeing. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [The Oral-Systemic Connection and Why It's Important for Medical Professionals](https://carequest.org/resource/the-oral-systemic-connection-and-why-its-important-for-medical-professionals/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, argues that medical schools need to do a better job of educating students about oral health. Many physicians understand that the mouth is important but don’t understand why. Better curricula are key for bridging that gap. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [Overcoming Barriers to Dental Care Access Through Community-Based Programs](https://carequest.org/resource/overcoming-barriers-to-dental-care-access-through-community-based-programs/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Sharity Ludwig, EPDH, MS, director of alternative care models at Advantage Dental Oral Health Center and Affiliated Practices, explains the potential of community care. Clinics may not be in easily accessible locations, so by deploying expanded practice hygienists to other sites — such as WIC programs and schools — patients can receive care in a trusting, familiar, and convenient environments. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Access to Care, Health Equity --- ### [The Challenges and Opportunities of Care Coordination](https://carequest.org/resource/the-challenges-and-opportunities-of-care-coordination/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** What are the challenges to care coordination? In this video, Sean Boynes, DMD, MS, vice president of health improvement at CareQuest Institute, explains how coordination can be daunting because it requires bridging silos and exposing a portion of your operation to someone else. Providers may hesitate to be open and honest about the weaknesses in their practices. But there are opportunities, too. True care coordination will require a significant cultural change and recognizing the deep connections between oral disease and overall systemic health. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Medical-Dental Integration --- ### [Person-Centered Care for Oral Health](https://carequest.org/resource/person-centered-care-for-oral-health/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Sean Boynes, DMD, MS, vice president of health improvement at CareQuest Institute, discusses the concept of person-centered care for oral health. Ultimately, it means putting an individual at the center of decision making, allowing them to codesign care, and asking them what they want out of this partnership. Person-centered care is holistic care in which there is a mutually satisfying relationship between patient and provider. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [A Primary Care Provider's Role in Oral Cancer Screenings](https://carequest.org/resource/a-primary-care-providers-role-in-oral-cancer-screenings/) **Published:** September 29, 2021 **Author:** Darren Edwards **Content:** In this video, Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, discusses the importance of screening patients for oral cancer. Because oral cancer occurs in hidden areas of the mouth and patients are often asymptomatic, primary care providers should examine the gums and teeth for any signs. Fortunately, adding this to a physical examination is easy and quick. You may also be interested in: - [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical-Dental Integration](https://www.carequest.org/topics/medical-dental-integration) web page, a collection of resources that explore the growing connections between oral health and overall health. **Categories:** Resource, Video **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Addressing Oral Health of Low-Income Populations: A Call to Action](https://carequest.org/resource/addressing-oral-health-of-low-income-populations-a-call-to-action/) **Published:** September 30, 2021 **Author:** Darren Edwards **Content:** A new commentary in *JAMA Network Open* underscores the importance of strengthening Medicaid benefits to include dental coverage. In the commentary, a response to “Addressing Oral Health of Low-Income Populations: A Call to Action,” authors Tamanna Tiwari, MPH, MDS, BDS, and CareQuest Institute’s Julie Franstve-Hawley, PhD, CAE, write that “it is imperative to have a concerted call to action for federal policy that mandates comprehensive, nationwide adult dental benefits as a permanent part of Medicaid.” Hawley and Tiwari go on to outline the mandate that would include: - Early and Periodic Screening, Diagnostic, and Treatment as a way to maintain consistency of access and provider participation - A benefit that is extensive enough to promote oral health, better outcomes, and cost savings for dental and medical costs - Data integration and interoperability to enable knowledge, quality improvement, and payment reform. The commentary was in response to the article and study that suggested that the combination of Medicaid expansion and addition of Medicaid dental benefits not only improved coverage and access to dental care among low-income adults but also produced significant improvements in clinical indicators of oral health. **[View the article](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784602)** **You may also be interested in:** - [Expanding Dental Benefits Is Good for States.\* \*Just Ask Colorado.,](https://www.carequest.org/resource-library/expanding-dental-benefits-good-states) a research report that outlines the results of a study of the impact of Medicaid expansion in Colorado. - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways), a visual report that shows how cuts could harm job growth and increase costs. - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefit-toolkit-advocates), a toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits but expand them as well. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Emergency and Urgent Dental Visits Among Medicaid Enrollees from 2013 to 2017](https://carequest.org/resource/emergency-and-urgent-dental-visits-among-medicaid-enrollees-from-2013-to-2017/) **Published:** August 9, 2021 **Author:** Darren Edwards **Content:** A recent research article published in *BMC Oral Health* concluded that most dental emergency encounters do not result in definitive treatment; rather, patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care. The goal of the research, which analyzed data from 2013 to 2017, was to better understand the frequency of dental emergencies and the procedures performed during those emergency visits, helping providers, insurers, and policymakers understand workforce and care provision needs. [Click here to view the article](https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-020-01345-7). **You may also be interested in:** - [Medicaid Adult Dental Benefit Forecasting Tool](https://www.carequest.org/system/files/CareQuest-Institute-Medicaid-Forecasting-Tool-User-Guide.pdf), a tool designed to give oral health providers the ability to forecast practice capacity and revenue from existing patients. - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.carequest.org/system/files/CareQuest-Institute-Cutting-Medicaid-Adult-Dental-Benefit-Infographic.pdf), an infographic that shows how adult dental coverage reduces costly visits to hospitals while increasing the odds for employment. - [Loss of Insurance Leads to Hard Decisions for Many Patients](https://www.carequest.org/system/files/CareQuest_Loss-of-Insurance-Leads-to%20Hard-Decisions.pdf), a report that offers more evidence that the pandemic is contributing to a coming surge in oral disease. **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Health Equity --- ### [The Effect of Well Child Visit Location on Preventative Dental Visit](https://carequest.org/resource/the-effect-of-well-child-visit-location-on-preventative-dental-visit/) **Published:** August 9, 2021 **Author:** Darren Edwards **Content:** A new study published in *MDPI* contributes to the understanding of medical-dental integration among Medicaid-enrolled children and offers insight into the promotion of oral health prevention within medical primary care. The study reveals most Medicaid enrolled children receive their well-child visit at an office and hospital, as compared to federally qualified health center, or rural or public health clinic. Furthermore, it demonstrates increased utilization of dental preventive services for children who receive a well-child visit. [Click here to view the article](https://www.mdpi.com/2227-9067/8/3/191). **You may also be interested in:** [School Dental Programs Face Stiff Challenges,](https://www.carequest.org/system/files/CareQuest-Institute-School%20Dental-Programs-Face-Stiff-Challenges-Brief.pdf) a report that highlights how COVID-19 pandemic has exacerbated access to health care outside of school, as school closures have limited the ability for children to receive basic preventative care. [Adolescent Dental Care Utilization](https://www.carequest.org/system/files/CareQuest-Institute-Trends-In-Adolescent-Dental-Care-Use-Research-Report.pdf), a report that explores dental care utilization among Medicaid-enrolled and commercial-insured adolescents. Additional reports and graphics on the [Medical-Dental Integration topic page.](https://www.carequest.org/topics/medical-dental-integration) **Categories:** Journal Article, Resource **Tags:** Health Equity, Medical-Dental Integration --- ### [A Systematic Review of Dental-Related Emergency Department Visits among Medicaid Beneficiaries](https://carequest.org/resource/a-systematic-review-of-dental-related-emergency-department-visits-among-medicaid-beneficiaries/) **Published:** August 9, 2021 **Author:** Darren Edwards **Content:** The results of a new study published in the *Journal of Public Health Dentistry* supports expanding insurance coverage in Medicaid programs to reduce emergency department use for nontraumatic dental conditions (NTDC) visits in the United States. The objective of this study was to conduct a systematic review to assess the incidence of dental-related ED visits for Medicaid dental enrollees compared to those with other insurances. [Click here to view the article](https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.12458) (subscription required). **You may also be interested in:** - [Emergency and Urgent Dental Visits Among Medicaid Enrollees from 2013 to 2017](https://www.carequest.org/resource-library/emergency-and-urgent-dental-visits-among-medicaid-enrollees-2013-2017-0), a report to better understand the frequency of dental emergencies and the procedures performed during those emergency visits. - [Recent Trends in Hospital Emergency Department Visits](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits), an infographic that shows patients who visit hospital EDs for non-traumatic dental conditions can divert critical resources and create added stress for ED personnel. - [Hospital Utilization for Non-Traumatic Dental Conditions in Oregon from 2013 to 2015](https://www.carequest.org/resource-library/hospital-utilization-non-traumatic-dental-conditions-oregon-2013-2015), a report that examines ED visits in Oregon for non-traumatic dental conditions, and found a need for multi-level solutions, such as teledentistry, to decrease ED utilization across the state. **Categories:** Journal Article, Resource **Tags:** Dental Coverage --- ### [Teledentistry Use Beyond the Pandemic](https://carequest.org/resource/teledentistry-use-beyond-the-pandemic/) **Published:** August 9, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Use-Beyond-Cover-229x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Use-Beyond.pdf)View visual report The COVID-19 pandemic has highlighted inequities in the United States and, at the same time, increased awareness of technologies that can help address those inequities. One such technology is teledentistry — a set of virtual tools that allow for electronic communication and delivery of oral health services. Even after the pandemic, teledentistry has the potential to increase access, improve health outcomes, and provide patients with an opportunity for a greater role and voice in their own care. A new visual report from CareQuest Institute for Oral Health explores four reasons why teledentistry is here to stay. Key points include: - During a crisis — whether an infectious disease outbreak or natural disaster — teledentistry will help ensure that people do not lose access to care. - Teledentistry reduces costs: in one study from 2018, patients with at least one teledentistry visit [cost 10% less](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money) than dental patients who didn’t use teledentistry. - Patients are embracing teledentistry: in a 2020 [CareQuest Institute survey](https://www.carequest.org/resource-library/patients-give-high-marks-their-teledentistry-experience), 86% of patients said they were satisfied with their overall teledentistry experience. **You may also be interested in:** - [Teledentistry: What to Know & How It Works](https://www.carequest.org/resource-library/teledentistry-what-know-how-it-works), a visual report that aggregates highlights from several surveys and reports to show how teledentistry is growing across different US states. - [State of Oral Health Equity in America: COVID-19, Vaccines, and Teledentistry](https://www.carequest.org/education/webinars/state-oral-health-equity-america-covid-19-vaccines-and-teledentistry), a recent webinar that, among other topics, discussed emerging opportunities teledentistry can provide for those with a lack of access to care. - Additional reports and graphics on our [Teledentistry topic page](https://www.carequest.org/topics/teledentistry). **Categories:** Resource, Visual Report **Tags:** Practice Management --- ### [Questions and Reflections While Discussing Patient Values](https://carequest.org/resource/questions-and-reflections-while-discussing-patient-values/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider focuses on understanding patient values and goals while using open-ended questions and reflective listening statements. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Close-Ended Questions During A Caries Risk Assessment](https://carequest.org/resource/close-ended-questions-during-a-caries-risk-assessment/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider asks closed-ended questions during a caries risk assessment with an adolescent patient to show how ineffective they can be. Often, closed-ended questions promote disengagement and provide little useful information. Open-ended questions, on the other hand, often result in more descriptive answers and increase engagement from patients. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Using Motivational Interviewing in Dentistry Video Series](https://carequest.org/resource/using-motivational-interviewing-in-dentistry-video-series/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** The “Using Motivational Interviewing in Dentistry” series, which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. ## An Open Ended Question During A Caries Risk Conversation In this video, the provider shows how to ask an open-ended question to gain additional information from an adolescent patient. Open-ended questions, as opposed to closed-ended questions (e.g., When was the last time you went to the dentist? Do you have any cavities?) often result in more descriptive answers and increase engagement in patients. ## Caries Risk Assessment vs Caries Risk Conversation In this video, the first provider asks closed-ended questions during a caries risk assessment with an adolescent patient to show how ineffective they can be. Then, a second provider engages in a caries risk assessment that is more like a conversation, creating an atmosphere that is warm, engaging, and inviting — and less like an exercise in checking boxes. We then hear from the patient about the difference between the two experiences. ## Risk Caries Conversation In this video, the provider engages in a caries risk assessment that is more like a conversation, creating an atmosphere that is warm, engaging, and inviting — and less like an exercise in checking boxes. ## Close Ended Questions During A Caries Risk Assessment In this video, the provider asks closed-ended questions during a caries risk assessment with an adolescent patient to show how ineffective they can be. Often, closed-ended questions promote disengagement and provide little useful information. Open-ended questions, on the other hand, often result in more descriptive answers and increase engagement from patients. ## Discussing Fluoride With a Parent In this video, we witness a conversation about fluoride between a provider and a parent who has concerns about the treatment. The provider attempts to create partnership, honor autonomy, and effectively share information. ## Elicit-Provide-Elicit (Ask-Tell-Ask) In this video, the provider showcases the Elicit-Provide-Elicit (also known as Ask-Tell-Ask) framework, an effective tool for sharing information with a patient. ## Engaging and Agenda Setting In this video, the provider focuses on the skills of engaging and agenda setting at the beginning of a dental appointment. ## Engaging Around Patient Goals In this video, the provider shows how discussing patient goals and values can increase engagement from an adolescent patient. ## Following Up on Patient Goals and Evoking During Planning In this video, the provider checks in on a patient self-management goal, remembering to continue eliciting and evoking, even while planning. ## Open Ended Questions and Affirmations In this video, the provider showcases the communication techniques of asking open-ended questions and providing affirmations with a parent. ## Questions and Reflections While Discussing Patient Values In this video, the provider focuses on understanding patient values and goals while using open-ended questions and reflective listening statements. ## Reflecting and Summarizing In this video, the provider shows how to use reflective listening statements and summarizations when engaging with an adolescent patient. **Categories:** Resource, Video **Tags:** Practice Management --- ### [Caries Risk Conversation](https://carequest.org/resource/caries-risk-conversation/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider engages in a caries risk assessment that is more like a conversation, creating an atmosphere that is warm, engaging, and inviting — and less like an exercise in checking boxes. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Reflecting and Summarizing](https://carequest.org/resource/reflecting-and-summarizing/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider shows how to use reflective listening statements and summarizations when engaging with an adolescent patient. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Caries Risk Assessment vs Caries Risk Conversation](https://carequest.org/resource/caries-risk-assessment-vs-caries-risk-conversation/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the first provider asks closed-ended questions during a caries risk assessment with an adolescent patient to show how ineffective they can be. Then, a second provider engages in a caries risk assessment that is more like a conversation, creating an atmosphere that is warm, engaging, and inviting — and less like an exercise in checking boxes. We then hear from the patient about the difference between the two experiences. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Following Up on Patient Goals and Evoking During Planning](https://carequest.org/resource/following-up-on-patient-goals-and-evoking-during-planning/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider checks in on a patient self-management goal, remembering to continue eliciting and evoking, even while planning. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Open-Ended Questions and Affirmations](https://carequest.org/resource/open-ended-questions-and-affirmations/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider showcases the communication techniques of asking open-ended questions and providing affirmations with a parent. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Elicit-Provide-Elicit (Ask-Tell-Ask)](https://carequest.org/resource/elicit-provide-elicit-ask-tell-ask/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider showcases the Elicit-Provide-Elicit (also known as Ask-Tell-Ask) framework, an effective tool for sharing information with a patient. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Engaging Around Patient Goals](https://carequest.org/resource/engaging-around-patient-goals/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider shows how discussing patient goals and values can increase engagement from an adolescent patient. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Engaging and Agenda Setting](https://carequest.org/resource/engaging-and-agenda-setting/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider focuses on the skills of engaging and agenda setting at the beginning of a dental appointment. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Discussing Fluoride With a Parent](https://carequest.org/resource/discussing-fluoride-with-a-parent/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, we witness a conversation about fluoride between a provider and a parent who has concerns about the treatment. The provider attempts to create partnership, honor autonomy, and effectively share information. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [An Open-Ended Question During A Caries Risk Conversation](https://carequest.org/resource/an-open-ended-question-during-a-caries-risk-conversation/) **Published:** August 10, 2021 **Author:** Darren Edwards **Content:** In this video, the provider shows how to ask an open-ended question to gain additional information from an adolescent patient. Open-ended questions, as opposed to closed-ended questions (e.g., When was the last time you went to the dentist? Do you have any cavities?) often result in more descriptive answers and increase engagement in patients. This video is part of the [“Using Motivational Interviewing in Dentistry” series](https://www.carequest.org/resource-library/using-motivational-interviewing-dentistry-video-series), which highlights skills and techniques used to effectively engage with patients and to encourage them to become designers of their own oral health care. Motivational interviewing promotes trust and collaboration between the care team and caregiver/patient and is a foundational skill of person-centered care. **Categories:** Resource, Video **Tags:** Clinical Practice --- ### [Pandemic Drives Dental Provider Confidence in Telehealth](https://carequest.org/resource/pandemic-drives-dental-provider-confidence-in-telehealth/) **Published:** August 11, 2021 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-ProviderSurvey-Telehealth-Cover-239x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-ProviderSurvey-Telehealth.pdf)Read report A new survey from CareQuest Institute for Oral Health provides insight into utilization of teledentistry over the past year as well as opportunities for growth beyond the pandemic. The survey asked providers about teledentistry use in early 2021 compared with two timepoints during the COVID-19 pandemic in 2020 (one in June, the other in August). Results from the survey, summarized in a new report, show that dental providers have grown comfortable with telehealth modalities and have continued to use them even as pandemic-related restrictions have been relaxed. **Key findings include:** - 22% of providers are seeing patients via telehealth, compared with 27% in June 2020 and 23% in August 2020. - 47% of dental providers are using free virtual meeting software compared to 42% in August 2020. - 36% of dental providers in 2021 are using a paid telehealth software compared to 29% in August 2020. The report also reviews the different services dental providers are offering virtually, current barriers to telehealth, and ideas for overcoming these barriers. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Abstract_Provider-Survey-Telehealth-300x171.jpg)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Abstract_Provider-Survey-Telehealth.pdf)View abstract **You may also be interested in:** - [Teledentistry Use Beyond the Pandemic](https://www.carequest.org/resource-library/teledentistry-use-beyond-pandemic), an infographic that explores four reasons why teledentistry should continue to serve as a tool to improve access to care and health outcomes even after the pandemic ends. - [Teledentistry: What to Know & How It Works](https://www.carequest.org/resource-library/teledentistry-what-know-how-it-works), an infographic that aggregates highlights from several surveys and reports to show how teledentistry is growing across different US states. - [Teledentistry: Removing Barriers and Moving Toward Implementation](https://www.carequest.org/resource-library/teledentistry-removing-barriers-and-moving-toward-implementation), an infographic that explores the current landscape, barriers, potential solutions, and action steps related to expanding teledentistry. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [A Geriatric Patient with Oral Health Issues Moves Through the Health System](https://carequest.org/resource/a-geriatric-patient-with-oral-health-issues-moves-through-the-health-system/) **Published:** August 17, 2021 **Author:** Darren Edwards **Content:** [![View journey](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Patient-Journey-Geriatric-300x194.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Patient-Journey-Geriatric.pdf)View journey *This is part of a series of case studies that depict various types of oral health care coordination. The series is designed to illustrate how individuals may interact with the health care system, demonstrate communication between providers, and highlight the importance of oral health information exchange.* Ms. Lena Walton is an 86-year-old woman with moderate to severe dementia, type 2 diabetes, hypertension, and hyperlipidemia. She lives with her daughter, Pamela, who serves as her primary caregiver along with her two sisters who take turns staying with Lena during the day. As her dementia has progressed, she requires increasing assistance to perform activities of daily living (ADLs) such as dressing, toileting, and bathing, but she enjoys reminiscing about the past, eating favorite foods including biscuits and roast chicken, and listening to music with her family. One morning, one of Lena’s front teeth breaks while she is eating breakfast. Because her mobility is limited, making outpatient medical visits is very difficult for Lena and Pamela, and Lena does not have a dental home. Lena does not seem to be upset by her broken tooth and so Pamela does not seek further care. Over two weeks, Pamela notices that Lena has less interest in her meals and is eating less. She tries to serve her softer foods like mashed potatoes, but Lena is less interested in these than her preferred foods. Over the next two weeks, Lena requires even more support to ambulate and transfer from a chair and becomes less talkative. Pamela and her sisters also notice that Lena it is very difficult to get Lena to take in fluids. **[Read Full Case](https://carequest.org/wp-content/uploads/2025/11/Case-Study_Care-Coordination-Lena.pdf)** **Categories:** Resource, Tool **Tags:** Medical-Dental Integration --- ### [Teledentistry: Removing Barriers and Moving Toward Implementation](https://carequest.org/resource/teledentistry-removing-barriers-and-moving-toward-implementation/) **Published:** August 19, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Remove-Barriers-Cover-228x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Remove-Barriers.pdf)View visual report Teledentistry has been shown to increase access to care, improve health outcomes, and reduce costs — and its use across the United States is growing. However, a variety of state-level barriers stand in the way of its continued expansion. What can stakeholders to do remove these barriers and facilitate the spread of teledentistry? A new visual report from CareQuest Institute for Oral Health explores the current landscape, barriers, potential solutions, and action steps related to teledentistry. **Recommendations include:** - Create State Practice Acts that permit each dental provider to practice to the full extent of their credentials and to provide care in community settings. - Update reimbursement policies to allow coverage for teledentistry beyond the current pandemic and to stipulate parity regardless of whether the procedure or service is provided via teledentistry or in person. - Address and clarify legal issues regarding liability and data security. **You may also be interested in:** - [Teledentistry: What to Know & How It Works](https://www.carequest.org/resource-library/teledentistry-what-know-how-it-works), a visual report that aggregates highlights from several surveys and reports to show how teledentistry is growing across different US states. - [Teledentistry Use Beyond the Pandemic](https://www.carequest.org/resource-library/teledentistry-use-beyond-pandemic), a visual report that explores four reasons why teledentistry is here to stay. - [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money), a report that explores dental service utilization patterns and rate of return following teledentistry visits. **Categories:** Resource, Visual Report **Tags:** Practice Management --- ### [Dentists are an Untapped Resource for Delivering COVID-19 Vaccines](https://carequest.org/resource/dentists-are-an-untapped-resource-for-delivering-covid-19-vaccines/) **Published:** April 28, 2021 **Author:** Darren Edwards **Content:** #### State of Oral Health Equity in America 2021 Research Report #2 [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dentists-Untapped-Resource-Report-1.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dentists-Untapped-Resource-Report.pdf)Read report The CareQuest Institute for Oral Health found that over half of respondents (57%) in a recent oral health equity survey are willing to receive the COVID-19 vaccine, and 60% of people who are willing to get the vaccine are also willing to receive it from a dentist. Why does this matter? Dentists are uniquely qualified health care providers who are extensively trained to perform complex injections. Some other findings from the survey include: - Respondents reported they did not have a physical examination in the past two years, but 12% had seen the dentist. - Vulnerable and underserved populations, such as those with lower income (less than $30,000 \[47%\]) and education (less than high school (43%), Hispanics (50%) and Blacks (42%), and those living in rural areas (49%) report lower rates of vaccine willingness. - Dentists can reach patients who are not otherwise receiving the vaccine from a regular medical care provider. Read more about the opportunity for dentists to participate in America’s mass COVID-19 vaccination efforts in Part 2 of our new series, **[State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021)**. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dentists-Untapped-Resource-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dentists-Untapped-Resource-Abstract.pdf)View abstract **Categories:** Publication, Resource **Tags:** Practice Management --- ### [The Connection Between Oral Health and Mental Health](https://carequest.org/resource/the-connection-between-oral-health-and-mental-health/) **Published:** May 4, 2021 **Author:** Darren Edwards **Content:** ## State of Oral Health Equity in America 2021 Research Brief [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Connection-Between-Oral-Health-and-Mental-Health-cover-232x300.png)](http://https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Connection-Between-Oral-Health-and-Mental-Health.pdf)Read brief New Survey Finds Poor Mental Health Status May Be Linked to Dental Fear and Delayed Dental Care Even before the COVID-19 pandemic, poor mental health could be linked to exacerbated oral health issues. Studies have shown that those with [poor mental health also tend to have poor oral health](https://www.carequest.org/resource-library/how-depression-linked-oral-health), and are more likely to have decayed teeth, periodontal disease, and dry mouth. During the last year there has been an increased incidence of cracked teeth which media reporting has linked to the stress caused by the COVID-19 pandemic. Access to care was also hindered by closure of dental offices at the height of the pandemic, which worsened oral problems. In January and February 2021, CareQuest Institute for Oral Health conducted a nationally representative survey to examine attitudes, experiences, and behaviors related to oral health. Respondents self-rated their mental health and oral health status and answered questions about oral healthcare utilization. The survey relied on self-report of the individual’s mental and emotional health, which is impacted by myriad factors and personal circumstances. Findings from this study showed consistent oral health disparities among those with self-identified poor mental health. Some findings from the survey include: - Almost one out of five respondents rated their current mental health status as fair or poor. - 47% of respondents with poor mental health said their last dental visit “went well, but they were nervous” compared with 27% of those with good mental health status. - Those who had poor mental health were nearly four times more likely to report they were self-conscious or embarrassed because of their teeth, mouth, or dentures than those respondents with good mental health. Download the report and read more about our findings from this survey in our new series, **[State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021)**. **You may also be interested in:** - [Three Resources That Explore the Connection Between Oral Health and Mental Health](https://www.carequest.org/about/news/three-resources-explore-connection-between-oral-health-and-mental-health), a blog post that summarizes facts and findings about the links between oral and mental health. - [Association Between Mental Health and Oral Health Status and Care Utilization](https://www.carequest.org/resource-library/association-between-mental-health-and-oral-health-status-and-care-utilization), an article in *Frontiers in Oral Health* that presents findings from the first study to evaluate the relationship between oral health and mental health during the pandemic. **Categories:** Publication, Resource **Tags:** Medical-Dental Integration --- ### [Challenges in Implementing School-Based Oral Health Programs: Short- and Long-Term Impact of COVID-19](https://carequest.org/resource/challenges-in-implementing-school-based-oral-health-programs-short-and-long-term-impact-of-covid-19/) **Published:** May 11, 2021 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Challenges-In-Implementing-School-Based-Oral-Health-Programs-Cover.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Challenges-In-Implementing-School-Based-Oral-Health-Programs.pdf)Read brief COVID-19 has disrupted K-12 learning and has limited children’s access to oral health services and programs. School-based oral health programs (SBOHPs) are an essential access point for children to receive preventive oral health services. CareQuest Institute for Oral Health and the Association of State and Territorial Dental Directors (ASTDD) surveyed state and territorial dental directors, and released a new report outlining the challenges COVID-19 has presented in providing and implementing SBOHPs. **Some findings from the survey include:** - Only 25% of surveyed dental directors said they were planning for school-based sealant programs, and 16% were planning school-based fluoride varnish and BSS programs for the 2021-2022 school year. - Among dental directors, 65% were confident that they could provide additional support to schools-based programs to increase readiness to participate in oral health programs. - As a result of the pause and delay in school-based oral health programming during the pandemic, there may be an increase in children’s oral diseases — especially among racial/ethnic minority students — in the coming years. **You may also be interested in:** - [School Dental Programs Face Stiff Challenges](https://www.carequest.org/education/resource-library/school-dental-programs-face-stiff-challenges) finds that the pandemic presents an opportunity for oral health programs to reassess priorities and develop contingency plans on how to continue providing these services to low-income children if a similar health crisis in the future disrupts SBOHPs. - [Why We Must Preserve School-Based Oral Care for Children](https://whatsnew.dentaquest.com/why-we-must-preserve-school-based-oral-care-for-children/) looks at why ensuring every child — regardless of their background — has access to oral health care is key to reducing the deep racial disparities in health care. - [School-Based Oral Health Care and COVID-19](https://www.carequest.org/education/webinars/school-based-oral-health-care-and-covid-19) webinar recording recognizes the challenges and lessons learned when SBOHP models need to be reassessed. - [Webinar Recording: Challenges in Implementing School-Based Oral Health Programs](https://www.carequest.org/education/webinars/challenges-implementing-school-based-oral-health-programs-short-and-long-term) **Categories:** Publication, Resource **Tags:** Health Equity, Practice Management --- ### [Medicaid Adult Dental Benefit Forecasting Tool](https://carequest.org/resource/medicaid-adult-dental-benefit-forecasting-tool/) **Published:** June 4, 2021 **Author:** Darren Edwards **Content:** [![Download guide](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Medicaid-Forecasting-Tool-User-Guide-1-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Medicaid-Forecasting-Tool-User-Guide.pdf)Download guide Comprehensive adult dental coverage expands access to oral health care, namely preventive care, and has the potential to improve overall health outcomes for patients and reduce costs of care. Medicaid also serves as a revenue source that enables clinics to increase capacity and broaden their scope of care. That is why the state of Virginia [expanded their Medicaid program](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage) to include a comprehensive adult dental benefit, effective July 1, 2021. In order to understand the impact of this new benefit, the CareQuest Institute created an interactive tool designed for oral health providers to evaluate the potential impact of existing and new patients covered under the Medicaid adult dental benefit on their practices. The tool enables providers to determine the potential financial impact and additional revenue the benefit could have on their practice to guide decision making about capacity. **Note:** This tool was created using the Virginia’s Medicaid dental benefit and should be used by providers in the state but may also be used by providers in other states for case-study comparisons. [![Download tool](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Medicaid-Forecasting-Tool-User-Guide-pg-2-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Medicaid-Forecasting-Tool-Template.xlsx)Download tool **Key Takeaways:** - This tool is designed to give oral health providers the ability to forecast practice capacity and revenue from existing patients with change in coverage who will be newly eligible for coverage as well as revenue from new patients with first-time dental coverage. - The tool includes a user guide that walks providers through how to effectively use the tool in a few simple steps. Additionally, the tool itself can be downloaded, manipulated with practice-level patient and procedure data and estimated revenue projections will automatically be calculated. *This tool was developed in collaboration with Virginia Health Catalyst.* **Categories:** Resource, Tool **Tags:** Dental Coverage, Practice Management --- ### [Trends in Adolescent Dental Care Use](https://carequest.org/resource/trends-in-adolescent-dental-care-use/) **Published:** June 7, 2021 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Trends-In-Adolescent-Dental-Care-Use-Research-Report-Cover.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Trends-In-Adolescent-Dental-Care-Use-Research-Report.pdf)View report CareQuest Institute for Oral Health explored dental care utilization among Medicaid-enrolled and commercial-insured adolescents. A new report highlights the importance of oral health care in adolescents and includes how schools, primary care providers, and more can play a part in helping the adolescent population establish a dental home. **Some key findings from the report:** - Commercial-insured adolescents have higher dental care utilization than Medicaid-enrolled adolescents. - Females are more likely than males to utilize dental care in both Medicaid-enrolled and commercial-insured adolescents. - The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend a routine preventive dental visit each year for adolescents. However, research has shown that a significant proportion of adolescents do not receive care this frequently. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Use-of-Dental-Care-Among-Adolescents-Abstract-cover-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Use-of-Dental-Care-Among-Adolescents-Abstract.pdf)View abstract **You may also be interested in:** - [Challenges in Implementing School-Based Oral Health Programs: Short- and Long-Term Impact of COVID-19](https://www.carequest.org/resource-library/challenges-implementing-school-based-oral-health-programs-short-and-long-term), a research brief outlining the challenges COVID-19 has presented in providing and implementing school-based oral health programs. - [School-Based Oral Health Care and COVID-19](https://www.carequest.org/education/webinars/school-based-oral-health-care-and-covid-19), a webinar which explores the impact school closures has on delivering dental care to children during the pandemic. - [School Dental Programs Face Stiff Challenges](https://www.carequest.org/resource-library/school-dental-programs-face-stiff-challenges), a report that explores how the oral health care of children has been disrupted because of COVID-19. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Dental Providers Offer a Key Access Point for COVID-19 Booster Shots](https://carequest.org/resource/dental-providers-offer-a-key-access-point-for-covid-19-booster-shots/) **Published:** June 7, 2021 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dental-Providers-Access-Booster-Vaccines_Brief-Cover.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dental-Providers-Access-Booster-Vaccines_Brief.pdf)Read brief After the early success in rolling out the COVID-19 vaccines, it’s becoming clear that people will likely need an additional “booster” shot to ensure ongoing immunity. Dental providers can play an important role by administering both vaccines and booster shots that will protect Americans from the virus or new variants. In March 2021, CareQuest Institute for Oral Health surveyed 377 dental providers in the DentaQuest network, assessing their willingness to administer the COVID-19 vaccine and subsequent boosters. **Key findings include:** - 49% of dental providers said they were either offering the COVID-19 vaccine to patients or were interested in doing so. - Dental providers in public health settings were 10 times more likely to be offering COVID-19 vaccines than providers in private practice (44% versus 4%). - However, 43% of providers in private practice expressed interest in offering the vaccine. Each year, more than 19 million Americans visit a dentist but do not see any other medical providers. Dental practices can be a key access point for the immunizations that will [reduce barriers to care](https://www.carequest.org/topics/expanding-access) and allow Americans to return to normal life. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dental-Providers-Role-Booster-Vaccines_Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Dental-Providers-Role-Booster-Vaccines_Abstract.pdf)View abstract **You may also be interested in:** - [Dentists are an Untapped Resource for Delivering COVID-19 Vaccines](https://www.carequest.org/resource-library/dentists-are-untapped-resource-delivering-covid-19-vaccines): CareQuest Institute for Oral Health found that over half of respondents (57%) in a recent oral health equity survey are willing to receive the COVID-19 vaccine, and 60% of people who are willing to get the vaccine are also willing to receive it from a dentist. - [State of Oral Health Equity in America: COVID-19, Vaccines, and Teledentistry:](https://www.carequest.org/education/webinars/state-oral-health-equity-america-covid-19-vaccines-and-teledentistry) This is the first of two webinars that focuses on the findings from a survey around oral health inequities, COVID-19 vaccination efforts by oral health care providers, and teledentistry experiences and access. - [State of Oral Health Equity in America 2021:](https://www.carequest.org/state-oral-health-equity-america-2021) A series of reports developed from findings from a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. **Categories:** Publication, Resource **Tags:** Medical-Dental Integration --- ### [New Survey Suggests Optimism about Teledentistry Experience and Access](https://carequest.org/resource/new-survey-suggests-optimism-about-teledentistry-experience-and-access/) **Published:** June 8, 2021 **Author:** Darren Edwards **Content:** ## State of Oral Health Equity in America 2021 Research Report #3 [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-New-Survey-Suggests-Optimism-about-Teledentistry-Report-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-New-Survey-Suggests-Optimism-about-Teledentistry-Report.pdf)Read report The COVID-19 pandemic changed health care in myriad ways, including the [acceleration of telehealth](https://www.carequest.org/topics/teledentistry). In fact, a nationally representative survey found that the majority of Americans have experienced a telehealth visit with a medical provider as of March 2021. Most of those telehealth visits, however, weren’t teledentistry. A new report based on the [State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021) survey found that many patients have not experienced a virtual visit with a dental provider — only 2% of survey respondents had received dental care remotely in the last year. This is, at least in part, because of limited awareness and availability — 63% of respondents were unaware of whether their dentist offered teledentistry and 33% said they knew their dentist did not. Overall, patients who had experiences with teledentistry had positive feedback, and many who had never had a virtual visit were willing to try it, given the opportunity. Of note: - Among the 2% who have seen providers remotely, nearly 4 in 10 respondents (39%) rated their teledental visit as being roughly the same as an in-person appointment. - Nearly as many (36%) said they were “very likely” to see a dental provider remotely in the future. - More than one-third (35%) of respondents who hadn’t yet participated in teledentistry said they would be willing to try it. This survey suggests an opportunity for dental providers to grow their capacity to use teledentistry, given the overall satisfaction among the small group of patients and positive attitude toward its potential use. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Can-Improve-Expand-Access-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Can-Improve-Expand-Access-Abstract.pdf)View abstract Read more about other findings from the survey in our new series, [**State of Oral Health Equity in America 2021**](https://www.carequest.org/state-oral-health-equity-america-2021). **You may also be interested in:** - [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money): A CareQuest Institute brief that explores dental service utilization patterns and rate of return following teledentistry visits. - Additional reports and graphics on our [Teledentistry topic page.](https://www.carequest.org/topics/teledentistry) **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Equity and Community Engagement in Statewide Oral Health Policy Advocacy](https://carequest.org/resource/equity-and-community-engagement-in-statewide-oral-health-policy-advocacy/) **Published:** June 22, 2021 **Author:** Darren Edwards **Content:** ## An Analysis of the Field and Recommendations for Improvement What can advocates, funders, and community-based organizations (CBOs) do to improve the oral health of underserved and marginalized communities? In 2020, Community Catalyst embarked on a research project, with the support of CareQuest Institute, to examine key aspects of this question related to advocacy and community engagement. A new report provides a roadmap — including key data and recommendations — that will help build partnerships that promote sustainable, equity-informed, [community-driven advocacy.](https://www.carequest.org/how-we-work/policy-and-advocacy) **Key recommendations from the report include:** - Cultivate funders outside of oral health. - Invest in effective coalition building. - Strengthen advocates’ competency in community engagement. - Equitably boost resources for community-based organizations. - Evaluate if advocacy strategies are centering communities. - Dedicate funding for long-term success. - Assess progress in many ways. The project examined how to strengthen advocacy efforts that more [effectively promote equity](https://www.carequest.org/topics/health-equity), engage marginalized communities, and meet their oral health needs. The research process for the report, which was co-authored by CareQuest Institute experts, consisted of qualitative interviews and quantitative pre-interview surveys with 22 participants from 12 states, including 9 statewide advocacy organizations, 6 CBOs, and 7 funders. [**Executive Summary**](https://www.communitycatalyst.org/resources/publications/document/FINAL-field-scan-exec-summary_formatted.pdf?1624305468) [**Full Report**](https://www.communitycatalyst.org/resources/publications/document/FINAL-field-scan-report_formatted-1.pdf) **You may also be interested in:** - CareQuest Institute’s [Advancing Equity Through Oral Health funding opportunities](https://www.carequest.org/grantmaking/advancing-equity-through-oral-health-fund) - CareQuest Institute [grant application process](https://www.carequest.org/grantmaking/apply) - Searchable database of [all CareQuest Institute grants](https://www.carequest.org/grantmaking/other-initiatives/search-all-grants) **Categories:** Publication, Resource **Tags:** Health Equity --- ### [Care Coordination in a Community Health Center with Integrated Scheduling and Electronic Health Records](https://carequest.org/resource/care-coordination-in-a-community-health-center-with-integrated-scheduling-and-electronic-health-records/) **Published:** June 28, 2021 **Author:** Darren Edwards **Content:** [![View journey](https://carequest.org/wp-content/uploads/2025/11/Case-Study_Care-Coordination-Journey-300x194.png)](https://carequest.org/wp-content/uploads/2025/11/Case-Study_Care-Coordination-Journey.pdf)View journey *This is part of a series of case studies that depict various types of oral health care coordination. The series is designed to illustrate how individuals may interact with the health care system, demonstrate communication between providers, and highlight the importance of oral health information exchange.* Dr. Vasquez is the primary care provider for Elena Thompson, a 42-year-old woman with a history of hypertension and opioid use disorder (OUD). She lives with her two young daughters and her husband. She is prescribed amlodipine 5mg for her hypertension and buprenorphine/naloxone 8mg/2mg which she takes three times daily for her OUD. At their quarterly visit, Elena’s BMI is 24, HR 67, BP 128/84 and temperature 97.8. Her urine toxicology screen is positive for buprenorphine but no other substances. Elena tells Dr. Vasquez that she would like to return to work as a paralegal but feels very anxious about interviewing for jobs because of her “bad teeth.” **[Review Full Case](https://carequest.org/wp-content/uploads/2025/11/Case-Study_Care-Coordination-Elena.pdf)** **Categories:** Resource, Tool **Tags:** Medical-Dental Integration --- ### [National Trends in Emergency Department Visits for Nontraumatic Dental Injuries](https://carequest.org/resource/national-trends-in-emergency-department-visits-for-nontraumatic-dental-injuries/) **Published:** July 1, 2021 **Author:** Darren Edwards **Content:** A new study published in *Pediatric Dentistry* examines trends and characteristics of pediatric nontraumatic dental condition (NTDC) visits to emergency departments in the United States from 2010 to 2017. According to the study, emergency department visits for NTDC by pediatric patients decreased over time following the implementation of the Affordable Care Act. Despite this decrease, low socioeconomic status children continue to utilize emergency departments for dental conditions at higher rates than their peers. [Click here to view the article](https://www.ingentaconnect.com/content/aapd/pd/2021/00000043/00000003/art00009;jsessionid=j3eafq22mnko.x-ic-live-02#trendmd-suggestions) (subscription required). **You may also be interested in:** [Pediatric Primary Care and Oral Health](https://www.carequest.org/resource-library/pediatric-primary-care-and-oral-health), a brief that evaluates oral health services being provided in medical well-child visits and the need for greater integration of oral health in primary care. [The Effect of Well Child Visit Location on Preventative Dental Visit](https://www.carequest.org/resource-library/effect-well-child-visit-location-preventative-dental-visit-0), an article that contributes to the understanding of medical‐dental integration among Medicaid‐enrolled children. [Trends in national opioid prescribing for dental procedures among patients enrolled in Medicaid](https://www.master-7rqtwti-hjhj5wgvaqgv6.us-4.platformsh.site/resource-library/trends-national-opioid-prescribing-dental-procedures-among-patients-enrolled), an article that shows how opioid prescription rates in dentistry for people enrolled in Medicaid declined substantially from 2012 through 2019 for both children and adults. **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Health Equity --- ### [Inequities Remain Pervasive in Oral Health](https://carequest.org/resource/inequities-remain-pervasive-in-oral-health/) **Published:** July 6, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_SNOHE-Info_OH-Attitudes-Cover-251x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-SNOHE-Info-Oral-Health-Attitudes.pdf)View visual report The COVID-19 pandemic exacerbated inequities in the United States and further limited access to dental care among already disadvantaged groups. But there is hope on the horizon. Increasingly, the American public is recognizing the importance of oral health and believes our oral health system needs to change. A new visual report from CareQuest Institute for Oral Health about pervasive inequities in oral health highlights findings from a recent survey of 5,320 adults. Most notably: - 57% of Black adults have lost one or more permanent teeth due to decay or gum disease compared to 46% of all American adults. - Black respondents (40%) were 2x more likely to respond that oral health is more important than physical health compared to white respondents (20%). - 95% of all respondents know that there is a connection between the health of the mouth and the health of the rest of the body. - 87% of respondents support the alignment of payment with prevention and management of disease, key elements in value-based care. The visual report, drawn from findings from the [State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021), also highlights disparities between different groups in terms of the prevalence of different oral health problems and attitudes toward value-based payment within different income levels. **You may also be interested in:** - [A suite of resources](https://www.carequest.org/state-oral-health-equity-america-2021) — including visual reports and research reports — developed from findings from a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. - [Consumer Perspectives on Oral Health Access, Outcomes, and Quality of Care](https://www.carequest.org/education/webinars/consumer-perspectives-oral-health-access-outcomes-and-quality-care), a recent webinar featuring a panel of experts who discuss the disparities in dental insurance coverage and access to care, and explore findings on the effects of the social determinants of health. - More on how CareQuest Institute is focusing on [health equity.](https://www.carequest.org/topics/health-equity) **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Oral Disease Is Common. Access to Care Is Not.](https://carequest.org/resource/oral-disease-is-common-access-to-care-is-not/) **Published:** July 6, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_SNOHE-Info_Access-and-Symptoms-Cover-265x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-SHONE-Info-Access-And-Symptoms.pdf)View visual report Oral diseases often cause pain and distress on their own — and they can lead to a variety of other health problems. To avoid those problems, access to dental care is critical. But in the U.S., that access is not universal. A new visual report from CareQuest Institute for Oral Health illustrates how oral health care is inequitably distributed among Americans. Drawing on results from the State of Oral Health Equity in America 2021 survey of 5,320 adults, the report shows that people of color and those who have lower incomes bear a disproportionate burden of oral disease and disproportionately lack access to needed care. The COVID-19 pandemic has only made the situation worse. **Key findings include:** - The lower a person’s income, the higher the likelihood of having an oral health symptom in the last 12 months. - 65% of respondents who lost their health insurance due to job loss or change in benefits caused by the COVID-19 pandemic had one or more oral health symptoms and did not get any treatment for them. - Black and Hispanic respondents were three times as likely as white respondents to report that they had never been to a dentist. **You may also be interested in:** - [A suite of resources](https://www.carequest.org/state-oral-health-equity-america-2021) — including visual reports and research reports — developed from findings from a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. - [Consumer Perspectives on Oral Health Access, Outcomes, and Quality of Care](https://www.carequest.org/education/webinars/consumer-perspectives-oral-health-access-outcomes-and-quality-care), a recent webinar featuring a panel of experts who discuss the disparities in dental insurance coverage and access to care, and explore findings on the effects of the social determinants of health. - More on how CareQuest Institute is focusing on [health equity.](https://www.carequest.org/topics/health-equity) **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Dental Insurance Is Out of Reach for Many](https://carequest.org/resource/dental-insurance-is-out-of-reach-for-many/) **Published:** July 6, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_SNOHE-Info_Dental-Insurance-Cover-1-300x295.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-SNOHE-Info-Dental-Insurance-1.pdf)View visual report A recent survey conducted by CareQuest Institute for Oral Health reveals that millions of Americans lack access to dental care, and that many lost their insurance during the COVID-19 pandemic. The survey also found that access is distributed unequally among races and income groups. But Americans of all demographics recognize the importance of dental insurance, agreeing that public plans should cover dental care for people of all ages. **Key findings include:** - An estimated 76.5 million adults, or 30%, do not currently have dental insurance. - Approximately 6 million of those without dental insurance reported recently losing their dental insurance due to COVID-19 benefit changes or job losses. - Nearly 2/3 of American adults strongly agree that comprehensive oral health care for adults should be covered by Medicaid (65%) and by Medicare (66%). The visual report, drawn from findings from the [State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021), also includes details about differences among racial and income groups in terms of oral health access and public opinion. **You may also be interested in:** - [A suite of resources](https://www.carequest.org/state-oral-health-equity-america-2021) — including visual reports and research reports — developed from findings from a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. - [A visual report](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways) on how cutting Medicaid benefits could hurt states in unexpected ways. - More on how CareQuest Institute is focusing on [protecting and expanding adult dental benefits.](https://www.carequest.org/topics/adult-dental-benefit) **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Health Equity --- ### [Teledentistry: What to Know & How It Works](https://carequest.org/resource/teledentistry-what-to-know-how-it-works/) **Published:** July 20, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-What-To-Know-Cover-233x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-What-To-Know.pdf)View visual report Teledentistry promotes equitable access to oral health care and represents an expansion of existing care, not a new form of care. Whether provided within a dental office, in a community setting, or from a patient’s home, the suite of virtual tools allows for the delivery of health care services when patients can’t be seen in a traditional office setting. How much did the use of teledentistry expand during the pandemic? And how do providers and patients feel about it? A new visual report from CareQuest Institute aggregates highlights from several surveys and reports to show how teledentistry is growing across different US states, the services teledentistry supports, and both provider and patient perspectives on the technology. Of note: - In a survey from August 2020, nearly a quarter of dental providers were seeing patients via telehealth platforms. - In that same survey, public health dental providers were twice as likely as all other practice types to use telehealth. - In a survey from June 2020, 86% of patients said they were satisfied with their overall teledentistry experience and would recommend teledentistry to another person. The visual report also highlights several examples of community-based programs, health centers, health systems, and private practices that are making use of teledentistry to help reduce barriers to care. **You may also be interested in:** - [New Survey Suggests Optimism about Teledentistry Experience and Access:](https://www.master-7rqtwti-hjhj5wgvaqgv6.us-4.platformsh.site/resource-library/new-survey-suggests-optimism-about-teledentistry-experience-and-access) A CareQuest Institute report that highlights patients’ positive experiences and willingness to try teledentistry. - [Teledentistry Is an Effective Tool to Triage Patients and Save Money:](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money) A CareQuest Institute brief that explores dental service utilization patterns and rate of return following teledentistry visits. - Additional reports and graphics on our [Teledentistry topic page.](https://www.carequest.org/topics/teledentistry) **Categories:** Resource, Visual Report **Tags:** Health Equity, Practice Management --- ### [Determinants of Tooth Loss in a Medicaid Adult Population](https://carequest.org/resource/determinants-of-tooth-loss-in-a-medicaid-adult-population/) **Published:** July 29, 2021 **Author:** Darren Edwards **Content:** A new study published in *JDR Clinical & Translational Research* examines the determinants of tooth loss in a Medicaid-enrolled population using claims data from 2016-2018, helping dental care providers understand the risk of tooth loss in their patient population. Among the findings: - Periodontal treatment is protective against tooth loss — especially reducing the odds of losing six or more teeth - Having comorbidity increased the odds of tooth loss compared to no comorbidity - Compared to zero comorbidity, having one, two, or 3+ comorbidities steadily increased the odds of tooth loss - Older African American and Hispanic patients had higher odds of six or more teeth loss compared to whites This study provides strong evidence for policymakers to consider policy changes to prevent tooth loss. The evidence of periodontal treatment’s protective effect in the prevention of tooth loss can be used to emphasize the increase in Medicaid adult dental coverage to include periodontal treatment in all states. [Click here to view the article.](https://journals.sagepub.com/eprint/AWDE3MTDFVTIYDJC83MB/full) **You may also be interested in:** - [Mouths Matter More Than You May Know](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know-0): A brief that outlines how tooth decay, gum disease, and more can have an impact on diabetes, respiratory health, and blood pressure. - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.master-7rqtwti-hjhj5wgvaqgv6.us-4.platformsh.site/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways): A visual report that shows how cuts could harm job growth and increase costs. - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.master-7rqtwti-hjhj5wgvaqgv6.us-4.platformsh.site/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways): A toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits, but expand them as well. **Categories:** Journal Article, Resource **Tags:** Dental Coverage --- ### [Trends in National Opioid Prescribing for Dental Procedures among Patients Enrolled in Medicaid](https://carequest.org/resource/trends-in-national-opioid-prescribing-for-dental-procedures-among-patients-enrolled-in-medicaid/) **Published:** August 2, 2021 **Author:** Darren Edwards **Content:** A study published in *The Journal of the American Dental Association* found that opioid prescription rates in dentistry for people enrolled in Medicaid declined substantially from 2012 through 2019 for both children and adults. More specifically, the results showed: - Consistent decreases in opioid prescription rates from 2.7% to 1.6% among children (aged 0-20 years) and from 28.6% to 12.2% for adults (aged 21-64 years). - A decrease in adult opioid prescription rate for nonsurgical [dental procedures](https://www.sciencedirect.com/topics/medicine-and-dentistry/dental-procedure "Learn more about dental procedures from ScienceDirect's AI-generated Topic Pages") from 9.7% to 2.9%. - A decrease in adult opioid prescription rate for surgical procedures from 48.0% to 28.7%. Although the trends revealed declining opioid prescription patterns, the analysis suggests that the overall rate is still too high, and prescriptions are being written unnecessarily when an alternative treatment would be more effective in managing pain and reducing the incidence of opioid use disorder. [Click here to view the article.](https://www.sciencedirect.com/science/article/pii/S0002817721002440) **You may also be interested in:** - [Opioid Overdose Deaths and Emergency Department Visits for Dental Conditions in Maryland](https://www.carequest.org/resource-library/opioid-overdose-deaths-and-emergency-department-visits-dental-conditions-maryland): A research that demonstrates how rates of opioid-related overdose deaths increased over time with the use of the ED for dental condition. - [Opioid Prescribing by TennCare Dentists](https://www.carequest.org/resource-library/opioid-prescribing-tenncare-dentists): A report that reveals dentists providing care within Tennessee’s Medicaid program wrote far fewer opioid prescriptions in 2019, indicating a successful policy change to reduce the number of opioids dispensed to dental patients. **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Health Equity --- ### [Provider and Public Perceptions of Silver Diamine Fluoride (SDF)](https://carequest.org/resource/provider-and-public-perceptions-of-silver-diamine-fluoride-sdf/) **Published:** August 4, 2021 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-SDF-Acceptance-Cover-238x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-SDF-Acceptance.pdf)View visual report Silver diamine fluoride (SDF) is highly effective in arresting the progression of active caries as well as preventing new lesions. It has been commonly used as a treatment for children, and many parents appreciate its ease of use. Evidence shows that the application of SDF in children arrested 61% of new carious lesions. However, SDF is not without downsides: it leaves a black stain on these lesions and may burn or stain the soft tissue surrounding them. Given all this, how do dental providers and patients view SDF? A new visual report from CareQuest Institute for Oral Health offers details on their attitudes. Key findings include: - 90% of nearly 400 surveyed providers agreed that [SDF is an effective treatment](https://www.carequest.org/about/blog-post/answers-17-your-silver-diamine-fluoride-questions). - 78% of the surveyed adults think that the application of SDF on posterior teeth is acceptable versus only 20% who think it is acceptable on anterior teeth. - Females were more likely than males to accept SDF as the treatment of choice for both posterior and anterior teeth. **You may also be interested in:** - [A suite of resources](https://www.carequest.org/state-oral-health-equity-america-2021) — including visual reports and research reports — developed from findings from a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. - [Consumer Perspectives on Oral Health Access, Outcomes, and Quality of Care](https://www.carequest.org/education/webinars/consumer-perspectives-oral-health-access-outcomes-and-quality-care), a recent webinar featuring a panel of experts who discuss the disparities in dental insurance coverage and access to care, and explore findings on the effects of the social determinants of health. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. **Categories:** Resource, Visual Report **Tags:** Clinical Practice, Minimally Invasive Care --- ### [Financial Impact of Emergency Department Visits for Dental Conditions in Maryland: An Update](https://carequest.org/resource/financial-impact-of-emergency-department-visits-for-dental-conditions-in-maryland-an-update/) **Published:** August 5, 2021 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-MDAC-Report-on-ED-Trends-Cover-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-MDAC-Report-on-ED-Trends.pdf)Read report When people don’t have access to dental insurance, they often resort to the emergency department (ED) for severe dental problems — resulting in far costlier care. In 2018, the state of Maryland launched a pilot program designed in part to address this issue. The program provided dental benefits for Maryland adults who were dually eligible for Medicare and Medicaid. Although additional research is needed to understand the efficacy of the program, an updated CareQuest Institute for Oral Health report underscores why expanding dental benefits to Medicaid participants is an opportunity for policy change to reduce ED visits for non-traumatic dental conditions (NTDC). Key findings include: - Although Medicaid members comprise only 17% of Maryland adults, they account for 54% of all the state’s ED visits for NTDCs and 46% of total cost. - Maryland continues to have rates of adult ED visits for NTDCs that exceed the national average. - Like in other states, younger adults are much more likely to visit hospital EDs for NTDCs than older adults in Maryland. In 2019, the rate of visits among adults aged 20-34 was more than double the rate among those aged 45 or older. This final and important finding suggests that states seeking to reduce ED visits could make greater progress toward reducing costs associated with ED visits for NTDCs by improving the quality of Medicaid dental benefits for all eligible members, as opposed to focusing on subgroups that are older or that have a higher prevalence of chronic diseases. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Abstract_Emergency-Department-Visits-for-Non-Traumatic_Dental-Conditions-Among-Adults-in-Maryland.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Emergency-Department-Visits-for-Non-Traumatic_Dental-Conditions-Among-Adults-in-Maryland.pdf)View abstract **You may also be interested in:** - [Determinants of Tooth Loss in a Medicaid Adult Population](https://www.carequest.org/resource-library/determinants-tooth-loss-medicaid-adult-population): A new study published in *JDR Clinical & Translational Research* examines the determinants of tooth loss in a Medicaid-enrolled population using claims data from 2016-2018, helping dental care providers understand the risk of tooth loss in their patient population. - [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt-states-unexpected-ways): A visual report that shows how cuts could harm job growth and increase costs. - [Medicaid Adult Dental Benefit Toolkit for Advocates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefit-toolkit-advocates): A toolkit designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits but expand them as well. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Loss of Insurance Leads to Hard Decisions for Many Patients](https://carequest.org/resource/loss-of-insurance-leads-to-hard-decisions-for-many-patients/) **Published:** August 5, 2021 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Loss-of-Insurance-Leads-to-Hard-Decisions-Cover.pdf_-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Loss-of-Insurance-Leads-to-Hard-Decisions.pdf)Read brief A new national survey of nearly 400 dental providers participating in Medicaid dental plans offers more evidence that the pandemic is contributing to a coming surge in oral disease. In the new survey, conducted by CareQuest Institute, nearly half of dental providers (46%) said they observed an increase in the number of patients who reported having lost their commercial dental insurance because of a job loss related to the pandemic. Providers who saw this increase in the loss of coverage said that patients lacking insurance had taken a variety of actions: - 73% of providers said these patients had cancelled a dental appointment. - 62% said these patients had postponed an appointment. - 41% said these patients had asked about alternative treatment plans. - 35% said these patients kept their appointments and asked about private pay or other options for financing the cost of care These findings echo the takeaways from a [2021 survey of consumers](https://www.carequest.org/learn/online-learning-center/resource-library/coming-surge-oral-health-treatment-needs) that showed about 6 million U.S. adults lost their dental insurance because of job losses or benefits changes during the COVID-19 pandemic. These data raise concerns that both the dental and medical care system could face a rising stream of patients with more acute oral health or systemic health needs. **You may also be interested in:** - [A suite of resources](https://www.carequest.org/state-oral-health-equity-america-2021) — including infographics and reports — developed from findings from a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. - [Dental Providers Offer a Key Access Point for COVID-19 Booster Shots](https://www.carequest.org/resource-library/dental-providers-offer-key-access-point-covid-19-booster-shots), a brief that assesses the willingness of dental providers to administer the COVID-19 vaccine and subsequent boosters. - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery), a report that explores the ways COVID-19 has changed how dentists will practice going forward. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [Dental Visits during Pregnancy: Pregnancy Risk Assessment Monitoring System Analysis 2012–2015](https://carequest.org/resource/dental-visits-during-pregnancy-pregnancy-risk-assessment-monitoring-system-analysis-2012-2015/) **Published:** August 9, 2021 **Author:** Darren Edwards **Content:** A new study published in *JDR Clinical & Translational Research* found the Black-white disparity and disparity among Medicaid-enrolled women in visiting dentists during pregnancy persist. Oral health, the authors conclude, needs to be included in the standard prenatal care through oral health education and timely dental care during pregnancy. With mounting evidence of persisting disparities in dental service utilization during pregnancy, both public and private prenatal programs and policies should address specific barriers in accessing and using dental care during pregnancy, especially for women from socially disadvantaged backgrounds. [Click here to view the article.](https://journals.sagepub.com/eprint/KVSWI7HAI2A7CEU3VP5H/full) **You may also be interested in:** [Oral Disease Is Common. Access to Care Is Not.](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) An infographic that illustrates how oral health care is inequitably distributed among Americans. [Inequities Remain Pervasive in Oral Health](https://www.carequest.org/resource-library/inequities-remain-pervasive-oral-health), an infographic that highlights disparities between different groups in terms of the prevalence of different oral health problems and attitudes toward value-based payment within different income levels. [Equity and Community Engagement in Statewide Oral Health Policy Advocacy](https://www.carequest.org/resource-library/equity-and-community-engagement-statewide-oral-health-policy-advocacy), a report that examines how to strengthen advocacy efforts that more effectively promote equity, engage marginalized communities, and meet their oral health needs. **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Medical-Dental Integration --- ### [School Dental Programs Face Stiff Challenges](https://carequest.org/resource/school-dental-programs-face-stiff-challenges/) **Published:** December 2, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-School-Dental-Programs-Face-Stiff-Challenges-Brief-Cover_0-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-School-Dental-Programs-Face-Stiff-Challenges-Brief.pdf)Read report School-Based Oral Health Programs (SBOHPs) provide a vital service to children who don’t always have access to health care outside of school. The COVID-19 pandemic has exacerbated this issue as school closures have limited the ability for children to receive basic preventative care. A new report from CareQuest Institute for Oral Health and the [Association of State and Territorial Dental Directors](https://www.astdd.org/) (ASTDD) finds that this disruption has major implications for the oral health of children. In June 2020, ASTDD disseminated a survey, supported by the Institute, of the oral health program directors in all U.S. states and territories to learn their plans for implementing SBOHPs during the 2020-2021 school year. In all, directors in 44 states or territories participated in the survey. **Some key findings from the report:** - 84% of state/territorial directors said they were spending at least some time on pandemic-related support, including communication materials for executive orders, dental licensing board consultation, dental provider communication, and [infection control guidance](https://www.carequest.org/osap). - The [Centers for Disease Control and Prevention](https://www.cdc.gov/) (CDC) has cited the [crucial role of SBOHPs](https://www.cdc.gov/healthyschools/npao/oralhealth.htm) in reducing decay and helping children “stay healthy and ready to learn.” The CDC has called these programs “especially important for reaching children from low-income families who are less likely to receive private dental care.” - 35% of directors said that most of their time was devoted to assisting with COVID-19 related activities. While it’s clear the pandemic has posed serious challenges for schools, parents and children, it also presents an opportunity for oral health programs to reassess priorities and develop contingency plans on how to continue providing these services to low-income children if a similar health crisis in the future disrupts SBOHPs. [![View infographic](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Access-to-Oral-Health-in-Schools-Infographic_Page_1-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Access-to-Oral-Health-in-Schools-Infographic.pdf)View infographic **You may also be interested in:** - [Why We Must Preserve School-Based Oral Care for Children](https://whatsnew.dentaquest.com/why-we-must-preserve-school-based-oral-care-for-children/) looks at why ensuring every child — regardless of their background — has access to oral health care is key to reducing the deep racial disparities in health care. - [Low-Income Students May Lose Dental Care Due To COVID-19 Related School Closings](https://whatsnew.dentaquest.com/low-income-students-may-lose-dental-care-due-to-covid-19-related-school-closings/) explores why it’s important for school districts and oral health stakeholders to work together to preserve school-based access to care for children and families who rely on their dental programs each year. - The Association of State and Territorial Dental Directors website contains [resources for SBOHPs during COVID-19](https://www.astdd.org/school-and-adolescent-oral-health-committee/). - The Centers for Disease control has released [guidance for school-based programs](https://www.cdc.gov/oralhealth/dental_sealant_program/school-sealant-programs-considerations-during-COVID-19.html). **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Public Health Dental Providers Embrace COVID-19-Related Changes](https://carequest.org/resource/public-health-dental-providers-embrace-covid-19-related-changes/) **Published:** December 10, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Public-Health-Dental-Providers-Embrace-COVID-19-Changes-Report-Cover_0.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Public-Health-Dental-Providers-Embrace-COVID-19-Changes-Report.pdf)Read report A new survey by CareQuest Institute for Oral Health reveals that the COVID-19 pandemic has spurred greater awareness and concerns among dental providers who work in Federally Qualified Health Centers (FQHCs) and other public health settings. **Some key findings from the report:** - Screening patients and staff for COVID-19 risk factors is more of a priority for public health dental professionals (PHDPs) than for providers in other types of settings. Over 85% of public PHDPs say screening is important, compared to 68% of other providers. - More than 90% of PHDPs think it is important to secure and properly use PPE and to clean and disinfect dental operatories, while only three-quarters of providers in other types of practices view these tasks as important. - Among PHDPs, 53% are currently using teledentistry or plan to use it soon, compared to 32% of other providers. The outcomes of the survey demonstrate the continuing need for providers to innovate during the pandemic and beyond. Teledentistry and alternative payment models such as value-based care are examples of ways to embrace the changes that resulted from the pandemic. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Public-Health-Dental-Providers-Embrace-COVID-19-Changes-Report-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Public-Health-Dental-Providers-Embrace-COVID-19-Changes-Report-Abstract.pdf)View abstract **You may also be interested in:** - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery)**,** a report that explores the ways COVID-19 has changed how dentists will practice going forward. - [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story) explains how and why community health centers are often well-positioned to adopt value-based care. **Categories:** Publication, Resource **Tags:** Health Equity, Practice Management --- ### [Alternative Payment Models in Dentistry](https://carequest.org/resource/alternative-payment-models-in-dentistry/) **Published:** November 24, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Alternative-Payment-Models-in-Dentistry-Report-Cover_0-230x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Alternative-Payment-Models-in-Dentistry-Report.pdf)Read report A report from CareQuest Institute for Oral Health — based on findings from a survey of 2,757 dental providers in more than 20 states — reveals that there is a need for provider awareness and education about alternative payment models and that COVID-19 has created opportunities to advance alternative payment models within the oral health care system. **Some key findings from the report:** - Half of (51%) of responding providers have never heard of APMs in dentistry, while 35% had only heard of APMs or knew a little about them. - APMs are increasingly being used both in Medicaid and Medicare and are even entering private insurance. Nearly 70% of Medicaid beneficiaries are enrolled in managed care plans today. - Federally Qualified Health Centers (FQHCs) have a model of care and organizational infrastructure that may allow for an advantage for engaging in APMs and value-based care delivery systems. Along with education and awareness, there is evidence that value-based care models in dentistry need to be piloted and tested. A value-based care payment approach in dentistry will involve incremental approaches since public financing plays a smaller role in dentistry than in medicine. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Alternative-Payment-Models-in-Dentistry-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Alternative-Payment-Models-in-Dentistry-Abstract.pdf)View abstract **You may also be interested in:** - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that explores how and why community health centers are often well-positioned to adopt value-based care. - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery)**,** a report that explores the ways COVID-19 has changed how dentists will practice going forward. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient and equitable. **Categories:** Publication, Resource **Tags:** Value-Based Care --- ### [Discrimination Reduces Utilization of Routine Dental Care](https://carequest.org/resource/discrimination-reduces-utilization-of-routine-dental-care/) **Published:** November 9, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Discrimination-Reduces-Utilization-of-Routine-Dental-Care-Report-Cover_0-229x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Discrimination-Reduces-Utilization-of-Routine-Dental-Care-Report.pdf)Read report A new research report from CareQuest Institute for Oral Health reveals that increased exposure to lifetime discrimination experiences is associated with a decreasing likelihood of getting routine dental care. More specifically, participants from the National Survey of Midlife Development in the United States Refresher who reported 4 or more discrimination experiences were 36% less likely to have a routine dental visit in the past 12 months. In this study, we defined discrimination as the accumulation of socially structured actions resulting in unfair or unjustified harm to the individual over the course of their lifetime. **Other findings from the report:** - With every additional discrimination experience, participants were 6% less likely to have a routine dental visit. - Over time, repeated discriminatory experiences, particularly within a health care setting, creates mistrust or fear in marginalized communities that can further impede the probability of patients accessing needed care. - There’s an ongoing need to address historic disparities that can result in unmet dental needs, while modernizing the oral health system to create more equitable outcomes. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Discrimination-Reduces-Utilization-of-Routine-Dental-Care-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Discrimination-Reduces-Utilization-of-Routine-Dental-Care-Abstract.pdf)View abstract **Additional resources you may be interested in:** - View a [webinar recording](https://www.carequest.org/education/webinars/covid-19-impact-health-inequity) that addressed the effects of COVID-19 on the oral and overall health of racial and ethnic minority groups. - Read a blog post about what [COVID-19 Is Teaching Us About Health Equity](https://whatsnew.dentaquest.com/lessons-from-the-pandemic-what-covid-19-is-teaching-us-about-health-equity/). - Watch a [video](https://www.youtube.com/watch?v=pUiJ9jr4lw4&feature=emb_logo) on racism and disparities in oral health. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [Opioid Prescribing by TennCare Dentists](https://carequest.org/resource/opioid-prescribing-by-tenncare-dentists/) **Published:** November 12, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-TennCare-Report-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-TennCare-Report.pdf)Read report A report from CareQuest Institute reveals that TennCare dentists — dentists providing care within Tennessee’s Medicaid program — wrote far fewer opioid prescriptions in 2019, indicating a successful policy change to reduce the number of opioids dispensed to dental patients. The corresponding decrease in the number of overdose deaths in Tennessee from 2017 to 2018 connected to prescription opioids suggests a link to the TennCare policy shift. Specifically, the report shows that, while the number of TennCare patients ages 0 to 20 who received dental care in 2019 was similar to the number in 2017, nearly 11,000 fewer opioid prescriptions were issued in 2019, a difference of 45%. Additional findings from the report include: - A significant drop in the number of higher dose prescriptions issued. The percentage of TennCare dental patients receiving higher daily doses of opioids dropped from 9% in 2017 to just 1.5% in 2019. - A notable reduction in the percent of opioids prescribed for non-surgical dental care, from 21% in 2017 to only 9% in 2019. - Zero prescriptions for opioids containing codeine issued to patients age 0-11 in 2019, while the majority of opioids prescribed to this population in the first half of 2017 contained codeine. Opioids with codeine carry a greater risk of life-threatening complications in children. This research builds off a [2019 report](https://www.carequest.org/sites/default/files/CareQuest-Institute-TennCare-Research-Brief_0.pdf) on opioid prescribing patterns by dental providers authorized by the TennCare dental network between 2017 and 2018. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-TennCare-Report-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-TennCare-Report-Abstract.pdf)View abstract **Additional Resources:** - [Pandemic Hasn’t Erased the Opioid Epidemic](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fcommonwealthmagazine.org%2Fopinion%2Fpandemic-hasnt-erased-the-opioid-epidemic%2F&data=04%7C01%7CMichael.Briddon%40greatdentalplans.com%7C642cb9fe107f453c29bd08d88110c93d%7Cb5014925e83f4fb6a482eb9184fe1c81%7C0%7C0%7C637401256389631970%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=ZnTsjDHYUFbPAh4TDdplh6%2F%2BX36fZUKIQiwG28FXrKg%3D&reserved=0), an article from DentaQuest president and CEO Steve Pollock in *CommonWealth Magazine.* - [Opioid Overdose Deaths and Emergency Department Visits for Dental Conditions in Maryland](https://www.carequest.org/resource-library/opioid-overdose-deaths-and-emergency-department-visits-dental-conditions-maryland), a poster presentation that examines the potential relationship between dental-related ED visits and opioid-related mortality. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [Provider Teledentistry Use Gains Traction During COVID-19](https://carequest.org/resource/provider-teledentistry-use-gains-traction-during-covid-19/) **Published:** November 13, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-Teledentistry-Use-Gains-Traction-During-Covid-19-Report-Cover_0.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-Teledentistry-Use-Gains-Traction-During-Covid-19-Report.pdf)Read report With most providers open for comprehensive dental services, telehealth has become a path to provide safe, efficient and accessible dental care during the pandemic. A new report from CareQuest Institute for Oral Health — based on findings from a survey of 2,767 providers — highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. Providers who experienced financial disruption and expect long-term changes to dental practice from COVID-19 were more likely to use telehealth, according to the report. For many providers, it has been a helpful tool to adapt to new and uncertain environments. **Some key findings from the report:** - 34% of providers see patients via telehealth platforms or plan to use it in the near future - 75% of providers who use telehealth services expect telehealth encounter volume to increase or stay the same during the next 12 months - Public health providers are more likely (44%) to use telehealth than all other practice types (21%) - 60% of providers are using telephone calls and 42% of providers are using free virtual meeting software for telehealth encounters The report also includes a breakdown of teledentistry usage by type and state, financial considerations and opportunities for growth. When the Institute published [a similar study in June](https://www.carequest.org/resource-library/dental-cares-new-normal-survey-reveals-need-adapt), many dental offices were closed or greatly restricted in the care provided. That study revealed that 27% of providers were seeing patients via telehealth and 13% planned to do so in the near future. Fast forward several months and the continued use of telehealth shows it has “staying power” in dentistry. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-Teledentistry-Use-Gains-Traction-During-Covid-19-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-Teledentistry-Use-Gains-Traction-During-Covid-19-Abstract.pdf)View abstract **You may also be interested in:** - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery)**,** a report that explores the ways COVID-19 has changed how dentists will practice going forward - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient and equitable - [Dental Care’s New Normal](https://www.carequest.org/resource-library/dental-cares-new-normal-survey-reveals-need-adapt), a report that explored changes in care from the first few months of the COVID-19 pandemic **Categories:** Publication, Resource **Tags:** Practice Management --- ### [COVID-19 Impacts on Dental Office Visits](https://carequest.org/resource/covid-19-impacts-on-dental-office-visits/) **Published:** December 2, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute-COVID-19-Impact-on-Dental-Visits-Report-cover.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute-COVID-19-Impact-on-Dental-Visits-Report.pdf)Read report A report from CareQuest Institute explores how COVID-19 has amplified the need for accessible and convenient oral health care, as dental teams need to consider how to alter care and business models to address a decrease in the use of dental services. Using aggregated personal mobile device location data from [SafeGraph](https://www.safegraph.com/) to analyze dental patient mobility patterns from Jan. 1, 2020 until Sept. 9, 2020, the Institute report demonstrates opportunities to implement whole-person health care approaches, such as nutrition counseling, and the need for technology-based dental encounters, such as teledentistry. **Some key findings from the report:** - Overall dental office visitation rate decreased from an average of 1.25% in April 2019 to less than 0.75% in the same month of 2020. - Transportation challenges only exacerbate social and health care disparities, particularly in marginalized communities. Costs associated with increased travel coupled with job loss and a plummeting economy seem to pose an additional hardship. - The increased adoption of teledentistry during the stay-at-home orders could have decreased the miles traveled since individuals were able to access oral health care from home. The report also emphasizes that targeted community and public health messaging can be impactful, and the use of mobile device data can be effective in refining these strategies. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-COVID-19-Impacts-on-Dental-Visits-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-COVID-19-Impacts-on-Dental-Visits-Abstract.pdf)View abstract **You may also be interested in:** - [Provider Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19), which demonstrates providers have found teledentistry to be a helpful tool to adapt to new and uncertain environments. - [Dental Care’s New Normal](https://www.carequest.org/resource-library/dental-cares-new-normal-survey-reveals-need-adapt), a report that explored changes in care from the first few months of the COVID-19 pandemic. - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery)**,** a report that explores the ways COVID-19 has changed how dentists will practice going forward. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Reshaping Dentistry in Turbulent Times](https://carequest.org/resource/reshaping-dentistry-in-turbulent-times/) **Published:** December 7, 2020 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Public-Health-Dental-Providers-Embrace-COVID-19-Changes-Report-Cover_0-225x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Public-Health-Dental-Providers-Embrace-COVID-19-Changes-Report-Cover_0.png)Read brief While COVID-19 has severely disrupted the dental care industry, a report from CareQuest Institute for Oral Health explores opportunities to innovate, improve financial sustainability and create greater access to care. Based on survey responses from thousands of dental providers throughout the country, the report reveals that while patient volumes have decreased, dental providers who serve low-income and vulnerable populations continue to leverage telehealth to improve access for their patients and are increasingly interested in alternate payment models (APMs) to enhance their financial sustainability. **Some key findings from the report:** - In June 2020, about 90% of dental providers said their patient volume was reduced on average by half. - Most dental offices had reopened by August 2020 and nearly a quarter (23%) of dental providers are seeing some patients via telehealth platforms. - APMs can offer financial stability and the turbulence resulting from COVID-19 has strengthened provider interest in these models. While dentistry is rapidly changing during the pandemic, the Institute has taken a lead role in reshaping the industry. [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) outlines a roadmap for future care that will be cost-effective, efficient, and more equitable. You may also be interested in other provider surveys and reports on topics related to how COVID-19 has created opportunities for the oral health care industry to create more sustainable financial models, accessibility to care and much more: - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery), a report that explores the ways COVID-19 has changed how dentists will practice going forward. - [Alternative Payment Models in Dentistry](https://www.carequest.org/resource-library/alternative-payment-models-dentistry) offers provider perspective on value-based care and more. - [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Oral Health Providers of Color Face Hardship From COVID-19](https://carequest.org/resource/oral-health-providers-of-color-face-hardship-from-covid-19/) **Published:** December 22, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-of-Color-Face-Greater-Hardships-Impact-COVID-19-Report-Cover_0.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-of-Color-Face-Greater-Hardships-Impact-COVID-19-Report.pdf)Read report Oral health providers of color have been hit hard by COVID-19, however, they are ready to embrace a new normal in oral health. A new report from the CareQuest Institute for Oral Health reveals how COVID-19 has impacted patient volumes, financial stability, infection control procedures and more for this group. **Some key findings from the report:** - 71% of oral health providers of color report significant reductions in patient volumes since the COVID-19 pandemic began, compared to 57% of white providers. - Roughly 60% of oral health providers of color think it’s extremely important to reduce the spread of aerosols through the air and to reduce the use of aerosol-generating procedures, compared to slightly less than half of white providers. - 30% of oral health providers of color anticipate increased use of noncontact dentistry (telehealth, telephone calls, etc.), compared to 18% of white providers. Since oral health providers of color understand that COVID-19 has disproportionately affected patients of color, they understand the impact of this disease and the need to care for their patients. This means these providers are also are more willing to consider minimally invasive procedures and alternative payment models as well as virtual patient encounters such as teledentistry, all in effort to work within dental care’s new normal. [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-of-Color-Face-Greater-Hardships-Impact-COVID-19-Report-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Providers-of-Color-Face-Greater-Hardships-Impact-COVID-19-Report-Abstract.pdf)View abstract **You may also be interested in:** - [Reshaping Dentistry in Turbulent Times](https://www.carequest.org/learn/online-learning-center/resource-library/reshaping-dentistry-turbulent-times) explores opportunities to innovate, improve financial sustainability and create greater access to care. - A [collection of content](https://www.carequest.org/learn/online-learning-center/resource-library/wicked-problem-oral-health-care-system?linkId=100000023901675) from a special edition of the *[Journal of Public Health Dentistry](https://onlinelibrary.wiley.com/toc/17527325/2020/80/S2)* focuses on how the transition to oral health value-based care can strengthen health equity and reduce disparities by redistributing resources aimed at oral health care. - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that explores how and why community health centers are often well-positioned to adopt value-based care. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [Teledentistry Is an Effective Tool to Triage Patients & Save Money](https://carequest.org/resource/teledentistry-is-an-effective-tool-to-triage-patients-save-money/) **Published:** December 10, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Effective-Tool-to-Triage-Patients-and-Save-Money-Report-Cover_0-230x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Teledentistry-Effective-Tool-to-Triage-Patients-and-Save-Money-Report.pdf)Read report Little evidence exists regarding oral health outcomes for patients after a teledentistry visit. To address this gap, CareQuest Institute for Oral Health used the IBM Watson MarketScan Medicaid Database to examine outpatient dental claims data for Medicaid enrollees, specifically looking at dental services utilization patterns and rate of return following a teledentistry visit for the entire year of 2018. **Key findings from the brief:** - Seven in 10 patients had an in-person dental visit within a week of their teledentistry visit. - Among patients who returned for an in-person visit following their teledentistry visit, only 1% of these patients returned for an emergency dental visit. - The cost of treating patients via teledentistry totals 11% ($75) less annually than dental patients seen in person. **You may also be interested in:** - [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) outlines a new model in dentistry that serves as a roadmap for a more cost-effective, efficient and equitable future. - [Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis) explores how providers can use telehealth to consult with patients, triage their needs and offer limited urgent services, deterring those with nontraumatic dental conditions from seeking care in emergency departments. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [System-Level Interventions to Reduce Utilization of General Anesthesia to Treat Dental Caries](https://carequest.org/resource/system-level-interventions-to-reduce-utilization-of-general-anesthesia-to-treat-dental-caries/) **Published:** December 11, 2020 **Author:** Darren Edwards **Content:** Untreated dental caries are common in children, and can result in severe pain and infection. They can sometimes even lead to hospitalization requiring general anesthesia. Interventions, such as community-based preventive care and pre-authorizations for treatment, can reduce the incidence of caries and the cost of treatment. This practice brief identifies interventions that reduced the utilization of general anesthesia for dental caries in children under the age of six at Advantage Dental, a dental service organization based in Oregon. Key points include: - The expansion of the community care team, metrics to reinforce provider education and training, and the use of incentive payments were all associated with reductions in the rate of operating room (OR) utilization. - The preauthorization system provided data to identify knowledge gaps among the providers. - Education and training on evidence-based alternative interventions were (and are) helpful to support behavior change. The practice brief also includes suggested strategies for implementing these initiatives. **[View the article](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12426)** **You may also be interested in:** - [Overcoming Barriers to Dental Care Access Through Community-Based Programs](https://www.carequest.org/resource-library/overcoming-barriers-dental-care-access-through-community-based-programs), a video featuring Sharity Ludwig, EPDH, MS, director of alternative care models at Advantage Dental Oral Health Center and Affiliated Practices, explaining the potential of community care. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient, and equitable. - [Medical Oral Expanded Care (MORE Care)](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), an initiative of CareQuest Institute that aims to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology. **Categories:** Journal Article, Resource **Tags:** Clinical Practice --- ### [The Wicked Problem of the Oral Health Care System](https://carequest.org/resource/the-wicked-problem-of-the-oral-health-care-system/) **Published:** December 30, 2020 **Author:** Darren Edwards **Content:** A special edition of the *[Journal of Public Health Dentistry](https://onlinelibrary.wiley.com/toc/17527325/2020/80/S2)* is dedicated to increasing awareness and education about value-based care (VBC) and the journey to systems change within oral health care. CareQuest Institute for Oral Health served as the guest editorial board, identifying and selecting key articles that advance VBC awareness and illustrate the need for oral health care transformation. In 1973, two *Policy Science* authors coined the phrase *a wicked problem* – one that is complex, hard to define, involves multiple stakeholders and is interconnected with other problems. **Oral Health Care is a Wicked Problem. Value-Based Care Can Help to Solve it.** Framing the special issue, our research leaders outline *The Wicked Problem of the Oral Health Care System* and describe VBC as the solution across these areas of transformation: 1. **Care Transformation.** The provision of care transitions from a siloed model toward a whole-health approach based on an integrated interprofessional practice model that leverages a health home. A transformed health care system engages patients through health promotion and improved outcomes, with a focus on disease prevention, and has a concerted effort to address health inequities and social determinants of health. This transformation includes strategies to reduce clinical variation, increase quality, improve cost savings, and enable patients to live healthier lives in an evidence-based way. 2. **Data & Analytic Transformation.** Health IT systems need to be interoperable and coordinated to allow sharing of health records across all disciplines and providers to coordinate care. A robust data and analytic platform also enables outcome measurement and tracking. 3. **Payment transformation.** Alternative payment models provide reimbursement based on improved access to care, quality, outcomes and cost savings. Financial incentives for providers and health systems are based on reporting data and quality measures that address preventive care and effective care coordination. These measures are evaluated at patient, health system, and population-levels. The oral health environment is at the early stages of transitioning to VBC, and the results of this transition will strengthen health equity and reduce disparities by redistributing resources aimed at oral health care. **You may also be interested in:** - [Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story](https://www.carequest.org/resource-library/value-based-care-federally-qualified-health-center-story), a white paper that explores how and why community health centers are often well-positioned to adopt value-based care. - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery), a report that explores the ways COVID-19 has changed how dentists will practice going forward. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient and equitable. - [Exploring the Wicked Problem of the Oral Health Care System](https://www.carequest.org/education/webinars/exploring-wicked-problem-oral-health-care-system), a webinar recording, and the first in a series that discusses perspectives and solutions. - [Oral Health During COVID](https://info.primarycare.hms.harvard.edu/oral-health-covid), the first webinar in a series from The Center for Primary Care at Harvard Medical School. **Categories:** Journal Article, Resource **Tags:** Value-Based Care --- ### [Medicaid Adult Dental Benefit Toolkit for Advocates](https://carequest.org/resource/medicaid-adult-dental-benefit-toolkit-for-advocates/) **Published:** January 26, 2021 **Author:** Darren Edwards **Content:** [![View toolkit](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Medicaid-Adult-Advocacy-Toolkit_12.9_0-238x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_Medicaid-Adult-Advocacy-Toolkit_12.9.22.pdf)View toolkit The need to keep Medicaid [adult dental benefits](https://www.carequest.org/topics/adult-dental-benefit) is critical, as a rule proposed by the Centers for Medicare & Medicaid Services (CMS) would allow states to reduce or eliminate optional benefits without any loss of enhanced federal funding. That’s why CareQuest Institute created a robust toolkit, designed to help advocates educate policymakers and other stakeholders to not only preserve Medicaid adult dental benefits, but expand them as well. **Some key takeaways from the toolkit:** - Robust dental coverage is highly valued by adults. In a survey of U.S. adults, 51% said they were concerned about their oral health, making it a greater concern than heart, eye, digestive, mental, and skin health. - Without robust Medicaid coverage, the cost of dental care will be unaffordable for many adults. A national survey showed adults were more likely to cite financial barriers as a reason for not getting dental care than they were to cite this as a barrier to medical care, prescription drugs, mental health services or eyeglasses. - Low-income adults without Medicaid dental coverage are more likely to address nontraumatic dental conditions (NTDCs) by seeking care at hospital emergency departments (EDs). The care provided in EDs is expensive and rarely addresses the root causes of NTDCs. This toolkit also contains resources, including an [infographic](https://www.carequest.org/system/files/CareQuest-Institute-Cutting-Medicaid-Adult-Dental-Benefit-Infographic.pdf) describing how cutting Medicaid adult dental benefits will hurt states, a [research report](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families) that reveals why dental coverage is so important for lower-income Americans and other materials to review or share with policy makers. **Categories:** Resource, Tool **Tags:** Dental Coverage --- ### [The COVID-19 Pandemic Deepens Oral Health Inequities](https://carequest.org/resource/the-covid-19-pandemic-deepens-oral-health-inequities/) **Published:** March 29, 2021 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-COVID-19-Pandemic-Deepens-Oral-Health-Inequalities-Brief-Cover-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-COVID-19-Pandemic-Deepens-Oral-Health-Inequalities-Brief.pdf)Read brief COVID-19 has impacted every facet of daily life in 2020. It has exacerbated social, economic, and health care inequities and further limited access to dental care and other necessary health services. Many of the communities that faced barriers to accessing dental care and subsequently experienced the effects of poor oral health prior to the pandemic are also those hardest hit by it. Moreover, oral health providers working to meet the needs of their patients and communities in the midst of the pandemic have experienced financial and operational challenges that impact their ability to reliably provide care. **Categories:** Publication, Resource **Tags:** Health Equity, Practice Management --- ### [A Coming Surge in Oral Health Treatment Needs](https://carequest.org/resource/a-coming-surge-in-oral-health-treatment-needs/) **Published:** April 7, 2021 **Author:** Darren Edwards **Content:** ## State of Oral Health Equity in America 2021 Research Report #1 [![Read report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Coming-Surge-Oral-Health-Treatment-Needs-Report-cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Coming-Surge-Oral-Health-Treatment-Needs-Report-1.pdf)Read report Even before the COVID-19 pandemic, many adults faced barriers to receiving oral health care, increasing their risk of infection and the need for emergency hospital visits. And now, as unmet dental needs worsen while the pandemic lingers and people suffer the loss of jobs and dental insurance, providers could see a surge in oral disease among adults. The prospects for this spike emerged from a recent, nationally representative survey of 5,320 adults commissioned by CareQuest Institute for Oral Health. The survey identified several troubling, simultaneous developments: - An estimated 6 million American adults have lost their dental insurance because of a job loss or benefits change that was caused by COVID-19. - Among those who cited COVID-19 as the reason for losing dental insurance, 65% reported having an oral symptom that often stems from a disease affecting teeth, gums, or other tissues in the oral cavity. - More than 1 in 10 (11%), or 28 million, adults have delayed getting dental care because of one or more concerns, including the cost of care, lack of insurance, or concerns about risk of exposure to the virus. These findings, along with other barriers to care, are setting us on a path to see more oral disease and other systemic health conditions in the near future. Read more about how expanding dental coverage and increasing the use of teledentistry can address these issues and improve our health system in Part 1 of our new series, **[State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021).** [![View abstract](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute-Coming-Surge-Oral-Health-Treatment-Needs-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute-Coming-Surge-Oral-Health-Treatment-Needs-Abstract.pdf)View abstract **You may also be interested in:** - [A Difficult Path to COVID-19 Recovery](https://www.carequest.org/resource-library/difficult-path-covid-19-recovery), a report that explores the ways COVID-19 has changed how dentists will practice going forward. - [A Three Domain Framework to Innovating Oral Health Care](https://www.carequest.org/education/resource-library/three-domain-framework), a white paper that outlines a new model in dentistry that will be more cost-effective, efficient and equitable. - [Exploring the Wicked Problem of the Oral Health Care System](https://www.carequest.org/resource-library/wicked-problem-oral-health-care-system), a webinar recording, and the first in a series that discusses perspectives and solutions. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Mouths Matter More Than You May Know](https://carequest.org/resource/mouths-matter-more-than-you-may-know/) **Published:** April 8, 2021 **Author:** Darren Edwards **Content:** Oral Health’s Connection to Overall Health [![Read brief](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Mouths-Matter-More-Than-You-May-Know-Brief-cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Mouths-Matter-More-Than-You-May-Know-Brief.pdf)Read brief CareQuest Institute’s research confirms the link between oral health and overall health. A new brief outlines how tooth decay, gum disease, and more can have an impact on diabetes, respiratory health, and blood pressure. **Some key findings from the report:** - People with periodontal disease (PD)—also called “gum disease”—have [a 28% higher risk](https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.115.020324) of suffering their first heart attack than those without this disease. - Human Papillomavirus (HPV) is believed to cause [70% of throat cancers](https://www.cdc.gov/cancer/hpv/basic_info/hpv_oropharyngeal.htm), which occur in the oropharynx—the tongue, the rear of the mouth, and the upper portion of the throat. - Researchers in Japan studied more than 1,500 older adults and found that [tooth loss was a risk factor](https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.14791) for dementia. Another research paper concluded that tooth loss “[may be a predictor](https://pubmed.ncbi.nlm.nih.gov/30126407/)” of dementia. The growing evidence connecting oral health with overall health provides helpful insights to inform state policies and integrating oral health into broader health strategies remains key. **You may also be interested in:** - [The Link Between Ventilator-Associated Pneumonia and the Mouth](https://www.carequest.org/resource-library/link-between-ventilator-associated-pneumonia-and-mouth) underscores the breadth of health issues that ongoing oral health care can protect against. - [Impacts Beyond the Mouth](https://www.carequest.org/resource-library/impacts-beyond-mouth), an infographic that highlights the connection between oral health and overall health. **Categories:** Publication, Resource **Tags:** Medical-Dental Integration --- ### [Solutions to Oral Health Inequities](https://carequest.org/resource/solutions-to-oral-health-inequities/) **Published:** April 23, 2021 **Author:** Darren Edwards **Content:** ### CareQuest Institute Contributes to a New Report from Harvard’s Center for Primary Care [![Read report](https://carequest.org/wp-content/uploads/2025/11/Primary-Care-in-the-COVID-19-Pandemic-Harvard-Report-1-244x300.png)](https://carequest.org/wp-content/uploads/2025/11/Primary-Care-in-the-COVID-19-Pandemic-Harvard-Report.pdf)Read report The COVID-19 pandemic has exacerbated previously existing health inequities bringing them into sharper focus. In early 2020, dental providers were under state mandates to limit provision of care. Access to care was reduced while health inequities were magnified – the elderly, people in congregate living facilities, people with underlying health conditions, minority groups, and others not only had higher rates of COVID-19, but also worse health outcomes and higher mortality rates. In addition, the connection between a heathy mouth and a healthy body can’t be ignored. Everything from eating, smiling, employability, self-perception, and perception of others is directly influenced by oral health. Tackling these [health inequities](https://www.carequest.org/topics/health-equity) is a huge challenge, but there are ways we can champion progress and work toward solutions. These solutions include sustained enhanced use of [teledentistry](https://www.carequest.org/topics/teledentistry), minimally invasive dentistry, interprofessional collaborative practice, workforce expansion, [value-based care](https://www.carequest.org/topics/value-based-care), and enhanced public insurance programs. In a new report from The Center for Primary Care at Harvard Medical School (HMS), the CareQuest Institute outlines Solutions to Oral Health Inequities. Check back soon for a recording of our webinar on Oral Health, Primary Care, and the COVID-19 Pandemic. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled](https://carequest.org/resource/the-burden-of-out-of-pocket-expenditures-for-dental-care-on-medicare-enrolled-elderly-and-disabled/) **Published:** February 19, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Burden-of-Out-of-Pocket-Expenditures-Report-cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Burden-of-Out-of-Pocket-Expenditures-Report_0.pdf)Read report A report from CareQuest Institute, the third in a three-part series addressing utilization of dental services and out-of-pocket costs for dental care, focuses on patients on Medicare. It compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. Key findings from the report: - Among all Medicare or Medicare Advantage recipients, at least 75% of total dental costs were paid for out-of-pocket. - Only four percent of those covered by traditional Medicare had dental costs covered by Medicare. - The lack of a mandated dental benefit in Medicare significantly contributes to poor health among America’s elderly and disabled populations. The lack of a dental benefit within Medicare can also contribute to other health problems, increasing costs for patients and for Medicare. Including oral health services within value-based programs could provide incentives for payers and providers to improve individual and population health. **Read the Additional Research Reports in this Series** [Part 1 of 3 Poor Families Spend 10 Times More of Their Income on Dental Care Than Wealthier Families](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families) analyzes oral health needs and financial implications for Americans of different income levels. [Part 2 of 3 Medicaid Adult Dental Benefits Increase Access and Reduce Out-of-Pocket Expenditures](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-increase-access-and-reduce-out-pocket-expenditures) compares the experience of adults enrolled in Medicaid to adults with private coverage and to those who lack coverage. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Hospital Utilization for Non-Traumatic Dental Conditions in Oregon from 2013 to 2015](https://carequest.org/resource/hospital-utilization-for-non-traumatic-dental-conditions-in-oregon-from-2013-to-2015/) **Published:** March 11, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Hospital-Utilization-for-Non-Traumatic-Dental-Conditions-in-Oregon-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Hospital-Utilization-for-Non-Traumatic-Dental-Conditions-in-Oregon.pdf)Read report Access to oral health benefits is a state by state issue – either the coverage is uneven or totally lacking – and can result in costly trips to the hospital for non-traumatic dental conditions. CareQuest Institute took an in-depth look into Emergency Department (ED) visits specifically in Oregon for non-traumatic dental conditions, and found a need for multi-level solutions, such as teledentistry, to decrease ED utilization across the state. ![](https://carequest.org/wp-content/uploads/2020/03/Oregon-map_500x284-1024x582.jpg) **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [The Interprofessional Oral Health Referral](https://carequest.org/resource/the-interprofessional-oral-health-referral/) **Published:** March 31, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Hospital-Utilization-for-Non-Traumatic-Dental-Conditions-in-Oregon-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Hospital-Utilization-for-Non-Traumatic-Dental-Conditions-in-Oregon.pdf)Read report Access to oral health benefits is a state by state issue – either the coverage is uneven or totally lacking – and can result in costly trips to the hospital for non-traumatic dental conditions. CareQuest Institute took an in-depth look into Emergency Department (ED) visits specifically in Oregon for non-traumatic dental conditions, and found a need for multi-level solutions, such as teledentistry, to decrease ED utilization across the state. ![](https://carequest.org/wp-content/uploads/2020/03/Oregon-map_500x284-1024x582.jpg) **Categories:** Publication, Resource **Tags:** Medical-Dental Integration --- ### [NHANES Oral Health Data Reflect Barriers & Inequities](https://carequest.org/resource/nhanes-oral-health-data-reflect-barriers-inequities/) **Published:** May 19, 2020 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-NHANES-Oral-Health-Data-Reflect-Barriers-Inequities-Infographic-1-300x206.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-NHANES-Oral-Health-Data-Reflect-Barriers-Inequities-Infographic.pdf)View visual report Mortality rates from the novel coronavirus are disproportionately high for people of color, generating a vigorous dialogue about health disparities in America. Lacking meaningful medical and dental insurance is one example of how Black and Latino adults can be uniquely vulnerable when a health-related crisis arrives. Access to routine dental care is limited for many Americans, and low-income adults face a particular challenge because of the cost of care or a lack of coverage through Medicaid or Medicare. Lacking access to preventive services, these Americans are less likely to maintain good oral health. Newly released data from the National Health and Nutrition Examination (NHANES) survey (2017-18) reveals that oral health inequities persist. **Categories:** Resource, Visual Report **Tags:** Health Equity --- ### [Dental Care's New Normal: Survey Reveals the Need to Adapt](https://carequest.org/resource/dental-cares-new-normal-survey-reveals-the-need-to-adapt/) **Published:** June 25, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuestInstitute-Dental-Care-New-Normal-Report-Cover-1-233x300.jpeg)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Dental-Care-New-Normal-Report-1.pdf)Read report The COVID-19 pandemic has placed dental offices under significant stress. To learn how they are navigating the situation, the CareQuest Institute for Oral Health surveyed nearly 4,000 dental providers. The results reveal a strong consensus among providers that it will not be possible to return to pre-pandemic operations, and that they must find new care and financial pathways for the future. Key findings of the survey include: - 93% of providers said they anticipated long-term changes in dentistry, including how care is provided. - Strong majorities expected long-term changes in the number of patients seen on a typical day (72%), the way that front desk and clinical staff work (71%) and in infection control procedures (69%). - The disruptions caused by COVID-19 have significantly reduced patient visits and, as a result, could accelerate a shift to telehealth for at least some oral health services. Due to the nature of oral health care, dental practices face unique challenges and providers will need to strategically refocus their practices. With certain changes in treatment protocols, along with a shift to telehealth, dentistry appears to be headed for a new normal. **You may also be interested in:** [Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis) explores how providers can use telehealth to consult with patients, triage their needs and offer limited urgent services, deterring those with nontraumatic dental conditions from seeking care in emergency departments. [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool) explores dental service utilization patterns and rate of return following teledentistry visits. [System Transformation: A Three Domains Framework to Innovating Oral Health Care](https://www.carequest.org/resource-library/three-domain-framework) outlines a Three Domain Framework that creates a new model in dentistry, a roadmap for the future that will be cost-effective, efficient and more equitable. **Categories:** Publication, Resource **Tags:** Special Patient Care --- ### [Impacts Beyond the Mouth](https://carequest.org/resource/impacts-beyond-the-mouth/) **Published:** July 7, 2020 **Author:** Darren Edwards **Content:** [![View infographic](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Impacts-Beyond-the-Mouth-Infographic-Image-300x143.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Impacts-Beyond-The-Mouth-Infographic.pdf)View infographic Oral health is about much more than a smile. This infographic shares the growing evidence of oral health’s connection to overall health, including: - High blood pressure - Diabetes - Obesity - Dementia - Respiratory health - Adverse birth outcomes **You may also be interested in:** - [More Than Meets the Eye: Oral Health, Eye Health, and Overall Health](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health), a report that explores how visual impairments are linked to diminished oral health. - [Mouths Matter More Than You Know: Oral Health’s Connection to Overall Health](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know), a brief that outlines how tooth decay, gum disease, and more can have an impact on diabetes, respiratory health, and blood pressure. - [The Association Between Accessing Dental Services and Nonventilator Hospital-Acquired Pneumonia in Medicaid Beneficiaries](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired), an article in the journal *Infection Control & Hospital Epidemiology* stresses the importance of dental hygiene and treatment of gum disease to prevent nonventilator hospital-acquired pneumonia. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Getting to the Heart of It](https://carequest.org/resource/getting-to-the-heart-of-it/) **Published:** July 28, 2020 **Author:** Darren Edwards **Content:** [![View infographic](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Getting-To-The-Heart-Infographic-300x194.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Getting-To-The-Heart-Infographic.pdf)View infographic Oral health is about much more than a smile. This infographic summarizes growing evidence that connects the health of the mouth with the health of the heart and circulatory system. ## Is Gum Disease Linked to Heart Disease and Stroke? - The odds of having a first heart attack were 28% higher for people with gum disease. - People with gum disease are 3 times more likely to have a stroke involving blood vessels in the back of the brain. - Tooth decay and other oral infections in childhood can contribute to atherosclerosis (clogged arteries) in adulthood. **You may also be interested in:** - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), this research report analyzes the potential cost savings of including treatment for gum disease in Medicare and estimates savings up to $28 billion annually for patients with heart disease. - [Mouths Matter More Than You Know: Oral Health’s Connection to Overall Health](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know), a brief that outlines how tooth decay, gum disease, and more can have an impact on diabetes, respiratory health, and blood pressure. - [More Than Meets the Eye: Oral Health, Eye Health, and Overall Health](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health), a report that explores how visual impairments are linked to diminished oral health. **Categories:** Resource, Visual Report **Tags:** Medical-Dental Integration --- ### [Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://carequest.org/resource/teledentistry-providing-access-to-care-during-the-covid-19-crisis/) **Published:** June 24, 2020 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Teledentistry-Providing-Access-to-Care-During-COVID-19-Brief-Cover.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Teledentistry-Providing-Access-to-Care-During-COVID-19-Brief.pdf)Read brief In a crisis such as the COVID-19 pandemic, telehealth can offer numerous advantages for dental patients and the overall health system. A new communications brief from CareQuest Institute reviews the benefits of teledentistry, its various modalities and how states can promote it. Highlights from the brief include: - Although most states are supporting some form of telehealth, progress in the area of teledentistry is lagging behind other health disciplines. - There are four key areas state policymakers should address to help teledentistry improve access: dental workforce, reimbursement policies, legal clarity and sharing patient information. - By making permanent changes to laws and policies related to teledentistry, states would be better prepared to address needs during the current pandemic and in similar crises in the future. Teledentistry can reach millions of children and adults who are not currently receiving services in the oral health system. And creating a supportive climate for teledentistry would help states reduce the barriers to care posed by a pandemic or another crisis in the future. **You may also be interested in:** - [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. - [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money) explores dental service utilization patterns and rate of return following teledentistry visits. - [Patients Give High Marks to Their Teledentistry Experience](https://www.carequest.org/resource-library/patients-give-high-marks-their-teledentistry-experience) highlights findings from a survey that shows of patients valued the option of teledentistry and that a clear majority who received it were pleased with their experience. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://carequest.org/resource/cutting-medicaid-adult-dental-benefits-would-hurt-states-in-unexpected-ways/) **Published:** October 7, 2020 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/FINAL_CareQuest-Institute_CuttingMedicaidAdultDentalBenefits-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Cutting-Medicaid-Adult-Dental-Benefit-Infographic.pdf)View visual report Cutting Medicaid adult dental benefits could harm job growth, increase costs, and harm states in other unexpected ways. If [adult dental coverage](https://www.carequest.org/topics/adult-dental-benefit) is championed it can improve job prospects, reduce costly visits to hospitals, preserve dental services that can save states money, and increase the likelihood of children getting dental care if their parents do. Explore CareQuest Institute’s report on how cutting Medicaid adult dental benefits would hurt states in unexpected ways to learn more. **You may also be interested in:** [Medicaid Adult Dental Benefit Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping them identify areas for improvement and expansion. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [Patients Give High Marks to Their Teledentistry Experience](https://carequest.org/resource/patients-give-high-marks-to-their-teledentistry-experience/) **Published:** June 25, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Teledentistry-Experience-Patient-Survey-Report-Cover_0.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Teledentistry-Experience-Patient-Survey-Report.pdf)Read report A report from CareQuest Institute for Oral Health shows that dental patients are amenable to receiving care via teledentistry. Although dental providers have been slower than their medical counterparts to make the shift to virtual care, the COVID-19 pandemic has highlighted the advantages of remote, video-enabled visits. The report, which highlights findings from a survey of 111 patients, shows that patients valued the option of teledentistry and that a clear majority who received it were pleased with their experience. **Key findings of the survey include:** - 86% of patients said they were satisfied with their overall teledentistry experience. - 86% said they would recommend teledentistry to another person. - 31% reported they didn’t need in-office care following their teledentistry appointment. This dental-specific survey can reassure oral health providers that their patients are likely to be satisfied with teledentistry and that most will appreciate the convenience, flexibility and safety it offers. **You may also be interested in:** - [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. - [Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis) explores how providers can use telehealth to consult with patients, triage their needs and offer limited urgent services, deterring those with nontraumatic dental conditions from seeking care in emergency departments. - [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money) explores dental service utilization patterns and rate of return following teledentistry visits. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [The Link Between Ventilator-Associated Pneumonia and the Mouth](https://carequest.org/resource/the-link-between-ventilator-associated-pneumonia-and-the-mouth/) **Published:** September 18, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Link-Between-Ventilator-Associated-Pneumonia-and-Mouth-Cover-1.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Link-Between-Ventilator-Associated-Pneumonia-and-Mouth-Report.pdf)Read report **The intersection of VAP, COVID-19, oral health, and equity** A report from CareQuest Institute for Oral Health reinforces the connection between oral health and overall health and underscores the breadth of health issues — including ventilator-associated pneumonia (VAP) — that ongoing oral health care can protect against. Key findings from the report include: - Preventive dental visits decreased the likelihood of acquiring VAP. - At least one preventive dental visit within three years reduced the likelihood of a VAP diagnosis by 22%. - Black patients are more likely than white patients to be diagnosed with VAP. The report asserts that addressing social conditions, structural racism, access to care, oral health education and other factors may not only improve oral health outcomes but also reduce the risk for COVID-19, VAP and even death in Black communities. **You may also be interested in:** - [Best Practices for Infection Control in Dental Clinics During the COVID-19 Pandemic](https://www.carequest.org/resource-library/best-practices-infection-control-dental-clinics-during-covid-19-pandemic), a 20-page guide filled with practical tools and resources. - [Impacts Beyond the Mouth](https://www.carequest.org/resource-library/impacts-beyond-mouth), an infographic that highlights the connection between oral health and overall health. **Categories:** Publication, Resource **Tags:** Clinical Practice, Health Equity, Medical-Dental Integration --- ### [A Difficult Path to COVID-19 Recovery](https://carequest.org/resource/a-difficult-path-to-covid-19-recovery/) **Published:** October 1, 2020 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Difficult-Path-to-Recovery-COVID-19-Recovery-Report-Cover_0.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Difficult-Path-to-Recovery-COVID-19-Recovery-Report.pdf)Read report **Changes remain for dental providers** Most dental providers have reopened their clinics, but it’s far from business as usual. A new report by CareQuest Institute outlines the findings from a recent survey of 2,767 providers, and it’s clear that the COVID-19 pandemic remains a source of stress and uncertainty with potential long-term implications for the financial foundation for dentistry. **Some findings from the report:** - 3 in 4 (76%) providers say the maximum number of patients they can see each day is reduced due to changes in treatment protocols, with 1 in 4 (25%) of those saying that they can see less than 50% of the normal patient volumes. - Only 18% of providers say their daily patient volumes are more than 80% of their usual pre-pandemic total. - Only 35% of providers say their practices or clinics are experiencing normal or near normal levels of revenue. - Dental providers who see adult Medicaid patients may suffer revenue losses as states seek to close budget shortfalls. How has COVID-19 changed the way dentists will practice going forward? The report highlights several strategies, including the expanded use of teledentistry, a greater focus on disease prevention and measurement and the use of alternative payment models that can help address the challenges created from the pandemic. [![View graphic](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Difficult-Path-to-Recovery-COVID-19-Recovery-Abstract-300x171.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Difficult-Path-to-Recovery-COVID-19-Recovery-Abstract.pdf)View graphic **You may also be interested in:** - [Dental Care’s New Normal: Provider Survey Reveals the Need to Adapt and Redesign](https://www.carequest.org/resource-library/dental-cares-new-normal-survey-reveals-need-adapt), a report on a survey conducted in May as the pandemic was in the early stages in the United States. - [Best Practices for Infection Control in Dental Clinics During the COVID-19 Pandemic](https://www.carequest.org/resource-library/best-practices-infection-control-dental-clinics-during-covid-19-pandemic), a 20-page guide filled with practical tools and resources. **Categories:** Publication, Resource **Tags:** Practice Management --- ### [Self-Care Tips After Teledentistry Appointment](https://carequest.org/resource/self-care-tips-after-teledentistry-appointment/) **Published:** October 6, 2020 **Author:** Darren Edwards **Content:** [![View tip sheet](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Self-Care-Tip-Sheet-cover_0-232x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Self-Care-Tip-Sheet_0.pdf)View tip sheet Here are some self-care recommendations to maintain your oral health at home between in-office or teledental visits. We will work with you on a care plan that supports you at home and in-office. Reach out to your dental team if your symptoms persist or escalate. **Categories:** Resource, Tool **Tags:** Practice Management --- ### [A Three Domain Framework to Innovating Oral Health Care](https://carequest.org/resource/a-three-domain-framework-to-innovating-oral-health-care/) **Published:** October 14, 2020 **Author:** Darren Edwards **Content:** Dentistry is changing rapidly and the COVID-19 pandemic has highlighted key opportunities within the oral health care system. A paper by CareQuest Institute for Oral Health outlines a Three Domain Framework that creates a new model in dentistry, a roadmap for the future that will be cost-effective, efficient, and more equitable. **Discover a Better Way Forward** This Three Domain Framework builds on health promotion and disease prevention while supporting value-based care. Informed by the work of the Community Oral Health Transformation (COrHT) Learning Community, the Framework creates a primary care-like structure for oral health care delivery. It facilitates value-based payment models and enables patients to invest in their oral health. ## Tele-Prevention **Domain One** builds an accessible evidence-based virtual care delivery approach to accompany oral health care delivery that applies technology for enhanced disease prevention and whole-person health. ## Minimally Invasive Care **Domain Two** focuses on minimally invasive care that reverses or slows early disease stages using a program of anticipatory guidance and collaborative decision-making with patients. ## Integrated and Personalized Care **Domain Three** introduces personalized oral health care that prolongs the life of hard and soft tissues by reducing tooth/tissue mortality through risk stratification, medical-dental integration, the utilization of predictive analytics and safe, individualized surgical intervention. The paper includes a thorough examination of each Domain, including clinical guidance; cost and financial implications; relative advantages for patients, providers and payors; and analyses of strengths, weaknesses, opportunities and threats. It concludes with a list of concrete steps for short- and long-term implementation. Oral health professionals and dentistry, as an industry, are at a crossroads: either return to the traditional fee-for-service surgical model or embrace a new paradigm of oral health care that focuses on overall health as an outcome. This paper, [which includes contributions from more than 110 oral health leaders](https://www.carequest.org/sites/default/files/CareQuest-Institute-Three-Domain-Framework-Contributors.pdf), presents that new paradigm. [Read white paper](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Three-Domain-Framework-White-Paper.pdf) [Read executive summary](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Three-Domain-Framework-Executive-Summary.pdf) **Categories:** Resource, Visual Report **Tags:** Practice Management, Value-Based Care --- ### [A Vaccine Can Prevent Throat Cancer](https://carequest.org/resource/a-vaccine-can-prevent-throat-cancer/) **Published:** October 23, 2020 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Vaccine-to-Prevent-Throat-Cancer-Infographic-1-232x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Vaccine-to-Prevent-Throat-Cancer-Infographic.pdf)View visual report Did you know Human Papillomavirus (HPV) causes 70% of throat cancers? And poor oral health is a risk factor. People with oral HPV are more likely to rate their oral health as fair or poor. Researchers found that poor oral health is a risk factor of oral HPV infection. Receiving both doses of the HPV vaccine can prevent more than 90% of the six types of cancers that this virus can cause. Health experts recommend HPV vaccination for girls and boys ages 11–12 years to protect against these cancers. Vaccination is also recommended for everyone through age 26, if they aren’t already vaccinated. Explore CareQuest Institute’s visual report about how a vaccine can prevent throat cancer. **Categories:** Resource, Visual Report **Tags:** Clinical Practice, Medical-Dental Integration --- ### [A Model for Better Health, Better Access, and Better Value: Advantage Dental's Approach](https://carequest.org/resource/a-model-for-better-health-better-access-and-better-value-advantage-dentals-approach/) **Published:** November 7, 2017 **Author:** Darren Edwards **Content:** [![Read white paper](https://carequest.org/wp-content/uploads/2017/11/CareQuest-Institute-Advantage-Dental-Approach-White-Paper-Cover-232x300.png)](https://carequest.org/wp-content/uploads/2017/11/CareQuest-Institute-Advantage-Dental-Approach-White-Paper.pdf)Read white paper Advantage Dental is the largest dental accountable care organization in the State of Oregon. It delivers services to approximately 284,000 members of the Oregon Health Plan, the state’s Medicaid program, and contracts with all 16 of the state’s coordinated care organizations. Advantage Dental has developed a model that offers a unique approach to oral health care, emphasizing prevention over surgery, care in the community, and population health management. **Categories:** Publication, Resource **Tags:** Health Equity, Value-Based Care --- ### [Medical Well-Child Visits and Preventive Dental Visits](https://carequest.org/resource/medical-well-child-visits-and-preventive-dental-visits/) **Published:** April 30, 2019 **Author:** Darren Edwards **Content:** The University of Colorado School of Dental Medicine and CareQuest Institute, then the DentaQuest Partnership for Oral Health Advancement, collaborated on a study that investigated the impact of well-child visits on promoting preventive dental visits using big data. Based on the analysis of over 1.3 million Medicaid claims for children aged 4 or less in 13 states, the study found increased utilization of preventive dental visits among children who had a well-child medical visit. This research builds on prior research to find that primary care medical providers can play an important role in encouraging pediatric patients to access dental care and receive preventive oral health services. Although the trend was present for all ages that were examined, utilization was lowest among the age 1 population. Because both the American Academy of Physicians and American Academy of Pediatric Dentistry recommend a dental visit by age 1, increased adoption of this guideline among pediatric physicians and parents is needed. [Click here to view the article.](https://journals.sagepub.com/doi/full/10.1177/2380084419841850) **Categories:** Journal Article, Resource **Tags:** Health Equity, Medical-Dental Integration, Minimally Invasive Care --- ### [Pediatric Primary Care and Oral Health](https://carequest.org/resource/pediatric-primary-care-and-oral-health/) **Published:** August 26, 2019 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Pediatric-Primary-Care-Policy-Brief-Cover.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Pediatric-Primary-Care-Policy-Brief.pdf)Read brief This research brief evaluates oral health services being provided in medical well-child visits and the need for greater integration of oral health in primary care to help facilitate early intervention and the prevention of dental disease. **Categories:** Publication, Resource **Tags:** Medical-Dental Integration --- ### [Poor Families Spend 10 Times More of Their Income on Dental Care than Wealthier Families](https://carequest.org/resource/poor-families-spend-10-times-more-of-their-income-on-dental-care-than-wealthier-families/) **Published:** September 9, 2019 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Poor-Families-Spend-10-Times-More-Brief-Part1-cover-1.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Poor-Families-Spend-10-Times-More-Brief-Part1-1.pdf)Read report A report from CareQuest Institute, the first in a three-part series about utilization of dental services and out-of-pocket costs, analyzes oral health needs and financial implications for Americans of different income levels. Based on data from the Medicare Expenditure Panel Survey and the National Health and Nutrition Examination Survey, the report finds that those living in poverty and with low incomes use fewer dental services, spend a significant portion of their annual income on dental care and still have substantial unmet dental needs. Key findings from the report: - 93% of individuals living in poverty have unmet dental needs, compared with 58% in high-income families. - Only 28% of individuals living in poverty utilized dental services, compared with 55% of high-income families. - As a proportion of annual family income, those in poverty spend ten times more on dental services than do those in high-income families. The cost of dental care remains a significant barrier to access in the United States. Expansion of a dental benefit to cover all adults who are enrolled in Medicaid and Medicare would reduce the cost burden and improve oral health for all. **Read the Additional Research Reports in this Series** [Part 2 of 3 Medicaid Adult Dental Benefits Increase Access and Reduce Out-of-Pocket Expenditures](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-increase-access-and-reduce-out-pocket-expenditures) compares the experience of adults enrolled in Medicaid to adults with private coverage and to those who lack coverage. [Part 3 of 3 The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-enrolled Elderly and Disabled](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled) compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. **Categories:** Publication, Resource **Tags:** Health Equity --- ### [Medicaid Adult Dental Benefits Increase Access and Reduce Out-of-Pocket Expenditures](https://carequest.org/resource/medicaid-adult-dental-benefits-increase-access-and-reduce-out-of-pocket-expenditures/) **Published:** November 8, 2019 **Author:** Darren Edwards **Content:** [![Read report](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Medicaid-Adult-Dental-Benefits-Increase-Access-Reduce-OOP-Expenses-cover.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Medicaid-Adult-Dental-Benefits-Increase-Access-Reduce-OOP-Expenses.pdf)Read report In some U.S. states, Medicaid provides at least some dental coverage for adults. Does that coverage lead to better access and lower out-of-pocket costs for patients? A report from CareQuest Institute, the second in a three-part series, analyzes data from the Medicare Expenditure Panel Survey to explore that question. The report compares the experience of adults enrolled in Medicaid to adults with private coverage and to those who lack coverage. Key findings from the report: - Medicaid, with its limited dental coverage, significantly improved adults’ access to and utilization of dental services, compared to those who lack medical coverage. - [Access to dental services for adults](https://www.carequest.org/topics/adult-dental-benefit) enrolled in Medicaid was nine percentage points higher than those who lack medical coverage but 23 percentage points lower than those with private medical coverage. - The average annual out-of-pocket cost for dental care was $196 for those covered by Medicaid, $283 for those with private medical coverage and $466 for those without medical coverage. Medicaid improved adults’ access to dental services, compared with those who lack medical coverage. However, the report shows that significant gaps remained between adults enrolled in Medicaid and those with private insurance. Requiring states to offer comprehensive dental coverage as part of Medicaid would go far in closing these gaps. **You may also be interested in:** [Part 1 of 3 Poor Families Spend 10 Times More of Their Income on Dental Care Than Wealthier Families](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families) analyzes oral health needs and financial implications for Americans of different income levels. [Part 3 of 3 The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-enrolled Elderly and Disabled](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled) compares costs associated with different types of Medicare coverage and reveals a high burden of out-of-pocket spending for Medicare enrollees. [Medicaid Adult Dental Benefit Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping them identify areas for improvement and expansion. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Exploring Alternative Payment Models for Oral Health Care](https://carequest.org/resource/exploring-alternative-payment-models-for-oral-health-care/) **Published:** January 21, 2020 **Author:** Darren Edwards **Content:** *An examination of the cost and utilization of alternative payment models for oral health care over a patient’s lifetime.* Can alternative payment methods (APM) transform dentistry? Under our current system, the United States pays the most for health care and achieves the lowest performance among comparable countries. CareQuest Institute analyzes how this applies to dentistry – and how APMs can make a difference. As more states use their purchasing power to encourage better access, quality and accountability in oral health care for children in Medicaid, growth of APMs will continue in dentistry. Learn how the approach works, as the costs were lower than traditional fee for service models, while utilization was higher in the APM plans. [Read the full article](https://decisionsindentistry.com/article/exploring-alternative-payment-models-oral-health-care/) **Categories:** Journal Article, Resource **Tags:** Health Equity, Value-Based Care --- ### [Healthy Mouths: Why They Matter for Adults and State Budgets](https://carequest.org/resource/healthy-mouths-why-they-matter-for-adults-and-state-budgets/) **Published:** February 5, 2020 **Author:** Darren Edwards **Content:** [![Read brief](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Health-Mouths-Why-They-Matter-for-Adults-and-State-Budgets-Brief-cover-232x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Health-Mouths-Why-They-Matter-for-Adults-and-State-Budgets-Brief.pdf)Read brief There are a variety of approaches to adult coverage, divided into four broad categories. The first category are the 20 states providing a comprehensive [Medicaid dental benefit for adults](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage) with annual spending caps of at least $1,000. The second category includes 16 states that provide a limited adult dental benefit with a lower spending cap. The third category are the 11 states whose Medicaid programs only cover emergency dental care and the last are the three states offering no services at all for adults. States without a comprehensive dental benefit not only make it harder for adults to stay healthy but the lack of a benefit can also undermine their state budgets. How? Because a lack of dental coverage has broad consequences that ripple back to state budgets. When oral health deteriorates, it can negatively affect low-income adults’ employment status and lead to larger health issues, such as diabetes, heart disease and more. **Categories:** Publication, Resource **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Talking Points Memo: Dental Tourism Is Booming Amid Trump Admin Medicaid Cuts](https://carequest.org/in-the-news/talking-points-memo-dental-tourism-is-booming-amid-trump-admin-medicaid-cuts/) **Published:** June 15, 2026 **Author:** Chernise Harris **Content:** Isabel Flores used to have nightmares about her teeth falling out when she was young. To this day, the 56-year-old Arizonian does her best to take care of her teeth to prevent that from happening. But her teeth are very sensitive, and her past struggles with substance use weakened them. Around 10 years ago, a dentist told her that she was losing bone in her teeth, and that she needed an emergency deep cleaning to scale plaque from below her gum line. But Isabel was on Medicaid at the time, and Arizona does not offer adult dental benefits to its program recipients. [Read the full article here.](https://talkingpointsmemo.com/news/dental-tourism-is-booming-amid-trump-admin-medicaid-cuts) **Categories:** In The News --- ### [The Nation's Health Podcast: Fluoridation: Your secret hack for better health](https://carequest.org/in-the-news/the-nations-health-podcast-fluoridation-your-secret-hack-for-better-health/) **Published:** May 14, 2026 **Author:** Chernise Harris **Content:** Fluoride — one of public health’s most effective and equitable tools — is facing a growing wave of policy rollbacks, misinformation and public skepticism. Host Sophia Meador talks with Wade Rakes, MBA, CEO of the CareQuest Institute for Oral Health, and pediatrician Susan Fisher-Owens, MD, MPH, to unpack what’s at stake for oral health, who could be most affected by potential bans and how to build trust in fluoride. [Read the full article here.](https://rss.com/podcasts/public-health-2025-what-is-ahead/2765439/) **Categories:** In The News --- ### [Talking Points Memo: The Cost of the GOP’s Medicaid Cuts: ER Bills for States and a Spiraling Oral Health Crisis](https://carequest.org/in-the-news/talking-points-memo-the-cost-of-the-gops-medicaid-cuts-er-bills-for-states-and-a-spiraling-oral-health-crisis/) **Published:** May 13, 2026 **Author:** Chernise Harris **Content:** Dentist Dr. Tara Prasad thinks a lot about the logistics of homelessness — how difficult it is to brush your teeth when you don’t have a place to store a toothbrush, or how to protect a life-changing set of dentures when you’re sleeping and someone may steal your belongings. Prasad is the dental director at Boston Health Care for the Homeless Program, where she often sees patients who have delayed dental care for a long time. [Read the full article here.](https://talkingpointsmemo.com/news/the-cost-of-the-gops-medicaid-cuts-er-bills-for-states-and-a-spiraling-oral-health-crisis) **Categories:** In The News --- ### [The Post-Journal: Lawmakers Want Senior Dental Care On Marketplace](https://carequest.org/in-the-news/the-post-journal-lawmakers-want-senior-dental-care-on-marketplace/) **Published:** May 8, 2026 **Author:** Chernise Harris **Content:** New York’s senior citizens may have a new avenue to purchase dental insurance. Assemblywoman Rebecca Seawright, D-New York City, and Sen. Cordell Cleare, D-New York City, are sponsoring legislation (A.11235/S.7594) that would require the NY State of Health Marketplace to require companies offering health insurance plans on the marketplace to also offer at least one dental plan for senior citizens. [Read the full article here.](https://www.post-journal.com/news/top-stories/2026/05/lawmakers-want-senior-dental-care-on-marketplace/) **Categories:** In The News --- ### [Oralhealth: Non-profit U.S. institute aims to link long-siloed medical and dental data using AI](https://carequest.org/in-the-news/oralhealth-non-profit-u-s-institute-aims-to-link-long-siloed-medical-and-dental-data-using-ai/) **Published:** February 18, 2026 **Author:** Chernise Harris **Content:** A U.S.-based oral health nonprofit is seeking to bridge the long-standing divide between medical and dental data using artificial intelligence. CareQuest Institute for Oral Health, a national nonprofit focused on advancing a more accessible and integrated oral health system, [announced](https://carequest.org/carequest-institute-partners-with-innovaccer-to-improve-medical-dental-data-integration/) Tuesday it has partnered with health-care AI company Innovaccer to integrate medical and dental claims and clinical data. [Read the full article here.](https://www.oralhealthgroup.com/dental-industry/non-profit-u-s-institute-aims-to-link-long-siloed-medical-and-dental-data-using-ai-1003993644/) **Categories:** In The News --- ### [Dr. Bicuspid: CareQuest Institute, Innovaccer partner](https://carequest.org/in-the-news/dr-bicuspid-carequest-institute-innovaccer-partner/) **Published:** February 24, 2026 **Author:** Chernise Harris **Content:** The CareQuest Institute for Oral Health has partnered with Innovaccer to integrate medical and dental data and better understand the effects of oral health on overall health outcomes. Using Innovaccer’s Humbi platform, the organizations will pair medical and dental claims with clinical data to create a more complete view of patient health. The organizations’ goal is to generate insights that improve care coordination, inform policy decisions, and support more person-centered, cost-effective care. [Read the full article here.](https://www.drbicuspid.com/dental-business/industry-updates/article/15817840/carequest-institute-innovaccer-partner) **Categories:** In The News --- ### [Human Resource Executive: Dental insurers brace for rise of cash-for-coverage employer health plans](https://carequest.org/in-the-news/human-resource-executive-dental-insurers-brace-for-rise-of-cash-for-coverage-employer-health-plans/) **Published:** February 24, 2026 **Author:** Chernise Harris **Content:** Dental insurance strategists are trying to figure out how to create products that can serve people who work in a post-group health world. Product designers are thinking about how an increase in the number of people who use Individual Coverage Health Reimbursement Arrangement plans and other types of “cash for coverage” health plans might affect the features that buyers seek and the level of coverage they can afford. [Read the full article here.](https://hrexecutive.com/dental-insurers-brace-for-rise-of-cash-for-coverage-employer-health-plans/) **Categories:** In The News --- ### [Becker’s Dental Review: 6 trends reshaping dentistry](https://carequest.org/in-the-news/beckers-dental-review-6-trends-reshaping-dentistry/) **Published:** February 25, 2026 **Author:** Chernise Harris **Content:** Here are six emerging trends for dental leaders to know regarding artificial intelligence, staffing, insurance and patient care: 1\. AI adoption: Several DSOs have added AI technology in recent weeks to enhance patient care and improve operational efficiency, including [DECA Dental Group](https://www.beckersdental.com/dso-dpms/deca-dental-group-adds-pearl-ai-platform/), [Great Expressions Dental Centers](https://www.beckersdental.com/dso-dpms/great-expressions-dental-centers-adds-videahealth-ai-platform/) and [Aspen Dental](https://www.beckersdental.com/dso-dpms/aspen-dental-completes-6-week-rollout-of-videahealths-ai/). DSO leaders have [predicted](https://www.beckersdental.com/featured-perspectives/dentistry-at-a-turning-point-a-10-year-outlook/) that AI will become the basis with which all dentistry will be practiced, and that advancements will continue with AI diagnostic tools. [Read the full article here.](https://www.beckersdental.com/dentists/6-trends-reshaping-dentistry/) **Categories:** In The News --- ### [Inside Health Policy: Stakeholders Mixed On Proposal To Remove Adult Dental As EHB Option](https://carequest.org/in-the-news/inside-health-policy-stakeholders-mixed-on-proposal-to-remove-adult-dental-as-ehb-option/) **Published:** February 26, 2026 **Author:** Chernise Harris **Content:** Dental care stakeholders are mixed over the Trump administration’s proposal to roll back a Biden-era rule allowing states to add adult dental as an Essential Health Benefit: Health care advocates who worked hard to get the option in place, the American Dental Association and the CareQuest Institute for Oral Health, are disappointed the state flexibility may disappear, while the National Association of Dental Plans says it backs the policy goal but the provision as written was unfeasible and should be removed. [Read the full article here.](https://insidehealthpolicy.com/daily-news/stakeholders-mixed-proposal-remove-adult-dental-ehb-option) **Categories:** In The News --- ### [Becker’s Dental Review: Federal Medicaid cuts threaten dental care access: See the potential impact by state](https://carequest.org/in-the-news/beckers-dental-review-federal-medicaid-cuts-threaten-dental-care-access-see-the-potential-impact-by-state/) **Published:** March 2, 2026 **Author:** Chernise Harris **Content:** Looming Medicaid cuts could reverse progress that has been made to expand access to dental care in the U.S., healthcare leaders are warning. The One Big Beautiful Bill Act is [expected](https://www.beckershospitalreview.com/hospital-management-administration/senate-passes-gop-budget-bill-heads-to-house-8-things-to-know/?__hstc=12529067.90633e589fa50c90610dd328186cf5fc.1776193496871.1776193496871.1776193496871.1&__hssc=12529067.7.1776193496871&__hsfp=d7f9dd0b696bf44310c5e028e871a526) to lead to a decrease in Medicaid spending by nearly $1 trillion over the next 10 years. The bill has been criticized by many organizations, with many leaders denouncing the bill’s cuts to healthcare. Dental organizations have criticized the budget for its potential impact on Medicaid, with the CareQuest Institute for Oral Health [calling](https://www.beckersdental.com/dentists/those-practices-need-a-plan-dentists-brace-for-impact-of-federal-budget/) the bill’s passage a “dangerous setback” for dentistry. [Read the full article here.](https://www.beckersdental.com/benchmarking/federal-medicaid-cuts-threaten-dental-care-access-see-the-potential-impact-by-state/) **Categories:** In The News --- ### [Becker’s Dental Review: 12 dental technology updates to know](https://carequest.org/in-the-news/beckers-dental-review-12-dental-technology-updates-to-know/) **Published:** March 3, 2026 **Author:** Chernise Harris **Content:** Several DSOs have invested in AI technology in recent months to boost patient care and practice efficiency. Here are 12 notable dental technology updates since Jan. 28: 1\. The American Dental Association [asked](https://www.beckersdental.com/ai-teledentistry/ada-urges-federal-support-for-ai-adoption-at-rural-dental-practices-5-notes/) that federal investment and support be provided to help boost small and rural practices’ adoption of artificial intelligence tools. 2\. The CareQuest Institute for Oral Health [partnered](https://www.beckersdental.com/ai-teledentistry/carequest-partners-with-ai-company-on-medical-dental-data-integration/) with healthcare AI company Innovaccer to advance medical-dental integration. [Read the full article here.](https://www.beckersdental.com/dental-technology/12-dental-technology-updates-to-know/) **Categories:** In The News --- ### [Dentistry33: CareQuest Institute Partners with Innovaccer](https://carequest.org/in-the-news/dentistry33-carequest-institute-partners-with-innovaccer/) **Published:** March 4, 2026 **Author:** Chernise Harris **Content:** CareQuest Institute for Oral Health®, a national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, today announced a new partnership with Innovaccer, a leading health care AI company, to integrate medical and dental data. The collaboration aims to help providers, payers, and policymakers better understand the impact of oral health on overall health outcomes. [Read the full article here.](https://www.dentistry33.com/companies/news/5142/carequest-institute-partners-with-innovaccer.html) **Categories:** In The News --- ### [KFF Health News: More Kids Are in ERs for Tooth Pain. Trump Cuts and RFK Jr.’s Anti-Fluoride Fight Aren’t Helping.](https://carequest.org/in-the-news/kff-health-news-more-kids-are-in-ers-for-tooth-pain-trump-cuts-and-rfk-jr-s-anti-fluoride-fight-arent-helping/) **Published:** March 10, 2026 **Author:** Chernise Harris **Content:** Eight-year-old Jonah woke up one May morning with a swollen face and a toothache. He refused the pain medication that his mom, Geneva Reynolds, tried to give him. He didn’t sleep or eat and cried constantly. Within a few days, Reynolds became so desperate that she and her husband had to physically restrain Jonah, dumping pain medication down his throat as he screamed in pain. [Read the full article here.](https://kffhealthnews.org/news/article/dental-care-emergency-rooms-special-needs-medicaid-shortage-areas/) **Categories:** In The News --- ### [Becker’s Hospital Review: EDs see jump in pediatric dental visits: 5 notes](https://carequest.org/in-the-news/beckers-hospital-review-eds-see-jump-in-pediatric-dental-visits-5-notes/) **Published:** March 10, 2026 **Author:** Chernise Harris **Content:** Children are increasingly visiting hospital emergency departments nationwide for dental issues amid shrinking access to pediatric dental care, [KFF Health News](https://kffhealthnews.org/news/article/dental-care-emergency-rooms-special-needs-medicaid-shortage-areas/) reported March 10. Five notes: 1\. ED visits for dental issues unrelated to physical trauma increased by 57.9% among children 14 and under, according to a 2025 [report](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Dental-Care-in-Crisis_10.31.25-1.pdf) from CareQuest Institute for Oral Health, a nonprofit organization based in Boston. [Read the full article here.](https://www.beckershospitalreview.com/care-coordination/eds-see-jump-in-pediatric-dental-visits-5-notes/) **Categories:** In The News --- ### [Dental Bite: The policy battles shaping oral health care](https://carequest.org/in-the-news/dental-bite-the-policy-battles-shaping-oral-health-care/) **Published:** March 10, 2026 **Author:** Chernise Harris **Content:** Policy plays a critical role in expanding access to oral health care. At [CareQuest Institute for Oral Health](https://carequest.org/?sub4=Spotlight&ref=dentalbite.co), that work is a key part of the organization’s mission to improve oral health. [Melissa Burroughs](https://www.linkedin.com/in/melissa-burroughs-2084b663/), the institute’s senior director of public policy, spoke with Dental Bite about the biggest issues shaping oral health policy in 2026. [Read the full article here.](https://www.dentalbite.co/the-policy-battles-shaping-oral-health-care/) **Categories:** In The News --- ### [NBC NEWS: If states ban fluoride, more kids will get cavities and Medicaid costs could soar, study finds](https://carequest.org/in-the-news/if-states-ban-fluoride-more-kids-will-get-cavities-and-medicaid-costs-could-soar-study-finds/) **Published:** March 19, 2026 **Author:** Chernise Harris **Content:** [CareQuest Institute for Oral Health](https://carequest.org), a nonprofit which advocates for fluoridation, used Medicaid claims data and survey responses to predict the outcomes if the five states — Florida, Kentucky, Louisiana, Missouri and Oklahoma — stopped adding fluoride to water systems. Florida has already banned it; the other states have legislation in the works to ban it or make it optional. [Read the full article here.](https://www.nbcnews.com/health/kids-health/fluoride-ban-kids-cavities-medicaid-costs-millions-study-rcna264070) **Categories:** In The News --- ### [AL.com: Water fluoridation is one of the top 10 public health achievements of the 20th Century: op-ed](https://carequest.org/in-the-news/al-com-water-fluoridation-is-one-of-the-top-10-public-health-achievements-of-the-20th-century-op-ed/) **Published:** March 24, 2026 **Author:** Chernise Harris **Content:** The recent announcement that Central Alabama Water (“CAW”) will cease adding fluoride to our drinking water is both shocking and concerning. Even more troubling than the decision itself is the lack of notice, transparency, and process by which it was made. [Read the full article here.](https://www.al.com/news/birmingham/2026/03/water-fluoridation-is-one-of-the-top-10-public-health-achievements-of-the-20th-century-op-ed.html) **Categories:** In The News --- ### [RDH: 3 ways to prevent caries in high-risk patients while increasing practice production](https://carequest.org/in-the-news/rdh-3-ways-to-prevent-caries-in-high-risk-patients-while-increasing-practice-production/) **Published:** March 25, 2026 **Author:** Chernise Harris **Content:** Minimally invasive caries management is moving beyond fluoride varnish, with emerging diagnostics and therapies enabling earlier detection, enamel fortification, and more predictable disease arrest in high-risk patients, which also drives practice production. [Read the full article here.](https://www.rdhmag.com/patient-care/article/55365880/four-ways-to-prevent-caries-in-high-risk-patients-while-increasing-practice-production) **Categories:** In The News --- ### [WTOP-FM (Washington, DC): America 250: The rise of oral health as a window into overall health](https://carequest.org/in-the-news/wtop-fm-washington-dc-america-250-the-rise-of-oral-health-as-a-window-into-overall-health/) **Published:** March 25, 2026 **Author:** Chernise Harris **Content:** Oral health refers to the condition of the mouth, teeth, gums and oral-facial system. While it affects the ability to eat, speak and smile, it is also closely linked to overall health — a connection that was not always widely understood. According to the American Dental Association, the idea that oral bacteria could cause disease has been discussed since the late 19th century. During that period, however, dental care largely consisted of extracting teeth to relieve pain, said Melissa Burroughs, senior director of public policy at the CareQuest Institute for Oral Health. [Read the full article here.](https://wtop.com/250-years-of-america/2026/03/the-rise-of-oral-health-as-a-window-into-overall-health/) **Categories:** In The News --- ### [Bloomberg Law News: Obamacare Dental Reversal Pits Insurers Against Consumer Groups](https://carequest.org/in-the-news/bloomberg-law-news-obamacare-dental-reversal-pits-insurers-against-consumer-groups/) **Published:** March 25, 2026 **Author:** Chernise Harris **Content:** The Trump administration’s proposal to block states from establishing adult dental services as an essential health benefit under the Affordable Care Act is prompting support from insurers and pushback from public interest groups. [Read the full article here.](https://news.bloomberglaw.com/health-law-and-business/obamacare-dental-reversal-pits-insurers-against-consumer-groups) **Categories:** In The News --- ### [DrBicuspid: CareQuest names new chief clinical officer](https://carequest.org/in-the-news/drbicuspid-carequest-names-new-chief-clinical-officer/) **Published:** April 9, 2026 **Author:** Chernise Harris **Content:** The CareQuest Institute for Oral Health appointed Dr. An Nguyen, MPH, as its new chief clinical officer. As a member of the executive leadership team, Nguyen will work closely with the CEO to further clinical strategy and advance the organization’s mission to build a more accessible, equitable, and integrated oral health system. [Read the full article here.](https://www.drbicuspid.com/dental-business/industry-updates/article/15821504/carequest-names-new-chief-clinical-officer) **Categories:** In The News --- ### [Talking Points Memo: How RFK’s War on Fluoride Is Taking Over the Dentist’s Office](https://carequest.org/in-the-news/talking-points-memo-how-rfks-war-on-fluoride-is-taking-over-the-dentists-office/) **Published:** April 9, 2026 **Author:** Chernise Harris **Content:** Health and Human Services Secretary Robert F. Kennedy has maintained that the target of his war on fluoride is ingested fluoride — specifically that from fluoridated drinking water and oral supplements. But the misinformed policy efforts to ban community water fluoridation and restrict access to fluoride supplements are having spillover effects in dentists’ offices. [Read the full article here.](https://talkingpointsmemo.com/news/how-rfks-war-on-fluoride-is-taking-over-the-dentists-office) **Categories:** In The News --- ### [This Green Earth: A year after Utah's fluoride ban, education and awareness are the biggest changes](https://carequest.org/in-the-news/this-green-earth-a-year-after-utahs-fluoride-ban-education-and-awareness-are-the-biggest-changes/) **Published:** April 28, 2026 **Author:** Chernise Harris **Content:** Utah stopped public water fluoridation in May 2025. While the health effects aren’t immediate, dentists and oral health advocates aren’t waiting for the cavities to pile up. [Read the full article here.](https://www.kpcw.org/state-regional/2026-04-28/a-year-after-utahs-fluoride-ban-education-and-awareness-are-the-biggest-changes) **Categories:** In The News --- ### [Penn Live Patriot-News: More dental professionals are needed to improve access to care for Pennsylvanians](https://carequest.org/in-the-news/penn-live-patriot-news-more-dental-professionals-are-needed-to-improve-access-to-care-for-pennsylvanians/) **Published:** April 30, 2026 **Author:** Chernise Harris **Content:** Pennsylvania is currently grappling with a significant and growing dental crisis, especially in its more rural areas. A shortage of dentists, hygienists and dental assistants across the state is disrupting access to the critical dental care many residents need to be their healthiest. [Read the full article here.](https://www.pennlive.com/opinion/2026/04/more-dental-professionals-are-needed-to-improve-access-to-care-for-pennsylvanians-opinion.html) **Categories:** In The News --- ### [Inside Dentistry: CareQuest Institute Expresses Concern Over FDA Fluoride Decision for Children](https://carequest.org/in-the-news/inside-dentistry-carequest-institute-expresses-concern-over-fda-fluoride-decision-for-children/) **Published:** November 4, 2025 **Author:** Jasmin Fernandes **Content:** CareQuest Institute for Oral Health has responded to new US Food and Drug Administration (FDA) enforcement actions that limit the use of fluoride supplements in children, emphasizing that the decision could reduce access to an important preventive measure for families without fluoridated water. [Read the full article here.](https://insidedentistry.net/news/?newsID=104051) **Categories:** In The News --- ### [Becker’s Dental Review: Dental organizations push back against FDA restrictions on ingestible fluoride products](https://carequest.org/in-the-news/beckers-dental-review-dental-organizations-push-back-against-fda-restrictions-on-ingestible-fluoride-products/) **Published:** November 4, 2025 **Author:** Jasmin Fernandes **Content:** The American Dental Association and the CareQuest Institute for Oral Health have spoken out against the FDA’s decision to limit the use of ingestible fluoride products. [Read the full article here.](https://www.beckersdental.com/clinical-leadership-infection-control/dental-organizations-push-back-against-fda-restrictions-on-ingestible-fluoride-products/) **Categories:** In The News --- ### [Dimensions of Dental Hygiene: Teledentistry Offers Benefits to Both Patients and Clinicians](https://carequest.org/in-the-news/dimensions-of-dental-hygiene-teledentistry-offers-benefits-to-both-patients-and-clinicians/) **Published:** November 24, 2025 **Author:** Jasmin Fernandes **Content:** In 2024, the Health Resources and Services Administration reported that approximately 60 million Americans live in dental health professional shortage areas, representing 17.4% of the total population.1 These regions lack oral health professionals and are unable to meet the population’s needs. Telehealth has emerged as a promising solution to bridge the gap in access to care, leading the way toward a more connected and responsive healthcare system. [Read the full article here.](https://dimensionsofdentalhygiene.com/article/teledentistry-offers-benefits-to-both-patients-and-clinicians/) **Categories:** In The News --- ### [WBIW-AM: New research partnership takes aim at unstudied crisis: Dental debt in Indiana](https://carequest.org/in-the-news/wbiw-am-new-research-partnership-takes-aim-at-unstudied-crisis-dental-debt-in-indiana/) **Published:** November 25, 2025 **Author:** Jasmin Fernandes **Content:** The Indiana Community Action Poverty Institute (ICAPI) has announced a new partnership with the CareQuest Institute for Oral Health to conduct critical research on the burden of dental debt among Hoosiers. This collaboration aims to illuminate an issue that, despite the state’s ongoing conversation about general medical debt, remains severely understudied and lacking specific policy focus at the state level. [Read the full article here.](https://www.wbiw.com/2025/11/25/new-research-partnership-takes-aim-at-unstudied-crisis-dental-debt-in-indiana/#google_vignette) **Categories:** In The News --- ### [The Indiana Citizen: DENTAL ISSUES: Research to study impact of this medical debt on Hoosiers](https://carequest.org/in-the-news/the-indiana-citizen-dental-issues-research-to-study-impact-of-this-medical-debt-on-hoosiers/) **Published:** November 26, 2025 **Author:** Jasmin Fernandes **Content:** A toothache may seem minor compared to the other medical conditions and accidents that can send people to the hospital, but the number of Americans seeking treatment in emergency rooms for nontraumatic dental conditions, and the costs associated with the care, have been increasing, making dental debt a growing concern. [Read the full article here.](https://indianacitizen.org/dental-issues-research-to-study-impact-of-this-medical-debt-on-hoosiers/) **Categories:** In The News --- ### [Money: 5 Best Dental Insurance Plans of 2025](https://carequest.org/in-the-news/money-5-best-dental-insurance-plans-of-2025/) **Published:** December 3, 2025 **Author:** Jasmin Fernandes **Content:** Along with brushing and flossing, good dental insurance goes a long way towards keeping your teeth healthy. Since 2016, Money’s editorial team has spent thousands of hours researching and vetting the best dental insurance providers and coverage. We’ve evaluated the most comprehensive policies from top insurers, including Delta Dental, Guardian Direct and Spirit Dental. [Read the full article here.](https://money.com/best-dental-insurance/) **Categories:** In The News --- ### [Kiowa County Press: New data tool shows Coloradans missing out on dental care](https://carequest.org/in-the-news/kiowa-county-press-new-data-tool-shows-coloradans-missing-out-on-dental-care/) **Published:** December 8, 2025 **Author:** Jasmin Fernandes **Content:** Young people living in rural parts of Colorado are accessing oral health care at half the rate of the general population, according to data from a new online [Dental Dashboard](https://civhc.org/get-data/public-data/dental-health-analysis/) created by the Center for Improving Value in Health Care in partnership with the Colorado Dental Association. [Read the full article here.](https://kiowacountypress.net/content/new-data-tool-shows-coloradans-missing-out-dental-care) **Categories:** In The News --- ### [New York Amsterdam News: Why Black and Brown patients get brushed off when it comes to affordable dental care](https://carequest.org/in-the-news/new-york-amsterdam-news-why-black-and-brown-patients-get-brushed-off-when-it-comes-to-affordable-dental-care/) **Published:** December 18, 2025 **Author:** Jasmin Fernandes **Content:** Furaha Moyé owes her smile to Harlem United. The community health center, based in Upper Manhattan, has served as a steady source of affordable, quality dental care for the 76-year-old Harlem resident for more than a decade. Faced with challenging dental issues since she was a child, Moyé said the services she receives at the center are essential to her career as an actor and model. [Read the full article here.](https://amsterdamnews.com/news/2025/12/18/black-and-brown-patients-burshed-off-for-affordable-dental-care/) **Categories:** In The News --- ### [Becker’s Dental Review: ‘We are at a crisis’: CareQuest CEO zeroes in on top priorities for dental care access in 2026](https://carequest.org/in-the-news/beckers-dental-review-we-are-at-a-crisis-carequest-ceo-zeroes-in-on-top-priorities-for-dental-care-access-in-2026/) **Published:** December 18, 2025 **Author:** Jasmin Fernandes **Content:** The CareQuest Institute for Oral Health will continue to advocate for dental care accessibility as the industry faces persistent challenges along with some new obstacles in 2026. [Wade Rakes](https://www.beckersdental.com/executive-moves/carequest-institute-for-oral-health-names-new-ceo/), the organization’s new CEO, recently spoke with *Becker’s* to discuss roadblocks to dental care accessibility in the U.S., including Medicaid cuts, fluoride pushback and workforce shortages. [Read the full article here.](https://www.beckersdental.com/featured-perspectives/we-are-at-a-crisis-carequest-ceo-zeroes-in-on-top-priorities-for-dental-care-access-in-2026/) **Categories:** In The News --- ### [Becker’s Dental Review: ‘We’ve got a lot of work to do ahead’: What dental leaders told us in December](https://carequest.org/in-the-news/beckers-dental-review-weve-got-a-lot-of-work-to-do-ahead-what-dental-leaders-told-us-in-december/) **Published:** December 22, 2025 **Author:** Jasmin Fernandes **Content:** This month, dental executives spoke with *Becker’s* about dental care accessibility, new investments and financial pressures facing the industry. Here is what six dental leaders told us in December: [Read the full article here.](https://www.beckersdental.com/featured-perspectives/weve-got-a-lot-of-work-to-do-ahead-what-dental-leaders-told-us-in-december/) **Categories:** In The News --- ### [Word in Black: Here’s What Doc Appointments You Need to Make in 2026](https://carequest.org/in-the-news/word-in-black-heres-what-doc-appointments-you-need-to-make-in-2026/) **Published:** December 29, 2025 **Author:** Jasmin Fernandes **Content:** As we look ahead to 2026, we need to continue to be proactive about our health care. With an upcoming second Trump administration, some in the Black community are fearful of what that can mean for health care access. But there are some practical steps we can all take to continue to care for our health as experts of our bodies. [Read the full article here.](https://wordinblack.com/2025/12/heres-what-docs-appointments-you-need-to-make-in-2025/) **Categories:** In The News --- ### [WVIZ-TV: Northeast Ohio's 'oral health deserts' put residents at risk of more than cavities](https://carequest.org/in-the-news/wviz-tv-northeast-ohios-oral-health-deserts-put-residents-at-risk-of-more-than-cavities/) **Published:** December 29, 2025 **Author:** Jasmin Fernandes **Content:** The sounds of suction and other dental tools drone in the background as Joseph Kunchik, chief dental officer for Lorain County Health and Dentistry, examines 20-year-old Jesus Cruz. Cruz is in pain after delaying dental care because he could not afford it. “I stayed up at nights crying because of this,” Cruz said. “And then eating, I’m not able to use the whole left side of my mouth.” [Read the full article here.](https://www.ideastream.org/health/2025-12-29/northeast-ohios-oral-health-deserts-put-residents-at-risk-of-more-than-cavities) **Categories:** In The News --- ### [Dental Bite: Leading the future of oral health](https://carequest.org/in-the-news/dental-bite-leading-the-future-of-oral-health/) **Published:** January 5, 2026 **Author:** Jasmin Fernandes **Content:** [**CareQuest Institute for Oral Health**](https://www.carequest.org/?sub4=Spotlight&ref=dentalbite.co) is a nonprofit focused on creating an equitable system for oral health care through research, policy, advocacy and philanthropy. In September, they announced a new CEO: [**Wade Rakes, MBA**](https://carequest.org/about/leadership-team/?ref=dentalbite.co). Months into his new role, Rakes sat down with Dental Bite to talk about his experience as a health care executive and how he continues to guide CareQuest forward on its mission. [Read the full article here.](https://www.dentalbite.co/leading-the-future-of-oral-health/) **Categories:** In The News --- ### [HIT Consultant: The Proprietary Trap: Why ‘Open Data’ is the Key to Scaling Your Dental Practice in 2026](https://carequest.org/in-the-news/hit-consultant-the-proprietary-trap-why-open-data-is-the-key-to-scaling-your-dental-practice-in-2026/) **Published:** January 19, 2026 **Author:** Chernise Harris **Content:** Care coordination in the dental industry barely exists. While the medical industry has made progress toward interoperability with several recent initiatives, dentistry continues to lag behind its healthcare counterparts in supporting the principles of “open data,” which allow information to be freely accessed, used, and shared across platforms without restrictive barriers. [Read the full article here.](https://hitconsultant.net/2026/01/19/innovation-dental-interoperability-standard-open-data-2026/) **Categories:** In The News --- ### [RDH: Crossing state lines: What the DDH Compact means for the future of dental hygiene](https://carequest.org/in-the-news/rdh-crossing-state-lines-what-the-ddh-compact-means-for-the-future-of-dental-hygiene/) **Published:** January 28, 2026 **Author:** Chernise Harris **Content:** The new DDH Compact could transform hygienists’ careers, making multistate licensure easier and expanding opportunities, mobility, and access to care across the country. Key Highlights - The DDH Compact allows dental hygienists and dentists to practice in multiple states with a single license, streamlining mobility and reducing administrative barriers. - Implementation of the Compact is estimated to take 18 to 24 months, with some states already enacting legislation and others pending approval. - Benefits include increased access to care, expanded employment opportunities, and the ability to serve underserved areas more effectively. - Legislative support and contacting state legislators are crucial for expanding the Compact and enhancing professional and public health benefits. - Advancements like the DDH Compact demonstrate the profession’s commitment to improving preventive care and addressing workforce shortages across the country. [Read the full article here.](https://www.rdhmag.com/career-profession/article/55333005/crossing-state-lines-what-the-ddh-compact-means-for-the-future-of-dental-hygiene) **Categories:** In The News --- ### [Axios: Fluoride ban efforts show RFK Jr.'s reach](https://carequest.org/in-the-news/axios-fluoride-ban-efforts-show-rfk-jr-s-reach/) **Published:** February 2, 2026 **Author:** Chernise Harris **Content:** Health Secretary Robert F. Kennedy Jr.’s push to remove fluoride from public water supplies is playing out on dual tracks, as the Environmental Protection Agency advances a fast-track review of health risks and at least 16 states weigh new restrictions. Why it matters: The efforts show how key parts of Kennedy’s “Make America Healthy Again” agenda are being steered outside of the department he oversees. - New fluoride limits could upend an 80-year-old standard that’s widely credited with reducing tooth decay by 25% and narrowing disparities for people without regular dental care. [Read the full article here.](https://www.axios.com/2026/02/02/fluoride-ban-water-kennedy-rfk-epa?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top) **Categories:** In The News --- ### [Becker’s Dental Review: Temple University to open dental clinic, education center](https://carequest.org/in-the-news/beckers-dental-review-temple-university-to-open-dental-clinic-education-center/) **Published:** February 5, 2026 **Author:** Chernise Harris **Content:** The Temple University Kornberg School of Medicine is planning a dental clinic and education center in Tamaqua, Pa. The rural dental center will host 10 third-year and fourth-year dental students, who will be supervised by licensed dentists, according to a Feb. 4 news release from the university. Rural populations often have the worst access to dental care, with 40% of adults in rural areas not having visited a dentist in the past year, according to a report from the CareQuest Institute for Oral Health. [Read the full article here.](https://www.beckersdental.com/dentists/temple-university-to-open-dental-clinic-education-center/) **Categories:** In The News --- ### [HedgeThink: The Impact of Dental Health on Your Career Success](https://carequest.org/in-the-news/hedgethink-the-impact-of-dental-health-on-your-career-success/) **Published:** February 9, 2026 **Author:** Chernise Harris **Content:** Teeth show up in almost every workplace interaction, in person or on video, today. They sit at the center of a smile, clear speech, and confidence on camera. In a busy week, many employees spend hours talking to coworkers, clients, or customers, and the mouth is part of that first impression. When dental problems flare, work can feel heavier. Pain, bad breath, or embarrassment can change how a person speaks up, networks, and handles pressure. Small worries can steal attention without any explanation. [Read the full article here.](https://www.hedgethink.com/the-impact-of-dental-health-on-your-career-success/) **Categories:** In The News --- ### [Becker’s Dental Review: CareQuest Institute, National Association of Community Health Centers partner on oral health integration](https://carequest.org/in-the-news/beckers-dental-review-carequest-institute-national-association-of-community-health-centers-partner-on-oral-health-integration/) **Published:** February 10, 2026 **Author:** Chernise Harris **Content:** The CareQuest Institute for Oral Health has [partnered](https://www.nachc.org/nachc-and-carequest-institute-for-oral-health-partner-to-promote-oral-health-at-community-health-centers/) with the National Association of Community Health Centers to support oral health integration at clinics throughout the U.S. The two organizations will work together to advance interdisciplinary, prevention-focused care models at community health centers, according to a Feb. 10 news release. The collaboration will also include initiatives to expand access to oral healthcare within community health centers, including workforce training programs and virtual learning opportunities. [Read the full article here.](https://www.beckersdental.com/dentists/carequest-institute-national-association-of-community-health-centers-partner-on-oral-health-integration/) **Categories:** In The News --- ### [Becker’s Dental Review: CareQuest partners with AI company on medical-dental data integration](https://carequest.org/in-the-news/beckers-dental-review-carequest-partners-with-ai-company-on-medical-dental-data-integration/) **Published:** February 17, 2026 **Author:** Chernise Harris **Content:** The CareQuest Institute for Oral Health has [partnered](https://www.businesswire.com/news/home/20260217701750/en/CareQuest-Institute-Partners-with-Innovaccer-to-Improve-Medical-Dental-Data-Integration) with healthcare AI company Innovaccer to advance medical-dental integration. The two organizations will link medical and dental claims and clinical data through Innovaccer’s Humbi platform, according to a Feb. 17 news release. They will then explore how the shared data can be used to improve care coordination and delivery, with the goal of helping providers, payers and policymakers better understand the impact of oral health on overall health outcomes. [Read the full article here.](https://www.beckersdental.com/ai-teledentistry/carequest-partners-with-ai-company-on-medical-dental-data-integration/) **Categories:** In The News --- ### [DrBicuspid: U.S. adults give public water fluoridation a thumbs-up](https://carequest.org/in-the-news/drbicuspid-u-s-adults-give-public-water-fluoridation-a-thumbs-up/) **Published:** July 30, 2025 **Author:** Jasmin Fernandes **Content:** At a time when states like Utah have stopped adding fluoride to public water systems, 81% of adults in the U.S. report supporting or not being opposed to community water fluoridation, according to a report from the CareQuest Institute for Oral Health. Only 6% of adults polled supported a complete ban on water fluoridation, according to the report. “This survey confirms that the campaign against water fluoridation is out of step with not only the vast majority of the scientific and medical communities, but with the American people, too,” Melissa Burroughs, senior director of public policy at CareQuest, said in a press release dated July 22. [Read the full story here.](https://www.drbicuspid.com/dental-hygiene/fluoride/article/15751537/us-adults-give-public-water-fluoridation-a-thumbsup) **Categories:** In The News --- ### [Central Florida Public Media: Before Florida banned Fluoride, Calgary did, too. So why did it return 14 years later?](https://carequest.org/in-the-news/central-florida-public-media-before-florida-banned-fluoride-calgary-did-too-so-why-did-it-return-14-years-later/) **Published:** July 30, 2025 **Author:** Jasmin Fernandes **Content:** It’s been one month since Florida banned fluoride in its drinking water. Gov. Ron DeSantis signed a bill earlier this summer that outlawed water facilities from adding water quality additives such as fluoride. Coincidentally, the day before Florida’s ban went into effect, Calgary, in Alberta, Canada, reintroduced fluoride to its water after stopping the practice 14 years prior. One of the big reasons why Calgarians voted to once again add fluoride to water was an eight-year study showing significant increases in tooth decay in second-grade children. [Read the full story here.](https://www.cfpublic.org/health/2025-07-30/before-florida-banned-fluoride-calgary-did-too-so-why-did-it-return-14-years-later) **Categories:** In The News --- ### [Dentistry Today: New Interactive Map Designed to Streamline Licensure Guidance for Dental Hygienists](https://carequest.org/in-the-news/dentistry-today-new-interactive-map-designed-to-streamline-licensure-guidance-for-dental-hygienists/) **Published:** July 31, 2025 **Author:** Jasmin Fernandes **Content:** This week the American Dental Hygienists’ Association (ADHA) and CareQuest Institute for Oral Health announced the launch of the Dental Hygienist Licensure Map, an interactive resource that provides state-by-state licensure information for dental hygienists across the United States. The tool consolidates previously scattered information into one accessible platform, serving the professional needs of more than 220,000 dental hygienists nationwide. The map provides detailed information across multiple licensure categories, including initial licensure requirements, continuing education renewal requirements, licensure by credentials, specialty licensure, and dental hygiene compact states. It also includes scope of practice information and direct links to state licensing boards, making it a 1-stop reference for dental hygienists navigating professional requirements. [Read the full story here.](https://www.dentistrytoday.com/new-interactive-map-designed-to-streamline-licensure-guidance-for-dental-hygienists/) **Categories:** In The News --- ### [Becker’s Dental Review: Good news, bad news for dentistry](https://carequest.org/in-the-news/beckers-dental-review-good-news-bad-news-for-dentistry/) **Published:** August 20, 2025 **Author:** Jasmin Fernandes **Content:** Here are six recent updates that have led to optimism and skepticism in the dental industry: **Artificial intelligence innovation** AI companies are continuing to expand ways for their technology to be used in dental practices, and industry leaders are expecting AI to soon change how every task is completed. Earlier this year, Alta AI launched a platform that allows hygienists to more quickly chart, record notes and access patient information. Planet DDS and Pearl also teamed up to launch AI Assist, which provides diagnostic insights to DSOs and multilocation practices by analyzing patient X-rays. Most recently, VideaHealth launched ClaimsAI, an RCM platform that has resulted in up to 90% faster claim submissions for dental practices. [Read the full story here.](https://www.beckersdental.com/dentists/good-news-bad-news-for-dentistry/) **Categories:** In The News --- ### [Becker’s Dental Review: Alaska dental providers prepare for increased demand ahead of Medicaid changes](https://carequest.org/in-the-news/beckers-dental-review-alaska-dental-providers-prepare-for-increased-demand-ahead-of-medicaid-changes/) **Published:** August 20, 2025 **Author:** Jasmin Fernandes **Content:** Alaska Medicaid providers are preparing for increased demand for dental care after the federal budget passage earlier this year, Alaska’s News Source reported Aug. 19. The One Big Beautiful Bill Act, which was signed into law July 4, is expected to lead to a decrease in Medicaid spending by nearly $1 trillion. The legislation has been criticized by many healthcare organizations, with many leaders denouncing the bill’s cuts to healthcare. Dental organizations have criticized the budget for its potential impact on Medicaid, with the CareQuest Institute for Oral Health calling the bill’s passage a “dangerous setback” for dentistry. Melinda Freemon, the executive director of Anchorage Project Access, said the nonprofit is seeing the highest demand for services in its history. [Read the full story here.](https://www.beckersdental.com/dentists/alaska-dental-providers-prepare-for-increased-demand-ahead-of-medicaid-changes/) **Categories:** In The News --- ### [STAT: Dental Care Is Increasingly Under Threat in the US](https://carequest.org/in-the-news/stat-dental-care-is-increasingly-under-threat-in-the-us-2/) **Published:** August 29, 2025 **Author:** Jasmin Fernandes **Content:** “The removal of access to fluoride, coupled with Congress’s cuts to Medicaid, will strip away vital protections for those most at risk.” In this article from STAT, CareQuest Institute Senior Director of Public Policy Melissa Burroughs is calling on the administration to take three critical steps to reverse the oral health crisis in the US. [Read the full story here.](https://www.statnews.com/2025/08/29/dental-care-medicaid-medicare-fluoridation-oral-health-crisis/) **Categories:** In The News --- ### [Becker’s Hospital Review: Matt Steele, Director of State and Local Advocacy at CareQuest](https://carequest.org/in-the-news/beckers-hospital-review-matt-steele-director-of-state-and-local-advocacy-at-carequest/) **Published:** September 11, 2025 **Author:** Jasmin Fernandes **Content:** In this episode, Matt Steele, Director of State and Local Advocacy at CareQuest, discusses the impact of upcoming Medicaid changes, the importance of community water fluoridation, and strategies for ensuring vulnerable populations maintain access to essential dental care. [Listen to this episode here.](https://www.beckershospitalreview.com/podcasts/uncategorized/matt-steele-director-of-state-and-local-advocacy-at-carequest/) **Categories:** In The News --- ### [Forbes: Denise Marks: Embracing Strengths, Joy & A Unique Path As CFO](https://carequest.org/in-the-news/forbes-denise-marks-embracing-strengths-joy-a-unique-path-as-cfo/) **Published:** September 17, 2025 **Author:** Jasmin Fernandes **Content:** Denise Marks is the CFO of the CareQuest Institute for Oral Health®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system. The organization does this through its work in grantmaking, research, health improvement programs, education, advocacy, and innovation. The organization collaborates with thought leaders, health care providers, patients, and local, state, and federal stakeholders to accelerate oral health care transformation and create a system designed for everyone. Denise and I discussed her path to becoming a CFO, the importance of taking on diverse opportunities, how to add value, and much more. [Read the full story here.](https://www.forbes.com/sites/jackmccullough/2025/09/17/denise-marks-embracing-strengths-joy--a-unique-path-as-cfo/) **Categories:** In The News --- ### [WOUB-TV: How pediatricians are helping more kids get dental care in Ohio](https://carequest.org/in-the-news/woub-tv-how-pediatricians-are-helping-more-kids-get-dental-care-in-ohio/) **Published:** September 17, 2025 **Author:** Jasmin Fernandes **Content:** Ohio kids on Medicaid are nearly twice as likely as kids nationwide to go to the emergency department for preventable dental issues, like cavities or tooth decay. The problem is especially acute in rural and poor parts of the state, where dentist shortages make it harder for children to get regular care. To address that issue, CareQuest Institute for Oral Health and Oral Health Ohio launched the Medical Oral Expanded Care (or MORE Care) pilot program across six Ohio counties in 2022. The pilot ended in 2024, and a report on its effectiveness was published in July. [Read the full story here.](https://woub.org/2025/09/17/pediatricians-helping-kids-get-dental-care-ohio/) **Categories:** In The News --- ### [DentistryIQ: New study projects economic and oral health effects of fluoride removal](https://carequest.org/in-the-news/dentistryiq-new-study-projects-economic-and-oral-health-effects-of-fluoride-removal/) **Published:** September 18, 2025 **Author:** Jasmin Fernandes **Content:** A new study coauthored by ADA President Dr. Brett Kessler warns that ending community water fluoridation in the US could trigger a nationwide oral health crisis—costing billions and disproportionately harming low-income children. Findings from a study by the Journal of the American Medical Association (JAMA) coauthored by ADA president Brett Kessler, DDS, and Scott D. Smith, DDS, MS, predict significant increases in dental disease and treatment costs if community water fluoridation were discontinued in the United States. [Read the full story here.](https://www.dentistryiq.com/dentistry/research-and-news/news/55317314/new-study-projects-economic-and-oral-health-effects-of-fluoride-removal) **Categories:** In The News --- ### [HealthCentral: Why Oral Health Is Critical to Managing Your Chronic Disease](https://carequest.org/in-the-news/healthcentral-why-oral-health-is-critical-to-managing-your-chronic-disease/) **Published:** September 18, 2025 **Author:** Jasmin Fernandes **Content:** The state of your gums and teeth can impact your risk for various health conditions—and vice-versa. Here’s how to protect yourself. Our oral health care is under attack. Whether it’s bans on fluoride in public water, cuts to Medicaid, or the elimination of the Centers for Disease Control and Prevention’s entire Division of Oral Health, experts are sounding an alarm that America’s oral health is facing a number of threats on several fronts. [Read the full story here.](https://www.healthcentral.com/chronic-health/importance-of-managing-oral-health) **Categories:** In The News --- ### [Florida Phoenix: 2026 Session is go time for dental therapist advocates](https://carequest.org/in-the-news/florida-phoenix-2026-session-is-go-time-for-dental-therapist-advocates/) **Published:** September 21, 2025 **Author:** Jasmin Fernandes **Content:** Armed with new data that show nearly $1 billion was spent on dental emergency room and hospital charges in 2024, a wide coalition of health care advocates is pushing the Legislature to approve a new mid-level dental health care provider known as dental therapists. Floridians for Dental Access is an effort led by Dr. Frank Catalanotto and it’s got the blessing of House Speaker Daniel Perez, R-Miami, who first sponsored the legislation as a freshman legislator. Past attempts have been quashed by the Florida Senate, which has targeted billions on bolstering the state’s health care workforce in recent years but has been unwilling to sign off on the idea. Rural counties are some of the hardest hit by dental shortages and cost increases with nearly 41% of Florida’s 32 rural counties reporting a 77% increase in dental-related hospital and emergency room billings. [Read the full story here.](https://floridaphoenix.com/2025/09/21/2026-session-is-go-time-for-dental-therapist-advocates/) **Categories:** In The News --- ### [DrBicuspid: CareQuest Institute for Oral Health appoints new CEO](https://carequest.org/in-the-news/drbicuspid-carequest-institute-for-oral-health-appoints-new-ceo/) **Published:** September 24, 2025 **Author:** Jasmin Fernandes **Content:** The CareQuest Institute for Oral Health has appointed Wade Rakes, MBA, as its new CEO to lead strategy, philanthropic investments, dental insurance services, and initiatives to improve access to care. Previously, Rakes served as chief growth officer at Centene Corporation and president and CEO of Peach State Health Plan. Additionally, he has held a cabinet-level position in Ohio and serves on multiple boards. [Read the full article here](https://www.drbicuspid.com/dental-business/industry-updates/organized-dentistry/article/15755890/carequest-institute-for-oral-health-appoints-new-ceo) **Categories:** In The News --- ### [The Oklahoman: Removing fluoride from water could cost Oklahomans $500M in dental care, report says](https://carequest.org/in-the-news/the-oklahoman-removing-fluoride-from-water-could-cost-oklahomans-500m-in-dental-care-report-says/) **Published:** September 27, 2025 **Author:** Jasmin Fernandes **Content:** A few months ago, Oklahoma officials removed the state’s recommendation for fluoride in drinking water as part of the “Make Oklahoma Healthy Again” campaign, which was announced alongside the U.S. Health Secretary Robert F. Kennedy Jr. But according to a recent report, ending community water fluoridation could come with a hefty cost. Data from the American Dental Association estimates a nearly $507 million price tag over five years in dental care costs for Oklahomans if fluoride were removed from community water systems. Around 57% of the state has fluoride exposure due to community water systems, according to the report. Fluoride is a naturally occurring mineral in almost all water supplies, and many communities add small amounts to their water to prevent cavities and promote oral health, per the CDC. The federal agency notes that fluoridated water reduces cavities by about 25% in both children and adults. [Read the full story here.](https://www.oklahoman.com/story/news/2025/09/27/fluoride-in-water-oklahoma-dental-care-costs-american-dental-association/86369268007/) **Categories:** In The News --- ### [Forbes: AI Meets Oral Health: The Race To Redefine Digital Dentistry](https://carequest.org/in-the-news/forbes-ai-meets-oral-health-the-race-to-redefine-digital-dentistry/) **Published:** September 30, 2025 **Author:** Jasmin Fernandes **Content:** In the United Kingdom, reports of people resorting to DIY dentistry — pulling teeth at home, gluing broken fillings, or leaving cavities untreated — have become alarmingly common. A British Dental Association survey found 82% of UK dentists have treated patients who attempted self-care since lockdown, a pattern tied to access gaps and the rise of so-called “dental deserts”. The situation isn’t much better over the Atlantic. An estimated 72 million Americans lack dental insurance, according to the 2024–2025 CareQuest State of Oral Health Equity in America survey, with so many having to wait until their pain makes it impossible to get care. The scale is staggering. The World Health Organization calls oral diseases the most common health condition worldwide, affecting nearly 3.7 billion people, while the CDC estimates $46 billion in lost productivity in the U.S. each year due to untreated oral disease. The unifying thread between these crises is that most oral diseases may be avoided, but systemic problems make prevention impossible. [Read the full story here.](https://www.forbes.com/sites/kolawolesamueladebayo/2025/09/30/ai-meets-oral-health-the-race-to-redefine-digital-dentistry/) **Categories:** In The News --- ### [Medscape: The Medical-Dental Divide Is Harming Your Patients](https://carequest.org/in-the-news/medscape-the-medical-dental-divide-is-harming-your-patients/) **Published:** October 8, 2025 **Author:** Jasmin Fernandes **Content:** Hugh J. Silk wishes he had a time machine. If he did, he’d go back to the year 1840 and persuade the staff at what is now the University of Maryland School of Medicine to accept a recommendation to include dental instruction in their curriculum. Instead, the medical school rejected the idea — and the Baltimore College of Dental Surgery, the nation’s first dental school, was born. “That was a pivotal moment,” said Silk, an MD and professor of family medicine and community health at UMass Chan Medical School in Worcester, Massachusetts. “This divide where people who go to dental school are in the dental profession vs people going to medical school in the medical profession has really set us back.” [Read the full story here.](https://www.medscape.com/viewarticle/medical-dental-divide-harming-your-patients-2025a1000r4y?form=fpf) **Categories:** In The News --- ### [Inside Dentistry: Quality Oral Health For The LGBTQ+ Population](https://carequest.org/in-the-news/inside-dentistry-quality-oral-health-for-the-lgbtq-population/) **Published:** October 9, 2025 **Author:** Jasmin Fernandes **Content:** “Oral health is a fundamental component of overall well-being; however, disparities persist among marginalized populations, including the LGBTQ+ community. Many LGBTQ+ individuals face health disparities linked to societal stigma and discrimination that equate to a denial of their civil and human rights.” [Read the full article here](https://www.aegisdentalnetwork.com/id/2024/01/quality-oral-health-for-the-lgbtq-population). **Categories:** In The News --- ### [Kansas City Star: Missouri cities are removing fluoride from water. That’s a huge health hazard](https://carequest.org/in-the-news/kansas-city-star-missouri-cities-are-removing-fluoride-from-water-thats-a-huge-health-hazard/) **Published:** October 14, 2025 **Author:** Jasmin Fernandes **Content:** Community water fluoridation has been a cornerstone of public health for decades because it protects people across their lifespan — especially children and older adults who may not have regular dental visits or even access to basic oral hygiene products. In Missouri, as in other states, communities have recently revisited this issue. Branson and Houston have already removed fluoride in their water. [Read the full story here.](https://www.kansascity.com/opinion/readers-opinion/guest-commentary/article312485808.html) **Categories:** In The News --- ### [Boston Globe: New CEO Wade Rakes gives Boston’s CareQuest Institute a reason to smile](https://carequest.org/uncategorized/boston-globe-new-ceo-wade-rakes-gives-bostons-carequest-institute-a-reason-to-smile/) **Published:** October 27, 2025 **Author:** Jasmin Fernandes **Content:** The board members at the **CareQuest Institute for Oral Health** have something to smile about: They’ve found a veteran health care executive to be the nonprofit’s new chief executive. **Wade Rakes** recently joined CareQuest as its CEO, leaving a top role at health insurance giant **Centene Corp.** to come to Boston. Rakes takes over for **Myechia Minter-Jordan**, who left CareQuest last year to lead **AARP** in Washington; CareQuest board chair **Pam Reeve** has been filling in as interim chief executive since Minter-Jordan’s departure. [Read the full article here.](https://www.bostonglobe.com/2025/10/27/business/wade-rakes-carequest-institute-ceo/) **Categories:** In The News, Uncategorized --- ### [Employee Benefit News: Wally Health offers subscription-based dental care for employers](https://carequest.org/in-the-news/employee-benefit-news-wally-health-offers-subscription-based-dental-care-for-employers/) **Published:** October 28, 2025 **Author:** Jasmin Fernandes **Content:** For years, dental benefits have been a sore spot for organizations, seen as [outdated, underutilized and unsupportive](https://www.benefitnews.com/news/why-menopause-support-should-include-dental-benefits) of employees’ real needs — but this provider is aiming to change that with a new approach to subscription-based care. [Read the full article here.](https://www.benefitnews.com/news/how-wally-health-is-making-dental-benefits-more-comprehensive) **Categories:** In The News --- ### [Becker’s Dental Review: Federal Funding Uncertainties: Can Dentistry Do More with Less?](https://carequest.org/in-the-news/beckers-dental-review-federal-funding-uncertainties-can-dentistry-do-more-with-less-2/) **Published:** May 21, 2025 **Author:** Jasmin Fernandes **Content:** As federal funding for health care faces growing uncertainty, dental leaders are raising a critical question: How will shifting policies impact access and care delivery? [Becker’s Dental & DSO Review breaks down the latest developments](https://www.beckersdental.com/dentists/federal-funding-uncertainties-can-dentistry-do-more-with-less/) with our Senior Director of Public Policy, Melissa Burroughs, and what they mean for dental practices nationwide. From Medicaid to workforce challenges, this is essential reading for anyone tracking health care policy. **Categories:** In The News --- ### [Decisions in Dentistry: Dental Insurance Gap Widens Across the United States](https://carequest.org/in-the-news/decisions-in-dentistry-dental-insurance-gap-widens-across-the-united-states-2/) **Published:** May 30, 2025 **Author:** Jasmin Fernandes **Content:** According to CareQuest Institute for Oral Health’s 2024 State of Oral Health Equity in America (SOHEA) survey, an alarming 27% of US adults, roughly 72 million people, do not have dental insurance. This figure stands in stark contrast to the 9.5% of adults without health insurance, highlighting a persistent and growing coverage gap that jeopardizes both oral and overall health. [Read the full article here.](https://decisionsindentistry.com/2025/05/dental-insurance-gap-widens-across-the-united-states/) **Categories:** In The News --- ### [Dr. Bicuspid: Over 25% of US Adults Don’t Have Dental Insurance](https://carequest.org/in-the-news/dr-bicuspid-over-25-of-us-adults-dont-have-dental-insurance-2/) **Published:** June 2, 2025 **Author:** Jasmin Fernandes **Content:** In the US, approximately 27% of adults, or about 72 million people, do not have dental insurance. This lack of coverage may contribute to worsening overall health, according to a report released by CareQuest Institute for Oral Health. [Read the full article here.](https://www.drbicuspid.com/dental-practice/office-management/insurance/article/15747443/over-25-of-us-adults-dont-have-dental-insurance) **Categories:** In The News --- ### [Medical News Today: Causes of Dental Pain during Pregnancy and How to Treat It](https://carequest.org/in-the-news/medical-news-today-causes-of-dental-pain-during-pregnancy-and-how-to-treat-it-2/) **Published:** June 4, 2025 **Author:** Jasmin Fernandes **Content:** Dental pain is a common concern during pregnancy. A person may develop dental pain during pregnancy because of pregnancy-related changes or because of pre-existing dental health issues. [Read the full article here.](https://www.medicalnewstoday.com/articles/dental-pain-in-pregnancy) **Categories:** In The News --- ### [TIME: America’s Dental Health Is in Trouble](https://carequest.org/in-the-news/time-americas-dental-health-is-in-trouble-2/) **Published:** June 5, 2025 **Author:** Jasmin Fernandes **Content:** A powerful *TIME* investigation exposes how misinformation, policy rollbacks, and systemic neglect are leaving millions without access to basic dental care. The most vulnerable communities are paying the price as fluoride is removed from water systems and Medicaid benefits are at risk. CareQuest Institute is calling for urgent action to treat oral health as essential to overall health. Read more in [this article](https://time.com/7291226/america-dental-oral-health/). **Categories:** In The News --- ### [WUSF: Many Florida kids face barriers to dental care. Will a fluoride ban heighten their risk of harm?](https://carequest.org/in-the-news/wusf-many-florida-kids-face-barriers-to-dental-care-will-a-fluoride-ban-heighten-their-risk-of-harm-2/) **Published:** June 5, 2025 **Author:** Jasmin Fernandes **Content:** Access is especially tough for kids in rural areas or whose families don’t have a lot of money. Some dentists say a new statewide ban on adding fluoride to drinking water affects these communities the most. [Watch news clip and read full article. ](https://www.wusf.org/health-news-florida/2025-06-05/florida-kids-barriers-dental-care-will-fluoride-ban-heighten-risk) **Categories:** In The News --- ### [WLUC: Houghton VetFest Highlights Need for Improved Veteran Dental Care](https://carequest.org/in-the-news/wluc-houghton-vetfest-highlights-need-for-improved-veteran-dental-care-2/) **Published:** June 11, 2025 **Author:** Jasmin Fernandes **Content:** The hundreds of veterans who visited Houghton’s annual VetFest on June 11 may have noticed something new. The Upper Great Lakes Family Health Center set up its mobile dental unit to provide free oral cancer screenings and referrals to veterans. [Watch news clip and read full article here.](https://www.uppermichiganssource.com/2025/06/12/houghton-vetfest-highlights-need-improved-veteran-dental-care/) **Categories:** In The News --- ### [Florida Times-Union: Jacksonville Mom Urges Florida Leaders to Expand Dental Care under Medicaid](https://carequest.org/in-the-news/florida-times-union-jacksonville-mom-urges-florida-leaders-to-expand-dental-care-under-medicaid-2/) **Published:** June 11, 2025 **Author:** Jasmin Fernandes **Content:** The Florida legislature extended its 2025 session but failed to pass the state budget or expand Medicaid dental coverage. The SMILES Act (HB 975/SB 1048) seeks to improve Medicaid dental benefits by covering routine care and increasing dentist reimbursement rates. Currently, Florida Medicaid primarily covers dentures and extractions for low-income parents, adults with disabilities, seniors and pregnant women, leaving preventative care largely inaccessible. [Read the full article.](https://www.jacksonville.com/story/opinion/columns/guest/2025/06/11/floridians-on-medicaid-shouldnt-have-to-visit-er-for-dental-care-opinion/84130132007/) **Categories:** In The News --- ### [The Santa Clarita Valley Signal: The Rise in Dental Injuries and Why It Is Sometimes Best to Visit a Dentist for Treatment, Instead of an Emergency Room](https://carequest.org/in-the-news/the-santa-clarita-valley-signal-the-rise-in-dental-injuries-and-why-it-is-sometimes-best-to-visit-a-dentist-for-treatment-instead-of-an-emergency-room/) **Published:** June 18, 2025 **Author:** Jasmin Fernandes **Content:** In recent years, there has been a notable increase in dental injuries, leading many to seek care in hospital emergency departments (EDs). However, for most dental issues, consulting a dentist is more effective and beneficial than visiting an ED. A 2022 report by CareQuest Institute for Oral Health highlighted that in 2019 there were approximately 1.8 million ED visits for non-traumatic dental conditions (NTDCs) in the US, costing about $3.4 billion. This reflects a significant rise in both the number and cost of such visits over recent years. [Read the full story here.](https://signalscv.com/2025/06/the-rise-in-dental-injuries-and-why-it-is-sometimes-best-to-visit-a-dentist-for-treatment-instead-of-an-emergency-room/) **Categories:** In The News --- ### [Rolling Stone: RFK Jr. Says He’s Fine with Giving Americans ‘More Cavities’](https://carequest.org/in-the-news/rolling-stone-rfk-jr-says-hes-fine-with-giving-americans-more-cavities-2/) **Published:** June 26, 2025 **Author:** Jasmin Fernandes **Content:** As RFK Jr. questions federal fluoride policy, public health experts like Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute, are weighing in on what it could mean for children’s dental health. [Read the full story here.](https://www.rollingstone.com/politics/politics-news/rfk-jr-fluoride-policy-more-cavities-1235373459/) **Categories:** In The News --- ### [Dentistry IQ: Are fluoride bans going to escalate the country’s dental health crisis?](https://carequest.org/in-the-news/dentistry-iq-are-fluoride-bans-going-to-escalate-the-countrys-dental-health-crisis/) **Published:** June 29, 2025 **Author:** Jasmin Fernandes **Content:** With fluoride bans gaining traction in states like Utah and Florida, the US may be heading into a deeper dental health crisis. Learn how legislative changes, misinformation, and rising out-of-pocket costs are compounding barriers to care—especially for low-income families. A 2025 dental health report by ValuePenguin found that more than one in three adults in America admit they don’t go to the dentist regularly. And false claims made against fluoride, recently purported by Health and Human Services Secretary RFK Jr., have exacerbated the current state of poor oral health in the US. [Read the full story here.](https://www.dentistryiq.com/dentistry/research-and-news/news/55294807/are-fluoride-bans-going-to-escalate-the-countrys-dental-health-crisis) **Categories:** In The News --- ### [Becker’s Dental Review: How the Trump Administration Should Approach Oral Health: Q&A](https://carequest.org/in-the-news/beckers-dental-review-how-the-trump-administration-should-approach-oral-health-qa/) **Published:** July 11, 2025 **Author:** Darren Edwards **Content:** What’s the future of oral health policy in the US? CareQuest Institute Senior Director of Public Policy Melissa Burroughs recently spoke with *Becker’s Dental + DSO Review* to discuss how the Trump administration can prioritize oral health improvement. [Read the full article here.](https://www.beckersdental.com/featured-perspectives/how-the-trump-administration-should-approach-oral-health-qa/) **Categories:** In The News --- ### [POLITICO: Dentists Are Struggling to Counter RFK Jr. on Fluoride](https://carequest.org/in-the-news/politico-dentists-are-struggling-to-counter-rfk-jr-on-fluoride-2/) **Published:** July 11, 2025 **Author:** Jasmin Fernandes **Content:** As more communities remove fluoride from drinking water, public health experts, including CareQuest Institute Senior Director of Public Policy Melissa Burroughs, warn of a surge in cavities and a backslide after decades of dental health progress. POLITICO breaks down the growing controversy and what it could mean for millions of people in the US. [Read the full article here.](https://www.politico.com/news/2025/07/10/rfk-jr-is-winning-on-fluoride-dentists-foresee-a-cavity-crisis-00445489) **Categories:** In The News --- ### [Illinois Business Journal: Delta Dental of Illinois Enhances Dental Coverage for Individuals With Disabilities](https://carequest.org/in-the-news/illinois-business-journal-delta-dental-of-illinois-enhances-dental-coverage-for-individuals-with-disabilities/) **Published:** July 11, 2025 **Author:** Jasmin Fernandes **Content:** More than half (52.8%) of individuals in households experiencing disabilities are more frequently denied health care or oral health care due to discrimination. To support individuals with disabilities, the Delta Dental of Illinois Enhanced Benefits Program included additional checkups, cleanings, and fluoride treatments. [Read the full story here. ](https://www.ibjonline.com/2024/07/10/delta-dental-of-illinois-enhances-dental-coverage-for-individuals-with-disabilities/) **Categories:** In The News --- ### [Becker’s Dental + DSO Review: New federal budget threatens continuation of Medicaid dental benefits: ADHA](https://carequest.org/in-the-news/beckers-dental-dso-review-new-federal-budget-threatens-continuation-of-medicaid-dental-benefits-adha/) **Published:** July 14, 2025 **Author:** Jasmin Fernandes **Content:** The recently enacted federal budget could lead states to remove dental benefits from Medicaid, the American Dental Hygienists’ Association said July 11. President Donald Trump signed the One Big Beautiful Bill Act July 4. The bill is expected to increase the national debt by $3.3 trillion, and lead to a decrease in Medicaid spending by nearly $1 trillion. The number of uninsured individuals is expected to grow by 11.8 million more people by 2034. The legislation has been criticized by many healthcare organizations, with many leaders denouncing the bill’s cuts to healthcare. Several dental organizations have also criticized the budget for its potential impact on Medicaid and patient care, with the CareQuest Institute for Oral Health calling the bill’s passage a “dangerous setback” for dentistry. [Read the full story here.](https://www.beckersdental.com/clinical-leadership-infection-control/new-federal-budget-threatens-continuation-of-medicaid-dental-benefits-adha/) **Categories:** In The News --- ### [Becker's Dental Review: 'Those Practices Need a Plan': Dentists Brace for Impact of Federal Budget](https://carequest.org/in-the-news/beckers-dental-review-those-practices-need-a-plan-dentists-brace-for-impact-of-federal-budget-2/) **Published:** July 15, 2025 **Author:** Jasmin Fernandes **Content:** Dental industry leaders are preparing for what may be some harsh consequences of the recently enacted federal budget bill. Melissa Burroughs, the Senior Director of Public Policy for the CareQuest Institute for Oral Health, called the bill’s passage a “dangerous setback,” adding that several provisions of the bill will make it more difficult for individuals to afford dental care and manage diseases linked to oral health. [Read the full story here.](https://www.beckersdental.com/dentists/those-practices-need-a-plan-dentists-brace-for-impact-of-federal-budget/) **Categories:** In The News --- ### [Listening In (With Permission): Oral Health is Healthcare with Caroline McLeod](https://carequest.org/in-the-news/listening-in-with-permission-oral-health-is-healthcare-with-caroline-mcleod/) **Published:** July 21, 2025 **Author:** Jasmin Fernandes **Content:** In this episode of Listening In (With Permission), Andréa Caballero of Catalyst for Payment Reform sits down with Caroline McLeod, a practicing dental clinician and leader at CareQuest Institute for Oral Health, for a deep dive into the overlooked world of oral healthcare—exploring why it’s far more than just teeth, and why health leaders need to pay attention. Caroline McLeod introduces CareQuest Institute, a nonprofit uniquely committed to improving oral health for all. She explains that CareQuest’s approach spans rigorous research, grant making, advocacy, education, and innovation—all rooted in the conviction that oral health is foundational to overall health. [Listen to the episode here.](https://www.catalyze.org/oral-health-is-healthcare-with-caroline-mcleod/) **Categories:** In The News --- ### [Becker’s Dental + DSO Review: Majority of Americans support water fluoridation: Poll](https://carequest.org/in-the-news/beckers-dental-dso-review-majority-of-americans-support-water-fluoridation-poll/) **Published:** July 22, 2025 **Author:** Jasmin Fernandes **Content:** A new report from the Carequest Institute for Oral Health shows that the majority of Americans support water fluoridation. CareQuest partnered with Marketing for Change Co. to conduct a survey of 1,114 U.S. adults between July 7-9. The survey comes as water fluoridation is under intense scrutiny at the state and federal levels due to concerns of its link to health complications. Some states have banned the practice, while HHS Secretary Robert F. Kennedy Jr. recently said he plans to advise the CDC to stop recommending adding fluoride to public water supplies. [Read the full story here.](https://www.beckersdental.com/clinical-leadership-infection-control/majority-of-americans-support-water-fluoridation-poll/) **Categories:** In The News --- ### [CNN: Prescription Fluoride Faces FDA Scrutiny Despite Widespread Support from Providers and the Public](https://carequest.org/in-the-news/cnn-prescription-fluoride-faces-fda-scrutiny-despite-widespread-support-from-providers-and-the-public-2/) **Published:** July 24, 2025 **Author:** Jasmin Fernandes **Content:** The US Food and Drug Administration appears poised to continue with a plan to ban prescription fluoride supplements at a time when many experts say that access to the products has become especially important. “There’s a changing political conversation, but it’s not necessarily changing where the average American perception of fluoride is yet,” said Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute for Oral Health, a nonprofit focused on equitable access to dental care. A poll conducted by the organization in July found that most US adults support community water fluoridation. [Read more in this CNN article.](https://www.cnn.com/2025/07/24/health/fluoride-prescription-supplement-fda) **Categories:** In The News --- ### [Next Avenue: Medicare Mystery](https://carequest.org/in-the-news/next-avenue-medicare-mystery-2/) **Published:** July 25, 2025 **Author:** Jasmin Fernandes **Content:** Traditional Medicare still does not cover dental care — despite the fact that most people support expanding coverage and oral health problems increase as we age. In this Next Avenue article, learn what we can do to address this shortcoming. [Read the full story here.](https://www.nextavenue.org/medicare-mystery/) **Categories:** In The News --- ### [Flintside: Doctors Expand Dental Care Access for Veterans in Need](https://carequest.org/in-the-news/flintside-doctors-expand-dental-care-access-for-veterans-in-need/) **Published:** March 16, 2025 **Author:** Darren Edwards **Content:** Two advocates for veteran care in Michigan are tackling the critical gap in veterans’ dental care, offering free clinics through grants and sustainable community programs. A 2022 report from the American Institute of Dental Public Health and CareQuest Institute highlights the disparities rural veterans face in accessing dental care. [Read the full story here.](https://www.flintside.com/features/doctors-expand-dental-care-access-for-veterans-in-need.aspx) **Categories:** In The News --- ### [Becker’s Dental Review: Dental Leaders Sound the Alarm on Potential Medicaid Cuts](https://carequest.org/in-the-news/beckers-dental-review-dental-leaders-sound-the-alarm-on-potential-medicaid-cuts/) **Published:** February 21, 2025 **Author:** Jasmin Fernandes **Content:** CareQuest Institute is raising concerns about potential Medicaid cuts that could impact millions of patients and dental providers. Reduced Medicaid funding may lead to limited access to care, lower reimbursement rates, and increased strain on dental practices. [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/45599-dental-leaders-sound-the-alarm-on-potential-medicaid-cuts.html) **Categories:** In The News --- ### [Fortune: Original Medicare Doesn’t Cover most Dental Work, but There Are 4 Other Ways to Get Coverage](https://carequest.org/in-the-news/fortune-original-medicare-doesnt-cover-most-dental-work-but-there-are-4-other-ways-to-get-coverage/) **Published:** February 13, 2025 **Author:** Jasmin Fernandes **Content:** Two common misconceptions about Medicare are that it doesn’t cover dental care and that beneficiaries need to pay all dental expenses out of pocket, which could explain why most older adults have gum disease. Roughly half of people with Medicare haven’t had a dental visit in a year, according to the KFF health policy research group. Poor oral health is associated with medical problems like heart disease, stroke, and cognitive impairment. “Visiting the dentist regularly not only prevents dental complications from developing but also prevents minor oral health issues from progressing into larger ones,” noted CareQuest Institute for Oral Health. It’s true that Original Medicare’s Part B medical insurance doesn’t cover most dental work, including routine cleanings, fillings, tooth extractions, or dentures. But there are other ways people with Medicare can get dental coverage aside from their employer or former employer. [Read the full story to learn more.](https://fortune.com/well/article/original-medicare-dental-coverage/) **Categories:** In The News --- ### [ABC10: What a Potential Federal Funding Freeze Could Mean for Medi-Cal's Dental Recipients](https://carequest.org/in-the-news/abc10-what-a-potential-federal-funding-freeze-could-mean-for-medi-cals-dental-recipients/) **Published:** February 18, 2025 **Author:** Jasmin Fernandes **Content:** California health advocates are expressing concerns over the Trump administration’s proposed federal funding freeze, which could significantly impact California’s Medicaid dental services. In this article in ABC10, Melissa Burroughs, CareQuest Institute Director of Public Policy, shares how any disruption of the state’s Medicaid program could reverse recent improvements in dental care access, leaving vulnerable populations at risk. [Watch news clip and read the full story here.](https://www.abc10.com/article/news/local/fedral-funding-freeze-medical-dental/103-6b77a1e3-75f2-4bf9-9689-4f4ed90a64cf) **Categories:** In The News --- ### [Oral Health: Florida Lawmakers Push Three-Year Dental Certification to Ease Dentist Shortage](https://carequest.org/in-the-news/oral-health-florida-lawmakers-push-three-year-dental-certification-to-ease-dentist-shortage/) **Published:** February 19, 2025 **Author:** Darren Edwards **Content:** The lack of access to dental care in Florida is reflected in alarming statistics. A 2023 report by CareQuest Institute for Oral Health found that children in Florida aged 14 and younger seek dental care through emergency departments for non-traumatic dental conditions (NTDC) at one of the highest rates in the country. The report also found that Florida hospitals were billed nearly $550 million for treating NTDC in 2021 alone. Florida lawmakers recently introduced a bill as a solution to this problem: a three-year dental therapist certification, contrasted with the usual eight years required to become a dentist. It would authorize dental therapists to provide services for patients, like routine dental work, under the supervision of a licensed dentist. [Read the full story here.](https://www.oralhealthgroup.com/news/florida-lawmakers-push-three-year-dental-certification-to-ease-dentist-shortage-1003984501/) **Categories:** In The News --- ### [Oral Health: Value-Based Care and the Value of Dental Hygienists: A Paradigm Shift Toward Better Outcomes](https://carequest.org/in-the-news/oral-health-value-based-care-and-the-value-of-dental-hygienists-a-paradigm-shift-toward-better-outcomes/) **Published:** February 21, 2025 **Author:** Darren Edwards **Content:** In this article from *Oral Health*, CareQuest Institute Value-Based Care Program Manager Danielle Apostolon dives into what value-based care (VBC) is, what VBC looks like in oral health, and what it looks like in practice. Apostolon also explains why dental hygienists are well-positioned to lead the shift to VBC in dental practices. [Read the full story here.](https://www.oralhealthgroup.com/features/value-based-care-and-the-value-of-dental-hygienists-a-paradigm-shift-toward-better-outcomes/) **Categories:** In The News --- ### [The Patient Experience Blueprint Podcast: The Power of Preventive Care: Value-Based Dentistry with Danielle Apostolon](https://carequest.org/in-the-news/the-patient-experience-blueprint-podcast-the-power-of-preventive-care-value-based-dentistry-with-danielle-apostolon/) **Published:** February 25, 2025 **Author:** Darren Edwards **Content:** Danielle Apostolon, Program Manager, Value-Based Care at CareQuest Institute, explains the shift toward value-based care (VBC) in dentistry in this episode of *The Patient Experience Blueprint Podcast.* She explains how this VBC model prioritizes quality outcomes over the quantity of services, and how dental practices can adopt this approach to improve patient care and satisfaction. Apostolon also explores how VBC transforms the patient journey by focusing on preventive measures, personalized treatment plans, and long-term health benefits, ultimately leading to more satisfied and healthier patients. [Listen to the full episode here.](https://podcasts.apple.com/us/podcast/the-power-of-preventive-care-value-based/id1716969158?i=1000695914179) **Categories:** In The News --- ### [Axios: Medicaid Cuts Put Adult Dental Care On the Chopping Block](https://carequest.org/in-the-news/axios-medicaid-cuts-put-adult-dental-care-on-the-chopping-block/) **Published:** March 5, 2025 **Author:** Darren Edwards **Content:** A new article in *Axios* explains how dental care for millions of people in the US could be one of the first casualties if the federal Medicaid budget is cut by $880 billion. Fluoridated water could be on the chopping block in many communities, too. Melissa Burroughs, CareQuest Institute Public Policy Director, explains how these two policy changes could lead to more visits to the emergency department for dental care, increased health care costs, and worsened health outcomes. [Read the full story here.](https://www.axios.com/2025/03/05/medicaid-cuts-dental-care-coverage-risk) **Categories:** In The News --- ### [The Burleson Box Podcast: Dr. Erinne Kennedy on Managing Burnout, Preventive Care, and Leadership in Dentistry](https://carequest.org/in-the-news/the-burleson-box-podcast-dr-erinne-kennedy-on-managing-burnout-preventive-care-and-leadership-in-dentistry/) **Published:** March 7, 2025 **Author:** Darren Edwards **Content:** In this episode of *The Burleson Box*, Dustin Burleson, DDS, welcomes Erinne Kennedy, DMD, MPH, MMSc, Assistant Dean for Curriculum and Integrated Learning at Kansas City University College of Dental Medicine. Kennedy shares her fascinating journey into dentistry, which was heavily influenced by her family of dental professionals and her passion for public health. A significant part of the conversation focuses on the future of preventive dentistry, and Kennedy shares her excitement about advancements in salivary testing, peptides, and microbiome management, predicting that these innovations will reshape how dental professionals approach prevention. She explains how new materials and techniques, such as peptide-based remineralization and nanoparticle technology, could reduce the need for surgical interventions and lead to better long-term patient outcomes. The podcast references several reports from CareQuest Institute for Oral Health. [Listen to the full episode here.](https://www.orthotown.com/blog/post/22268/episode-51-dr-erinne-kennedy-on-managing-burnout-preventive-care-and-leadership-in-dentistry) **Categories:** In The News --- ### [The Islands’ Sounder: Everyone Deserves Dental Care](https://carequest.org/in-the-news/the-islands-sounder-everyone-deserves-dental-care/) **Published:** March 7, 2025 **Author:** Darren Edwards **Content:** A new article in *The Islands’ Sounder* highlights Jessica Dubek, DDS, the founder of DentALL, who travels around Western Washington providing free dental services. Dubek and her team are now operating the Community Dental Clinic on Orcas Island. The Orcas Island Community Foundation launched a community dental program in 2012 after learning that dental care was the number one issue for county residents living at or below the federal poverty level. According to a CareQuest Institute for Oral Health report, in 2021, poorer families paid 7.4 times more out-of-pocket expenditures for dental care compared to high-income families. [Read the full article here.](https://www.islandssounder.com/news/everyone-deserves-dental-care/) **Categories:** In The News --- ### [Decisions in Dentistry: How a Pilot Program Is Transforming Dental Care for Patients with Disabilities](https://carequest.org/in-the-news/decisions-in-dentistry-how-a-pilot-program-is-transforming-dental-care-for-patients-with-disabilities/) **Published:** March 12, 2025 **Author:** Darren Edwards **Content:** For individuals with intellectual and developmental disabilities, a trip to the dental office can be overwhelming. A new pilot program at Tufts Dental Facilities, a grantee of CareQuest Institute, is breaking barriers with home visits and telehealth, making dental care more accessible and personalized. [Read the full story here.](https://decisionsindentistry.com/2025/02/how-a-pilot-program-is-transforming-dental-care-for-patients-with-disabilities/) **Categories:** In The News --- ### [New York Post: I’m a Harvard-Educated Doctor — This Bad Nightly Habit Can Increase Your Risk of Heart Disease](https://carequest.org/in-the-news/new-york-post-im-a-harvard-educated-doctor-this-bad-nightly-habit-can-increase-your-risk-of-heart-disease/) **Published:** April 2, 2025 **Author:** Darren Edwards **Content:** While poor oral hygiene is often linked to issues like tooth loss, gum disease and bad breath, experts warn it can also have a far-reaching impact on your entire well-being — including your heart. In this article in the *New York Post*, experts explain the connection between oral health and heart disease, including a report from CareQuest Institute. [Read the full story here.](https://nypost.com/2025/04/02/health/poor-oral-hygiene-can-increase-your-heart-disease-risk/) **Categories:** In The News --- ### [Becker’s Dental Review: ‘Catastrophe’: Dental Leaders React to Shutdown of CDC Oral Health Division](https://carequest.org/in-the-news/beckers-dental-review-catastrophe-dental-leaders-react-to-shutdown-of-cdc-oral-health-division/) **Published:** April 4, 2025 **Author:** Darren Edwards **Content:** The recent dismantling of the CDC Division of Oral Health has sent shockwaves through the dental community, raising concerns about the future of dental public health efforts and the prioritization of oral health at the federal level. Our Senior Director of Public Policy, Melissa Burroughs, and other industry leaders gave their reactions in Becker’s Dental + DSO Review. [Read the full article here.](https://www.beckersdental.com/clinical-leadership-infection-control/catastrophe-dental-leaders-react-to-shutdown-of-cdc-oral-health-division/) **Categories:** In The News --- ### [Becker’s Dental Review: Dental Groups Stand Firm on Fluoride as Federal Threats Loom: 'Our nation is at risk'](https://carequest.org/in-the-news/beckers-dental-review-dental-groups-stand-firm-on-fluoride-as-federal-threats-loom-our-nation-is-at-risk-2/) **Published:** April 9, 2025 **Author:** Jasmin Fernandes **Content:** Dental organizations, including CareQuest Institute, are continuing to back community water fluoridation as the future of this practice comes under threat at the federal level. [Read the full story here.](https://www.beckersdental.com/clinical-leadership-infection-control/dental-groups-stand-firm-on-fluoride-as-federal-threats-loom-our-nation-is-at-risk/) **Categories:** In The News --- ### [Health Affairs: All Veterans Deserve Comprehensive Dental Care](https://carequest.org/in-the-news/health-affairs-all-veterans-deserve-comprehensive-dental-care-2/) **Published:** April 10, 2025 **Author:** Jasmin Fernandes **Content:** Of the more than nine million veterans who are eligible for medical care through the VHA, approximately 1.8 million are also eligible for dental care. Among veterans eligible for dental care, a third use that benefit annually—inclusive of the community care network (CCN). The CCN is a private network of VA-affiliated providers available to eligible veterans who cannot get care in a VA facility due to long wait times or geographic distance. The PACT Act of 2022, considered to be the largest health care and benefit expansion in VA history, increased dental eligibility by 330,000 veterans. Still, many veterans report struggling with access to affordable dental care. The influx of eligible veterans has strained an already overburdened health care infrastructure within the VHA, extending beyond what even CCN can manage. [Read the full story here.](https://www.healthaffairs.org/content/forefront/all-veterans-deserve-comprehensive-dental-care) **Categories:** In The News --- ### [Fierce Healthcare: Medicaid on the Brink? Perspectives from 23 Health Care Voices as Cuts Loom](https://carequest.org/in-the-news/fierce-healthcare-medicaid-on-the-brink-perspectives-from-23-health-care-voices-as-cuts-loom-2/) **Published:** April 23, 2025 **Author:** Jasmin Fernandes **Content:** With Medicaid funding on the chopping block, we must protect access to comprehensive care. CareQuest Institute Senior Director of Public Policy, Melissa Burroughs, spoke to Noah Tong at Fierce Healthcare about how dental benefits are usually one of the first things states eliminate when Medicaid funding is cut, or state budgets are tight. [Read the full article here.](https://www.fiercehealthcare.com/payers/medicaid-brink-perspectives-23-healthcare-voices-cuts-loom) **Categories:** In The News --- ### [Newstrail: Can Dental Insurance Plans Bridge the Gap in Oral Health Care Accessibility?](https://carequest.org/in-the-news/newstrail-can-dental-insurance-plans-bridge-the-gap-in-oral-health-care-accessibility-2/) **Published:** April 24, 2025 **Author:** Jasmin Fernandes **Content:** According to CareQuest Institute for Oral Health, in 2023 nearly 68.5 million adults in the US lacked dental insurance. Based on the organization’s State of Oral Health Equity in America survey, these projections may further surge by the end of 2023 because of the loss of coverage from other household members and the process of Medicaid redetermination. More adults are currently uninsured for dental care which leads to a rise in the number of people needing these plans. [Read the full story here.](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.newstrail.com%2Fcan-dental-insurance-plans-bridge-the-gap-in-oral-healthcare-accessibility-2%2F&data=05%7C02%7CCLocklear%40carequest.org%7C357bf345609e4ad308db08dd872a579e%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638815338123949912%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=x8qnas6HUkv3uoUaclII0BitE2SlcntYkTwF%2FHEBNqs%3D&reserved=0) **Categories:** In The News --- ### [KSHB-TV: ‘We fight tooth and nail,’ Lee's Summit Dentist Restores Smiles for Veterans for Free](https://carequest.org/in-the-news/kshb-tv-we-fight-tooth-and-nail-lees-summit-dentist-restores-smiles-for-veterans-for-free-2/) **Published:** April 28, 2025 **Author:** Jasmin Fernandes **Content:** A Missouri dentist is working to restore smiles to veterans for free. In a new article, featuring stats from a CareQuest report, he emphasizes the importance of veteran oral health. [Watch news clip and read the full story here.](https://www.kshb.com/news/local-news/we-fight-tooth-and-nail-lees-summit-dentist-restores-smiles-for-veterans-for-free) **Categories:** In The News --- ### [Secrets of Rockstar CFOs: CFO Career Paths: Finding Your Value and Embracing the Journey with Denise W. Marks](https://carequest.org/in-the-news/secrets-of-rockstar-cfos-cfo-career-paths-finding-your-value-and-embracing-the-journey-with-denise-w-marks-2/) **Published:** May 13, 2025 **Author:** Jasmin Fernandes **Content:** There are many ways to add value and have an amazing career as a CFO. In this episode, Denise W. Marks, CFO of the CareQuest Institute for Oral Health, shares her insights on navigating a successful career path in finance. Denise discusses the importance of embracing diverse opportunities, not being afraid to ask for help, and finding your own unique way to add value as a CFO. Discover how to embrace the journey, have fun, and make the most of your career in finance. [Listen to the episode here.](https://podcasts.apple.com/us/podcast/cfo-career-paths-finding-your-value-and-embracing/id1708455706?i=1000708305229) **Categories:** In The News --- ### [Fierce Healthcare: House E&C Advances Medicaid Overhaul after Marathon Session](https://carequest.org/in-the-news/fierce-healthcare-house-ec-advances-medicaid-overhaul-after-marathon-session-2/) **Published:** May 19, 2025 **Author:** Jasmin Fernandes **Content:** As state budgets face severe impacts, CareQuest Institute is deeply concerned that optional dental benefits will be the first services cut. Oral health is crucial for overall well-being, and cutting these benefits would be a significant setback. Read more about the ongoing discussions in DC ahead of the Medicaid markup hearing [in Fierce Healthcare.](https://www.fiercehealthcare.com/payers/health-plans-advocacy-groups-descend-dc-ahead-medicaid-hearing) **Categories:** In The News --- ### [Healthcare Innovation: What Is the Potential for Value-Based Care in Dentistry?](https://carequest.org/in-the-news/healthcare-innovation-what-is-the-potential-for-value-based-care-in-dentistry/) **Published:** September 25, 2024 **Author:** Jasmin Fernandes **Content:** “Caitlin Walsdorf recently spoke with Healthcare Innovation about a new survey-based report that explores value-based care (VBC) implementation in dentistry. The survey was a collaboration between HealthScape, the CareQuest Institute of Oral Health and the National Association of Dental Plans.” [Read the full story here.](https://www.hcinnovationgroup.com/policy-value-based-care/article/55142576/what-is-the-potential-for-value-based-care-in-dentistry) **Categories:** In The News --- ### [Border Belt: ‘Not Enough Dentists’: Border Belt Counties Need Better Access To Dental Care](https://carequest.org/in-the-news/border-belt-not-enough-dentists-border-belt-counties-need-better-access-to-dental-care/) **Published:** October 1, 2024 **Author:** Jasmin Fernandes **Content:** Across the country, 40% of adults living in rural environments said they have not visited the dentist in over a year, and over 65% of rural areas nationwide have dentist shortages, according to a 2023 report by the nonprofit CareQuest Institute for Oral Health. [Read the full story here.](https://borderbelt.org/columbus-county-nc-toothmobile-has-dentist-care/) **Categories:** In The News --- ### [Investopedia: How Harris and Democrats Will Change Medicare If They Win](https://carequest.org/in-the-news/investopedia-how-harris-and-democrats-will-change-medicare-if-they-win/) **Published:** October 8, 2024 **Author:** Jasmin Fernandes **Content:** Adding dental benefits to Medicare enjoys broad support among the public, with 72% “very much” supporting the idea, including 64% of voters loyal to former President Donald Trump, according to a July 2024 CareQuest-OPEN poll. [Read the full story here.](https://www.investopedia.com/how-harris-and-democrats-will-change-medicare-if-they-win-8725240) **Categories:** In The News --- ### [California Dental Association: CDA Supports LGBTQIA+ Oral Health Week With A Commitment To Inclusive Care](https://carequest.org/in-the-news/california-dental-association-cda-supports-lgbtqia-oral-health-week-with-a-commitment-to-inclusive-care/) **Published:** October 15, 2024 **Author:** Jasmin Fernandes **Content:** Research conducted by CareQuest found that LGBTQ+ individuals were 31% more likely than non-LGBTQ+ individuals to say their most recent dental visit was two or more years ago. [Read the full story here.](https://www.cda.org/newsroom/access-to-care/cda-supports-lgbtqia-oral-health-week-with-a-commitment-to-inclusive-care/) **Categories:** In The News --- ### [Dentistry IQ: New Study Finds Patients With ADHD Are At A Greater Risk For Poor Oral Health](https://carequest.org/in-the-news/dentistry-iq-new-study-finds-patients-with-adhd-are-at-a-greater-risk-for-poor-oral-health/) **Published:** October 14, 2024 **Author:** Jasmin Fernandes **Content:** A recent report by the CareQuest Institute for Oral Health discovered that adults with attention-deficit/hyperactivity disorder (ADHD) are more likely to have poor oral health than those without ADHD. [Read the full story here.](https://www.dentistryiq.com/dentistry/research-and-news/article/55235362/new-study-finds-patients-with-adhd-are-at-a-greater-risk-for-poor-oral-health) **Categories:** In The News --- ### [Gizmodo: X-Raying Your Head Every Year at the Dentist Might Be Totally Unnecessary](https://carequest.org/in-the-news/gizmodo-x-raying-your-head-every-year-at-the-dentist-might-be-totally-unnecessary/) **Published:** October 15, 2024 **Author:** Jasmin Fernandes **Content:** X-rays are wildly popular among dentists. A 2023 study found that 320 million dental radiography procedures were performed in 2016, or just under one for every resident of the country. That’s incredible, given that, according to the CareQuest Institute for Oral Health, over a quarter of the population doesn’t have dental insurance. [Read the full story here.](https://gizmodo.com/x-raying-your-head-every-year-at-the-dentist-might-be-totally-unnecessary-2000512098) **Categories:** In The News --- ### [The Dentist Magazine: Patients With ADHD Often Suffer With Worse Oral Health, Says Study](https://carequest.org/in-the-news/the-dentist-magazine-patients-with-adhd-often-suffer-with-worse-oral-health-says-study/) **Published:** October 15, 2024 **Author:** Jasmin Fernandes **Content:** Adults with attention-deficit/hyperactivity disorder (ADHD) are at a greater risk of having poor oral health, according to a report released by the CareQuest Institute for Oral Health. [Read the full story here.](https://www.the-dentist.co.uk/content/news/patients-with-adhd-often-suffer-with-worse-oral-health-says-study/) **Categories:** In The News --- ### [Bite Magazine: New Study Finds Patients With ADHD Are At A Greater Risk Of Poor Oral Health](https://carequest.org/in-the-news/bite-magazine-new-study-finds-patients-with-adhd-are-at-a-greater-risk-of-poor-oral-health/) **Published:** October 21, 2024 **Author:** Jasmin Fernandes **Content:** According to the study by the CareQuest Institute for Oral Health in Boston, 35.5 per cent of participants with ADHD rated their oral health as either fair or poor, with only 24.9 per cent of neurotypical respondents giving the same rating. [Read the full story here.](https://www.bitemagazine.com.au/new-study-finds-patients-with-adhd-are-at-a-greater-risk-for-poor-oral-health/) **Categories:** In The News --- ### [Dental Products Report: New Report From The CareQuest Institute For Oral Health Finds Adults With ADHD At Greater Risk For Poor Oral Health](https://carequest.org/in-the-news/dental-products-report-new-report-from-the-carequest-institute-for-oral-health-finds-adults-with-adhd-at-greater-risk-for-poor-oral-health/) **Published:** October 23, 2024 **Author:** Jasmin Fernandes **Content:** A new report from the CareQuest Institute shows that adults with ADHD are more likely to experience poor oral health, with higher rates of dental anxiety, delayed dental visits, and emergency room visits for dental issues compared to adults without ADHD. [Read the full story here.](https://www.dentalproductsreport.com/view/new-report-from-the-carequest-institute-for-oral-health-finds-adults-with-adhd-at-greater-risk-for-poor-oral-health) **Categories:** In The News --- ### [Keystone: Lack Of Dental Coverage Traps PA Residents In Medical And Credit Debt](https://carequest.org/in-the-news/keystone-lack-of-dental-coverage-traps-pa-residents-in-medical-and-credit-debt/) **Published:** October 24, 2024 **Author:** Jasmin Fernandes **Content:** “CareQuest Institute for Oral Health, which advocates for accessible and equitable dental care, found that 67% of Pennsylvanians visited a dentist in 2023, while 7% of residents skipped visiting a dentist while having an oral health problem due to costs.” [Read the full story here.](https://keystonenewsroom.com/2024/10/24/lack-dental-coverage-in-pa/) **Categories:** In The News --- ### [Rolling Stone: RFK Jr. Wants To Get Rid of Fluoride. Here’s What That Means](https://carequest.org/in-the-news/rolling-stone-rfk-jr-wants-to-get-rid-of-fluoride-heres-what-that-means/) **Published:** November 7, 2024 **Author:** Jasmin Fernandes **Content:** “Removing fluoride from drinking water would also exacerbate existing health disparities — especially for underserved populations who may struggle to access regular dental care, says Melissa Burroughs, public policy director at CareQuest Institute for Oral Health, a national nonprofit focused on creating an accessible, equitable, and integrated oral health system.” [Read the full story here.](https://www.rollingstone.com/culture/culture-features/rfk-jr-fluoride-health-1235156256/) **Categories:** In The News --- ### [What Does LinkedIn Think About . . .](https://carequest.org/in-the-news/what-does-linkedin-think-about-2/) **Published:** November 19, 2024 **Author:** Jasmin Fernandes **Content:** We feel fortunate to have nearly 28,000 CareQuest Institute for Oral Health LinkedIn followers. And because our mission is to improve the oral health of all, we have a wide range of followers — everyone from dentists, dental hygienists, and students to policymakers, researchers, and countless stakeholders who want to see a better oral health system. To learn more about our LinkedIn audience and how it feels about various issues within oral health and health care, we invite our followers to participate in a quick poll every two weeks. As we approach the end of the year, we thought this was the perfect time to look back and see the oral health community’s perspective and experiences on . . . ![Poll: Have you ever visited the ED?](https://www.carequest.org/sites/default/files/2024-11/Poll%201.png) ![Poll: Have you been to the dentist in the past year?](https://www.carequest.org/sites/default/files/2024-11/Poll%202.png) ![Poll: Have you ever attended a teledentistry appointment?](https://www.carequest.org/sites/default/files/2024-11/Poll%203.png) ![Poll: Systemic health](https://www.carequest.org/sites/default/files/2024-11/Poll%204.png) ![Poll: Value-Based Care](https://www.carequest.org/sites/default/files/2024-11/Poll%205.png) ![Poll: Avoided dental due to finances](https://www.carequest.org/sites/default/files/2024-11/Poll%206.png) ![Poll: Dental anxiety](https://www.carequest.org/sites/default/files/2024-11/Poll%207.png) ![Poll: Teledentistry participation](https://www.carequest.org/sites/default/files/2024-11/Poll%208.png) ![Poll: Diverse workforce](https://www.carequest.org/sites/default/files/2024-11/Poll%209.png) If you don’t follow CareQuest Institute on LinkedIn, [we invite you to join here](https://www.linkedin.com/company/carequest-institute/mycompany/). We’ll have another poll out soon! **Categories:** In The News --- ### [Scientific American: Fluoride In Drinking Water Is Safe. Here’s The Evidence](https://carequest.org/in-the-news/scientific-american-fluoride-in-drinking-water-is-safe-heres-the-evidence/) **Published:** November 27, 2024 **Author:** Jasmin Fernandes **Content:** “Today at least 68.5 million Americans lack dental insurance, according to a 2023 survey by the CareQuest Institute for Oral Health. Having multiple fluoride sources offers peoples’ teeth much needed protection, says Susan Fisher-Owens, a University of California, San Francisco, Medical Center pediatrician, who studies barriers to children’s dental health.” [Read the full story here.](https://www.scientificamerican.com/article/fluoride-in-drinking-water-is-safe-heres-the-evidence/) **Categories:** In The News --- ### [Washington Examiner: Dismal failures In Healthcare System Make The US An Unsuccessful Nation, Report Says](https://carequest.org/in-the-news/washington-examiner-dismal-failures-in-healthcare-system-make-the-us-an-unsuccessful-nation-report-says/) **Published:** November 29, 2024 **Author:** Jasmin Fernandes **Content:** “Shifting toward value-based care, in which providers are rewarded for quality care and health outcomes, rather than the quantity of care delivered, will incentivize prevention and personalization in care,” said Melissa Burroughs, public policy director at Boston-based CareQuest Institute for Oral Health. [Read the full story here.](https://www.washingtonexaminer.com/magazine-business/3232675/dismal-failures-healthcare-system-make-us-unsuccessful-nation-report-says-subhed-care-must-be-more-accessible-affordable-for-patients-same-time-being-more-profitable-sustainable-for-providers/) **Categories:** In The News --- ### [Newsday: NYS Bill Seeks to Expand Access To Dentistry By Licensing Dental Therapists](https://carequest.org/in-the-news/newsday-nys-bill-seeks-to-expand-access-to-dentistry-by-licensing-dental-therapists/) **Published:** December 2, 2024 **Author:** Jasmin Fernandes **Content:** “An estimated 68.5 million adults go without dental insurance, according to the 2023 State of Oral Health Equity in America survey by the CareQuest Institute for Oral Health.” [Read the full story here.](https://www.newsday.com/news/health/dental-therapist-bill-mba9hojg) **Categories:** In The News --- ### [Public News Service: Medicaid expansion critical for ensuring WV dental care access](https://carequest.org/in-the-news/public-news-service-medicaid-expansion-critical-for-ensuring-wv-dental-care-access/) **Published:** December 9, 2024 **Author:** Jasmin Fernandes **Content:** “According to the CareQuest Institute for Oral Health, in 2021, the nation’s poorest households paid more than seven times more for dental care than higher-income and insured households.” [Read the full story here.](https://www.publicnewsservice.org/2024-12-09/health/medicaid-expansion-critical-for-ensuring-wv-dental-care-access/a93785-1) **Categories:** In The News --- ### [Word In Black: Here’s What Docs Appointments You Need To Make In 2025](https://carequest.org/in-the-news/word-in-black-heres-what-docs-appointments-you-need-to-make-in-2025/) **Published:** December 23, 2024 **Author:** Jasmin Fernandes **Content:** Melissa Burroughs, public policy director at CareQuest Institute for Oral Health, says poor oral health can increase the chances of depression and mental health issues. Moreover, Black adults are 68% more likely than white adults to have an unmet dental need, according to CareQuest Institute research. [Read the full story here.](ttps://carequest.org/word-in-black-heres-what-docs-appointments-you-need-to-make-in-2025/) **Categories:** In The News --- ### [Becker’s Dental Review: Oral Health Care Under Trump: The Policies that Could Transform Dental Care](https://carequest.org/in-the-news/beckers-dental-review-oral-health-care-under-trump-the-policies-that-could-transform-dental-care/) **Published:** February 6, 2025 **Author:** Jasmin Fernandes **Content:** As President Donald Trump gets settled into his second term, many industry leaders are wondering which policy changes could affect oral healthcare in the US. Melissa Burroughs, director of public policy at CareQuest Institute for Oral Health, spoke with Becker’s Healthcare to discuss the policies needed to improve oral care in the US under the Trump administration. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/45483-oral-healthcare-under-trump-the-policies-that-could-transform-dental-care.html) **Categories:** In The News --- ### [Dr. Bicuspid: 9 in 10 U.S. Voters Approve Adding Dental to Medicare](https://carequest.org/in-the-news/dr-bicuspid-9-in-10-u-s-voters-approve-adding-dental-to-medicare/) **Published:** July 23, 2024 **Author:** Jasmin Fernandes **Content:** In the U.S., 92% of voters across the political spectrum support adding a dental benefit to Medicare, according to a report from the CareQuest Institute for Oral Health and the Oral Health Progress and Equity Network. [Read the full story here.](https://www.drbicuspid.com/dental-business/industry-updates/organized-dentistry/article/15680087/9-in-10-us-voters-approve-adding-dental-to-medicare) **Categories:** In The News --- ### [Spotlight Delaware: Fractured & Decayed: Latinos Struggle for Delaware Dental Care](https://carequest.org/in-the-news/spotlight-delaware-fractured-decayed-latinos-struggle-for-delaware-dental-care/) **Published:** August 1, 2024 **Author:** Jasmin Fernandes **Content:** Nationally, over 6 million adults lost their dental coverage in 2023 with Hispanic people being twice as likely to have lost dental insurance than white non-Hispanic individuals, according to a CareQuest Institute for Oral Health survey. [Read the full story here.](https://spotlightdelaware.org/2024/08/01/delaware-latino-dental-care/) **Categories:** In The News --- ### [Dental Assistant Nation: Shocking Statistics and the Dental Patient Connection](https://carequest.org/in-the-news/dental-assistant-nation-shocking-statistics-and-the-dental-patient-connection/) **Published:** August 5, 2024 **Author:** Jasmin Fernandes **Content:** Kevin Henry interviews Lisa Heaton from CareQuest Institute for Oral Health about the importance of health screenings in dental practices. They discuss the disconnect between patients’ willingness to undergo screenings and the low percentage of patients actually receiving them. [Listen to the full episode here.](https://soundcloud.com/user-649058115/episode-343-shocking-statistics-and-the-dental-patient-connection?si=fdae6776530c4ee5aeff8f564f946062&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing) **Categories:** In The News --- ### [Beckers Dental Review: 24.8M People Now Disenrolled from Medicaid: 13 Notes for Dentists](https://carequest.org/in-the-news/beckers-dental-review-24-8m-people-now-disenrolled-from-medicaid-13-notes-for-dentists/) **Published:** August 6, 2024 **Author:** Jasmin Fernandes **Content:** Recent data from CareQuest shows that about 12 million adults and children lost their dental coverage between April and September of 2023, with an additional two million people estimated to have lost coverage between September and December 2023. [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/44224-24-8m-people-now-disenrolled-from-medicaid-13-notes-for-dentists.html) **Categories:** In The News --- ### [10 Tampa Bay WTSP: Veteran Overcomes Dental Struggles with Help from Florida Nonprofit](https://carequest.org/in-the-news/10-tampa-bay-wtsp-veteran-overcomes-dental-struggles-with-help-from-florida-nonprofit/) **Published:** August 16, 2024 **Author:** Jasmin Fernandes **Content:** According to a new study from CareQuest and the American Institute of Dental Public Health, of the more than 9 million veterans who are eligible for medical care from the VA, 85% are not eligible for dental coverage. [Watch news clip and read full story here. ](https://www.wtsp.com/article/news/local/hillsboroughcounty/florida-veteran-dental-coverage-nonprofit/67-3ae59045-058b-4d58-9ae7-478903b6a4db) **Categories:** In The News --- ### [Journal of Public Health Dentistry: Teledentistry utilization by oral health professionals and policy considerations: A mixed methods case study](https://carequest.org/in-the-news/journal-of-public-health-dentistry-teledentistry-utilization-by-oral-health-professionals-and-policy-considerations-a-mixed-methods-case-study/) **Published:** August 19, 2024 **Author:** Jasmin Fernandes **Content:** In this mixed methods case study, we collected teledentistry claims data from patient electronic health records encompassing various types of teledentistry utilization in clinical settings and through community outreach from a Dental Support Organization (DSO) in Oregon from January 2021 to November 2022. [Read the full story here.](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12640) **Categories:** In The News --- ### [Beckers Dental Review: 180+ Groups Urge Congress to Back Continuous Medicaid Coverage: 7 Notes for Dental Leaders](https://carequest.org/in-the-news/beckers-dental-review-180-groups-urge-congress-to-back-continuous-medicaid-coverage-7-notes-for-dental-leaders/) **Published:** August 19, 2024 **Author:** Jasmin Fernandes **Content:** Nearly 190 organizations signed a letter urging legislators to pass the Stabilize Medicaid and CHIP Coverage Act. Dental and oral health organizations that signed the bill include the Carequest Institute for Oral Health and more. [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/44293-180-groups-urge-congress-to-back-continuous-medicaid-coverage-7-notes-for-dental-leaders.html) **Categories:** In The News --- ### [Beckers Dental Review: What A Harris-Walz Ticket Could Mean For Oral Health Care](https://carequest.org/in-the-news/beckers-dental-review-what-a-harris-walz-ticket-could-mean-for-oral-health-care/) **Published:** August 22, 2024 **Author:** Jasmin Fernandes **Content:** Tim Walz, the vice president nominee for the Democratic Party, could help advance certain oral healthcare initiatives based on his actions as the current governor of Minnesota, according to Melissa Burroughs, the director of policy at CareQuest Institute for Oral Health. [Read the full story here.](https://www.beckersdental.com/dentists/44326-what-a-harris-walz-ticket-could-mean-for-oral-healthcare.html) **Categories:** In The News --- ### [US News: Where the Presidential Candidates Stand on Retirement](https://carequest.org/in-the-news/us-news-where-the-presidential-candidates-stand-on-retirement/) **Published:** September 3, 2024 **Author:** Jasmin Fernandes **Content:** “Medicare dental coverage is a critical, but often overlooked, retirement issue,” said Melissa Burroughs, policy director at the Washington-based CareQuest Institute for Oral Health, in an email. “Medicare does not cover dental care, making it unaffordable and out of reach for many Medicare enrollees.” [Read the full story here.](https://money.usnews.com/money/retirement/articles/where-the-presidential-candidates-stand-on-retirement) **Categories:** In The News --- ### [The Cap Times: Why Is Dental Care So Hard To Get In Wisconsin?](https://carequest.org/in-the-news/the-cap-times-why-is-dental-care-so-hard-to-get-in-wisconsin/) **Published:** September 4, 2024 **Author:** Jasmin Fernandes **Content:** In 2020, Wisconsin was one of just three states and the District of Columbia whose Medicaid programs offered “extensive” dental coverage for adults, according to a survey by the nonprofit CareQuest Institute for Oral Health. [Read the full story here.](https://captimes.com/news/business/why-is-dental-care-so-hard-to-get-in-wisconsin/article_1b14e29e-6a1c-11ef-b0af-fbafddb1a729.html) **Categories:** In The News --- ### [Becker's Dental Review: Medicaid Disenrollment Surpasses 25M: 11 Notes For Dentists](https://carequest.org/in-the-news/beckers-dental-review-medicaid-disenrollment-surpasses-25m-11-notes-for-dentists/) **Published:** September 5, 2024 **Author:** Jasmin Fernandes **Content:** Recent data from CareQuest shows that about 12 million adults and children lost their dental coverage between April and September of 2023, with an additional two million people estimated to have lost coverage between September and December 2023. [Read the full story here.](https://www.beckersdental.com/dentists/44421-medicaid-disenrollment-surpasses-25m-11-notes-for-dentists.html) **Categories:** In The News --- ### [NCSL Podcasts: Ideas and Opportunities: Highlights From NCSL’s Health Policy Seminar](https://carequest.org/in-the-news/ncsl-podcasts-ideas-and-opportunities-highlights-from-ncsls-health-policy-seminar/) **Published:** September 12, 2024 **Author:** Jasmin Fernandes **Content:** From soaring costs of health care to record high rates of infectious diseases and widespread mental health issues, lawmakers across the country face mounting health challenges affecting their constituents. [Read the full story here.](https://www.ncsl.org/state-legislatures-news/details/ideas-and-opportunities-highlights-from-ncsls-health-policy-seminar) **Categories:** In The News --- ### [Authority Magazine: Melissa Burroughs of CareQuest Institute for Oral Health on How the US Health System Can Improve Medical Care for Women Over Forty](https://carequest.org/in-the-news/authority-magazine-melissa-burroughs-of-carequest-institute-for-oral-health-on-how-the-us-health-system-can-improve-medical-care-for-women-over-forty/) **Published:** September 12, 2024 **Author:** Jasmin Fernandes **Content:** Women over forty often face unique health challenges and disparities in the medical care they receive. These women are at a critical stage in life where they may be dealing with menopause, increased risk of chronic diseases, and other age-related health issues. Despite the importance of tailored medical care, many feel underserved by the current health system. [Read the full story here.](https://medium.com/authority-magazine/melissa-burroughs-of-carequest-institute-for-oral-health-on-how-the-us-health-system-can-improve-f0fc51a8e8ac) **Categories:** In The News --- ### [American Journal of Managed Care: 5 Specialty Care Shortages in Rural Communities](https://carequest.org/in-the-news/american-journal-of-managed-care-5-specialty-care-shortages-in-rural-communities/) **Published:** September 13, 2024 **Author:** Jasmin Fernandes **Content:** With oral health being a “key indicator of overall health,” the disproportionate effect of oral disease is moreso seen in rural environments, where 40% of residents have not visited a dentist in the past year. [Read the full story here.](https://www.ajmc.com/view/5-specialty-care-shortages-in-rural-communities) **Categories:** In The News --- ### [RDH Magazine: Dental Hygienists Need To Push For Oral Health Equity](https://carequest.org/in-the-news/rdh-magazine-dental-hygienists-need-to-push-for-oral-health-equity/) **Published:** September 17, 2024 **Author:** Jasmin Fernandes **Content:** According to the 2023 State of Oral Health Equity in America report by Care Quest Institute, when study participants were asked why they don’t plan to see a dentist for preventive or routine care in the coming year, 45% cited cost, while 28% pointed to a lack of insurance. [Read the full story here.](https://www.rdhmag.com/patient-care/article/55140445/dental-hygienists-need-to-push-for-oral-health-equity) **Categories:** In The News --- ### [Rock Health: Brushing Up On Oral Health: The Case For Expanded Oral Health Innovation And Investment](https://carequest.org/in-the-news/rock-health-brushing-up-on-oral-health-the-case-for-expanded-oral-health-innovation-and-investment/) **Published:** September 23, 2024 **Author:** Jasmin Fernandes **Content:** According to a 2021 CareQuest Institute survey, 96% of oral health providers believe data-driven decision support technologies improve patient care, signaling high real-world acceptance. New tech also strengthens the provider-patient relationship by involving patients more in their treatment decisions. [Read the full story here.](https://rockhealth.com/insights/brushing-up-on-oral-health-the-case-for-expanded-oral-health-innovation-and-investment/) **Categories:** In The News --- ### [Beckers Dental Review: Federal Bills A 'Huge Step Forward' For Dental Care Accessibility](https://carequest.org/in-the-news/beckers-dental-review-federal-bills-a-huge-step-forward-for-dental-care-accessibility/) **Published:** September 24, 2024 **Author:** Jasmin Fernandes **Content:** U.S. Rep. Debbie Dingell introduced the Comprehensive Dental Care Reform Act of 2024 Sept. 17 as a companion to legislation previously introduced by Sen. Bernie Sanders in May. Melissa Burroughs, the director of policy at the CareQuest Institute for Oral Health, told Becker’s the bill is a “huge step forward” for enhancements to dental care in the U.S. [Read the full story here.](https://www.beckersdental.com/dentists/44555-federal-bills-a-huge-step-forward-for-dental-care-accessibility.html) **Categories:** In The News --- ### [USA Today: Dental Coverage For Seniors Is Wildly Popular. Why Don't Candidates Discuss It?](https://carequest.org/in-the-news/usa-today-dental-coverage-for-seniors-is-wildly-popular-why-dont-candidates-discuss-it/) **Published:** September 24, 2024 **Author:** Jasmin Fernandes **Content:** About nine in 10 voters support adding a dental benefit to Medicare, according to a poll of 1,000 registered voters commissioned this summer by the nonprofit CareQuest Institute for Oral Health, which is focused on access and equity, and the Oral Health Progress and Equity Network. The issue has nearly universal support among Democratic voters and 85% support from Republicans. [Read the full story here.](https://www.usatoday.com/story/news/health/2024/09/22/dental-insurance-medicare-popular/75054735007/) **Categories:** In The News --- ### [Beckers Dental Review: Voters Care About Dentistry – Why The Candidates Should Too](https://carequest.org/in-the-news/beckers-dental-review-voters-care-about-dentistry-why-the-candidates-should-too-2/) **Published:** September 24, 2024 **Author:** Jasmin Fernandes **Content:** Voters across the political spectrum have expressed strong support for legislation to improve and expand access to dental care, according to polls from CareQuest Institute for Oral Health. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/44564-voters-care-about-dentistry-why-the-candidates-should-too.html) **Categories:** In The News --- ### [Dentistry IQ: US Senate Confronts Dental Staffing Crisis](https://carequest.org/in-the-news/dentistry-iq-us-senate-confronts-dental-staffing-crisis/) **Published:** June 21, 2024 **Author:** Jasmin Fernandes **Content:** More than 56 million Americans reside in areas with a shortage of dental professionals, and over 68 million adults lack dental insurance, creating substantial barriers to accessing care.5 Marginalized populations are disproportionately affected by these shortages, exacerbating existing disparities in oral health outcomes. A diverse dental workforce is necessary to better understand and respond to the unique cultural and socioeconomic needs of these communities, fostering trust and improving patient engagement. [Read the full story here.](https://www.dentistryiq.com/dentistry/research-and-news/article/55089666/us-senate-confronts-dental-staffing-crisis) **Categories:** In The News --- ### [ADHA Journal of Dental Hygiene: Community Oral Health Initiative: Driving Value-Based Transformation In North Carolina](https://carequest.org/in-the-news/adha-journal-of-dental-hygiene-community-oral-health-initiative-driving-value-based-transformation-in-north-carolina/) **Published:** June 21, 2024 **Author:** Jasmin Fernandes **Content:** CareQuest Institute for Oral Health’s mission is to improve the oral health of all. One way to achieve this is through programmatic initiatives, which train dental clinics to provide equitable, integrated and accessible care for their communities. The Community Oral Health Transformation (COrHT) Initiative, allowed CareQuest Institute to collaborate with the North Carolina Oral Health Collaboration (NCOHC) and Blue Cross Blue Shield (BCBS) of North Carolina Foundation to implement and support the initiative in North Carolina. [Read the full story here.](https://jdh.adha.org/content/98/3/13) **Categories:** In The News --- ### [Beckers Dental Review: 'Dental Health is More Than a Nice Smile': What We Heard in June](https://carequest.org/in-the-news/beckers-dental-review-dental-health-is-more-than-a-nice-smile-what-we-heard-in-june/) **Published:** June 28, 2024 **Author:** Jasmin Fernandes **Content:** This month, several dental industry leaders spoke with Becker’s about the most pressing issues and trends in the field, including DSO consolidation, cybersecurity threats and medical-dental integration. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/43983-dental-health-is-more-than-a-nice-smile-what-we-heard-in-june.html) **Categories:** In The News --- ### [Becker's Dental Review: Lower-income Families Spend 7 Times More on Dental Care: Report](https://carequest.org/in-the-news/beckers-dental-review-lower-income-families-spend-7-times-more-on-dental-care-report/) **Published:** June 26, 2024 **Author:** Jasmin Fernandes **Content:** “CareQuest concluded that more solutions are needed to improve dental care accessibility in the U.S. Some of these solutions include expanding adult dental coverage under Medicaid and increasing provider participation in Medicaid, CareQuest said.” [Read the full story here.](https://www.beckersdental.com/dentists/43962-lower-income-families-spend-7-times-more-on-dental-care-report.html) **Categories:** In The News --- ### [Dental Products Report: CareQuest Study Reveals Lower-Income Families Spend 7X More on Dental Care](https://carequest.org/in-the-news/dental-products-report-carequest-study-reveals-lower-income-families-spend-7x-more-on-dental-care/) **Published:** June 28, 2024 **Author:** Jasmin Fernandes **Content:** “A new Care Quest Institute for Oral Health® report shows that poorer families paid 7.4 times more in out-of-pocket expenditures for dental care compared to high-income families between 2007 and 2021. The report, “Lower-Income Families Still Spend More on Dental Care,” also reveals that families living in poverty and those with lower incomes were less likely to have visited a dentist in the past year compared to families with higher incomes in the U.S.” [Read the full story here.](https://www.dentalproductsreport.com/view/carequest-study-reveals-lower-income-families-spend-7x-more-on-dental-care) **Categories:** In The News --- ### [Journal Of Public Health Dentistry: Dental Anxiety And Oral Health In American Indian And Alaska Natives](https://carequest.org/in-the-news/journal-of-public-health-dentistry-dental-anxiety-and-oral-health-in-american-indian-and-alaska-natives/) **Published:** July 2, 2024 **Author:** Jasmin Fernandes **Content:** Members of other ethnic minority groups, such as Hispanic populations, avoid dental visits due to dental care related fear and anxiety, but no known studies have directly explored dental fear and anxiety among AI/AN populations. Moreover, a dearth of literature exists more generally regarding dental anxiety in the AI/AN population, except for one recent white paper report by CareQuest Institute for Oral Health. [Read the full story here.](https://onlinelibrary.wiley.com/doi/full/10.1111/jphd.12633) **Categories:** In The News --- ### [Dr. Bicuspid: Lower-income Families Disproportionately Pay More for Dental Care](https://carequest.org/in-the-news/dr-bicuspid-lower-income-families-disproportionately-pay-more-for-dental-care/) **Published:** July 2, 2024 **Author:** Jasmin Fernandes **Content:** “In the U.S., inequalities in unmet dental needs and care costs persist across income groups, with out-of-pocket costs rising significantly among lower-income families in recent years. The new report was released by the CareQuest Institute for Oral Health.” [Read the full story here.](https://www.drbicuspid.com/dental-practice/public-health/vulnerable-populations/article/15678669/lowerincome-families-disproportionately-pay-more-for-dental-care) **Categories:** In The News --- ### [Beckers Dental Review: 'Extremely frustrating': Dental Leaders Concerned for Impact of Medicaid Disenrollments](https://carequest.org/in-the-news/beckers-dental-review-extremely-frustrating-dental-leaders-concerned-for-impact-of-medicaid-disenrollments/) **Published:** July 3, 2024 **Author:** Jasmin Fernandes **Content:** “The CareQuest Institute for Oral Health warned in April 2023 that more than 14 million adults could lose their dental coverage as part of the redetermination process. Recent analysis from the organization shows that about 12 million adults and children lost their dental coverage between April and September of 2023.” [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/44003-extremely-frustrating-dental-leaders-concerned-for-impact-of-medicaid-disenrollments.html) **Categories:** In The News --- ### [Beckers Dental Review: Nearly 24M People Disenrolled From Medicaid: 9 Notes for Dentists](https://carequest.org/in-the-news/beckers-dental-review-nearly-24m-people-disenrolled-from-medicaid-9-notes-for-dentists/) **Published:** July 8, 2024 **Author:** Jasmin Fernandes **Content:** Recent data from CareQuest shows that about 12 million adults and children lost their dental coverage between April and September of 2023, with an additional two million people estimated to have lost coverage between September and December 2023. [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/44013-nearly-24m-people-disenrolled-from-medicaid-9-notes-for-dentists.html) **Categories:** In The News --- ### [Dental Products Report: Employing Value-Based Care in the Dental Practice](https://carequest.org/in-the-news/dental-products-report-employing-value-based-care-in-the-dental-practice/) **Published:** July 8, 2024 **Author:** Jasmin Fernandes **Content:** This model focuses on preventive care, patient satisfaction, and long-term health benefits, aiming to improve overall dental health and reduce costs associated with extensive treatments. By prioritizing effective treatments and patient-centered care, value-based dentistry seeks to deliver better health outcomes, enhance patient experiences, and foster a more sustainable health care system, according to Danielle Apostolon, program manager and value-based care expert at CareQuest Institute for Oral Health. [Read the full story here.](https://www.dentalproductsreport.com/view/employing-value-based-care-in-the-dental-practice) **Categories:** In The News --- ### [Incisal Edge Magazine: 8th Annual – 32 Most Influential People in Dentistry](https://carequest.org/in-the-news/incisal-edge-magazine-8th-annual-32-most-influential-people-in-dentistry/) **Published:** July 9, 2024 **Author:** Jasmin Fernandes **Content:** It’s no secret that underserved communities score poorly on just about every measure of oral health. In steps Dr. Myechia Minter-Jordan, the head of the CareQuest Institute for Oral Health, a Boston-based organization that aims to stem these inequities through a variety of grants and awards. [Read the full story here.](https://www.incisaledgemagazine.com/mag/article/8th-annual-32-most-influential-people-in-dentistry/) **Categories:** In The News --- ### [Dentistry IQ: New Report Explores The Critical Link Between Oral Health and Alzheimer’s Disease](https://carequest.org/in-the-news/dentistry-iq-new-report-explores-the-critical-link-between-oral-health-and-alzheimers-disease/) **Published:** July 9, 2024 **Author:** Jasmin Fernandes **Content:** The report from CareQuest Institute1 highlights research that shows poor oral health—particularly periodontal disease—can increase the risk of being diagnosed with Alzheimer’s disease and related dementias (ADRD). The aggregated findings indicate that having an infection of periodontal bacteria, notably Porphyromonas gingivalis, may trigger the accumulation of beta-amyloid protein in the brain, contributing to cognitive decline and memory loss associated with ADRD. [Read the full story here.](https://www.dentistryiq.com/dentistry/oral-systemic-health/article/55124722/new-report-explores-the-critical-link-between-oral-health-and-alzheimers-disease) **Categories:** In The News --- ### [Incisal Edge Magazine: 8th Annual – 32 Most Influential People in Dentistry](https://carequest.org/in-the-news/incisal-edge-magazine-8th-annual-32-most-influential-people-in-dentistry-2/) **Published:** July 9, 2024 **Author:** Jasmin Fernandes **Content:** It’s no secret that underserved communities score poorly on just about every measure of oral health. In steps Dr. Myechia Minter-Jordan, the head of the CareQuest Institute for Oral Health, a Boston-based organization that aims to stem these inequities through a variety of grants and awards. [Read the full story here.](https://www.incisaledgemagazine.com/mag/article/8th-annual-32-most-influential-people-in-dentistry/) **Categories:** In The News --- ### [USA Today: Dental Access is an American 'Crisis': Here's How Vulnerable People Are Shut Out.](https://carequest.org/in-the-news/usa-today-dental-access-is-an-american-crisis-heres-how-vulnerable-people-are-shut-out/) **Published:** July 14, 2024 **Author:** Jasmin Fernandes **Content:** Senator Bernie Sanders told USA TODAY that U.S. dental care is “in crisis” with far too many Americans shut out of the system. Nearly 69 million U.S. adults did not have dental insurance or access to routine oral health care last year, according to the nonprofit CareQuest Institute for Oral Health. [Read the full story here.](https://www.usatoday.com/story/news/health/2024/07/14/dental-access-is-an-american-crisis-how-the-vulnerable-are-shut-out/74125834007/) **Categories:** In The News --- ### [Dentistry IQ: How Do Patients Feel About Extra Screenings? New Data Might Surprise You](https://carequest.org/in-the-news/dentistry-iq-how-do-patients-feel-about-extra-screenings-new-data-might-surprise-you/) **Published:** July 16, 2024 **Author:** Jasmin Fernandes **Content:** Some patients don’t want to be bothered with health care screenings when they’re at the dentist, but new data says that’s far from the norm. These kinds of screenings are sorely needed to improve health outcomes in the United States. Oral health and heart health may seem unrelated, but recent data from CareQuest reveals those with periodontal diseases are more likely to suffer cardiovascular complications. In fact, the risk of experiencing a heart attack or stroke is two to three times higher. [Read the full story here.](https://www.dentistryiq.com/for-patients/dental-hygiene-and-prevention/article/55125579/how-do-patients-feel-about-extra-screenings-new-data-might-surprise-you) **Categories:** In The News --- ### [DentistryIQ: New Survey Finds Overwhelming Majority of US Voters Support Medicare Dental Coverage](https://carequest.org/in-the-news/dentistryiq-new-survey-finds-overwhelming-majority-of-us-voters-support-medicare-dental-coverage/) **Published:** July 17, 2024 **Author:** Jasmin Fernandes **Content:** A new poll by CareQuest Institute and the Oral Health Progress and Equity Network (OPEN) reveals that, regardless of political orientation, 92% of voters nationwide are in favor of adding dental coverage to Medicare. [Read the full story here.](https://www.dentistryiq.com/dentistry/research-and-news/article/55126619/new-survey-finds-overwhelming-majority-of-us-voters-support-medicare-dental-coverage) **Categories:** In The News --- ### [Zocalo Public Square: Why Is Accessing Good Dental Care Like Pulling Teeth?](https://carequest.org/in-the-news/zocalo-public-square-why-is-accessing-good-dental-care-like-pulling-teeth/) **Published:** July 17, 2024 **Author:** Jasmin Fernandes **Content:** According to the CareQuest Institute, a nonprofit aiming to increase equity in dental care, 93% of people living in poverty need dental care they aren’t getting. For many, it’s simply too expensive. [Read the full story here.](https://www.zocalopublicsquare.org/2024/07/17/why-is-accessing-good-dental-care-like-pulling-teeth/ideas/essay/) **Categories:** In The News --- ### [Beckers Dental Review: 9 in 10 Voters Support Adding Dental Coverage to Medicare: Poll](https://carequest.org/in-the-news/beckers-dental-review-9-in-10-voters-support-adding-dental-coverage-to-medicare-poll/) **Published:** July 17, 2024 **Author:** Jasmin Fernandes **Content:** Approximately 50% of all Medicare enrollees do not have dental coverage, and nearly 24 million individuals on Medicare have not visited a dentist within the last 12 months, according to a July 16 news release from CareQuest. [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/44084-9-in-10-voters-support-adding-dental-coverage-to-medicare-poll.html) **Categories:** In The News --- ### [Dental Products Report: Addressing the Mental-Oral Health Link for Veterans](https://carequest.org/in-the-news/dental-products-report-addressing-the-mental-oral-health-link-for-veterans/) **Published:** July 18, 2024 **Author:** Jasmin Fernandes **Content:** Eighty-five percent of veterans are ineligible for dental coverage through the Veterans Affairs (VA), making lack of access to dental care a significant and devastatingly common issue for those who have served our country. [Read the full story here.](https://www.dentalproductsreport.com/view/addressing-the-mental-oral-health-link-for-veterans) **Categories:** In The News --- ### [Becker's Hospital Review: 111 Hospital And Health System Chief Diversity, Equity And Inclusion Officers To Know | 2024](https://carequest.org/in-the-news/beckers-hospital-review-111-hospital-and-health-system-chief-diversity-equity-and-inclusion-officers-to-know-2024/) **Published:** July 19, 2024 **Author:** Jasmin Fernandes **Content:** Kaz Rafia, DDS. Chief Health Equity Officer at CareQuest Institute for Oral Health (Boston). Dr. Rafia is the inaugural chief health equity officer at CareQuest, which he has successfully transitioned into a sustainable and impactful grantmaking institution. In his role, is particularly focused on increasing health equity, Medicare and Medicaid advocacy, safety net clinics and healthcare workforce support. He is active in the Health Equity Compact and contributes to their efforts towards health equity in the state of Massachusetts. [Read the full story here.](https://www.beckershospitalreview.com/lists/111-hospital-and-health-system-chief-diversity-equity-and-inclusion-officers-to-know-2024.html) **Categories:** In The News --- ### [Decisions in Dentistry: Breaking the Silence: Senate Takes Aim at America’s Dental Crisis with Eye-Opening Testimony](https://carequest.org/in-the-news/decisions-in-dentistry-breaking-the-silence-senate-takes-aim-at-americas-dental-crisis-with-eye-opening-testimony/) **Published:** May 20, 2024 **Author:** Jasmin Fernandes **Content:** In a landmark hearing before the Senate HELP Committee, led by Chairman Bernie Sanders and ranking member Bill Cassidy, oral health stakeholders and dental professionals delivered compelling testimony on the staggering disparities in dental care accessibility and affordability across America. Speakers, which included Myechia Minter-Jordan, MD, MBA, president, and CEO of CareQuest Institute for Oral Health. [Read the full story here.](https://decisionsindentistry.com/2024/05/breaking-the-silence-senate-takes-aim-at-americas-dental-crisis-with-eye-opening-testimony/) **Categories:** In The News --- ### [Dimensions of Dental Hygiene: Is the Affordable Care Act Coming to Dentistry?](https://carequest.org/in-the-news/dimensions-of-dental-hygiene-is-the-affordable-care-act-coming-to-dentistry-2/) **Published:** May 21, 2024 **Author:** Jasmin Fernandes **Content:** The numbers are staggering: nearly 69 million United States adults lacked dental insurance or access to routine oral health care last year, according to a survey by the CareQuest Institute for Oral Health. This issue has been exacerbated by the rollback of Medicaid expansions post-COVID-19. [Read the full story here.](https://dimensionsofdentalhygiene.com/is-the-affordable-care-act-coming-to-dentistry/) **Categories:** In The News --- ### [USA Today: Imagine if the Government Offered Dental Care. New Federal Rule Could Make that a Reality.](https://carequest.org/in-the-news/usa-today-imagine-if-the-government-offered-dental-care-new-federal-rule-could-make-that-a-reality/) **Published:** May 20, 2024 **Author:** Jasmin Fernandes **Content:** The deficit in dental coverage is immense: nearly 69 million U.S. adults did not have dental insurance or access to routine oral health care last year, according to a survey by the nonprofit CareQuest Institute for Oral Health. Millions more lost dental insurance last year when states began to unwind Medicaid coverage for people who signed up during the COVID-19 pandemic. [Read the full story here.](https://www.usatoday.com/story/news/health/2024/05/20/dental-care-insurance-costs-too-much-aca-rule/73766660007/) **Categories:** In The News --- ### [Dental Products Report: Senator Bernie Sanders Introduces Dental Care Crisis Legislation](https://carequest.org/in-the-news/dental-products-report-senator-bernie-sanders-introduces-dental-care-crisis-legislation/) **Published:** May 21, 2024 **Author:** Jasmin Fernandes **Content:** This bill is cosponsored by Ohio Senator Sherrod Brown, and is endorsed by Families USA, CareQuest Institute for Oral Health, and Community Catalyst. To learn more about the bill, the HELP Committee, or to read the legislation, visit here. [Read the full story here.](https://www.dentalproductsreport.com/view/senator-bernie-sanders-introduces-dental-care-crisis-legislation) **Categories:** In The News --- ### [Newsweek: How Medicare Benefits Would Change Under Plan Proposed by Doctors](https://carequest.org/in-the-news/newsweek-how-medicare-benefits-would-change-under-plan-proposed-by-doctors/) **Published:** May 22, 2024 **Author:** Jasmin Fernandes **Content:** Dr. Myechia Minter-Jordan, president and CEO of Boston’s CareQuest Institute for Oral Health, echoed Simon’s statements. She added that because of Medicare’s current guidelines, around 25 million older Americans and people with disabilities have no dental benefits. “There is currently no financial support for adults to purchase dental insurance through \[the Affordable Care Act’s\] Health Insurance Marketplace,” Minter-Jordan said. “And adult dental coverage is optional under state Medicaid programs, which means that coverage varies widely from extensive benefits to none at all.” [Read the full story here.](https://www.newsweek.com/how-medicare-benefits-would-change-under-plan-doctors-1903646) **Categories:** In The News --- ### [Disability Insider: Advance Legislation to Improve Health of the Disability Community – Kids Like Lillian Need You](https://carequest.org/in-the-news/disability-insider-advance-legislation-to-improve-health-of-the-disability-community-kids-like-lillian-need-you/) **Published:** May 23, 2024 **Author:** Jasmin Fernandes **Content:** Research from CareQuest Institute for Oral Health also reveals that individuals with disabilities are more frequently denied care due to discrimination and are more likely to have to visit the emergency department for dental care. [Read the full story here.](https://disabilityinsider.com/story/advance-legislation-to-improve-health-of-the-disability-community-kids-like-lillian-need-you/) **Categories:** In The News --- ### [Dental Products Report: CareQuest Institute for Oral Health Awards Grant Funding for Oral Health Equity Projects](https://carequest.org/in-the-news/dental-products-report-carequest-institute-for-oral-health-awards-grant-funding-for-oral-health-equity-projects/) **Published:** May 28, 2024 **Author:** Jasmin Fernandes **Content:** Oral health nonprofit CareQuest Institute for Oral Health has proudly announced its rewarding of over $2.3 million in grant funds to various equity projects across the U.S. Organizations in Alabama, California, Colorado, Florida, Massachusetts, Nebraska, Texas, and Vermont have received funding for projects that aim to make oral health care more accessible, according to Director of Grants and Programs at CareQuest Institute for Oral Health, Trenae Simpson. [Read the full story here.](https://www.dentalproductsreport.com/view/carequest-institute-for-oral-health-awards-grand-funding-for-oral-health-equity-projects) **Categories:** In The News --- ### [KFF Health News: Variation in Use of Dental Services by Children and Adults Enrolled in Medicaid or CHIP](https://carequest.org/in-the-news/kff-health-news-variation-in-use-of-dental-services-by-children-and-adults-enrolled-in-medicaid-or-chip/) **Published:** May 29, 2024 **Author:** Jasmin Fernandes **Content:** Nearly half of children covered by Medicaid or CHIP receive at least one dental service within the year compared with only one-fifth of adult Medicaid enrollees, reflecting differences in coverage policies for children and adults. [Read the full story here.](https://www.kff.org/medicaid/issue-brief/variation-in-use-of-dental-services-by-children-and-adults-enrolled-in-medicaid-or-chip/) **Categories:** In The News --- ### [The Kansas City Star: Poor Dental Health and Poverty are Related. Stronger Teeth Can Lead to a Better Life](https://carequest.org/in-the-news/the-kansas-city-star-poor-dental-health-and-poverty-are-related-stronger-teeth-can-lead-to-a-better-life/) **Published:** May 29, 2024 **Author:** Jasmin Fernandes **Content:** The correlation between poor dental health and poverty cannot be overlooked. Just last year, this “neglected epidemic” saw nearly 69 million U.S. adults without dental insurance, according to a survey by the nonprofit CareQuest Institute for Oral Health. [Read the full story here.](https://www.kansascity.com/opinion/readers-opinion/guest-commentary/article288813440.html) **Categories:** In The News --- ### [You Earned This Podcast: "Teeth are Part of the Body Too!" aka "Medicare Should Cover Dental Coverage"](https://carequest.org/in-the-news/you-earned-this-podcast-teeth-are-part-of-the-body-too-aka-medicare-should-cover-dental-coverage/) **Published:** May 31, 2024 **Author:** Jasmin Fernandes **Content:** Half of Medicare beneficiaries did not visit the dentist during the past year because they couldn’t afford to. Melissa Burroughs of the advocacy group Care Quest says neglecting oral health can contribute to serious health issues in older people — including Alzheimer’s, heart disease, and diabetes. Worse yet, traditional Medicare does not cover routine dental care. As Melissa tells us, it’s time for that to change! [Listen to the full episode here.](https://open.spotify.com/episode/63j2Qdi1NNcuSL0LExxkoq) **Categories:** In The News --- ### [The Tennessean: Black Maternal Health is in Crisis. Good Dental Hygiene Could Help Expectant Mothers](https://carequest.org/in-the-news/the-tennessean-black-maternal-health-is-in-crisis-good-dental-hygiene-could-help-expectant-mothers/) **Published:** June 1, 2024 **Author:** Jasmin Fernandes **Content:** Unfortunately, fewer than half of pregnant women nationally have their teeth cleaned during pregnancy. Black women are 14% less likely to get their teeth cleaned during pregnancy than white women, even though data shows no difference in dental visits prior to pregnancy for those groups. [Read the full story here.](https://www.tennessean.com/story/opinion/contributors/2024/06/01/black-maternal-health-crisis-improve-dental-care-pregnant-mothers/73632277007/) **Categories:** In The News --- ### [Forbes: Dental Facts And Statistics In 2024](https://carequest.org/in-the-news/forbes-dental-facts-and-statistics-in-2024/) **Published:** June 3, 2024 **Author:** Jasmin Fernandes **Content:** What’s more, one 2023 study found that individuals with periodontal disease may have a higher risk of certain chronic respiratory diseases like chronic obstructive pulmonary disease (COPD). However, at least one preventative dental visit within three years may reduce the risk of ventilator-acquired pneumonia by as much as 22%, according to 2020 research from the CareQuest Institute for Oral Health. [Read the full story here.](https://www.forbes.com/health/dental/dental-facts-statistics/) **Categories:** In The News --- ### [The Virginian-Pilot: Column: Alleviate the Oral Health Workforce Crisis in Virginia](https://carequest.org/in-the-news/the-virginian-pilot-column-alleviate-the-oral-health-workforce-crisis-in-virginia/) **Published:** June 6, 2024 **Author:** Jasmin Fernandes **Content:** Good oral health is crucial for overall well-being, yet access to high-quality care remains a persistent challenge for many Virginians. Virginia’s Medicaid program offers comprehensive dental coverage to all members, for example, but slightly more than half of enrolled children saw a dentist last year — and even fewer adults received care. Access issues are multifaceted, with those most in need often facing barriers such as lack of transportation, limited translation resources, and the inability to take time off work for appointments. There’s one pervasive challenge that connects to all of these issues, an issue we’re taking direct aim at in 2024: Virginia’s oral health workforce is in crisis. [Read the full story here.](https://www.pilotonline.com/2024/06/06/column-alleviate-the-oral-health-workforce-crisis-in-virginia/) **Categories:** In The News --- ### [Becker’s Dental Review: Why 2 MDs Testified Before a Senate Committee About Oral Health Care](https://carequest.org/in-the-news/beckers-dental-review-why-2-mds-testified-before-a-senate-committee-about-oral-health-care/) **Published:** June 10, 2024 **Author:** Jasmin Fernandes **Content:** Myechia Minter-Jordan, MD, and Lisa Simon, MD, DMD, recently joined two dentists to testify before the U.S. Senate Committee on Health, Education, Labor and Pensions about how to improve dental care affordability and accessibility. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/43856-why-2-mds-testified-before-a-senate-committee-about-oral-healthcare.html) **Categories:** In The News --- ### [Beckers Physician Leadership: The Health Care Issue That Brought 2 Physicians in Front of The Senate](https://carequest.org/in-the-news/beckers-physician-leadership-the-health-care-issue-that-brought-2-physicians-in-front-of-the-senate/) **Published:** June 12, 2024 **Author:** Jasmin Fernandes **Content:** Dr. Minter-Jordan is an internal medicine physician and the president and CEO of the CareQuest Institute for Oral Health. Dr. Simon is an associate physician at Brigham and Women’s Hospital and a fellow in oral health and medicine integration at the Harvard School of Dental Medicine in Boston. Both doctors recently spoke with Becker’s about their Senate committee testimonies, the consequences of dental care inequities and the importance of medical-dental integration. [Read the full story here.](https://www.beckersphysicianleadership.com/news/the-healthcare-issue-that-brought-2-physicians-in-front-of-the-senate.html) **Categories:** In The News --- ### [Military Times: A Dental Debacle: Why Veterans Struggle To Navigate VA’s Oral Care](https://carequest.org/in-the-news/military-times-a-dental-debacle-why-veterans-struggle-to-navigate-vas-oral-care/) **Published:** June 17, 2024 **Author:** Jasmin Fernandes **Content:** In a report released earlier this year, researchers from the American Institute of Dental Public Health and CareQuest Institute found higher rates of dental problems among veterans than their civilian peers, including issues with tooth decay (56% among veterans versus 37% in the general population) and gum disease (42% versus 27%). [Read the full story here.](https://www.militarytimes.com/news/your-military/2024/06/17/a-dental-debacle-why-veterans-struggle-to-navigate-vas-oral-care/) **Categories:** In The News --- ### [ADHA Journal of Dental Hygiene: Medical-Dental Integration In Ohio: Improving Prevention and Coordination at The Local Level](https://carequest.org/in-the-news/adha-journal-of-dental-hygiene-medical-dental-integration-in-ohio-improving-prevention-and-coordination-at-the-local-level/) **Published:** June 18, 2024 **Author:** Jasmin Fernandes **Content:** Medical-dental integration is a critical component designed to enhance and broaden the oral health care delivery model. MORE Care® is a framework for communities to leverage their resources and relationships by providing tools and resources to integrate preventive oral health services into primary care settings. This report will show how local stakeholders advocated for an innovative approach to improve oral health gaps for children in Ohio. [Read the full story here.](https://jdh.adha.org/content/98/3/19) **Categories:** In The News --- ### [KSHB 41 News: How Much Are You Willing To Pay For Your Smile?](https://carequest.org/in-the-news/kshb-41-news-how-much-are-you-willing-to-pay-for-your-smile/) **Published:** June 18, 2024 **Author:** Jasmin Fernandes **Content:** The CareQuest Institute, a nonprofit that focuses on equitable care, reports millions of Americans lost their dental insurance from Medicaid last fall, adding to the more than 68 million adults who don’t have dental insurance. [Watch news clip and read full article here.](https://www.kshb.com/news/local-news/how-much-are-you-willing-to-pay-for-your-smile) **Categories:** In The News --- ### [Beckers Dental: Why 4 Leaders Are Pushing For Dental-Medical Integration](https://carequest.org/in-the-news/beckers-dental-why-4-leaders-are-pushing-for-dental-medical-integration/) **Published:** June 20, 2024 **Author:** Jasmin Fernandes **Content:** Integration between the medical and dental fields is still in the early stages, but these four leaders are looking to keep the momentum going. Here, four leaders of the dental industry share why they believe medical-dental integration is important and how the integration could be accelerated. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/43919-why-4-leaders-are-pushing-for-dental-medical-integration.html) **Categories:** In The News --- ### [The Conversation: Caring for Older Americans’ Teeth and Gums is Essential, but Medicare Generally Doesn’t Cover that Cost](https://carequest.org/in-the-news/the-conversation-caring-for-older-americans-teeth-and-gums-is-essential-but-medicare-generally-doesnt-cover-that-cost/) **Published:** April 19, 2024 **Author:** Jasmin Fernandes **Content:** “The Biden administration initially considered the addition of comprehensive Medicare dental coverage as part of its proposed Build Back Better legislation, a broad US$1.8 trillion legislative package designed to fix problems ranging from child care costs to climate change, but failed to get enough support in Congress.” [Read the full story here.](https://theconversation.com/caring-for-older-americans-teeth-and-gums-is-essential-but-medicare-generally-doesnt-cover-that-cost-225345) **Categories:** In The News --- ### [Becker's Dental Review: CMS Dental Rule a Step Forward, But More Work Still Needed](https://carequest.org/in-the-news/beckers-dental-review-cms-dental-rule-a-step-forward-but-more-work-still-needed/) **Published:** April 10, 2024 **Author:** Jasmin Fernandes **Content:** “Dr. Rafia, the chief health equity officer and executive vice president at the CareQuest Institute for Oral Health, recently spoke with Becker’s to discuss the new CMS dental rule and what it means for dental care accessibility going forward.” [Read the full story here.](https://www.beckersdental.com/dentists/43419-cms-dental-rule-a-step-forward-but-more-work-still-needed-exec.html) **Categories:** In The News --- ### [The Gazette: Bigger Clinic Means More People Can See a Dentist](https://carequest.org/in-the-news/the-gazette-bigger-clinic-means-more-people-can-see-a-dentist/) **Published:** April 11, 2024 **Author:** Jasmin Fernandes **Content:** “An estimated 91 million adults in America had no dental insurance at the end of 2023, according to the CareQuest Institute of Oral Health. The vast majority are low-income, minorities and older Americans.” [Read the full story here.](https://www.thegazette.com/business/bigger-clinic-means-more-people-can-see-a-dentist/) **Categories:** In The News --- ### [Savannah Magazine: When Teeth Become Trendy](https://carequest.org/in-the-news/savannah-magazine-when-teeth-become-trendy/) **Published:** April 15, 2024 **Author:** Jasmin Fernandes **Content:** “For the estimated 68.5 million adults who lack dental insurance in the United States, according to the 2023 State of Oral Health Equity in America survey from CareQuest Institute, that individual care can seem elusive. There are options, though, that are much safer than DIY care.” [Read the full story here.](https://savannahmagazine.com/health/when-teeth-become-trendy/) **Categories:** In The News --- ### [IndyStar: Nearly 370,000 Hoosiers Lost Dental Insurance Last Year. Here's What Happened.](https://carequest.org/in-the-news/indystar-nearly-370000-hoosiers-lost-dental-insurance-last-year-heres-what-happened/) **Published:** April 18, 2024 **Author:** Jasmin Fernandes **Content:** “Indiana’s steep drop in insured families came after a national pandemic-era policy ensuring Medicaid dental coverage ended, according to Dr. Kaz Rafia, chief health equity officer at Boston-based CareQuest Institute for Oral Health, which released the study.Nationwide, 12 million people lost dental insurance.” [Read the full story here.](https://www.indystar.com/story/news/health/2024/04/18/nearly-370000-hoosiers-lost-dental-insurance-last-year/73311826007/) **Categories:** In The News --- ### [The Week: Doctors are Taking on Dental Duties in Low-Income Areas](https://carequest.org/in-the-news/the-week-doctors-are-taking-on-dental-duties-in-low-income-areas/) **Published:** April 23, 2024 **Author:** Jasmin Fernandes **Content:** “Poor oral health can have far-reaching consequences, not only as a precursor to other physical health issues but as a factor in depression and mental health issues,” said Myechia Minter-Jordan, the president and CEO of the CareQuest Institute for Oral Health. [Read the full story here.](https://theweek.com/health/doctors-dental-deserts-health-care) **Categories:** In The News --- ### [Washington Post: Biden’s Election-Year Play to Further Expand Obamacare](https://carequest.org/in-the-news/washington-post-bidens-election-year-play-to-further-expand-obamacare/) **Published:** April 25, 2024 **Author:** Jasmin Fernandes **Content:** An estimated 68.5 million U.S. adults lacked dental insurance in 2023, according to the nonprofit CareQuest Institute for Oral Health. That’s more than 2.5 times the roughly 26 million Americans of all ages who lack health insurance. [Read the full story here.](https://www.washingtonpost.com/politics/2024/04/25/bidens-election-year-play-further-expand-obamacare/) **Categories:** In The News --- ### [Atlanta Black Star: ‘They’ll Love Him In Prison’: Veneer Techs Are Not a Real Thing and Here’s Why You Shouldn’t Let Basement Dentists Play In Your Mouth](https://carequest.org/in-the-news/atlanta-black-star-theyll-love-him-in-prison-veneer-techs-are-not-a-real-thing-and-heres-why-you-shouldnt-let-basement-dentists-play-in-your-mouth/) **Published:** April 26, 2024 **Author:** Jasmin Fernandes **Content:** In 2019, a reported 68.5 million Americans lack dental insurance. According to the CareQuest Institute for Oral Health, families with lower incomes reported cost as a reason for not going to the dentist regularly compared to families with higher incomes. [Read the full story here.](https://atlantablackstar.com/2024/04/26/veneer-techs-not-thing-real-dentist/) **Categories:** In The News --- ### [Becker's Dental Review: Number of People Disenrolled from Medicaid Surpasses 20M: 10 Notes for Dentists](https://carequest.org/in-the-news/beckers-dental-review-number-of-people-disenrolled-from-medicaid-surpasses-20m-10-notes-for-dentists/) **Published:** April 30, 2024 **Author:** Jasmin Fernandes **Content:** The CareQuest Institute for Oral Health warned in April 2023 that more than 14 million adults who are on Medicaid could lose their dental coverage as part of the redetermination process. [Read the full story here.](https://www.beckersdental.com/revenue-cycle-management/43571-number-of-people-disenrolled-from-medicaid-surpasses-20m-10-notes-for-dentists.html) **Categories:** In The News --- ### [The Seattle Times: The Northwest's 'Dental Care Divide' is Becoming a Crisis](https://carequest.org/in-the-news/the-seattle-times-the-northwests-dental-care-divide-is-becoming-a-crisis/) **Published:** May 3, 2024 **Author:** Jasmin Fernandes **Content:** “A staggering 68.5 million Americans are estimated to be without dental insurance. The causes and reasons are complex, but the result is an enormous gap in our health care system.” [Read the full story here.](https://www.seattletimes.com/opinion/the-northwests-dental-care-divide-is-becoming-a-crisis/) **Categories:** In The News --- ### [Health Affairs: New ACA Policy Expands Access To Dental Care. Now, States Need To Act](https://carequest.org/in-the-news/health-affairs-new-aca-policy-expands-access-to-dental-care-now-states-need-to-act/) **Published:** May 8, 2024 **Author:** Jasmin Fernandes **Content:** “This new rule holds the potential to make dental coverage available to millions of people who do not have it. According to the 2023 State of Oral Health Equity in America survey from CareQuest Institute for Oral Health, nearly 70 million adults do not have dental insurance. This number has almost certainly increased, as the survey was conducted before the start of the Medicaid redetermination process following the end of the COVID-19 public health emergency.” [Read the full story here.](https://www.healthaffairs.org/content/forefront/new-aca-policy-expands-access-dental-care-now-states-need-act) **Categories:** In The News --- ### [Dr. Bicuspid: Poor Oral Health, Gum Bacteria Linked to Dementia](https://carequest.org/in-the-news/dr-bicuspid-poor-oral-health-gum-bacteria-linked-to-dementia/) **Published:** May 8, 2024 **Author:** Jasmin Fernandes **Content:** Poor oral health may be associated with a higher risk of developing Alzheimer’s disease and related dementias (ADRD), according to a report recently released from the CareQuest Institute for Oral Health. [Read the full story here.](https://www.drbicuspid.com/dental-hygiene/oral-systemic-link/brain/article/15670310/poor-oral-health-gum-bacteria-linked-to-dementia) **Categories:** In The News --- ### [Dentistry Today: Teledentistry](https://carequest.org/in-the-news/dentistry-today-teledentistry/) **Published:** May 9, 2024 **Author:** Jasmin Fernandes **Content:** “More current and prospective patients, especially younger ones, expect a virtual encounter option from all of their healthcare providers. Moreover, according to a recent survey conducted by CareQuest Institute, 86% of patients were satisfied with their teledental experiences and would recommend teledentistry.” [Read the full story here.](https://www.dentistrytoday.com/focus-on-teledentistry/) **Categories:** In The News --- ### [Task & Purpose: PTSD and Oral Health Degradation are Correlated, so Why Doesn’t the VA Automatically Service-Connect Them?](https://carequest.org/in-the-news/task-purpose-ptsd-and-oral-health-degradation-are-correlated-so-why-doesnt-the-va-automatically-service-connect-them-2/) **Published:** May 13, 2024 **Author:** Jasmin Fernandes **Content:** “Oral and mental health ailments have been well-researched, correlated, and understood within American healthcare for decades, yet 85% of the approximately 9 million American veterans do not have dental or oral health coverage through the VA.” [Read the full story here.](https://taskandpurpose.com/news/veterans-ptsd-oral-health-service-connected/) **Categories:** In The News --- ### [WTSP Tampa Bay 10: A Veteran's Fight to Restore His Smile Highlights Dental Care Issues Through the VA](https://carequest.org/in-the-news/wtsp-tampa-bay-10-a-veterans-fight-to-restore-his-smile-highlights-dental-care-issues-through-the-va/) **Published:** May 16, 2024 **Author:** Jasmin Fernandes **Content:** “According to a new study from CareQuest and the American Institute of Dental Public Health, of the more than 9 million veterans who are eligible for medical care from the VA, 85% are not eligible for dental coverage.” [Watch the news clip and read the full article here.](https://www.wtsp.com/article/news/local/hillsboroughcounty/struggle-veterans-dental-care/67-51a6985f-63e4-4bfb-8c01-2e92cb8460fb) **Categories:** In The News --- ### [News From the States: Medicare Should Include Dental Coverage, Dentists Tell U.S. Senate Panel](https://carequest.org/in-the-news/news-from-the-states-medicare-should-include-dental-coverage-dentists-tell-u-s-senate-panel/) **Published:** May 16, 2024 **Author:** Jasmin Fernandes **Content:** “Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health in Boston, told the panel that traditional Medicare’s exclusion of dental benefits leaves about “half of Medicare enrollees, nearly 25 million older Americans and people with disabilities, without dental benefits.”’ [Read the full story here.](https://www.newsfromthestates.com/article/medicare-should-include-dental-coverage-dentists-tell-us-senate-panel) **Categories:** In The News --- ### [Healthcare Innovation: At Senate Hearing, Experts Call for More Dental Coverage in Medicare, Medicaid](https://carequest.org/in-the-news/healthcare-innovation-at-senate-hearing-experts-call-for-more-dental-coverage-in-medicare-medicaid/) **Published:** May 17, 2024 **Author:** Jasmin Fernandes **Content:** “’That was a moment of reckoning for me. It was unacceptable that a preventable disease was impacting our children in this way. This experience is what ultimately led me to my work at CareQuest Institute,” Minter-Jordan said.” [Read the full story here.](https://www.hcinnovationgroup.com/policy-value-based-care/news/55040711/at-senate-hearing-experts-call-for-more-dental-coverage-in-medicare-medicaid) **Categories:** In The News --- ### [Dental Products Report: Dental Leaders Testify Before Senate HELP Committee on Dental Care Crisis](https://carequest.org/in-the-news/dental-products-report-dental-leaders-testify-before-senate-help-committee-on-dental-care-crisis/) **Published:** May 17, 2024 **Author:** Jasmin Fernandes **Content:** Dr Myechia Minter-Jordan, President and CEO of CareQuest Institute for Oral Health®, also testified, highlighting the stark reality that nearly 70 million adults and nearly 8 million children in the U.S. lack dental insurance. This coverage gap exacerbates the oral health crisis, leading many to forgo essential dental care. “It’s up to all of us to create a more accessible, equitable, and integrated health care system that includes oral health.” Dr Minter-Jordan said during the hearing. [Read the full story here.](https://www.dentalproductsreport.com/view/dental-leaders-testify-before-senate-help-committee-on-dental-care-crisis) **Categories:** In The News --- ### [Beckers Dental: Sen. Bernie Sanders Introduces Comprehensive Dental Care Reform Act: 5 Notes](https://carequest.org/in-the-news/beckers-dental-sen-bernie-sanders-introduces-comprehensive-dental-care-reform-act-5-notes/) **Published:** May 17, 2024 **Author:** Jasmin Fernandes **Content:** Sen. Bernie Sanders introduced a bill May 17 to expand dental care coverage for veterans and low-income individuals as well as increase the oral healthcare workforce. The legislation has been endorsed by several organizations, including the CareQuest Institute for Oral Health. [Read the full story here.](https://www.beckersdental.com/dentists/43721-sen-bernie-sanders-introduces-comprehensive-dental-care-reform-act-5-notes.html) **Categories:** In The News --- ### [Dental Products Report: Addressing Oral Health Disparities: Grant Proposals Invited by CareQuest Institute](https://carequest.org/in-the-news/dental-products-report-addressing-oral-health-disparities-grant-proposals-invited-by-carequest-institute/) **Published:** March 18, 2024 **Author:** Jasmin Fernandes **Content:** Access to proper dental care is a problem facing people from various backgrounds and demographics, and that’s why groups like the CareQuest Institute for Oral Health® work hard to forge a more inclusive, fair, and interconnected oral health landscape. [Read the full story here.](https://www.dentalproductsreport.com/view/addressing-oral-health-disparities-grant-proposals-invited-by-carequest-institute) **Categories:** In The News --- ### [Medical Xpress: Minor Dental Restorations Found to Decrease After Implementation of Sugar-Sweetened Beverage Tax](https://carequest.org/in-the-news/medical-xpress-minor-dental-restorations-found-to-decrease-after-implementation-of-sugar-sweetened-beverage-tax/) **Published:** March 19, 2024 **Author:** Jasmin Fernandes **Content:** The study, by Eric Tranby of CareQuest Institute for Oral Health, Boston, MA, U.S., analyzed dental claims data from 2016-2023 for Colorado state residents living in and outside the city of Boulder who received minor restorative care during the study period. [Read the full story here.](https://medicalxpress.com/news/2024-03-minor-dental-decrease-sugar-sweetened.html) **Categories:** In The News --- ### [AEGIS Dental Network: New Report Shows How Dental Disparities Impact Veterans’ Productivity and Well-Being](https://carequest.org/in-the-news/aegis-dental-network-new-report-shows-how-dental-disparities-impact-veterans-productivity-and-well-being/) **Published:** March 19, 2024 **Author:** Jasmin Fernandes **Content:** Veterans across the US face significant challenges in accessing dental care, which influences their overall well-being and productivity, according to a new report by CareQuest Institute for Oral Health and the American Institute of Dental Public Health (AIDPH). [Read the full story here.](https://www.aegisdentalnetwork.com/news/2024/03/19/new-report-shows-how-dental-disparities-impact-veterans-productivity-and-well-being) **Categories:** In The News --- ### [Medical Xpress: Examining Family Out-Of-Pocket Expenditure on Dental Care](https://carequest.org/in-the-news/medical-xpress-examining-family-out-of-pocket-expenditure-on-dental-care/) **Published:** March 19, 2024 **Author:** Jasmin Fernandes **Content:** The study, by Lisa J. Heaton of CareQuest Institute for Oral Health, Boston, MA, U.S., utilized 2007-2020 Medical Expenditure Panel Survey data and calculated three quantities of interest: \[1\] probability of at least one dental visit per year by family income quintile, \[2\] total expenditure for dental care as a proportion of total family income by family income quintile and \[3\] out-of-pocket expenditure for dental care as a proportion of total family income by family income quintile. [Read the full story here.](https://medicalxpress.com/news/2024-03-family-pocket-expenditure-dental.html) **Categories:** In The News --- ### [WV News: West Virginia's Expansion of Medicaid Adult Dental Benefits is Win for All](https://carequest.org/in-the-news/wv-news-west-virginias-expansion-of-medicaid-adult-dental-benefits-is-win-for-all/) **Published:** March 23, 2024 **Author:** Jasmin Fernandes **Content:** Whether you consider it part of your regular health maintenance or a bit of a chore, going to the dentist — and even having access to oral health care — is a crucial indicator of a person’s health. Yet oral health care has consistently been treated by our health system as non-essential and separate from overall health. [Read the full story here.](https://www.wvnews.com/theet/opinion/columns/west-virginias-expansion-of-medicaid-adult-dental-benefits-is-win-for-all/article_8ff5db10-e7de-11ee-9169-eba8b7aa76ff.html) **Categories:** In The News --- ### [Becker's Dental Review: Number of People Disenrolled from Medicaid Hits 19.2M: 8 Notes for Dentists](https://carequest.org/in-the-news/beckers-dental-review-number-of-people-disenrolled-from-medicaid-hits-19-2m-8-notes-for-dentists/) **Published:** March 27, 2024 **Author:** Jasmin Fernandes **Content:** “The CareQuest Institute for Oral Health warned in April that more than 14 million adults who are on Medicaid could lose their dental coverage as part of the redetermination process.” [Read the full story here.](https://www.beckersdental.com/dentists/43304-number-of-people-disenrolled-from-medicaid-hits-19-2m-8-notes-for-dentists.html) **Categories:** In The News --- ### [Becker's Dental Review: The Biggest Effects DSOs Have on Dentistry, Per 8 Leaders](https://carequest.org/in-the-news/beckers-dental-review-the-biggest-effects-dsos-have-on-dentistry-per-8-leaders/) **Published:** March 28, 2024 **Author:** Jasmin Fernandes **Content:** Rebekah Mathews, Vice President of Health Transformation at CareQuest Institute for Oral Health (Boston): “Health information technology is expanding in response to the economies of scale that DSOs create and the business intelligence support they need as a result.” [Read the full story here.](https://www.beckersdental.com/featured-perspectives/43318-the-biggest-effects-dsos-have-on-dentistry-per-8-leaders.html) **Categories:** In The News --- ### [Dr. Bicuspid: Dental Disparities Affect Veterans' Well-Being](https://carequest.org/in-the-news/dr-bicuspid-dental-disparities-affect-veterans-well-being/) **Published:** March 28, 2024 **Author:** Jasmin Fernandes **Content:** “Veterans often face challenges in accessing necessary dental care, which negatively affects their overall well-being and work productivity, according to a report from the CareQuest Institute for Oral Health and the American Institute of Dental Public Health (AIDPH).” [Read the full story here.](https://www.drbicuspid.com/dental-practice/public-health/vulnerable-populations/article/15667299/dental-disparities-affect-veterans-wellbeing) **Categories:** In The News --- ### [MD Linx: Has US Health Care Forgotten Black Mothers?](https://carequest.org/in-the-news/md-linx-has-us-health-care-forgotten-black-mothers/) **Published:** April 3, 2024 **Author:** Jasmin Fernandes **Content:** “Dr. Minter-Jordan believes that expanding Medicaid could help provide support to Black women. “Medicaid benefits for pregnant people vary widely by state and, in many cases, Medicaid coverage may extend only 60 days postpartum, even though 50% of maternal deaths occur up to a year after giving birth,” she says.” [Read the full story here.](https://www.mdlinx.com/article/has-us-healthcare-forgotten-black-mothers-kansas-city-chiefs-cheerleader-dies-after-delivering/1tz8kn4Ggmy2WM3G4BfMCn) **Categories:** In The News --- ### [MedCity News: The Price We Pay for Poor Oral Health](https://carequest.org/in-the-news/medcity-news-the-price-we-pay-for-poor-oral-health/) **Published:** April 8, 2024 **Author:** Jasmin Fernandes **Content:** “With high prices discouraging many families from seeking routine dental care, 92% of adults said they have considered delaying dental care due to costs. [Research also found](https://www.carequest.org/system/files/CareQuest_Institute_Americans-Are-Still-Not-Getting-Dental-Care-They-Need_3.pdf) that 27% of adults put off dental care because they could not afford it.” [Read the full story here.](https://medcitynews.com/2024/04/the-price-we-pay-for-poor-oral-health/) **Categories:** In The News --- ### [The Bulletin: Address The Dental Care Inequity by Empowering Hispanic Communities](https://carequest.org/in-the-news/the-bulletin-address-the-dental-care-inequity-by-empowering-hispanic-communities/) **Published:** January 24, 2024 **Author:** Jasmin Fernandes **Content:** “To treat people as a whole, we need to bridge the gaps between oral and overall health systems and start integrating medical and dental care, including better integrating electronic health records so dentists and primary care providers can share and access pertinent patient information.” [Read the full story here.](https://www.bendbulletin.com/opinion/guest-column-address-the-dental-care-inequity-by-empowering-hispanic-communities/article_abcb4b70-ba1d-11ee-a946-bb2cc42b26eb.html) **Categories:** In The News --- ### [The Herald Journal Column: Utah’s Significant Expansion of Medicaid Adult Dental Benefits is a Win For All](https://carequest.org/in-the-news/the-herald-journal-column-utahs-significant-expansion-of-medicaid-adult-dental-benefits-is-a-win-for-all/) **Published:** January 4, 2024 **Author:** Jasmin Fernandes **Content:** “Utah joins several states nationwide in taking crucial steps toward increasing access to oral health care. According to CareQuest Institute for Oral Health’s recently updated Medicaid Adult Dental Coverage Checker, which highlights the progress advocates and policymakers have made to expand adult dental benefits in the past few years, eight states now offer an extensive Medicaid adult dental benefit. That’s double the four states that boasted this in 2020.” [Read full article here](https://www.hjnews.com/opinion/columns/column-utah-s-significant-expansion-of-medicaid-adult-dental-benefits-is-a-win-for-all/article_2116ae08-aa81-11ee-87b9-c7292d4434f7.html). **Categories:** In The News --- ### [The Hill: It’s Time For Health Care Policy to Prioritize Oral Health Equity](https://carequest.org/in-the-news/the-hill-its-time-for-health-care-policy-to-prioritize-oral-health-equity/) **Published:** February 2, 2024 **Author:** Jasmin Fernandes **Content:** “Access to oral health should not be a luxury reserved only for some. It is a fundamental right that must be extended to every American, regardless of their background or zip code,” says Representative Nanette Barragán (D-CA). Barragán recently sat down with Myechia Minter-Jordan, president and CEO of CareQuest Institute, for [Chew on This](https://usw2.nyl.as/t1/156/8dt34yv5tufigvm7k7064b06t/1/c8538907690072758ae69571420c58dab3cc4578819bf14043d1eadea96dc746), a livestream conversation series on health and equity. They discussed the connections between oral health and overall health, and the need to strengthen coverage and access for patients.” [Read the full story here.](https://thehill.com/opinion/congress-blog/4445114-its-time-for-health-care-policy-to-prioritize-oral-health-equity/) **Categories:** In The News --- ### [Dentistry IQ: The High Cost of Dental-Related Lost Productivity](https://carequest.org/in-the-news/dentistry-iq-the-high-cost-of-dental-related-lost-productivity/) **Published:** February 8, 2024 **Author:** Jasmin Fernandes **Content:** “US adults lose some 243 million hours of productivity annually to oral health issues, with those with lower-paying and hourly jobs more likely to lose more work hours due to either their own or someone else’s unplanned dental visit. Among the key findings in a new report by CareQuest Institute on lost productivity and dental issues is the high cost of such missed productivity in the US: an estimated $45 billion annually.” [Read the full story here.](https://www.dentistryiq.com/dentistry/article/14304870/the-high-cost-of-dental-related-lost-productivity) **Categories:** In The News --- ### [Kansas Reflector: Expansion of Medicaid Adult Dental Benefits in Kansas a Win For All](https://carequest.org/in-the-news/kansas-reflector-expansion-of-medicaid-adult-dental-benefits-in-kansas-a-win-for-all/) **Published:** February 8, 2024 **Author:** Jasmin Fernandes **Content:** “Kansas joins several states nationwide in taking crucial steps toward increasing access to oral health care. According to CareQuest Institute for Oral Health’s recently updated Medicaid Adult Dental Coverage Checker, which highlights the progress advocates and policymakers have made to strengthen adult dental coverage in the past few years, eight states now offer extensive Medicaid adult dental benefits.” [Read the full story here.](https://kansasreflector.com/2024/02/08/expansion-of-medicaid-adult-dental-benefits-in-kansas-a-win-for-all/) **Categories:** In The News --- ### [BBC: A Tooth Examination Can Be Terrifying for Victims of Rape and Assault. These Dentists Want to Help Them](https://carequest.org/in-the-news/bbc-a-tooth-examination-can-be-terrifying-for-victims-of-rape-and-assault-these-dentists-want-to-help-them/) **Published:** February 26, 2024 **Author:** Jasmin Fernandes **Content:** “In the US, TACHC worked with the non-profit CareQuest Institute for Oral Health to create an online course for dental professionals on trauma-informed oral healthcare. This was made available in April 2023.” [Read the full story here.](https://www.bbc.com/future/article/20240226-how-dentistry-is-becoming-safer-for-survivors-of-trauma-and-assault) **Categories:** In The News --- ### [Entering the Inspiration Zone: Transforming Health Care and Embracing Health Equity with Myechia Minter-Jordan](https://carequest.org/in-the-news/entering-the-inspiration-zone-transforming-health-care-and-embracing-health-equity-with-myechia-minter-jordan/) **Published:** March 4, 2024 **Author:** Jasmin Fernandes **Content:** In this captivating episode, Myechia Minter-Jordan, President and CEO of CareQuest Institute for Oral Health, opens up about the interconnectedness of oral health and overall wellness and shines a light on the communities often overlooked in the healthcare system. [Listen to the full episode here.](https://inspirationzonellc.com/podcast/transforming-healthcare-embracing-health-equity-with-myechia-minter-jordan/) **Categories:** In The News --- ### [Dentistry IQ: Are Kids Getting More Cavities?](https://carequest.org/in-the-news/dentistry-iq-are-kids-getting-more-cavities/) **Published:** March 11, 2024 **Author:** Jasmin Fernandes **Content:** “The American Dental Association (ADA) celebrates Children’s Dental Health Month in February. What started in 1941 as a single day morphed into an entire month by 1981. And judging by the stats, that might not be enough. The CareQuest Institute for Oral Health reports that “early childhood caries remains the most common, preventable infectious disease among children in the United States.”’ [Read the full story here.](https://www.dentistryiq.com/dental-hygiene/article/14310118/are-kids-getting-more-cavities) **Categories:** In The News --- ### [Dental Economics: Value-Based Payment Alignment: A Case Study For Oral Health](https://carequest.org/in-the-news/dental-economics-value-based-payment-alignment-a-case-study-for-oral-health/) **Published:** October 13, 2022 **Author:** Jasmin Fernandes **Content:** Because of Texas advancing quality care and dental APMs, the CareQuest Institute for Oral Health conducted an evaluation of dental utilization data against the CMMI quality and cost criteria. An analysis was conducted using claims data from DentaQuest, a participating DMO. It used DentaQuest claims associated with Texas Medicaid from January 2016 to September 2021 for two group practices that are part of the risk-based APM program, as well as two comparison group practices with similar claims volumes with an FFS payment model. [Read the full article here.](https://www.dentaleconomics.com/macro-op-ed/dental-outreach/article/14282099/valuebased-payment-alignment-a-case-study-for-oral-health) **Categories:** In The News --- ### [USA Today: American Indian, Alaska Native Communities Face 'Disproportionate Burden' of Poor Oral Health](https://carequest.org/in-the-news/usa-today-american-indian-alaska-native-communities-face-disproportionate-burden-of-poor-oral-health/) **Published:** April 1, 2023 **Author:** Jasmin Fernandes **Content:** American Indians and Native Alaskans face a “disproportionate burden” of oral health disease in the U.S. from childhood onward, a crisis with roots in structural racism and exacerbated by lack of access to healthy food and housing stability, a joint research effort has found. The situation was outlined in a report compiled by CareQuest Institute for Oral Health, a nonprofit group based in Boston, in collaboration with the Society of American Indian Dentists, the National Indian Health Board and Southern Plains Tribal Health Board. Poor oral health can have far-reaching consequences, not only as a precursor to other physical health issues but as a factor in depression and mental health issues, said Myechia Minter-Jordan, CareQuest’s president and CEO. Poor oral health can also prevent people from getting jobs or affect elderly people’s ability to eat, she added. [Read the full article here](https://www.usatoday.com/story/news/nation/2023/04/01/native-americans-facing-oral-health-crisis-rooted-structural-racism/11529998002/). **Categories:** In The News --- ### [New York Times: Why Oral Hygiene Is Crucial to Your Overall Health](https://carequest.org/in-the-news/new-york-times-why-oral-hygiene-is-crucial-to-your-overall-health/) **Published:** April 6, 2023 **Author:** Jasmin Fernandes **Content:** In another study, published in April, scientists found that diabetics who were treated for periodontal disease saw their overall health care costs decrease by 12 to 14 percent. [Read the full article here](https://www.nytimes.com/2023/04/06/well/oral-health-hygiene.html). **Categories:** In The News --- ### [NBC News: Millions Expected to Lose Dental Care Coverage After Medicaid Review](https://carequest.org/in-the-news/nbc-news-millions-expected-to-lose-dental-care-coverage-after-medicaid-review/) **Published:** April 14, 2023 **Author:** Jasmin Fernandes **Content:** An issue that few have identified, however, is that about 14.2 million people, or 28% of adults currently enrolled in Medicaid, will also lose their dental health coverage, according to the data compiled by CareQuest Institute for Oral Health, a think tank dedicated to oral health in the country. [Read the full article here](https://www.nbcnews.com/news/us-news/millions-expected-lose-dental-care-coverage-medicaid-review-rcna79112). **Categories:** In The News --- ### [USA Today: Number of Native American Dental Program Applicants Plummets as Community Faces Oral Health Crisis](https://carequest.org/in-the-news/usa-today-number-of-native-american-dental-program-applicants-plummets-as-community-faces-oral-health-crisis/) **Published:** May 19, 2023 **Author:** Jasmin Fernandes **Content:** The shortage was cited in a report released earlier this year describing the “disproportionate burden” of oral health disease faced by American Indians and Native Alaskans in the U.S. from childhood onward, a crisis it said was rooted in structural racism and exacerbated by a lack of access to healthy food and stable housing. The report was compiled by Boston nonprofit CareQuest Institute for Oral Health in collaboration with the National Indian Health Board, Society of American Indian Dentists and Southern Plains Tribal Health Board. “The lack of representation is significant, because the importance of cultural competency cannot be overstated,” said Myechia Minter-Jordan, CareQuest’s president and CEO. “There’s a level of connection and credibility.” [Read the full article here](https://www.usatoday.com/story/news/nation/2023/05/19/native-americans-with-oral-health-in-crisis-dental-students-decline/70213380007/?gnt-cfr=1). **Categories:** In The News --- ### [Journal Hispanic Dental Association: The Connection Between Women's Oral Health and Cancer](https://carequest.org/in-the-news/journal-hispanic-dental-association-the-connection-between-womens-oral-health-and-cancer/) **Published:** September 10, 2023 **Author:** Jasmin Fernandes **Content:** “Despite evidence establishing a profound link between oral health and the pathogenesis of systemic diseases, there is a surprising lack of research regarding its impact on women’s health,” writes Josefine Ortiz Wolfe, PhD, MPH, RDH, education specialist at CareQuest Institute in an article published by the *Journal Hispanic Dental Association.* Wolfe and a group of co-authors explain the connection between oral health and cancers in Hispanic women, the need for more research into those findings, and the six steps to help improve women’s health care. [Read the full story here.](https://issuu.com/hdassoc.org/docs/jhda_8th_edition/36) **Categories:** In The News --- ### [AP News: Many States are Expanding Their Medicaid Programs to Provide Dental Care to Their Poorest Residents](https://carequest.org/in-the-news/ap-news-many-states-are-expanding-their-medicaid-programs-to-provide-dental-care-to-their-poorest-residents/) **Published:** September 25, 2023 **Author:** Jasmin Fernandes **Content:** “All states provide some Medicaid dental benefits for adults, but some limit it to only specific segments of the population, like pregnant women or those who have intellectual disabilities, or cover only emergency care, according to CareQuest Institute for Oral Health, a nonprofit that advocates for expanded dental care.” [Read the full story here.](https://apnews.com/article/medicaid-dental-care-adults-low-income-tennessee-c45d52fc9f7e24adf877a3063b086da4) **Categories:** In The News --- ### [OPEN Hill Day 2026: Oral Health Advocacy in Action](https://carequest.org/blog/open-hill-day-2026-oral-health-advocacy-in-action/) **Published:** June 12, 2026 **Author:** Caitlin Locklear **Content:** ![A group of adults seated in a formal meeting room, discussing documents around a coffee table with papers and cups visible.](https://carequest.org/wp-content/uploads/2026/06/IMG_3405-scaled.jpeg)Seven OPEN advocates from New Hampshire meet with Representative Maggie Goodlander (NH-2) More than 130 advocates from across the country gathered in Washington, DC, on June 4 for OPEN Hill Day with one purpose: to meet with their state legislators and push for policies that prioritize oral health in their communities. “OPEN is a great place to connect with providers and experts in oral health care,” says Kelsey Arends with [Nebraska Appleseed](https://neappleseed.org/), a nonprofit organization that fights for justice and opportunity for all Nebraskans. “We’ve benefitted from that in our state, and it’s helpful to come here and meet with folks from other states, too.” [OPEN](https://carequest.org/policy-advocacy/open/) is a diverse network of people and organizations who use their unique experiences, knowledge, and skills to make oral health care more affordable and accessible — especially for underserved populations. Members connect in person and virtually throughout the year to share resources, learn from one another, and align on policy priorities. Each year, including this one, that collaboration culminates at OPEN Hill Day on Capitol Hill. ![Group of diverse adults posing on stone steps with the U.S. Capitol dome in the background on a sunny day.](https://carequest.org/wp-content/uploads/2026/06/HillDay_44-scaled.jpg)OPEN members in front of Capitol Hill This was OPEN’s fifth Hill Day. And this year — on a day filled with 130 advocates, 138 meetings, and the recognition of a policymaker who is championing oral health — collaboration was front and center. “This year’s OPEN Hill Day highlighted what makes this work effective — collaboration grounded in community voice, a shared vision, and multiple perspectives,” says Trenae Simpson, CareQuest Institute Senior Director of Philanthropy. “That foundation allows us to shape policy in ways that reflect real needs and drive the systems change required to expand access to oral health care.” ## **Preparing to Advocate on Capitol Hill** In the weeks leading up to Hill Day, before heading into meetings with lawmakers, OPEN members participated in trainings and discussions led by CareQuest team members and policy experts. The trainings helped the advocates make the most of their limited time with policymakers on Capitol Hill. ![](https://carequest.org/wp-content/uploads/2026/06/HillDayTraining_103-scaled.jpg)OPEN members participate in Hill Day training “We had some wonderful panels where we got to hear about how to get the most out of our meetings,” says Emma Vann with [Healthy Mothers, Healthy Babies Coalition of Georgia](https://www.hmhbga.org/), a nonprofit organization that tries to improve maternal and infant health through advocacy, education, and access to vital resources. “The role play was the most helpful. Not only did it bring some lightheartedness to the situation, but it really helped to portray what our meetings were going to look like.” Advocates also reviewed [state-specific data](https://carequest.org/resource/state-oral-health-dashboard/) compiled by CareQuest Institute, highlighting how improving access to oral health care can reduce costs and improve overall health outcomes in their communities. “The [Health Data Exchange](https://dataexchange.carequest.org/) is very beneficial in getting specific state resources when it comes to numbers — because we all know people in government want to see numbers,” says Summer McMenamin, RDH, MS, FADHA, MCHES, a member of the [Delaware Dental Hygienists’ Association](https://delawaredha.org/). Equipped with both data and personal stories, they headed into meetings ready to make their case. This year’s OPEN Hill Day focused on [three key priorities](https://carequest.org/resource/open-hill-day-2026-policy-priorities/): 1. [**Improving access to dental care for veterans**](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Veterans-Need-Affordable-Dental-Care_May2026_FINAL.pdf)**:** The majority of veterans do not qualify for VA dental benefits, and those who do often face provider shortages, geographic barriers, and high out-of-pocket costs, placing them at greater risk for chronic conditions and financial strain. 2. [**Protecting Medicaid as a critical pathway to care**](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Protect-Medicaid_May2026_FINAL.pdf)**:** Proposed changes under the One Big Beautiful Bill Act could unintentionally limit access to dental services, leading to increased emergency room use and higher system-wide health care costs. 3. [**Ensuring sustained federal investment in oral health infrastructure and prevention**](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Need_Federal_Oral_Health_Programs_FINAL.pdf)**:** Recent federal rollbacks include the elimination of the CDC’s Division of Oral Health, which administers grants to fund states’ oral health programs. ## **Oral Health Advocacy Is Personal** While data and policy priorities shape the conversations, the motivation behind advocacy can be deeply personal. For McMenamin, her commitment to oral health access is rooted in her father’s experience. ![](https://carequest.org/wp-content/uploads/2026/06/IMG_3443-scaled.jpeg)Jandra Korb, DDS, speaks with Representative Josh Brecheen’s (OK-2 aides “My father had no teeth and wore dentures, and that affected his mental health and overall well-being,” she says. “When he went through cancer treatments, the oral health complications became so severe that he eventually needed a feeding tube because he could no longer wear his dentures to eat.” For others, their advocacy is shaped by lived experience navigating the health care system. “I’m a disabled American veteran myself,” says Kevin Miller with [Disabled American Veterans](https://www.dav.org/), a nonprofit that provides support for veterans. “I’ve had to pay out of pocket for dental care, which can be prohibitively expensive. At times, I’ve even been refused treatment because I couldn’t afford it.” And for many, showing up is about using their voice to support others. “I find joy in bringing my voice to the table to shine a light on some of our most important public health issues here in the US,” Vann says. ## **Educating Lawmakers about Oral Health** Throughout the day, advocates met with dozens of members of Congress from both sides of the political aisle, bringing oral health to the forefront of conversations on Capitol Hill. “It was encouraging to hear that many of the folks we met with regardless of political ideology were interested in what we had to say,” says Saumya Ayyagari, RN, MSN, MPH, with [Special Outreach Services](https://specialoutreachservices.org/), a free preventive oral health care program for people with intellectual disabilities in Pennsylvania. “It was great to educate our lawmakers about why oral health is health.” Many advocates said the meetings were productive and reinforced the importance of continuing to elevate oral health as a national priority. “Senator \[Raphael\] Warnock has always been a large supporter of these issues,” Vann says. “It was a very positive meeting, and we were all on the same page about how important oral health is to everyone’s health and how it’s connected to everything.” ![](https://carequest.org/wp-content/uploads/2026/06/HillDay_125-scaled.jpg)Representative Julia Brownley (CA-26) is recognized as OPEN Oral Health Champion of the Year The day also included a moment of recognition for leadership in advancing oral health. Congresswoman Julia Brownley (CA-26) was named the 2026 Oral Health Champion of the Year for her work to expand access to dental care — particularly for [veterans through the Dental Care for Veterans Act](https://juliabrownley.house.gov/brownley-introduces-legislation-to-expand-dental-care-for-veterans-2/) — and for supporting the integration of oral health and overall health. For many advocates, the work doesn’t end when Hill Day concludes. Some are already planning follow-up conversations to continue building relationships with their legislators. “Our conversation with Representative \[Cliff\] Bentz (OR-2) was very fruitful,” says Laura McKeane, an oral health advocate. “He asked for specific data points, so we have a mission to provide that as soon as possible. We’re hopeful he’ll be a champion for these issues moving forward.” At the same time, participants reflected on the broader significance of showing up and speaking out. “Doing something like this always reminds you that there’s so much going on,” says Margaret Master with Healthy Mothers, Healthy Babies Coalition of Georgia. “While it may seem obvious that veterans and families should have oral health coverage, it often takes someone sharing their story to show why it matters — and why action is needed.” *Editor’s Note: For more information on OPEN and OPEN Hill Day, go to* [*carequest.org/policy-advocacy/open/*](https://carequest.org/policy-advocacy/open/). **Categories:** Blog **Tags:** Dental Coverage --- ### [CareQuest Institute Awards $2.3 Million in Grant Funding for Projects Focused on Advancing Equity](https://carequest.org/press-release/carequest-institute-awards-2-3-million-in-grant-funding-for-projects-focused-on-advancing-equity/) **Published:** May 22, 2024 **Author:** Jasmin Fernandes **Content:** ## ***Funds Support Grantees to Advance Health Care Policy, Build Community Capacity, and Expand Access to Care.*** [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has awarded more than $2.3 million in grant funds to help advance equity in oral health across the nation. Grants were awarded to 14 organizations across the country from Alabama, California, Colorado, Florida, Massachusetts, Nebraska, Texas, Vermont, and beyond. “We are excited to award funding to organizations dedicated to advancing equity in oral health locally and across the nation,” said **Trenae Simpson, director of Grants and Programs at CareQuest Institute**. “Allocation of these funds underscores CareQuest Institute’s commitment to fostering inclusive and accessible oral health systems, particularly within historically marginalized communities. By supporting initiatives with equity-driven approaches, we aim to spark transformative change and ensure that everyone has the opportunity to attain optimal oral health.” In 2024, CareQuest Institute will award $13 million in grants, with a focus on collaborating with organizations that embody and reflect the communities that have historically been hurt by glaring inequities in oral health, including racial and ethnic minorities, immigrants, refugees, persons with disabilities, veterans, and tribal and rural communities. This quarter, CareQuest Institute provided grants to the following organizations: **Alabama Arise** ($150,000) to support work to advocate for expanded Medicaid coverage including educational advocacy efforts around oral health, opportunities to advance teledentistry and medical-dental integration. **Berkeley Free Dental Clinic** ($13,000) to support the clinic’s oral health services by purchasing a flash sterilizer, additional dental hygiene instruments, and installation of an Isodry system in dental chairs. **Center for Medicare Advocacy** ($145,000) to support work to expand oral health coverage for Medicare beneficiaries. **Community Catalyst** ($564,334) to support continued federal and state advocacy for comprehensive health coverage, inclusive of oral health, that is centered on the needs and perspectives of the community, as well as provide technical assistance and training around equity-driven community engagement in service of oral health systems change. **Health Care For All** ($150,000) to support efforts to enhance oral health integration and promote teledentistry, protect and defend adult dental Medicaid benefits, advocate for state and federal policies aimed at expanding access to vulnerable populations, and conduct listening sessions with community members and organizations to inform the organization’s 2025-2026 oral health legislative agenda. **Heart Ministry Center** ($150,000) to support the center as they determine their oral health policy and advocacy priorities through trauma-informed story gathering of community members impacted by oral health challenges. **Hispanic Dental Association** ($278,535) to inform evidence-based policy decisions and support Hispanic dental providers as equity driven advocates for oral health. **Kentucky Voices for Health** ($125,000) to support the efforts as they advocate to prevent the unraveling of Medicaid expansion including expanded dental benefits through the leveraging of community voice. **Massachusetts League of Community Health Centers** ($150,000) to expand and pilot a four-part curriculum developed to equip oral health staff within community health center dental clinics with culturally sensitive communication skills to improve patient-providers relationships and care outcomes. **Pacific Northwest University of Health Sciences** ($78,500) to support the teams at Pacific Northwest University School of Dental Medicine (PNWU-SDM) and the Northwest Interprofessional Health Collaborative (NIHC) to develop, implement, measure, and share a comprehensive, multi-year interprofessional education (IPE) curriculum for DMD students and professionals. **Suwannee River Area Health Education Center** ($112,488) to support the Education Center as the fiscal sponsor for Floridians for Dental Access (FLDA), to advocate for the passage of dental therapy legislation in Florida. **Texas Health Institute** ($184,848) to support the development of a state-level dashboard with population health data that will inform advocacy efforts in the 2025 legislative session. The grant funding will also support efforts to address access gaps for minority populations in Texas by conducting a landscape scan of current efforts, develop a learning collab for providers to advance solutions to these gaps, and engage with academic institutions to advance policies to address care gaps. **University of Colorado School of Dental Medicine** ($150,000) to support the University of Colorado School of Dental Medicine to strengthen the community voices of the American Indian community living on the Pine Ridge Reservation in South Dakota, through authentic partnership development to test a theoretical framework on perceived discrimination and other dental care-related experiences in the utilization of dental care among adults in this population. **Voices for Vermont’s Children** ($125,000) to support the creation of an outreach and awareness campaign that reflects community-identified oral health policy priorities, promotes the use of medical management of dental disease, and improves access to care for Medicaid-enrolled and uninsured patients through intentional medical-dental integration policy design. To learn more about CareQuest Institute’s philanthropy work, [**click here**](https://carequest.org/grants-overview/). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [New Report: Lower-Income Families Spend Seven Times More on Dental Care Than Wealthier Families](https://carequest.org/press-release/new-report-lower-income-families-spend-seven-times-more-on-dental-care-than-wealthier-families/) **Published:** June 25, 2024 **Author:** Jasmin Fernandes **Content:** ## *A New CareQuest Institute Report Reveals Deep, Income-Based Health Disparities.* Revealing deep health disparities based on income, a new [CareQuest Institute for Oral Health®](https://www.carequest.org/) report shows that poorer families paid 7.4 times more in out-of-pocket expenditures for dental care compared to high-income families between 2007 and 2021. At the same time, families living in poverty and those with lower incomes were less likely to have visited a dentist in the past year compared to families with higher incomes in the US. The [new report](https://www.carequest.org/resource-library/lower-income-families-still-spend-more-dental-care), “Lower-Income Families Still Spend More on Dental Care,” shows that between 2007 and 2021, the most recent data available, inequities in out-of-pocket expenditures between the poorest and wealthiest families in the US have continued to grow. In 2007, the poorest families paid 5.5 times more. “As these inequities continue to widen, we need solutions to make dental coverage and care more accessible and affordable for low-income families,” said CareQuest Institute CEO and President Myechia Minter-Jordan, MD, MBA. “While we’ve seen some progress in recent years, policymakers need to do more to fully address these disparities, including expanding Medicaid adult dental coverage.” The report recommends comprehensive [Medicaid adult dental benefits in all states](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), increased dental provider participation in Medicaid, and support for safety-net providers serving low-income patients as solutions to make dental coverage and care more accessible and affordable for low-income families. Incentivizing oral health providers to practice in Dental Health Professional Shortage Areas can also help improve access to affordable oral health care in these geographies. [Read the full report.](https://www.carequest.org/resource-library/lower-income-families-still-spend-more-dental-care) **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Value-Based Care --- ### [New National Poll Shows Overwhelming Bipartisan Support for Medicare Dental Coverage](https://carequest.org/press-release/new-national-poll-shows-overwhelming-bipartisan-support-for-medicare-dental-coverage/) **Published:** July 16, 2024 **Author:** Jasmin Fernandes **Content:** ## *9 in 10 Voters Favor Adding Dental Coverage to Medicare; Survey also Finds Broad Support for Medicaid Adult Dental Benefits and Better Coverage for Veterans.* A [new national poll ](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results)shows that the vast majority of voters across the political spectrum favor adding dental coverage to Medicare. The results of the poll, commissioned by [CareQuest Institute for Oral Health](https://www.carequest.org/)® and the [Oral Health Progress and Equity Network (OPEN)](http://www.carequest.org/open), show that more than 9 in 10 national voters (92%) support adding a dental benefit to Medicare. “These poll results show that people all across our nation understand just how important oral health is to overall health,” said Melissa Burroughs, director of public policy at CareQuest Institute. “No one in this country should have to choose between getting the care they need and putting food on the table. As candidates consider their health care platforms this year, the informed ones will make Medicare dental coverage a top priority.” Half of all Medicare enrollees don’t have dental coverage, meaning [nearly 24 million](https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/) older Americans lack access to this essential form of health care. Approximately the same number of Medicare enrollees [haven’t visited a dentist in 12 months](https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/), which has profound implications for the health and well-being of older adults. The poll revealed that 85% of respondents who voted for Trump in both 2016 and 2020 and 99% of those who voted for the Democrat candidate in those two elections would like to see a dental benefit added to Medicare. When ranking health care topics they find “most important,” voters rank adding dental coverage to Medicare just as highly as abortion and even higher than the future of the Affordable Care Act. Dental care also ranked the highest on the list of services that voters would like to see added to Medicaid. Additionally, separate polling showed broad support for dental coverage in Medicare in key states for the 2024 presidential election: in Michigan, 91% of voters support it; in Ohio, 92%; and in Pennsylvania, 93%. The poll also revealed that 91% of voters want expanded coverage to include dental services for veterans. Additionally, 74% of voters support adding adult dental benefits to Medicaid at the state or federal level. The national polling was conducted by Marketing for Change Co. from May 29 – June 4, 2024, using a representative sample of 1,000 registered voters nationwide from the YouGov online panel. The margin of error is +/- 3.1%. Marketing for Change also conducted separate polling in Michigan (n=765), Ohio (n=761) and Pennsylvania (n=760) using the Centiment online panel between May 30 and June 13. The margin of error for those surveys was between +/- 3.54% and +/-3.55%. [View more details and results from the poll. ](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results) **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Value-Based Care --- ### [CareQuest Institute Earns 2024 Great Place To Work Certification™](https://carequest.org/press-release/carequest-institute-earns-2024-great-place-to-work-certification/) **Published:** August 6, 2024 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute for Oral Health®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, is proud to be Certified™ by Great Place To Work®.* [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, is proud to be Certified™ by Great Place To Work®. The prestigious award is based entirely on what current employees say about their experience working at CareQuest Institute. This year, 81% of employees said it’s a great place To Work – 24 points higher than the average U.S. company. Great Place To Work® is the global authority on workplace culture, employee experience, and the leadership behaviors proven to deliver market-leading revenue, employee retention and increased innovation. “At CareQuest Institute, we know that our biggest asset is our dedicated employees who show up each day to drive us toward a more accessible and equitable health care system,” says Leslie Carver, MHA, chief operating officer and executive vice president at CareQuest Institute. “We are proud to be Great Place To Work-Certified™ and are grateful to our employees who brought us this noteworthy recognition.” “Great Place To Work Certification is a highly coveted achievement that requires consistent and intentional dedication to the overall employee experience,” says Sarah Lewis-Kulin, the Vice President of Global Recognition at Great Place To Work. She emphasizes that Certification is the sole official recognition earned by the real-time feedback of employees regarding their company culture. “By successfully earning this recognition, it is evident that CareQuest Institute stands out as one of the top companies to work for, providing a great workplace environment for its employees. “CareQuest Institute is committed to supporting the physical and mental well-being of employees. The organization offers a wide range of health and wellness focused benefits to employees, including: - Medical, Dental, Vision Insurance Plans - Health Savings Accounts (HSA) - Flexible Spending Accounts (FSA) - 401(k) Retirement Plan with Employer Match - Short-Term & Long-Term Disability Insurance (employer provided and supplemental) - Life Insurance (employer provided and supplemental) - Paid Parental Leave - Financial planning and education - Paid Time Off (PTO) and Holidays - Tuition Reimbursement - Optional Insurance (Auto & Home, Legal, Accident, Pet, Identity Theft) - Employee Resource Groups (ERGs) - Employee Assistance Program (EAP) While CareQuest Institute has a physical office in Charlestown, MA, employees are based all over the country, so it continuously strives to create a connected virtual work experience. The organization offers home office reimbursements, supports colleague resources groups (CRGs), and hosts an annual in-person company retreat to encourage collaboration and community. According to [Great Place To Work research,](https://www.greatplacetowork.com/resources/blog/job-seekers-are-4-5x-more-likely-to-find-a-great-boss-at-a-certified-great-workplace) job seekers are 4.5 times more likely to find a great boss at a Certified great workplace. Additionally, employees at Certified workplaces are 93% more likely to look forward to coming to work, and are twice as likely to be paid fairly, earn a fair share of the company’s profits and have a fair chance at promotion. **We’re hiring!** Looking to grow your career at a company that puts its people first? Visit our careers page at: . **About Great Place to Work Certification™** Great Place To Work® Certification™ is the most definitive “employer-of-choice” recognition that companies aspire to achieve. It is the only recognition based entirely on what employees report about their workplace experience – specifically, how consistently they experience a high-trust workplace. Great Place to Work Certification is recognized worldwide by employees and employers alike and is the global benchmark for identifying and recognizing outstanding employee experience. Every year, more than 10,000 companies across 60 countries apply to get Great Place To Work-Certified. About Great Place To Work® As the global authority on workplace culture, Great Place To Work® brings 30 years of groundbreaking research and data to help every place become a great place to work for all. Their proprietary platform and For All™ Model helps companies evaluate the experience of every employee, with exemplary workplaces becoming Great Place To Work Certified™ or receiving recognition on a coveted Best Workplaces™ List. Learn more at [greatplacetowork.com](http://www.greatplacetowork.com/) and follow Great Place To Work on [LinkedIn](https://www.linkedin.com/company/28924/), [Twitter](https://twitter.com/gptw_us), [Facebook](https://www.facebook.com/GreatPlacetoWork) and [Instagram](https://www.instagram.com/gptw_us). **Categories:** Press Release --- ### [CareQuest Institute Awards $1.25 Million in Grant Funding for School-Related Oral Health Initiatives](https://carequest.org/press-release/carequest-institute-awards-1-25-million-in-grant-funding-for-school-related-oral-health-initiatives/) **Published:** August 20, 2024 **Author:** Jasmin Fernandes **Content:** ## *Funds Support Grantees to Improve Oral Health Access and Outcomes Through School-Based Programs.* [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has awarded $1.25 million in grant funds for school-based and school-linked initiatives to improve oral health outcomes. Grants were awarded to 10 organizations across the country, including in California, Colorado, Illinois, Florida, Louisiana, Maine, Montana, Pennsylvania, and Wisconsin. “Schools play a critical role in supporting positive health outcomes for children, particularly those from under resourced communities. Oral health programs at schools have the potential to increase student success, improve health outcomes for children, and reduce racial, ethnic, and economic disparities,” said **Trenae Simpson, Director of Grants and Programs at CareQuest Institute**. “School-based programs meet children where they are, connect them with community-driven resources, encourage preventive care habits, and improve oral health outcomes. CareQuest Institute is proud to support organizations that engage with and support communities to achieve their best health.” The School-Based and School-Linked Initiatives to Improve Oral Health RFP will support the following organizations: - [American Academy of Pediatrics in Illinois](https://illinoisaap.org/) ($125,000) to adapt the Training, Education, Assistance, Mentorship, and Support (TEAMS) model to improve oral health in schools and development of an oral health micro-module for the AAP Health Services Assessment Tool for Schools (HATS). - [Center for Oral Health in California](https://www.centerfororalhealth.org/) ($125,000) to support the success of the Early Smiles Program to advocate for critical policy reforms at local and state levels in California. This initiative seeks to expand and enhance oral health services provided through their school-based program, which has demonstrated significant impact in Sacramento, Yolo, Alpine, and Trinity counties (California). - [EXCELth, Inc. in Louisiana](https://www.excelth.com/) ($125,000) to implement the Louisiana Smile Krewe School-Linked Initiative with the goal of increasing the number of children utilizing dental services as well as promote widespread use of teledentistry to address barriers to oral health for rural communities. - [MCD Global Health in Maine](https://www.mcd.org/) ($125,000) to integrate oral health with health, dental, and school partners, and increased access to care for Maine children utilizing school nurses to provide screenings and preventive services. - [Montana State University](https://www.montana.edu/) ($125,000) to launch the Youth Voice Project, which will conduct focus groups with 7th-12th grade students to identify their perceptions of oral health in their community. Montana State University will also pilot a same day treatment protocol in the School-Based Health Center to disrupt the current model where students are referred to treatment over 100 miles away in Billings. - [More Smiles Wisconsin](https://www.moresmileswi.org/) ($125,000) to expand oral health collaborations between schools, school-based prevention programs, and local dentists through the existing and recently established Hometown Smiles program. - [Nicklaus Children’s Hospital Foundation in Florida](https://www.nicklauschildrens.org/home) ($125,000) to increase access to oral health care for recent immigrant children in partnership with Borinquen Medical Center (BMC) and eight elementary public schools in Miami-Dade County. - [Oral Health Unit at CDPHE in Colorado](https://coloradooralhealth.org/about/#:~:text=The%20Oral%20Health%20Unit%20(OHU,highest%20level%20of%20health%20possible.) ($125,000) to expand school-based oral health in collaboration with Youth Healthcare Alliance through engaging schools and communities to address systemic barriers to oral health for children and their families. - [Pennsylvania Chapter of the American Academy of Pediatrics](https://www.paaap.org/) ($125,000) to implement a school-based oral health program. This will include preventive education, topical fluoride varnish application, and dental referral through targeted educational resources for school nurses. - [Well Child Center in Illinois](https://www.wellchildcenter.org/about/) ($125,000) to form and convene a Community of Practice to improve oral health in the second largest school district in Illinois (western suburbs of Chicago). In 2024, CareQuest Institute will award a total of $13 million in grants, with a focus on collaborating with organizations that embody and reflect the communities that have historically been hurt by glaring inequities in oral health, including racial and ethnic minorities, immigrants, refugees, persons with disabilities, veterans, and tribal and rural communities. To learn more about CareQuest Institute’s philanthropy work, [click here](https://carequest.org/grants-overview/). **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [New Report Finds Adults with ADHD Are at Greater Risk for Poor Oral Health](https://carequest.org/press-release/new-report-finds-adults-with-adhd-are-at-greater-risk-for-poor-oral-health/) **Published:** October 8, 2024 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute Data Show Adults with ADHD Have Worse Oral Health Outcomes and Experiences* A [new report](https://www.carequest.org/resource-library/adhd-and-oral-health) released today by [CareQuest Institute for Oral Health®](https://www.carequest.org/) finds that adults with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for poor oral health than adults without ADHD. The data reveal that adults with ADHD rated their oral health as fair or poor (35.5%) and were embarrassed about the state of their oral health in greater numbers than those without ADHD (24.9%). They also reported visiting a dentist less often, but more often seeking dental care through an emergency department, compared to adults without ADHD. Those with ADHD also reported experiencing discrimination in the oral health care setting and experiencing high levels of dental anxiety in greater numbers than adults without ADHD. These findings come from the third annual [State of Oral Health Equity in America (SOHEA) survey](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024), the largest nationally representative survey focused on adults’ attitudes, experiences, and behaviors related to oral health. “These new data illustrate some of the many disparities that exist in oral health and the need to work toward a more accessible and equitable system,” said Leslie Carver, chief operating officer at CareQuest Institute. “While not all adults with ADHD have poor oral health, it is important for oral health professionals to be aware of the potential oral health challenges associated with ADHD and consult with their patients to help them achieve optimal oral health.” Key findings include: - More adults with ADHD report being embarrassed by their teeth or mouth very often, often, or occasionally compared to adults without ADHD (48.4% vs. 29.6%). - More adults with ADHD (40.4%) report not having visited a dentist in more than a year compared to adults without ADHD (31.9%). - More adults with ADHD report having visited an emergency department for dental care in the prior year compared to adults without ADHD (13.0% vs. 2.3%). - A higher percentage of adults with ADHD report having experienced discrimination in an oral health care setting (11.7%) compared to adults without ADHD (7.0%). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [CareQuest Institute Awards $1.25 Million in Grant Funding for Veterans’ Oral Health](https://carequest.org/press-release/carequest-institute-awards-1-25-million-in-grant-funding-for-veterans-oral-health/) **Published:** October 29, 2024 **Author:** Darren Edwards **Content:** [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has awarded $1.25 million in grant funds to organizations working to address barriers to oral health care for veterans and active-duty military members and their families. Individual grants of $125,000 were awarded to 10 organizations across the country in California, Michigan, Missouri, North Carolina, Ohio, Oregon, Texas, Washington, and West Virginia. “Veterans and their families have given so much to our country, but many of them lack access to dental care, which we know is directly connected to overall well-being and quality of life,” **said Trenae Simpson, Senior Director of Grants and Programs at CareQuest Institute**. “We are proud to support these organizations that are doing the research, testing, and community engagement on the ground to provide critical oral health services to veterans and military families.” Recognizing the unique oral health challenges facing veterans, CareQuest Institute began this initiative to improve access to care for the 17 million veterans in the US. Of the more than 9 million veterans who are eligible for medical care through the US Department of Veterans Affairs (VA), [85% are not eligible for dental coverage](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being#:~:text=Veterans%20with%20urgent%20dental%20needs,chronic%20conditions%2C%20including%20heart%20disease.) or care. Veterans are [disproportionately affected by tooth decay and periodontal issues](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being#:~:text=Veterans%20with%20urgent%20dental%20needs,chronic%20conditions%2C%20including%20heart%20disease.), making this grant opportunity critical in advancing oral health equity among this population. The Veterans’ Oral Health: Expanding Access and Equity grant funding will support the following organizations: **Dentistry4Vets** (California), to address system-level barriers to oral health for veterans and spotlight their care delivery model that delivers cost-effective, comprehensive dental treatment tailored specifically for veterans. **East Carolina University** (North Carolina), to help inform policy changes that improve veterans’ oral health by creating a care model that employs multidisciplinary teams to facilitate comprehensive care for veterans with chronic illnesses and disabilities. East Carolina University plans to demonstrate that reduced net costs and improved quality of life for veterans can be achieved by focusing on prevention and early intervention in medical-dental integration. **Everyone for Veterans** (Washington), for training dental schools and students on veteran-specific oral care, speaking engagements that focus on the voices of veterans, and advocacy for veterans’ oral health. **Family Medicine Education Consortium** (Ohio), to work with the academic family medicine system to effect change in how primary care providers approach the oral health care of patients, with a focus on access to appropriate and comprehensive care for veterans. **Marshall University Research Corporation** (West Virginia), to assess the knowledge gaps around veterans’ oral health access and capture veteran perspectives on care in West Virginia to inform statewide and national oral health systems change efforts. **Mercy Foundation** (Oregon), to increase access to care and connections to care for in-hospital patients, advocate for increasing the number of veterans eligible for Veterans Dental Program, share best practices via a public awareness campaign, and create a hub dedicated to oral health for veterans. **Missouri Coalition for Oral Health** (Missouri), to gather and apply data-driven and lived experience insights to better understand and address the unmet dental needs of Missouri veterans while elevating the importance of veteran oral health among MCOH members, partners, and stakeholders. **Missouri Office of Dental Health** (Missouri), to learn why veterans seek dental treatment, how dentists can improve care provided, why dental students want to provide care to veterans, and what would encourage them to continue to provide care post-graduation. **University of Texas Health Science Center at Houston** (Texas), to pilot a study to investigate the impact of dental care in behavioral health treatment among veterans. **Upper Peninsula Commission for Area Progress** (Michigan), to conduct community forums in multiple locations across a 15-country region to engage veterans, service members, family/caregivers, dental providers, insurers/health plan providers, and policy makers regarding the state of veteran oral health care and barriers to access. In 2024, CareQuest Institute will award a total of $13 million in grants, with a focus on collaborating with organizations that embody and reflect the communities that have historically been hurt by glaring inequities in oral health, including racial and ethnic minorities, immigrants, refugees, persons with disabilities, veterans, and tribal and rural communities. To learn more about CareQuest Institute’s philanthropy work, [click here](https://www.carequest.org/how-we-work/grantmaking). **Categories:** Press Release **Tags:** Minimally Invasive Care --- ### [New Report: Integrating Oral and Mental Health During and After Pregnancy Is Critical to Improving Health Outcomes](https://carequest.org/press-release/new-report-integrating-oral-and-mental-health-during-and-after-pregnancy-is-critical-to-improving-health-outcomes/) **Published:** December 3, 2024 **Author:** Jasmin Fernandes **Content:** [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, released a new report that provides crucial insights into how pregnancy-related changes can be linked to oral and mental health. The data-driven report emphasizes the critical need for integrated health care approaches that connect medical, dental, and behavioral health services. The report [Oral and Mental Health During and After Pregnancy: The Importance of Medical-Dental-Behavioral Integration](https://www.carequest.org/resource-library/oral-and-mental-health-during-and-after-pregnancy), reveals that pregnant individuals are at a greater risk for oral health conditions like periodontal disease, which is linked to adverse pregnancy outcomes such as low birth weight and preterm birth. Despite the clear connection between oral health and pregnancy, only about two-thirds of pregnant persons seek dental care. The report also emphasizes the significant increase in mental health conditions during pregnancy, with diagnoses of perinatal mood and anxiety disorders rising by 93% from 2008 to 2020. “Pregnancy is a crucial time for a birthing parent’s health, and it’s time that we view oral health, overall health, and mental health as intertwined,” **said Leslie Carver, chief operating officer at CareQuest Institute.** “By bridging these gaps and advocating for health systems that better integrate care, we can better address whole-person health and improve health outcomes for families.” Key Findings: - Pregnant individuals face increased risks for dental caries and periodontal disease, which are linked to negative pregnancy outcomes. - Mental health conditions such as anxiety disorders and mood disorders (including depression) are linked to poorer oral health outcomes. - Implementing a comprehensive, integrated medical-dental-behavioral care model is essential to improving outcomes for both the birthing parent and newborn. The report calls for the integration of medical, dental, and behavioral health services to better serve pregnant and postpartum individuals, highlighting the need for obstetrician-gynecologists (OB/GYNs) to refer patients for both oral and behavioral health care. Only 4% of individuals reported receiving a dental referral during pregnancy, underscoring the greater need for collaboration between health care providers. For more information and to read the full report, visit this [link](https://www.carequest.org/resource-library/oral-and-mental-health-during-and-after-pregnancy). **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Reacts to Health Secretary Robert F. Kennedy Jr. and Lee Zeldin’s Statements on Fluoride](https://carequest.org/press-release/carequest-institute-reacts-to-health-secretary-robert-f-kennedy-jr-and-lee-zeldins-statements-on-fluoride/) **Published:** April 8, 2025 **Author:** Jasmin Fernandes **Content:** CareQuest Institute for Oral Health®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, issued a statement today regarding US Health Secretary Robert F. Kennedy Jr.’s plans to direct the Centers for Disease Control and Prevention (CDC) to stop recommending fluoridation in communities nationwide and US Environmental Protection Agency (EPA) Administrator Lee Zeldin’s announcement that the EPA, which oversees water quality, will also “take action.” **CareQuest Institute Senior Director of Public Policy Melissa Burroughs issued the following statement:** “Decades of research have proven that at safe and optimal levels, fluoride is safe and plays a critical role in preventing tooth decay and promoting good oral health. Efforts to remove it from public water systems — like those recently proposed by Health Secretary Robert F. Kennedy Jr. and already enacted in Utah — ignore this well-established science and risk worsening our nation’s oral health crisis. “These actions come at a time when 70 million people in the US lack dental insurance, 23 million face potential cuts to Medicaid dental coverage, and recent HHS layoffs have scaled back vital oral health programs at the federal level. As a result, our nation is at risk of losing critical layers of protection for basic oral health access. Without these programs and infrastructure, the US could see a sharp rise in not just dental disease, but also preventable conditions linked to poor oral health — including diabetes, hypertension, and adverse pregnancy outcomes. As this administration works to make America healthier, we need solutions on oral health that continue to make improvements and address challenges posed by recent changes.” **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Value-Based Care --- ### [New Report: People with Disabilities Face Major Barriers to Accessing Oral Health Care](https://carequest.org/press-release/implications-and-populations-affected-heres-a-breakdown-of-the-most-relevant-tags-from-your-list-along-with-a-few-suggestions-✅-highly-relevant-tags-health-equity-the-report-h/) **Published:** May 13, 2025 **Author:** Jasmin Fernandes **Content:** ## *New Data from CareQuest Institute for Oral Health Shows Adults with Disabilities Are Less Likely to Visit a Dentist or Have Dental Insurance.* According to new data released today by CareQuest Institute for Oral Health®, adults with disabilities face major barriers to accessing oral health care and are at greater risk for poor oral health outcomes. This data comes from the annual State of Oral Health Equity in America (SOHEA) survey, the largest nationally representative survey focused on adults’ attitudes, experiences, and behaviors related to oral health. Findings from the report show that for adults reporting at least one disability, factors including income, education, and having dental insurance are often linked to oral health outcomes such as self-rated oral health, recency of the last dental visit, having a dental home, and visiting an Emergency Department (ED) for dental care. “People with disabilities deserve the basic right to access the care they need, yet they continue to face significant obstacles in receiving adequate dental care,” said Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute. “This report gives us actionable insights to help guide our efforts to reduce inequities and improve the quality of life for individuals with disabilities.” The results of the report reveal the following: - Fewer adults with a disability reported a dental visit in the past 12 months (56%) compared to those without a disability (70%). - Nearly a third of adults with a disability report their dental office doesn’t provide special help and/or accommodations for their dental visit. - Adults with a disability are less likely to have dental insurance (66%) than those without one (76%). - One quarter of adults with a disability (25%) said they delayed care, missed an appointment, or were unable to obtain needed health care, including oral health care. - Adults with a disability have significantly higher odds of reporting fair/poor oral health compared to adults without a disability. - More adults with a disability have visited an emergency department for dental care than adults without one. To improve access to oral health care for people with disabilities, the report recommends enhancing Medicare and Medicaid coverage for adult dental care, providing additional training for providers on treating people with disabilities, and integrating medical and dental care with specialty oral health care. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [New Report: 72 Million Adults in the US Lack Dental Insurance, Nearly Three Times the Number Without Health Insurance](https://carequest.org/press-release/new-report-72-million-adults-in-the-us-lack-dental-insurance-nearly-three-times-the-number-without-health-insurance-2/) **Published:** May 21, 2025 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute for Oral Health Data Show 27% of Adults Do Not Have Dental Insurance.* [A new report](https://www.carequest.org/resource-library/out-pocket) from CareQuest Institute for Oral Health® reveals that 27% of US adults — an estimated 72 million people — do not have dental insurance, nearly three times the number of adults who lack health insurance (9.5%, or 26 million). The findings, from the latest “[State of Oral Health Equity in America (SOHEA)](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024)” survey, underscore a persistent and troubling gap in access to dental care. Lack of dental insurance puts adults at risk for delayed treatment and worsening oral health, which is closely tied to broader health problems, including diabetes, heart disease, and even dementia. “These findings reinforce the fact that oral health care is too expensive and out of reach for too many families in America,” said Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute. “Gaps in dental insurance force families to make impossible tradeoffs between things like putting food on the table and getting the care they need — any cuts to the Medicaid program would only make this problem worse. It’s time for policy solutions that address our nation’s oral health, starting by preserving Medicaid adult dental coverage.” The report, “[Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://www.carequest.org/resource-library/out-pocket),” also finds that: - **Adults with lower incomes and education levels are more likely to lack dental insurance.** 40% of adults without a high school diploma and 38% of those earning under $30,000 annually are uninsured for dental care. - **One-third of adults with Medicare or Medicaid lack dental coverage.** Traditional Medicare does not include dental services, and Medicaid adult dental coverage varies widely by state. - **More than 80% of adults without health insurance also lack dental insurance.** - **Nearly one in four adults with dental insurance gained it in the last year,** either by changing from a previous insurance plan to a new plan or by enrolling in an insurance plan after being uninsured. - **Among adults currently without dental insurance, 12% lost coverage in the past year,** disproportionately affecting younger adults and Asian/Pacific Islander, Black, and Hispanic adults. Despite growing recognition that oral health is essential to overall health, significant policy gaps remain. Medicare does not guarantee dental coverage, Medicaid coverage for adults is optional and inconsistent across states, and marketplace dental plans often lack affordability and accessibility, with no subsidies available. The SOHEA survey is the largest nationally representative survey focused exclusively on oral health attitudes, behaviors, and experiences among adults. Conducted from March to May 2024 by the National Opinion Research Center (NORC) at the University of Chicago, the study reflects the voices of more than 9,000 adults nationwide. The full report is available [here](https://www.carequest.org/resource-library/out-pocket). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Raises Alarm Over Medicaid Cuts That Threaten Dental Access](https://carequest.org/press-release/carequest-institute-raises-alarm-over-medicaid-cuts-that-threaten-dental-access/) **Published:** July 3, 2025 **Author:** Jasmin Fernandes **Content:** CareQuest Institute for Oral Health, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, today issued a statement regarding the passage of a tax and spending package that includes significant changes and deep funding cuts to the Medicaid program which may result in [nearly 12 million people losing access to coverage](https://www.kff.org/affordable-care-act/issue-brief/how-will-the-2025-reconciliation-bill-affect-the-uninsured-rate-in-each-state-allocating-cbos-estimates-of-coverage-loss/). ****CareQuest Institute Senior Director of Public Policy Melissa Burroughs issued the following statement:**** “The passage of this legislation marks a dangerous setback for Medicaid and the millions of people who rely on it for essential health care, which includes oral health. Deep cuts to Medicaid funding, new work requirements, and caps on the mechanisms that states use to fund the program threaten to drastically reduce access to care across the country. This bill will make it harder for millions of families to afford dental care, for adults to manage chronic conditions tied to oral health, and for children and families in rural and low-income areas to find providers who can accept Medicaid or keep their doors open at all. History tells us that when states are forced to cut dental benefits, the damage can take years to undo–and often results in higher costs and overcrowded emergency rooms. At a time when we should be improving access to prevention and care, this bill moves in the wrong direction. We urge Congress to prioritize policies that protect and strengthen access to oral health care–not dismantle it.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [New Poll: Majority of Americans Support Water Fluoridation and Trust Dental and Medical Providers on the Issue](https://carequest.org/press-release/new-poll-majority-of-americans-support-water-fluoridation-and-trust-dental-and-medical-providers-on-the-issue/) **Published:** July 22, 2025 **Author:** Jasmin Fernandes **Content:** ## *New Survey from CareQuest Institute for Oral Health Highlights Public Perception of Fluoride in Water as Bans Take Place Across the Country.* Amid a federal push to end the use of fluoride in the country’s drinking water, [a new survey](https://www.carequest.org/resource-library/community-water-fluoridation-national-opinion-poll-results) from [CareQuest Institute for Oral Health](https://www.carequest.org/) finds that the vast majority of Americans — 81% — either support (52%) or are not opposed (29%) to the practice. Only 6% of respondents supported banning water fluoridation for all communities. With more than [7,000 scientific studies](https://pubmed.ncbi.nlm.nih.gov/?term=water+fluoridation&sort=pubdate&sort_order=asc), the overwhelming weight of scientific evidence shows fluoridating water at levels approved in the US is safe and effective. Nearly all respondents, 96%, trust their family doctor or pediatrician to educate them about fluoride in drinking water. Major US health organizations, including the American Academy of Pediatrics, the Mayo Clinic, and the American Dental Association, support community water fluoridation. “This survey confirms that the campaign against water fluoridation is out of step with not only the vast majority of the scientific and medical communities, but with the American people, too,” said **Melissa Burroughs**, Senior Director of Public Policy at CareQuest Institute. “The government should protect oral health, not cut off access to basic preventive care like fluoride.” **The national survey results show the attitudes surrounding fluoride, including:** - 86% of Americans use some form of fluoride. - 79% believe the government should do what it can to protect and improve oral health. - Most people who oppose fluoridation still feel that each community should decide whether it wants to fluoridate. A [recent study](https://www.carequest.org/about/blog-post/new-study-shows-costly-consequences-states-banning-fluoride?utm_source=chatgpt.com) in the *Journal of the American Medical Association* found that ending water fluoridation in the US could result in more than 25 million additional decayed teeth among children and an estimated $9.8 billion in added health care costs — with the greatest impact on low-income and uninsured families. The CareQuest Institute poll was conducted online by Marketing for Change Co. between July 7 and July 9, 2025, among a sample of 1,114 US adults. The margin of error due to sampling is +/- 2.94%. The full report is available [here](https://www.carequest.org/resource-library/community-water-fluoridation-national-opinion-poll-results). **Media Contact:** Sara Ward sward@carequest.org (314) 276-6727 **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Value-Based Care --- ### [Public Comment: FDA Advisory Committee Meeting — Use of Orally Ingestible Prescription Drug Products Containing Fluoride for the Pediatric Population](https://carequest.org/press-release/public-comment-fda-advisory-committee-meeting-use-of-orally-ingestible-prescription-drug-products-containing-fluoride-for-the-pediatric-population/) **Published:** July 24, 2025 **Author:** Jasmin Fernandes **Content:** CareQuest Institute issued a public comment to the US Food and Drug Administration supporting the overwhelming scientific evidence of the safety and effectiveness of fluoride supplements. CareQuest Institute urged the FDA to keep pediatric fluoride prescription therapies on the market and available to children and families who choose to use them. The FDA sought public input on its [proposed rule](https://www.federalregister.gov/documents/2025/06/16/2025-10943/use-of-orally-ingestible-unapproved-prescription-drug-products-containing-fluoride-in-the-pediatric), “Use of Orally Ingestible Unapproved Prescription Drug Products Containing Fluoride in the Pediatric Population,” in advance of the public meeting on July 23. Under the direction of US Secretary of Health and Human Services, Robert F. Kennedy, Jr., community water fluoridation and fluoride supplements are at risk of being unavailable as a tool to prevent tooth decay. [Read the full public comment](https://carequest.org/carequest-institute-reacts-to-new-fda-action-on-childrens-fluoride-supplements-and-urges-continued-focus-on-prevention-and-access/). [Read the CNN article](https://www.cnn.com/2025/07/24/health/fluoride-prescription-supplement-fda): “Prescription Fluoride Faces FDA Scrutiny Despite Widespread Support from Providers and the Public” **Categories:** Press Release **Tags:** Health Equity --- ### [New Interactive Map Streamlines Licensure Guidance for Dental Hygienists Nationwide](https://carequest.org/press-release/new-interactive-map-streamlines-licensure-guidance-for-dental-hygienists-nationwide/) **Published:** July 29, 2025 **Author:** Jasmin Fernandes **Content:** ## *ADHA and CareQuest Institute partner to launch comprehensive tool consolidating key information to improve navigation of state requirements.* The American Dental Hygienists’ Association (ADHA®) and CareQuest Institute for Oral Health today announced the launch of the Dental Hygienist Licensure Map, an interactive resource that provides state-by-state licensure information for dental hygienists across the United States. The tool consolidates previously scattered information into one accessible platform, serving the professional needs of more than 220,000 dental hygienists nationwide. The map provides detailed information across multiple licensure categories, including initial licensure requirements, continuing education renewal requirements, licensure by credentials, specialty licensure, and dental hygiene compact states. It also includes scope of practice information and direct links to state licensing boards, making it a one-stop reference for dental hygienists navigating professional requirements. “This interactive map represents a significant advancement in supporting our profession’s mobility and growth,” said Lancette VanGuilder, ADHA president. “By consolidating essential licensure information into an intuitive, visual format, we’re empowering dental hygienists to make informed decisions about their careers and practice locations.” The map replaces multiple resources that previously required dental hygienists to search through various pages and documents to find complete licensure information. CareQuest Institute sponsored this project to fill a critical gap in the oral health workforce infrastructure with a comprehensive resource for dental hygienists whose role is essential in expanding access to care. “Dental hygienists play a critical role in supporting community oral health by delivering preventive care, promoting health education, and serving as accessible, trusted providers — especially in underserved and high-need populations,” said Trenae Simpson, Senior Director, Philanthropy at CareQuest Institute. “Each of these components is essential if we are to reach a point where everyone has the same opportunity to maximize their health through oral health.” The map aligns with CareQuest Institute’s mission to improve oral health by promoting equity and access through clearer licensure pathways, supporting workforce development by making licensure requirements more transparent and navigable, and enabling policy advocacy through a centralized, data-driven tool. Key features of the Dental Hygienist Licensure Map include: - Initial Licensure Information: Entry-level program requirements, accepted clinical exams, and state-specific scope of practice - Renewal Requirements: Continuing education requirements, renewal cycles, fees, and special requirements for each state - Compact Status Visualization: Clear identification of states participating in the Dentist and Dental Hygienist Licensure Compact for professional mobility - Direct State Connections: Links to state licensing boards and regulations for the most current official information - User-Friendly Interface: Interactive design that makes finding state-specific information quick and easy Development of the resource was made possible through a grant from CareQuest Institute. The six-month project involved consolidating and updating information from multiple existing ADHA resources and external sources, ensuring accuracy across all 50 states, and US territories. “ADHA is grateful for CareQuest Institute’s support in making this practical resource available to our profession,” added VanGuilder. “Their partnership enables us to provide dental hygienists with the tools they need to navigate their professional requirements successfully.” The map will be updated semiannually with current information. Future enhancements are planned to expand the resource’s capabilities and user experience. For more information about ADHA’s Dental Hygienist Licensure Map, visit [adha.org/licensuremaps](http://www.adha.org/licensuremaps). **Categories:** Press Release **Tags:** Health Equity --- ### [CareQuest Institute Names Wade Rakes as New CEO](https://carequest.org/press-release/carequest-institute-names-wade-rakes-as-new-ceo-2/) **Published:** September 15, 2025 **Author:** Jasmin Fernandes **Content:** ## *Accomplished Fortune 25 Health Care Executive Will Guide CareQuest Institute’s Mission to Create an Accessible, Integrated Oral Health System.* CareQuest Institute for Oral Health®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has named longtime health care executive Wade Rakes its new CEO. Rakes previously served as Chief Growth Officer at the Fortune 25 health care company Centene Corporation and as President and CEO of its Georgia-based subsidiary, Peach State Health Plan. ![CareQuest CEO Wade Rakes](https://carequest.org/wp-content/uploads/2025/12/CEO-Wade_Cropped_2-248x300.jpg)CareQuest CEO Wade Rakes As CEO, Rakes will oversee the strategic direction and operations of CareQuest Institute, including the management of its endowment; its philanthropic investments and advocacy efforts; its dental insurance and benefits administrator; and its innovation arm, which is dedicated to transforming oral health access and outcomes for underserved populations across the United States. “I am deeply grateful for this opportunity and energized by the chance to work alongside the team at CareQuest, its expansive operations, and our Board in advancing a mission that touches every community: improving oral health outcomes for all Americans,” said Rakes. “Together, we will expand access, drive innovation, shape policy, and ensure that oral health is recognized as essential to overall health.” With more than two decades of leadership experience in the health care industry, Rakes brings both a distinguished track record of driving growth and a keen understanding of how access to oral health care impacts overall health outcomes. “We are excited to welcome Wade’s vision, energy, and expertise,” said Pam Reeve, acting CEO and Board Chair for CareQuest Institute. “With his leadership, we are poised to strengthen our partnerships, broaden our impact, and accelerate our efforts to break down barriers to oral health for all.” During his 15 years at Centene, Rakes rose to Chief Growth Officer, contributing to the expansion and reach of a multi-product health care entity deeply connected to local communities. As President and CEO of Peach State Health Plan, he guided his team in supporting the health care journey of members statewide. Earlier in his career, Rakes also served as a cabinet-level official in the State of Ohio and has remained a committed civic leader. He is Chair of the Board of LGBTQ+ Victory, Vice Chair of the Board of the High Museum, a Trustee of the Woodruff Arts Center, and a member of the Board of Advisors of the James A. Baker III Institute at Rice University. Rakes earned a Bachelor of Arts degree from Princeton University and a Master of Business Administration degree from the University of Michigan. **Categories:** Press Release --- ### [CareQuest Institute Reacts to New FDA Action on Children’s Fluoride Supplements and Urges Continued Focus on Prevention and Access](https://carequest.org/press-release/carequest-institute-reacts-to-new-fda-action-on-childrens-fluoride-supplements-and-urges-continued-focus-on-prevention-and-access/) **Published:** November 3, 2025 **Author:** Darren Edwards **Content:** ## *New actions could limit fluoride access for children most at risk of tooth decay.* The US Food and Drug Administration (FDA) has announced new enforcement actions addressing fluoride supplements for children. The agency advises that these supplements should not be used in children under three years old, or in older children who are not at high risk for cavities. CareQuest Institute for Oral Health appreciates the FDA’s engagement with pediatric and dental experts and encourages continued collaboration with health professionals to ensure that decisions around fluoride are guided by the best available science and evidence. However, the agency’s new enforcement actions diverge from long-standing recommendations from the American Academy of Pediatrics and the American Dental Association, who in addition to older children, advise that children from six months through age three — a period critical for tooth formation and lifelong oral health — benefit from fluoride supplements when their water lacks fluoride. “While this action is not nearly as restrictive as the FDA’s early proposals, we remain concerned that these recommendations would reduce access to an important preventive tool — especially for families in communities without fluoridated drinking water,” said ****Melissa Burroughs, Senior Director of Policy and Advocacy for CareQuest Institute****. “Decades of research show that fluoride — when used appropriately — is a safe and effective tool for preventing tooth decay and strengthening developing teeth. This conflicts with decades of guidance from pediatric and dental experts and risks deepening a growing oral health crisis for children.” Under the new enforcement action, manufacturers can no longer market ingestible fluoride products for children under three or for older children not deemed “high risk.” This leaves the youngest children without basic protection against cavities at a time when several states are also scaling back access by ending water-fluoridation mandates. Utah and Florida have already enacted statewide bans, and other states are considering similar measures. Overall, children’s oral health is already worsening. CareQuest Institute analysis shows emergency department visits among children 14 and under for preventable dental problems rose nearly 60 percent from 2019 to 2022 — the only age group now above pre-pandemic levels. “We’re already seeing the consequences of limited access to oral health care, and this decision will only make them worse,” Burroughs said. “Every child deserves the chance to grow up free from preventable dental disease, no matter where they live.” **Categories:** Press Release **Tags:** Dental Coverage --- ### [CareQuest Institute Partners with Innovaccer to Improve Medical-Dental Data Integration](https://carequest.org/press-release/carequest-institute-partners-with-innovaccer-to-improve-medical-dental-data-integration/) **Published:** February 17, 2026 **Author:** Darren Edwards **Content:** ## This collaboration brings medical and dental data together to better understand patient journeys and support more integrated care. [CareQuest Institute for Oral Health®](https://carequest.org/), a national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, today announced a new partnership with [Innovaccer](https://innovaccer.com/), a leading health care AI company, to integrate medical and dental data. The collaboration aims to help providers, payers, and policymakers better understand the impact of oral health on overall health outcomes. [Despite growing evidence](https://carequest.org/medical-and-dental-integration-a-need-for-improved-electronic-health-records/) linking oral health to conditions such as heart disease and diabetes, pregnancy outcomes, and overall health and well-being, medical and dental care data remain largely siloed. This fragmentation limits visibility into the full patient journey, making it difficult to identify opportunities for earlier intervention, coordinated care and improved outcomes for providers, payers, and policymakers. Through this partnership, CareQuest Institute and Innovaccer will link medical and dental claims and clinical data through Innovaccer’s [Humbi](https://www.humbi.ai/) platform, drawing on Innovaccer’s expertise in unifying complex health data at scale. By creating a more complete, longitudinal view of patient health, the collaboration will support deeper insights into how oral health influences overall patient outcomes and total cost of care. The collaboration will also explore how these insights can inform interventions that improve care coordination and support more effective, person-centered health care delivery. “Oral health is an essential part of overall health, yet our systems and data have long treated it as separate,” said Wade Rakes, Chief Executive Officer at CareQuest Institute. “By partnering with Innovaccer to integrate medical and dental data, we’re working to better understand patient journeys across the health system and help advance care models that reflect the reality that oral health and overall health are deeply connected.” “True integration is what enables autonomous health care, systems that don’t just store data, but actively surface insights and coordinate action across the care continuum,” said Abhinav Shashank, cofounder and CEO of Innovaccer. “CareQuest Institute brings deep expertise and credibility in advancing oral health equity, and together we’re building the data foundation needed to connect medical and dental care in a way that improves outcomes, reduces cost, and reflects how care actually happens in people’s lives.” This partnership aligns with CareQuest Institute’s broader mission to advance oral health equity and strengthen the health care system through data, research, integration, and innovation. **Categories:** Press Release --- ### [CareQuest Institute Names An Nguyen, DDS, MPH, as Chief Clinical Officer](https://carequest.org/press-release/carequest-institute-names-an-nguyen-dds-mph-as-chief-clinical-officer/) **Published:** April 6, 2026 **Author:** Darren Edwards **Content:** ## National leader in oral health integration and equity joins CareQuest Institute executive team. [CareQuest Institute for Oral Health®](https://carequest.org/) today announced the appointment of An Nguyen, DDS, MPH, as its new Chief Clinical Officer. Dr. Nguyen joins CareQuest Institute from Colorado-based Clinica Family Health and Wellness, where she has served as Chief Dental Officer since 2010. ![An Nguyen, DDS, MPH](https://carequest.org/wp-content/uploads/2026/04/An-Nguyen.jpg)An Nguyen, DDS, MPH As Chief Clinical Officer, Dr. Nguyen will be a key member of the executive leadership team, working closely with the CEO to drive clinical strategy and advance CareQuest Institute’s mission to build a more accessible, equitable, and integrated oral health system. She will lead efforts to integrate oral health with overall health, guide enterprise-wide clinical initiatives, and further position CareQuest Institute as a national leader in oral health transformation. “I have a deep, personal connection to marginalized communities that navigate systems not built for them, and this connection has shaped my belief that advancing health equity and overall well-being makes oral health indispensable,” said Dr. Nguyen. “CareQuest Institute has long driven bold, inclusive change in oral health systems, and I’m honored to join the team’s efforts to build a future where health is a catalyst for opportunity, dignity, and prosperity for every person in every community.” Dr. Nguyen has dedicated her career to the care of underserved communities and brings nearly two decades of clinical practice and leadership to advancing equitable oral health care, expanding access, and improving outcomes for patients and communities. As Chief Dental Officer at Clinica Family Health and Wellness, she led interdisciplinary care models serving tens of thousands of patients while advancing medical-dental integration and chronic disease management. “Dr. Nguyen is a highly respected leader whose work spans clinical practice, public health, and systems transformation,” said Wade Rakes, Chief Executive Officer of CareQuest Institute. “She will play a key role in advancing our mission by driving innovation for new and emerging solutions while expanding access to improve oral health nationwide.” A respected national thought leader, Dr. Nguyen is Immediate Past President of the National Network for Oral Health Access and is Chair-Elect of the Dental Quality Alliance. She was appointed by the governor of Colorado to the state’s Department of Health Care Policy and Financing Medical Services Board and previously served on the board of the Caring for Colorado Foundation. She is also active in several national organizations, including the American Association of Public Health Dentistry, American Dental Association, and the National Association of Community Health Centers, where she contributes to health integration, public health, and policy and advocacy efforts. Dr. Nguyen holds a Master of Public Health in community health and behavioral science from Saint Louis University and a Doctor of Dental Surgery degree from the University of Tennessee. **Categories:** Press Release --- ### [CareQuest Institute Awards $2.7 Million in Grants to Help Advance Health Equity](https://carequest.org/press-release/carequest-institute-awards-2-7-million-in-grants-to-help-advance-health-equity/) **Published:** May 11, 2023 **Author:** Jasmin Fernandes **Content:** ## *Funds Support Grantees Working with Marginalized Communities to Address Oral health Disparities.* [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has awarded more than $2.7 million in grant funds so far this year to help advance equity through oral health. The grants, awarded to nine organizations, support on-the-ground efforts across the country to dismantle unjust structures and systems that drive disparities related to access to care, treatment, and outcomes. “Our philanthropy strategy is rooted in our commitment to racial and health equity and the intentional engagement of communities most often harmed by the existing oral health system,” said CareQuest Institute Chief Health Equity Officer Kaz Rafia, DDS, MBA, MPH. “We’re proud to support these organizations and their work with historically marginalized populations toward a more equitable health care system through community-driven solutions.” Each year, CareQuest Institute awards $14 million in grants, with a focus on collaborating with organizations that embody and reflect the communities that have historically been hurt by glaring inequities in oral health, including racial and ethnic minorities, immigrants, refugees, persons with disabilities, veterans, and tribal and rural communities. This quarter, CareQuest Institute provided grants to the following organizations: **Achieva/The Arc of Greater Pittsburgh ($148,000)** This grant supports advocacy efforts to designate people with disabilities as a Medically Underserved Population on a state-wide and national scale, which would increase access to primary, behavioral, and oral health care through federal funding opportunities. **Alabama Arise ($148,500)** This grant supports the Cover Alabama Coalition, a nonpartisan alliance of over 100 community partners, consumer groups, businesses, health care providers and faith groups advocating for the state of Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system. **Community Catalyst ($485,000)** This grant supports federal and state advocacy efforts to advance comprehensive health coverage, inclusive of oral health. It also supports technical assistance and training on equity-driven community engagement strategies for oral health systems change. **Dental Connections, Inc. ($50,000)** This grant supports the Iowa Smiles pilot project which is aimed at improving care coordination and public health partnerships to improve oral health for refugee communities living in Iowa. **Health Care for All ($215,000)** This grant helps expand access to oral health care in Massachusetts through community-driven policy advocacy related to integration, telehealth, coalition-building, workforce solutions, and expansion of benefits to all children regardless of immigration status. **Hispanic Dental Association ($264,500)** This grant supports critical research on topics related to oral health outcomes and access for Hispanic and Latinx populations, the development of policy recommendations to broaden access to oral health care for this population, and the dissemination of the Hispanic Dental Association’s white paper Addressing the Oral Health Needs of Hispanics in the U.S to key oral health stakeholders across the country. **Maryland Dental Action Coalition ($150,802)** This grant supports implementation efforts for Maryland’s newly expanded Medicaid dental coverage including, consumer outreach and education, care coordination engagement, and continued advocacy for policies that address barriers to care for vulnerable adults. **Maine Equal Justice Partners ($105,358)** This grant supports the facilitation of consumer input and feedback within the implementation of Maine’s Medicaid adult dental benefit and advocacy for expansion of Medicaid to all Mainers regardless of immigration status. **Massachusetts League of Community Health Centers ($150,000)** This grant supports the launch of a project that will design, implement, and spread the use of new communication tools within racially discordant patient-provider relationships to reduce the impacts of structural racism in health care. To learn more about CareQuest Institute’s philanthropy work, [click here](https://carequest.org/grants-overview/). **Categories:** Press Release **Tags:** Health Equity, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Supports New Bill to Add Comprehensive Dental Benefits to Medicare](https://carequest.org/press-release/carequest-institute-supports-new-bill-to-add-comprehensive-dental-benefits-to-medicare/) **Published:** June 27, 2023 **Author:** Jasmin Fernandes **Content:** ## *Representative Barragán and Senator Cardin file bill to address unmet dental needs of older adults, people with disabilities.* Today, [CareQuest Institute for Oral Health®](https://www.carequest.org/) — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — expressed its support of a new bill that would add comprehensive dental benefits to Medicare. The bill, the [Medicare Dental Benefit Act of 2023](https://barragan.house.gov/2023/06/15/reps-barragan-and-kelly-sen-cardin-introduce-bill-to-expand-medicare-dental-coverage/), was introduced by US Representative Nanette Barragán (D-CA-44th) and US Senator Ben Cardin (D-MD). It would help address significant unmet dental needs faced by older adults and people with disabilities and represent a move toward a more equitable health care system. **CareQuest Institute President and CEO Myechia Minter-Jordan, MD, MBA issued the following statement:** “We commend Representative Barragán and Senator Cardin for filing this bill and prioritizing the health and well-being of millions of older adults and people with disabilities across our country. This legislation is an opportunity to help address the health care disparities that have plagued our country for generations. “Oral health care is essential health care, and we know that a person’s inability to access dental care presents a clear threat to overall health, especially for some of our most vulnerable populations. Poor oral health has a direct connection to increased risks of chronic illnesses and can negatively affect mental health and overall quality of life. Still, millions of people with Medicare — a population that often [faces comorbidities](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit) associated with periodontal disease like diabetes, heart disease, and dementia — don’t have access to this basic and necessary coverage. “Adding a dental benefit to Medicare is a commonsense measure that would save taxpayer money, improve health outcomes, and address inequities that have existed for far too long in our health care system.” **Additional research and facts about oral health and Medicare:** - Poor oral health is [directly linked](https://carequest.org/impacts-beyond-the-mouth/) to conditions such as diabetes, heart disease, respiratory illness, and even Alzheimer’s — all diseases that particularly impact our older citizens. - Of the 60 million Medicare beneficiaries, [more than two-thirds](https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/) don’t have any dental coverage at all. - Nearly half of all Medicare patients [haven’t visited a dentist within the past year](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare). That number is closer to 70 percent for Black, Hispanic, and lower-income Medicare beneficiaries. - [One in five](https://familiesusa.org/wp-content/uploads/2019/09/RuralSeniorOralHealth_120718_Fact-Sheet.pdf) rural seniors haven’t seen a dentist in the past five years. - [One study](https://oralhealth.hsdm.harvard.edu/files/oralhealth/files/avalere_health_estimated_impact_of_medicare_periodontal_coverage.pdf) estimated $63.5 billion in medical savings over 10 years simply by providing dental and periodontal treatment through Medicare. - Older adults [delayed dental care ](https://carequest.org/surveys-show-older-adults-delayed-dental-care-more-than-any-other-care-during-pandemic/)more than any other health care during the pandemic. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Requests Grant Proposals Focused On Care Transformation](https://carequest.org/press-release/carequest-institute-requests-grant-proposals-focused-on-care-transformation/) **Published:** May 19, 2023 **Author:** Jasmin Fernandes **Content:** ## *Submissions Should Include Proposals for How Community Organizations Can Expand Their Care Delivery.* [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has launched a [request for proposals (RFP)](https://www.carequest.org/content/community-and-care-transformation-request-proposals) to fund projects and partners geared toward health care transformation. Applicants will likely be community organizations looking to expand how oral health care is delivered or safety net clinical facilities looking to grow their community engagement. Proposals are now open and are due by June 30. Relevant RFPs should combine two core interrelated elements of work: (a) carry forward care transformation concepts; and (b) ensure authentic and deep community engagement is embedded in the practical implementation of those concepts. “Investing in organizations that share in our vision of an oral health care system that works better for everyone allows us to get one step closer to a future where everybody can access the health care they need,” said Trenae Simpson, Director of Grants and Programs at CareQuest Institute. “We know that oral health care solutions will not be as effective and meaningful without those individuals most impacted by oral health disparities driving the work. This RFP is an opportunity for oral health providers, advocates, and researchers to share information, act, and collaborate with communities toward a healthier, more equitable future.” To advance oral health equity and access to quality, whole-person care at a systemic level, CareQuest Institute, along with other partners in oral health care, has been at the forefront of developing and testing care transformation best practices. Winning proposals will focus on the idea that care transformation efforts cannot advance effectively without the community members those efforts intend to serve driving the project forward. Examples of projects that fall within the Community and Care Transformation Request for Proposals: - A safety net partner piloting new value-based care procedures within clinical practice, overseen by a representative patient/community body that has active input into the planning, implementation, and evaluation of the new practice impact on patient experience - A state policy organization utilizing a formal process that ensures ongoing community input and involvement to advocate for medical/dental integration measures within state Medicaid policy - A community-based or grassroots organization building power among community members to participate in advocacy in local or state policy spaces around care transformation concepts - A safety net provider collaborating with community partners to expand and use innovative workforce models that are representative of their patients and families Specific details related to eligibility, proposal requirements, and evaluation criteria can be found on our [Community and Care Transformation Request for Proposals page](https://www.carequest.org/content/community-and-care-transformation-request-proposals). **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [Statement on Recent Decisions by the Supreme Court of the United States by Kaz Rafia, DDS, MBA, Chief Health Equity Officer, CareQuest Institute for Oral Health](https://carequest.org/press-release/statement-on-recent-decisions-by-the-supreme-court-of-the-united-states-by-kaz-rafia-dds-mba-chief-health-equity-officer-carequest-institute-for-oral-health/) **Published:** June 30, 2023 **Author:** Jasmin Fernandes **Content:** “The US Supreme Court has again issued several decisions that will fundamentally change the ways in which we pursue equity and social justice in this country. From affirmative action in higher education to student loan forgiveness to LGBTQ+ protections, these recent decisions will have lasting impacts on all of us but particularly for historically marginalized individuals. The impact of inequity and injustice is felt in every sector of society – health care is no exception. We need health systems that represent the people they serve and that requires a pipeline of graduating clinicians as diverse as our population. We encourage our medical, dental, and STEM-focused educational institutions throughout the country to renew their commitment to equity and diversity and create purposeful plans of action. At CareQuest Institute, we are committed to building an accessible, equitable, and integrated system for all. While our work is made more challenging by these decisions, we will not be deterred.” **Categories:** Press Release **Tags:** Health Equity, Person-Centered Care, Special Patient Care --- ### [Leslie Carver Joins CareQuest Institute as Chief Operating Officer](https://carequest.org/press-release/leslie-carver-joins-carequest-institute-as-chief-operating-officer/) **Published:** May 16, 2023 **Author:** Jasmin Fernandes **Content:** ## *Carver Will Lead Critical Strategy, Integration, and Operational Efforts Across the Organization’s Full Portfolio.* Today, [CareQuest Institute for Oral Health®](https://www.carequest.org/) announced that Leslie Carver, MHA, has joined the organization as Chief Operating Officer. With over 30 years of health care industry experience, Carver will leverage her leadership and expertise to create the operational rigor necessary to build a more accessible, equitable, and integrated oral health system for all. As part of the CareQuest Institute executive team, Carver will lead critical strategy, integration, and operational efforts across the organization’s full portfolio. “I am thrilled to welcome Leslie to our team at CareQuest Institute,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “As a strategic and hands-on operational leader, Leslie has shown clear dedication to health care transformation over the course of her career, proving that she will be an invaluable leader to help us reimagine oral health and create a better health care system.” “CareQuest Institute is not only elevating the critical importance of oral health but taking intentional steps to break down barriers to care for everyone,” said Carver. “My new colleagues are passionate about this work, and I welcome the opportunity to join them in pursuit of operational excellence and a more equitable health care system.” Carver’s responsibilities as Chief Operating Officer will include: - Directing CareQuest Institute’s daily operations and strategic growth - Overseeing CareQuest Institute’s data and information strategy, project management, marketing, and operations teams - Building organizational infrastructure to support the organization’s mission and intended impact Before joining CareQuest Institute, Carver served as executive director of Boston HealthNet, where she led an integrated network of 11 Federally Qualified Health Centers affiliated with Boston Medical Center and managed the implementation of MassHealth’s Accountable Care Organizations program for more than 115,000 members. Carver also brings extensive experience with health plans, including leading value-based contracting strategy at Blue Cross Blue Shield of Rhode Island and contract management at Tufts Health Plan. Carver earned her bachelor’s degree in health management and policy from the University of New Hampshire and her master’s degree in health administration from the University of North Carolina at Chapel Hill. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Value-Based Care --- ### [Dental Danger: CareQuest Institute Warns About At-Home Dental Remedies](https://carequest.org/press-release/dental-danger-carequest-institute-warns-about-at-home-dental-remedies/) **Published:** July 12, 2023 **Author:** Jasmin Fernandes **Content:** ## *Lack of Access to Routine Dental Care Leads to Dangerous Home Remedies.* As the use of dangerous at-home health remedies continues to gain traction on social media, [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, is warning people about the dangers of treating oral pain at home. The [new report ](https://www.carequest.org/resource-library/dental-danger-home-remedies-avoid-when-awaiting-care)reveals that more than half (53.8%) of adults in the US do not have consistent access to dental care and may resort to self-prescribed home remedies, which are not always safe. In fact, half of the adults who experienced an oral health problem in the last year used a home remedy to try to alleviate the problem. CareQuest Institute analyzed data from its [State of Oral Health Equity in America survey](https://www.carequest.org/SOHEA2022), revealing insights into home remedies used by consumers. The most common unsafe home remedies included: - tobacco poultice; - pain medication prescribed for another purpose; - illegal narcotics; - a needle to lance a gum abscess; - aspirin powder applied to the gums; and - alcohol/spirits. “We’ve seen an uptick of potentially dangerous at-home dental care trends across social media, and our data support the fact that many people resort to home remedies, often because they cannot access routine care,” said Kelly Schroeder, health scientist and dental hygienist at CareQuest Institute. “Remedies that mask pain are delaying having a larger problem such as an infection being treated properly. It’s critical that people seek care and advice from a trusted dental professional for their oral health issues.” The report reveals additional insights, including: - Those who had not had a dental visit in the last two years were 10% more likely to use dangerous home remedies than those who had a dental visit more recently. - Those who smoke used one or more dangerous home remedies twice as often as those who do not smoke. - Individuals who identify as Black (62.4%) and as two or more race/ethnicities (60.0%) reported that they used a home remedy for oral health symptoms more often than individuals identifying as white (49.5%), Hispanic (45.5%), Asian (42.9%), or “other” (47.6%). When people don’t have a dental home where they receive regular, preventive dental care, [both oral health and overall health can easily deteriorate](https://www.carequest.org/resource-library/beyond-nice-smile). One important part of the solution is to increase dental insurance coverage through employer-sponsored plans as well as by strengthening and [protecting adult dental benefits within Medicaid and Medicare](https://www.carequest.org/topics/adult-dental-benefit). One [recent study](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-increase-access-and-reduce-out-pocket-expenditures) showed that Medicaid, even with its limited dental coverage, significantly improved adults’ access to and utilization of dental services, compared to those who lack medical coverage. It’s important for people to have access to a dental home where safe, effective, and personalized home care guidance is provided to prevent individuals from using unsafe home remedies. Read the full report [here](https://www.carequest.org/resource-library/dental-danger-home-remedies-avoid-when-awaiting-care). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Applauds US House and Senate Bills to Improve Veteran Oral Health](https://carequest.org/press-release/carequest-institute-applauds-us-house-and-senate-bills-to-improve-veteran-oral-health/) **Published:** July 13, 2023 **Author:** Jasmin Fernandes **Content:** ## *Legislation Would Require The Dept. Of Veterans Affairs To Assess Its Oral Health Care Program And Its Ability To Meet The Needs Of Veterans.* Today, [CareQuest Institute for Oral Health®](https://www.carequest.org/) — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — applauds members of the US House and Senate Military Construction and Veterans Affairs Appropriations Subcommittees for including language in their respective versions of the FY24 appropriations bills that would require the US Department of Veterans Affairs (VA) to assess its oral health care program and its ability to adequately meet the needs of current and future veterans. The bills were voted out favorably by the US House Appropriations Committee on June 13 and by the US Senate Appropriations Committee on June 22, 2023. The Senate bill also includes language that would require the VA to assess the feasibility of expanding dental care to all veterans diagnosed with heart disease or diabetes. **CareQuest Institute for Oral Health President and CEO Myechia Minter-Jordan, MD, MBA issued the following statement:** “The inclusion of this language in the House and Senate Appropriations bills recognizes the unfortunate reality that millions of veterans struggle to access basic health care services across our country each day. “Right now, [85% of veterans](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) are not eligible for dental care through the VA and many end up paying out of pocket or do not receive care at all, putting their financial and physical health at risk. We also know that compared to nonveterans, veterans are more likely to experience [worse oral health outcomes](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), including higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care. “After putting their lives on the line to serve our country, access to critical health care services is the last thing that veterans should have to worry about. This proposal will require the assessment of the current VA oral health care program and help us start taking the steps necessary to ensure veterans are getting the care they need and deserve. “We thank the House and Senate Appropriations Committees for their advocacy and look forward to continuing to work with Congress to address this unmet health need faced by our veterans.” Additional research and facts about veterans’ oral health: - The VA reports that only 15% of veterans are eligible to access dental services through the VA health system. - The [majority of the 85% of veterans](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) who are not eligible for dental care through the VA access dental insurance through an employer, through self-pay, or not at all, creating health risks and/or undue financial burden. - Approximately [42% of veterans](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) report having had gum treatment or bone loss around their teeth as compared to 27% of nonveterans. - Roughly two in five, or 8 million veterans, [describe their oral health as fair or poor](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity). - [Nearly 24% of veterans live in rural areas](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), where consistent access to care can be challenging. A [visual report ](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health)from CareQuest Institute and the American Institute of Dental Public Health (AIDPH) shows that improving dental care for veterans reduces costs, improves overall health, and stimulates the economy. The report includes some [heartbreaking firsthand accounts](https://carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health) from veterans who are struggling to access oral health care. CareQuest Institute and AIDPH also released a [white paper](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) focused on solutions supporting veteran oral health. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care --- ### [New Report Spotlights Pediatric Emergency Department Use for Dental Care in Florida](https://carequest.org/press-release/new-report-spotlights-pediatric-emergency-department-use-for-dental-care-in-florida/) **Published:** July 18, 2023 **Author:** Jasmin Fernandes **Content:** ## *Children Seeking Emergency Care for Non-Traumatic Dental Conditions Among the Highest Rates in the Country.* A [new report](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions) by CareQuest Institute for Oral Health®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, spotlights pediatric emergency department use for dental care in Florida. Researchers found that children in Florida aged 14 and younger are seeking dental care through emergency departments for non-traumatic dental conditions at one of the highest rates in the country. Use rates per 10,000 people were higher among Black (48.75) and Hispanic (22.95) children compared to white children (19.6). The most common diagnoses for these children at the time of their emergency department visit were abscesses, dental caries, stomatitis, and chronic gingivitis — conditions that are largely preventable with routine preventive oral health care. “These findings are a stark example of why it is critically important for every child to have regular access to preventive oral health care,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute. “Dental disease is almost entirely preventable, yet cavities are the leading chronic illness among children in this country. And Black and Hispanic children are disproportionately bearing the highest burden of this disease. Dental coverage is necessary, and these results reinforce the need to do more to address the many access barriers facing children.” Millions of people living in the US, including those living in FL, do not have access to routine dental care due to [high costs of care](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families), [lack of dental coverage](https://www.carequest.org/topics/adult-dental-benefit), [cultural and linguistic issues](https://www.carequest.org/topics/health-equity), shortages of dental professionals in rural areas, and the [lack of integration](https://www.carequest.org/topics/medical-dental-integration) between the medical and dental health care systems. People without dental coverage suffering from active dental disease have few viable options to access the care they need, leaving many to seek relief through [hospital emergency departments](https://www.carequest.org/ED-Use). “I have seen patients of all ages who, far too often, visit the emergency department in a lot of pain from really poor dental decay where their nerves were exposed,” said Dr. Brandon Allen, vice chair of clinical operations in the department of emergency medicine at UF Health Shands Hospital in Gainesville. “They didn’t have to come here. It didn’t have to get this far. We need to have robust access to preventive dental care so people can feel that the emergency department is not their only option.” Most emergency departments are not equipped to provide dental treatment, and patients are often treated for symptomatic pain or possible infection without a definitive diagnosis and appropriate treatment for the underlying problem. These visits are costly — to patients, health systems, public and private payors, and taxpayers — and fail to address underlying oral health needs that would be more effectively treated by dental professionals in dental offices, clinics, and community locations. Florida hospitals [billed nearly $550 million](https://www.iamforkids.org/oral-health-equity-and-dental-access/) for treating non-traumatic dental conditions in 2021 alone. Unfortunately, the use of emergency departments for non-traumatic dental conditions is not new. At a time when emergency departments are strained and in high demand, reducing the number of preventable dental visits in these settings is of vital importance. “These current trends show how vitally important access to oral health care is for our families,” explained Dr. Frank Catalanotto, president and founder of Floridians for Dental Access. “We can and must do better for Floridians which is why we have recently teamed up with American Children’s Campaign to form a new statewide coalition to urge Florida leaders to improve oral health equity and dental access in the state.” Addressing Florida’s oral health epidemic will require robust collaboration and cross- sector data sharing to better understand how community members access dental health care. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care, Value-Based Care --- ### [New White Paper Explores the Health Disparities Hispanic Communities Face in the US](https://carequest.org/press-release/new-white-paper-explores-the-health-disparities-hispanic-communities-face-in-the-us/) **Published:** July 31, 2023 **Author:** Jasmin Fernandes **Content:** ## *Authors Offer Recommendations to Address Dental Needs, Utilization of Dental Services, and Workforce in Hispanic Communities.* The [Hispanic Dental Association](https://www.hdassoc.org/) (HDA) and [CareQuest Institute for Oral Health®](https://www.carequest.org/) recently released a [comprehensive white paper](https://www.carequest.org/resource-library/addressing-oral-health-needs-hispanics-us) on oral health disparities in Hispanic communities. “Addressing the Oral Health Needs of Hispanics in the US” identifies several key policies that can improve oral health and reduce inequities among Hispanics in the US, which now represent nearly 19% of the total population. “To effectively address health inequities among Hispanic populations, we need to understand the unique barriers they face in accessing care,” said CareQuest Institute Chief Health Equity Officer and Executive Vice President Kaz Rafia, DDS, MBA, MPH. “It’s also critical that those most impacted by disparities are included in those conversations and solutions. We are grateful to the HDA for their work on this important report that offers actionable insights on how we can work together to improve the health and well-being of Hispanic people across our country.” “It is the first time in American history that we have national research revealing the oral health disparities that Hispanics and other racial/minority groups face,” said President-Elect and Chair of the Research Initiative at the Hispanic Dental Association, Martha Mutis, DDS, MPH, EdD, FICD. “The publication offers valuable recommendations for advocacy at federal, state, and local levels to improve access, quality, and coverage in oral health for minority and underserved populations.” The authors engaged with over 60 experts representing public health, dentistry, and academia to analyze findings from multiple surveys and collaborate on recommendations to benefit Hispanic communities. The white paper traces the history of Hispanics in the US, analyzes the utilization of dental services, evaluates Hispanic representation within the dental workforce, and makes recommendations for policy changes to improve overall health and quality of life for Hispanics. Key findings include: - Hispanic people reported higher percentages of being treated for gum disease than other racial/ethnic groups, especially in the 35–49-year-old age group. - Hispanic children aged 6–11 years had the highest prevalence of decayed and filled teeth compared to other children in that age group. - The prevalence of losing at least one permanent tooth was higher for Hispanic adults compared to white, non-Hispanic adults. - Approximately 15% of Hispanic adults aged 65 or over had no teeth. - Hispanic people were more likely to report the status of their teeth and gums as “fair” or “poor” compared to non-Hispanic individuals in most age groups. - Hispanic dentists represent 6% of the total national dentists’ workforce, 10.7% of dental hygienists, 30.4% of dental assistants, and 19.8% of dental laboratory technicians. Policy recommendations from the white paper include: - Improve the collection and disaggregation of data to better understand disparities, especially among Hispanic subgroups. - Provide more oral health education, especially for parents and children. - Increase community-friendly access to dental care opportunities, such as mobile and school-based dental services, in communities with high proportions of undocumented persons. - Build more career pathway programs for minority students going into dental careers and more cultural competency training for dentists. Read the [full white paper](https://www.carequest.org/resource-library/addressing-oral-health-needs-hispanics-us). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Special Patient Care --- ### [CareQuest Institute Requests Grant Proposals Focused on Disability Inclusion and Justice in Oral Health](https://carequest.org/press-release/carequest-institute-requests-grant-proposals-focused-on-disability-inclusion-and-justice-in-oral-health/) **Published:** August 3, 2023 **Author:** Jasmin Fernandes **Content:** ## *Seeking Innovative Submissions That Promote Access To Dental Care For People With Disabilities.* CareQuest Institute for Oral Health®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has launched a request for proposals (RFP) to fund projects and partner with organizations that are working to address systemic barriers to oral health for people with disabilities. Proposals can be submitted now through August 31. CareQuest Institute will select proposals that reflect the applicant’s authentic commitment to meaningfully and consistently engage members of the disability community throughout their proposed project. They will fund 10 projects at $125,000 each through the Disability Inclusion and Justice in Oral Health RFP. “We know systemic barriers to oral health care exist for many marginalized populations, including those with disabilities. That’s why it is important for us to collaborate as oral health providers, advocates, researchers, and community members to find effective ways to eliminate those barriers,” said Trenae Simpson, director of grants and programs at CareQuest Institute. “This RFP is an opportunity to work together to create a health care system that works for all of us. We’re excited to see what innovative approaches we receive to increase access – in its broadest definition – for people with disabilities. This includes addressing issues of provider availability, the delivery of evidence-based care, and amplifying the voices of the community, enabling us all to come together as we work towards a more just oral health system.” CareQuest Institute’s philanthropic approach is centered on the belief that oral health care solutions are not as effective without the individuals and communities that have been most negatively impacted by oral health disparities driving their design, development, and implementation. This RFP is an opportunity to support new partners to reshape, disrupt, and transform the oral health system. Examples of projects that fall within the Disability Inclusion and Justice in Oral Health Care RFP include, but are not limited to: - A national organization developing a disability-focused oral health policy agenda in collaboration with disability advocates - A state-based organization hosting community listening sessions and advocacy trainings to strengthen the capacity of community members to advocate for expanding access to Medicaid oral health services - A clinical organization piloting innovative clinical, workforce, and workflow solutions to inform and/or validate creative payment models that support oral health care for people with disabilities Specific details related to eligibility, proposal requirements, and evaluation criteria can be found on our [Disability Inclusion and Justice in Oral Health Request for Proposals page.](https://www.carequest.org/content/disability-inclusion-and-justice-oral-health-rfp) **Categories:** Press Release **Tags:** Health Equity, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [New Report: 68.5 Million Adults in the US Don’t Have Dental Insurance, May Rise to 91.4 Million by End of Year](https://carequest.org/press-release/new-report-68-5-million-adults-in-the-us-dont-have-dental-insurance-may-rise-to-91-4-million-by-end-of-year/) **Published:** September 6, 2023 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute Releases New Data on Inequities in Oral Health Care.* An estimated 68.5 million adults in the United States do not have dental insurance, according to [new data](https://www.carequest.org/resource-library/uninsured-and-need) released today by [CareQuest Institute for Oral Health®](https://www.carequest.org/). This data, which comes from the third annual State of Oral Health Equity in America (SOHEA) survey, also reveals that the number of adults without dental coverage could rise significantly by the end of 2023 due to additional household members losing coverage and the [Medicaid redetermination](https://carequest.org/policy-advocacy/medicaid/) process. In addition to the estimated 68.5 million adults without dental insurance, an additional 8.9 million household members may have lost dental insurance in the last year due to loss of coverage in a household, as many family and household members receive dental coverage through a single member of the household. Furthermore, there are an estimated 14 million adults in the US who stand to lose their Medicaid dental insurance coverage with the public health emergency expiration. This results in as many as 91.4 million individuals without dental insurance by the end of this calendar year. “With the millions of uninsured adults across the country, we are facing a nationwide oral health crisis that forces many people to forgo critical dental care and disproportionately affects low-income individuals and racial and ethnic minorities,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “To help combat this, we are calling on health care professionals, administrators, policymakers, and advocates to join us in our efforts to increase broad dental coverage in both Medicaid and Medicare.” CareQuest Institute supports enhancements to government programs like Medicaid and Medicare by including extensive dental benefits for all enrollees. Currently, state [Medicaid programs are not required to provide dental coverage](https://www.valuepenguin.com/medicaid-dental-coverage) to adults. This results in varied coverage state-to-state — from extensive benefits essential to maintaining optimal health to very limited or emergency-only benefits. Similarly, the Medicare program does not provide [comprehensive dental benefits to all eligible older adults and people living with disabilities](https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/). While the data show a 3% increase in the proportion of adults with dental insurance from 2021 to 2023, the increase is likely related to an increase in Medicare Advantage plan enrollment during the same period. Medicare Advantage plans offer some dental benefits as a way to attract enrollees who have a choice of plans. However, dental benefits offered through Medicare Advantage plans [vary widely and are quite limited](https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/), often resulting in high out-of-pocket costs for individuals with severe dental needs. The 2023 survey results show the oral health challenges faced by many throughout the country, including: - The portion of the population without dental insurance (27%) is almost 3x as high as those without health insurance (9.3%). - Adults living in rural areas (34%) were more likely to lack dental insurance compared to adults living in suburban (24%) or urban (29%) areas. - Hispanic individuals were two times more likely to have lost dental insurance in the last year compared with white non-Hispanic individuals. - Approximately one-third of both Medicare and Medicaid participants do not have dental coverage. - Adults with lower incomes were significantly more likely than those with higher incomes to report cost as a barrier to seeing a dentist in the last two years. CareQuest Institute’s State of Oral Health Equity in America (SOHEA) survey is the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. The survey was administered in January and February 2023, with a final sample size of 5,240 adults (18+) by the National Opinion Research Center (NORC) at the University of Chicago as part of the AmeriSpeak panel. The findings are included in a [new report](https://www.carequest.org/resource-library/uninsured-and-need), “Uninsured and in Need: 68.5 Million Lack Dental Insurance, More May Be Coming,” one of several publications CareQuest Institute will release based on the SOHEA survey results. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Value-Based Care --- ### [New Report: Discrimination and Socioeconomic Factors Contribute to Persistent Oral Health Disparities in US](https://carequest.org/press-release/new-report-discrimination-and-socioeconomic-factors-contribute-to-persistent-oral-health-disparities-in-us/) **Published:** September 26, 2023 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute Survey Reveals Income, Race, and Ethnicity Directly Tied to Dental Access.* [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, released [new data](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system) showing that discrimination and socioeconomic factors are leading contributors to persistent oral health disparities in the US. The survey revealed that among adults who reported encountering discrimination across various factors and social contexts in their lifetime, 37% had not undergone a routine dental visit in the last 12 months, in contrast to the 31% who had not faced discrimination. Furthermore, the experience of discrimination in oral health care showed a significant correlation with economic variables. For instance, individuals lacking dental insurance were almost twice as likely to report discrimination in oral health care (11%) compared to those with dental insurance (6%). “The findings from this year’s survey underscore the troubling health disparities based on race, ethnicity, and economic status that continue to plague our health care system,” said Kaz Rafia, DDS, MBA, chief health equity officer and executive vice president of CareQuest Institute for Oral Health. “Every person should be able to achieve optimal health regardless of their background, and we will continue our work with policymakers, legislators, and advocates to ensure that dental care becomes more accessible for all.” Findings in the report, based on a nationally representative survey of more than 5,000 adults, point to the significant gaps in health care access and affordability for Hispanic, Black, and Asian adults. According to the survey, individuals in minoritized communities reported worse oral health and irregular access to adequate dental care, despite reporting similar and, in some cases, better rates of oral hygiene habits such as brushing and cleaning between their teeth. Adults identifying their race/ethnicity as “other” were also more likely to report experiencing discrimination in the oral health care setting. Key findings, summarized in the [“Cost, Race, and the Persistent Challenges in Our Oral Health System”](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system) report include: - More than half of Black adults (52%) reported having lost one or more permanent teeth due to decay or gum disease, compared with 43% of all adults. - Adults earning $100,000 or more a year were much more likely to rate their oral health as excellent, very good, or good (87%), compared with 60% of those making less than $30,000 per year. - Homeownership was linked to higher rates of having a dental home, better self-rated oral health, and more regular dental visits, compared with renting or occupying a home without payment. - Among adults with a disability, 14% said they had experienced discrimination in the dental setting, and 27% said they had been denied oral health care due to discrimination. These findings emphasize the need to continue working toward an oral health care system that includes enhanced dental coverage for all, including those enrolled in public programs like Medicare and Medicaid. The State of Oral Health Equity in America survey created by CareQuest Institute is a nationally representative survey of 5,240 adults to study knowledge, attitudes, experiences, and behaviors related to oral health. It is the largest survey of its kind in the industry. Read the [full report](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Special Patient Care --- ### [CareQuest Institute Lauds President’s Commitment to Improve Health for Veterans](https://carequest.org/press-release/carequest-institute-lauds-presidents-commitment-to-improve-health-for-veterans/) **Published:** November 28, 2023 **Author:** Jasmin Fernandes **Content:** ## *National Nonprofit Urges Administration to Similarly Address Oral Health Access and Care.* Following President Biden’s [announcement](https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2024/11/11/fact-sheet-to-mark-veterans-day-biden-harris-administration-highlights-historic-care-benefits-new-actions-to-support-veterans-and-their-families-2/) of new actions to lower health care costs for veterans, [CareQuest Institute for Oral Health](https://www.carequest.org/)®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, encouraged President Biden to continue to improve access and care for our nation’s veterans — especially as it pertains to oral health. CareQuest Institute CEO and President Myechia Minter-Jordan, MD, MBA, issued the following statement: “We applaud President Biden in his efforts to lower costs and expand health care eligibility for veterans. This change will result in improved health outcomes for many of our nation’s veterans, but there’s still a lot of room to improve oral health care for roughly 19 million veterans living in the US. “We know that oral health is inextricably linked to individual well-being, community health, and economic security. According to our research, roughly one-quarter of veterans surveyed said they had no dental coverage at all, so these veterans are left fronting the cost entirely out-of-pocket. This needs to change. “To improve access and quality of care, we need to expand eligibility criteria for veterans to receive oral health services, expand the role of federally qualified health centers and rural health clinics, and advance medical-dental integration in overall veteran health care. Like President Biden, we believe that access to health care is a right not a privilege. We look forward to continuing our work with the Administration and other policymakers to expand upon these important improvements in veterans’ health care access.” **CareQuest Institute and the American Institute of Dental Public Health (AIDPH)** [**research**](https://carequest.org/veteran-dental-care-stimulates-the-economy-and-improves-overall-health/) **highlights disparities in veterans’ oral health.** A new [visual report](https://carequest.org/veteran-dental-care-stimulates-the-economy-and-improves-overall-health/) shows that improving dental care for veterans reduces costs, improves overall health, and stimulates the economy. The report includes [firsthand accounts](https://carequest.org/veteran-dental-care-stimulates-the-economy-and-improves-overall-health/) from veterans who are struggling to access oral health care. In 2021, CareQuest Institute and AIDPH also released a [white paper](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) focused on solutions supporting veterans’ oral health. - The VA reports that 15% of veterans are eligible to access dental services through the VA health system. - The [majority of the 85% of veterans](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) who are not eligible for dental care through the VA access dental insurance through an employer, through self-pay, or not at all, creating health risks and/or undue financial burden. - Approximately [42% of veterans](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) report having had gum treatment or bone loss around their teeth as compared to 27% of nonveterans. - Roughly two in five, or 8 million veterans, [describe their oral health as fair or poor](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity). - [Nearly 24% of veterans live in rural areas](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), where consistent access to care can be challenging. - Poor oral health has a [direct link](https://www.carequest.org/about/blog-post/how-oral-health-affects-overall-health-and-how-improve-both#:~:text=Evidence%20increasingly%20shows%20the%20strong,also%20treat%20their%20dental%20problems.) to higher risks of chronic illnesses, including heart disease, diabetes, dementia, hypertension, asthma, and more. It can also lead to [greater instances of depression](https://www.carequest.org/about/blog-post/three-resources-explore-connection-between-oral-health-and-mental-health) and other mental health diseases. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care, Value-Based Care --- ### [New Report: Rural Populations Have Worse Oral Health Care Access, Utilization, and Outcomes Compared to Urban Areas](https://carequest.org/press-release/new-report-rural-populations-have-worse-oral-health-care-access-utilization-and-outcomes-compared-to-urban-areas/) **Published:** January 17, 2024 **Author:** Jasmin Fernandes **Content:** ## *4 in 10 Adults Living in Rural Environments Have Not Visited the Dentist in More Than a Year.* [CareQuest Institute for Oral Health®](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, released a [new report](https://carequest.org/still-searching-meeting-oral-health-needs-in-rural-settings/) detailing the causes of worsening oral health access and outcomes for rural populations in comparison with their urban and suburban counterparts. The report reveals that four in 10 adults living in rural environments (40%) have not visited the dentist in more than one year, compared with 35% of urban and 30% of suburban residents. Among the most significant challenges preventing people living in rural areas from receiving adequate oral health care are provider shortages, lack of insurance coverage, and transportation barriers. “This new report underscores the importance of our mission to advance oral health access and equity for all people living and working in the US,” stated Kaz Rafia, Chief Health Equity Officer and Executive Vice President at CareQuest Institute for Oral Health. “Oral health is more than just a health issue, it’s an equity issue impacting people of all backgrounds, economic statuses, and geographic locations. We must continue to collect data, share our findings, and advance policies and practices that guide these populations to adequate care and better health.” Other key findings summarized in the [“Still Searching: Meeting Oral Health Needs in Rural Settings” report](https://carequest.org/still-searching-meeting-oral-health-needs-in-rural-settings/) include: - 34% of individuals living in a rural environment rate their oral health as fair or poor, compared with 27% of urban residents and 24% of suburban residents. - 67% of rural areas are Dental Health Professional Shortage Areas. - Just over one-third of rural residents (34%) do not have dental insurance coverage, compared to 29% of urban and 24% of suburban residents. Employers in rural areas are less likely to offer dental insurance than employers in more populated areas. In response to these challenges, the report recommends ways to mitigate barriers to access for approximately 46 million people who reside in rural areas. These strategies include teledentistry, expanding dental coverage and the dental workforce, and medical-dental integration. The findings of this report are based on responses to the [2023 State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2023), the largest nationally representative, annual survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. Read the [full report](https://carequest.org/still-searching-meeting-oral-health-needs-in-rural-settings/). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care, Value-Based Care --- ### [US Adults Miss 243 Million Hours of Work or School Annually Due to Oral Health Problems](https://carequest.org/press-release/us-adults-miss-243-million-hours-of-work-or-school-annually-due-to-oral-health-problems/) **Published:** February 26, 2024 **Author:** Jasmin Fernandes **Content:** ## *New CareQuest Institute for Oral Health Report Highlights Impact of Untreated Dental Disease and the Cost of Lost Productivity.* [CareQuest Institute for Oral Health®](https://www.carequest.org/) has released a new report that shows that adults 18 and older in the US lose more than 243 million work or school hours annually due to oral health problems. The lost productivity time due to untreated dental disease costs the US an [estimated $45 billion each year.](https://repository.ubn.ru.nl/bitstream/handle/2066/250096/250096.pdf?sequence=1#page=30) The visual report, [The Hour of Need: Productivity Time Lost Due to Urgent Oral Health Needs](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs), reveals that oral health problems and unplanned dental visits have a greater impact on daily activities such as work and school for individuals with [lower incomes, no dental insurance, and less education](https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.82.12.1663). “No one should have to sacrifice their schedule or pay because of preventable health issues” said **Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute**. “This new report underscores the urgency of promoting equitable access to oral and overall health care, particularly for those with lower incomes and education levels.” The report also finds that dental issues don’t just impact the person experiencing them; caregivers’ and parents’ lives are also impacted by unexpected dental visits and tending to oral pain. In fact, approximately 5.7 million parents/guardians missed an estimated total of 38.5 million productive hours due to their children’s oral pain or unplanned dental visit. Additionally, caregivers reported missing an estimated total of 22 million hours of productivity time as a result of either taking those for whom they care to an unplanned dental visit or staying home with them due to their oral pain. **Key findings, summarized in the visual report include:** - Lost productivity time due to untreated dental disease costs the US an estimated $45 billion each year. - Adults reported missing productivity time for their own oral pain or unplanned dental visits (182.6 million hours) and the oral pain or dental visits of children (38.5 million hours) or adults (22 million hours) in their care. - Nine million adults lost more than 60 million total work/school hours due to others’ oral health problems. - Approximately 5.7 million parents/guardians missed an estimated total of 38.5 million productive hours due to their children’s oral pain or unplanned dental visit. - Approximately 3.3 million adults said that, in the past year, the adult for whom they care had oral pain or an unexpected dental visit. The report is based on findings from CareQuest Institute’s [State of Oral Health Equity in America (SOHEA)](https://carequest.org/state-oral-health-equity-america-page/), an annual, nationally representative survey of 5,240 adults about knowledge, attitudes, experiences, and behaviors related to oral health. [Read the full report.](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs) **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Value-Based Care --- ### [CareQuest Institute Awards $1.25 Million in Grant Funding for Projects Focused on Disability Inclusion and Justice in Oral Health](https://carequest.org/press-release/carequest-institute-awards-1-25-million-in-grant-funding-for-projects-focused-on-disability-inclusion-and-justice-in-oral-health/) **Published:** February 28, 2024 **Author:** Jasmin Fernandes **Content:** ## *Organizations From Across the Country Will Work to Address Barriers to Oral Health Care for Those With Disabilities.* [CareQuest Institute for Oral Health](https://www.carequest.org/) awarded $1.25 million in funding to 10 organizations selected for their Disability Inclusion and Justice in Oral Health Request for Proposals (RFP). Each organization received $125,000 to fulfill work to address systemic barriers to oral health — including access to oral health — for people with disabilities. “As we work to build true systemic change, we have to listen and learn from those who have been negatively impacted by the current oral health system, with a specific focus on historically marginalized and under-resourced communities,” said **Trenae Simpson, director of Grants and Programs at CareQuest Institute**. “These insights shape our philanthropic strategy and our intentional investments in community-driven projects that amplify these voices and solutions. The organizations that CareQuest Institute has selected for this funding are working in their communities, clinical practices, and academia to address and correct years of institutional discrimination and access barriers for those with disabilities—we are proud to support this work.” CareQuest Institute provided grants to the following organizations: - **American Academy of Pediatric Dentistry (AAPD) Foundation** aims to improve the dental delivery system to better serve people with disabilities as they transition from childhood to adulthood. - **Alameda Health System Foundation** plans to develop a dedicated Augmentative and Alternative Communication (AAC) mobile application that draws on the input from patients with Intellectual and Developmental Disabilities, their family members/caregivers, and dental professionals who care for this patient community, specifically through focus group interviews and beta testing among this community. - **New Mexico Dental Association Foundation** plans to collaborate with the University of New Mexico Department of Dental Medicine and the New Mexico Dental Association to develop a comprehensive statewide report with recommendations aimed at addressing the oral health needs of individuals with disabilities. - **The American Institute of Dental Public Health** will partner with Coalition of Texans with Disabilities to create a 5-part toolkit for advocates to expand access to care for people with disabilities in Medicaid, deliver a series of trainings and workshops for advocates around these legislative levers, and create a policy and bill bank for advocates to reference. - **The Arc of the United States** plans to launch the Dental for All project to promote outreach in communities to address disparities in dental outcomes for people with disabilities. - **UCLA School of Dentistry** plans to expand clinic operations to focus on developing a more inclusive patient-centered dental home for people with disabilities. - **University of Cincinnati Foundation** will pilot a dental program through the Timothy Freeman, MD, Center for Intellectual and Developmental Disabilities at University of Cincinnati (UC) Health. A Disability Dental Focus Group will be formed to inform the creation of the dental program and provide feedback. - **University of Colorado Denver (UCD)** will advocate for administrative policy in reimbursement for care for people with disabilities, maintain a coalition of disability partners to maintain the work, provide training for dental students, and advocate for state government funding to develop a new center at UCD for people with disabilities, and implement a patient Navigator. - **University of Florida Foundation** will create a mobile program to provide dental services for people with disabilities. The program will include pre-visit telehealth screens, a psychologist as part of the team, and minimally invasive care when appropriate. - **University of Pennsylvania School of Dental Medicine** proposes to build a network (Community Advocates for Resource Enhancements) and a coalition in Philadelphia of organizations and individuals committed to improving the oral health of people with disabilities. The coalition will complete an assessment, identify and pilot solutions, create resources for families and caregivers of people with disabilities and provide ongoing input for the clinical program. CareQuest Institute prioritized proposals that reflect the applicant’s authentic commitment to meaningfully and consistently engage members of the disability community throughout their proposed project. This definition of engagement goes beyond treatment to nurture environments ripe for community empowerment and justice. Additional details can be found on CareQuest Institute’s [Disability Inclusion and Justice in Oral Health Request for Proposals page](https://www.carequest.org/content/disability-inclusion-and-justice-oral-health-rfp). **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Requests Grant Proposals Addressing Oral Health Disparities](https://carequest.org/press-release/carequest-institute-requests-grant-proposals-addressing-oral-health-disparities/) **Published:** March 13, 2024 **Author:** Jasmin Fernandes **Content:** ## *Proposals Now Open for Veterans and School-Related Initiatives to Improve Oral Health Access and Outcomes.* [CareQuest Institute for Oral Health](https://www.carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, has launched two grant opportunities aimed at addressing systemic barriers to oral health access. The Requests for Proposals (RFPs) include: (1) School-Based and School-Linked Initiatives to Improve Oral Health Grant as well as (2) Veterans Oral Health Access and Equity Grant. Proposals are now open and are due by May 1, 2024. Ten projects, funded up to $125,000, will be selected for each RFP. “In our pursuit of a more accessible and equitable oral health system, CareQuest Institute invites proposals aimed at breaking down barriers for our nation’s veterans and strengthening our school-based oral health programs,” said **Trenae Simpson, director of Grants and Programs at CareQuest Institute**. “Through these initiatives, we hope to authentically engage and amplify community voices, encourage innovation, and improve health outcomes for those who have often been unheard and left behind in our health and oral health care system.” **School-Based and School-Linked Initiatives to Improve Oral Health Grant** In alignment with its mission to enhance oral health outcomes, CareQuest Institute is inviting proposals for initiatives focused on school-based and school-linked interventions. Schools can become the center for multiple opportunities to improve the oral health and overall health of the students, increasing their chances to stay in school and succeed in life. School-based and school-linked oral health programs have potential to improve health for children, reducing racial, ethnic, and economic disparities. Relevant responses to the RFPs should reflect the applicant’s commitment to meaningfully and consistently engage members of the community throughout their proposed project. This definition of engagement goes beyond clinical treatment to nurture environments ripe for community empowerment and justice. Examples include, but are not limited to: - **Workforce Considerations**: Exploring effective student-facing roles (e.g., school nurses) and strategies individuals in these roles use to support the expansion of oral health prevention, messaging, and access to care for students. - **Community Engagement:** Advocacy by community members to support policy to implement or expand school-based or school-linked oral health programs. - **Policy Solutions to Improve Oral Health:** Local education agency, state, or national policies to support school-based or school-linked oral health programs. - **Expansion of the Capacity of Federally Qualified Health Centers (FQHCs).** School-based oral health programs may either be operated by or partner with FQHCs to refer students and their family members, so that everyone eventually secures a dental home. - **School-Based Technology and Tools**: Teledentistry can enable children to receive diagnostic, preventive, and early intervention dental care at their school. - **Alternative Payment Models:** A clinical organization piloting innovative clinical, workforce, and workflow solutions to inform and/or validate creative payment models that support school-based or school-linked oral health. **Veterans Oral Health Access and Equity Grant** Recognizing the unique oral health challenges facing veterans, CareQuest Institute is also requesting proposals aimed at improving access and care for the 17 million veterans in the United States. Veterans are [disproportionately affected by tooth decay and periodontal issues](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being#:~:text=Veterans%20with%20urgent%20dental%20needs,chronic%20conditions%2C%20including%20heart%20disease.), making this grant opportunity critical in advancing oral health equity among this population. Examples include, but are not limited to: - A national organization developing a veteran-focused oral health policy agenda in collaboration with veteran self-advocates and veteran-focused partners. - A state-based organization hosting community listening sessions and advocacy trainings to strengthen the capacity for oral health advocacy toward expanding access to care. - A clinical organization piloting innovative clinical, workforce, and workflow solutions to inform and/or validate creative payment models that support oral health care for veterans. - A community-driven approach where project design and decision-making is led by the veteran community. CareQuest Institute’s philanthropic approach is centered on the belief that oral health care solutions are more effective when individuals and communities that have been most negatively impacted by oral health disparities are driving their design, development, and implementation. Both grant opportunities underscore CareQuest Institute’s commitment to fostering collaboration to address oral health disparities and promote health equity across diverse communities. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [New Report Shows How Dental Disparities Impact Veterans’ Productivity and Well-Being](https://carequest.org/press-release/new-report-shows-how-dental-disparities-impact-veterans-productivity-and-well-being/) **Published:** March 19, 2024 **Author:** Jasmin Fernandes **Content:** ## *Report Highlights Barriers Veterans Face Accessing Dental Care, Including 85% Who Are Ineligible for Dental Coverage or Care.* Veterans across the US face significant challenges in accessing dental care, which influences their overall well-being and productivity, according to a [new report](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being) by CareQuest Institute for Oral Health and the American Institute of Dental Public Health (AIDPH). The report finds that lack of access to dental care leads to significant losses in productivity time and money for veterans and their employers. Veterans are a strong presence in the workforce, with many federal and state programs financially incentivizing employers to hire veterans. But many of those veterans are disproportionately impacted by dental disease. Veterans are 60% more likely to experience tooth decay compared to nonveterans, and 42% report having gum disease. Out of the 9 million veterans who are eligible for medical care through the US Department of Veterans Affairs (VA), 85% are not eligible for dental coverage or care. In fact, veterans pay 65% more in out-of-pocket dental costs on average compared to nonveterans. “We must and can do better to ensure that our veterans have access to high-quality comprehensive health care, including dental services,” said **Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute**. “The solutions exist, and now is the time to enact needed policy change to ensure our nation’s veterans, who have made incredible sacrifices for our country, are able to live healthy, productive lives when they return home.” “The continued lack of access to dental care experienced by veterans compounds negative health care outcomes, extending beyond just health and oral health into daily work lives,” said **Annaliese Cothron, DHSc, MS, CPH, co-founder and executive director of AIDPH**. “When veterans are in dental pain or experience social anxiety from unmet dental needs, their workplaces can suffer from low productivity. Veterans are the backbone of our national workforce and deserve solutions that keep them healthy and economically thriving.” The report, which analyzes data from the National Health and Nutrition Examination Survey (NHANES) and the Medical Expenditure Panel Survey (MEPS), highlights the profound impact of untreated dental disease on veterans’ quality of life and productivity in the workplace. Key findings include: - Veterans with urgent dental needs were approximately five times more likely to report poor functioning and work compared to veterans who needed routine dental care. - Poor oral health is linked to several chronic conditions, including heart disease. Among veterans with heart disease, the annual cost of missed workdays was four times higher for those who did not have a dental visit in the past year. - Nearly 3 million veterans felt self-conscious or embarrassed because of their teeth, mouth, or dentures, which “has profound effects on socialization and feelings of loneliness.” - Dental-related issues contribute to over $45 billion in lost work productivity annually among US adults. - Veterans who reported experiencing oral pain at least occasionally within the past year were 13.5 times more likely to have oral health-related productivity loss compared to veterans who reported never experiencing oral pain. The report underscores the urgent need for more integrated health care solutions that prioritize cost-effective dental care for our nation’s veterans. Recommendations outlined in the report include strengthening the Community Care Network, ensuring that veterans who are eligible for dental care through the VA utilize the benefit, supporting Federally Qualified Health Centers, and implementing policy solutions on the local and state level to improve access and quality of care for veterans. The most effective policy solution to decreasing costs and improving oral health is expanding dental eligibility criteria for veterans who are already receiving medical care and chronic disease management through the VA. Read the [full report](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care, Value-Based Care --- ### [12 Million People Lost Dental Coverage after COVID-19 Public Health Emergency](https://carequest.org/press-release/12-million-people-lost-dental-coverage-after-covid-19-public-health-emergency/) **Published:** April 3, 2024 **Author:** Jasmin Fernandes **Content:** ## *New Analysis Reveals Impact of Medicaid Redetermination Process on Access to Dental Health Care and Oral Health Equity.* A [new analysis](https://www.carequest.org/resource-library/estimated-12-million-children-and-adults-lost-medicaid-dental-insurance-after) from CareQuest Institute for Oral Health® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — reveals that 12 million people across the country lost Medicaid dental coverage between April 2023, when the COVID-19 public health emergency (PHE) expired, and September 2023. That figure includes 5.9 million adults and 6.1 million children. The analysis estimates the number will jump to 13.9 million when data is received through December 31, 2023. When the national COVID-19 PHE expired, states began conducting eligibility redeterminations and un-enrolling individuals determined to no longer be eligible for their state’s Medicaid program. The new report, [An Estimated 12 Million Children and Adults Lost Medicaid Dental Insurance after the COVID-19 Public Health Emergency Expired](https://www.carequest.org/resource-library/estimated-12-million-children-and-adults-lost-medicaid-dental-insurance-after), by CareQuest Institute projects that nearly 10 million of these adults and children were not re-enrolled in dental benefits through the private marketplace or their employer and remained without dental insurance after redetermination. “These data confirm that we have a long way to go to ensure that everyone has access to necessary oral health coverage, especially those most marginalized by our current system,” said CareQuest Institute for Oral Health CEO and President Myechia Minter-Jordan, MD, MBA. “While coverage alone does not address long-standing oral health and overall health disparities, it is an essential bridge to care that remains out of reach for far too many people.” Poor [oral health](https://www.carequest.org/resource-library/impacts-beyond-mouth) has a direct link to a person’s overall health — including greater risk of diabetes, high blood pressure, obesity, dementia, mental health, and adverse birth outcomes. Regular preventive dental care significantly saves overall medical and dental care costs. For example, [one recent study](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs) found that adults with diabetes who were treated for periodontal disease saw their overall health care costs decrease by 12 to 14 percent. In addition, as states grapple with the high costs of emergency department visits, access to preventive [dental care has been shown to reduce emergency department visits](https://id.elsevier.com/as/authorization.oauth2?platSite=SD%2Fscience&scope=openid%20email%20profile%20els_auth_info%20els_idp_info%20els_idp_analytics_attrs%20els_sa_discover%20urn%3Acom%3Aelsevier%3Aidp%3Apolicy%3Aproduct%3Aindv_identity&response_type=code&redirect_uri=https%3A%2F%2Fwww.sciencedirect.com%2Fuser%2Fidentity%2Flanding&authType=SINGLE_SIGN_IN&prompt=login&client_id=SDFE-v4&state=retryCounter%3D0%26csrfToken%3D79343e3f-17ed-42f6-aecc-713b93fc989c%26idpPolicy%3Durn%253Acom%253Aelsevier%253Aidp%253Apolicy%253Aproduct%253Aindv_identity%26returnUrl%3D%252Fscience%252Farticle%252Fabs%252Fpii%252FS0735675721001066%253Fvia%25253Dihub%26prompt%3Dlogin%26cid%3Datp-95642e9d-5fff-44ec-acc7-a5ca810aca3e&els_policy=idp_policy_indv_identity_plus) for oral health problems that are better treated in a dental office. As community and state organizations support impacted Medicaid enrollees during the redetermination process, there needs to be a focus on the importance of oral health and helping people find new coverage options that include dental benefits. In particular, it is critical for states to act on the new [finalized CMS rule](https://www.hhs.gov/about/news/2024/04/02/hhs-finalizes-policies-make-marketplace-coverage-more-accessible-expand-essential-health-benefits.html) that will allow them to add adult dental benefits to the essential health benefits covered by their private market plans. This analysis supports a [previous report](https://www.carequest.org/about/press-release/new-carequest-institute-analysis-more-14-million-people-may-lose-dental) in April 2023 that projected more than 14 million people would lose dental coverage during redetermination. Read the [full report](https://www.carequest.org/resource-library/estimated-12-million-children-and-adults-lost-medicaid-dental-insurance-after). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Value-Based Care --- ### [CareQuest Institute CEO Testifies at Senate Committee Hearing on Dental Care Crisis in US](https://carequest.org/press-release/carequest-institute-ceo-testifies-at-senate-committee-hearing-on-dental-care-crisis-in-us/) **Published:** May 16, 2024 **Author:** Jasmin Fernandes **Content:** ## *Myechia Minter-Jordan, MD, MBA, Addressed the US Senate Committee on Health, Education, Labor, and Pensions.* Today, Myechia Minter-Jordan, MD, MBA, president and CEO of [CareQuest Institute for Oral Health®](http://carequest.org/) — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — testified before the Senate HELP Committee about dental care affordability and accessibility. The Senate HELP Committee, led by Chairman Senator Bernie Sanders (I-Vt.) and Ranking Member Senator Bill Cassidy, MD (R-LA), convened a full hearing on the dental care crisis in America and how to make dental care more affordable and available to all. “Our data show that nearly 70 million adults and nearly 8 million children in the United States do not have dental insurance,” said Minter-Jordan. “Unfortunately, dental coverage gaps have exacerbated a nationwide oral health crisis that forces many people to forgo critical dental care. “We are grateful to Chairman Sanders, Ranking Member Cassidy, and all the committee members for holding this hearing on a critical issue that has been overlooked for far too long. While the situation is dire, policymakers are talking about these issues more than ever and taking steps toward change, and the momentum is encouraging,” she added. “It’s up to all of us to create a more accessible, equitable, and integrated health care system that includes oral health.” “In America today we have a dental crisis that we have got to address,” said Senator Sanders. “Dental care in America is way too expensive. We don’t have enough dentists, dental hygienists, or dental therapists. Far too many Americans, especially in rural areas, do not have access to a dentist, which forces them to either travel long distances or go without the care they need. Very few dentists accept Medicaid preventing the most vulnerable people in America from getting the dental procedures they need. And there is a major lack of transparency in the prices dentists charge. The results have been tragic: One out of five seniors in our country are missing all of their natural teeth. Over 40% of children in America have tooth decay by the time they reach kindergarten. And about half of Americans with dental insurance skip getting the dental care they need because they cannot afford it. That is unacceptable and has got to change.” “People don’t experience health issues in isolation. A person with a cavity could have substance use disorder or heart disease, yet need to schedule multiple appointments with multiple providers. When we fail to provide people holistic health care – including primary, visual and dental – in an accessible way, community health can decay. Strengthening the enamel of our health care system requires that we support and invest in integrated care. I am proud that Dr. Myechia Minter-Jordan is a leader in the fight for health justice from Massachusetts to Capitol Hill,” said Senator Edward J. Markey (D-Mass.). The hearing is in response to the millions of people across the country who cannot access the oral health care they need — most often because they cannot afford it. In fact, [dental care](https://www.federalreserve.gov/publications/files/2022-report-economic-well-being-us-households-202305.pdf) is the number one medical service skipped due to cost, even more than prescription drugs. Nearly 70 million adults and nearly [8 million children](https://www.nidcr.nih.gov/sites/default/files/2021-12/Oral-Health-in-America-Advances-and-Challenges.pdf#page=159) in the United States do not have dental insurance. Oral health [has significant impacts ](https://www.carequest.org/resource-library/impacts-beyond-mouth)on overall health and well-being. Hypertension, diabetes, heart disease, dementia, and adverse birth outcomes are all correlated with oral health. Dental disease [can also threaten](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs) family financial stability; it can keep children home from school and adults from being able to work. Findings from CareQuest Institute’s annual [State of Oral Health Equity](https://www.carequest.org/content/state-oral-health-equity-america-2023) survey — the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health — and other sources show that the dental care crisis is widespread. It disproportionately impacts low-income individuals, older adults, people living with disabilities, people in rural communities, and racial and ethnic minorities. For example: - When people from lower-income families can access dental care, they pay over [seven times](https://www.carequest.org/resource-library/lower-income-families-still-spend-more-dental-care) more out-of-pocket for their dental care than higher-income families. - [One in five](https://pubmed.ncbi.nlm.nih.gov/25973996/) adults aged 65 years or older have untreated tooth decay and about [2 in 3](https://pubmed.ncbi.nlm.nih.gov/25688694/) (68%) have gum disease. - [Four in 10](https://www.carequest.org/resource-library/still-searching-meeting-oral-health-needs-rural-settings) adults in rural areas have not seen a dentist for over a year, which is about 10% higher than in urban and suburban areas. - The prevalence of early childhood tooth decay in American Indian and Alaska Native communities is [three times higher](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral) than it is for white children. - Black and Hispanic adults report that they have never been to a dentist at more than [twice the rate](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system) of white adults. Lisa Simon, MD, DMD, associate physician at Brigham and Women’s Hospital and member of the faculty at Harvard Medical School; Brian Jeffrey Swann, DMD, MPH, board of directors of Remote Area Medical (RAM) and co-chair of Global Oral Health Outreach at the National Dental Association; and Gordon Roswell Isbell, III, DMD, MAGD, past trustee of the Academy of General Dentistry also testified at the hearing, highlighting similar troubling statistics and realities. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Applauds Federal Law Strengthening Medicaid Coverage for Pregnant People, Urges States to Act Quickly to Adopt This Pathway](https://carequest.org/press-release/carequest-institute-applauds-federal-law-strengthening-medicaid-coverage-for-pregnant-people-urges-states-to-act-quickly-to-adopt-this-pathway/) **Published:** April 1, 2022 **Author:** Jasmin Fernandes **Content:** ## *Effective Today, States can Extend Medicaid Coverage for Pregnant People from 60 Days to 1 Year Postpartum.* [CareQuest Institute for Oral Health](https://www.carequest.org/)® – a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system – commended the strengthening of Medicaid coverage for pregnant people under the American Rescue Plan Act that became effective today. CareQuest Institute also urged states to act quickly to adopt this additional pathway to extend coverage from 60 days to 1 year postpartum. CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement: “We are facing a maternal health crisis across our nation right now. Gaps in health insurance coverage are putting pregnant people at risk, especially Black women, who are three times more likely to die from a pregnancy-related complication than white women. Expanding the breadth and duration of maternal health care covered by Medicaid — especially preventive care including oral health — is a critical part of the fight to improve health outcomes for mothers and children. This new pathway will help save lives, and we are urging states to act immediately to make this option available to their residents. While this is a positive development, there is much more to be done to ensure that people, particularly Black women, can access comprehensive pre- and postpartum care for themselves and their babies.” Congress has made this new pathway available for states to extend coverage through a State Plan Amendment, but states still need to act to adopt it. CMS released [guidance](https://www.medicaid.gov/federal-policy-guidance/downloads/sho21007.pdf) on how states can implement this new option. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [Americans Are Not Getting the Dental Care They Need, According to a National CareQuest Institute Survey](https://carequest.org/press-release/americans-are-not-getting-the-dental-care-they-need-according-to-a-national-carequest-institute-survey/) **Published:** April 28, 2022 **Author:** Jasmin Fernandes **Content:** ## *Results of Largest Survey of Its Kind Indicate Americans Rate Oral Health as Critical, but That Barriers to Care Persist.* Two years after dental care was disrupted for millions of Americans, many are still not getting the dental care they need and disparities in oral health care persist, according to [the results](https://carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need) of an annual national survey from [CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system. CareQuest Institute today released [initial findings](https://carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need) from the second annual State of Oral Health Equity in America survey, a nationally representative survey of adults’ knowledge, attitudes, experiences, and behaviors related to oral health. The survey is the largest and most comprehensive of its kind, with more than 5,000 participants and 170 questions. Its depth and breadth offer researchers the ability to uncover trends in oral health equity gaps for specific populations based on race/ethnicity, sexual orientation, income, insurance status, disability status, and social determinants of health. Providing timely and actionable insights into the state of oral health equity in the US allows for a deeper understanding among key consumer segments and historically underserved communities. Some of the noteworthy findings from the 2022 survey include: - More adults identified cost as a reason they are likely to avoid dental care in 2022 (43%) than in 2021 (38%). - More than half of adults (55%) reported some type of oral health problem in 2022, similar to 2021 (56%). In both years, toothache, cracked or broken teeth, swollen or bleeding gums, and frequent dry mouth were the most frequently cited dental problems. - 96% of adults know that there is a connection between the health of the mouth and the rest of the body. - Nearly 7 out of 10 adults rate oral health about as important as physical health. - White adults were least likely to experience discrimination in an oral health care setting (33%), as compared to Hispanic adults (49%), Asian adults (49%), and Black adults (48%). - More than two-thirds of adults strongly agree that dental care should be covered by Medicaid (67%) and Medicare (70%). - Nearly 6 in 10 (59%) of Black adults have lost one or more permanent teeth to decay or gum disease compared to 45% for all adults. - 9% of Black adults and 6% of Hispanic adults reported visiting the emergency department or emergency room for a dental condition or pain/discomfort in their mouth in the last year, compared to 4% of all white adults. “These findings offer powerful insights into the state of oral health equity in this country — insights that we hope will inform advocacy, policy, technology advancement, and clinical integration to increase access for oral health care, especially for historically marginalized populations,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “In part, this survey confirms what we already know — our system does not work for everyone and deep-rooted health inequity exists across our nation. Too often, we don’t have the oral health data we need to drive systemic change. A survey of this size and scope is critical to the development of actionable steps to help transform the oral health system into one that is more accessible, equitable, and integrated.” This survey is a follow-up to a [similar survey from 2021](https://www.carequest.org/state-of-oral-health-equity-america-2021), which identified [multiple troubling issues](https://carequest.org/a-coming-surge-in-oral-health-treatment-needs/) emerging during the early stages of the COVID-19 pandemic in the US. Findings from the 2022 survey reveal that while some aspects of oral health have rebounded since the earlier stages of the pandemic, inequities still exist within oral health care. While barriers to oral health care have been well recognized in the past, data from the survey provide new perspectives on inequities related to factors such as food insecurity, housing instability, discrimination experiences, and social determinants of health. CareQuest Institute will be releasing a series of in-depth reports in the coming weeks and months analyzing the results of the survey focusing on topics including the impact of discrimination on oral health access; dental anxiety; the oral health of specific populations, including veterans, LGBTQIA+ individuals, people with intellectual and developmental disabilities, and American Indians and Alaska Natives; integration of medical and dental care; teledentistry utilization and experience; and more. The [first report](https://carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need) in the series — “Americans Are Still Not Getting the Dental Care They Need” — indicates that two years after the start of the pandemic, oral health inequities persist due to cost of care, lack of insurance, dental anxiety, and lingering fears of COVID-19 exposure. The report recommends solutions to increase access to care, such as teledentistry and expanding the reach of the oral health care workforce. This series of reports will allow health professionals, policymakers, and thought leaders to better understand the state of oral health equity in the US and drive progress in eliminating barriers to excellent health for everyone. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [New CareQuest Institute Report Reveals Growing Link Between Mental Health and Oral Health](https://carequest.org/press-release/new-carequest-institute-report-reveals-growing-link-between-mental-health-and-oral-health/) **Published:** May 27, 2022 **Author:** Jasmin Fernandes **Content:** ## *In Recognition of Mental Health Awareness Month, Report Highlights Eight Findings on How Depression is Linked to Oral Health.* [CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — released a [new report](https://www.carequest.org/resource-library/how-depression-linked-oral-health) during Mental Health Awareness Month that spotlights the growing link between mental health and oral health. The [new visual report](https://carequest.org/how-depression-is-linked-to-oral-health/), which is based on an increasing body of research from CareQuest Institute’s [2022 State of Oral Health Equity in America survey](https://carequest.org/state-oral-health-equity-america-page/) and other scientific literature, highlights eight findings that show how mental health is connected to oral health. For example, [depression is linked to poor oral hygiene](https://www.carequest.org/resource-library/how-depression-linked-oral-health), fewer dental visits, and other oral health problems. “We know that depression can significantly affect an individual’s emotional well-being and overall functioning,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health. “This Mental Health Awareness Month, we are highlighting a growing body of research that shows that our emotional state is also connected to our oral health and why it’s so important to integrate oral health into broader, overall health strategies.” The eight findings from CareQuest Institute and other scientific literature include: 1. Adults with severe depression are more than twice as likely to report they do not brush their teeth at least twice a day. 2. Adults with depression report flossing their teeth less often than those without depression. 3. Individuals with depression visit the dentist for care significantly less often than those without depression. 4. Adults with poor mental health (including depression) are more likely to have one or more unmet oral health need and are less likely to seek care for these needs. 5. Depression is linked to higher levels of dental caries (decay). 6. Periodontal (gum) disease is associated with higher scores on measures of depression. 7. Scores on measures of depression are higher in individuals with a temporomandibular disorder (TMD) — that is, chronic pain in the face and jaw — compared to those without a TMD. 8. Young adults with a history of depression are more likely to have extended use of opioid prescriptions after wisdom tooth removal than those without depression. To learn more about this topic, read CareQuest Institute’s recent post, “[Three Resources That Explore the Connection Between Oral Health and Mental Health](https://carequest.org/three-resources-that-explore-the-connection-between-oral-health-and-mental-health/).” **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [National Oral Health Groups Applaud U.S. Senator Sanders for Legislative Push to Improve Access to Oral Health Care for Veterans](https://carequest.org/press-release/national-oral-health-groups-applaud-u-s-senator-sanders-for-legislative-push-to-improve-access-to-oral-health-care-for-veterans/) **Published:** June 9, 2022 **Author:** Jasmin Fernandes **Content:** ## *Senator Files Amendments to Help Eliminate Barriers to Dental Care Faced by Many Veterans.* [American Institute of Dental Public Health](https://aidph.org/) and [CareQuest Institute for Oral Health](https://www.carequest.org/)® today commended U.S. Senator Bernie Sanders (I-Vt.) for filing [amendments](https://www.congress.gov/bill/117th-congress/house-bill/3967/amendments) to help expand access to dental care for veterans. The amendments are being considered as part of the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act of 2022. Veterans are more likely than non-veterans to [experience oral diseases](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) that affect their quality of life, including higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care. Additionally, many veterans don’t have access to or aren’t eligible for dental care through the Department of Veterans Affairs (VA). “One of the many crises facing the dysfunctional health care system in the United States is that we do not recognize dental care as health care,” said Sanders. “There is no question that dental problems have an impact on overall health. You have veterans out there who are struggling with diabetes, struggling with heart disease, and their problems are exacerbated by poor oral health and yet they can’t get the dental care they need. By ignoring dental care, we cause other health care problems and we increase expenses to the VA. That is absurd. The bottom line is, dental care is health care.” “We applaud Sen. Sanders for filing this amendment to improve access to dental services for veterans and address the long-standing obstacles many of them face when seeking this critical care,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health. “Here at CareQuest Institute, we believe that all veterans deserve access to equitable oral health care. In partnership with the American Institute of Dental Public Health (AIDPH) and the veteran community, we are actively exploring solutions to close this existing gap in care and access and we are committed to continuing our work with Sen. Sanders and others to push for legislative changes to help veterans get the oral health care they need and deserve.” “This amendment is an important step in addressing the longstanding dental inequity experienced by U.S. veterans,” said Dr. Annaliese Cothron, executive director of the American Institute of Dental Public Health. “Our collaborative research with CareQuest Institute has clearly highlighted not only the substantial need but significant cost savings associated with expanded access to dental care through the VA. We appreciate Sen. Sanders leading necessary legislative efforts that increase access to care and look forward to jointly advancing equitable oral health for veterans.” Sen. Sanders’ amendment #5074 directs the Secretary of Veterans Affairs to provide dental care to all covered veterans who are not currently eligible for dental services, including through the use of mobile dental clinics, teledentistry, and dental therapists to help address the many barriers veterans face when accessing dental care. The amendment also includes language to establish education programming to promote dental health for veterans, and creates a student debt repayment program for incoming dental professionals who serve veterans at VA dental clinics. A [new visual report](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health) from CareQuest Institute and AIDPH shows that improving dental care for veterans reduces costs, improves overall health, and stimulates the economy. The report includes some [heartbreaking firsthand accounts](https://carequest.org/veteran-dental-care-stimulates-the-economy-and-improves-overall-health/) from veterans who are struggling to access oral health care. CareQuest Institute and AIDPH also recently released [a white paper](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) focused on solutions supporting veteran oral health. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [New Report: 77 Million Adults Do Not Have Dental Insurance](https://carequest.org/press-release/new-report-77-million-adults-do-not-have-dental-insurance/) **Published:** June 22, 2022 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute Releases New Data on Inequities in Oral Health Care.* [CareQuest Institute for Oral Health](https://www.carequest.org/)® released new data on inequities in oral health care from the second annual [State of Oral Health Equity in America](https://carequest.org/state-oral-health-equity-america-page/) survey in [a webinar last week.](https://www.carequest.org/education/webinars) According to the survey, 77 million adults in the US do not have dental insurance, and disparities in oral health exist for many populations, including people of color, low-income or uninsured people, and veterans. The[ ](https://www.carequest.org/content/state-oral-health-equity-america-2022)[State of Oral Health Equity in America survey](https://carequest.org/state-oral-health-equity-america-page/) created by CareQuest Institute is a nationally representative survey of 5,682 adults to study knowledge, attitudes, experiences, and behaviors related to oral health. “We created this survey to better understand the disparities in oral health,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “These newly released findings give additional insight into the many barriers facing historically underserved populations and will help inform our ongoing work to address inequities in our oral health care system.” This new data was released during a virtual discussion, “[How’s America’s Oral Health? Barriers to Care, Common Problems, and Ongoing Inequity,](https://www.carequest.org/education/webinars/hows-americas-oral-health-barriers-care-common-problems-and-ongoing-inequity)” based on the survey results and attended by more than 300 people. “This survey is the most comprehensive of its kind and the results validate the inequities we already knew exist in oral health,” said Ifetayo B. Johnson, Executive Director of The Oral Health Progress and Equity Network (OPEN), who was a panelist during the virtual discussion. “We look forward to working with CareQuest Institute and our other partners to use those findings to implement systemic change and break the cycle of oral health disparities.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Special Patient Care --- ### [CareQuest Institute Partners with Journal of Public Health Dentistry on Anti-Racism Issue](https://carequest.org/press-release/carequest-institute-partners-with-journal-of-public-health-dentistry-on-anti-racism-issue/) **Published:** June 23, 2022 **Author:** Jasmin Fernandes **Content:** ## *Special Issue Focuses on Moving Toward Anti-Racist Practices in Dental Public Health.* [CareQuest Institute for Oral Health](https://www.carequest.org/)® has partnered with the [*Journal of Public Health Dentistry*](https://onlinelibrary.wiley.com/journal/17527325) (JPHD) to release a [special issue](https://onlinelibrary.wiley.com/toc/17527325/2022/82/S1) this month on anti-racist solutions in dental public health. JPHD is published on behalf of the [American Association of Public Health Dentistry](https://www.aaphd.org/) (AAPHD). The special issue, [“Antiracism in Dental Public Health: Engaging Science, Education, Policy, and Practice”](https://onlinelibrary.wiley.com/toc/17527325/2022/82/S1) includes 19 articles — a mix of original research, commentaries, editorials, and community action reports — that cover a range of topics related to anti-racism, including the effects of discrimination and anti-racist solutions for research, education, practice, advocacy, and workforce. Michael Monopoli, DMD, MPH, MS, vice president for grant strategy at CareQuest Institute, co-authored one of the action reports, [“Undermining Racism: A Road to Promoting Equity in Oral Health.”](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12511) “In order to combat the structural racism that exists throughout our health care system, including in oral health, we must employ deliberate anti-racist practices,” said Monopoli. “CareQuest Institute is proud to have partnered with JPHD on this important effort and we hope that this special issue spurs action to promote more equity in the dental industry.” The special issue is one action step from AAPHD’s white paper, [“Anti-Racism in Dental Public Health: A Call to Action,”](https://www.aaphd.org/assets/Webinars/White%20paper%20FINAL%20July%202021.pdf) which was published in July 2021. “AAPHD is committed to leading and supporting efforts to address oral health disparities that contribute to systemic racism,” said Frances Kim, DDS, MPH, DrPH, executive director of the American Association of Public Health Dentistry. “We hope that this issue will encourage the dental public health community — who are all part of the oral health community — to take action to address racism and more importantly, ensure that we continue moving towards anti-racist practices.” Eleanor Fleming, PhD, DDS, MPH, FICD, assistant dean for equity, diversity, and inclusion at the University of Maryland School of Dentistry, and Julie Reynolds, DDS, MS, assistant professor in Preventive and Community Dentistry at the University of Iowa, are the guest editors of the special issue. “In contrast to other disciplines, dentistry has been relatively quiet in the space of anti-racism,” said Fleming. “This special issue fills that void and offers a strategic path forward for dental public health using the lens of anti-racism.” “If we are not part of the solution, then we are part of the problem,” said Reynolds. “This special issue is a call to action. We hope it will compel people in the industry to critically examine practices with the goal of creating policies, systems, and institutions that are more diverse, equitable, inclusive, and just.” For more information about this special issue, [read the CareQuest Institute interview with the guest editors](https://carequest.org/taking-action-on-racism-an-inside-look-at-a-special-issue/). CareQuest Institute will also be hosting a roundtable discussion with some of the authors of the special issue on July 28. More information on that virtual event [can be found here soon.](https://www.carequest.org/education/webinars) **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [Statement on Recent Decisions by the Supreme Court of the United States by Myechia Minter-Jordan, MD, MBA, President and CEO, CareQuest Institute for Oral Health](https://carequest.org/press-release/statement-on-recent-decisions-by-the-supreme-court-of-the-united-states-by-myechia-minter-jordan-md-mba-president-and-ceo-carequest-institute-for-oral-health/) **Published:** July 1, 2022 **Author:** Jasmin Fernandes **Content:** “Over the past several weeks we have witnessed a series of decisions from the US Supreme Court that have changed the landscape in the fight for health equity and social justice. From gun control, to reproductive health, to climate policy, these decisions will have lasting impacts on all Americans but the implications for marginalized and underserved communities is particularly concerning. There is now greater urgency in breaking down the barriers to care that so many populations, especially people of color, face every day. The actions taken in the wake of these decisions will undoubtedly have ripple effects for years and generations to come — on individuals, families, communities, and our health care system. For those of us committed to creating a more equitable, accessible, and integrated health system, we will need an even greater commitment to our work and to the ways in which we support our partners and employees. At CareQuest Institute, we will continue the work of dismantling systemic barriers to optimal health. We recognize that the work may get more challenging, and we are up to the task. We will continue to fight for more equitable health care for all.” **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care --- ### [CareQuest Institute Applauds Congressional Leaders for Urging Expansion of Dental Health Coverage](https://carequest.org/press-release/carequest-institute-applauds-congressional-leaders-for-urging-expansion-of-dental-health-coverage-2/) **Published:** July 5, 2022 **Author:** Jasmin Fernandes **Content:** ## *Members of the U.S. House and Senate Sent Letters to the Federal Administration Advocating for Greater Access to Dental Care Under Medicare.* Today,[ ](https://www.carequest.org/)[CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — applauded members of the U.S. Senate and House of Representatives for urging the Administration to expand access to medically necessary dental care under the Medicare program. In letters to the Centers for Medicare and Medicaid Services (CMS), the Senators and Representatives stressed the need to expand coverage of medically necessary oral and dental health services to improve the health of Americans enrolled in Medicare and reduce medical costs for the program. **CareQuest Institute for Oral Health President and CEO Dr. Myechia Minter-Jordan issued the following statement:** “We commend these members of Congress for recognizing that oral health care is essential. Expanding medically necessary dental coverage under Medicare would greatly improve access to oral health coverage for millions of eligible seniors and people with disabilities. Dental care is unaffordable and inaccessible for so many, leaving millions of people without the care they need to manage chronic illness and maintain quality of life. Right now, too many Medicare beneficiaries — including a disproportionate number of people of color, Indigenous communities, and rural Americans — have been left without basic oral health care and the impact on their physical and mental well-being is profound. Strengthening Medicare by including dental coverage would represent a giant step toward improving health equity, access, and outcomes for seniors and people with disabilities. We will continue to work with lawmakers and our other partners to advocate for dental care to be covered by Medicare because it’s a commonsense solution to the many barriers that millions of people, including older adults, face when accessing health care.” Additional research and facts about oral health and Medicare: - Poor oral health is [directly linked](https://carequest.org/impacts-beyond-the-mouth/) to conditions such as diabetes, heart disease, respiratory illness, and even Alzheimer’s — all diseases that particularly impact our older citizens and put them at greater risk of COVID-19. - Of the 60 million Medicare beneficiaries, [more than two-thirds don’t have any dental coverage at all](https://carequest.org/why-we-still-need-to-add-dental-to-medicare/). - Nearly half of all Medicare patients [haven’t visited a dentist within the past year](https://carequest.org/why-we-still-need-to-add-dental-to-medicare/). That number is closer to 70 percent for Black, Hispanic, and lower-income Medicare beneficiaries. - [One in five](https://familiesusa.org/wp-content/uploads/2019/09/RuralSeniorOralHealth_120718_Fact-Sheet.pdf) rural seniors hasn’t seen a dentist in the past five years. - [One study](https://oralhealth.hsdm.harvard.edu/files/oralhealth/files/avalere_health_estimated_impact_of_medicare_periodontal_coverage.pdf) estimated $63.5 billion in medical savings over 10 years simply by providing dental and periodontal treatment through Medicare. - Older adults [delayed dental care](https://www.carequest.org/about/news/surveys-show-older-adults-delayed-dental-care-more-any-other-care-during-pandemic) more than any other health care during the pandemic. Read the full [House](https://doggett.house.gov/sites/evo-subsites/doggett.house.gov/files/evo-media-document/Expand%20Medically%20Necessary%20Dental%20Coverage.pdf) and[ ](https://www.cardin.senate.gov/wp-content/uploads/2022/06/Letter-to-CMS-on-Medically-Necessary-Dental-Coverage.pdf)[Senate](https://www.cardin.senate.gov/wp-content/uploads/2022/06/Letter-to-CMS-on-Medically-Necessary-Dental-Coverage.pdf) letters. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [Citing New Data on Racial Disparities in Oral Health Care, CareQuest Institute Urges Improvements in Dental Coverage](https://carequest.org/press-release/citing-new-data-on-racial-disparities-in-oral-health-care-carequest-institute-urges-improvements-in-dental-coverage/) **Published:** July 12, 2022 **Author:** Jasmin Fernandes **Content:** ## *Nonprofit Urges Improvements in Dental Coverage to Reduce Health Disparities.* [CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — today released new data on racial and ethnic disparities in oral health care from its second annual[ ](https://www.carequest.org/content/state-oral-health-equity-america-2022)[State of Oral Health Equity in America](https://www.carequest.org/state-oral-health-equity-america/) survey. The organization is advocating for improvements in dental coverage to reduce health disparities that can lead to significant consequences within and beyond oral health. The[ ](https://www.carequest.org/content/state-oral-health-equity-america-2022)[State of Oral Health Equity in America survey](https://www.carequest.org/state-oral-health-equity-america/) is the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. That survey and other research from CareQuest Institute gathered in the past two years reveal the disproportionate impact of oral health disparities on Black, Hispanic, Asian, and American Indian/Alaska Native individuals. “New insights from our survey confirm the stark reality that race and ethnicity are closely linked with the health of an individual’s mouth and their livelihood,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “To eliminate these disparities and advance health equity, we must make dental coverage more available and accessible to everyone, including through Medicare and Medicaid.” Key insights from the research include: - Nearly 1 in 6 Black adults (16%) reported having lost at least six teeth due to tooth decay or gum disease. This degree of tooth loss is much higher than the proportions among adults who are white (12%), Hispanic (9%), or Asian (3%). - Black (17%) and Hispanic (16%) adults were more likely than white adults (14%) to say they had felt “self-conscious or embarrassed because of \[their\] teeth, mouth, or dentures” either very often or fairly often over the past year. - Black (9%), Asian (5%), and Hispanic (4%) adults were more likely than white adults (2%) to believe they “did not get a job” because of their teeth, mouth, or dentures. - Black adults were at least 2.5 times more likely than white, Hispanic, or Asian adults to have visited a hospital emergency department for dental care. The data also spotlight the economic and educational implications of these disparities, challenges for providers of color, and the importance of expanding oral health coverage through Medicaid and Medicare. To read the full brief, [click here](https://carequest.org/the-glaring-scope-of-racial-disparities-in-oral-health/). More information on the 2022 survey and 2021 survey information can be accessed [here](https://carequest.org/state-oral-health-equity-america-page/). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Hires Kaz Rafia as Chief Health Equity Officer](https://carequest.org/press-release/carequest-institute-hires-kaz-rafia-as-chief-health-equity-officer/) **Published:** August 9, 2022 **Author:** Jasmin Fernandes **Content:** ## *Rafia Will Lead Strategic Initiatives to Advance Access to Integrated Oral Health Care for Ethnically and Socially Diverse Communities***.** [CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — today announced that Kaz Rafia, DDS, MBA, MPH, has been named as the organization’s first Chief Health Equity Officer. Rafia, a former state dental director, is a leader in the oral health field who has pursued equitable clinical outcomes through innovative health care approaches throughout his career. As a member of the CareQuest Institute executive team, Rafia will leverage his expertise to spearhead strategic initiatives and partnerships that advance access to integrated, person-centered, and value-based oral health care. “As a mission-focused organization centered on improving the oral health for all, [advancing health equity](https://www.carequest.org/topics/health-equity) is central to everything that we do at CareQuest Institute,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “Having a leader like Kaz join us as Chief Health Equity Officer sends a strong message: eliminating health disparities and breaking down systemic barriers to care, especially for marginalized and underserved communities, is nonnegotiable. Kaz’s experience and knowledge as a dental provider, state official, and educator is an incredible asset to our team and partners.” Rafia will drive CareQuest Institute’s strategic efforts to advance the integration of oral health and overall health through the oversight of CareQuest Institute’s health improvement and grantmaking work. “I’m honored to join CareQuest Institute in pursuit of an accessible, equitable, and integrated health system for everyone,” said Rafia. “The inequities in oral health outcomes for people of color, those living in rural communities, people with disabilities, people who identify as LQBTQ, and other marginalized communities in the US are unacceptable. The work that CareQuest Institute is advancing, in collaboration with an impressive group of partners at the community, state, and national levels, is critical to eliminating oral health disparities once and for all.” Before joining CareQuest Institute, Rafia served as the state dental director for the Oregon Health Authority, where he set the equity-focused State Oral Health Strategic Plan. That Plan focused on population health measures, health care workforce development, optimization of value-based care coordination model, and telehealth. Prior to that, Rafia was the director of operations for the Partnership for International Medical Access-Northwest, working to build sustainable long-term international partnerships with culturally diverse authorities and leaders to better understand and serve their needs. Rafia was also a founding partner of Rafia Dental, a clinical associate professor at Oregon Health & Science University, and a clinic director at Kaiser Permanente. Kaz earned his doctor of dental surgery degree from the Ohio State University, a master of business administration degree from University of Illinois, and a master of public health degree from Johns Hopkins University. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Value-Based Care --- ### [New Tool Launches to Assess Extensiveness of Medicaid Adult Dental Coverage](https://carequest.org/press-release/new-tool-launches-to-assess-extensiveness-of-medicaid-adult-dental-coverage/) **Published:** August 30, 2022 **Author:** Jasmin Fernandes **Content:** ## *The Medicaid Adult Dental Coverage Checker Categorizes Benefits to Help Identify Potential Areas for Improvement.* CareQuest Institute for Oral Health®, in partnership with the American Dental Association (ADA) Health Policy Institute, Center for Health Care Strategies, Inc., and the National Academy of State Health Policy (NASHP), announced the release of an innovative new resource to better assess and understand the extensiveness of [Medicaid adult dental coverage in each state](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage). The [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) is an interactive tool for policymakers, administrators, and advocates to easily understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits, helping identify areas for improvement and expansion. “Lack of dental insurance is a driving factor of wide health disparities that exist across underserved and marginalized communities,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “Recent research has shown that increasing dental coverage is one policy lever that can make a difference in more equitable access to dental care. Our hope is that this new tool raises awareness for administrators, policymakers, and advocates so they can design and strengthen dental benefits in Medicaid that meet the oral health needs of millions of adults across the country who do not currently have access to this critical care.” Four leading oral health and health policy organizations built this new Coverage Checker to help stakeholders gain a deeper understanding of current benefits and clear guidance on ways to improve coverage. The organizations first created an updated evidence-based definition of an extensive Medicaid adult dental benefit and then developed a consensus-driven assessment survey, completed by state dental directors, to collect detailed information about adult dental benefits offered through the Medicaid program in each state. “The Coverage Checker allows us to evaluate Medicaid programs based on very specific types of dental care services covered by the program as well as dollar annual limits. This is a huge step forward in understanding the policy landscape in oral health,” said Marko Vujicic, PhD, chief economist and vice president of the ADA Health Policy Institute. The Coverage Checker looks at coverage of specific procedures and services, including allowed frequency, in eight service categories that are most commonly reimbursed by employer-based dental benefit plans and are critical to maintaining lifelong oral health. “Oral health is critical to overall health and there are significant disparities for those who do not have access to dental services,” said Hemi Tewarson, NASHP’s president and executive director. “This tool gives a more complete picture of dental coverage across the country providing state leaders with data to help inform policy decisions and innovation.” Medicaid is a key source of health care coverage for more than 80 million people in the United States. Although states are required to provide comprehensive dental benefits for children covered by Medicaid and the Children’s Health Insurance Program (CHIP), dental coverage for adult Medicaid beneficiaries [is optional for states](https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html). While most states provide at least emergency/urgent dental benefits (defined differently by states) for adults, [nearly one-third of all states ](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/whitepaper_0721.pdf)do not provide dental care beyond emergency procedures. According to new data from CareQuest Institute’s second annual [State of Oral Health Equity in America](https://carequest.org/state-oral-health-equity-america-page/) survey, 77 million adults in the US do not have dental insurance. Recent studies reveal the following benefits of comprehensive Medicaid coverage: - Increased access to dental care can lead to lower medical care costs among individuals who are pregnant or who have chronic conditions such as diabetes and heart disease. - Dental coverage significantly reduces costly emergency department (ED) visits for dental conditions. Dental-related ED visits nationwide cost an estimated $2.1 billion per year, but nearly 79% of those visits could’ve been addressed in a dental office, saving up to $1.7 billion per year. - Children whose parents have Medicaid dental coverage are more likely to have had a dental visit in the past year and less likely to have deferred dental care. - Adults who obtain dental coverage through Medicaid report improved oral health and employability. Visit the CareQuest Institute website to [access the new Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [New CPT Code Empowers Medical Professionals to Apply Silver Diamine Fluoride (SDF) to Treat Cavities](https://carequest.org/press-release/new-cpt-code-empowers-medical-professionals-to-apply-silver-diamine-fluoride-sdf-to-treat-cavities/) **Published:** October 17, 2022 **Author:** Jasmin Fernandes **Content:** ## *This is a major milestone in advancing an integrated approach to oral health equity and expanding access to person-centered care.* Last month, the American Medical Association (AMA) approved a new category III CPT code for the application of [silver diamine fluoride (SDF)](https://www.carequest.org/about/blog-post/answers-17-your-silver-diamine-fluoride-questions) by medical teams to arrest dental decay without a dental filling. The addition of this code is a milestone in improving access to dental care and, ultimately, helping more people achieve better oral health. Previously only dental care providers could apply SDF, but now primary care team members will be able to apply SDF to treat cavities and be reimbursed for it. The CPT code approval for SDF will benefit patients by providing many new points of access for treating tooth decay. “To achieve oral health equity, we need the participation of the entire health system,” said Myechia Minter-Jordan, MD, MBA, president and CEO of [CareQuest Institute for Oral Health](https://www.carequest.org/)®. “The inclusion of a new CPT code for medical professionals to offer critical non-invasive therapeutic oral health care to their patients is a key step toward a more accessible, equitable, and integrated health system that meets the needs of everyone.” SDF is a brush-on liquid that stops cavities by strengthening affected tooth structures and keeping bacteria from growing on them. It prevents dental decay from progressing and spreading to other teeth. Unlike traditional treatments such as drilling and filling a cavity, SDF is quick, painless, and does not require local anesthesia or sedation. “Accompanied by a bolstering of Medicaid medical program benefits and coverage by commercial carriers, physicians and other qualified health professionals can finally help tame the scourge of tooth decay using a simple, inexpensive clinical strategy,” said Peter Milgrom, DDS, Member of Advantage Silver Dental Arrest, LLC and advocate for the approval of the SDF code. “This change should also serve as a guidepost along the road to the long sought, and badly needed, Medicare dental benefit that could help countless more millions of people in the US.” Tooth decay is the most common noncommunicable disease worldwide and can lead to serious health problems, including brain or heart infections, if left untreated. Now, medical teams are empowered to administer SDF as a tool to impact the overall health of their patients, especially those at higher risk of dental disease and lower access to regular dental care including those living in poverty, minority populations, and those living in dental “deserts” or health professional shortage areas. The code proposal was supported by a diverse group of dental and medical care professionals and advocates including The American Dental Association (ADA), American Dental Hygienists Association (ADHA), National Dental Association (NDA), Society of American Indian Dentists, Children’s Health Alliance of Wisconsin, National Coalition of Dentists for Health Equity, NorthWest Health Law Advocates, Community Catalyst, and the Center for Medicare Advocacy. “Medical and public health professionals care for children and adults with tooth decay who cannot get care from a dentist,” said Karen Sokal-Gutierrez, MD, MPH, clinical professor at UC Berkeley and fellow of the American Academy of Pediatrics. “This initiative offers us a pathway to get training and support to join the oral health care team and provide effective, safe, and fear-free treatment to stop tooth decay. It’s a critical opportunity to expand access to care and improve health, well-being, and equity.” The newly approved CPT code is expected to be inputted into code sets by electronic health records (EHR) vendors in July 2023. CareQuest Institute will partner with Smiles for Life Oral Health to develop training and educational materials on dental cavities identification and SDF application for medical professionals. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Minimally Invasive Care, Person-Centered Care, Value-Based Care --- ### [CareQuest Institute Funds 100 Million Mouths Campaign to Integrate Oral Health into Primary Care](https://carequest.org/press-release/carequest-institute-funds-100-million-mouths-campaign-to-integrate-oral-health-into-primary-care/) **Published:** November 30, 2022 **Author:** Jasmin Fernandes **Content:** ## *Initiative, Part of CareQuest Institute’s Grantmaking Efforts, Aims to Establish an Oral Health Champion in Each State.* [CareQuest Institute for Oral Health](https://www.carequest.org/)®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, is partnering with the Center for Integration of Primary Care and Oral Health (CIPCOH) on a campaign 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. The initiative, the [100 Million Mouths: Creating Primary Care Champions for Equitable Oral Health Campaign](https://www.hsdm.harvard.edu/100-million-mouths-campaign), was originally funded by Health Resources and Service Administration and is now part of CareQuest Institute’s grantmaking efforts. It aligns closely with the Institute’s efforts to create an oral health system that is more accessible, equitable, and integrated. “As an organization focused on centering health equity and the voices of marginalized communities, we aim to continue to explore ways to meet communities where they are, develop intentional tools and opportunities to support their health, and integrate a community-driven perspective as we explore ways to improve care delivery and coordination,” said Trenae Simpson, Director of Grants and Programs at CareQuest Institute. “We made this investment to grow a new health care workforce that is directly contributing to meeting the oral health needs of everyone and helping educational institutions rethink how they approach oral health as a part of overall health.” Many Americans visit their primary care provider more regularly than they do a dentist. Additionally, disparities in access to oral health exist across income, race, geography, and immigrant status. In fact, more than 56 million Americans live in areas with [a shortage of dental professionals](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis). Through this initiative, CareQuest Institute hopes to help give more primary care providers the tools and training to advise patients about their oral health, fill a critical gap, and advance oral health equity. Shenam Ticku, BDS, MPH, instructor in Oral Health Policy and Epidemiology at Harvard School of Dental Medicine, and Hugh Silk, MD, MPH, professor in the department of family medicine and community health at UMass Chan Medical School, co-lead the 100 Million Mouths campaign. “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,” said Ticku. “Our Champions can train their peers and create more advocates for oral health.” “The project is to create 50 state champions who will work to implement some oral health curricula in every health school in the country,” said Silk. “We named it 100 Million Mouths because 100-plus million people do not visit a dentist in any given year but are likely to visit their primary care provider. So, if we could have oral health promotion and disease prevention addressed by primary care graduates in their practices, we could improve the health of that many people.” The initiative launched in 2021 with [Oral Health Champions](https://www.hsdm.harvard.edu/100-million-mouths-campaign) from six different states across the US: Alabama, Delaware, Hawaii, Iowa, Missouri, and Tennessee. Now in its second year, Champions have joined from eight additional states: Arizona, Georgia, Kansas, Kentucky, Maine, New Jersey, New Mexico, and Ohio. The program is in the process of recruiting Champions from Mississippi, West Virginia, Louisiana, Idaho, Alaska, Vermont, South Dakota, and Wyoming. Champions represent a range of personal demographics and professional backgrounds, including physician assistants, nurse practitioners, pediatricians, family medicine doctors, med-peds physicians, dental hygienists, and pediatric dentists. The goal, within a decade, is to have at least one Champion in each state. Once Oral Health Champions are accepted in the program, they receive training that gives them a toolkit to engage with health profession schools and programs in their home states to improve oral health education. To learn more, read [CareQuest Institute’s blog on the Campaign](https://carequest.org/the-connection-between-100-million-mouths-and-oral-health-equity/). CIPCOH is joint effort between the Harvard School of Dental Medicine, Harvard Medical School, and UMass Chan Medical School’s Department of Family Medicine and Community Health. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [Oral Health Organizations Urge Congress to Strengthen Extensive Adult Dental Benefits for All State Medicaid Programs](https://carequest.org/press-release/oral-health-organizations-urge-congress-to-strengthen-extensive-adult-dental-benefits-for-all-state-medicaid-programs/) **Published:** December 7, 2022 **Author:** Jasmin Fernandes **Content:** ## *Oral Health Leaders Say This Change Will Promote Positive Health Outcomes, Address Inequities, and Curb Rising Health Care Costs.* The Oral Health Response Workgroup, a collection of leaders and organizations from across the dental industry, is calling on Congress to improve oral health equity and access by including extensive adult dental benefits in all state Medicaid programs. The Workgroup recently released a community statement affirming that this change will promote positive health outcomes, address health inequities, and curb health care costs. “Access to affordable oral health care is out of reach for millions of low-income people, people with disabilities, communities of color, LGBTQIA+ people, and tribal and rural communities,” said Myechia Minter-Jordan, MD, MBA, president and CEO at CareQuest Institute for Oral Health®. “Congress has the opportunity to change that by ensuring that all state Medicaid programs offer extensive dental benefits to all members. This is a chance to meaningfully address long-standing health disparities that have existed in this system for far too long. We stand ready to serve as a resource and to work with Congress to ensure improved health outcomes for all communities.” Medicaid is a key source of health care coverage for more than 80 million people in the United States, but dental coverage for adult Medicaid beneficiaries [is optional for states](https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html). While most states provide at least emergency/urgent dental benefits (defined differently by states) for adults, [nearly one-third of all states](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/whitepaper_0721.pdf) do not provide dental care beyond emergency procedures. According to [a new Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), 47 state Medicaid programs are not currently offering dental benefits sufficient to maintain optimal oral health. “Oral health equity in this country is a very real issue and is exacerbated within the Medicaid population,” said Ann Lynch, director of advocacy for the American Dental Hygienists’ Association. “Virtually all dental disease is preventable. In the US, it is incumbent on us to make the investment to better the lives of all.” In its community statement, the Oral Health Response Workgroup stressed the [relationship between oral health and overall health](https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf) and the need for Medicaid programs to address whole-person health. When whole-person health is addressed, the whole community benefits by lower health care costs, increased employability, and healthy applicants across industries. The Workgroup also highlighted that access to routine, preventive dental care can offset the cost of expensive and unanticipated problems in chronic disease maintenance in conditions such as [diabetes, heart disease](https://www.sciencedirect.com/science/article/pii/S0749379714001536), and [behavioral health conditions](https://bmjopen.bmj.com/content/11/12/e048296). [A recent study](https://familiesusa.org/wp-content/uploads/2021/07/HPI-CC-FUSA-WhitePaper_0721.pdf) conducted by the American Dental Association Health Policy Institute estimates $273 million per year in medical care savings if extensive dental services were offered in the 28 state Medicaid programs where they are restrictive. “Oral health is the top unmet health need,” said Marko Vujicic, PhD, chief economist and vice president at the ADA Health Policy Institute (HPI). “When low-income adults have access to dental coverage, their employability prospects improve. There’s less spending for chronic health conditions when oral health is maintained. Until we ensure low-income adults have dental coverage, we’re paying an economic penalty.” Additionally, increased access to dental care for Medicaid adult enrollees can significantly reduce costly emergency department (ED) visits for dental conditions. Dental-related ED visits nationwide cost an estimated $2.1 billion per year, but nearly 79% of those visits been addressed in a dental office, saving up to $1.7 billion per year. “It is vital for Congress to understand and acknowledge the critical need to reassess our dental care delivery system to ensure that everyone is able to get the care they need,” said Colin Reusch, senior advisor of oral health policy at Community Catalyst. “We’re asking lawmakers to consider comprehensive and long-term policy solutions that eliminate inequitable barriers to oral health for adults across the country. Support for extensive dental coverage for Medicaid-enrolled adults come from across the dental industry including providers, consumer advocates, dental plans, dental service organizations, dental practices, payors, dental supply manufacturers, state dental boards, community clinics, the public health community, government, academia, and philanthropy. The organizations include: - American Dental Association - American Dental Hygienists’ Association - Association of State and Territorial Dental Directors (ASTDD) - CareQuest Institute for Oral Health - Community Catalyst - Dental Trade Alliance - Diverse Dental Society - Families USA - Henry Schein Cares Foundation - Hispanic Dental Association - National Association of Dental Plans - National Dental Association - National Rural Health Association - Oral Health Progress and Equity Network (OPEN) - Overjet, Inc. - Project Accessible Oral Health - Santa Fe Group - The California Pan-Ethnic Health Network **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Report Highlights Serious Oral Health Risks from Vaping](https://carequest.org/press-release/carequest-institute-report-highlights-serious-oral-health-risks-from-vaping/) **Published:** February 8, 2023 **Author:** Jasmin Fernandes **Content:** ## *Risks Include Bone Loss, Dental Decay, and “Hairy Tongue”.* [CareQuest Institute for Oral Health](https://www.carequest.org/)®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, [released a report](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health) that points to a variety of oral health risks associated with the use of e-cigarettes, including gum disease, dental decay, bone loss, and hairy tongue. “The surge in e-cigarette use by teens and adults poses serious risks to their health, including their oral health,” said Myechia Minter-Jordan, MD, MBA, president and CEO at CareQuest Institute. “And dental professionals are not the only ones who can help patients understand the risks vaping has on their health. All medical professionals, counselors, and teachers need to work together to share these important facts about vaping and urge patients to quit before it becomes detrimental to their health.” The use of e-cigarettes has increased in popularity in the US since 2007, particularly among middle and high school students. In 2020, approximately [3.6 million adolescents](https://www.cdc.gov/media/releases/2020/p0909-youth-e-cigarette-use-down.html) and [9.1 million adults](https://www.cdc.gov/mmwr/volumes/71/wr/mm7111a1.htm) reported e-cigarette use. Some individuals have turned to e-cigarettes as a strategy to stop smoking conventional cigarettes. However, [as of June 2022](https://www.fda.gov/tobacco-products/products-ingredients-components/e-cigarettes-vapes-and-other-electronic-nicotine-delivery-systems-ends), no e-cigarette products have been approved by the US Food and Drug Administration (FDA) as a tobacco cessation device. Additionally, the Centers for Disease Control and Prevention (CDC) recommends that smokers use alternative smoking cessation options (such as [nicotine replacement](https://smokefree.gov/tools-tips/how-to-quit/using-nicotine-replacement-therapy) patches, gum, or lozenges) due to the unknown hazards associated with chemicals in electronic cigarettes. The [visual report](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health) calls out the vaping risks related to oral health, including: - Individuals who use e-cigarettes are significantly more likely to report having periodontal (gum) disease compared to those who do not smoke or use other nicotine products. - E-cigarette use is linked with signs of periodontal disease such as increased plaque, deeper periodontal pockets around the teeth, and bone loss. - Oral lesions such as nicotine stomatitis (“smoker’s palate”), hairy tongue (discoloration of the tongue), and angular cheilitis (sores in the corners of the mouth) are commonly seen in the mouths of e-cigarette users. - There is growing evidence that individuals who use e-cigarettes are at a higher risk for dental caries (decay). - Although long-term evidence is limited, prolonged use of e-cigarettes may increase the risk of oral cancer. [Click here to access the full report](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health). **Categories:** Press Release **Tags:** Clinical Practice, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care --- ### [CareQuest Institute Applauds President’s State of the Union Call to Strengthen Medicaid](https://carequest.org/press-release/carequest-institute-applauds-presidents-state-of-the-union-call-to-strengthen-medicaid/) **Published:** February 9, 2023 **Author:** Jasmin Fernandes **Content:** ## *National Nonprofit Also Commends Biden’s Commitment to Improving Access and Care in Medicare.* Following the Presidential State of the Union Address, [CareQuest Institute for Oral Health](https://www.carequest.org/)®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, commended President Joe Biden’s commitment to expanding Medicaid coverage and improving access and care in the Medicare system. CareQuest Institute for Oral Health CEO and President Myechia Minter-Jordan, MD, MBA, issued the following statement: “We applaud President Biden’s call to strengthen Medicaid coverage in his State of the Union address, a move that will improve the health and well-being of underserved populations across our nation. We urge Congress to ensure that all state Medicaid programs offer extensive dental benefits to all members to help improve employability and productivity with less time away from work due to dental problems. “We also commend President Biden’s commitment to lowering health care costs for Americans across the country by, for example, allowing Medicare to negotiate lower prices for prescription drugs. The savings generated by these policy changes, and others, should be used to further strengthen the Medicare program by including comprehensive dental coverage for millions of seniors and people living with disabilities. All Americans deserve access to affordable, quality health care, including oral health. We look forward to continuing our work with the Biden Administration and other policymakers to create a more equitable system for all.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Seeks Research Proposals](https://carequest.org/press-release/carequest-institute-seeks-research-proposals/) **Published:** February 14, 2023 **Author:** Jasmin Fernandes **Content:** [CareQuest Institute for Oral Health](https://www.carequest.org/)®, a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, is launching a request for proposals (RFP) to invite researchers to apply to utilize CareQuest Institute [data resources](https://www.carequest.org/resource-library) to complete a peer-reviewed publication. Research proposals should align with one of six focus areas geared toward building a future where every person can reach their full potential through excellent health. Interested researchers can submit proposals between February 15 and March 24 at 5:00 p.m. ET. “At CareQuest Institute, collaboration and partnership are key pillars to achieving our mission and this process will introduce us to new voices and ideas in the field,” said Eric Tranby, PhD, director of analytics and data insights at CareQuest Institute. “We are actively searching for innovative and engaging ways to work with researchers and provide them access to our extensive data resources, so that together, we can uncover findings and insights that will help improve the oral health system for everyone.” CareQuest Institute creates and disseminates [actionable research](https://www.carequest.org/how-we-work/research), analytics, and evaluations that providers, policymakers, and advocates use to make informed decisions and improve the oral health care system. Researchers with selected proposals will have access to data resources that include medical, dental, and hospital claims data as well as data from a nationally representative oral health survey developed and conducted by CareQuest Institute. They will also be awarded up to $10,000 for indirect costs. Proposals should focus on one of the following topic areas: - Population oral health**;** - Health system transformation and the impact of oral health integration; - Patient care innovations to better classify and predict oral health outcomes and evaluate alternative care approaches (e.g., teledentistry or minimally invasive care) to improve patient access; - Factors that influence oral health equity for historically underserved and vulnerable populations, including racial and ethnic minorities, people with physical, intellectual, or developmental disabilities; people with low incomes, residents of rural or dental professional shortage areas, pre- and post-natal people, enrollees in government insurance programs, patients with chronic health conditions, veterans, or individuals facing barriers to care due to social determinants of health; - Value-based care approaches; - Public policies that increase access and affordability of care for vulnerable populations, especially through safety net clinics. There will be an Online Informational Session on February 21, 2023 at 1 p.m. ET. Members of our research team will be available to answer questions about submitting your proposal. Specific details related to eligibility, proposal requirements and evaluation criteria can be found on our Call for Oral Health Research Proposals page. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Minimally Invasive Care, Special Patient Care, Value-Based Care --- ### [White Paper Reveals Striking Data on Health Disparities in American Indian and Alaska Native Communities](https://carequest.org/press-release/white-paper-reveals-striking-data-on-health-disparities-in-american-indian-and-alaska-native-communities/) **Published:** March 20, 2023 **Author:** Jasmin Fernandes **Content:** ## *Authors Offer Recommendations on How to Address Health Inequities.* Today, [CareQuest Institute for Oral Health®](https://www.carequest.org/), the [Society of American Indian Dentists](https://www.thesaidonline.org/) (SAID), and the National Indian Health Board’s (NIHB) Tribal Oral Health Initiative released a [white paper](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral) on oral health disparities in American Indian and Alaska Native (AI/AN) communities. The white paper, “American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease’: Reversing Inequities Involves Challenges and Opportunities,” includes striking new data from CareQuest Institute’s [State of Oral Health Equity in America survey](https://www.carequest.org/SOHEA2022) and offers strategic recommendations on how to address disparities and inequities facing AI/AN communities. Filled with graphics, quotes, and frameworks, the paper details how historical and intergenerational trauma including genocide, exposure to infectious diseases, forced boarding school attendance, lack of access to nutritional and affordable food, and lack of access to routine preventive care place AI/AN communities at high risk of poor overall and oral health outcomes. “The data and research in this white paper affirm the serious health disparities that AI/AN communities have faced for generations due to structural racism and historical trauma,” said CareQuest Institute CEO and President Myechia Minter-Jordan, MD, MBA. “We need broad distributive justice to break this cycle. Our hope is that the data and recommendations in this white paper help address the deep health inequities facing this population. We are grateful to SAID and NIHB for their partnership on this important project and look forward to continuing to work with all stakeholders toward solutions.” “SAID is committed to achieving equal representation for AI/ANs in the field of dentistry and we are grateful for the opportunity to partner with CareQuest Institute to contribute to the understanding of oral disease as it impacts our communities and people,” said Cristin Haase, DMD, MPH, president of Society of American Indian Dentists. “Partnerships such as these are important for opening the door to critical conversations and driving change towards inclusive oral health care for AI/AN communities. It is common for our population to be excluded or erased from data collection regarding dentistry workforce and oral health, and it is vital that we continue to remain visible and raise awareness of the issues.” Findings from the white paper include: - The prevalence of early childhood caries (tooth decay) in AI/AN communities is three times higher than it is for white children. - AI/AN adults are twice as likely to have untreated decay as the overall US population, and 83% of AI/AN adults report tooth loss compared to 66% of the overall US population. - Three and a half times as many people who identified as AI/AN reported going to the emergency department for dental care or mouth pain in the last year (13.5%) compared with those who do not identify as AI/AN (3.9%). - More than half of AI/AN adults (54.1%) reported being denied health care or oral health care at some point due to discrimination, compared to 40% of non-AI/AN respondents. - The number of AI/AN students applying to dental school has decreased dramatically over the past decade, with a record high of 92 in 2006 to record lows within the past 20 years of 16 AI/AN applicants in 2019 and only eight in 2021. The authors also make several strategic recommendations on how to reduce oral health disparities in AI/AN communities, including: - Developing partnerships with AI/AN communities and organizations to better understand their priorities. - Collecting more accurate data, including the inclusion of AI/AN as an individual category to avoid misclassification. - Increasing representation of AI/AN individuals in dental education settings. - Developing career pathway programs for AI/AN individuals to enter all dental workforce positions. - Ensuring state and federal oral health care policies are made in collaboration and consultation with tribal leaders and the Indian Health Service. Read the full white paper [here](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral). CareQuest Institute is hosting [a webinar](https://www.carequest.org/education/webinars/american-indian-and-alaska-native-oral-health-challenges-and-opportunities), in collaboration with native-led organizations, to discuss the findings and recommendations from the white paper on Thursday, March 30 at 1 p.m. ET. A panel of experts will detail the disparities facing AI/AN populations and share ongoing culturally and community-driven strategies to improve AI/AN oral health. [Register here](https://www.carequest.org/education/webinars/american-indian-and-alaska-native-oral-health-challenges-and-opportunities). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Special Patient Care --- ### [New CareQuest Institute Analysis: More Than 14 Million People May Lose Dental Coverage Under Medicaid Redetermination](https://carequest.org/press-release/new-carequest-institute-analysis-more-than-14-million-people-may-lose-dental-coverage-under-medicaid-redetermination/) **Published:** April 19, 2023 **Author:** Jasmin Fernandes **Content:** ## *First-Of-Its Kind Analysis Reveals Impact Redetermination Process Will Have on Access to Dental Health Care and Oral Health Equity.* A new analysis from [CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — reveals that more than 14 million people across the country may lose dental coverage under the Medicaid redetermination process that began on April 1. As the expiration of the national COVID-19 Public Health Emergency (PHE) on May 11 approaches, states are required to begin conducting eligibility redeterminations and un-enrolling individuals determined to no longer be eligible for their state’s Medicaid program. [Approximately 15 million](https://aspe.hhs.gov/sites/default/files/documents/404a7572048090ec1259d216f3fd617e/aspe-end-mcaid-continuous-coverage_IB.pdf) people are expected to lose their health coverage as a result. But until now, little to no data has been reported about how many people are expected to lose dental coverage as well. [The new analysis](https://www.carequest.org/content/medicaid-redetermination) released by CareQuest Institute shows that 28% of the country’s adult population currently enrolled in Medicaid may lose dental coverage. As people are removed from Medicaid coverage and seek to secure coverage through other programs or the private market, there is no guarantee that they will find or be able to afford coverage that includes dental benefits. This gap will likely have a greater impact on families of lower incomes and people of color. “This new analysis illustrates the concerning impact that the Medicaid redetermination process will have on oral health equity for millions of people across our nation, especially in some of the most marginalized populations,” said CareQuest Institute for Oral Health CEO and President Myechia Minter-Jordan, MD, MBA. “We cannot walk back the incredible progress made to strengthen Medicaid dental coverage and connect more people with care in recent years. Access to oral health is critical to good overall health and well-being.” Poor [oral health](https://www.carequest.org/resource-library/impacts-beyond-mouth) has a direct link to a person’s overall health — including greater risk of diabetes, high blood pressure, obesity, dementia, mental health, and adverse birth outcomes. We also know that regular preventive dental care significantly saves overall medical and dental care costs. For example, [one recent study](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs) found that diabetics who were treated for periodontal disease saw their overall health care costs decrease by 12 to 14 percent. In addition, as states grapple with the high costs of emergency room visits, access to preventive [dental care has been shown to reduce emergency room visits](https://www.carequest.org/ED-Use) by patients due to oral health problems. As community and state organizations support impacted Medicaid enrollees navigate this redetermination process, we must elevate the importance of oral health and help people find new coverage options that include dental benefits. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Value-Based Care --- ### [CareQuest Institute Urges Extension of Postpartum Medicaid Benefits to Improve Maternal Health](https://carequest.org/press-release/carequest-institute-urges-extension-of-postpartum-medicaid-benefits-to-improve-maternal-health/) **Published:** May 4, 2023 **Author:** Jasmin Fernandes **Content:** ## *New Report Recommends Extension of Benefits to Reduce Racial Disparities in Birth Outcomes.* [CareQuest Institute for Oral Health](https://www.carequest.org/)® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system — released [a new report](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum) urging states to extend Medicaid postpartum coverage from 60 days to at least 12 months to help improve health equity and reduce racial and ethnic disparities in birth outcomes. “Expanding the breadth and duration of Medicaid coverage for pregnant people, including preventive care and oral health care, is an essential part of the fight to improve health outcomes — especially for Black mothers and families experiencing the most severe adverse maternal outcomes in the US,” said CareQuest Institute for Oral Health CEO and President Myechia Minter-Jordan, MD, MBA. “By strengthening these benefits, state Medicaid programs across the country have an opportunity to show that health care is a human right and bring us closer to real health equity.” Under the American Rescue Plan Act, states have the opportunity to [extend Medicaid coverage for postpartum people to a full year](https://www.kff.org/medicaid/issue-brief/medicaid-provisions-in-the-american-rescue-plan-act/#:~:text=Coverage%20provisions&text=In%20addition%20to%20the%2090,years%20after%20expansion%20takes%20effect), including benefits that are not only “pregnancy-related.” Currently, [more than 35 states](https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/) have implemented or are planning to implement an extension to the Medicaid postpartum coverage period. However, some states have taken no action to extend this coverage including Arkansas, Idaho, Iowa, Montana, Nebraska, Nevada, and South Dakota. The report, “[The Role of Medicaid Adult Dental Benefits During Pregnancy and Postpartum](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum),” also calls on each state to provide extensive [Medicaid dental benefits to all adults](https://www.carequest.org/topics/adult-dental-benefit), including postpartum adults. When looking at Medicaid dental coverage by state, [47 state Medicaid programs](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) do not offer adult dental benefits sufficient to maintain optimal oral health. “CareQuest Institute urges Congress to make extensive dental coverage for adults a permanent part of the Medicaid program and establish a baseline of covered services for all states,” Minter-Jordan added. A recent and related [visual report](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes) from CareQuest Institute outlines the worsening state of both maternal and infant health in our nation, with rising rates of maternal mortality and preterm birth. Black and American Indian/Alaska Native women are 2.9 and 2.5 times more likely, respectively, to die from pregnancy-related causes than non-Hispanic white women. Additionally, US infants born to Black and Native American mothers are 62% more likely to be born preterm than those born to white women. The [visual report](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes) also highlights how poor oral health during pregnancy is directly linked to [adverse birth outcomes](https://www.cdhp.org/resources/384-coverage-brief-improving-access-to-oral-health-care-in-pregnancy), including preeclampsia, preterm birth, and low birth weight deliveries. Preeclampsia and other hypertensive disorders are responsible for [15% of maternal mortality.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095624/) **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care --- ### [Dentists Can Play Key Role in Administering Potential COVID-19 Booster Shots](https://carequest.org/press-release/dentists-can-play-key-role-in-administering-potential-covid-19-booster-shots/) **Published:** June 30, 2021 **Author:** Jasmin Fernandes **Content:** ## *National CareQuest Institute survey shows half of dentists offering or would offer COVID-19 vaccines.* Oral health providers across the country stand poised to be a critical access point for any additional “booster” shot that may be required to ensure continued immunity against COVID-19, [according to a report released by CareQuest Institute for Oral Health](https://www.carequest.org/resource-library/dental-providers-offer-key-access-point-covid-19-booster-shots). The report comes as studies are underway in the U.S. and abroad to examine the efficacy of a booster shot at bolstering protection against the virus. As COVID-19 variants continue to spread, key Biden administration officials and the CEO of Pfizer have indicated it is likely that booster shots will be required to protect against the coronavirus. According to our survey of nearly 400 oral health providers across the country, 49% indicated they either already administer the COVID-19 vaccine or are interested in doing so. “If we want to ensure equitable and comprehensive distribution of the COVID-19 vaccine and potential booster shots, oral health professionals must be part of the solution,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute. “Dentists and hygienists have the trust of their patients and the training and capability to administer vaccines safely. According to our survey, dentists stand ready and willing to help, and we encourage states to include them as an essential part of their ongoing vaccination programs.” Annually, more than 19 million people visit the dentist but not a primary care physician or other medical professional. Many dental professionals, especially those operating in community health care settings such as Federally Qualified Health Centers (FQHCs), are well positioned to serve as an important public health access point for COVID-19 vaccinations. According to the report, dental providers in public health settings, like FQHCs, are 10 times more likely to be offering COVID-19 vaccines than providers in private practice. As racial and ethnic disparities persist in vaccination rates among Black and Latino communities, increasing access points to the vaccine in public health settings is one critical way to reduce existing gaps. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [Statewide Survey Finds Broad, Bipartisan Support for Medicare Dental Coverage in West Virginia](https://carequest.org/press-release/statewide-survey-finds-broad-bipartisan-support-for-medicare-dental-coverage-in-west-virginia/) **Published:** August 4, 2021 **Author:** Jasmin Fernandes **Content:** ## *A new survey shows more than three-quarters of West Virginia voters favor adding dental coverage to Medicare.* West Virginians across the political spectrum are ready for Medicare dental coverage. A new YouGov survey found that an overwhelming majority of likely midterm voters in West Virginia – including 73% of conservative voters – favor adding dental benefits to Medicare. Almost eight in 10 West Virginia voters surveyed in July support adding dental coverage to Medicare as proposed in the $3.5 trillion budget plan introduced in the Senate. Over nine in 10 respondents believe dental care is a necessary part of overall health care and about half of respondents hold their members of Congress responsible for the current lack of coverage. A further 67% of Republicans and 90% of Democrats in West Virginia believe their legislators should prioritize Medicare dental coverage. “West Virginians pride ourselves on knowing what’s best for our community,” said West Virginia Oral Health Coalition Coordinator Gina Sharps. “Our residents work hard and contribute to Medicare for decades. Our political leadership should ensure they receive the full benefits they deserve, including oral health coverage.” The survey also revealed the human and social cost of inaction: 60% of respondents aged 65 or higher reported avoiding necessary dental visits due to cost. Emergency dental visits for preventable oral health conditions cost the U.S. health system an estimated $2 billion per year. “Oral health coverage is critical for preventing serious health problems, from cardiovascular disease to diabetes.” said Ifetayo Johnson, Executive Director of the Oral Health Progress and Equity Network (OPEN). “Strengthening Medicare by adding dental coverage for all is an important step in advancing health equity for older Americans, people living with disabilities, communities of color, tribal communities, and those living in rural areas. No West Virginian should have to forgo necessary health care because it is unaffordable.” The YouGov poll was conducted on July 7-19, 2021 among a representative sample of 404 likely 2022 midterm voters in West Virginia. The margin of error is +/- 5.8%. The poll was commissioned by CareQuest Institute for Oral Health, Families USA, and the Oral Health Progress and Equity Network (OPEN), a group of organizations dedicated to strengthening access to the oral health coverage needed to keep Americans healthy. **About Medicare Dental Coverage** Medicare does not currently include coverage for dental health services as a standard benefit. Of the 60 million older adults and individuals with disabilities who receive Medicare benefits, 24 million do not have dental coverage. Lower-income adults and people of color are overrepresented in this group. Poor oral health is linked with cardiovascular disease, diabetes, cancer, and pneumonia, the risk of which increases among older adults. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Commends Congressional Legislation to Provide Oral Health Care Benefit in Medicare](https://carequest.org/press-release/carequest-institute-commends-congressional-legislation-to-provide-oral-health-care-benefit-in-medicare/) **Published:** July 7, 2021 **Author:** Jasmin Fernandes **Content:** ## *Statement from President and CEO, Dr. Myechia Minter-Jordan: “Dental care is essential health care . . . If we value the lives of seniors and people with disabilities, we must strengthen Medicare coverage to include dental benefits.”* Rep. Lloyd Doggett, Chair of the House Ways & Means Health Subcommittee, unveiled legislation that would strengthen the Medicare program by including oral health coverage. An additional 75 members of Congress support the legislation, which builds upon growing momentum to include access to comprehensive oral health care for all Medicare beneficiaries. In his statement, Congressman Doggett specifically calls for treating oral health care the same as existing Medicare-covered benefits. CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement, applauding Congressman Doggett and his 75 colleagues in the U.S. House of Representatives for their support of Medicare dental benefits. “Seniors and people with disabilities served by the Medicare program don’t have access to necessary dental coverage. This leaves millions of people without the care they need to manage chronic illness and maintain quality of life as they age. The *Medicare Dental, Vision, and Hearing Benefit Act* unveiled this week adds to the chorus of support for strengthening the Medicare program by providing comprehensive oral health benefits to more than 60 million seniors and people with disabilities. Congressman Doggett is right: dental care is essential health care with direct connections to systemic health, chronic illness, and mental health diseases. If we value the lives and the dignity of seniors and people with disabilities, there is no question that we must strengthen Medicare coverage to include dental benefits. This country continues to grapple with an oral health crisis, and it has only been exacerbated by the effects of the COVID-19 pandemic. To leave our seniors without access to essential oral health care is to abandon their overall health and wellness at the very time they need it most.” This latest action by members of the House, championed by advocates and community-based organizations throughout the country, builds on efforts from several key Senators to include Medicare dental coverage in a human infrastructure package this year. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Applauds Senate Plan to Strengthen Medicare to Include Oral Health Care Benefit](https://carequest.org/press-release/carequest-institute-applauds-senate-plan-to-strengthen-medicare-to-include-oral-health-care-benefit/) **Published:** July 14, 2021 **Author:** Jasmin Fernandes **Content:** ## *President and CEO Dr. Myechia Minter-Jordan calls Senate action “a step toward fixing this giant gap in how we care for older adults and people with disabilities and a move toward a more equitable health care system for all.”* Last night, members of the Senate Budget Committee announced an agreement on an infrastructure package that would, among other things, expand the Medicare program to include an oral health care benefit. The agreement reflects a growing movement among the public and in both chambers of Congress to expand Medicare to include dental, vision, and hearing coverage. As a result of the lack of coverage, nearly half of all Medicare beneficiaries didn’t visit a dentist in 2019. Those numbers are even greater for Black, Latino, and low-income Americans. This results in significant unmet dental need and impacts oral and overall health outcomes and spending. **CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement, applauding the Senate Budget Committee for its inclusion of Medicare dental benefits:** “If we want to end the disparities in health care that have plagued our country for generations, then we must strengthen our Medicare program to include dental coverage. And now is the time to do it. Dental care is essential health care. Poor oral health has a direct connection to increased risks of chronic illnesses like heart disease and diabetes, and can negatively affect mental health and overall quality of life. Yet millions of older adults and people with disabilities served by the Medicare program don’t have access to this basic and necessary coverage. These adults are disproportionately people of color, low-income Americans, and live in rural communities. The Senate Budget Committee’s action is a step toward fixing this giant gap in how we care for our seniors. And it moves us toward a more equitable health care system for all.” **Why dental coverage in Medicare is critical:** - Of the 60 million Medicare beneficiaries, 24 million don’t have any dental coverage. - Nearly half of all Medicare patients [haven’t visited a dentist within the past year](https://www.kff.org/medicare/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/). Those numbers are closer to 70% for Black, Latino, and low-income Americans. One in five rural seniors haven’t seen a dentist in the past five years. - Fifteen percent of older adults — including [one in three low-income older](https://www.kff.org/medicare/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/) adults — have lost all of their teeth. - Poor oral health care has a direct impact on overall health and is associated with increased risk of chronic illnesses like heart disease and diabetes, as well as mental health illnesses. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [National Survey Finds Broad, Bipartisan Support for Medicare Dental Coverage](https://carequest.org/press-release/national-survey-finds-broad-bipartisan-support-for-medicare-dental-coverage/) **Published:** July 22, 2021 **Author:** Jasmin Fernandes **Content:** ## *A new survey shows eight in 10 voters favor adding dental coverage to Medicare. Support is even higher in 2022 Senate battleground states.* Americans across the political spectrum are ready for Medicare dental coverage. A new YouGov survey found an overwhelming majority of likely midterm voters – including 82% of voters in 2022 Senate battleground states – favor adding dental benefits to Medicare. More than three-quarters of American voters surveyed in July support adding dental coverage to Medicare as proposed in the $3.5 trillion budget plan introduced in the Senate. Nine out of 10 respondents believe dental care is a necessary part of overall health care and 55% hold their members of Congress responsible for the current lack of coverage. “These results make it clear to Congress – their constituents overwhelmingly support adding dental coverage to Medicare,” said Frederick Isasi, Executive Director of Families USA. “Our health should not depend on our wealth, yet the health of one out of every two people who rely on Medicare suffers because they can’t afford to get the oral health care they need. The time for Medicare to provide oral health care benefits is long overdue. It’s time for Congress to act.” Ifetayo Johnson, Executive Director of the Oral Health Progress and Equity Network (OPEN) agrees, “Millions of older adults and people with disabilities in this country pay into Medicare their whole working lives and yet it completely leaves out the mouth. It’s no surprise eight out of ten voters want to see this problem fixed, especially when it has such critical implications for advancing health equity.” The survey also revealed the human and social cost of inaction: 52% of respondents aged 65 or older reported avoiding necessary dental visits due to cost. Emergency dental visits for preventable oral health conditions cost the U.S. health system an estimated $2 billion per year. “The pandemic has made clear that our most vulnerable neighbors – older Americans, people living with disabilities, low-income adults, and communities of color – need life-saving support,” said Dr. Myechia Minter-Jordan, President and CEO of CareQuest Institute for Oral Health (CareQuest Institute). “We can no longer exclude oral health as vital to creating equitable health outcomes across America.” The YouGov poll was conducted on July 6-13, 2021 among a representative sample of 1,000 likely 2022 midterm voters nationwide. The margin of error is +/- 3.47%. The poll was commissioned by CareQuest Institute, Families USA, and OPEN, a group of organizations dedicated to strengthening access to the oral health coverage needed to keep Americans healthy. **About Medicare Dental Coverage** Medicare does not currently include coverage for dental health services as a standard benefit. Of the 60 million older adults and individuals with disabilities who receive Medicare benefits, 24 million do not have dental coverage. Low-income adults and people of color are overrepresented in this group. Poor oral health is linked with cardiovascular disease, diabetes, cancer, and pneumonia, the risk of which increases among older adults. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [Coalition of Leading Health Professionals and Advocates Calls on Congress to Act Now to Strengthen Medicare by Adding Dental Coverage](https://carequest.org/press-release/coalition-of-leading-health-professionals-and-advocates-calls-on-congress-to-act-now-to-strengthen-medicare-by-adding-dental-coverage/) **Published:** August 5, 2021 **Author:** Jasmin Fernandes **Content:** ## *Group urges Congress to use savings from Medicare drug pricing provisions to make dental, vision, and hearing coverage available for 60M Medicare beneficiaries.* Calling it an imperative to “improve equity, access, and health outcomes,” today a coalition of health industry executives, clinical professionals, public health experts, and advocates sent a letter to Congress urging expansion of Medicare to include dental benefits. The letter, sent to Speaker Nancy Pelosi, Senate Majority Leader Chuck Schumer, Finance Committee Chair Roy Wyden, Energy and Commerce Committee Chair Frank Pallone, Jr., and Ways and Means Chair Richard Neal, called on Congress to pay for this critical expansion with savings realized through negotiating prescription drug prices. The letter follows the release of a recent [Morning Consult poll,](https://pro.morningconsult.com/articles/health-care-proposals-reconciliation-bill-polling) showing that an overwhelming majority of Americans across the political spectrum and across the country favor adding dental, vision, and hearing coverage to Medicare. The poll revealed that 84% of all voters – 89% of Democrats and 79% of Republicans – favored inclusion of these benefits in Medicare. “Medicare’s lack of an oral health benefit means that two-thirds of all enrollees – more than 37 million Americans – do not have dental coverage,” the group states in their letter. “These are disproportionately Black, Indigenous, Hispanic and other people of color, those with disabilities, and those living in rural communities who are left without a way to afford the care they need to maintain health and well-being. For example, in the last year seven out of 10 Black Medicare enrollees and six out of 10 Hispanic enrollees did not see a dentist, and 20 percent of rural seniors have not seen a dentist in more than five years. This disproportionate lack of access to care can have serious consequences. One [study](https://www.ihs.gov/doh/documents/surveillance/IHS_Data_Brief_March_2016_Oral_Health%20Survey_35_plus.pdf) showed that almost half of American Indians and Alaska Natives aged 65 or older had untreated tooth decay, compared to 19% of that age group for the U.S. as a whole.” The letter makes clear that strengthening Medicare by including dental coverage is not only an equity issue, but also makes financial sense, as studies have shown that adding the benefit would result in a reduction of long-term health care costs. Providing benefits to people with chronic conditions has been shown to result in reduced health care spending. Additionally, people without dental benefits are also more likely to seek dental care at emergency departments, which are not equipped to provide this type of care and add significant costs to our health care system. The group calls for funding the enhanced benefit package by allowing the federal government to negotiate prescription drug costs in Medicare, which the Congressional Budget Office projects would result in $456 billion in savings. Allowing drug price negotiation would also reduce out-of-pocket prescription drug costs to Medicare enrollees. The letters signatories include American Dental Hygienists’ Association, Arcora Foundation, Association of State and Territorial Dental Directors, California Pan-Ethnic Health Network, CareQuest Institute for Oral Health, Community Catalyst, Families USA, Hispanic Dental Association, National Dental Association, National Dental Hygienists’ Association, National Indian Health Board, National Rural Health Association, Oral Health Progress and Equity Network, Project Accessible Oral Health, Santa Fe Group, and Dr. Bruce Donoff, DMD, MD, FACS, FACD, former Dean of Harvard School of Dental Medicine. The group behind the letter came together at the start of the pandemic to highlight and address the impact of the COVID-19 pandemic on our nation’s oral health. **About Medicare Dental Coverage** Medicare does not currently include coverage for dental health services as a standard benefit. Of the 60 million older adults and individuals with disabilities who receive Medicare benefits, 24 million do not have dental coverage. Low-income adults and people of color are overrepresented in this group. Poor oral health is linked with cardiovascular disease, diabetes, cancer, and pneumonia, the risk of which increases among older adults. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [National Oral Health Organization Praises Senate Inclusion of Dental Medicare Benefit in “Human Infrastructure” Budget Blueprint](https://carequest.org/press-release/national-oral-health-organization-praises-senate-inclusion-of-dental-medicare-benefit-in-human-infrastructure-budget-blueprint/) **Published:** August 10, 2021 **Author:** Jasmin Fernandes **Content:** ## *“Millions of older Americans and people with disabilities served by the Medicare program are one step closer to a more equitable health care system.”* CareQuest Institute for Oral Health, a leading national organization focused on improving oral health, is praising the Senate’s inclusion of Medicare dental coverage in its budget blueprint. Strengthening Medicare by including dental coverage would represent a giant step toward improving health equity, access, and outcomes for seniors and people with disabilities. If passed by Congress, the legislation would help address several troubling trends: - In 2018, according to the Kaiser Family Foundation, almost half of all Medicare beneficiaries did not have a dental visit, with higher rates among those who are Black (68%), Hispanic (61%), or have low incomes (73%). - Twenty percent of rural seniors have not seen a dentist in more than five years. - Poor oral health is linked to conditions such as diabetes, heart disease, respiratory illness, and Alzheimer’s. - Those without dental benefits are more likely to seek dental care at emergency departments, resulting in suboptimal care and significant costs to the health care system. **CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement, applauding senators for including Medicare dental coverage in their budget blueprint.** “Millions of older Americans and people with disabilities served by the Medicare program are one step closer to a more equitable health care system. Thanks to the tireless efforts of Congressional and community champions, dental coverage for Medicare beneficiaries is part of this budget blueprint. Too many Medicare beneficiaries — including a disproportionate number of people of color, Indigenous communities, and rural Americans — have been left without basic oral health care for far too long and the impact on their physical and mental well-being is far too real. We celebrate progress while continuing to advocate for this necessary policy change.” Adding dental coverage to Medicare is also popular with voters: A [recent CareQuest Institute poll](https://carequest.org/national-survey-finds-broad-bipartisan-support-for-medicare-dental-coverage/) revealed that 8 in 10 voters favored the inclusion of dental benefits in Medicare. Last week, CareQuest Institute joined with a coalition of leading health professionals to send [a letter urging Congress to include dental coverage under Medicare](https://carequest.org/wp-content/uploads/2025/12/PRW-Letter-to-Congress-Urging-a-Dental-Benefit-in-Medicare-Part-B-1.pdf). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [Dentists Are Well Positioned to Administer COVID-19 Booster Shots](https://carequest.org/press-release/dentists-are-well-positioned-to-administer-covid-19-booster-shots/) **Published:** August 19, 2021 **Author:** Jasmin Fernandes **Content:** ## *National CareQuest Institute survey shows half of dentists offering or would offer COVID-19 vaccines.* Oral health providers across the country stand poised to be a critical access point for care as the Biden administration announced yesterday the US will begin offering COVID-19 booster shots in September. [A recently released report by CareQuest Institute for Oral Health](https://www.carequest.org/resource-library/dental-providers-offer-key-access-point-covid-19-booster-shots) makes clear that including dentists could significantly boost the number of providers administering boosters, increasing the speed and reach of the vaccination effort. According to the report, drawn from a survey of nearly 400 oral health providers across the country, 49% of providers indicated they either already administer the COVID-19 vaccine or are interested in doing so. Annually, more than 19 million people visit the dentist but not a primary care physician or other medical professional. This means many dental professionals, especially those operating in community health care settings such as Federally Qualified Health Centers (FQHCs), are well positioned to serve as an important public health access point for COVID-19 vaccinations and boosters. According to the report, dental providers in public health settings, like FQHCs, are 10 times more likely to offer COVID-19 vaccines than providers in private practice. As racial and ethnic disparities persist in vaccination rates among Black and Latino communities, increasing access points to the vaccine and boosters in public health settings is one critical way to reduce existing gaps. **The following is a statement from Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health:** “If we want to ensure equitable and comprehensive distribution of the COVID-19 vaccine and booster shots, oral health professionals must be part of the solution. Dentists and hygienists have the trust of their patients and the training and capability to administer vaccines safely. According to our survey, dentists stand ready and willing to help, and we encourage states to include them as an essential part of their ongoing vaccination programs.” **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care, Value-Based Care --- ### [Statewide Survey Finds Broad, Bipartisan Support for Medicare Dental Coverage in Arizona](https://carequest.org/press-release/statewide-survey-finds-broad-bipartisan-support-for-medicare-dental-coverage-in-arizona/) **Published:** August 19, 2021 **Author:** Jasmin Fernandes **Content:** ## *A new survey shows more than three-quarters of Arizona voters favor adding dental coverage to Medicare.* Arizonans across the political spectrum are ready for Medicare dental coverage. A new YouGov survey found that an overwhelming majority of likely midterm voters in Arizona – including 56% of conservative voters and 93% of liberal voters – favor adding dental benefits to Medicare. Three out of four Arizona voters (76%) surveyed in July support adding dental coverage to Medicare as proposed in the $3.5 trillion budget plan introduced in the Senate. More than 9 in 10 respondents believe dental care is a necessary part of overall health care and 56% of respondents hold their members of Congress responsible for the current lack of coverage. “The affordability of dental care is a leading concern for older Arizonans,” said Maddy Bynes, director of the Arizona Association of Area Agencies on Aging. “Accessing dental care helps to increase overall health, nutrition, and to reduce social isolation. We support adding dental coverage into Medicare to improve the lives of older Arizonans.” The survey also revealed the human and social cost of inaction: Half of Arizona voters, aged 65 or older reported avoiding necessary dental visits due to cost. Emergency dental visits for preventable oral health conditions cost the U.S. health system an estimated $2 billion per year. “Oral health coverage is critical for preventing serious health problems, from cardiovascular disease to diabetes.” said Ifetayo Johnson, Executive Director of the Oral Health and Progress Equity Network (OPEN). “Strengthening Medicare by adding dental coverage for all is an important step in advancing health equity for older Americans, people living with disabilities, communities of color, tribal communities, and those living in rural areas. No Arizonan should have to forgo necessary health care because it is unaffordable.” The YouGov poll was conducted on July 7-19, 2021 among a representative sample of 414 likely 2022 midterm voters in Arizona. The margin of error is +/- 6.2%. The poll was commissioned by CareQuest Institute, Families USA, and the Oral Health Progress and Equity Network (OPEN), a group of organizations dedicated to strengthening access to the oral health coverage needed to keep Americans healthy. **About Medicare Dental Coverage** Medicare does not currently include coverage for dental health services as a standard benefit. Of the 60 million older adults and individuals with disabilities who receive Medicare benefits, 24 million do not have dental coverage. Lower-income adults and people of color are overrepresented in this group. Poor oral health is linked with cardiovascular disease, diabetes, cancer, and pneumonia, the risk of which increases among older adults. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [National Oral Health Leader Launches Major Ad Campaign to Support Medicare Dental Benefit](https://carequest.org/press-release/national-oral-health-leader-launches-major-ad-campaign-to-support-medicare-dental-benefit/) **Published:** September 29, 2021 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute for Oral Health’s campaign will run in 16 key Senate districts.* CareQuest Institute for Oral Health®, a national organization focused on improving oral health of all, today launched a multi-platform digital advertising campaign advocating for the inclusion of dental coverage under Medicare Part B. The United States Senate included a Medicare dental benefit as part of its budget blueprint released in August and is expected to release a formal legislative package this fall. The launch of the digital campaign is part of CareQuest Institute’s efforts to secure passage of this benefit that would improve the health of millions of Americans. “Of the 60 million Medicare beneficiaries, 26 million do not have dental coverage,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health. “This means a population that is disproportionately people of color, rural Americans, and people with disabilities is left without basic care that affects their physical and mental well-being. If we care about ending the deep health disparities in this country, we must include dental coverage under Medicare Part B.” The campaign will encourage individuals to sign a petition asking Congress to pass the dental benefit and will target key Senate seats, including Arizona, Colorado, Delaware, Maine, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Virginia, West Virginia, and Washington. Oral health care is essential care, especially for older adults. According to the CDC, one in five adults aged 65 years or older have untreated tooth decay or have lost all their teeth and more than two in three older adults have gum disease. Poor oral health has a direct impact on overall health and is associated with increased risk of chronic illnesses like heart disease and diabetes, as well as mental health. In August, CareQuest Institute joined with a coalition of leading health professionals to send [a letter urging Congress to include dental coverage under Medicare](https://carequest.org/wp-content/uploads/2025/12/PRW-Letter-to-Congress-Urging-a-Dental-Benefit-in-Medicare-Part-B.pdf). If passed by Congress, the legislation would help improve rates of dental visits among historically marginalized populations and lower-income beneficiaries, reduce long-term health care costs, and more. Adding dental coverage to Medicare is also popular with voters: A [recent CareQuest Institute poll](https://carequest.org/national-survey-finds-broad-bipartisan-support-for-medicare-dental-coverage/) revealed that eight in 10 voters favored the inclusion of dental benefits in Medicare. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute and the American Institute of Dental Public Health Partner to Advance Veteran Oral Health](https://carequest.org/press-release/carequest-institute-and-the-american-institute-of-dental-public-health-partner-to-advance-veteran-oral-health/) **Published:** October 5, 2021 **Author:** Jasmin Fernandes **Content:** ## *New Collaboration Will Focus on Data-Driven Recommendations and* *Oral Health Access for Veterans.* CareQuest Institute for Oral Health and the American Institute of Dental Public Health (AIDPH) have entered into a new partnership that will explore solutions to veteran oral health care, increase accessibility to care, and stimulate rural oral health innovation. Veterans are more likely to experience oral diseases that affect their quality of life than non-veterans and many veterans do not qualify for dental care from Veterans Affairs unless they have a pre-existing dental condition, a disability, or were a prisoner of war. Additionally, Medicare only pays for certain dental services patients receive in the hospital and Medicaid provides limited or no adult dental benefits in several states. The partnership between CareQuest Institute and AIDPH will focus on developing and implementing data-driven recommendations informed by the veteran community. “We owe veterans a great deal of gratitude and having access to good oral health care is the last thing they should be worrying about,” said Sean Boynes, DMD, MS, vice president of health improvement at CareQuest Institute. “We need a better understanding of the obstacles veterans face when accessing oral health care and to do that, we need data. We look forward to working with AIDPH to bring solutions to our veterans to give them the equitable care they deserve.” “AIDPH is excited to work with CareQuest Institute on advancing health equity in the oral health and well-being of veterans,” said Annaliese Cothron, AIDPH executive director. “Now more than ever, veterans need innovative, whole-person approaches to care in an integrated system that they have a voice in designing. We have been listening to the veteran community, stakeholders, and veteran-run organizations to set the priorities for our joint work.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care --- ### [CareQuest Institute Commends WHO For Adding Three Minimally Invasive Oral Health Care Medicines](https://carequest.org/press-release/carequest-institute-commends-who-for-adding-three-minimally-invasive-oral-health-care-medicines/) **Published:** October 6, 2021 **Author:** Jasmin Fernandes **Content:** The World Health Organization (WHO) published the [new edition of its Model Lists of Essential Medicines (EML) and Essential Medicines for Children](https://apps.who.int/iris/bitstream/handle/10665/345554/WHO-MHP-HPS-EML-2021.01-eng.pdf) on Oct. 1, 2021, in which it recommended the establishment of a new section for children and adult dental preparation. The WHO’s Expert Committee added three new oral health medicines — fluoride toothpaste, silver diamine fluoride, and glass ionomer cement — to the lists aimed at addressing global health priorities. These medicines provide the greatest benefits, according to WHO, and should be available and affordable for all. These medicines are central to minimally invasive care, a care philosophy of decreasing and even eliminating the need for a dental drill and local anesthetic. They empower more oral health providers to treat tooth decay because they don’t require advanced skills such as drilling or numbing. This approach to care for tooth decay improves access, outcomes, and experience for many patients. Jeremy Horst Keeper, DDS, PhD, director of clinical innovation at CareQuest Innovation Partners, a subsidiary of CareQuest Institute for Oral Health, was part of the group of international experts who developed the proposal for glass ionomer cement to be included in the EML. He applauded the committee for their acknowledgement of oral health care’s impact on the global public health problem and addition of these medicines: “This is a huge milestone in ensuring that billions of people will gain access to simple, non-invasive treatments for the most common disease in the world. The WHO has recognized that these three medicines, and not fillings, are the first-line treatment for tooth decay.” Keeper also explained why this shift in treatment is so important for children. “Traditional dental procedures can be difficult for children, so providers often use sedation and anesthesia, which is expensive and can have adverse health effects on the overall body. Adding silver diamine fluoride and glass ionomer cement to the WHO EML for both children and adults eases the management of disease for all, but especially kids. We thank the WHO for taking this step toward a more person-centric and accessible approach to oral health care and helping millions of children in the process. Oral health care is health care. We are encouraged by this news and must continue to improve access to dental medicines and support additional innovations that allow us to improve health outcomes for all.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Minimally Invasive Care, Person-Centered Care, Special Patient Care --- ### [CareQuest Institute for Oral Health on Congress’ Failure to Include a Dental Benefit in Medicare](https://carequest.org/press-release/carequest-institute-for-oral-health-on-congress-failure-to-include-a-dental-benefit-in-medicare/) **Published:** October 28, 2021 **Author:** Jasmin Fernandes **Content:** ## *“Today’s announcement is a huge disappointment to all those who care so deeply about creating a more equitable health system.”* CareQuest Institute for Oral Health, a leading national organization focused on improving oral health for all, expressed disappointment in the reconciliation framework announced today that does not include a Medicare dental benefit, [despite massive support for the program among the American people.](https://www.carequest.org/about/news/national-survey-finds-broad-bipartisan-support-medicare-dental-coverage) Strengthening Medicare by including dental coverage, as discussed over the last several months as a deal was being negotiated, would represent a giant step toward improving health equity, access, and outcomes for seniors and people with disabilities. The decision to leave this program out of the reconciliation bill will only exacerbate existing disparities and troubling trends: - According to the CDC, one in five adults aged 65 years or older have untreated tooth decay or have lost all their teeth and more than two in three older adults have gum disease. - In 2018, according to the Kaiser Family Foundation, almost half of all Medicare beneficiaries did not have a dental visit, with higher rates among those who are Black (68%), Hispanic (61%), or have low incomes (73%). - Twenty percent of rural seniors have not seen a dentist in more than five years. - Poor oral health has a direct impact on overall health and is associated with increased risk of chronic conditions such as diabetes, heart disease, respiratory illness, and Alzheimer’s. A [recent CareQuest Institute poll](https://www.carequest.org/about/news/national-survey-finds-broad-bipartisan-support-medicare-dental-coverage) revealed that eight in 10 voters favored the inclusion of dental benefits in Medicare. CareQuest Institute and its long-standing partners have been fiercely advocating for the dental benefit inclusion, including the launch of a [significant digital campaign](https://carequest.org/national-oral-health-leader-launches-major-ad-campaign-to-support-medicare-dental-benefit/) in 16 key states and [convening a coalition of health leaders](https://carequest.org/coalition-of-leading-health-professionals-and-advocates-calls-on-congress-to-act-now-to-strengthen-medicare-by-adding-dental-coverage/) in urging its passage. **CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement:** “Today’s announcement is a huge disappointment to all those who care so deeply about creating a more equitable health system. By failing to include a Medicare dental benefit, Congress is leaving in place one of the greatest drivers of disparities in our health system and leaving millions of older Americans and people with disabilities without access to essential care.” “Progress is never a straight line. We urge Congress to add critical dental benefits to Medicare as the package is finalized. CareQuest Institute will continue to fight until everyone has access to the health care they deserve, and we build a more equitable health system for all.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Special Patient Care, Value-Based Care --- ### [With Deal On Prescription Drugs, Oral Health Advocates Urge Savings To Go Toward Inclusion Of Medicare Dental Benefit](https://carequest.org/press-release/with-deal-on-prescription-drugs-oral-health-advocates-urge-savings-to-go-toward-inclusion-of-medicare-dental-benefit/) **Published:** November 3, 2021 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute President and CEO Dr. Myechia Minter-Jordan: “By closing this giant gap in our Medicare system, we’ll be building a path to a healthier future for millions of people who have been left behind by a broken health system.”* With Congressional Democrats announcing an agreement to lower prescription drug prices, and a reported plan to use at least some of the funds to go toward paid family leave policies, oral health advocates today urged Congress to include Medicare dental benefits as part of the Build Back Better reconciliation package. CareQuest Institute for Oral Health, a national nonprofit championing a more equitable future through quality oral health for all, urged Congressional leaders to utilize the prescription drug savings – expected to be in the billions of dollars annually – to include Medicare dental benefits. Expanding access to quality oral health for seniors and people with disabilities is key to improving health outcomes and reducing the deep racial disparities that exist in our health system. It will also reduce costs in the long-term through better management of chronic diseases and a reduction in emergency department use for preventable oral health conditions. Additional facts about oral health and Medicare include: - Poor oral health is directly linked to conditions such as diabetes, heart disease, respiratory illness, and even Alzheimer’s – all diseases that particularly impact our older citizens and put them at even greater risk of COVID-19. - Of the 60 million Medicare beneficiaries, [more than two-thirds don’t have any dental coverage at all.](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) - Nearly half of all Medicare patients [haven’t visited a dentist within the past year](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare). Those numbers are closer to 70 percent for Black, Hispanic and lower-income Medicare beneficiaries. - One in five rural seniors haven’t seen a dentist in the past five years. - One study estimated $65 billion in medical savings over ten years simply by providing dental and periodontal treatment through Medicare. **CareQuest** **Institute for Oral Health CEO and President Dr.** **Myechia** **Minter-Jordan issued the following statement:** “This pandemic has presented us with enormous public health challenges, but it has also given us the opportunity to rewrite the book and recover stronger, healthier, and more equitably than ever before. Improving access to oral health is foundational to that work. We recognize that Congress is weighing a number of important programs to include in the Build Back Better plan and we encourage policymakers to affirm that oral health care is health care. A deal on prescription drug pricing gives us a once-in-a-generation opportunity to finally include dental coverage under Medicare. By closing this giant gap in our Medicare system, we’ll be building a path to a healthier future for millions of people who have been left behind by a broken health system. We urge Congress and President Biden to act.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute and American Institute of Dental Public Health Issue Recommendations on Veteran Oral Health](https://carequest.org/press-release/carequest-institute-and-american-institute-of-dental-public-health-issue-recommendations-on-veteran-oral-health/) **Published:** December 15, 2021 **Author:** Jasmin Fernandes **Content:** ## *Organizations Highlight Need to Expand Access, Improve Care for Veterans.* Today, CareQuest Institute for Oral Health and American Institute of Dental Public Health (AIDPH) issued [several strategic recommendations](https://www.carequest.org/veteran) to improve veteran oral health, highlighting a worrying gap in care and access. Compared to nonveterans, veterans are more likely to experience worse oral health outcomes, including higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care. The recommendations are part of a new [white paper](https://www.carequest.org/veteran) from CareQuest Institute and AIDPH — *Veteran Oral Health: Expanding Access and Equity* — that focuses on the need to better understand the significant deficits surrounding veteran oral health. “Today’s announcement is meant to shed light on the struggles veterans can face with oral health care and offer potential solutions,” said Sean G. Boynes, DMD, MS, vice president of health improvement at CareQuest Institute. “We are proud to partner with veteran organizations and AIDPH to galvanize community stakeholders and care teams to help close these gaps.” According to the white paper, which includes a review of the latest research on veteran oral health: - Approximately 42% of veterans report having had gum treatment or bone loss around their teeth as compared to 27% of nonveterans - Roughly two in five, or 8 million veterans, describe their oral health as fair or poor - Nearly 24% of veterans live in rural areas, where consistent access to care can be challenging “AIDPH, in collaboration with CareQuest Institute, is dedicated to centering the veteran voice in our research, advocacy, and education as we improve the oral health and well-being of the veteran community,” said Annaliese Cothron, DHSc, MS, CPH, executive director of AIDPH. “Veterans deserve equitable oral health. Our community of veteran advocates is committed to pursuing strategic initiatives that innovate in the veteran oral health space.” The white paper details the coverage and benefits for dental services available to veterans, analyzes data to evaluate veteran oral health, and provides strategic recommendations to support equitable oral health for veterans, including: - Expanding eligibility criteria for veterans to receive oral health services - Expanding the role of Federally Qualified Health Centers and rural health clinics - Advancing medical-dental integration in veteran health care View the Executive Summary or read the full [white paper](https://www.carequest.org/veteran). **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute: Pass Build Back Better Act](https://carequest.org/press-release/carequest-institute-pass-build-back-better-act/) **Published:** December 21, 2021 **Author:** Jasmin Fernandes **Content:** ## *National Nonprofit Calls for Legislation to Reduce Health Care Costs and Improve Access and Equity.* Following recent developments in Washington, DC, CareQuest Institute for Oral Health stressed the importance of passing the Build Back Better Act to lower health care costs, improve access, and promote equity for millions of people across the country. **CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement:** “The Build Back Better Act includes significant social and health care safety net measures that will improve the lives of millions of people across this country, especially those in underserved communities. This legislative package is a real opportunity to put people first by improving access to necessary services, promoting equity, and making progress toward greater integration of the health and social factors impacting peoples’ well-being. CareQuest Institute will continue to work alongside our partners to advocate for President Biden’s Build Back Better Act and fight for a healthier future for all Americans.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Value-Based Care --- ### [Oral Health Pandemic Response Workgroup Urges Federal Prioritization of Oral Health](https://carequest.org/press-release/oral-health-pandemic-response-workgroup-urges-federal-prioritization-of-oral-health/) **Published:** January 5, 2022 **Author:** Jasmin Fernandes **Content:** ## *Group Asks to Convene Stakeholders and Develop Action Plan to Promote Health Equity and Access. The Oral Health Pandemic Response Workgroup, a group of executives from across the dental landscape convened by [CareQuest Institute for Oral Health](https://www.carequest.org/ "CareQuest Institute Website"), is urging health officials at the US Department of Health and Human Services (HHS) to prioritize oral health equity and access at the federal level. The group sent letters to Assistant Secretary for Health Admiral (ADM) Rachel L. Levine, MD, and the National Coordinator for Health Information Technology Micky Tripathi, PhD, MPP, asking to convene stakeholders and develop an action plan to promote equitable oral health policies and programs in its work. The pandemic has shown that oral health inequities in our nation are profound. Access to oral health care remains out of reach for many low-income families and individuals, individuals with disabilities, communities of color, Tribal communities, and many rural communities. A growing body of evidence also demonstrates that [poor oral health can contribute to significant complications in systemic disease](https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf "Oral health and systemic disease"), such as diabetes and heart disease. In addition, studies have demonstrated that poor oral health contributes to increased overall medical costs. “Oral health is essential health care, but across our country, people continue to experience deep disparities in access to services and health outcomes,” said Myechia Minter-Jordan, MD, MBA, president and CEO at CareQuest Institute for Oral Health. “As leaders from the health care industry, we are urging top federal health officials to prioritize oral health and we stand ready to collaborate on those efforts.” [In the letter to ADM Levine](https://carequest.org/wp-content/uploads/2025/12/PRWLettertoADMLevine.pdf "ADM Levine Letter"), the Oral Health Pandemic Response Workgroup calls for promoting oral health in the broader administrative, policymaking, legislative, and regulatory activities of HHS and the Biden Administration, including organizing an oral health summit or similar opportunity to get input from the oral health community on all health policy commissions, task forces, and health-related meetings hosted by the Administration. [In its letter to Dr. Tripathi](https://carequest.org/wp-content/uploads/2025/12/PRWLettertoDr.Tripathi.pdf "Tripathi letter"), the group identifies the lack of medical-dental integration as a major barrier to oral health equity. Currently, data exchange between medical and dental providers is limited. Many dental practices are not yet using electronic dental records (EDR). Those that are using EDRs often encounter challenges with the lack of integration with other platforms, preventing streamlined communication between health care providers. The letter goes on to ask for Dr. Tripathi to convene key stakeholders across medicine, dentistry, health information technology, and federal and state entities to explore opportunities to improve the nation’s oral health and overall health by ensuring that providers have the information they need to provide patient-centered, comprehensive, and integrated medical and dental care. “Now is the time to bring Government officials and the health care community together to promote a more equitable health system that includes oral health,” said Cheryl Lee, DDS, president of the National Dental Association. “Our members look forward to working closely with HHS officials and key stakeholders to make oral health a priority across the board.” The Oral Health Pandemic Response Workgroup looks forward to bringing oral health stakeholders to the table and working with ADM Levine and Dr. Tripathi to develop a plan of action for this important work. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care, Value-Based Care --- ### [CareQuest Institute on President Biden’s State of the Union Address](https://carequest.org/press-release/carequest-institute-on-president-bidens-state-of-the-union-address/) **Published:** March 2, 2022 **Author:** Jasmin Fernandes **Content:** ## *National Nonprofit Commends President’s Commitment to Improving Medicare and to Lowering Health Care Costs. Following the Presidential State of the Union Address, [CareQuest Institute for Oral Health](https://carequest.org/), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, commended President Joe Biden’s commitment to improving access and care in the Medicare system and to lowering health care costs. **CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement:** “We applaud President Biden’s commitment to improving access and care in the Medicare system and lowering health care costs for Americans across the country, including by allowing Medicare to negotiate lower prices for prescription drugs. The savings generated by these policy changes can and should be used to further strengthen the Medicare program by including comprehensive dental coverage for 26 million seniors and people living with disabilities. Health care is a right, not a privilege and all Americans deserve access to affordable, quality health care, including oral health. CareQuest Institute shares the President’s dedication to improving the health and well-being of millions of people across this country, especially those in marginalized communities. We will continue to work with the Biden Administration and our other partners to not just imagine a healthier future for all Americans, but to fight for it each day through our work.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Value-Based Care --- ### [CareQuest Institute CEO Dr. Myechia Minter-Jordan Presents on Health Equity at SXSW](https://carequest.org/press-release/carequest-institute-ceo-dr-myechia-minter-jordan-presents-on-health-equity-at-sxsw/) **Published:** March 15, 2022 **Author:** Jasmin Fernandes **Content:** ## *CEO of National Nonprofit Makes “Business Case” for Investing in BIPOC Communities to Achieve Health Equity.* Highlighting racism as a public health crisis, Dr. Myechia Minter-Jordan, president and CEO of [CareQuest Institute for Oral Health](https://carequest.org/) – a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system – led a presentation at [SXSW this weekend](https://schedule.sxsw.com/2022/events/PP115820) on health equity, in which she made the “business case” for scalable investments in community-driven health solutions by and for communities of color. “Our health care system doesn’t work for everyone because it wasn’t built for everyone. From maternal health to oral health, people of color have been experiencing worse health outcomes than their white counterparts for generations,” said Dr. Minter-Jordan of CareQuest Institute. “While models that successfully engage these communities in solutions to address inequity are rare, there has never been a better moment — from a moral and a business perspective — to truly invest in communities of color. Scalable and sustainable investments that meaningfully engage historically marginalized people will help create a system that is fairer and more equitable, providing a path forward to transforming our health care system to work better for everyone.” [SXSW](https://www.sxsw.com/) is one of the world’s premier events and brings thousands of people to Austin, Texas each year to showcase music, film and interactive media. Dr. Minter-Jordan’s session was part of [SXSW’s Health & MedTech Track](https://sxsw.com/conference/health/), which is centered on how social and technological changes are impacting one of the world’s largest industries. During her presentation, Dr. Minter-Jordan discussed the systemic racism that impacts every aspect of our society, including health care, and how the COVID-19 pandemic has only exacerbated these inequities. Dr. Minter-Jordan argued that this environment has never been stronger for business investment in new models, technologies, and services that are informed and led by BIPOC communities and address social determinants of health. **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [Surveys Show Older Adults Delayed Dental Care More Than Any Other Care During Pandemic](https://carequest.org/press-release/surveys-show-older-adults-delayed-dental-care-more-than-any-other-care-during-pandemic/) **Published:** March 22, 2022 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute calls for Medicare dental benefit as America faces anticipated pandemic-related spike in oral health needs.* A [new analysis](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic) has shown that older adults delayed dental care more than any other health care during the pandemic, [CareQuest Institute for Oral Health](https://www.carequest.org/) announced today. CareQuest Institute – a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system – is reiterating its call for dental coverage to be added to Medicare, which would expand access to oral health for seniors and people with disabilities, improve health outcomes, and reduce the deep racial inequities that exist in our health system. CareQuest Institute analyzed responses from three surveys of Medicare beneficiaries conducted by federal health officials. It released several key findings from the analysis today, including: - 1 in 5 Medicare beneficiaries (21%), or 13 million people, delayed some form of health care due to the disruption caused by COVID-19. - Nearly 44% of those who delayed care, or 5.7 million people, put off dental care — a higher rate than any of the other seven types of care, including medical treatment, medical surgery, and vision or hearing services. - Between the summer and fall of 2020, the likelihood of delaying dental care fell in white and Hispanic participants, while Black participants who delayed dental care increased from 36% to 45% in the same period. “We continue to advocate that dental care be covered by Medicare because it’s a commonsense solution to the many barriers that millions of people, including older adults, face when accessing health care,” said Michael Monopoli, DMD, MPH, MS, FACD, FICD, vice president of grant strategy at CareQuest Institute. “It’s also a way for us to address some of the many adverse effects of the COVID-19 pandemic, including a likely increase in oral disease because of delayed care.” Strengthening Medicare by including dental coverage would also help counter the likely scenario revealed by the surveys: that America will experience a pandemic-related spike in tooth decay and other forms of oral disease. A 2021 [CareQuest Institute poll](https://carequest.org/national-survey-finds-broad-bipartisan-support-for-medicare-dental-coverage/) revealed that 8 in 10 voters favored the inclusion of dental benefits in Medicare. CareQuest Institute and its long-standing partners have been fiercely advocating for the dental benefit inclusion. Older adults in the US face [barriers to accessing dental care](https://www.researchgate.net/profile/Donna-Shelley/publication/263130351_Barriers_to_Dental_Services_for_Older_Adults/links/557a158f08ae752158717d5e/Barriers-to-Dental-Services-for-Older-Adults.pdf), including cost of care, lack of transportation, and difficulty navigating the oral health care system. In 2021, [over 26 million Medicare beneficiaries lacked dental coverage, exacerbating older adults’ risk](https://carequest.org/a-snapshot-of-the-76-5-million-americans-without-dental-insurance/) for poor oral health outcomes. Without coverage, dental care can impose significant out-of-pocket costs on older adults and many don’t receive regular routine dental services. Disruptions in access to dental care due to the COVID-19 pandemic [further worsened oral health disparities](https://carequest.org/oral-disease-is-common-access-to-care-is-not/). [Click here](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic) to read the full CareQuest Institute analysis. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [New National Nonprofit Will Battle Inequity in Health Care](https://carequest.org/press-release/new-national-nonprofit-will-battle-inequity-in-health-care/) **Published:** March 29, 2021 **Author:** Jasmin Fernandes **Content:** ## *The CareQuest Institute for Oral Health will champion health transformation to build a future in which better health through oral health is possible for everyone.* Amidst a national reckoning on the deep inequities that exist across this country, a new national nonprofit organization launches today with a commitment to creating a health system that is more accessible, equitable, and connected. CareQuest Institute for Oral Health — with two billion dollars in revenues and in estimated assets — will serve as a national champion of oral health transformation, because good overall health depends on good oral health. This new organization will amplify and expand the programming, resources, and strengths of past organizations — including the DentaQuest Partnership for Oral Health Advancement – to broaden its impact and move faster toward creating a health system designed for everyone. CareQuest Institute is also announcing the creation of CareQuest Innovation Partners, a for-profit affiliate dedicated to advancing innovation to transform oral health access and outcomes for underserved populations. CareQuest Innovation Partners will officially launch later this year. “The past year has laid bare what we knew long before the COVID-19 crisis—we have a health system that does not work for everyone because it was not built for everyone,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute. “We cannot stand by and allow the status quo to define our future. At CareQuest Institute for Oral Health, we are putting everything we have into championing progress and solving these issues. And we will stand with anyone who shares our belief in a future where better health through oral health is possible for everyone.” “There is no shortage of work to be done to fix our health care system and achieve one that recognizes that health care is a fundamental human right,” said Kedar Mate, MD, president and CEO at the Institute for Healthcare Improvement (IHI). “Oral health is a significantly underappreciated driver of inequity in health care. That’s why I am grateful that the CareQuest Institute for Oral Health is prioritizing a focus on oral health equity. Science and knowledge can guide action, but they do not always cause action. A commitment to progress and action from organizations like CareQuest Institute will help us achieve meaningful change.” A recent survey conducted by CareQuest Institute highlights the urgent need for action to create a more equitable, accessible, and integrated oral health care system. Among its findings, the survey reveals that roughly 6 million adult Americans have lost their dental insurance due to a job loss or benefits change that was caused by the COVID-19 pandemic. Additionally, 65% of this group reported having a health symptom that often stems from an oral health disease affecting teeth, gums, or other tissues in the oral cavity. This statistic suggests that lack of dental coverage and inaccessibility of affordable care is fueling an oral health crisis. “We cannot continue to separate the mouth from the body,” said Caswell A. Evans, Jr., DDS, MPH, emeritus professor, past associate dean for prevention and public health sciences, University of Illinois at Chicago, College of Dentistry. “Oral and systemic diseases are inextricably linked and improving patient health outcomes requires us to upend long standing barriers to health by transforming our systems of care. This is exactly the kind of work that the CareQuest Institute is focusing its collaborative energy and expertise on to address inequity in health.” Like the COVID-19 pandemic, the oral health crisis is disproportionately impacting communities of color, those living in rural communities, people with disabilities, older adults, and other historically marginalized groups. According to CareQuest Institute’s recent survey, Black Americans suffered a loss of dental coverage at a rate that was more than double that of white Americans, while Asian Americans were three times more likely to have lost coverage. “Oral health care, like primary care, faces serious challenges from outdated approaches to care delivery, payment, and data exchange that result in systemic barriers to optimal health for millions of people,” said Russ Phillips, MD, director of the Center for Primary Care at Harvard Medical School. “The dedicated scientists, researchers, clinicians, and public health experts at the CareQuest Institute not only offer a deep understanding of these barriers but practical solutions working with communities to advance real systems change.” While this new data illustrates the compounding effects of the pandemic on disparities in health, these disparities are not new. [Prior research](https://www.carequest.org/resource-library/nhanes-oral-health-data-reflect-barriers-inequities) has shown that Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance. Black adults are 68% more likely to have an unmet dental need than white adults, and nearly 4 in 10 Black and Latinx adults reside in 14 states where Medicaid’s adult dental benefits cover no services or emergency-only care. “Transforming health through oral health demands a person-centered, equity-driven approach,” said Ann Greiner, president and CEO, Primary Care Collaborative. “The leadership at CareQuest Institute is committed to that approach and understands that integration of oral health into primary care is fundamental to addressing long-standing disparities.” CareQuest Institute will operate as a catalyst for systems change, bringing forth ideas and solutions to create a more equitable, accessible, and integrated health system for everyone. It will do this through its five areas of activation: - Grantmaking – investing strategically to strengthen communities and improve the overall health system. - Care Improvement – partnering with public and private stakeholders across the care continuum to test and measure prevention-focused, person-centered strategies. - Research – conducting innovative research and actively seeking out and analyzing data to reveal opportunities to transform oral health care and improve patient outcomes. - Education – building a world-class education program for medical and dental professionals, students and community partners who are committed to attaining the knowledge and skills required to transform oral health and health care. - Policy and Advocacy – mobilizing diverse coalitions, creating pathways and championing policies that lead us to a more integrated, accessible and equitable oral health care system. The full CareQuest Institute portfolio — organizations in which CareQuest Institute has full or majority ownership stakes — includes dental benefits companies that collectively serve more than 32 million people nationwide, care delivery settings, and CareQuest Innovation Partners. **Categories:** Press Release **Tags:** Clinical Practice, Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care, Value-Based Care --- ### [Major National Survey Reveals Impending Spike in Oral Health Needs](https://carequest.org/press-release/major-national-survey-reveals-impending-spike-in-oral-health-needs/) **Published:** April 8, 2021 **Author:** Jasmin Fernandes **Content:** ## *CareQuest Institute for Oral Health, survey finds 6 million people have lost oral health coverage because of COVID-19 pandemic.* Uncovering a potential surge in upcoming health needs, CareQuest Institute for Oral Health today [released the first in a series of reports](https://www.carequest.org/resource-library/coming-surge-oral-health-treatment-needs) that will provide in-depth analysis of the results of a comprehensive national survey aimed at understanding oral health equity in the US. The report released today, “A Coming Surge in Oral Health Treatment Needs,” looks specifically at the impacts of the COVID-19 pandemic on our oral health and overall health systems. The findings of the survey of more than 5,000 Americans indicate that the nation’s health system, including hospitals and ambulatory care centers, should expect a significant spike in the need to treat oral disease and address its impact on overall health. The report cites lack of dental benefits due to job loss, delays in care due to cost of care, and concerns about exposure to the coronavirus as major contributors to the anticipated surge in oral health treatment needs. “As we emerge from the depth of the pandemic, we expect to confront an additional challenge caused by the untreated health needs of so many people, particularly among historically marginalized communities,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute. “Our survey shows that millions of people have lost coverage and delayed care during the pandemic, and many are already showing signs of oral health disease. This will impact all of us because of the potential this surge has to further strain our health care system. We know poor oral health has a direct tie to poor overall health. At the CareQuest Institute for Oral Health, we are putting everything we have — our research, grants, advocacy, education, and health improvement programs — to address this crisis and build a health system that works for everyone.” Based on the survey results, report authors found that an estimated 6 million adults in the US have lost dental insurance as a result of losing their jobs because of the COVID-19 pandemic. Among those surveyed who identified the pandemic as the reason for losing dental insurance, 65% reported having an oral health symptom that often stems from a disease affecting teeth, gums, or other tissues in the oral cavity. Additionally, an estimated 28 million adults have delayed getting dental care because of one or more concerns, including the cost of care, lack of insurance, or concerns about risk of exposure to the virus. This suggests that lack of dental coverage and inaccessibility of affordable care is further fueling the ongoing oral health crisis in the US. Research has shown that adults who lack coverage for preventive or restorative dental care often put off care until pain prompts them to visit a hospital emergency department. These visits are expensive — costing $2.7 billion in 2017 — and rarely address the root cause because emergency departments are not equipped to properly treat oral disease. More than one-third (35%) of adults surveyed said they have at least one chronic health condition, and 68% of this group also reported an unaddressed oral health symptom. Nearly 58% of this group had not sought care for their oral health symptom. Given the [link between oral health and a variety of chronic health conditions](https://www.carequest.org/resource-library/impacts-beyond-mouth), the anticipated rise in oral diseases has serious implications for the broader health care system and the overall health of the population. “This report should serve as notice to the health care provider community that as the pandemic recedes, the health system could face a tsunami of patients with severe health issues that have gone untreated over the last year,” said Dr. Minter-Jordan. “This increased need for care will consist of a disproportionate share of individuals from historically marginalized communities seeking care from places like emergency departments that are ill equipped to address their oral health needs. When a lack of insurance, cost barriers, and other access issues prevent millions of Americans from receiving basic oral health care, there is no question that our system does not work for everyone.” Like the COVID-19 pandemic, the oral health crisis is disproportionately impacting communities of color, those living in rural communities, people with disabilities, older adults, and other historically marginalized groups. According to the survey, Black Americans suffered a loss of dental coverage at a rate that was more than double that of white Americans, while 19% of Asian Americans lost dental insurance, a rate three times that of white Americans. Asian Americans also reported the highest loss of medical insurance, with 35% having lost this coverage during the pandemic. While the new data illustrate the compounding effects of the pandemic on disparities in health, these disparities are not new. [Prior research](https://www.carequest.org/resource-library/nhanes-oral-health-data-reflect-barriers-inequities) has shown that Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance. Black adults are 68% more likely to have an unmet dental need than white adults, and nearly 4 in 10 Black and Latinx adults reside in 14 states where Medicaid’s adult dental benefits cover no services or emergency-only care. Additional reports in this series will similarly include actionable insights based on the results of the national survey and will be released in the coming weeks and months. The survey — State of Oral Health Equity in America — will be conducted on an annual basis. Taken together, the reports will allow health professionals, policymakers, and thought leaders to better understand the state of oral health equity in the US and drive progress in eliminating barriers to excellent health for everyone. **Survey methodology** State of Oral Health Equity in America 2021 is a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. Survey data was collected in January and February 2021 on adults 18 and older by the National Opinion Research Center on the AmeriSpeaks panel. Amerispeaks is a probability-based panel designed to be representative of the US household population. Randomly selected US households were sampled using area probability and address-based sampling, with a known, non-zero probability of selection from NORC National Sample Frame. Sampled households were contacted by US mail, telephone, and field interviewers. A sampling unit of 16,986 was used with a final sample size of 5,320, with a final weighted cumulative response rate of 5.2%. All data presented account for appropriate sample weights. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [CareQuest Institute Commends CDC For Declaring Racism A Public Health “Epidemic”](https://carequest.org/press-release/carequest-institute-commends-cdc-for-declaring-racism-a-public-health-epidemic/) **Published:** April 12, 2021 **Author:** Jasmin Fernandes **Content:** ## *Statement from Dr. Myechia Minter-Jordan: “We cannot truly address disparities in health care without addressing systemic racism that underlies it all.”* On April 8, Center for Disease Control and Prevention Director Dr. Rochelle Walensky issued a statement declaring racism an “epidemic” that is impacting public health. Today, CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement commending Dr. Walensky for her comments. Dr. Minter-Jordan, also a physician and former CEO of the Dimock Health Center, states that we cannot truly address health care disparities without addressing systemic racism across all areas of society that “underlies it all.” **The following is a statement from CareQuest Institute CEO and President Dr. Myechia Minter-Jordan** “I commend the CDC and Dr. Rochelle Walensky for calling out racism as the public health epidemic that it is. The COVID-19 crisis has laid bare the deep racial disparities in our health care system. But we cannot expect those inequities to simply fade after the pandemic, because the pandemic didn’t create them. Lack of economic opportunity, lack of affordable housing and healthy food options, lack of access to health insurance, lack of quality affordable care, lack of representation in the medical field, implicit bias and, stereotyping – these are all barriers that have blocked people of color from their access to a fair system for generations. We cannot address inequities in health care without addressing the systemic racism that underlies it all. Oral health must be part of that work. Oral health care has been treated as separate from our overall health system for far too long. Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance, and Black adults are 68% more likely to have an unmet dental need than white adults. With the direct tie between oral health and overall health, there is no question that these disparities lead to poorer health outcomes for people of color. I appreciate the words of Dr. Walensky and implore everyone in our health care and public policy community to declare racism a public health crisis and take action. When we do, we can truly begin the long, difficult journey of building a health system that works for everyone. Finally.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [COVID-19 Pandemic Disproportionately Impacting Access to Health Care for Asian Americans](https://carequest.org/press-release/covid-19-pandemic-disproportionately-impacting-access-to-health-care-for-asian-americans/) **Published:** April 15, 2021 **Author:** Jasmin Fernandes **Content:** ## *National survey finds alarming rates of insurance coverage loss and denial of care among Asian Americans.* Amidst the rise in hate and violence against Asian Americans during the pandemic, a new analysis by CareQuest Institute for Oral Health reveals that the COVID-19 public health crisis has disproportionately impacted health access and increased health disparities among Asian Americans. Researchers analyzed results from CareQuest Institute’s nationwide survey of more than 5,000 households conducted earlier this year on consumer and patient attitudes, experiences, and behaviors related to health and oral health. Of the 5.4 million people who reported losing their health insurance due to the pandemic, 12% were Asian American. This is a significantly disproportionate impact when compared to the percent of the total population identifying as Asian American (5%). In fact, Asian Americans were three times more likely to have experienced this loss of coverage compared to their white peers. This disproportionate impact is similarly reflected in the numbers of people who lost dental insurance with nearly 10% of the 6 million people who lost dental coverage identifying as Asian American. Additionally, Asian Americans were the second most likely group to report being denied health care or dental care due to discrimination (15%). The discrimination experienced by Asian communities has also translated to a negative impact on health care access as a result of the pandemic. “These findings are yet another example of how the pandemic is disproportionately impacting communities of color in unconscionable ways,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health. “These findings are most alarming because people who identify as Asian have historically experienced some of the lowest uninsured rates of any group in the US. We are experiencing a racial reckoning on multiple fronts in this country and we need to ensure that we continue to face systemic racism head on — including its many manifestations in health care.” Researchers also found that those who have experienced loss of insurance coverage or denial of care will likely see their overall health impacted by these disparities: - Among those who cited COVID-19 as the reason for losing dental insurance, 65% reported having an oral health symptom that often stems from a disease affecting teeth, gums, or other tissues in the oral cavity. - Many others have cancelled or put off important preventive care in the last year – 28 million adults, have delayed care because of concerns ranging from cost and lack of insurance to risk of exposure to the virus. **Survey methodology** State of Oral Health Equity in America 2021 is a nationally representative survey of consumer and patient attitudes, experiences, and behaviors on oral health. Survey data was collected in January and February 2021 on adults 18 and older by NORC at the University of Chicago on the AmeriSpeak panel. Amerispeak is a probability-based panel designed to be representative of the US household population. Randomly selected US households were sampled using area probability and address-based sampling, with a known, non-zero probability of selection from NORC National Sample Frame. Sampled households were contacted by US mail, telephone, and field interviewers. A sampling unit of 16,986 was used with a final sample size of 5,320, with a final weighted cumulative response rate of 5.2%. All data presented account for appropriate sample weights. The margin of error in the survey is 1.86%. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [New Report Outlines Dramatic Reduction in Access to Primary Care – Including Oral Health Care – During Pandemic](https://carequest.org/press-release/new-report-outlines-dramatic-reduction-in-access-to-primary-care-including-oral-health-care-during-pandemic/) **Published:** April 29, 2021 **Author:** Jasmin Fernandes **Content:** ## *Harvard Center for Primary Care, CareQuest Institute, Milbank Memorial Fund support expert analyses of COVID-19 impacts to identify opportunities for future of primary care.* The COVID-19 pandemic dramatically reduced [access to primary care](https://www.carequest.org/topics/expanding-access) worldwide, including oral health care, especially for those who were already disproportionately at risk for COVID-19, according to a [new report](http://info.primarycare.hms.harvard.edu/primary-care-during-covid-0) released today. The [Harvard Center for Primary Care](https://primarycare.hms.harvard.edu/), with support from the [CareQuest Institute for Oral Health](https://www.carequest.org/) and the [Milbank Memorial Fund](https://www.milbank.org/), released, “Primary Care in the COVID-19 Pandemic,” which provides analysis of primary care trends over the course of the pandemic from top health care leaders. The report also includes a range of strategies for primary care clinical teams, health care industry leaders, and policy experts to improve access to high quality primary care, accelerate transitions to alternative forms of care delivery, and address health disparities. Authors of the report seek to uncover and provide a deeper understanding of the following: 1. How access to high quality primary care is being preserved or improved during the COVID-19 pandemic. 2. Which primary care practice challenges and responses during the COVID-19 pandemic provide opportunities for accelerating transitions to alternative care delivery models including virtual care and value-based payments for population health. 3. Specific care strategies that can best address health disparities highlighted or heightened by the COVID-19 pandemic. “Primary care suffered greatly at the hands of COVID-19. In-person visits were eliminated nearly everywhere, loss of revenue threatened the survival of several, especially small, primary care practices and concerns about exposure to the virus kept at-risk patients from seeking primary care services for months. This has exposed disparities that have long existed in health care and are deeply rooted in structural racism, poverty, and other social determinants that disproportionally impact marginalized communities,” said Russ Phillips, Director of the Harvard Center for Primary Care. “That is why we partnered with some of health care’s most brilliant minds to identify opportunities to best advance primary care in support of health equity.” Oral health is a critical, yet often disregarded, aspect of primary care that was particularly impacted by the pandemic. According to [research](https://www.carequest.org/resource-library/covid-19-pandemic-deepens-oral-health-inequities) by CareQuest Institute for Oral Health, more than six million adult Americans lost their dental insurance due to the pandemic and nearly two-thirds of them had a symptom frequently linked to oral diseases. Many others cancelled or put off important preventive care over the last year – nearly 4 in 10 adults delayed care because of concerns ranging from cost and lacking insurance to risk of exposure to the virus. “Oral health care is a significant, yet overlooked, driver of health disparities,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute. “The communities hit hardest by the pandemic are those that have historically faced structural barriers to accessing dental care, including low-income communities, rural communities, and communities of color. Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance, and Black adults are 68% more likely to have an unmet dental need than white adults. Moreover, oral health providers working to meet the needs of these patients and communities in the midst of the pandemic have experienced financial and operational challenges that affect their ability to reliably provide care. The research and analysis by leading experts in primary care and oral health included in the report released today offer practical solutions for a better, more equitable health care system moving forward.” The oral health chapters included in the report can also be found [here](https://www.carequest.org/resource-library/solutions-oral-health-inequities). **About HMS Center for Primary Care** The Center for Primary Care was founded in 2010 to strengthen primary care education and innovation at Harvard Medical School. Over the past 10 years, the Center has grown successfully by facilitating innovations in practices, conducting original research by studying exemplar primary care systems, launching new training programs, assisting with curricular change at HMS, supporting entrepreneurs in primary care delivery, and engaging students. Now, the Center looks to a future focused on saving and improving lives through primary care, and commits to fostering a dynamic community at Harvard Medical School to promote and support primary care resilience, equity, and value in order to improve health and wellbeing. To learn more, visit and follow us on [Twitter](https://twitter.com/HMSPrimaryCare/), [LinkedIn](https://www.linkedin.com/company/harvardmedicalschoolcenterforprimarycare/), [Facebook](https://www.facebook.com/HMSPrimaryCare/), and [Instagram](https://www.instagram.com/hmsprimarycare/). **About Milbank Memorial Fund** The Milbank Memorial Fund is an endowed operating foundation that works to improve population health by connecting leaders and decision makers with the best available evidence and experience. It does this work by: identifying, informing, and inspiring current and future state health policy leaders to enhance their effectiveness; working with state health policy decision makers on issues they identify as important to population health, particularly in areas related to primary care, aging, and total costs of care; and publishing high-quality, evidence-based publications and *The Milbank Quarterly*, a peer-reviewed journal of population health and health policy **Categories:** Press Release **Tags:** Clinical Practice, Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care, Value-Based Care --- ### [CareQuest Institute for Oral Health Commends U.S. Senators’ Push to Include Medicare Dental Coverage in American Families Plan](https://carequest.org/press-release/carequest-institute-for-oral-health-commends-u-s-senators-push-to-include-medicare-dental-coverage-in-american-families-plan/) **Published:** April 27, 2021 **Author:** Jasmin Fernandes **Content:** ## *Statement from Dr. Myechia Minter-Jordan: “Dental care is essential health care. If we value the lives of seniors and people with disabilities, there is no question that we must strengthen Medicare coverage to include oral health care.”* On April 25, seventeen United States Senators [sent a letter to President Biden](https://www.sanders.senate.gov/wp-content/uploads/Sanders-Medicare-Letter_FINAL_April-25.pdf), calling on the president to strengthen Medicare coverage in his American Families Plan, expected to be unveiled as early as today. The Senators specifically argue for the inclusion of dental benefits, citing a “dental crisis in America” that is taking a particularly acute toll on our nation’s seniors. Today, CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement commending the Senators for their support of Medicare dental benefits and urging the Biden Administration to strengthen Medicare to include dental coverage through the American Families Plan. **The following is a statement from CareQuest Institute CEO and President Dr. Myechia Minter-Jordan** “Seniors and people with disabilities served by the Medicare program are left without access to necessary dental coverage. Dental care is essential health care with direct ties to chronic illness and mental health diseases. Many Americans enter their retirement years with good oral health due to a lifetime of employer-sponsored dental benefits. Yet they are often surprised to discover that traditional Medicare does not cover preventive dental care. To leave our seniors without access to this essential health care is to abandon their overall health and wellness at the very time they need it most. I commend Senator Sanders and the 16 Senators from across the country for their leadership and strong advocacy for the inclusion of dental benefits to strengthen the Medicare program. This country is in the midst of an oral health crisis, and it has only been exacerbated by the effects of the COVID-19 pandemic. If we value the lives of seniors and people with disabilities, there is no question that we must strengthen Medicare coverage to include dental benefits.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [President and CEO of CareQuest Institute for Oral Health Dr. Myechia Minter-Jordan Named to Extraordinary Women Advancing Healthcare Awards](https://carequest.org/press-release/president-and-ceo-of-carequest-institute-for-oral-health-dr-myechia-minter-jordan-named-to-extraordinary-women-advancing-healthcare-awards/) **Published:** June 16, 2021 **Author:** Jasmin Fernandes **Content:** ## *Award Recognizes Dr. Minter-Jordan’s Transformative Leadership in Health Equity* CareQuest Institute for Oral Health announced today that President and CEO Dr. Myechia Minter-Jordan will be receiving a **Second Annual Extraordinary Women Advancing Healthcare Award** (EWAH) from The Commonwealth Institute (TCI), the leading nonprofit organization devoted to advancing all women leaders. This groundbreaking award reaches across diverse sectors of health care — from life sciences, healthcare education and systems, to healthcare foundations, professions, and public health. It recognizes and celebrates remarkable Massachusetts-based health care leaders for their outstanding career achievements and impact. “Women are driving transformational change in health care,” said Dr. Minter-Jordan. “Our system has failed those who need it most and the impact of disparities in health care — including oral health — are very real. We need not look further than the nearly three million women in the U.S. who left the workforce during the COVID-19 pandemic, facing an impossible choice between family and a paycheck. Now is the time to meet the moment and address the inequities that have plagued our communities for far too long, and I am honored to be a part of this prestigious group of women.” Through Dr. Minter-Jordan’s leadership, CareQuest Institute operates as a catalyst for systems change, bringing forth ideas and solutions to create a more equitable, accessible, and integrated health system for everyone. Before joining CareQuest Institute, Dr. Minter-Jordan served as chief medical officer and CEO of the Dimock Center, one of the largest community health centers in Massachusetts. During Dr. Minter-Jordan’s tenure, Dimock was recognized as a national model for comprehensive, integrated health and human services. As CEO, Myechia formed partnerships with world-class institutions to advance person-centered care, including Harvard Medical School, Beth Israel Deaconess Medical Center, and Partners HealthCare. Prior to Dimock, Dr. Minter-Jordan worked for Johns Hopkins Medicine as an attending physician and instructor of medicine. TCI received more than 100 nominations for the 2021 awards and selected 10 finalists for their work in advancing health care, inspiring and leading others, and fostering diversity. In addition to Dr. Minter-Jordan, TCI also selected: - Juliana H. Chen, MD, *associate director*, MGH Center for Cross-Cultural Student Emotional Wellness; *co-director, The Resilience Project Parents Program*, MGH, Newton-Wellesley Hospital - Brandi Davis-Dusenbery, PhD, *chief scientific officer,* Seven Bridges - Parastoo Khoshakhlagh, PhD, *CEO & co-founder*, GC Therapeutics, Inc. - Laura Kleiman, PhD, *CEO & founder*, Reboot Rx - Maria Palasis, PhD, *president & CEO*, Lyra Therapeutics - Claire-Cecile Pierre, MD, *executive director, Kerry Murphy Healy Center for Global Healthcare Entrepreneurship,* Babson College; *chief medical officer*, Harbor Health Services, Inc - Claire Wagner, MD, MBA, *chief of staff*, Bill & Melinda Gates Medical Research Institute - Sally (Yuanheng) Wang Liang, JD MPH, vice president*, business development*, Zonsen PepLib Biotech - Simone Wildes, MD, FACP, FIDSA, *associate director, Infectious Disease*, South Shore Health / Tufts Medical Center “The Commonwealth of Massachusetts is a global leader in the health care industry so it is fitting that The Commonwealth Institute — an organization founded over 24 years ago to help women leaders in Massachusetts achieve greater success – would celebrate and honor emerging women leaders in the industry,” said Elizabeth L. Hailer, CEO of The Commonwealth Institute and EWAH co-chair. “This award is a testament to the dedication, innovation, and influence of each of these extraordinary women leaders.” Dr. Minter-Jordan will be honored at the virtual EWAH celebration on September 30, 2021. Find a link to tickets to the celebration event, as well as more information on the awards and sponsorship opportunities at [http://commonwealthinstitute.org/programs-events/extraordinary-women-in-healthcare/](http://thecommonwealthinstitute.org/programs-events/extraordinary-women-in-healthcare/). **Categories:** Press Release **Tags:** Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care --- ### [CareQuest Institute for Oral Health Applauds Texas’s New Law Allowing Teledentistry](https://carequest.org/press-release/carequest-institute-for-oral-health-applauds-texass-new-law-allowing-teledentistry/) **Published:** June 23, 2021 **Author:** Jasmin Fernandes **Content:** Texas Governor Greg Abbott [signed into law legislation](https://legiscan.com/TX/text/HB2056/id/2304804) legalizing the use of teledentistry (TX HB 2056), requiring health benefit plans to cover approved oral health services delivered remotely. CareQuest Institute for Oral Health CEO and President Dr. Myechia Minter-Jordan issued the following statement, commending the community-based advocates and health care experts who worked together with Texas officials on this landmark legislation. Together, their efforts will remove barriers to care by [approving the use of teledentistry](https://www.carequest.org/topics/teledentistry) and requiring insurers to cover the critical mode of delivering person-centered care. “Americans have embraced telemedicine and teledentistry during the pandemic, and for good reason. Use of teledentistry expands access to care for historically marginalized populations, prioritizes dental chair time for the highest-risk patients, and helps keep low-risk patients healthy. According to our own research, in one state where teledentistry has been authorized for some time, [86% of patients said they were satisfied](https://www.carequest.org/resource-library/patients-give-high-marks-their-teledentistry-experience) with their overall teledentistry experience, and the same percentage said they would recommend teledentistry to another person. With this week’s bill signing, Texans are one step closer to expanding access to care and improving the patient experience. We applaud the many state leaders and advocates who worked tirelessly for this bill’s passage — including the Texas Dental Association, Texas Oral Health Coalition, Texas Health Initiative, Texas e-Health Alliance, and DentaQuest — and encourage the Texas State Board of Dental Examiners to act swiftly in issuing guidance so Texas dentists can begin using technology to meet the needs of their patients.” **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Practice Management, Special Patient Care --- ### [New Study Shows Costly Consequences for States Banning Fluoride](https://carequest.org/blog/new-study-shows-costly-consequences-for-states-banning-fluoride/) **Published:** May 29, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)An issue historically left to local governments is now drawing attention from some state and federal leaders — and the outcome could affect our health for generations. Water fluoridation has been a hot topic during the last few months, with Florida and Utah enacting statewide bans and similar proposals under consideration across the country. Against this backdrop, two researchers — Sung Eun Choi, PhD, from the Harvard School of Dental Medicine and Lisa Simon, MD, DMD, from Brigham and Women’s Hospital — conducted an eye-opening study to model the potential impact of removing fluoride from public water systems nationwide. The article, “[Projected Impact of Removing Fluoride from Public Water Systems in the United States](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2834515),” was published May 30 in *JAMA Health Forum*. The findings are clear: Ending water fluoridation could result in more than 25 million additional decayed teeth among children in the next five years, with the greatest impact on low-income and uninsured families. This would lead to an estimated $9.8 billion in added health care costs, further straining an already overburdened dental workforce and deepening the nation’s existing oral health crisis. We spoke with Drs. Simon and Choi about what motivated their research, what advocates need to know, and how evidence-based policymaking and storytelling can work together to protect a proven health intervention. Their insights reinforce that water fluoridation is a safe, cost-effective way to improve oral health — and that any efforts to remove it will drive up health care costs, including in Medicaid. **![](https://carequest.org/wp-content/uploads/2025/05/Fill-up-cup-of-water.jpg)Why did you do this research now? What was the intent?** **Dr. Simon:** Water fluoridation has been one of the great victories of public health, and as both a physician and a dentist, I have seen how patients growing up in unfluoridated communities have suffered worse oral health. But fluoridation is under threat, with Utah and Florida already passing bans and several other states considering a ban. We wanted to empower citizens and lawmakers with information about the potential harms that could come from stopping fluoridation. **What would you point to as the key findings?** **Dr. Choi:** Using a simulation model designed to mimic the progression and impact of dental disease in the current population, our study found that removing fluoride from US public water systems would significantly increase the risk of tooth decay among children — resulting in an estimated 25.4 million additional decayed teeth and $9.8 billion in added costs over the next five years. Given the current distribution of access to fluoridated water, this change would disproportionally affect publicly insured and uninsured children, who already face a high risk of unmet dental needs. **Why is fluoridation so critical for children from families with lower incomes or who live in rural areas?** **Dr. Simon:** Fluoridation is beneficial for everyone who receives it, including both adults and children. But the people who benefit the most are those who would otherwise not have access to preventive dental care. We know that rural and low-income families are less likely to have a dentist who works in their neighborhood or who accepts their insurance, making it more difficult for them to receive dental care to prevent tooth decay and tooth loss. But fluoridation is easily accessible to all — straight from the tap. **What, if any, are the limitations of the research?** **Dr. Choi:** Disease simulation modeling is a powerful tool, but it also has inherent limitations. These models rely on assumptions about disease progression, behavior, and intervention effects. Although we calibrated our model to reflect national averages in disease progression, it may not fully capture local or subgroup variations, reducing the model’s applicability to certain communities or states. We conducted sensitivity analyses to assess the robustness of our results, but uncertainty in how parameters interact may still influence outcomes in ways that are not fully measurable. Our study also adopted a health care system perspective, which may exclude broader societal impacts, such as missed school hours or caregiver burden resulting from increased risk of tooth decay — potentially underestimating its impact on total costs and quality of life. **If funds were limitless, what additional research would you like to do on this topic?** **Dr. Choi:** We focused our analysis on the pediatric population due to the limited data on water fluoridation access among adults. And even among children, the most recent data available were from 2013–2016. With access to more current and comprehensive data on fluoridation coverage, including geographic variation across states, we could expand our model to represent the entire US population. This would allow us to assess the broader national impact of removing fluoride, as well as state-specific effects, which would enhance the relevance of our findings for policymakers and public health planning. **What are people misunderstanding about fluoride?** **Dr. Simon:** When something has worked for so long and so well, people can start to take it for granted. People in the US rightfully want to keep their families safe and healthy — but fluoridation is a way to do so, not a threat to health. We know that fluoridation greatly decreases tooth decay, which has individual, population, and economic benefits. We also know that it takes chronic fluoride exposure at levels multiple times that of community water fluoridation to cause any negative cognitive effects. Our absolute best evidence is that water fluoridation is all positive. In fact, Calgary, Canada, removed fluoride from their water in 2011 and, this year, voted to put it back due to the sharp rise in tooth decay! **What do you want a policymaker to take away from this study?** **Dr. Choi:** Removing fluoride from US public water systems would substantially increase tooth decay among children, resulting in billions of dollars in additional health care costs, and further disadvantage children with the greatest oral health needs. Maintaining and optimizing water fluoridation remains a cost-effective public health strategy, offering well-established benefits and minimal risk at current recommended levels. **What advice do you have for oral health advocates who are trying to get through to policymakers on this topic?** **Dr. Simon:** First, follow the evidence. We hope our research allows advocates to put a price on the harms caused by stopping fluoridation. Evidence from other countries like Canada and Israel who removed fluoridation and saw the impact on children’s teeth are instructive, too. Second, share your stories. It’s important for all of us to remember that stopping fluoridation has real, human costs. It will mean more children getting toothaches that keep them from learning, parents missing work to seek emergency care for their kids, and adults missing more teeth decades down the line. These stories — your stories about the value of oral health — can be even more powerful than numbers. **Where would you point any oral health stakeholders — providers, policymakers, patients — to go to learn more about fluoridation?** ![](https://carequest.org/wp-content/uploads/2025/08/Caroline-Le-Headshot_Cropped-238x300.jpg)Caroline Le **Dr. Simon:** I recommend the American Academy of Pediatrics’ Fluoridation hub (). It’s a wonderful resource with lots of information about the benefits and safety of fluoride for both families and clinicians. For those interested in a deeper dive, the 2024 National Toxicology Program monograph on fluoride ([https://ntp.niehs.nih.gov/sites/default/files/2024-08/fluoride\_final\_508.pdf](https://ntp.niehs.nih.gov/sites/default/files/2024-08/fluoride_final_508.pdf)) is the most comprehensive resource on the safety of fluoridation, produced by government experts. *Authored By Caroline Le, Public Policy Analyst, CareQuest Institute* *Editor’s Note: Oral Health Policy Perspective is a new occasional blog series from the CareQuest Institute Policy & Advocacy team. Look for more stories, news, and updates about critical oral health policy issues in the coming months.* **Categories:** Blog **Tags:** Health Equity --- ### [Voices from the Field: A Student Perspective on OPEN Hill Day](https://carequest.org/blog/voices-from-the-field-a-student-perspective-on-open-hill-day/) **Published:** May 30, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/05/OPEN-Staff-Web-scaled.jpg)CareQuest Institute team members kick off OPEN Hill Day OPEN Hill Day brought more than 90 members from across the US to Capitol Hill to meet with legislators about prioritizing oral health in their communities. For this Hill Day on May 14, the fourth one since 2019, there was more at stake: Potential Medicaid cuts are on the horizon, some policymakers are pushing to remove fluoride from public water supplies, and recent staff cuts to the Department of Health and Human Services are reshaping the oral health landscape. India Washington, MHS, CPH, a master’s student at Johns Hopkins Bloomberg School of Public Health, was one of those OPEN members in DC. ([OPEN, an initiative of CareQuest Institute](https://www.carequest.org/content/open?campaign=open), is the national network striving to make oral health care more affordable and accessible.) “As a pre-dental student learning public health,” she says, “this event bridged the solution to my concerns and unveiled a future of dental health change making.” ![](https://carequest.org/wp-content/uploads/2025/05/India-Washington-at-Hill-Day.jpg)India Washington at OPEN Hill Day This wasn’t Washington’s first time advocating on Capitol Hill. She lobbied for prison reform as a sophomore in high school. In her junior year of college at Howard University, she rallied for the National Institutes of Health medical research funding. And now she joined other OPEN members to ask legislators to: 1\) Oppose Medicaid cuts that would jeopardize access to dental care for [72 million people who rely on the program](https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights). 2\) Improve access to dental care for [veterans who get medical care through the United States Department of Veterans Affairs](https://www.carequest.org/resource-library/veterans-need-affordable-dental-care). 3\) Support the [HEADs UP Act](https://www.cdc.gov/heads-up/index.html), which would designate people with intellectual and developmental disabilities as a medically underserved population and increase their access to oral health care. “I had an unforgettable experience these past two days training, networking, and raising overlooked issues to politicians in the House and Senate,” Washington says. ![](https://carequest.org/wp-content/uploads/2025/05/Hill-Day-Capitol.jpg)OPEN members at Hill Day Below, she shared more about her first OPEN Hill Day: **Why are you passionate about helping expand access to oral health for individuals who don’t have it?** I have not even started my oral health career, and through volunteer work, I have been exposed to the devastating impacts of oral health disparities. While doing my pre-dental shadowing, I have seen people come into the dental office after years of avoidance. They come only when the pain is unbearable. Many people I talk to when I tell them that I want to be a dentist express their fears, the expense, or how hard it is to get treatment. I recently graduated from the Bloomberg School of Public Health, where I was trained to think critically about policy and systems change. My passion stems from both personal exposure and academic training. Oral health is public health, and I’m committed to ensuring it’s treated as such. It is a human right, not a luxury. **Who did you meet with at OPEN Hill Day?** ![](https://carequest.org/wp-content/uploads/2025/05/India-Washington-1.jpg)India Washington at Senator Warren’s Office I met with Senator Elizabeth Warren’s (D-MA) office and Representative Ayanna Pressley’s (D-MA) office. Both offices were extremely receptive and were open to prioritizing oral health, but, unfortunately, in this climate, the offices could only offer their support for the future. Both offices are already opposed to Medicaid cuts. Additionally, they promised to be on the lookout for the HEADs UP Act and Veterans Health Administration bills as they get introduced. **Did you feel intimidated at all as a student at your first Hill Day?** Initially, as a student, I felt imposter syndrome. I was going to an event by myself, surrounded by experts in their fields, and was stepping out of my comfort zone. I have had past advocacy experiences, but none were centered around oral health. On the training day, I happened to sit with the friendliest group of people and immediately felt welcome. Dr. McGrath-Barnes and Dr. Herman were extremely inviting, connected me to other dental students, and affirmed that I should be there. I believe that more pre-dental students should be exposed to the policy side of dentistry because public oral health is necessary. **What moment sticks with you from the event?** The best moment from OPEN Hill Day was connecting with professionals who share a deep passion for expanding access to oral health. At the Bloomberg School of Public Health, conversations about oral health equity aren’t always front and center. Being surrounded by people who truly care about this issue made me feel seen and part of a larger community. That sense of belonging is what stays with me from Hill Day — to know that there are people with the same vision as me was powerful. **What will you do next after your experience at OPEN Hill Day?** I’m currently applying to dental school, and I hope to continuously return to future Hill Days as a provider-in-training and, eventually, a dentist. I also look forward to staying involved with CareQuest Institute and continuing to advocate for policies that center equity and access in oral health. It is important that more people show up to these events. Without strength in numbers, policy will not progress. **Do you have any advice for people thinking about attending Hill Day next year?** My advice to people thinking about attending Hill Day is to do it. Your voice matters, no matter how experienced you are in oral health advocacy. If you watch the OPEN trainings and connect personally to the policies, you will be prepared. Additionally, Hill Day gives you the opportunity to connect with like-minded individuals. As for advocacy work, it is vital. Politicians are humans, too, and their job is to listen to you. You may be representing someone who may not have the means to come to Capitol Hill. Power in numbers is what we need to make a real change in oral health access. To learn more about OPEN and the network’s upcoming events, go to [carequest.org/open](https://www.carequest.org/content/open?campaign=open). **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Connecting the Dots: Two Innovative Approaches that Help Kids Access Care](https://carequest.org/blog/connecting-the-dots-two-innovative-approaches-that-help-kids-access-care/) **Published:** June 16, 2025 **Author:** Caitlin Locklear **Content:** For children across the US, accessing oral health care has its obstacles. The main one? ![](https://carequest.org/wp-content/uploads/2025/06/More-Smiles-Wisconsin2.png)More Smiles Wisconsin dental team examines student’s teeth “They don’t have a choice in the matter,” says Stacy Nehmer, Executive Director of More Smiles Wisconsin, a nonprofit that provides health-related community care to people in need. Parents who work during the day may struggle to find time to take their kids to the dentist, Nehmer adds. They may not have transportation, may not be able to find a dental office that accepts Medicaid, or may not feel comfortable navigating the system if English is their second language. They may also be misinformed. “Something that we often hear in this program is parents thinking, ‘Okay, well, the decay is in a baby tooth that’s going to fall out anyway,’” Nehmer says. “Yes, baby teeth do fall out, but it could be years before they do. And in the meantime, the decay can spread to other teeth, turning into the child needing a crown or extensive work.” Organizations like [More Smiles Wisconsin](https://www.moresmileswi.org/) and [Nicklaus Children’s Foundation](https://give.nicklauschildrens.org/home) in Florida have been working for years to help children get access to oral health care. (Last year, [CareQuest Institute awarded 10 organizations, including More Smiles Wisconsin and the Nicklaus Children’s Hospital Foundation, $125,000 each](https://www.carequest.org/about/blog-post/access-academics-improving-oral-health-through-schools) to promote school-based or school-linked oral health programs that drive systemic change.) The two organizations have employed several strategies to improve access to care, including sending dental professionals to schools to perform exams and making recommendations to parents. They’ve made progress and can point to many successes, but they were still seeing gaps in the system. “Many times, we encountered children who either had an infection, or they had extensive dental needs, and we would give them a referral to go to a local dentist or to come to our clinic,” says Oscar Arevalo, DDS, Program Director of the Pediatric Residency Program at Nicklaus Children’s Hospital. “And when we returned to that particular facility three or six months down the road, we would find that the kid was still in pain and his or her dental needs had not been addressed.” Both organizations realized it was time to try something new. ## Prioritizing a Population in Need of Providers The Nicklaus Children’s Hospital Foundation in Florida helps students in the Miami-Dade Country public school system access oral health care. “There are many kids in our public school system who are from the working poor,” Arevalo says. “A collaboration with Miami-Dade County Public Schools, the third-largest school system in the country, made sense, and our mobile dental team goes out three days a week to visit those schools. In addition, Nicklaus Children’s dental team visits churches, and community-based organizations to help children in need.” But Arevalo says many times the team would return a few months later to find that the child still had the infection or dental need. “We realized we needed to have somebody who would connect the families with a provider — either us, or a community health center, or a local dentist who serves the Medicaid patient population,” he says. A few years ago, the organization hired a community dental health coordinator to help eligible families enroll in Medicaid and connect children to the care they need. “We wanted to ensure that the kids got their treatment completed and would not continue falling through the cracks,” Arevalo says. But then history started to repeat itself — this time with the growing Haitian community in South Florida. “We were encountering the same situation,” Arevalo says. “So, there were many of these Haitian children where they have, or in some cases did not have, dental benefits, but they do not have a pediatric dentist.” A potential solution? The organization is using the funds from CareQuest Institute to hire another community health coordinator — but this one is working specifically with the Haitian population. “She’s Haitian, so she understands all the cultural aspects,” he says. “She’s very active in her church, and she has been able to establish very meaningful connections in the community for us. She has opened a lot of doors for us.” They are already seeing some results. “We have seen a larger influx of these children coming not just to our clinic, but also to our partner medical center,” Arevalo says. ![](https://carequest.org/wp-content/uploads/2025/06/More-Smiles-Wisconsin3.jpg)More Smiles Wisconsin dental team examines student’s teeth ## Making It Easier to Access Dental Care Nehmer at More Smiles Wisconsin loves the idea of having a community dental care coordinator, like the one with Nicklaus Children’s, to help educate parents about oral health, access transportation, and overcome language barriers. “I’m learning a couple of the grantees from our peer learning groups have this person in place and have had really great success with it,” she says, pointing to a unique feature of CareQuest Institute’s philanthropy model. “I think that is something that every community could benefit from.” Although the organization currently does not have a community dental care coordinator, More Smiles Wisconsin does have their Hometown Smiles Program. With that program, a dentist, dental assistant, support team, and administrative assistants go to a school and provide comprehensive exams for every kid who’s enrolled and in school that day. “It is not only for children insured through Medicaid,” Nehmer says. “They provide exams for all children in every grade.” If the child does not have a dental home, the dental team tries to find a local private clinic that is willing to provide oral health care for them. “We have contracts in place with some dentists, so if they wanted reimbursement for their services, we would bill Medicaid and then reimburse them for whatever care they delivered,” Stacy says. “We’ve been very fortunate that every office that does accept kids has done the work charitably. They have not asked for any portion of reimbursement.” Looking at the school district they cover, they realized that getting the children into a dental home had long-lasting rewards. “About 70% of the kids that we’re seeing at follow-up had no additional treatment needs,” Stacy says. “So, once we were able to connect them with a dental home, their oral health stayed in good shape.” But some dentists are hesitant to be a part of the program. If they don’t accept Medicaid at their clinic, they believe it could be a complicated process to enroll in and then bill Medicaid. That gap led More Smiles Wisconsin to apply for the CareQuest Institute grant. “We came up with informational sheets on enrolling in Medicaid and offering assistance to offices who are interested in enrolling,” Nehmer says. “The grant funds have definitely helped with the outreach.” Nehmer says dentists are also more inclined to listen to one of their peers, so with funds from the grant, More Smiles hired a dentist champion to get them in the doors of these offices. “He is spending time in the schools performing the exams, recruiting other dentists,” she says. On top of that, the organization is using the grant funds to help with processes within the program. More Smiles acquired a standalone server to store information like health records and X-rays when they’re at a school without secure internet access. “These funds have helped us work through these processes to make it as easy as possible for the schools to want to participate in the program,” Nehmer says. She hopes programs in other communities can benefit from the processes More Smiles developed. “We’re trying to just educate other communities so they don’t have to recreate the wheel,” she says. “We can encourage them to recruit their own dentists, their own support staff. We’re just giving them the model and showing them the results.” **Categories:** Blog **Tags:** Health Equity --- ### [Seeking Comments: Let’s Elevate Oral Health in the National Interoperability Conversation](https://carequest.org/blog/seeking-comments-lets-elevate-oral-health-in-the-national-interoperability-conversation/) **Published:** June 4, 2025 **Author:** Caitlin Locklear **Content:** The Centers for Medicare and Medicaid Services (CMS) have made it clear that patients must be at the center of our digital ecosystem and are asking one critical question: **How should federal policy evolve to support more connected, patient-centered care?** A few weeks ago, CMS and the Office of the National Coordinator for Health IT (ONC) released a [Request for Information](https://www.federalregister.gov/documents/2025/05/16/2025-08701/request-for-information-health-technology-ecosystem), seeking public input on the future of: - Interoperability - Digital health infrastructure - Technology-enabled, value-based care And earlier this week, [CMS hosted an in-person listening session](https://www.cms.gov/newsroom/press-releases/cms-building-foundational-infrastructure-digital-healthcare-ecosystem) to discuss the RFI and how health technology innovations can reduce fraud, cut administrative burdens, and deliver higher-quality care to millions. To me, this is a critical moment for the oral health community to share experiences and highlight the unique needs of dental providers and patients in health data exchange. It’s up to all of us—dental providers, dental service organizations (DSOs), Federally Qualified Health Centers (FQHCs), dental schools, health IT teams, and oral health leaders—to raise our voices for oral health. ## Why Your Comment Matters Oral health has historically been siloed from broader health IT and care coordination strategies, despite its essential role in overall health. This RFI offers a distinct platform to raise awareness of the unique needs and barriers oral health providers and patients face. Without input from the oral health community, dental perspectives risk being underrepresented in future policies and funding priorities. As evidenced by this request, CMS’s goal is to build a future where patients can have: - Easy access to their overall health records, including dental information - Digital tools to manage their care across providers - Customized support for prevention and chronic diseases management - Resources available to coordinate care without barriers To better understand why this issue matters, I invite you to explore these resources: - [What Do We Mean by Interoperability in Oral Health?](https://www.carequest.org/about/blog-post/what-do-we-mean-interoperability-oral-health) - [Care Coordination and Interoperability](https://www.carequest.org/topics/care-coordination-and-interoperability) - FDI World Dental Federation’s [*Consensus Statement on digital health for oral health*](https://www.fdiworlddental.org/sites/default/files/2025-03/FDI_EHR_Consensus%20Statement_Web.pdf), a global call to include oral health in national health systems ## How and When to Comment If you are involved in oral health or digital care delivery, we urge you to lend your voice. More specifically, this RFI is aimed at: - Dental providers, DSOs, and FQHCs - Dental schools and educators - Health IT teams, EDR vendors, and data specialists - Interoperability advocates and policy professionals - Medical-dental integration (MDI) project teams The deadline to comment is Monday, June 16, 2025, at 11:59 p.m. ET, and you can [access the RFI here on the *Federal Register*](https://www.federalregister.gov/documents/2025/05/16/2025-08701/request-for-information-health-technology-ecosystem). You can submit as an individual or on behalf of an organization. And even brief comments help show that oral health stakeholders are engaged and affected. ![](https://carequest.org/wp-content/uploads/2025/06/Renee-Clark-2025-scaled.jpg)Renee Clark Please take a few minutes to submit your comment and be part of the movement to integrate oral health into the broader health IT landscape. Your voice can help shape the future of health data and digital infrastructure. Whether you are a provider, educator, advocate, or technologist, your perspective can help influence national priorities and close long-standing gaps in oral health interoperability. *Authored by Renee Clark, Care Coordinator & Interoperability Manager* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Better Health Through Oral Health: Four Takeaways (and Four Questions) from the Primary Care Collaborative Conference](https://carequest.org/blog/better-health-through-oral-health-four-takeaways-and-four-questions-from-the-primary-care-collaborative-conference/) **Published:** June 9, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/06/Katie-and-Azeem_Resized-1.jpg)Katie D’Amico and Azeem Mallick “We leave dental out all the time. It makes no sense.” “The mouth is the gateway to the body, so focusing on oral health has great impact on other conditions downstream.” “The best care meets the demands of the life of the patient.” Those quotes — and others like them — stuck with both of us as we flew home from Washington, DC, after “Scaling: What Works for Better Health,” the [2025 Primary Care Collaborative Conference](https://thepcc.org/event/scaling-what-works-for-better-health/) last week. There, we had the opportunity to hear leaders from across the health care landscape discuss innovative new approaches to primary care delivery and payment. And we were excited to bring oral health to the discussions. We know that oral health *is* overall health — and [that improving one will improve the other](https://www.carequest.org/about/blog-post/how-oral-health-affects-overall-health-and-how-improve-both). We were excited to hear that the primary care community agrees. Throughout the conference, we received a lot of great input and acknowledgement that oral health should be a part of the overall holistic care model for patients. And there was consensus that any work that helps make the linkage to the primary care setting, especially with underserved populations, adds great value. Primary care providers (PCPs) are doing incredible work. The question is: How can the oral health community support and integrate with that work? These four takeaways from the conference shined a light on trends that are shaping primary care. At the end of each one, we offer a question about opportunities for integration between oral health and overall health. ## The Overlaps Between Oral Health and Overall Health ![](https://carequest.org/wp-content/uploads/2025/06/IMG_6097-scaled.jpeg)Oral Health Is Health signage **1. Prevention is the foundation of health.** - Both primary care and oral health care are converging on the same insight: Prevention, including good nutrition, is central to long-term health. - Both systems must shift from treating symptoms to addressing root causes of chronic disease. (Focus on “roots” of chronic disease, not the “fruits.”) - Current policies and payment models disincentivize prevention. We need to invest in keeping people healthy, not just treating illness. - As one speaker, Vivek Garg, MD, MBA, Chief Medical Officer for Humana’s Primary Care Organization, put it, “Primary care is the best drug ever created.” *Consider: How can primary care embed basic oral care to deliver more holistic preventive care and improve outcomes?* **2. Collaboration is essential for systemic change.** - Tackling complex health challenges requires strategic, cross-sector collaboration. - Regional efforts, like coalitions of employers negotiating with payers, are gaining traction and proving more effective than isolated efforts. We heard promising examples of stakeholders leaving their logos at the door and solving for what the community needs. - Primary care is a rare bipartisan issue, offering a unique opportunity for unified action. Medicaid cuts threaten the entire system, with ripple effects on access and infrastructure for all, regardless of insurance type. Nursing homes, for example, could [face an even more challenging reality if the cuts come to fruition](https://www.pbs.org/newshour/nation/what-republicans-possible-medicaid-cuts-could-mean-for-nursing-homes). - We need a public health awareness campaign to elevate the value of primary care in the public’s mind, a point Leslie Crutchfield, Executive Director of Business for Impact at Georgetown’s McDonough School of Business, made in an engaging presentation. *Consider: How can the dental crisis drive consumer change that benefits primary care? How could primary and oral care collaborate to drive consumer activation? And, going a step further, how can oral health drive that collaboration?* ![](https://carequest.org/wp-content/uploads/2025/06/IMG_6129-scaled.jpeg)2025 Primary Care Collaborative Conference **3. Innovation, leadership, and technology tools are key to the solution.** - PCPs are overwhelmed — many with an estimated 27 hours of work needed per day — highlighting the need for better tools and support, including GenAI. - The system has the heart and brain, but it needs more spine — leaders willing to take bold, courageous steps. That sentiment, shared by Robert Pearl, MD, author of ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine, resonated in the hallways after the sessions ended. - The Centers for Medicare & Medicaid Services is setting the tone of modernization: [Tech ecosystems must integrate and loop data back to PCPs to be effective](https://www.carequest.org/about/blog-post/seeking-comments-lets-elevate-oral-health-national-interoperability-conversation). In fact, CMS hosted an [in-person listening](https://www.cms.gov/newsroom/press-releases/cms-building-foundational-infrastructure-digital-healthcare-ecosystem) session to discuss a Request for Information (RFI) on improving technology to empower Medicare beneficiaries. *Consider: How can technology better link oral health and overall health to benefit patients? For example, how could better oral health data, including from saliva and the oral microbiome, benefit patients?* **4. Employers are critical drivers of change**. - Post-pandemic, employers are grappling with a less healthy workforce, especially those with diverse employee bases. - There’s growing momentum among employers to prioritize primary care and mental health as essential to workforce productivity. - [A healthy workforce is a thriving workforce](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs), and employers are increasingly recognizing their role in health system transformation. *Consider: What plans, designs, and care models* [*that integrate oral and overall health will prove to be the most effective*](https://rockhealth.com/insights/brushing-up-on-oral-health-the-case-for-expanded-oral-health-innovation-and-investment/)*?* PCPs are continuing to find new innovative ways to do more with less. The oral health community needs to continue to find ways to support them in that journey. *Authored by Katie D’Amico, MBA, Vice President Growth & Innovation, CareQuest Innovation Partners and Azeem Mallick, MBA, Vice President, Enterprise Strategic Partners, CareQuest Institute* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Navigating Dental Hygienist Licensure in Multiple States](https://carequest.org/blog/navigating-dental-hygienist-licensure-in-multiple-states/) **Published:** August 25, 2025 **Author:** Caitlin Locklear **Content:** Obtaining a license in dental hygiene or dentistry in more than one state has historically been quite challenging, especially for those who live near state borders or need to move to another state. ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-scaled.png)Kelly Schroeder, MS, RDH But the [American Dental Hygienists’ Association (ADHA)](https://www.adha.org/) is listening to dental hygienists’ needs for licensure portability and navigating individual state requirements. With grant funding from CareQuest Institute, the organization created an [RDH License Renewal Map](https://www.adha.org/education-resources/licensure-maps/). The map helps dental hygienists navigate all the complexities of being licensed in one or more states. ## Licensure Challenges Across State Lines For years, dental hygienists, like CareQuest Institute Clinical Content and Education Specialist Stephanie Clester, RDH, MA, had to navigate extreme challenges with getting licensed in additional states. Clester had to retake courses, even though she was an experienced dental hygienist. “The financial strain of relocating as a dental hygienist is significant,” Clester says. “Not only are clinical board exams costly, often exceeding a few thousand dollars, but they’re offered infrequently, creating long delays. During that time, you’re unable to work in your profession, which compounds the burden with lost income and uncertainty.” In addition to the initial licensure challenges, the next ongoing issue was managing the continuing education requirements and different licensing renewal processes for each state. Many dentists and dental hygienists must get licensed in another state because of family relocations, military assignments, or other opportunities. “I’ve been a military spouse for 29 years and am too stubborn to give up my career!” says Shannon Bryant McCharen, RDH. She holds dental hygiene licenses in Texas, Virginia, Wisconsin, Mississippi, and North Carolina. ## Moving Toward Interstate Licensure The Department of Defense recognized the need for dentists and dental hygienists to be able to practice in more than one state. The Department initiated action and collaboration with the American Dental Association (ADA), ADHA, and the Council of State Governments. In November 2020, these entities began working together to create the [Dentist and Dental Hygienist Compact](https://ddhcompact.org/), an interstate licensure compact. The compact says a licensed dentist or dental hygienist who graduated from an accredited dental or dental hygiene program and is in good standing no longer has to reapply for a license in a compact state. Currently, there are 12 states that have passed legislation that will allow dentists and dental hygienists to work in other compact states, including Maine, Ohio, Virginia, Tennessee, Arkansas, Wisconsin, Minnesota, Iowa, Nebraska, Kansas, Colorado, and Washington. States that have legislation pending include Massachusetts, New Jersey, Pennsylvania, Delaware, and Oklahoma. The Dentist and Dental Hygienist Compact has more information about those rules and processes. This licensure compact also prevents the need for oral health professionals to maintain separate renewal timelines and continuing education requirements to accompany each state license. Dentists and dental hygienists who engage with the licensure compact are only required to keep up the renewal and continuing education requirements for one state. This saves them time and money, as well as the frustration that comes with applying for multiple professional licenses. It also prevents the financial burden that comes with lost wages while waiting for months to obtain a license. One area that doesn’t change when practicing in a compact state is scope of practice laws. The United States consists of 50 different state statutes with 50 different variations of the scope of practice for dental hygienists. Variations in scope of practice between states can include levels of supervision required from a dentist, providing local anesthetic, dental hygiene diagnosis, and more. Keeping track of these variations can be very challenging. ## Navigating the Complexities of Licensure ## ![](https://carequest.org/wp-content/uploads/2025/11/RDH-Renewal-Map.png)To solve the problem of keeping track of which states are compact states, along with each state’s continuing education requirements and scope of practice laws, the ADHA, with funding from CareQuest Institute, created an interactive map that centralizes this information in one location. The [RDH License Renewal Map](https://www.adha.org/education-resources/licensure-maps/) is a color-coded interactive map that shows the states where licensure compact legislation has been enacted, where legislation is pending, and where there is no active legislation. By hovering over each state, dental professionals can see that state’s renewal cycle. Then, clicking on the state brings up even more details, including continuing education requirements and scope of practice. This tool can be used by professionals who are seeking to practice in another state or are reactivating their license(s). Many users have said they also plan to share the map with their students to help them navigate the initial licensure process. The map is also supporting a campaign to address the dental hygienist workforce shortage and lack of diversity. Currently, the ADHA updates the tool about every six months, but will make updates as needed. In the future, the ADHA would like to add more resources to the map, such as average salary by state and the number of dental hygiene programs per state. ADHA and CareQuest Institute are working to support oral health professionals by advocating for expanded scope of practice laws and making it easier to understand individual state requirements. Dentists and dental hygienists can continue to improve their professional experience by sharing their needs with their professional associations. **Categories:** Blog **Tags:** Health Equity --- ### [‘They’ve done so much for us. Why aren’t we taking care of them?’](https://carequest.org/blog/theyve-done-so-much-for-us-why-arent-we-taking-care-of-them/) **Published:** May 6, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/05/Veteran-in-chair-looking-in-mirror-D4V.jpg)Veteran looks at teeth in dental chair at D4V It’s a nationwide problem for our nation’s heroes: Veterans struggle to get access to oral health care. For a veteran to get [dental benefits from the US Department of Veterans Affairs (VA)](https://www.va.gov/health-care/about-va-health-benefits/dental-care/), they need to have been a former prisoner of war, be 100% disabled, or have a service-related dental injury. Out of the 9 million veterans who are eligible for medical care through VA, [80% are not eligible for dental coverage or care](https://www.carequest.org/resource-library/veterans-need-affordable-dental-care). To repeat: **80%** are **not eligible**. The consequences? Compared to non-veterans, [veterans have consistently higher rates of gum disease, missing teeth, and filled teeth](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity). And veterans are more likely to have chronic conditions such as diabetes and heart disease that are associated with poor oral health and often lead to higher out-of-pocket costs for patients. “For a number of reasons, many veterans don’t have insurance through the VA,” says Lisa Platt, the Executive Director at [Mercy Foundation](https://mercygiving.org/) in Oregon. “So, they can’t go over to their local VA hospital to receive care.” Even eligible veterans have significant barriers to accessing care: (1) There are [geographic barriers due to the distance between VA centers](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) that provide dental care, and some veterans may have no way to travel to those centers; and (2) if a veteran goes to a community provider, [the VA approval process](https://www.va.gov/COMMUNITYCARE/revenue-ops/Dental-Claims.asp#:~:text=Dental%20claims%20must%20be%20filed,provided%20on%20the%20ADA%20website.) can be long, frustrating, and filled with paperwork. “For veterans living on the central coast of California, there are 355 miles between the two closest VA hospitals where dental care is provided, one being in Palo Alto and the other being in LA,” says Patricia Yellich, the Executive Director and Co-founder of [Dentistry4Vets (D4V)](https://www.dentistry4vets.org/). “So, what do you do with the 35,000-plus veterans living on that coast?” Both D4V and Mercy Foundation, grantees of CareQuest Institute, are working to improve veterans’ access to oral health care. Last year, the Institute put a unique focus on veteran oral health, [awarding 10 organizations $125,000 each](https://www.carequest.org/about/blog-post/urgent-case-improving-veteran-oral-health) to help them take action to improve access to oral health care for our nation’s heroes. ## Partnering with Veterans in Local Communities ### Dentistry4Vets At D4V, a nonprofit dental clinic in Marina, California, veterans and their spouses can receive continuity of dental care from a full-time dedicated staff of dentists and registered dental assistants, comprehensive dental care with access to dental specialists, and emergency dental care. ![](https://carequest.org/wp-content/uploads/2025/05/D4V-Picture7-300x300.jpg)A veteran’s teeth before and after going to D4V for dental care “About 50% of our patients have had no continuity of dental care for various reasons,” Yellich says. “So, we need to establish a comprehensive dental plan to achieve (1) treating the aesthetic zone, which is what people see when you smile and speak; (2) treating occlusion, which is how molars come together to chew food; and (3) treating infections, which includes education and a solid hygiene schedule. Many of our patients need dental specialists. We cannot just schedule a cleaning on a new patient until we complete an exam with X-rays and a full health history.” “Over 50% of our patients are age 67 and older,” she says. “About 25%–30% of them have a form of disability, either physical and/or mental disability. About 30% of them have an underlying health issue. Usually, it’s heart disease or diabetes.” With CareQuest Institute funding, Yellich and veterans with D4V traveled to Washington, DC, to talk to Congress about veteran dental care and potential solutions that could help them. She says the current model of care for veterans isn’t working, especially for veterans who aren’t fully covered by the VA and are on Medicare or Medicaid. ![](https://carequest.org/wp-content/uploads/2025/05/D4V-in-DC-scaled.jpg)D4V representatives in Washington, DC “It doesn’t really take care of our veterans the way they should be taken care of,” Yellich says. “The issue with Medi-Cal (California Medicaid) is that a veteran can go into an office to get dental care, but the care is extremely limited. It’s basically what we call a Band-Aid approach. It isn’t continuity of care and comprehensive dental care.” Yellich says the CareQuest Institute grant also allowed D4V to conduct research on how veterans get their oral health care, develop a blueprint of the D4V model to show how the organization takes care of its veterans, and highlight the positive outcomes achieved through the program. She gathered [dozens of testimonials of veterans](https://www.dentistry4vets.org/testimonials/) who received care from D4V — many with low self-esteem, dental anxiety, and difficulty eating because of their poor oral health. ### Mercy Foundation In 2023, Mercy Foundation started an in-patient dental program at Mercy Medical Center and [hired an expanded practice dental hygienist (EPDH)](https://www.youtube.com/watch?v=l5u0n9f9ics) and dental assistant. The medical team at the hospital was also educated to look out for potential oral health problems and alert the hygienist. ![](https://carequest.org/wp-content/uploads/2025/05/Carcinoma-300x225.png)Growth found in a veteran’s mouth by EPDH at Mercy Medical Center When the dental professionals would look at people who had chronic diseases, like heart disease and diabetes, or patients in the ICU or PCU, they noticed many also had oral health problems — and many of them were veterans. “We were horrified to learn that we have a significant VA population that doesn’t necessarily have insurance through the VA,” Platt says. ![](https://carequest.org/wp-content/uploads/2025/05/Lisa-Platt-Headshot-240x300.jpg)Lisa Platt, Executive Director of Mercy Foundation The hygienist and assistant provide patients with preventive care, like fluoride varnish, silver diamine fluoride (SDF), sealants, and education. They teach veterans about proper hygiene and how to take care of their oral health properly. “Sometimes having someone who is as dedicated as our hygienist and her dental assistant willing to walk people through the process is all it takes,” says Shawn Watson, Grant Manager and Writer at Mercy Foundation. “They feel like somebody’s listening to them. They don’t feel like they’re just a number in a system.” Mercy Foundation is using the CareQuest Institute funds to help pay for a percentage of the preventive care supplies and a percentage of the hygienist’s salary. “One of the things that \[the hygienist\] really brought to the table was an attitude about oral health being a public health issue, so we really felt that we were fortunate to get her,” Watson says. “It’s important that we retain her because it’s a hard position to fill and, more importantly, she’s doing a great job.” The foundation also is using the funds to do outreach — having their hygienist and assistant go to the Oregon Department of Human Services to talk to veterans about the importance of oral health care and give out hygiene kits. ## Ideas to Improve Veteran Oral Health Both Mercy Foundation and D4V have been able to collaborate and learn from other grantees in the CareQuest Institute cohort who are helping veterans get the oral health care they deserve. “We recognize it does take a village to keep our community healthy,” Platt says. “So, any which way we can work together to make that happen, we’re in.” And there’s a lot more work that needs to be done. “They’ve done so much for us. Why aren’t we taking care of them?” Platt says. Yellich thinks a solution could be for the federal government to give all veterans an annual voucher that could be used specifically for dental care. “I really wish I could talk to everybody in Congress,” Yellich says. “We don’t really need to fund a bill to do more research on facts that we already know to be true. The funding should be dedicated to solving the foundational problem, which is a lack of dental care to veterans. There are funds available; it is just a matter of how they are spent.” And Watson believes federal leaders need to act, but she knows it’s not going to be easy. “I think that is really going to be an uphill battle,” Watson says. “It’s one thing to pay lip service to the contributions of veterans. It seems to be another to fund these programs.” To learn more about veteran oral health, go to [carequest.org/veteran-oral-health](https://www.carequest.org/veteran-oral-health). **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Mary Lynne Davis on Improving Pediatric Oral Health Outcomes](https://carequest.org/blog/voices-from-the-field-mary-lynne-davis-on-improving-pediatric-oral-health-outcomes/) **Published:** May 20, 2025 **Author:** Caitlin Locklear **Content:** Early in her career as a dental assistant, Mary Lynne Davis, CRDH, had the privilege of working with a dentist who was deeply committed to creating a comfortable, caring experience for every patient. His passion left a lasting impression on her, shaping the way she approached patient care throughout her career as an assistant, a hygienist, a mentor, and now a research coordinator.![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg) “I believe that by prioritizing positive dental experiences, especially from a young age, we can shift the culture of dentistry from reactive treatment to proactive prevention,” Davis says. “This not only leads to better oral health outcomes for patients of all ages but also has the potential to create generational change in how families view and engage with dental care.” Davis and her colleague Daniel McNeil, PhD, presented about their unique approach and program — Dental-Child Interaction Training (DCIT) — at last month’s National Oral Health Conference in Orlando. DCIT, Davis shared, equips providers with effective behavioral strategies to improve child cooperation and reduce anxiety. ![](https://carequest.org/wp-content/uploads/2025/05/MLDaction1-300x270.png)Mary Lynne Davis, CRDH, examines a patient’s mouth. “Since many children are anxious and fearful about getting dental care, or just uncertain about what is going to happen, a very high level of interpersonal skill is required of providers to help kids feel comfortable,” Davis adds. Below, Davis shares more about the program, opportunities for training, and the team’s ongoing work to make oral health more accessible for some of the youngest patients. **Can you share a bit more about the DCIT program?** Since most children are seen by general dentists and dental hygienists, it’s essential that they have the skills to work positively and effectively with kids. Initially, a research study funded by the National Institute of Dental and Craniofacial Research (NIDCR) helped determine what skills were being used in general dental practice to work with children. Those findings illuminated specific skills that most providers could enhance to make dental appointments a comfortable experience for kids. ![](https://carequest.org/wp-content/uploads/2025/05/Voices1.png)What children often see when they look up during a dental appointment, an image Davis and colleagues shared during the NOHC presentation After that initial study, the NIDCR funded a seven-year project to confirm the effectiveness of DCIT for dentists, dental hygienists, dental therapists, dental assistants, and anyone interacting with children in the dental setting. Together with partners from the University of North Carolina Chapel Hill, the University of Arkansas, West Virginia University, and a team of colleagues at the University of Florida (UF) College of Dentistry, the effectiveness of this continuing education (CE) training will be tested over the next few years in full-day workshops for dental providers. **Did the UF College of Dentistry develop the program?** Dr. Dan McNeil and Dr. Cheryl McNeil — both clinical psychologists — pioneered DCIT, and are the principal investigators for the DCIT grants. They joined the UF faculty from West Virginia University three years ago, bringing DCIT with them. Their intent is to offer the DCIT skills training to dental providers across several states, where it is being tested, and ultimately, to offer the training nationally and internationally. **How is DCIT different from other techniques?** Grounded in clinical child and behavioral psychology, DCIT focuses on teaching evidence-based interactional skills to dental providers working with children ages 2–10. Adapting core principles from Parent-Child Interaction Therapy (PCIT) to the dental setting, DCIT equips providers with effective behavioral strategies to improve child cooperation and reduce anxiety. Just as PCIT emphasizes the importance of parent-child interactions, DCIT focuses on positive communication, guided participation, and reinforcement to build trust and foster a more comfortable dental experience. **Can you briefly explain the PRIDE skills that are part of DCIT?** Sure, the PRIDE skills are just that: Praise, Reflect, Imitate, Describe, Enjoy/Enthusiasm. They are key components of DCIT, designed to modify how dental providers interact with young patients. These strategies help improve communication and cooperation during dental visits. - **Praises** (both labeled and unlabeled) are used to reinforce appropriate behavior. - **Reflections** involve repeating or rephrasing the child’s language to acknowledge their communication. - **Imitation** encourages the provider to mirror the child’s actions, fostering connection. - **Describe** involves verbally sharing what the provider observes the child doing or saying. - **Enjoy/Enthusiasm** incorporates humor and excitement to make the visit more positive and engaging. **Can you give some examples of teaching points from DCIT? What should providers say or avoid saying?** DCIT employs positive communication tools to foster cooperation during child interactions. These tools include: - Labeled praises, such as “Thank you for keeping your mouth open.” - Direct commands, like “Please open your mouth.” - Imitation, with statements like “You are opening your mouth like a lion.” In addition, DCIT emphasizes language to avoid, referred to as “The Avoid Skills.” These include frequent questions that don’t allow the child time to respond, rapid-fire commands that don’t provide the child with a chance to comply, and negative language such as “no,” “don’t,” “stop,” “quit,” and “not.” **Why is an immersive one-day session the preferred delivery method?** DCIT workshops are eight-hour CE sessions that are immersive, experiential, and immediately applicable. Led by a team of experts in behavioral psychology and clinical dental care, these workshops combine didactic learning with hands-on role-play to bridge the gap between theory and practice. Traditional dental education (i.e., dental school, hygiene programs, or assistant training) offers limited exposure to managing children in the operatory. While countless articles outline pediatric behavior guidance techniques, the DCIT approach takes these methods off the page and into real-world, interactive training. Through in-the-moment (“in vivo”) coaching, engaging role-play scenarios, and practical strategies for navigating challenging behavior, DCIT equips providers with the confidence and skills to create a supportive, child-friendly environment. The result, we believe, is improved cooperation, more positive dental visits, and stronger foundations for lifelong oral health. **What can a reader do if they want to learn more about the training?** Readers can contact me via email or phone — , (352) 222-7034 — and I would be happy to discuss the training workshops and answer any other questions. **Categories:** Blog **Tags:** Clinical Practice, Medical-Dental Integration --- ### [Aging Out: A Story of an Adult with Disabilities Trying to Find Oral Care](https://carequest.org/blog/aging-out-a-story-of-an-adult-with-disabilities-trying-to-find-oral-care/) **Published:** June 16, 2025 **Author:** Caitlin Locklear **Content:** Victoria Neely noticed that her son Joshua was having some behavioral issues when he was in elementary school. She wasn’t sure why. When she took him to a pediatric dentist, they discovered a potential culprit: an abscessed tooth. “He was very combative in the dental chair,” Neely says. “But he was little enough that his dad could hold him.” Today, that’s not an option. ![Joshua sitting on the floor at his house](https://www.carequest.org/sites/default/files/2025-06/Joshua3_Resized.jpg)Joshua Neely Joshua was born with Down Syndrome and a congenital heart defect. When he was in elementary school and having behavioral issues, pediatric specialists diagnosed him with non-speaking autism. The medical challenges quickly piled up. “All through his life, Joshua had a lot of hospitalizations for pneumonias, surgeries,” Neely says. “He was hospitalized and put on a ventilator, had spinal fusion surgery, open-heart surgery, and had complications with his lungs.” Joshua also has severe sensory issues where he doesn’t like anything near his mouth. Haircuts and cutting his nails are a challenge, too. Joshua is now 23 and lives in northeast Florida with Victoria and his siblings. Pediatric care is no longer an option, which has made it even more complicated for him to get the oral health care he needs. “We can’t find anybody,” Neely says. Going to the dentist can be a nerve-wracking experience for people of any age, race, gender, or ability. But for people with developmental disabilities, going to the dentist can be a stressful and alarming experience — for providers, patients, and their caretakers. Pediatric dentists go through a residency where they learn how to provide care for children with special needs. But dentists who care for adults typically *don’t* get that extra training. According to a CareQuest Institute for Oral Health report, “[Exploring Oral Health and Care Access among Adults with Disabilities](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities),” more than 15% of adults with a disability say their disability makes it difficult for them to access needed oral health care. Joshua is one of those adults. ![Joshua and his mom share sweet moment together](https://www.carequest.org/sites/default/files/2025-06/Josuha2_Resized.jpg)Joshua shares sweet moment with his mom ## Going Under to Get Care As Joshua got older and grew, it became more and more challenging to get him to cooperate. “We would basically go straight to an operating room, and we would have many things done at the same time,” Neely says. Because of his heart condition, Joshua was sedated at a hospital; there, multiple specialists can provide care for him — everything from echocardiograms to dental exams. His last dental cleaning came in 2019, when he was 17 years old. The next year, the pandemic hit. “I was very afraid to take him anywhere out in public — or to a dentist — because I was so afraid of COVID and him getting sick,” she says. But by the time Neely felt safe taking her son back to a dental clinic, he had turned 19 and aged out of pediatric care. ## The Struggle to Find an Adult Provider Now that Joshua is an adult, Neely says she hasn’t found a dentist who is willing to go to a hospital and provide care for Joshua while he is under anesthesia. “If he gets a \[tooth\] infection, that can cause a heart problem,” she says. “We need preventive care and for somebody to at least go in and look at his mouth so that we know everything is okay.” Although sedation in a hospital to receive oral health care may not be common for people with disabilities, Joshua is not alone in the struggle to access oral health care. As CareQuest Institute’s report highlights, of adults who said they have a disability, [56% say they had a dental visit in the past 12 months, compared to 70% of adults who did not report having a disability](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities). ## Providing Better Access for Individuals with Disabilities Neely’s full-time job is taking care of Joshua. Her other children, who are now adults, also do what they can to help, from assisting him at appointments to helping him brush his teeth. “Sometimes I feel guilty,” Neely says. “It’s hard for me to go out because I’m always feeling a little guilty that they’re having to watch him.” She has been working with Joshua’s primary doctor at the University of Florida Jacksonville Program for Adults with Intellectual and Developmental Disabilities. He helped Joshua transition between pediatric to adult providers, but has come up short when it comes to finding a dentist. The only dentist Neely could find to provide dental care for Joshua under sedationed in a hospital is in Gainesville, Florida, and is no longer taking new patients. ![Joshua Neely wearing sunglasses](https://www.carequest.org/sites/default/files/2025-06/Josuha1_Resized_0.jpg)Joshua Neely “Why aren’t other dentists willing to do that?” Neely says. “I understand liability, but when you go to the hospital with any kind of surgery, you sign off that you know what you’re getting into. And you have an anesthesiologist and other professionals there, too.” “[Exploring Oral Health and Care Access among Adults with Disabilities](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities)” highlights three critical changes that will help improve access for individuals with disabilities: - Enhancing Medicare and Medicaid coverage for adult dental care - [Providing additional training for providers to care for people with disabilities](https://www.carequest.org/education/webinars/strategies-manage-sensory-overload-neurodivergent-patients) - Integrating medical and dental care with specialty oral health care. Neely is determined to get help for her son — even if she has to travel long distances to do it. She is working with Joshua’s dental insurance company and a caseworker to explore all options. Just last week, Neely says the caseworker recommended a practice in northeast Florida that may be able to help Joshua and is less than an hour drive away. Neely set up an appointment for him for the end of the month. But she’s trying not to get her hopes up just yet. “I always see so much stuff about, ‘We specialize in . . .’” Neely says. “But not as special as his needs, apparently.” **Categories:** Blog **Tags:** Health Equity, Special Patient Care --- ### [Winning on Water Fluoridation: Lessons from Louisiana and Connecticut](https://carequest.org/blog/winning-on-water-fluoridation-lessons-from-louisiana-and-connecticut/) **Published:** June 26, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/07/oral-health-policy-perspective-01-3-1.png)Despite community water fluoridation (CWF) being a safe and effective public health measure that has helped reduce tooth decay for decades, more than 20 states introduced legislation this year aimed at restricting — or outright banning — CWF. Even one state, to us, is too much. The issue of CWF has become increasingly politicized in those 20 states — and in many others. For grassroots organizers, health care providers, patients, and community stakeholders, these debates carry real-world consequences: Removing fluoride from water can lead to increased oral health disparities, higher treatment costs, and reduced access to preventive care. And fluoridation remains one of the most cost-effective ways to promote oral health equity, particularly for underserved populations. At a time when state-level decisions increasingly determine local health outcomes, recent wins in [Louisiana](https://lailluminator.com/briefs/attempt-to-remove-fluoride-from-louisiana-drinking-water-goes-flat/) and [Connecticut](https://ctmirror.org/2025/01/21/ct-senators-seek-to-guard-against-federal-cuts-in-health-funding/) offer timely and informative case studies. These victories demonstrate that a united stakeholder front, evidence-based data, and local engagement can protect access to fluoride, regardless of the political environment. ![](https://carequest.org/wp-content/uploads/2025/06/Image-10-e1765834416912.jpg)Matthew Steele and other advocates in Louisiana ## Louisiana: Defeating a Fluoride Ban with a United Front In Louisiana, [Senate Bill 2](https://www.legis.la.gov/legis/ViewDocument.aspx?d=1393944) threatened to ban fluoride from public water systems across the state. This move would have deepened existing oral health disparities, especially in rural and underserved communities. Prior to legislative hearings on the bill, advocates were already sensing momentum building behind banning CWF statewide. Misinformation and distrust fed into anti-fluoride arguments that were spreading among legislators, bolstered by misinformation and distrust in public health institutions largely stemming from COVID-19 public health measures. To counter this, CareQuest Institute, along with the [Louisiana Dental Association (LDA)](https://www.ladental.org/) and local members of OPEN, organized a coalition of local stakeholders and created a rapid-response strategy to defeat the bill. At the outset, the coalition swiftly countered misinformation with credible, evidence-based data. Coalition members responded in real time to anti-fluoride claims and equipped advocates with [science-backed messages to dispel any myths](https://ilikemyteeth.org/debate-fluoridation/fluoride-myths-facts/). This proactive approach helped correct misconceptions and kept the conversation focused on the public health benefits of fluoride. To support this work, the LDA led a coordinated effort to mobilize dentists statewide, urging them to contact their legislators directly and attend committee hearings to testify in opposition to the bill. Those dentists testified in the Senate and House committee hearings, reinforcing the science and public health rationale behind CWF from a trusted provider perspective. OPEN members Celeste Terry, RDH, and Douglas Cross, DDS, also testified and spoke from their personal experience of treating underserved patients. Ultimately, Senate Bill 2 was defeated in the House Committee on Health in a 10-5 vote. This outcome affirmed the importance of coalition mobilization, data-backed messaging, and grassroots advocacy. Key lessons from Louisiana’s effort: 1. 1. Coalition strength matters: The coordinated effort between LDA, OPEN, the Louisiana Academy of Physician Assistants, and other partners ensured lawmakers heard a unified message. 2. Grassroots engagement works: Constituents’ personalized calls and emails helped shift votes. 3. Health care voices are persuasive: Dentists and dental hygienists explaining real-world impact brought credibility and urgency to the conversation. 4. Rapid rebuttals to misinformation were essential. Advocates were prepared to counter false claims with facts in real time during lawmaker meetings and testimony. 1. 1. ## ![](https://carequest.org/wp-content/uploads/2025/06/Child-drinking-water-3.jpg)Connecticut: A Model for Proactive Fluoride Protection While many states saw efforts to weaken or ban fluoride in community water systems during this legislative cycle, Connecticut emerged as a beacon of proactive public health leadership. In June, state lawmakers passed [Senate Bill 7](https://www.cga.ct.gov/2025/TOB/S/PDF/2025SB-00007-R04-SB.PDF), a landmark health protection package that protects water fluoridation. The bill mandates that water systems serving 20,000+ people — and this gets a bit detailed — maintain fluoride at 0.7 mg/L ± 0.15 mg/L, codifying the standard endorsed by Centers for Disease Control even if federal guidance shifts. This safety buffer ensures consistent dental protection for nearly 90% of residents across 32 systems. [Connecticut Oral Health Initiative (COHI)](https://www.ctoralhealth.org/), a long-standing CareQuest Institute grantee, championed the bill. The organization built upon its track record, developing the state’s oral health improvement plan that includes fluoride education and varnish programs in pediatric primary care. According to the Connecticut Department of Public Health, [CWF reduces cavities by 25% in children and adults](https://portal.ct.gov/DPH/Oral-Health/Fluoride) and is less costly over a lifetime than treating even a single cavity. COHI Executive Director and State Representative Gary Turco and COHI Policy & Advocacy Director Sandra Ferreira-Molina headed the legislative victory. They built a powerful, data-driven coalition, leveraging COHI’s longstanding collaborations with health departments and dental providers to inform stakeholders and dispel misinformation during legislative hearings. ## A Blueprint for Other States Connecticut is the only state this 2025 legislative cycle to enact proactive water fluoridation protection, underscoring its innovative stance. The effort offers several lessons: 1. Future-proofing: Codifying fluoride levels shields communities when federal recommendations become politicized. 2. Health equity through consistency: With fluoride reaching Medicaid-eligible and vulnerable populations, codified standards reduce disparities. 3. Educator‐advocate collaboration: COHI’s dual role in data collection and advocacy ensured both evidence and community voices were heard. 4. Holistic integration: Working across sectors, including primary care providers who apply fluoride varnish, reinforced the message that oral health is inextricable from general health. Connecticut’s experience demonstrates that proactive, collaborative, and evidence-grounded policy can not only defend but advance public health. COHI’s strategy represents a replicable blueprint: Legislate stable protections, leverage data-driven advocacy, and embed oral health within broader health systems. Whether defeating a fluoride ban in Louisiana or advancing protections in Connecticut, these victories demonstrate that success is achievable even in vastly different political climates. In both states, strong coalitions, grassroots activation, and trusted health provider voices secured wins and fought back against misinformation. As threats to fluoride continue to emerge across the country, these case studies provide a blueprint for how to defend and strengthen community water fluoridation. ![](https://carequest.org/wp-content/uploads/2025/10/Matt-Steele-Headshot.jpeg)Matthew Steele *Authored by Matthew Steele, CareQuest Institute Director of State and Local Advocacy Government Affairs* *Editor’s Note: To stay in the loop on the latest fluoride policy developments and connect with other advocates, consider joining* [*OPEN*](https://www.carequest.org/content/open) *and participating in the new* [*CWF Learning Collaborative*](https://communities.openoralhealth.org/s/)*.* **Categories:** Blog **Tags:** Health Equity --- ### [Veterans Deserve Dental Care: A Push for Policy Solutions](https://carequest.org/blog/veterans-deserve-dental-care-a-push-for-policy-solutions/) **Published:** July 15, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/07/Vets-event_patty_pam_caroline_melissa-scaled.jpg)Caroline Le, Patty Ma, Melissa Burroughs, and Pam Reeve at Veterans Deserve Dental Care event For far too many veterans, dental care is unaffordable and out of reach. Gaps in dental benefits and difficulty finding providers [push many veterans to go without care — or to extreme lengths to get it](https://www.carequest.org/resource-library/veterans-need-affordable-dental-care). That’s why CareQuest Institute is leading efforts to educate policymakers and drive awareness of these gaps in care. Last week, CareQuest Institute, The American Legion, and Philips Healthcare cohosted a Capitol Hill briefing — *Veterans Deserve Dental Care: Policy Solutions to Improve Veterans’ Oral Health*. The goal of the briefing was to engage policymakers and veteran advocates in a discussion spotlighting the oral health challenges veterans face, share data and lived experiences, and explore policy solutions to improve access to care for those who have served. During the event, a panel of experts emphasized that millions of veterans suffer from higher rates of chronic disease and a diminished quality of life because they lack access to affordable dental care and often delay or forgo care entirely. The panel included an array of perspectives from national organizations, community advocates, and local providers: - **Eric Johnson from** [**The American Legion**](https://www.legion.org/) outlined current Veterans Affairs (VA) dental eligibility criteria, noting that typically, only those who are 100% service-connected disabled or meet special conditions (like being a former prisoner of war) qualify for dental care. He shared his own experience receiving care through the VA, highlighting both the progress made and the persistent gaps that leave many veterans behind. The American Legion supports policy changes that would enable the VA to extend oral health care to all veterans, acknowledging that such reforms may need to be phased in over time. ![](https://carequest.org/wp-content/uploads/2025/07/IMG_1707-scaled.jpg)Expert panel at Veterans Deserve Dental Care event - **Matina Vidalis from** [**Philips Healthcare**](https://www.philips.com/a-w/about.html) discussed how private sector partners can play a role in improving preventive care and access to oral health resources. She shared Philips’ longstanding partnership with the VA and highlighted opportunities for collaboration if dental benefits were expanded. - **Frank Lombard from** [**Upper Peninsula Commission for Area Progress**](https://www.upcap.org/) shared insights from his work assessing veterans’ oral health needs in his community in the Upper Peninsula of Michigan — a very rural area with a high proportion of veterans. He pointed to barriers like being ineligible for VA dental care, lack of transportation, and limited provider availability as major obstacles to veterans getting the dental care they need, [forcing some to resort to dangerous measures like pulling out their own teeth at home](https://www.carequest.org/about/blog-post/urgent-case-improving-veteran-oral-health). - **John Decarvalho from** [**Union Community Health Center**](https://uchcbronx.org/) described how Federally Qualified Health Centers (FQHCs) are stepping in to fill some of the gaps for veterans, offering critical services but still facing resource constraints that limit their reach. He noted that other FQHCs may lack strong relationships with the VA, which creates challenges in referrals and day-to-day coordination of care. He emphasized the need for federal policy support to better integrate FQHCs as natural partners in the veterans’ care system and to expand access to dental services for veterans. The discussion concluded with a call to action, urging policymakers and advocates to stay engaged and keep veterans’ oral health at the forefront of policy conversations. *Authored by Caroline Le, CareQuest Institute Public Policy Analyst* *Editor’s Note: To learn more about CareQuest Institute’s efforts to elevate the importance of veterans’ oral health and work with others to come up with solutions, go to* [*carequest.org/veteran-oral-health*](https://www.carequest.org/veteran-oral-health)*.* **Categories:** Blog **Tags:** Health Equity --- ### [It’s Time, Right Now, for Policy Leaders to Address America’s Oral Health Crisis](https://carequest.org/blog/its-time-right-now-for-policy-leaders-to-address-americas-oral-health-crisis/) **Published:** July 23, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)The reality is both stark and straightforward: People in the US are already facing an oral health crisis — and recent policy changes are likely to make it worse. [Seventy-two million people in the US already lack dental insurance](https://www.carequest.org/resource-library/out-pocket), and millions more struggle to find affordable care in their area. Many people in the US skip getting care due to cost, go into debt to fund dental care, or go to extremes — like leaving the country or seeing an unlicensed provider to find care they can afford. And despite that current crisis, federal leaders recently passed cuts to the Medicaid program, putting dental coverage even more at risk, especially for adults. Even further, recent efforts to roll back access to fluoride undermine decades of oral health prevention efforts. Today, right now, our oral health system is crying out for help. ![](https://carequest.org/wp-content/uploads/2025/07/Melissa-Boroughs-Web-250x300.gif)Melissa Burroughs A [new national poll](https://www.carequest.org/resource-library/community-water-fluoridation-national-opinion-poll-results) shows that roughly 80% of US adults think the government has a role to play in improving oral health. First and foremost, policy leaders should work to protect the oral health care gains we’ve made — protecting access through Medicaid in light of cuts and ensuring that people can continue to access safe, effective oral health prevention solutions like water fluoridation and fluoride supplements. But there is much more this administration can do to advance oral health. This country needs oral health policy solutions, and policy leaders need to address it before it’s too late. **Here’s what we’re urging US Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. and HHS to do:** - **Prioritize oral health within health agencies.** Following Kennedy’s comments in recent testimony that he is “committed to oral health,” HHS should prioritize oral health within the new Administration for a Healthy America. Oral health is related to many chronic diseases, including heart disease and diabetes, making it a logical and important component in this new agency’s charge to address chronic disease. This is particularly important with recent oral health staff eliminations in the Centers for Disease Control and Prevention and the Health Resources and Services Administration. - **Prioritize oral health prevention.** The Secretary has indicated his support for topical fluoride products in recent testimony, including fluoride varnishes and oral health care products. While these products cannot replace the benefits of community water fluoridation, the administration should work to ensure more children, particularly in high need or unfluoridated areas, can get fluoride varnish at their pediatrician and dentist offices. The administration should also ensure that parents understand that fluoride varnish, as well as fluoridated mouthwashes and toothpastes, are safe and effective. ![](https://carequest.org/wp-content/uploads/2025/07/Fluoride-Varnish-Resized-199x300.jpg)Dental hygienist applies fluoride varnish to child’s teeth - **Improve oral health access for people in rural areas in the US.** Recent research shows that [40% of adults living in rural environments](https://www.carequest.org/resource-library/still-searching-meeting-oral-health-needs-rural-settings) have not visited the dentist in more than one year, a significantly higher rate than those not in rural areas. Like many health care fields, dentistry is facing a workforce crisis. The administration should invest in innovative workforce models and supporting the dental workforce, particularly in rural areas, dental deserts, and areas without key preventive measures like water fluoridation, to ensure that everyone can access preventive care. - **Improve oral health integration.** For too long, dental care has been siloed from the rest of the health care system, including dental records and dental data. This Administration should ensure that oral health is included in its efforts to improve data sharing, health record interoperability, and digital tools and applications. - **Prioritize oral health research.** Oral health is directly connected to overall health, and the Secretary has indicated his interest in advancing research that further demonstrates this connection. This issue should remain a priority at the National Institutes of Health (NIH), and the Secretary should make clear how it will be prioritized when the NIH is slated to eliminate the National Institute for Dental and Craniofacial Research and fold it into a broader institute focus. Additionally, the administration should prioritize research that looks at the impact of water fluoridation in the US, rather than relying on studies that look at the excessively high levels of fluoride found in other countries, and use an evidence-based approach to the FDA’s assessments of fluoride supplements. Our country is in desperate need of policy changes to improve oral health, and [there is much more the administration can do to promote this cause](https://www.beckersdental.com/featured-perspectives/how-the-trump-administration-should-approach-oral-health-qa/). While we value Kennedy’s expressed dedication to oral health, we need to see concrete actions that further this commitment. *Authored by Melissa Burroughs, Senior Director of Policy & Advocacy at CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Resources, Resilience, and Real Change: How Community Health Centers in North Carolina Are Improving the Oral Health System](https://carequest.org/blog/resources-resilience-and-real-change-how-community-health-centers-in-north-carolina-are-improving-the-oral-health-system/) **Published:** August 1, 2025 **Author:** Caitlin Locklear **Content:** CareQuest Institute is working to transform the oral health system of the future into one that is accessible, equitable, and integrated — but none of that work would be possible without our Community Health Center (CHC) partners. Today, and this National Health Center Week, we are showing our appreciation (and sharing a helpful resource) for CHCs, nonprofit organizations that provide comprehensive, affordable primary and preventive care, including oral health services, to underserved communities. In 2023 alone, [CHCs served more than 31 million patients](https://www.hrsa.gov/about/news/press-releases/new-data-health-center-patients) across the US. And every day, they change countless individual lives. “CHCs play an integral role in our health care system,” says Leslie Carver, Executive Vice President and Chief Operating Officer at CareQuest Institute. “For 60 years, health centers have been delivering neighborhood-based care tailored to the unique cultural, social, and health needs of the diverse communities they serve, both urban and rural.” One project we’re particularly proud of — a project our team worked on for more than two years — highlights that work and those lives in North Carolina. ![](https://carequest.org/wp-content/uploads/2025/08/NC-COrHT.png)Map of North Carolina clinics who participated in COrHT ## The Cornerstones of Health Equity As of 2024, 93 of 100 counties in North Carolina are dental health provider shortage areas, making access to oral health care difficult in those regions. Oral health leaders, including North Carolina Oral Health Collaborative and Blue Cross Blue Shield of North Carolina Foundation, recognized that CHCs across the state were uniquely positioned to improve health equity. The CHC model of care’s emphasis on access and affordability is critical to close care gaps for high-needs populations across the state. The [Community Oral Health Transformation Initiative (COrHT)](https://www.carequest.org/how-we-work/health-improvement-programs/corht) provided the opportunity for CHC dental programs in North Carolina to create meaningful change for the patients they serve. The initiative, developed by CareQuest Institute, provided a framework for safety net dental clinics to implement medical-dental integration and value-based oral health care. ## A Coordinated Approach to Transformation Before starting the initiative, stakeholders, including CareQuest Institute, North Carolina Oral Health Collaborative, and Blue Cross Blue Shield Foundation of North Carolina, conducted a comprehensive assessment to develop program goals. The assessment included: - Data collection and environmental scanning: Using public data sources allowed stakeholders to understand the external factors influencing oral health across the state, including policy, infrastructure, and workforce. - Expert insights: Stakeholders surveyed and interviewed state experts to provide additional context and experience with the status of oral health care in the state, identify opportunities, and understand perceived barriers. ![](https://carequest.org/wp-content/uploads/2025/08/COrHT_NC_Feb23_CM.jpg)Mid-point convening for COrHT Initiative in North Carolina With this data in hand, the initiative brought together an approach to transformation that was coordinated, shaped by evidence, rooted in community voice, and supported by feedback. The data showed: - Development of a common goal: Based on the findings of the assessment, initiative stakeholders identified technology, minimally invasive care, personalized and interprofessional care, alternative payment, and policy change as priority areas of focus for participating CHCs. - A road map for action: The assessment provided a foundation for program participant strategic and action planning. Despite their common goals, each CHC took a different approach to create sustainable, community-driven solutions. Some focused on building their school-based programs, launching local outreach campaigns, or streamlining preventive care. ## Small Changes Led to Meaningful Results Program participants didn’t need to wait on a massive shift in oral health policy to make changes. They had the power to enhance care practices for their patients now. The COrHT Initiative provided them with the support, tools, and data to better understand their state and local communities. They also had a care team that was not afraid to make changes and maintained a commitment to provide quality oral health care. One participant summarized the importance of a community-focused approach to health transformation: “We encourage staff to think beyond teeth,” they said. “Mental health, general health, and social disparities are just as important as dental health.” ![](https://carequest.org/wp-content/uploads/2025/08/COrHT-NC-Feb-scaled.jpg)Mid-point convening for COrHT Initiative in North Carolina COrHT teams were able to align clinical care with data-driven decision-making and address operational inefficiencies such as scheduling, hygiene workflows, and reimbursement. This led to enhancing access to care through teledentistry, extending care into the community, streamlining preventive care, and focusing on what the patient needs. With the help of COrHT, one participant, [Blue Ridge Health, integrated its elementary school-based mobile dental services](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina). Blue Ridge Health was able to provide at-risk school children with preventive care and identify children who required more intensive care. Another participant, Carolina Family Health Centers, focused on improving access and availability of care to special populations. By the end of the initiative, they exceeded their previous year’s totals for [Ryan White](https://ryanwhite.hrsa.gov/) and methadone addiction treatment visits. The report, “[The Collaborative Effect Transforming Oral Health in North Carolina](https://www.carequest.org/resource-library/collaborative-effect-transforming-oral-health-north-carolina),” offers additional details of how the initiative’s framework allowed CHCs to make sustainable improvements. ## Ready to Try It Yourself? ![](https://carequest.org/wp-content/uploads/2025/08/Danielle-Apostolon-2-scaled.jpg)Danielle Apostolon Aligning with our celebration of National Health Center Week, CareQuest Institute recently published a [Community Oral Health Needs Assessment](https://www.carequest.org/resource-library/community-oral-health-needs-assessment-tool). A community health needs assessment is a way of using readily available information to plan health care and public health programs in the future. It also helps existing programs better understand the environment that they are working in and identify potential partners to help meet oral health needs in the community. The assessment: - Describes the populations residing in the service area - Helps identify barriers to oral health, major risk factors, and causes of poor health - Helps identify actions needed to address the variables in the previous bullet Federally Qualified Health Centers (FQHCs) can also use this assessment, as the Health and Resources Services Administration expects FQHCs to conduct a needs assessment every three years. ![](https://carequest.org/wp-content/uploads/2025/08/Christine-Kanan_Cropped-scaled.jpg)Christine Kanan *Authored by Danielle Apostolon, Value-Based Care Program Manager, and Christine Kanan, Implementation Health Transformation Senior Manager, at CareQuest Institute* *Editor’s note: Thank you to the CHC teams across the country who work tirelessly to provide access to equitable, integrated, and coordinated care to millions of patients who are underserved and underinsured. To learn more how organizations can improve their patient experience of care, use data to drive decisions leading to meaningful operational changes, and improve access and continuity of care, visit* [*www.*]()[*carequest.org/health-transformation*]()*.* **Categories:** Blog **Tags:** Value-Based Care --- ### [6 Questions on HPV That Every Dental Health Provider Should Know](https://carequest.org/blog/6-questions-on-hpv-that-every-dental-health-provider-should-know/) **Published:** August 11, 2025 **Author:** Caitlin Locklear **Content:** Can someone transmit human papillomavirus (HPV) even if they don’t have any visible lesions or symptoms? Is it true that the HPV vaccine is not recommended for older adults because they may have already been infected? Do only girls need the HPV vaccine? The questions came fast during CareQuest Institute’s recent webinar, “Human Papillomavirus (HPV) and Dentistry: What Every Provider Should Know.” So fast, in fact, that the hour of education ended before the expert speaker could answer all of them. That speaker — Lilliam Marie Pinzon, DDS, MS, MPH, Associate Professor, Dental Medicine at Kansas City University — answered many questions for the 700+ learners who joined. She then took time out of her preparations for the fall semester to answer several more, which are summarized below. ![](https://carequest.org/wp-content/uploads/2025/08/lilliam-pinzon-cropped.jpg)Lilliam Marie Pinzon, DDS, MS, MPH Why is this knowledge critical for the dental team? HPV is a leading cause of oropharyngeal cancer, and dental providers are uniquely positioned as the first line of defense in early detection of such cancers. Yet, despite its prevalence, HPV is often overlooked and not well understood in dental education and care delivery, leaving dental providers unprepared in addressing these questions with patients. (Note: You can view the full webinar, including the Q&A, in the [CareQuest Institute webinar library.](https://learning.carequest.org/#/catalog/e1597e24-1823-43fb-b6c5-4319bd2b8259)) **Q: If someone tested positive for HPV at a young age but now tests negative, are they still at risk? Do they need the vaccine? Can they transmit the disease?** **A:** Yes, they still need the HPV vaccine. Even if someone previously tested positive and now tests negative, they are not immune. And being previously infected does not provide immunity, so vaccination is still important for protection. **Q: Is there a correlation between the rise of vaping and HPV? Could vaping be considered a risk factor for HPV or related cancers?** **A:** Well, if it’s tobacco, it is a risk factor for developing cancers. Not just HPV, but lung cancer or other cancers because it’s tobacco, which potentially increases cancer risk over time. And then your immune system is going to get affected if you’re consuming tobacco. So that increases the risk for you to be a cancer patient at a certain point. **Q: Is it true that the HPV vaccine is not recommended for older adults because they may have already been infected? What about people over 40?** **A:** The HPV vaccine is generally recommended up to age 26, as that’s the age group most likely to benefit before potential exposure to the virus. However, the age range has been expanded in some cases. (You can [learn more about the guidance on the CDC website](https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html).) **![](https://carequest.org/wp-content/uploads/2025/08/HPV-scaled.jpg)Q: Is there still a misconception that only girls need the HPV vaccine? What can be done to address this?** **A:** Well, I think we need to be more open about the kind of cancers that HPV can cause in men, because I don’t think that’s been communicated properly, and I don’t know why. I also know that there are some countries where they’re promoting the vaccine mainly in girls, not in boys. And the reason . . . I don’t know it. But that’s a fact. So, I think we need to improve the communication and outreach. And talk more openly. It’s just a difficult topic to talk professionals about because, you know, people feel embarrassed, or they don’t want to talk about these topics. But as health professionals we need to normalize this topic, because by normalizing the topic, we can save lives. **Q: In clinical practice, if a lesion is observed in the mouth, is there value in waiting 1–2 weeks before reevaluating the patient?** **A:** Yes, there can be value in waiting 1–2 weeks. Some lesions may be related to temporary conditions like tonsillitis, which can resolve on their own. Waiting allows time to see if symptoms improve. However, if the lesion persists after that period, it’s important to refer the patient for further evaluation, as it could be something more serious like HPV-related oropharyngeal cancer, which can sometimes be misdiagnosed as a benign condition. **Q: Do patients trust the dental team to provide recommendations about HPV and its prevention?** **A:** Yes, I think so. We are health professionals, and they trust their mouth to us. They’re seeking our services. They’re paying us. It is our responsibility to feel more like we should contribute to the prevention of cancer cases. It is in our hands to also provide feedback and education — not just in this topic \[but\] on many topics that we can educate our patients about. By educating them, we build trust. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Helping Older Adults with Their Oral Health . . . from Miles Away](https://carequest.org/blog/helping-older-adults-with-their-oral-health-from-miles-away/) **Published:** August 18, 2025 **Author:** Caitlin Locklear **Content:** For the past four years, Tirzah Weiskotten has been trying to help her 75-year-old father from more than 500 miles away. “I face a lot of challenges,” Weiskotten says. “Caregiving from far away is very different from living with him at home and seeing him day to day.” ![](https://carequest.org/wp-content/uploads/2025/08/Tirzah-and-Dad.png)Tirzah and her father Her father was diagnosed with dementia in 2021 and lives in Maine. Weiskotten lives in Washington, DC, with her husband and three young children. Even though she and her siblings try to visit their father as much as they can, she realized she needed help. “I was looking for a way to connect with resources that were especially helping Mainers,” she says. That’s when she discovered the [MOTIVATE at Home program](https://lunderdineen.org/program/motivate-at-home-portal/), a free oral health education program for care partners of older adults created by Lunder-Dineen Health Education Alliance of Maine, a CareQuest Institute for Oral Health grantee. (The program was also the focus of a [recent CareQuest Institute webinar](https://www.carequest.org/education/webinars/long-term-care-home-caregiving-how-support-older-adults-oral-health-needs).) Lunder-Dineen is a program of the Peter L. Slavin, MD Academy for Applied Learning in Health Care at Massachusetts General Hospital. Weiskotten was so pleased with MOTIVATE at Home’s mission to provide resources for caregivers and care partners that she joined its caregiver advisory committee. The role of the advisory committee was to shape the program’s development. “I really wanted to be a voice for remote caregivers by sharing my experience,” she says. “I felt it was important to contribute to this project to codesign content that truly reflected what we need.” Since she joined the committee, unfortunately, she’s noticed that her father has been struggling to stick with his daily routines. And when she visited him a few months ago, she also noticed another routine might be declining. “His whole bathroom counter was cleared off,” she says. “I’m not sure where he keeps his toothbrush anymore.” ## The MOTIVATE at Home Program Weiskotten grew up in Maine, and her parents made sure dental health was a priority. “I loved going to the dentist so much that I dressed as a tube of toothpaste for Halloween a few years in a row,” she says. “I loved my dentist. He was so funny.” Because she knows the importance of oral health, she wanted to make sure her father continues to take good care of his mouth and teeth. Using the MOTIVATE at Home tools and tips and becoming part of the committee where other caregivers shared their experiences helped her become aware of what was missing in her father’s bathroom and the steps to take before his dental health suffers. “Because I was on the panel, I have conversations about his dental health with my dad, his doctor, and his dentist,” she says. “I don’t know if I would have had I not been a part of this.” Lunder-Dineen Associate Director Denise O’Connell, MSW, LCSW, CCM, says the organization created the MOTIVATE at Home program two years ago. The first year was dedicated to getting input from caregivers like Weiskotten about what the program should look like while also using the latest older adult oral health evidence and applying best practices for creating engaging adult learning. “We learned that they really wanted easy access 24/7 on demand, so that’s why it’s a website,” she says. O’Connell says typically most people, including health care professionals, are not well informed about the importance of oral health care for older adults. They often make other health aspects a priority when managing the day-to-day lives of their loved ones and overlook oral health care. Weiskotten noticed when she was touring long-term care facilities that dental care didn’t come up unless she asked about it. “I asked a lot of questions like ‘Is there a dentist who comes in, or do we have to take him to the dentist?’” she says. “Those were things that were not mentioned on the tour unless you asked.” Now in its second year, Lunder-Dineen has been reaching out to organizations, like Maine’s Area Agencies on Aging, the Senior Companion Program, and [Age Friendly Windham](https://agefriendlywindham.org/) to ask them to adopt the program to reach even more people. ## Driving Home That Oral Health Is Health A recent CareQuest Institute report shows people with Alzheimer’s disease and related dementias — including those living in long-term care facilities — [are at increased risk of poor oral health, due to challenges with maintaining oral hygiene](https://www.carequest.org/resource-library/poor-oral-health-may-contribute-risk-dementia) and accessing professional oral health care. “Oral health is more than having a mouth full of white teeth,” O’Connell says. “Most are unaware of the elevated risks to older adults when oral health care is overlooked. If you do not brush and floss well and routinely, bacteria will grow. And if you’re an older adult and your mouth environment is already at higher risk because it’s dry — and if you can’t brush yourself — that bacteria is going to grow and cause decay, which can lead to other systemic problems. The MOTIVATE at Home program explains this well and what a person can do each day to minimize those risks.” The program’s tools and tips can be passed along to anyone who is caring for older adults facing different challenges across the country. Weiskotten has shared them with her siblings and her husband. “My husband has been asking me for help in caring for his uncle, and the MOTIVATE at Home tools are useful to him as well,” she says. “We’re trying to figure out how to support him and what community resources are available to him. My husband isn’t as ingrained in the community where his uncle lives as I am in the community in Maine, and the resources created by Lunder-Dineen can be accessed anywhere by anyone. I’m grateful for that. In a way, Lunder-Dineen is helping Mainers spread helpful tips across the country, which is pretty cool.” Now, Weiskotten and her siblings are thinking about finding ways to make sure their father can continue living at home as long as possible. Because of MOTIVATE at Home, Weiskotten says her family now feels well equipped to know what to look out for when it comes to his oral health. “I have a lot of tools in my toolbox that I think are going to help when we do find those in-home supports,” she says. “We’ll be able to provide more information for the people who are helping him on a day-to-day basis.” **Categories:** Blog **Tags:** Special Patient Care --- ### [Protecting Oral Health Access: How Advocates Can Respond to Medicaid Cuts in the One Big Beautiful Bill Act](https://carequest.org/blog/protecting-oral-health-access-how-advocates-can-respond-to-medicaid-cuts-in-the-one-big-beautiful-bill-act/) **Published:** August 29, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)More than [78 million people rely on Medicaid for their health care](https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights) — about one in five people living in the US. The program is also a critical lifeline to dental care for people with disabilities, children, older adults, and families with low incomes. Medicaid is the largest source of federal funding to states, helping to stabilize state budgets and promote health and economic security for families by keeping people in school, working, and out of medical debt. The One Big Beautiful Bill Act (OBBBA), passed on July 4, 2025, included deep cuts to Medicaid that will have lasting impacts, including on oral health care. Now is a critical time for advocates to understand how these Medicaid cuts will affect oral health access and to take action to mitigate the impact on families likely to lose affordable care. ## OBBBA Medicaid Provisions that Impact Oral Health Access ![](https://carequest.org/wp-content/uploads/2025/08/Caroline-Le-Headshot_Cropped-scaled.jpg)Caroline Le [Twenty-three million adults get their dental coverage through Medicaid](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs), but new provisions put this access at risk. Eligibility changes could result in millions losing their Medicaid coverage entirely. Medicaid adult dental benefits (MADB) are optional, and states are not required to cover them. This means they are often the first benefit states cut when they face budget pressures. The provisions in OBBBA that are likely to impact oral health access include: **1. New work requirements and eligibility redeterminations will result in unnecessary loss of coverage.** Frequent eligibility redeterminations and work requirements are among the first policies set to take effect. [These measures are proven to be unnecessary and burdensome](https://www.cbpp.org/research/health/medicaid-work-requirements-will-take-away-coverage-from-millions-state-and), pushing eligible people off Medicaid coverage through bureaucratic hurdles. As a result, eligible families will lose access to their health and dental coverage, posing one of the biggest risks to access to dental care. Changes in the bill include: - Requiring states to implement community engagement requirements: Adults covered through Medicaid expansion must report at least 80 hours per month of work, school, or other “community engagement” activities at least once every six months — or more often if required by their state. – By June 2026, the US Department of Health and Human Services Secretary must issue interim final rules to implement the new work reporting requirements. Within seven months of rule issuance, states must design, test, and launch their programs. States may request a waiver for delayed implementation (up to January 2029) if they demonstrate a good faith effort to comply. - Requiring Medicaid expansion populations to redetermine eligibility every six months starting January 1, 2027 While there are some technical exceptions for children, pregnant people, people with disabilities, and certain hardship cases, history shows that they may still lose coverage through burdensome verification processes. Those processes are projected to result in millions of people being disenrolled from Medicaid and losing their premium tax credit eligibility in the marketplace. **2. Cuts to provider taxes threaten adult dental benefits.** Provider taxes are a critical financing tool for states. Without flexibility to raise provider taxes — and with many states losing revenue due to required reductions in those taxes — states will have fewer dollars to maintain optional benefits. This makes adult dental benefits especially vulnerable. Changes in the bill include: - Freezing provider taxes at current levels, disallowing increases in any new or existing taxes - Phasing down the safe harbor limit, the maximum tax rate states can charge without penalty, from 6% to 5.5% starting in FY 2028, and then down to 3.5% in FY 2032 For a full timeline of when key Medicaid OBBBA provisions will go into effect, see [this timeline](https://familiesusa.org/wp-content/uploads/2025/07/Implementation-Timeline-Fact-Sheet.pdf). ## Why This Matters for Oral Health History has shown that [loss of coverage impacts access to dental care](https://www.carequest.org/resource-library/federal-medicaid-cuts-threaten-state-dental-benefits), emergency room (ER) use, and overall health system costs: - In Oregon, California, Maryland, and Pennsylvania, eliminating MADBs led to increased dental ER visits and increased costs of care overall because an ER visit costs three times more than a dental visit. - In Missouri, California, and Massachusetts, MADB cuts shifted costs to community health centers, straining their capacity and financial stability. - In Massachusetts, private practice dentists experienced a drop in revenue because they had provided the majority of dental care for adults with Medicaid. Cuts to dental coverage will worsen already severe barriers to oral health and carry major economic consequences. [More than 72 million adults in the US currently lack dental insurance](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage), and dental care is already [one of the most expensive health services for individuals](https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0800?). Without coverage, more families risk dental debt or delaying care until problems become emergencies. Access to dental coverage through [Medicaid also supports](https://pubmed.ncbi.nlm.nih.gov/33754344/?) employment, contributing to both personal financial security and the stability of the broader economy. Despite these deep cuts to Medicaid, advocates can take action to help mitigate the impacts. Now is the time to engage with state and federal policymakers to delay or offset potential state budget cuts, minimize coverage losses, and protect adult dental benefits. Here is a helpful [tool to see current Medicaid adult dental coverage](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) by state and illustrate what these cuts could mean nationwide. If these changes cannot be further delayed and do take effect, advocates can also support and educate providers and families as they navigate eligibility changes to help as many people as possible maintain coverage and access to care. *Authored by Caroline Le, Public Policy Analyst, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [Medicaid Adult Dental Benefits May Be Optional in Some States, but Oral Health Is Not](https://carequest.org/blog/medicaid-adult-dental-benefits-may-be-optional-in-some-states-but-oral-health-is-not/) **Published:** September 16, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)Federal leaders have made steep cuts to Medicaid in the recent budget and spending bill, but one thing remains clear: Medicaid matters. And *dental* coverage matters — to individuals, families, local communities, and states. Research consistently shows that dental coverage leads to greater access to — and utilization of — regular dental care. This, in turn, leads to improved health outcomes, lower overall health care costs, fewer emergency department visits, improved school outcomes, and greater workforce productivity. Fortunately, many policymakers and state leaders continue to recognize the significance of adult dental benefits. As shown in our newly updated [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), there are key gains from 2024 and the first half of 2025: - More states now offer extensive adult dental benefits. - Several states meaningfully extended coverage for all adults. - Increases in annual benefit maximums (ABMs) are helping to increase access to care. Yet these trends come at a time when Medicaid budgets are under significant threat. When state budgets are tight and cuts are needed, optional benefits are often the first to go. Between 2000 and 2025, at least 21 states reduced or eliminated benefits for some or all adult Medicaid beneficiaries. The results were devastating — beneficiaries went without necessary care, leading to pain, worsening health conditions, and increased use of hospital emergency departments — and, ultimately, [drove up health care costs](https://www.carequest.org/resource-library/federal-medicaid-cuts-threaten-state-dental-benefits). This year’s Coverage Checker shows both how far we’ve come and how much we have to lose. Below are this year’s most noteworthy takeaways. **1. The number of states with an extensive benefit continues to grow.** As of December 31, 2024, 11 states and DC meet the criteria for providing an extensive Medicaid adult dental benefit: Alaska, Iowa, Maine, Minnesota, Montana, Nebraska, New Jersey, Oregon, Tennessee, West Virginia, Wisconsin, and DC. How do we know? Since 2020, CareQuest Institute for Oral Health, ADA Health Policy Institute, the Center for Health Care Strategies, Inc., and an advisory committee of state and national leaders have conducted an [annual survey](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) of state Medicaid agencies. In order to meet the survey’s criteria for an extensive Medicaid adult dental benefit, a state must have an ABM of $1,000 or greater *and* provide coverage of specific CDT codes within seven dental service categories: diagnostic (exams), preventive (cleanings and fluoride treatments), restorative (fillings and crowns), endodontic (root canal therapy), periodontal (scaling and root planing and periodontal maintenance), prosthodontic (dentures, relines, and rebases), and extraction services. Coverage must be offered to all adult beneficiaries. Based on this survey, and as displayed in the Coverage Checker, we can see that the number of states that provide an extensive benefit to all their adult beneficiaries has increased every year since 2020. In our first year of surveying, four states met the criteria. The number increased to seven in 2022 and nine in 2023. The graphic below illustrates how states have strengthened — and cut — adult dental benefits in the past 35 years. Gains from the past decade, in particular, are now at risk. ![](https://carequest.org/wp-content/uploads/2025/09/coverage-checker-graphic-_timeline-for-Social-9.16.png) **2. New and meaningful expansions of covered services went into effect in the last year.** In 2024, nine states broadened their benefit offerings by one or more services (e.g., cleanings, periodontal services, partial dentures) and/or increased the frequency of existing services (e.g., increasing coverage of cleanings from once to twice per year).![](https://carequest.org/wp-content/uploads/2025/09/Number-of-States-Added-Covered-Services-Graph_Web.png) The most commonly added services were preventive services: cleanings and application of fluoride. Two states (Georgia and Kansas) began providing coverage of cleanings and four states (Georgia, Kansas, Minnesota, and West Virginia) began providing coverage for the application of fluoride. It is important to note that in Kansas prior to 2024, these services were provided as “value-added benefits” (VABs) by the state’s Medicaid-contracted managed care organizations. Georgia, Kansas, and Minnesota saw the greatest expansions of benefits overall from 2023 to 2024. - Georgia: Thanks to an [$11 million increase in the FY 2025 budget](https://www.dentaquest.com/en/news-and-resources/news-events/news-releases/statement-from-steve-pollock-on-newly-funded-medicaid-adult-dental-benefit-in-georgia#:~:text=%E2%80%94%20May%209%2C%202024%20%E2%80%94%20Georgia,obtain%20routine%20oral%20health%20care), Georgia’s Medicaid dental program expanded coverage in 2024. Effective July 1, 2024, coverage of oral evaluations, cleanings, application of fluoride, fillings and crowns, anterior and posterior root canal therapy, and complete and partial dentures is available to all adult beneficiaries. Prior to this benefit expansion, the majority of adult beneficiaries were covered only for limited oral evaluations and emergency extractions. - Kansas: In the spring of 2024, the Kansas Legislature approved additional funding to cover examinations and cleanings — services that have been offered by the state’s three Medicaid-contracted managed care organizations as “VABs” since 2013. How the VABs were structured varied by managed care organization and from year to year, thus making the system difficult to navigate. Making these preventive services part of the state Medicaid dental benefit allows for more predictability to consumers and providers and is expected to increase adult access to dental care. - Minnesota: In May 2023, state lawmakers signed the [Health and Human Services omnibus bill](https://www.prnewswire.com/news-releases/minnesota-dental-association-successfully-leads-effort-to-expand-adult-dental-medicaid-benefit-set-301833834.html) into law. Among other provisions, this legislation required the state to provide dental benefits based on medical necessity to all Medicaid-enrolled adults, regardless of age or pregnancy status. This change took effect January 1, 2024. In 2009, Medicaid dental benefits for adults were significantly reduced due to budget cuts. In the years following, Minnesota had two different dental benefit sets for Medicaid enrollees, including a benefit set for pregnant adults and children and a benefit set for nonpregnant adults. While pregnant adults and children under the age of 21 received extensive benefits, [many adult enrollees were not covered for these same services until this year](https://www.prnewswire.com/news-releases/minnesota-dental-association-successfully-leads-effort-to-expand-adult-dental-medicaid-benefit-set-301833834.html). **3. Increases in coverage have taken place in every service category since 2020.![](https://carequest.org/wp-content/uploads/2025/09/Services-with-Greatest-Increases-Graph.png)** There have been significant increases in coverage across all seven service categories since our first round of surveying in 2020. The services with the biggest gains are cleanings, complete and partial dentures, periodontal scaling and root planing and periodontal maintenance, and crowns. **4. States are making changes to their ABMs to increase access to needed services.** Another area of positive change is in ABMs, or the annual limit states place on dental service spending per member per year. ABMs are generally put in place by states to control annual program costs. In some instances, they can limit individual patient access to care because treatment needs may exceed the annual limit. In such instances, a patient may need to delay care or forego it entirely. ![](https://carequest.org/wp-content/uploads/2025/09/Changes-in-Annual-Benefit-Maximum-Graph_Web-2.png) In 2020, six states had an ABM of less than $1,000, six had an ABM of $1,000 or greater, and 32 states placed no limit on dental service spending per member. In 2024, by comparison, one state had an ABM of less than $1,000, 14 had an ABM of $1,000 or greater, and 35 states placed no limit on dental service spending per member. In 2024, Nebraska and West Virginia lifted their ABM. Each cited the limiting effect on access to care their previous ABM had for beneficiaries. [Nebraska first implemented an ABM of $1,000](https://files.kff.org/attachment/report-headed-for-a-crunch-an-update-on-medicaid-spending-coverage-and-policy-heading-into-an-economic-downturn-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-year-2008-and-2009) in 2008. It then [reduced the ABM to $750](https://neappleseed.org/wp-content/uploads/2022/12/Nebraska-Appleseed-Dental-Policy-Brief-12.2022.pdf) in 2021. In lifting the ABM in January 2024, the Nebraska Department of Health and Human Services noted that the $750 ABM “[creates a barrier to care for new and high-need members who may need additional dental care](https://dhhs.ne.gov/Pages/Medicaid-Dental-Care.aspx). Removing the dental benefit maximum will improve member access to care and remove an administrative obstacle for dentists across the state.” [West Virginia implemented a $1,000 ABM](https://bms.wv.gov/) in 2021 when the state extended its Medicaid adult dental benefits. In July 2024, the [state increased its ABM to $2,000](https://dhhr.wv.gov/bms/Provider/Documents/Manuals/Chapter%20505%20Oral%20Health%20Services.pdf). This limit applies to all covered diagnostic, preventive, and restorative procedures, and was implemented with the express purpose of allowing beneficiaries to [obtain a full set of dentures](https://westvirginiawatch.com/briefs/governor-signs-medicaid-denture-bill-law-will-become-effective-july-1/) at the same time. **5. States continue to recognize the enhanced needs of certain populations.** Recognizing the distinct oral health needs of certain groups of adult beneficiaries, some states have opted to provide additional or enhanced services to these groups — most notably pregnant and postpartum adults, those with certain health conditions, adults with intellectual and/or developmental disabilities, and those utilizing long-term care. In 2024, 21 states reported that they offer different coverage to specific groups of beneficiaries than they offer to other adult beneficiaries ages 21–64. Two states, Connecticut and Utah, added coverage for certain groups in 2024. Historically, Connecticut has not covered periodontal services for its adult members. Effective January 1, 2024, [Connecticut Medicaid began covering periodontal services for certain adult beneficiaries](https://ctdhp.org/wp-content/uploads/2023/12/Provider-FAQs_Perio_Coverage_12_26_23.pdf). To be eligible, members must have treatable periodontal disease and be diagnosed with [certain chronic health conditions](https://ctdhp.org/wp-content/uploads/2023/12/Provider-FAQs_Perio_Coverage_12_26_23.pdf). Utah eliminated non-emergency dental services for all but pregnant adults in 2009. Beginning in 2017, and in partnership with the University of Utah School of Dentistry, the state began providing adult dental benefits incrementally by population group (seniors, adults with disabilities, adults enrolled in the state’s Targeted Adult Medicaid program). Effective January 1, 2024, Utah Medicaid and the Children’s Health Insurance Program (CHIP) extended dental coverage for pregnant members from [60 days to 12 months postpartum](https://medicaid-documents.dhhs.utah.gov/Documents/manuals/pdfs/Medicaid%20Information%20Bulletins/Traditional%20Medicaid%20Program/2024/January2024-MIB.pdf). CareQuest Institute’s report on [coverage offered to specific beneficiary groups](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups), updated in 2025, outlines what adult dental benefits are available through each state’s [Medicaid](https://carequest.org/policy-advocacy/medicaid/) program. **6. Benefits are constantly evolving.** Although our survey captures coverage updates through December 31, 2024, changes at the state level happen throughout the year. In the first six months of 2025 alone, several states took very promising steps to improve coverage and access to care. - Utah: After years of extending Medicaid adult dental benefits incrementally by population group, Utah began offering dental benefits to all adults effective April 1, 2025.This change was initiated in 2023 when the Utah legislature passed Senate Bill 19, which directed the state to [pursue federal Medicaid waivers to extend Medicaid dental care to all adults 21 years of age and older](https://le.utah.gov/~2023/bills/static/SB0019.html). Utah’s 1115 Waiver was approved on January 8, 2025, and [expanded dental benefits took effect April 1, 2025](https://medicaid.utah.gov/expansion/#:~:text=The%20expansion%20extends%20Medicaid%20eligibility,state%20covering%20the%20remaining%2010%25.). All adult beneficiaries are [now covered for exams, X-rays, cleanings, fillings, crowns, root canals, dentures, and extractions](https://medicaid.utah.gov/dental-coverage-and-plans/). - Nevada: In 2019, the Nevada legislature passed AB223, which directed the state to pursue federal Medicaid waivers to [expand Medicaid dental benefits to nonpregnant adults diagnosed with diabetes](https://legiscan.com/NV/bill/AB223/2019). Approved on July 19, 2024, the 1115 Waiver will allow beneficiaries to [receive a limited dental benefit package](https://dhcfp.nv.gov/Pgms/waivers/1115OHDiabetes/#:~:text=The%20Nevada%20Department%20of%20Health%20and%20Human,program%20or%20Children%27s%20Health%20Insurance%20Program%20(CHIP)), including diagnostic and preventive, restorative, endodontic, and periodontic dental services through the provider network of selected Federally Qualified Health Centers (FQHCs) and participating Tribal Health Centers with dental clinics. The new benefits are expected to take effect by the end of this year. As noted in the approval letter, “This demonstration furthers the objectives of Medicaid by improving access to dental services in Nevada for certain Medicaid-enrolled adults. Through these efforts, the state will be able to test the value of improved access to oral health care on enrollee health outcomes and in controlling expenditures for a high-risk adult diabetic population in Medicaid. Nevada does not currently cover non-emergency dental benefits for its non-pregnant adult or parent population; this demonstration is a helpful tool to test the potential return on investment of providing dental benefits for this population.” - Arkansas: State legislators signed a new bill into law in April 2025 to [increase the ABM for adults with special needs](https://legiscan.com/AR/bill/SB347/2025). The ABM was increased from $500 to $1,000 and is expected to take effect in September 2025.Additionally, the legislation increases reimbursement rates for oral and maxillofacial surgeons’ dental services, pediatric dental services, and dental services for adults with special needs. ![](https://carequest.org/wp-content/uploads/2025/09/Stacey-Auger-topaz.jpg)Stacey Auger, MPH - Virginia: Since 2015, Virginia has provided [comprehensive Medicaid adult dental benefits to pregnant beneficiaries](https://www.dmas.virginia.gov/media/2603/medicaid-memo-released-3115.pdf). In 2021, this coverage was [extended from two months to 12 months postpartum](https://www.dmas.virginia.gov/about-us/mission-and-values/state-plan/chip-state-plan-and-waiver-related-documents/). Lawmakers signed a bill into law in March 2025 that [codifies the dental benefits provided to pregnant and postpartum beneficiaries](https://legiscan.com/VA/text/HB2539/2025). The bill — one of several this session aimed at improving maternal and child health outcomes — specifies that pregnant beneficiaries will be eligible for at least four dental visits during their pregnancy, with the possibility of additional visits recommended by a licensed dentist or obstetrician. Additionally, and for the first time since extending benefits to pregnant beneficiaries, the bill requires the Department of Medical Assistance Services to submit an annual report to the governor and General Assembly detailing the implementation of these dental services, including the number of pregnant women who used the services, the impact on maternal and infant health outcomes, any access barriers, and recommendations for future improvements. The first such report is to be submitted by November 1, 2026, providing an opportunity to evaluate the effectiveness of the expanded dental care coverage for pregnant beneficiaries. *Authored by Stacey Auger, MPH, Policy Consultant, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Dr. Hal Jeter on the Benefits of Alternative Payment Models in Dentistry](https://carequest.org/blog/voices-from-the-field-dr-hal-jeter-on-the-benefits-of-alternative-payment-models-in-dentistry/) **Published:** September 26, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)As immediate past president of the Ohio Dental Association (ODA) and member of the ODA’s Executive Committee, Hal Jeter, DDS, has had the privilege of participating in several projects that seek to improve access to dental care, especially for underserved populations. One such initiative is Medical Oral Expanded Care (MORE Care®) in Ohio, which he highlighted in a [recent letter](https://www.oda.org/news/improving-access-to-dental-care/) to ODA members. MORE Care in Ohio was a two-year collaborative program between CareQuest Institute for Oral Health, Oral Health Ohio, and dental and pediatric primary care practices in the state. This [program](https://www.carequest.org/resource-library/partners-progress-pursuing-medical-dental-integration-ohio) supported medical-dental integration by increasing preventive oral health services and coordinating dental referrals across several Ohio counties. The program’s alternative payment model (APM) combined pay-for-reporting and pay-for-performance designs to incentivize medical and dental providers to collaborate and achieve shared goals: ![](https://carequest.org/wp-content/uploads/2025/09/Dr-Jeter-image.png)Hal Jeter, DDS - Preventive dental services rose from 30% to 34% of all dental visits, while surgical interventions declined from 16% to 12%, reflecting a shift toward minimally invasive, risk-based care. - Oral health integration during medical well-child visits increased from less than 1% to an average of 8%, with Medicaid-covered visits reaching 10%, highlighting the growing role of medical providers in preventive oral health. - Medical practices made 407 dental referrals, with 34% resulting in completed visits and 83% of those referrals successfully closed through coordinated follow-up. Dr. Jeter’s reflections below on this experience offer valuable insights into the benefits and challenges of implementing APMs in dental practice. He highlights the importance of trust, transparency, and communication in designing APMs that improve medical-dental integration and access to preventive oral health care. Fostering collaboration across disciplines and actively including dental professionals in the design process, he notes, can break down silos and create innovative payment strategies that reflect the full spectrum of care, ultimately improving outcomes for patients and communities alike. **Q: What was your initial reaction to participating in a dental APM?** Honestly, there was some skepticism at first. In Ohio, many providers still carry the sting of a previous APM model, where dentists’ efforts received varying financial outcomes without fully understanding what influenced those differences. The lack of transparency made it difficult for providers to trust the model or adjust their practices with confidence. That experience left a bad taste, and when MORE Care was introduced, some feared it was just another version of capitation. But as the project evolved, it became clear that this was something different — something better. **Q: What made the MORE Care experience stand out from previous APM efforts?** MORE Care was stellar. It emphasized prevention and collaboration, not punishment. There were no negative incentives, and the goal was clear: improve communication between medical and dental providers and reduce surgical dental interventions through preventive dental care. That clarity and focus made a huge difference. I even made changes in my practice because of it, and I’d absolutely do it again. **Q: Can you talk about the changes? What impact did medical-dental integration have on your practice?** It strengthened relationships. I became a resource for pediatricians, and we improved care coordination, even knowing the medical electronic records didn’t talk to each other at all. That’s the heart of integration — closing the loop between referral and treatment. When a child comes back caries-free after treatment and preventive care, that’s the value. That’s what we should be measuring. **Q: What challenges did you encounter while participating in the APM?** One challenge was when the program first started, it was a lot of information, and it took me some time to settle in and understand how the main goals of the APM — increasing preventive services and decreasing the need for surgical dental services — were being measured in the model. Additionally, when we had changes in workflows, like losing staff or receiving new referrals for patients with many surgical dental needs, the quality metrics didn’t always reflect that reality. These are things future models need to address. **Q: What advice would you give to other providers considering APM participation?** Communication is key. Providers need to know exactly what’s being measured, how incentives work, and what the contract says. If you can make it clear that the incentive is in addition to regular reimbursement — and not a replacement — that goes a long way. Also, avoid \[unnecessary\] negative incentives. If providers feel they’re being penalized unfairly, they’ll walk away. Trust and transparency are everything. **Q: What would you say to those designing future APMs?** Keep it simple, fair, and focused on prevention. Make sure providers understand the goals and the data. Build in flexibility for real-world changes. And above all, communicate. If you do that, you’ll get more buy-in and better outcomes. *Editor’s Note: Curious about how the MORE Care Ohio program and APMs transformed dental care in the state? Dive into our [impact report and case study.](https://www.carequest.org/resource-library/partners-progress-pursuing-medical-dental-integration-ohio) And check out our* [*self-paced courses*](https://www.carequest.org/education/course/value-based-care-oral-health-principles-and-practices/overview) *for more on APMs.* **Categories:** Blog **Tags:** Value-Based Care --- ### [Successes and Setbacks: 9 Quotes about Oral Health in 2025](https://carequest.org/blog/successes-and-setbacks-9-quotes-about-oral-health-in-2025/) **Published:** December 9, 2025 **Author:** Caitlin Locklear **Content:** 2025 brought significant challenges for the oral health system in the US, deepening what many already believe is a crisis. About [72 million Americans lack dental insurance](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage) today. State-level decisions to eliminate community water fluoridation threatened access and prevention efforts. And federal cuts to Medicaid will jeopardize dental benefits for millions in the coming years. Despite these setbacks, CareQuest Institute and its partners remain committed to meeting these challenges and advocating for a stronger, more equitable oral health system. Together, we continue to drive change, advance equity, and broadcast the voices of many individuals who work every day to improve the oral health system. Below are nine quotes from 2025 that capture these challenges, the progress made, and the vision for the future: 1. ****“We are already facing an oral health crisis. Medicaid cuts and water fluoridation rollbacks are the two biggest ways in which the oral health crisis is likely to be exacerbated.”**** — Melissa Burroughs, Senior Public Policy Director, CareQuest Institute, in ***TIME Magazine*** ![](https://carequest.org/wp-content/uploads/2025/04/Melissa-Boroughs-Web-250x300.gif)Melissa Burroughs In a *TIME Magazine* article, [dentists and experts, including Burroughs, say they’re worried that a perfect storm of public policy changes could further worsen](https://time.com/7291226/america-dental-oral-health/) oral health across the country. With the federal government making cuts to Medicaid, fewer people will be able to access dental care. On top of that, the federal government eliminated the Division of Oral Health at the US Centers for Disease Control and Prevention (CDC), and states including Florida and Utah banned the addition of fluoride to drinking water, with other states considering similar bans. Dentists say the oral health of children and adults will suffer. ![](https://carequest.org/wp-content/uploads/2025/12/Lisa-Platt-Headshot-240x300.jpg)Lisa Platt 2. **“They’ve done so much for us. Why aren’t we taking care of them?” —** Lisa Platt, Executive Director, Mercy Foundation Out of the 9 million veterans who are eligible for medical care through the US Department of Veterans Affairs, 80% are not eligible for dental coverage or care. Oregon’s Mercy Foundation, [one of 10 CareQuest Institute grantees awarded $125,000 to improve veterans’ access](https://www.carequest.org/about/blog-post/theyve-done-so-much-us-why-arent-we-taking-care-them) to oral health care, used the funds to support their inpatient dental program at Mercy Medical Center. 3. **“I wish I could see every kid by age 1, but there are still a lot of kids at age 1 who are getting a lot of cavities.”** — Jessica Robertson, DMD, Board-Certified Pediatric Dentist, Around the Mountain Pediatric Dentistry ![](https://carequest.org/wp-content/uploads/2025/12/Jessica-Robertson-Headshot-241x300.jpg)Jessica Robertson, DMD Robertson served as an expert panelist on CareQuest Institute’s webinar “[Starting Strong: The Importance of the Age One Dental Visit](https://www.carequest.org/education/webinars/starting-strong-importance-age-one-dental-visit),” where she shared why dental visits at age 1 are critical to promoting oral health and minimizing the risk of early childhood caries. As a [dentist in a rural area, she says the biggest barriers to oral health care for her patients](https://www.carequest.org/about/blog-post/voices-field-dr-jessica-robertson-providing-care-rural-areas) are food deserts. Many patients have to travel far distances to get to a grocery store once a month and settle for processed food. 4. **“I think it’s time for all aspects of dentistry to be included in essential health.” —** Brett Kessler, DDS, Former President, American Dental Association In the past few years, oral health has moved from the sidelines at HLTH to its rightful place as a key part of its programming. HLTH is an annual event where industry leaders gather to explore innovative trends and technologies. CareQuest Innovation Partners, a for-profit subsidiary company of CareQuest Institute, [hosted an Oral Health Pavilion at the event to demonstrate what connected care looks like](https://carequestinnovation.com/hlth-2025-medical-dental-integration-takes-center-stage/), with A1C, saliva, and blood pressure testing. During the panel sessions, experts discussed the importance of medical-dental integration and why it is one of the strongest opportunities to advance prevention of tooth decay and early detection of chronic diseases. 5. **“We see the youth as Generation 2.0 that really need to see firsthand the prevention and the support that is needed in the community.”** — Hibo Omer, Executive Director, New Mainers Public Health Initiative (NMPHI) In Maine, several dental practices and clinics have shut down, leaving many without a dental home. With the help of a CareQuest Institute grant, [NMPHI engaged junior community health workers to help individuals](https://www.carequest.org/about/blog-post/learning-lead-teens-connect-community-oral-health-care) in their communities access and learn about oral health, specifically about oral hygiene and how to get dental insurance. 6. **“I see it as an opportunity to improve integrated care and make a positive impact in the health outcomes for patients in critical condition.”** — Michelle Gross-Panico, Clinical Program Research and Development Manager and ICU Project Director, Dignity Health ![](https://carequest.org/wp-content/uploads/2025/12/MGross-Panico-Cropped-237x300.png)Michelle Gross-Panico In 2019, Dignity Health launched a grant-funded pilot program to address oral care for patients in the intensive care unit (ICU) at Dignity Health Chandler Regional Medical Center. Through the program, the organization embedded five critical care dental hygienists into the Medical and Trauma ICUs. Going strong five years later, [the organization received a grant from CareQuest Institute to work toward bringing their model to the larger health care system](https://www.carequest.org/about/blog-post/how-hygienists-are-providing-critical-oral-care-icu-patients), both state- and nationwide. The funding allowed the organization to conduct a study to evaluate changes in patient oral conditions, assess the interprofessional care model, and complete a cost analysis. 7. **“Recent wins in Louisiana and Connecticut demonstrate that a united stakeholder front, evidence-based data, and local engagement can protect access to fluoride, regardless of the political environment.”** — Matthew Steele, Director of State and Local Advocacy, CareQuest Institute ![](https://carequest.org/wp-content/uploads/2025/12/Matt-Steele-Headshot-244x300.jpeg)Matthew Steele Despite community water fluoridation (CWF) being a safe and effective public health measure that has helped reduce tooth decay for decades, more than 20 states introduced legislation this year aimed at restricting — or outright banning — CWF. The issue of CWF has become increasingly politicized in those 20 states and many others. At a time when state-level decisions increasingly determine local health outcomes, [wins in Louisiana and Connecticut offered timely and informative case studies](https://www.carequest.org/about/blog-post/winning-water-fluoridation-lessons-louisiana-and-connecticut). As threats to fluoride continue to emerge across the country, the case studies will provide a blueprint for how to defend and strengthen community water fluoridation. 8. **“Being surrounded by people who truly care about this issue made me feel seen and part of a larger community. That sense of belonging is what stays with me from Hill Day — to know that there are people with the same vision as me was powerful.” — India Washington, MHS, CPH, Master’s Student, Johns Hopkins Bloomberg School of Public Health ![](https://carequest.org/wp-content/uploads/2025/12/India-Washington-at-Hill-Day_Cropped-265x300.jpg)India Washington, MPH, CPH OPEN Hill Day brought more than 90 members, including Washington, from across the US to Capitol Hill [to meet with legislators about prioritizing oral health in their communities](https://www.carequest.org/about/blog-post/voices-field-student-perspective-open-hill-day). At the event, she joined other OPEN members to ask legislators to (1) oppose Medicaid cuts that would jeopardize access to dental care for millions of people, (2) improve access to dental care for veterans who get medical care from the VA, and (3) support the HEADs UP Act, which would designate people with intellectual and developmental disabilities as a medically underserved population and increase their access to oral health care. 9. **“Whether it’s advocating for coverage, investing in innovative care delivery models, or supporting our health professionals on the front lines, expanding affordable and available access to oral health care is the game changer. It’s the key to unlocking better outcomes for millions.”** — Wade Rakes, MBA, CEO, CareQuest Institute ![](https://carequest.org/wp-content/uploads/2025/12/CEO-Wade_Cropped_2-248x300.jpg)Wade Rakes, MBA As the new CEO of CareQuest Institute, Rakes will lead an organization dedicated to transforming oral health access and outcomes for underserved populations across the US. [Rakes answered eight questions about himself and his vision](https://www.carequest.org/about/blog-post/new-perspective-eight-questions-carequest-institute-ceo-wade-rakes) for the future of CareQuest Institute. **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Worth a Read: The 5 Most Popular CareQuest Institute Publications of 2025](https://carequest.org/blog/worth-a-read-the-5-most-popular-carequest-institute-publications-of-2025/) **Published:** December 16, 2025 **Author:** Caitlin Locklear **Content:** How many adults in the US do not have dental insurance? What’s the value of integrating oral health into interprofessional education? How much does it cost to treat non-traumatic dental conditions in an emergency department? In 2025, CareQuest Institute analysts and authors answered those questions — and many more — through our research and publications. The answers to those questions then drive systems change, giving providers, policymakers, and advocates knowledge and insights to improve the oral health system. From the importance of medical-dental integration to the inequities facing communities of color, our work illuminates the myriad challenges and opportunities in oral health care. **Which publications resonated most with our readers in 2025?** We’ve compiled the top five most-viewed publications of the year, highlighting insights into the current oral health landscape in the US and opportunities for improvement in the future. [![](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Out-of-Pocket_SOHEA2024_612x792-232x300.png)](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage) 1\. [Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage) Approximately 72 million adults in the US (27%) do not have dental insurance. That’s almost three times the number of adults who lack health insurance. These findings come from CareQuest Institute’s 2024 State of Oral Health Equity in America (SOHEA) survey, which sheds light on the attitudes, experiences, and behaviors of more than 9,000 adults when it comes to oral health. In this report, researchers unpacked the key insights and explored what they reveal about the state of dental care in America today. 2\. [Transforming Oral Health Care Through Interprofessional Education](https://www.carequest.org/resource-library/transforming-oral-health-care-through-interprofessional-education)[![](https://carequest.org/wp-content/uploads/2025/12/Transforming-Oral-Health-Care-Through-Interprofessional-Education.png)](https://www.carequest.org/resource-library/transforming-oral-health-care-through-interprofessional-education) Interprofessional education (IPE) is all about collaboration — where students from different health care disciplines engage in shared learning. Yet, oral health education (like dental and dental hygiene programs) has traditionally been siloed, separate from other areas of health care. This separation matters because oral health is deeply connected to overall health, influencing conditions such as diabetes, heart disease, and respiratory infections. This white paper from CareQuest Institute with contributions from 19 academic institutions highlighted why integrating oral health into IPE is critical. The authors concluded that IPE is essential for creating collaborative, patient-centered care — and for breaking down the barriers that have long divided dental care from medical care. 3\. [Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups)[![](https://carequest.org/wp-content/uploads/2025/12/Medicaid-Adult-Dental-Benefits-Offered-to-Specific-Beneficiary-Groups-229x300.png)](https://carequest.org/medicaid-adult-dental-benefits-offered-to-specific-beneficiary-groups/) Medicaid adult dental benefits aren’t guaranteed — they are considered “optional” by the Centers for Medicare and Medicaid Services (CMS). This gives states the power to limit the types of services covered, restrict eligibility to certain beneficiary groups, and even exclude adult dental care entirely. An updated CareQuest Institute report revealed that 21 states now provide extra dental coverage for specific populations, such as pregnant adults and adults with disabilities. The report also included a detailed rubric showing how states vary in coverage across eight categories: diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and extraction services, as well as annual benefit maximum. 4\. [Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions![](https://carequest.org/wp-content/uploads/2025/12/Dental-Care-in-Crisis-233x300.png)](https://www.carequest.org/resource-library/dental-care-crisis) Emergency department (ED) visits for non-traumatic dental conditions (NTDCs) may have declined since 2019, but they’re costing more. In fact, costs have risen by $500 million. These visits strain hospital resources and add pressure to already overworked ED staff. On top of that, most hospitals aren’t equipped to provide definitive dental treatment, meaning patients often leave with temporary relief rather than a real solution. In this analysis, CareQuest Institute researchers dug into the numbers and trends behind ED usage for dental issues — and what these patterns reveal about broader challenges in access to dental care across America. 5\. [Partners in Progress: Pursuing Medical-Dental Integration in Ohio![](https://carequest.org/wp-content/uploads/2025/12/Partners-in-Progress-231x300.png)](https://www.carequest.org/resource-library/partners-progress-pursuing-medical-dental-integration-ohio) For two years, the Medical Oral Expanded Care (MORE Care) Ohio pilot program, led by CareQuest Institute and Oral Health Ohio, worked to integrate oral health into pediatric primary care across six counties in the state. The initiative brought together seven private and health-system-affiliated practices to expand access to preventive dental services for nearly 20,000 children. This impact report and case study gave a behind-the-scenes look inside the MORE Care Ohio program, highlighting its design, implementation, and outcomes. **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [How Rural Health Transformation Program Awards Can Improve Oral Health Access](https://carequest.org/blog/how-rural-health-transformation-program-awards-can-improve-oral-health-access/) **Published:** January 20, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)Rural populations experience poorer [oral health care access, lower utilization, and worse outcomes](https://carequest.org/still-searching-meeting-oral-health-needs-in-rural-settings/) compared with their urban and suburban counterparts. An estimated 34% of rural residents lack dental insurance coverage, and 40% have not visited the dentist in more than one year. We also know oral health is [deeply connected to overall health and well-being](https://carequest.org/mouths-matter-more-than-you-may-know/), and improved access to dental care is associated with reduced disease burden and lower costs for chronic conditions that disproportionately affect rural communities. In response, states are looking to strengthen oral health systems in rural communities with support from a new federal initiative: the [Rural Health Transformation Program (RHTP)](https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview). RHTP will make $50 billion in federal grants available to states — $10 billion per federal fiscal year from 2026 through 2030. Fifty percent of the funds will be allocated equally among the states, while the remaining 50% “will be allocated by the US Centers for Medicare & Medicaid Services based on a variety of factors.” [All 50 states applied for and were approved to receive RHTP funding](https://www.cms.gov/newsroom/press-releases/cms-announces-50-billion-awards-strengthen-rural-health-all-50-states), with totals ranging from $281 million (Texas) to $147 million (New Jersey). CMS’s [Office of Rural Health Transformation](https://www.federalregister.gov/documents/2025/12/22/2025-23588/statement-of-organization-functions-and-delegations-of-authority) will oversee the RHTP and provide monitoring and technical assistance to states throughout the program’s five years. Many state RHTP applications reflected growing recognition of these rural oral health needs, with several proposals incorporating oral health trends and innovative strategies to expand access, strengthen the workforce, and integrate dental care into broader rural health systems. While these initiatives are not guaranteed to be implemented exactly as proposed, they present meaningful opportunities for oral health advocates to engage with states and help ensure that oral health investments are fully leveraged to address persistent rural access gaps. ## **Oral Health Trends We’re Seeing Across States** Across state applications, several clear and recurring themes emerged around how states propose to leverage RHTP funding to strengthen oral health access in rural communities: **Workforce Development and Scope-of-Practice Expansion:** Many states emphasized strengthening the rural dental workforce through training pipelines, recruitment and retention strategies, and scope-of-practice expansions — particularly for dental hygienists and allied providers — to address persistent provider shortages and improve access to care. **Mobile, Teledentistry, and Remote Access Models:** States proposed expanding mobile, portable, and teledentistry models delivered through schools and community settings to bring preventive and diagnostic dental services directly to rural residents. **Facility-Based Expansion and Specialized Dental Services:** Several states proposed upgrading facilities or establishing specialized dental centers, including integrated and special care clinics, to better serve patients with complex, high-need, or disability-related dental conditions. **Technology Adoption, Efficiency, and Interoperability:** States prioritized investments in dental health IT, interoperability, and teledentistry tools to improve care coordination, efficiency, and integration across medical, behavioral, and dental systems. **Community Integration and Expanded Access Points:** Many states highlighted community-embedded dental care models — such as school-based clinics and multidisciplinary teams — to reduce access barriers, support prevention, and integrate dental services with broader community health care. ## **The Top Five: State Proposals That Stand Out** In addition to these overall trends, five states included particularly promising oral health proposals: [Tennessee](https://www.tn.gov/content/dam/tn/health/TN_RHTF_Application_Full_Document.pdf) Tennessee proposes up to $75 million to extend and expand its existing rural dental workforce pilot through FY 2030. The initiative will recruit clinicians to rural areas, add and upgrade dental suites, and incentivize preventive and restorative services. The proposal also includes extending value-based payment (VBP) principles into existing Patient-Centered Dental Home models, creating opportunities to link reimbursement to outcomes and better integrate oral health. The state also establishes oral health–specific metric targets, such as the number of oral health clinicians placed (25) and new dental suites established (15). These explicit, actionable, time-bound goals create momentum while underscoring Tennessee’s commitment to improving access to critical services. [Wisconsin](https://www.dhs.wisconsin.gov/business/dhs-rhtp-application-narrative.pdf) Wisconsin plans to award Dental Technology Grants to expand rural Medicaid access to dental services and increase provider throughput. These grants will incentivize Medicaid participation by rural dental providers, modernize clinical technologies, and expand mobile and telehealth access. Wisconsin’s plan also emphasizes integrating dental services into multidisciplinary, team-based care models in rural communities. The state also plans pilots and a Medicaid state plan amendment to support dental prevention and care navigation by community health workers in rural areas. Additionally, grants will support care coordination efforts and IT upgrades in tribal clinics. The state proposes interoperability infrastructure investments specifically for dental providers and plans to use dental-inclusive Wisconsin Collaborative for Healthcare Quality (WCHQ) data to identify gaps, track outcomes, and coordinate care across organizations. [Alaska](https://health.alaska.gov/media/bxangqdz/alaska-rhtp-project-narrative-and-supporting-documents.pdf) Alaska proposes expanding its Dental Health Aide Therapist (DHAT) program, including investments in recruitment, retention, and training. The state also plans to include preventive, school-based health center (SBHC) and DHAT dental services in alternative payment model (APM) reimbursement designs. Alaska’s plans further include investments in interoperability and health information exchange (HIE) connectivity for dental providers, technical assistance for oral health quality reporting, and maternal–child and school wellness integration efforts that include oral–systemic health education. [Maine](https://www.maine.gov/dhhs/ruralhealth#:~:text=The%20award%20period%20spans%20from,of%20rural%20health%20systems%20statewide.) Maine’s RHTP plans include expanding the number of SBHCs with dental services; contracting for a teledentistry network to connect children to ongoing dental care through schools, childcare, and other community settings; funding mobile units that include oral health services; and making interoperability and technology investments targeted specifically at dental providers. The state also plans to design multipayer APMs that include dental reimbursement. [Connecticut](https://portal.ct.gov/dss/-/media/departments-and-agencies/dss/health-and-home-care/rural-health-transformation-program/cms_project_narrative_20251105.pdf) Connecticut will use RHTP funds to deploy four mobile dental vans. The state also plans to onboard rural providers — including dental providers — to its HIE and invest in telehealth and IT capacity to improve care coordination inclusive of dental care. Connecticut further intends to include dental care in VBP model design alongside primary, maternal, and behavioral health services. ![](https://carequest.org/wp-content/uploads/2024/03/Andrea-Clark-Cropped-220x300.png)Andrea Clark, MS ![](https://carequest.org/wp-content/uploads/2025/08/Caroline-Le-Headshot_Cropped-238x300.jpg)Caroline Le CareQuest Institute applauds the integration of oral health into state plans to strengthen rural health sustainability and improve access to care. These grants represent powerful opportunities to advance the Institute’s goals of increasing the adoption of integrated, whole-person care inclusive of oral health and expanding access to better oral and systemic health to underserved populations. *Authored by Andrea Clark, MS, Director of Health Care Economics, CareQuest Institute, and Caroline Le, Public Policy Analyst, CareQuest Institute* *Editor’s note: Visit carequest.org to [learn more about oral health’s critical role in systemic health](https://carequest.org/about/medical-dental-integration/).* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Behind the Study: Coauthor Shares Insights on Fluoridation and Low Birth Weight](https://carequest.org/blog/behind-the-study-coauthor-shares-insights-on-fluoridation-and-low-birth-weight/) **Published:** January 27, 2026 **Author:** Caitlin Locklear **Content:** Is fluoride in drinking water safe? This question has become a popular one during the last year, [as states continue to consider legislation](https://carequest.org/policy-advocacy/community-water-fluoridation/) that will influence communities across the US. Recently, the Environmental Protection Agency (EPA) announced [plans to review public health risks from fluoride in drinking water](https://www.epa.gov/newsreleases/epa-announces-next-step-gold-standard-review-fluoride-inform-protective), keeping the discussion firmly in the spotlight. ![](https://carequest.org/wp-content/uploads/2026/01/LisaSimon_Headshot-246x300.jpg)Lisa Simon, MD, DMD Research on the topic has never been more important. Last year, [findings showed](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2834515) ending water fluoridation could result in more than 25 million additional decayed teeth among children in the next five years and an estimated $9.8 billion in added health care costs. And now, a new study, “[Community Water Fluoridation and Birth Outcomes](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2844076),” published in *JAMA Network Open*, shows that community water fluoridation is *not* associated with infant health as measured by birth weight. “Our paper is part of the attempt to prove that fluoride is safe and that its benefits far outweigh the potential for harm,” says Lisa Simon, MD, DMD, coauthor of the study. Dr. Simon was recently appointed to serve as the new director of Harvard School of Dental Medicine’s (HSDM) Initiative to Integrate Oral Health and Medicine. She also serves as an assistant professor of Oral Health Policy and Epidemiology at HSDM, assistant professor of Medicine at HMS, and associate physician at Brigham & Women’s Hospital. Below, Dr. Simon dives deeper into the reasons she and her coauthors conducted the research and the potential next steps. **What are the key findings of this study?** Our study found that babies born between 1968 and 1988 in counties that added fluoride to public drinking water did not have a lower birth weight than babies born in those same counties before fluoride was added, or in counties that never added fluoride to public drinking water. **![](https://carequest.org/wp-content/uploads/2026/01/Baby-touching-water-from-sink-1024x683.jpg)What motivated you and your coauthors to undertake this study? Was there a gap in existing research you hoped to address?** There is ample evidence of fluoride’s benefits to teeth, but a few small observational studies have suggested that community water fluoridation could cause neurologic damage. These studies have, unfortunately, had traction in alternative health circles, leading to proposals for fluoride bans, like those that have taken effect in Utah and Florida. Yet, a growing body of work using the best scientific techniques available has not found any evidence of harm from fluoride exposure at typical, safe levels. **Clinicians often field questions from patients about fluoride safety — how do these results influence those conversations?** Based on our study, dentists can tell patients that, using the best evidence available, being exposed to fluoride during gestation does not negatively affect fetal brain development. And we know that fluoride exposure before birth strengthens the already-developing primary teeth! **Does your study tell us anything about fluoride and IQ or neurodevelopment? If not, are there any plans to study those?** While birth weight doesn’t directly tell us about cognitive outcomes, it is one measure of infant development that may be associated with cognition. We also have plans to study this more directly in future work. **What are the next steps for this line of research?** Our next project, funded by CareQuest Institute, will use a similar model to identify whether fluoridated water exposure in childhood has effects on cognitive measures in early and late adulthood. **Why are you personally passionate about this research? Why is community water fluoridation important to you?** Fluoridated water is a public health success that makes me proud to be a dentist, and one of the best tools we have to equitably deliver an oral health benefit to people regardless of whether they can access a dentist or dental supplies. Along with CareQuest Institute’s advocacy, researchers need to play a role in teaching people about the safety and benefits of fluoride and help protect this beautiful piece of public health infrastructure. *Editor’s Note: Visit CareQuest Institute’s* [*Community Water Fluoridation page*](https://carequest.org/policy-advocacy/community-water-fluoridation/) *for more information on the benefits of fluoride.* **Categories:** Blog **Tags:** Health Equity --- ### [Fluoride at a Crossroads: What the EPA’s New Review Means — and Why It Matters](https://carequest.org/blog/fluoride-at-a-crossroads-what-the-epas-new-review-means-and-why-it-matters/) **Published:** February 5, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)The US Environmental Protection Agency (EPA) announced it will open a [new, off-cycle evidence review of fluoride in drinking water](https://www.epa.gov/newsreleases/epa-announces-next-step-gold-standard-review-fluoride-inform-protective) — a move that comes amid increasing political pressure, growing state-level activity, and heightened public attention to community water fluoridation (CWF). Decades of research show that CWF is a safe, effective, and cost-saving public health measure. A recent study found that ending CWF in the US would [lead to an estimated $9.8 billion in added health care costs](https://carequest.org/new-study-shows-costly-consequences-for-states-banning-fluoride/), and another study found that children exposed to recommended levels of fluoride in drinking water [performed better on math, reading, and vocabulary tests in secondary school](https://www.science.org/doi/10.1126/sciadv.adz0757) compared to their peers not exposed to those levels. The EPA’s evidence review will not change fluoride policy immediately, but it will shape the landscape for future federal and state decisions. Now is a critical time for advocates to understand what the EPA is — and is not — reviewing, how this process might affect oral health access for millions of people, and what actions they can take to protect CWF. ## ![](https://carequest.org/wp-content/uploads/2026/02/iStock-1461453182-1024x681.jpg)The EPA Opens New Evidence Review on Fluoride On January 28, the EPA [released a preliminary plan](https://www.federalregister.gov/documents/2026/01/28/2026-01657/review-of-science-on-fluoride-in-drinking-water-preliminary-assessment-plan-and-literature-survey) for public comment to update its Human Health Toxicity Assessment for fluoride through the Office of Water. The Office of Water is the only federal entity with authority to regulate fluoride levels nationally under the [Safe Drinking Water Act (SDWA)](https://www.epa.gov/sdwa/overview-safe-drinking-water-act). Under the SDWA, the EPA is prohibited from *requiring* substances to be added to drinking water for preventive health purposes. Decisions about fluoridating drinking water remain at the state and local level, provided that fluoride levels stay below the EPA’s toxicity threshold. That threshold is currently set at 4.0 mg/L — well above the 0.7 mg/L level used by most community water systems as the standard for optimal oral health. The purpose of the review is to establish a revised “reference dose,” or level of fluoride exposure at which adverse health effects may occur. Although the EPA does not decide whether communities fluoridate their drinking water, its toxicity assessments can shape future regulatory standards that could effectively bar communities from fluoridating. The EPA has stated it will focus its assessment on two health outcomes, particularly in children: dental fluorosis and neurodevelopmental effects. The agency will not consider the benefits of fluoride for cavity prevention, nor will it evaluate cancer or bone-related outcomes. The EPA has opened a 30-day [public comment period](https://www.federalregister.gov/documents/2026/01/28/2026-01657/review-of-science-on-fluoride-in-drinking-water-preliminary-assessment-plan-and-literature-survey) on the preliminary assessment plan, closing on February 27. After that, the agency will: 1. Finalize a systematic review protocol incorporating public input. 2. Develop a draft Toxicity Assessment and proposed reference dose. 3. Release the draft for external expert peer review and public comment. 4. Revise and publish a final assessment, which will establish any next steps for further regulating fluoride or updating national guidance. ## Parallel State-Level Momentum The recent EPA announcement is unfolding alongside growing state-level action. In 2025, Florida and Utah enacted statewide bans on community water fluoridation, and momentum has carried into 2026. So far this year: - Fifteen states have introduced legislation to restrict or ban fluoridation. - New Jersey has taken the opposite approach, advancing protections for CWF. A [recent CareQuest Institute analysis](https://carequest.org/how-ending-water-fluoridation-would-affect-children-and-state-medicaid-costs/) estimates that eliminating CWF in just five states would result in 132,000 additional children developing cavities and nearly $40 million in added Medicaid costs within three years. Even in states where bills are unlikely to advance, the volume of proposals reflects a shifting political environment. CareQuest Institute is tracking fluoridation-related legislation in real time and regularly updating this [map](https://carequest.org/2026-community-water-fluoridation-policy-state-legislative-activity/) to reflect the political landscape. ## How Advocates Can Respond Dental and medical professionals remain among the most trusted voices on fluoride. Amidst circulating misinformation, clear, evidence-based, and person-centered conversations with patients are essential. But advocacy cannot stop at the provider front. Fluoride policy wins in 2025 — including preventing the US Food and Drug Administration (FDA) from completely removing fluoride supplements for children from the market, defeating a [proposed fluoride ban in Louisiana](https://carequest.org/the-new-fault-lines-on-fluoride-in-four-states-and-what-they-mean-for-medicaid/), and advancing fluoridation protections in Connecticut — demonstrate that coordinated, multi-stakeholder engagement works. In each case, advocates combined strong data, local leadership, and sustained outreach to protect access to fluoridated water and supplements, even in politically complex environments. At this moment, engagement with the EPA is especially important. Submitting comments on the preliminary assessment plan can help ensure the agency hears from dental, public health, and scientific experts. We urge your organization to act. *Editor’s Note: If you would like more information or resources that can support your organization’s efforts to submit comments, please reach out to* [*info@carequest.org*](mailto:info@carequest.org)*.* **Categories:** Blog **Tags:** Health Equity --- ### [2026 CareQuest Philanthropy Priorities and What We Are Up Against](https://carequest.org/blog/2026-carequest-philanthropy-priorities-and-what-we-are-up-against/) **Published:** February 17, 2026 **Author:** Caitlin Locklear **Content:** As we enter 2026, we recognize the increasing urgency of our unique work. Simply put, it’s a year unlike any other we’ve seen. Why? Access to oral health care — and the proven prevention strategies that support it — are under mounting threat. State legislators are likely to cut Medicaid adult dental benefits as one of the first casualties of state budget shortfalls. While lawmakers may frame these cuts as short-term cost saving measures, they merely shift costs to already overburdened hospital emergency departments and fail to address the underlying causes of oral pain and disease. The result, for all of us, is worse health outcomes, higher system costs, and deeper inequities. We believe this is unacceptable, fiscally irresponsible, and an inefficient use of public resources. Our priorities for 2026 reflect this reality: The CareQuest Institute Philanthropy team is focused on building practical tools for organizations across the country, elevating oral health care as a public health and equity necessity, and accelerating prevention-focused solutions that protect communities from oral health problems. ![](https://carequest.org/wp-content/uploads/2026/02/OPEN-Hill-Day-Appointments_15_small-1024x683.jpg)OPEN members participate in Hill Day 2025. ## **Community Water Fluoridation, Coalitions, and Collective Action**. - [**Community water fluoridation (CWF)**](https://carequest.org/policy-advocacy/community-water-fluoridation/) remains a cornerstone of this work. It’s one of the most effective evidence-based public health interventions available — and one we must defend at the national, state, and local levels. At the end of 2025, CareQuest Institute awarded 14 rapid-response grants to partners working on the ground in states where CWF could be restricted or outright banned. In partnership with our Policy and Advocacy team, we are actively monitoring legislation, connecting with coalitions, and providing technical assistance in high-risk states. We are also supporting partners on this topic through OPEN’s CWF Learning Collaborative, which is dedicated to protecting access to CWF. - History reminds us that moments like this demand collective resolve, coordinated action, and an unwavering commitment to oral health equity. To meet these challenges, we are partnering with the [**American Network of Oral Health Coalitions (ANOHC)**](https://anohc.org/) to provide leadership development, technical assistance, and shared resources to state and regional coalitions. These coalitions are often the first line of defense against policy rollbacks and emerging threats, but they are increasingly stretched thin. By investing in coalition capacity (for example, learning sessions and the creation of a capacity assessment tool), coordination, and leadership, we aim to combat fragmentation, strengthen shared strategy, and ensure advocates are equipped to respond swiftly and effectively. - This commitment to collective action will come into sharper focus during **[OPEN](https://carequest.org/policy-advocacy/open/) Hill Day,** June 3–4 in Washington, DC, when advocates from across the country come together to talk to lawmakers about the need for policies that expand access to care and protect public health investments. Hill Day is more than a convening; it is a powerful reminder that when we align data, lived experiences, and shared values, we can influence decisions that shape oral health outcomes for generations. Following dozens of productive meetings with members of Congress and their staff during Hill Day in 2025, as well as training in advocacy best practices, OPEN members are motivated to make policy impacts that will reverberate for years. ![](https://carequest.org/wp-content/uploads/2026/02/Trenae-Simpson-Web-250x300.gif)Trenae Simpson The year ahead will require courage, collaboration, and clarity of purpose. We are grateful to stand alongside partners, grantees, and advocates who are rising to meet this moment. Together, we will continue building the tools, relationships, and momentum needed to protect hard-won gains and to advance an oral health system rooted in prevention, equity, and community well-being. *Authored by Trenae Simpson, Senior Director of Philanthropy, CareQuest Institute* **Categories:** Blog **Tags:** Health Equity --- ### [A Conversation about Oral Health Policy Priorities in 2026](https://carequest.org/blog/a-conversation-about-oral-health-policy-priorities-in-2026/) **Published:** March 4, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective-300x300.png)As 2026 unfolds, state and federal lawmakers are increasingly treating oral health as part of larger health care conversations — especially around cost, access, workforce challenges, and public health. Melissa Burroughs, Senior Director of Public Policy at CareQuest Institute, is watching a series of developments that could decide who gets the opportunity to access quality oral health care — and who will continue to face barriers. Below, she answers eight questions about what is shaping up to be the most critical time for oral health policy in decades. ![](https://carequest.org/wp-content/uploads/2025/07/Melissa-Boroughs-Web-250x300.gif)Melissa Burroughs **Q: When you look ahead to 2026, what feels most urgent to address in oral health policy?** What feels most urgent is that oral health is being pulled into multiple policy conversations at once — public health, affordability, workforce, Medicaid, and even election politics. Decisions that may not seem “dental-specific,” like Medicaid work requirements or higher insurance premiums, can have outsized consequences for people’s ability to access dental care or improve their oral health. At the same time, there are very specific threats to oral health, like attacks on water fluoridation or efforts to scale back Medicaid dental benefits. Lawmakers need to understand this full picture, and how all of these issues can either exacerbate or help to improve our nation’s oral health crisis. **Q: Speaking of science, fluoride has been in the headlines more lately. What’s happening on the national and state levels?** [![](https://carequest.org/wp-content/uploads/2026/03/Fluoride-Map-1200X630-1024x538.png)](https://carequest.org/policy-advocacy/community-water-fluoridation/)This map from CareQuest Institute shows the states considering legislation to restrict or ban fluoride in drinking water. We’re seeing a new wave of state legislation aimed at restricting or banning community water fluoridation (CWF), alongside growing pressure on the US Environmental Protection Agency (EPA) to regulate fluoride. Right now, [several states](https://carequest.org/policy-advocacy/community-water-fluoridation/) have introduced bills related to water fluoridation. That matters because CWF is one of the most effective, evidence-based public health measures we have, especially for [children and low-income communities](https://carequest.org/how-ending-water-fluoridation-would-affect-children-and-state-medicaid-costs/). Rolling it back would [increase rates of tooth decay](https://carequest.org/new-study-shows-costly-consequences-for-states-banning-fluoride/) and widen existing inequities. **Q: The federal government recently passed a law that will cut states’ Medicaid budgets. How does that affect access to oral health care?** Yes, states are facing serious budget pressure. And on top of those budget cuts, most states will also be implementing work-reporting requirements. Both trends put Medicaid dental coverage at risk. Adult dental benefits, which are optional under Medicaid, are often among the first items states cut in tight budgets. And if people lose their Medicaid because they can’t fulfill work-reporting requirements, they will lose their Medicaid health coverage *and* their dental coverage. We’re closely monitoring states like California, Colorado, Idaho, and Massachusetts, as well as Washington, D.C., as places where specific proposals to cut benefits are under consideration. The reality is that millions of people rely on Medicaid for dental care; losing that coverage often means patients with oral health problems will delay getting care until it becomes an emergency. **Q: Many states are focusing on dental therapy, too. What are dental therapists, and what could we see as far as legislation in 2026?** Dental therapy is a newer profession that can improve access to routine, affordable oral health care — particularly in rural, underserved, and low-income communities. Dental therapists are licensed, mid-level providers, similar to physician assistants in medicine. They work under a dentist’s supervision and provide preventive and restorative care such as fillings, simple extractions, exams, and temporary crowns. In 2026, we could see major legislative movement to authorize dental therapy in large states like Florida, Massachusetts, and New York. This would be a game changer for access to care and workforce capacity in those states. **Q: How could changes to the Affordable Care Act marketplace health insurance affect dental coverage?** With Congress appearing unlikely to extend enhanced premium tax credits, which make health insurance premiums more affordable, we’re concerned that rising premiums will squeeze household budgets even further. When that happens, standalone dental coverage is often one of the first benefits people drop. That creates a ripple effect as people skip preventive care, problems worsen, and eventually they end up in emergency rooms for issues that could have been treated earlier and more affordably. **Q: With midterms coming up, where does dental care fit into the political conversation?** Dental care isn’t always front and center in election coverage, but it’s absolutely part of the broader affordability conversation voters and policymakers are having. The cost of care, the cost of insurance premiums, and health care workforce shortages also determine whether people can get the access to dental care they need. As affordability becomes a defining issue in the midterms, oral health will have a seat at the table. **Q: Are there any government programs that make you optimistic about the future?** Yes! Oral health projects in some states’ [Rural Health Transformation Grants](https://carequest.org/how-rural-health-transformation-program-awards-can-improve-oral-health-access/) give me hope. New federal investments have the potential to improve rural oral health infrastructure where states prioritize it. We’re seeing some promising early trends, and if those investments are sustained, they could help close long-standing access gaps. Also, there’s growing bipartisan support on Capitol Hill to improve veterans’ access to care. Lawmakers are increasingly recognizing that oral health is essential to overall health — and that [veterans need solutions](https://carequest.org/theyve-done-so-much-for-us-why-arent-we-taking-care-of-them/). Currently, US Veterans Affairs (VA) dental coverage is limited to veterans who have service-connected dental conditions, are former prisoners of war, or are 100% disabled. That leaves about [80% of veterans without dental benefits](https://carequest.org/policy-advocacy/veteran-oral-health/) through the VA. **Q: What is the most important message you want policymakers to understand in 2026?** Oral health isn’t separate from health care; it’s foundational to it. When policies undermine access to dental care, people don’t just lose dental cleanings or fillings; they lose their ability to eat, work, learn, and stay healthy. The reverse is true when policymakers invest in oral health: It can benefit overall health, save constituents money, and improve the health care system. The choices policymakers make in 2026 will have real, long-term oral health impacts for millions of people. **Categories:** Blog **Tags:** Dental Coverage --- ### [Why We're Hiring a Grants Officer to Focus on Native Communities](https://carequest.org/blog/why-were-hiring-a-grants-officer-to-focus-on-native-communities/) **Published:** March 10, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/03/MJM07216-scaled.jpg)Senior Grants & Programs Manager John Gabelus participates in brainstorming workshop. One of our team’s priorities this year is to build our capacity to work more closely with American Indian and Alaska Native (AI/AN) communities. Much of that thinking is based on recent [CareQuest Institute research showing that AI/AN communities face a disproportionate burden of oral disease](https://carequest.org/american-indian-and-alaska-native-communities-face-a-disproportionate-burden-of-oral-disease/). For decades, structural racism and a lack of necessities, such as healthy food and adequate housing, have contributed to disparities, including: - The prevalence of early childhood caries in AI/AN communities is three times higher than for white children. - AI/AN adults are twice as likely to have untreated decay as the overall US population, and 83% of AI/AN adults report tooth loss compared with 66% of the overall US population. - Three and a half times as many people who identify as AI/AN report going to the emergency department for dental care or mouth pain in the last year (13.5%) compared with those who do not identify as AI/AN (3.9%). In 2026, we’re expanding our team by [hiring a new Grants & Programs Officer](https://carequest.org/careers/?jobId=12574450-2598-d803-95af-3269a5e7628b) who will focus on this portfolio and deepen engagement with existing partners and tribal communities so that our investments are more targeted, more responsive, and better positioned to deliver meaningful impact. ## Building on Existing Work with AI/AN Communities We’re fortunate to already be working with several partners within AI/AN communities, including the Society for American Indian Dentistry, the Northwest Portland Area Indian Health Board, the Southern Plains Tribal Health Board, and the American Dental Therapy Association (ADTA), among others. Earlier this year, we were also pleased to award a grant to a new partner, the National Council of Urban Indian Health, which will complete research about the oral health status and experience of the more than 70% of AI/AN people who live in urban areas. ![](https://carequest.org/wp-content/uploads/2026/03/Marcie-at-Meeting.jpg)Grants & Programs Officer Marceline English speaks at the 2026 annual retreat. Those grants are just one step on our journey to learn from and with tribal communities about their unique oral health needs. Educating our team about those unique needs is important, too. To that end, some members of our team attended the [National Dental Therapy Conference in Sacramento in December 2025](https://amdta.memberclicks.net/index.php?option=com_jevents&task=icalrepeat.detail&evid=470&Itemid=185&year=2025&month=12&day=09&title=2025-national-dental-therapy-association-conference&uid=5cc42ff61d808b7e71ea5400fd991740). ADTA and another grantee partner, Community Catalyst, hosted the conference, which featured voices from across the country, including the California Pan-Ethnic Health Network, Asian Resources, Florida Voices for Health, and the Michigan Primary Care Association. Dental therapy has its roots in tribal communities. It is a community-driven model of care delivery that aims to improve access and expand the workforce, making sure it is demographically and culturally reflective of the patients being served. Much like the origin of dental therapy, the conference was diverse and action oriented, with sessions focusing on communications, advocacy, and practice. Mari Houlihan, Grants & Programs Officer for Texas and the West, joined representatives from Delta Dental of Michigan Foundation and Arcora Foundation on a panel to discuss philanthropic investment in dental therapy. The discussion highlighted dental therapy’s role in expanding access, strengthening cultural representation within the workforce, and delivering care in nontraditional settings such as schools, nursing homes, and emergency departments. The panel also underscored alignment with organizational efforts to build an accessible, equitable, and integrated oral health system, noting momentum achieved through partnerships across states including California, Washington, and Colorado. In addition, the conversation reinforced the importance of pairing direct care investments with sustained support for advocacy and organizing to ensure long‑term, systemic change. ![](https://carequest.org/wp-content/uploads/2026/03/Katinka-Hakuta_Resized-scaled.jpg)Katinka Hakuta, MPH As we continue into this year and bring on a new team member, we’ll continue to collaborate with our Policy & Advocacy team to support tribal partners working to advance dental therapy through policy change at the state level while exploring other ways to improve access to oral health services and the oral health experience of AI/AN communities. *Editor’s note: Learn more and [apply for the position on our website](https://carequest.org/careers/?jobId=12574450-2598-d803-95af-3269a5e7628b).* *Authored by Katinka Hakuta, MPH, Senior Manager, Grants & Programs, CareQuest Institute* **Categories:** Blog **Tags:** Health Equity --- ### [Maintaining Momentum on Medical-Dental Integration](https://carequest.org/blog/maintaining-momentum-on-medical-dental-integration/) **Published:** March 31, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/03/Azeem-Mallick-cropped-scaled.jpg)Azeem Mallick Medical-dental integration isn’t a new idea. For years, organizations have pointed to the benefits of connecting oral health care with medical care. But despite widespread agreement, progress has not grown in a sustained or meaningful way. “I just don’t think it has had the staying power,” says Azeem Mallick, Vice President of Enterprise Strategic Partners at CareQuest Institute. “Reprioritization of work, short-term funding, or pilots that don’t have the necessary runway have made it difficult for these efforts to last or scale.” As a result, many medical-dental integration initiatives have not had the momentum needed to drive long-term, system-wide changes. That’s something CareQuest Institute is addressing in 2026. “A lot of people are saying, ‘We’ve been talking about this for a long time. Now we need to be doing more to create real, measurable impact,’” Mallick says. We sat down with Mallick to talk about why CareQuest Institute is prioritizing medical-dental integration now — and how the organization is working to ensure these efforts have the scale and staying power to make a difference. **First, how are we defining medical-dental integration?** [Medical-dental integration](https://carequest.org/about/medical-dental-integration/) brings aspects of oral health care into traditional medical settings such as primary care, while also expanding the role of dental providers to include screenings and interventions for chronic conditions. It has the potential to improve outcomes, reduce inequities, and better serve communities that have historically struggled to access the care they need. **Why is this a priority for CareQuest Institute?** We continue to see rising rates of chronic disease that are directly linked to oral health — conditions like diabetes and heart disease. Those connections disproportionately affect populations that are already vulnerable, contributing to greater health inequities. At the same time, health care costs continue to rise, and changes in Medicaid benefit design and government programs are directly impacting the populations that need care the most. We at CareQuest Institute sit in a unique position to address this. We have the ability to pilot and test new approaches, influence policies and systems, and we are well positioned to support other organizations that are advancing integration in their communities. **What, specifically, is CareQuest Institute doing to advance medical-dental integration in the US?** ### **![](https://carequest.org/wp-content/uploads/2026/03/MDI.jpg)** Our primary approach is working through partnerships and serving as a convener. We can’t do this work alone — and really, no single organization or entity can. Because of the role CareQuest Institute plays in the market, our credibility, and our independence from many of the pressures other organizations face, we’re in a strong position to bring the right partners to the table. We are partnering with [Innovaccer](https://carequest.org/carequest-institute-partners-with-innovaccer-to-improve-medical-dental-data-integration/) and [Kno2](https://carequestdev.wpengine.com/carequest-innovation-partners-and-kno2-launch-national-initiative-to-integrate-dental-into-health-information-exchange-infrastructure/), two health care technology companies. Through those partnerships, we want to develop and launch pilot programs in new and existing settings that can demonstrate results and be scaled — so they lead to broader impact, including policy change, Medicaid benefit design changes, and shifts in how both medical and dental professionals are trained. We don’t want to launch one-off projects or initiatives that only work if CareQuest Institute is directly involved. Additionally, we are supporting broader infrastructure change. That includes interoperability and connectivity between medical and dental claims data, which makes it easier to understand longitudinal patient journeys — seeing both the oral health care and medical care a person receives over time. **Why are you optimistic about these two partnerships you mentioned?** What excites me most about the partnerships we have recently announced is how they move beyond point solutions to tackle the structural barriers that have long prevented oral health from being fully integrated into the broader health system. By working with Innovaccer to close medical–dental data gaps and with Kno2 to scale interoperable information exchange, CareQuest Institute is convening the right technology, clinical, and innovation partners to make collaboration practical, not just aspirational. These partnerships create shared infrastructure that enables providers, payers, and innovators to test solutions, align incentives, and act on real‑time insights. Together, they help remove fragmentation, advance whole-person care, and create the conditions for sustainable, system‑level change in how oral health is delivered, measured, and valued. **How does medical-dental integration specifically help underserved communities?** By increasing access. Marginalized communities often don’t have equitable access to both oral health care and broader medical care. Any opportunity where we can help bridge that gap and give patients a more holistic care experience is going to make a meaningful difference. Better information sharing between medical and dental settings also helps ensure patients receive improved access to care. When a patient in an underserved community has a dental emergency, because they can’t access a dental or medical provider, they often end up in a hospital emergency department for an issue that could have been prevented altogether or addressed earlier in a different setting. Integration creates opportunities to reduce those avoidable visits. Many patients also struggle with transportation, so minimizing the number of visits and types of care settings a patient has to navigate can improve both access and outcomes. Integration also helps us take what’s proven to work in safety-net environments and extend those practices more broadly. Many FQHCs and safety-net hospitals have already shown how coordinated, integrated care can improve access and quality. Applying those same approaches in non-FQHC settings means more communities can benefit from the better outcomes we already know are achievable. **What outcomes does CareQuest Institute hope to achieve through improved medical-dental integration — for patients, providers, and the broader health system?** Broadly, we’re trying to improve whole-person care by integrating oral health interventions into medical settings — and medical interventions into oral health settings. The outcomes we’re working toward are better chronic disease outcomes, greater access to care, and more efficient care delivery. For patients, if they can receive basic oral health screenings and support in settings such as their primary care office, home health services, or a safety-net hospital, providers can address needs sooner and keep problems from escalating. For the health system, we want to strengthen preventive care infrastructure and improve quality outcomes — like reducing avoidable emergency department use and repeat visits for the same underlying problems. The goal is to identify needs earlier, so patients aren’t cycling through the system without getting to the root cause of their issue. And for providers, our focus is practicality. We want to fit interventions into existing structures and workflows, while being mindful of how different providers are paid and incentivized. If we can help providers find efficiencies within what they’re already doing — and connect care across settings — we should see improvements in outcomes and a lower total cost of care over time. **Looking ahead, how do you hope integrated care will change the experience for patients and providers?** The big picture answer would be: Patients will no longer feel like their oral health care and general health care are siloed and segmented, and they will feel as though their overall health care is seamless. In the short term, we would love to see advancements such as dental and medical providers having greater access to their patients’ broader health records. A dentist would be able to see more of their patients’ primary care claims, and a primary care provider would be able to see more of their dental claims. We also want patients in a dental setting to have access to things like blood pressure screenings, like what they’re used to seeing in a medical setting. And likewise, when they show up at their pediatrician’s office or primary care office, they’d get oral health assessments or screenings. We want patients to feel more like their care is connected between what’s in their mouth and what’s in the rest of their body, versus it feeling completely separate. To learn more about medical-dental integration, go to our [Medical-Dental Integration page](https://carequest.org/about/medical-dental-integration/) on our website. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a Superutilizer](https://carequest.org/resource/repeated-use-of-emergency-departments-for-nontraumatic-dental-conditions-factors-associated-with-being-a-superutilizer/) **Published:** April 16, 2026 **Author:** Lisa Sall **Content:** Emergency department (ED) visits for non-traumatic, often preventable, dental conditions are a large burden on the US health care system with 1.3 million ED visits each year costing more than $1 billion. This article by CareQuest Institute investigates characteristics of “superutilizers” — people who visit the ED for dental care four or more times per year. The authors found that dental superutilizers are more likely to be white, have insurance coverage through Medicaid, Medicare, or be uninsured, and have one or more medical comorbidities. The authors write: > Expansion of dental services for adults, particularly those on Medicaid, is needed to ensure they can access timely preventative and restorative services and avoid the burden of dental crisis requiring a visit to the ED.” [Read the article](https://onlinelibrary.wiley.com/doi/10.1111/cdoe.70060) in *Community Dentistry and Oral Epidemiology* (open access) **You may also be interested in:** - [Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions](https://www.carequest.org/resource-library/dental-care-crisis), a visual report finding an alarming increase in ED visits by children for dental conditions. - [The Need for Medicaid Adult Dental Coverage Across All States](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states), a fact sheet outlining the health risks and economic consequences of Medicaid’s varying adult dental benefits across states. - [Medicaid Dental 360](https://public.tableau.com/app/profile/carequest/viz/MedicaidDental360/MedicaidDental360), a dashboard providing a clear, consolidated view of Medicaid dental coverage data across the US. **Categories:** Journal Article, Resource **Tags:** Dental Coverage --- ### [CareQuest Institute and NxtCare Launch Initiative to Integrate Oral Health Insights into Home-Based Care](https://carequest.org/press-release/carequest-institute-and-nxtcare-launch-initiative-to-integrate-oral-health-insights-into-home-based-care/) **Published:** April 28, 2026 **Author:** Carly Strang **Content:** ## Data-driven program integrates medical and dental care to improve outcomes for patients. [CareQuest Institute for Oral Health®](https://carequest.org/), a national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, today announced a data-driven program with [NxtCare](https://mynxtcare.com/). As a health care operations and analytics company, NxtCare partners with post acute providers, health systems, payers, and accountable care organizations (ACOs). The program integrates oral health insights into home-based care settings. It will launch in Nebraska with the goal of scaling nationally over time. This initiative focuses on home health patients, a high-risk population that is traditionally underrepresented in oral health evaluation across the broader health care continuum. By systematically analyzing oral health assessments within postacute settings, NxtCare and CareQuest Institute will generate clinical intelligence that connects oral health status to broader health outcomes. These insights will equip providers, payers, and ACOs with the data needed to improve care quality, reduce costs driven by unaddressed oral health conditions, and accelerate access to treatment before conditions escalate. “We know that oral health is essential to overall health, but it’s often missing from how medical care is delivered and measured,” said **Wade Rakes, Chief Executive Officer at CareQuest Institute**. “Through our partnership with NxtCare, we can improve oral health for this high-risk population, directly enhancing clinical outcomes and positively impacting not only the individual but also the broader care environment — which is critical for sustained systems change.” “This partnership represents a significant step forward in how the health care ecosystem understands the relationship between oral health and whole-person outcomes,” said **Bob Mikulak, CEO of NxtCare**. “CareQuest Institute brings the research credibility and mission alignment that makes this work matter. NxtCare brings the data infrastructure to translate that mission into population-level intelligence. Together, we are creating visibility into the patient journey that has never existed before.” Oral health is deeply connected to overall health and well-being, with [growing evidence](https://carequest.org/beyond-a-nice-smile/) linking it to conditions such as heart disease, diabetes, and adverse pregnancy outcomes. Yet medical and dental care remain largely disconnected. By improving [data sharing](https://carequest.org/medical-and-dental-integration-a-need-for-improved-electronic-health-records/) and coordination across these systems, providers, payers, and policymakers can gain a clearer view of the full patient journey, helping to identify risks earlier and intervene before conditions worsen. This partnership aligns with CareQuest Institute’s broader mission to advance oral health equity and strengthen the health care system through data, research, and innovation. **About NxtCare** [NxtCare](https://www.mynxtcare.com) builds curated postacute care networks and delivers the analytics platform that connects patient outcomes to provider performance. For payers, health systems, and ACOs, NxtCare provides real-time visibility into the discharge ecosystem, enabling smarter network decisions, fewer avoidable adverse events, and measurable accountability across the care continuum. To learn more, visit [www.mynxtcare.com](https://www.mynxtcare.com). **Categories:** Press Release --- ### [Forward Together: Advancing Health Equity in Uncertain Times](https://carequest.org/resource/forward-together-advancing-health-equity-in-uncertain-times/) **Published:** April 28, 2026 **Author:** Lisa Sall **Content:** This [special issue of the *Journal of Public Health Dentistry*](https://onlinelibrary.wiley.com/toc/17527325/2026/86/S1) inspires readers to consider how they can continue to advance health equity during “the worst of times for the specialty and for health.” [![](https://carequest.org/wp-content/uploads/2026/03/JPHD_Health-Equity_cover-228x300.png)]()Read the special issue Through this collection of editorials, articles, and commentaries, the authors hope to renew commitments, spark deep reflection, and support action to advance health equity in the areas of science, education, public health practice, workforce, and advocacy. In his closing editorial, Dr. Caswell Evans urges readers to stay the course toward health equity, writing: > If the guiding light of health equity is extinguished, we are destined to the darkness of health inequity as the norm. The health of the public cannot be advanced under that standard.” The special issue, with contributions and support from CareQuest Institute, explores the following topics: - [Moving Forward to Advance Health Equity: Elevating Best Practice in Science Education, Public Health Practice, Workforce, and Advocacy ](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70028) - [Association Between Perceived Racial Discrimination, Socioeconomic Status, and Oral Health Among Children: Evidence from the National Survey of Children’s Health 2016–2022](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70016) - [Combating Misinformation in the Digital Age: A Machine Learning Approach to Protect Community Water Fluoridation and Promote Oral Health Equity ](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70020) - [Transforming Public Health Dentistry: Incorporating Social Mission into Dental Education](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70017) - [Dental Public Health as Prime Catalyst for Advancing Solidarity and Accompaniment Within Dental Service-Learning and Community-Based Dental Education](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70023) - [Combating the Silent Othering in Dental Education, Dental Public Health, and Community Health Practice to Advance Health Equity](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70021) - [Expanding Oral Health Access and Equity: The Impact of Federally Qualified Health Centers](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70018) - [Quality Improvement as a Tool for Health Equity: Perspectives from North Carolina](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70009) - [Equitable Data Collection in Dental Public Health](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70015) - [Advancing Oral Health in Puerto Rico: A Policy Success Story Featuring the Puerto Rico Oral Health Coalition](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70010) - [Dental Therapy in the United States as a Public Health Imperative: Perspectives from the Front Lines](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70025) - [Workforce Equity and Dental Health Aides in CHAP: A Scoping Review](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70022) - [Policy Levers to Support the Transition from Pediatric to Adult Dental Care for People with Intellectual and Developmental Disabilities](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70038) - [Recommitting Public Health Dentistry to Equity, Diversity, and Inclusion](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70013) - [Beyond Charity: Systems-Change Philanthropy for Structural Health Equity in Oral Health](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70008) - [Equity — A Commentary by Caswell A. Evans](https://onlinelibrary.wiley.com/doi/10.1111/jphd.70029) [Read the special issue](https://onlinelibrary.wiley.com/toc/17527325/2026/86/S1) of the *Journal of Public Health Dentistry* (open access) **You may also be interested in:** - [Oral Health in America: Who Gets Left Behind?](https://carequest.org/oral-health-in-america-who-gets-left-behind/), findings from the latest State of Oral Health Equity in America survey reveal both progress and gaps in access to dental care. - [Framing for Oral Health Equity Now](https://carequest.org/framing-for-oral-health-equity-now-a-communications-toolkit-for-advancing-oral-health-reform/), a toolkit with strategies and examples to help oral health advocates communicate effectively about solutions to eliminate oral health disparities. - [How Ending Water Fluoridation Would Affect Children and State Medicaid Costs](https://carequest.org/how-ending-water-fluoridation-would-affect-children-and-state-medicaid-costs/), a report finding that ending water fluoridation in just five states could cause 132,000 additional children to need cavities filled or teeth pulled, and cost state Medicaid programs nearly $40 million. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Teaching Dental Students to Confidently Care for Patients with Disabilities](https://carequest.org/blog/teaching-dental-students-to-confidently-care-for-patients-with-disabilities/) **Published:** April 14, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/04/Smallwood-and-Laura.png)Photo from the University of Florida: (Left to Right) Michelle Cooper, Smallwood, and Mai What started as a pilot program at the University of Florida (UF) College of Dentistry has evolved into a new way of training the next generation of dentists to confidently care for patients with special needs. “Being able to build those long-term relationships with somebody I wouldn’t necessarily really meet in everyday life — and being able to impact their life in a really positive way — is probably the most special experience out of this whole program,” says Lauren Mai, a first-year dental student at UF. Launched in 2024 [with the help of a $125,000 CareQuest Institute grant](https://carequest.org/addressing-an-unmet-need-providing-oral-health-care-for-adults-with-disabilities/), the College of Dentistry collaborated with the Arc of Alachua County to create a pilot program that provides oral health to adult patients with intellectual and developmental disabilities (IDD). To date, faculty and students in the program have treated 80 patients, with many more still waiting for care. “As of right now, we have 100 people filling out paperwork to register,” says Bryan Smallwood, DMD, MPH, CPH, clinical assistant professor and dentist at UF. But expanding access is only one part of the program’s value; it also includes a classroom, bringing the first hands-on experience in special needs dentistry into UF’s dental curriculum. Now, two years later, the pilot has evolved into an elective course, with the potential to become required if administrators can secure an on-campus clinic space. So far, 35 dental students have completed the program. “They rotate through our clinic, and they rotate through the OR \[operating room\] with Dr. Tim Garvey (a UF faculty dentist) they can see the different levels of care that you can provide for adults with special needs,” Smallwood says. “The experience for them is two full days, which is not enough, but it’s way better than nothing.” ## **Why Many Providers Don’t Accept Special Needs Patients** When the clinic first opened, patients completed intake forms asking about barriers to accessing dental care. One common response surfaced: Many said they couldn’t find a dentist willing to treat them. Dr. Smallwood says one of his patients had been turned away by 56 providers — not because of complex medical needs, but because she used a wheelchair. “She couldn’t get out of it, but she could raise up and lean back,” Smallwood says. “And we were able to do all of her treatment right there in her wheelchair. No problem. We didn’t have to do anything extra. She was wonderful. She laughed the whole time. And it was just because she was in a wheelchair that no one would see her. That’s crazy to me.” Those insights inspired Mai, who is set to graduate in 2029, to dig deeper. She reached out to local providers to better understand why patients with IDD are so often referred elsewhere — or not treated at all. She interviewed 15 general dentists in Florida; 14 said they did not feel prepared after graduating to treat these patients and often lacked a referral network when they were unable to provide care. “If they did find there’s nothing they can do for a patient in their operatory, who do they refer them to?” Mai says. “Oftentimes, they would just refer them to oral surgery where they have crazy waiting times, or they just don’t have a solution at all.” Dr. Smallwood says that any dental student or dental professional can learn to work with special needs patients. “It’s about changing minds — not just hearts, but minds — about what’s possible and making people see that it’s something that you can do every day,” he says. “And it does not take that much extra time to do it.” ## **Integrating Special Needs Care into the Curriculum** For Mai, the elective course fills a critical gap in dental education. “We are stuck all the time in a simulation lab,” Mai says. “We have these perfect little patients that we work on all the time. And so, it’s super important for us to get the exposure and to have that different experience because once we get to clinic, every patient is different.” Mai admits she didn’t fully know what she was signing up for at first. “I actually applied for an administrative position in community dentistry,” she says. “They never told me it was for special needs dentistry until the day of the interview. I always like new experiences, so I thought it was something that I could do.” That openness has helped her build strong relationships with patients, including one patient with behavioral disorders who previously struggled during dental visits. She would get upset when dentists would give her anesthetics, so she asked Mai and Dr. Smallwood to talk to her as she was getting treated. Over time, that approach made a difference. “Every time she leaves, she seems a little brighter. She seems a little bit happier. She’s sending people pictures, and we talk about her day,” Mai says. “I think the fact that she is coming back and building a really good relationship with us is rewarding.” Experiences like Mai’s illustrate how exposure and relationship‑building translate into growth — not just for patients, but for students as well. For Dr. Smallwood, that willingness to engage and adapt is exactly what prepares students to succeed. “When students gain experience treating individuals with conditions such as stroke-related communication challenges, multiple comorbidities, or autism with severe anxiety or repetitive behaviors, they develop clinical flexibility and confidence to manage a wide range of situations,” Dr. Smallwood says. “If you can prepare a student to treat some of our most difficult patients, they can treat anybody.” ## **What CareQuest Institute Made Possible** Dr. Smallwood says the CareQuest Institute grant — and the connections that came with it — led to UF’s investment in the program. Just as important, it created a pathway for sharing what the team has learned so other schools and organizations don’t have to start from scratch. “They don’t have to reinvent the wheel and have to figure it out for themselves,” he says. “We want everybody to be successful immediately.” Smallwood also says the grant created something that’s often missing in clinical training: time. “Everyone is moving so fast,” he said. “Patients often leave a doctor’s office feeling disappointed after a rushed 15-minute visit. CareQuest gave us the time to slow down, sit with patients, and truly connect, building relationships where both the provider and the patient can grow together.” **Categories:** Blog **Tags:** Person-Centered Care --- ### [Giving Beyond Oral Health: CareQuest Institute Initiative Supports Local Communities](https://carequest.org/blog/giving-beyond-oral-health-carequest-institute-initiative-supports-local-communities/) **Published:** August 19, 2024 **Author:** Caitlin Locklear **Content:** In 2024, CareQuest Institute has awarded more than $8.3 million in grants to organizations that are helping underserved populations gain better access to oral health care. That work, core to CareQuest Institute’s DNA, is focused on the oral health system. Help, of course, is needed in other areas, too — in housing, in disease research, in community-based organizations that are committed to change. Every sector of society needs a boost. This year, as part of its philanthropic efforts, CareQuest Institute gave its employees a chance to give that boost in their own local communities through a Community Grants program. Each employee had the opportunity to choose a nonprofit and award a $1,000 grant. “This program has had a tremendous impact, not just for the organizations who received funding, but for CareQuest Institute team members as well,” says CareQuest Institute Grants & Programs Associate Mari Houlihan. “With more than 90% staff participation, we were able to showcase connections in our own communities and give back to those who need it most.” Employees could choose any organization; it did not have to be associated with oral health. For many, the decision was easy — they had been personally touched in some way by the nonprofit they selected. “The \[[Jewish Community Center of Youngstown’s](https://www.jccyoungstown.org/)\] generosity in allowing us to pay whatever we could afford so that we had a place to go after school and their complete acceptance and inclusion without reservation (well before inclusion was a “thing”) were instrumental in my developing a sense of belonging and growth in the US,” says CareQuest Institute Chief Dental Officer Kaz Rafia, DDS, MBA, MPH. In total, Rafia and 83 other employees participated, providing $84,000 total to 84 organizations in 27 states. Below, we offer 10 stories from CareQuest Institute employees that explain the “why” behind the organization they chose: **Sara Ward, Public Relations Manager:** [Ollie Hinkle Heart Foundation](https://theohhf.org/) (Webster Groves, Missouri) ![](https://carequest.org/wp-content/uploads/2024/08/Sara-Ward-Web.jpg)Sara Ward **Why she chose it:** When I was 24 weeks pregnant with my second daughter, Lily, I heard the seven words that changed my life forever: There’s something wrong with your baby’s heart. After seeing a pediatric cardiologist, we found out that our baby has Tetralogy of Fallot, a congenital heart condition that would require open heart surgery for a newborn to survive. The rest of my pregnancy was filled with fear and anxiety of the unknown. The Ollie Hinkle Heart Foundation (OHHF) gave me a support system that I desperately needed. They are a local pediatric heart foundation that is focused on the mental health of parents of children with congenital heart disease. They hosted a Heart Mom Support Group that I attended where I met my tribe. These women are truly some of the strongest people I know. It felt so good to be with others that just get it — the fears, the tears, the hospital stays, the celebrations over milestones big and small. Lily is now five years old and getting ready to start kindergarten. Of course, I will be taking the obligatory school bus photo, and do you know the first people I’m going to send that picture to? My Heart Mom tribe. Giving the community grant to OHHF is just a small token of my appreciation for this wonderful organization that is helping so many families in the area. **Orletta Cross, People & Culture Director:** [Jackson Transitional Housing Center](https://jthcenter.com/?fbclid=IwY2xjawEwLHpleHRuA2FlbQIxMAABHYaYprREU4zMjMvO5NjxhTsjZA_OrKi6C9mrgCZvEWQW9U-dS4u5PLjL9A_aem_0P5J377AEQQWh3jPULZ26A) (Detroit, Michigan) ![](https://carequest.org/wp-content/uploads/2024/08/Orletta-Cross-Web.jpg)Orletta Cross **Why she chose it:** I am humbled to share my connection with Jackson Transitional Housing Center (JTHC), a beacon of hope for women in Metro Detroit who are facing displacement and homelessness. As a survivor of domestic abuse myself, I understand the critical importance of organizations like JTHC in providing comprehensive support to women in their time of need. At CareQuest Institute, we believe in the power of community and collective action to drive positive change. By selecting JTHC for this grant, I am proud to stand with an organization that embodies compassion, resilience, and hope. **Carly Strang, Director of Corporate Marketing:** [ALS United Connecticut](https://alsunitedct.org/) (Milford, Connecticut) ![](https://carequest.org/wp-content/uploads/2024/08/Carly-Strang-Web.jpg)Carly Strang **Why she chose it:** In 2018, I lost my mother to amyotrophic lateral sclerosis (ALS), an incurable progressive neurodegenerative disease. ALS United Connecticut was invaluable in providing us with resources and equipment that supported her quality of life, dignity, and desire to receive end-of-life care at home. ALS United CT not only provides services to support patients and caregivers in the form of equipment, transportation, care assist grants, and bereavement support, but also supports advocacy efforts at the state and federal level to accelerate ALS research and access to treatment. ![](https://carequest.org/wp-content/uploads/2024/08/Francesca-Gattuso-Web.jpg)Francesca Gattuso **Francesca Gattuso, Content Specialist:** [KidneyCAN](https://kidneycan.org/) (Philadelphia, Pennsylvania) **Why she chose it:** Earlier this year my aunt was unfortunately diagnosed with kidney cancer. This sudden and shocking news has made a huge impact on her day-to-day life, and my family is determined to learn more about the rarity of her diagnosis to better help care and support her through her journey back to optimal health. **Melissa Burroughs, Director of Public Policy:** [The Marian Cheek Jackson Center](https://jacksoncenter.info/) (Chapel Hill, North Carolina) ![](https://carequest.org/wp-content/uploads/2025/07/Melissa-Boroughs-Web.gif)Melissa Burroughs **Why she chose it:** I have lived in Chapel Hill most of my life, and it is a town full of contradictions: Its politics are progressive, but many practices are exclusionary; the town is built around a university with a history of segregation and racism that is now manifesting into gentrification and racism, but also has a history of providing jobs, economic opportunities, and educational opportunities; we’re in the heart of the South, but much of the white population is made up of northern transplants, while the Black community has been here for generations. The Marian Cheek Jackson Center (MCJC) is dedicated to preserving the history and the future of historically Black neighborhoods in Chapel Hill. MCJC combines community-first organizing in historically Black neighborhoods with access to resources, while also ensuring that the contradictions and histories of these communities are told, retold, and written into the future. I have long admired and donated to this organization and am grateful to increase my impact through the Community Grants program. **Greg Winn, Vice President of Treasury:** [Westwood Community Chest](https://westwoodcommunitychest.org/) (Westwood, Massachusetts) ![](https://carequest.org/wp-content/uploads/2024/08/Greg-Winn-Web.jpg)Greg Winn **Why he chose it:** My next-door neighbor’s house burned to the ground the week before Thanksgiving. All she had left were the clothes on her back. She spent the first few nights after the fire at my house. The Westwood Community Chest came by our house and asked her what she needed. They picked up clothes for her and gave her a few gift cards to help her get personal items. They brought by food and prepared meals for her as she dealt with insurance companies, town officials, etc. They were incredibly empathetic and helped her to start the process of adjusting and moving on from what was an incredibly traumatic event. ![](https://carequest.org/wp-content/uploads/2024/08/Hannah-Cheung-Web.jpeg)Hannah Cheung, MPH, MS, RDH **Hannah Cheung, MPH, MS, RDH, Health Sciences Specialist:** [Triangle Disability & Autism Services](https://triangledisability.org/) (Morrisville, North Carolina) **Why she chose it:** Having a family member with an intellectual and developmental disability, I know what a tremendous difference community support has on an individual’s well-being. I’ve seen the amazing work Triangle Disability & Autism Services does to help children and adults with disabilities lead fulfilled, inclusive lives in their communities, and I want to continue to support them in achieving their mission. **Michael Briddon, Education & Content Director:** [Epilepsy Foundation New England](https://epilepsynewengland.org/) (Lowell, Massachusetts) ![](https://carequest.org/wp-content/uploads/2024/08/Mike-Briddon-Web.jpg)Mike Briddon **Why he chose it:** I was introduced to this organization earlier this year when my sister, Lisa, asked if I would participate in the Boston Walk for Epilepsy. When she was a toddler, carefree on a playground, Lisa had her first seizure, and the doctors found a tumor. Several surgeries — and an epilepsy diagnosis — followed. Since then, she has been on medication to control her seizures, and many everyday activities that we take for granted are frustrations for Lisa. Still, she persevered. She was valedictorian of her high school class and graduated from college four years later. She studied long and hard to succeed, to show everyone that her epilepsy wouldn’t define her. I look up to Lisa, but I also know the tremendous obstacles she and others with epilepsy face. I’m thankful for the opportunity to support her and this wonderful organization that improves the lives of individuals and families impacted by this disease. **Megan Tenpas, Grants & Programs Associate:** [Opportunity Development Centers, Inc.](https://www.odcinc.com/) (Wisconsin Rapids, Wisconsin) ![](https://carequest.org/wp-content/uploads/2024/08/Megan-Tenpas-Web.jpg)Megan Tenpas **Why she chose it:** Opportunity Development Centers (ODC) empowers people with disabilities to achieve their work and life goals, supporting individuals from early years through adulthood. I have connections with ODC both personally and professionally. Personally, I have participated in their “Run, Walk, ROCK & Roll” fundraiser each year since it started and visited their Milkwood Market storefront to purchase many of their handmade crafts. Professionally, I was involved in an oral health pilot project called “100 Days, 100 Smiles,” which was part of their life skills learning/training. ODC facilitated conversations around the importance of oral health, from the basics of brushing to overcoming fear of the dentist. This is a phenomenal organization doing great things for those differently abled across central Wisconsin! **Ashley Pugliares, Executive Assistant:** [Home Base](https://homebase.org/) (Boston, Massachusetts) ![](https://carequest.org/wp-content/uploads/2024/08/Ashley-Pugliares.jpg)Ashley Pugliares **Why she chose it:** In January of 2023, my husband, who is a marine veteran and local police officer, was involved in a serious on-duty, work-related incident. He was diagnosed with anxiety and post-traumatic stress disorder. At this time, he was referred to the Home Base program in Boston, where they worked with him to heal from the trauma. I cannot thank this program enough for the work they do with veterans, law enforcement, and more. In the end, they saved him. For more information on CareQuest Institute’s philanthropic work, go to [carequest.org/philanthropy](https://www.carequest.org/grantmaking). **Categories:** Blog **Tags:** Health Equity --- ### [Transforming Incentives: Moving to Alternative Payment Models in Oral Health](https://carequest.org/blog/transforming-incentives-moving-to-alternative-payment-models-in-oral-health/) **Published:** August 26, 2024 **Author:** Caitlin Locklear **Content:** al·ter·na·tive: of one or more things available as another possibility.![](https://carequest.org/wp-content/uploads/2024/12/CQ_Ask-The-Experts-300x300.png) Reusable water bottles as an alternative to single-use plastic bottles. Oat milk as an alternative to dairy milk. An electric toothbrush as an alternative to a manual toothbrush. When trying new things, there are always growing pains. The same is true in oral health, as many health centers and organizations are navigating their way through new payment and care models that are better for patients and, ultimately, better for providers. When looking at how oral health care is typically paid for, many providers use the fee-for-service payment model, which pays a provider for each service given to an individual. This volume-based model incentivizes: - A high volume of expensive, invasive services - Treating symptoms and restoring health rather than preventing disease - No tracking of health outcomes after providing care For example, provider reimbursement for dental implants or dentures is higher than periodontal and nutritional services to prevent tooth loss. This focus on volume-based payment has resulted in [increased health care spending and worsening health outcomes. ](https://www.pgpf.org/article/infographic-us-healthcare-spending/) With increasing care costs and chronic disease prevalence, [over the last decade the health care industry has been embracing an alternative approach to paying for services](https://www.carequest.org/resource-library/unlocking-value-alternative-payment-models) known as [alternative payment models](https://www.carequest.org/resource-library/alternative-payment-models-dentistry) (APMs). APMs take what we know about the fee-for-service model and improve upon its known challenges to: - Link financial incentives to improvements in care quality and health outcomes - Focus on disease management and prevention to lower spending - Pay for comprehensive and coordinated services The Centers for Medicare and Medicaid Services [operationalizes](https://www.cms.gov/priorities/innovation/about/alternative-payment-models) APMs across the nation. The design of each model follows a [framework](https://hcp-lan.org/apm-framework/) created by the Health Care Payment Learning and Action Network. The framework showcases how APMs can take a variety of forms: giving performance bonuses to reward providers for quality care, for example, or capitation, which is an upfront payment to a provider to coordinate comprehensive, multidisciplinary care. So, what do APMs look like in dentistry? - From 2016–2021, [California Medicaid tested bundled payments](https://www.dhcs.ca.gov/provgovpart/Pages/DTI.aspx) of $126 per pediatric patient for completion of caries risk assessment, nutritional counseling, and motivational interviewing. The provider-designated patient risk level informed the frequency of covered preventive care, where individuals with a higher risk for caries (cavities) received more frequent coverage for preventive services. - Since 2017, Texas Medicaid has operated a [capitation-based model](https://www.dentaleconomics.com/macro-op-ed/dental-outreach/article/14282099/value-based-payment-alignment-a-case-study-for-oral-health) with dental plans to hold dental providers accountable for performance on [quality measures](https://www.hhs.texas.gov/about/process-improvement/improving-services-texans/medicaid-chip-quality-efficiency-improvement/pay-quality-p4q-programs) of oral evaluations, topical fluoride, sealants, emergency department visits, and care continuity for children. When one option may not work for current circumstances, trying something different creates space for discovery, growth, and new perspectives on success. As the health care industry tests APMs, it is constantly learning how to better set providers up for success, improve practice infrastructure for participation, and ensure models address health equity and do not perpetuate health disparities. CareQuest Institute is committed to understanding how oral health best fits into the changing health care payment landscape. Are you testing an oral health APM? Let us know [here](https://carequest.org/contact-us/). Interested in learning more about APMs? Check out our resources below. ![](https://carequest.org/wp-content/uploads/2024/08/Caroline-Mcleod-High-Res.jpg)Caroline McLeod, MS, RDH - [Unlocking Value in Alternative Payment Models](https://www.carequest.org/resource-library/unlocking-value-alternative-payment-models) - [Update on Alternative Payment Models in Oral Health Care ](https://www.carequest.org/resource-library/update-alternative-payment-models-oral-health-care) - [Alternative Payment Models in Dentistry ](https://www.carequest.org/resource-library/alternative-payment-models-dentistry) - [An Introduction to Value-Based Care in Oral Health: Moving from Volume to Value](https://www.carequest.org/education/course/introduction-value-based-care-oral-health-moving-volume-value/overview) *Authored by Caroline McLeod, MS, RDH, Value-Based Solutions Manager at CareQuest Institute, and Andrea Clark, MS, Director, Health Care Economics at CareQuest Institute* ![](https://carequest.org/wp-content/uploads/2024/03/Andrea-Clark-Cropped.png)Andrea Clark, MS *Caroline McLeod, RDH, MS, is a published thought leader and researcher of alternative payment models. As a dental hygienist, she is passionate about unifying oral health and overall health, facilitated by reimbursement models that empower providers, improve health outcomes, and bolster health equity. Andrea Clark, MS, is a health care economist and data scientist with more than 25 years of experience informing strategy and overseeing efforts to enable value-based care in the Medicaid and oral health spaces.* **Categories:** Blog **Tags:** Value-Based Care --- ### [Access & Academics: Improving Oral Health Through Schools](https://carequest.org/blog/access-academics-improving-oral-health-through-schools/) **Published:** September 5, 2024 **Author:** Caitlin Locklear **Content:** Ensuring children have access to oral health care is a local challenge in many parts of the country. ![](https://carequest.org/wp-content/uploads/2024/09/Courtney-for-CareQuest-scaled.png)Courtney Vannah, IPDH, MS, MPH, with MCD Global Health, examines child’s teeth “Maine has reached a low in access to care like we’ve never seen,” says Courtney Vannah, IDPH, MS, MPH, senior program manager at MCD Global Health, a nonprofit dedicated to improving the health and well-being of people worldwide. “Children in Maine have long faced challenges in access to dental care within the traditional dental care delivery model.” It’s a national problem, too. Laura S. Larsson, PhD, MPH, RN, a professor at Montana State University, sees those same struggles in her state. “Among Montana’s indigenous and rural communities, these challenges are amplified and result in poor oral health status at early ages,” Larsson says. “For example, the untreated decay rate is twice as high among the indigenous preschool group in Montana (40.8%) than for kindergarten-aged students statewide.” The reasons for those barriers to access to care range from provider shortages to a limited number of dentist offices that accept Medicaid. To help, earlier this year, CareQuest Institute put out a call for proposals to find creative, innovative projects that drive systemic change in oral health and promote school-based or school-linked oral health programs. In all, the Institute selected 10 organizations to receive $125,000 each, for a total investment of $1.25 million. “Schools play a critical role in supporting positive health outcomes for children, particularly those from under-resourced communities,” says Trenae Simpson, director of grants and programs at CareQuest Institute. “Oral health programs at schools have the potential to increase student success, improve health outcomes for children, and reduce racial, ethnic, and economic disparities.” ## Funding New Collaboratives and Future Workforces In unique and novel ways, the organizations will use the funds to reduce racial, ethnic, and economic disparities, and, in turn, increase students’ chances to stay in school and achieve in life. ![](https://carequest.org/wp-content/uploads/2024/09/IMG_6510-scaled.jpg)Dental hygienist shows children how to brush teeth Montana State University, one of the 10 grantees, will use its funds to advance a medical-dental integration model with nurses and nurse practitioners in a new school-based health center. “We hope to impact the success and sustainability of the clinic, improve health care access, reduce time to treatment, and excite teenage schoolchildren about health occupations careers,” Larsson says. “By developing a health career pipeline with Lame Deer Junior and Senior High Schools, we hope indigenous adolescents will be inspired by this project, pursue health careers, and ultimately return to serve their neighbors and community.” At MCD Global Health, the funding will train school nurses to apply silver diamine fluoride (SDF), a topical medication to treat and prevent dental caries. “We immediately recognized this as an opportunity to bring equity in access to care to children in all of Maine’s schools,” Vannah says. “By expanding the workforce providing oral health services beyond the traditional dental workforce, the increase in access to preventive and early intervention caries arrest services will be significant.” Here’s how all 10 organizations plan to use the funds to improve the oral health and overall health of students. - The [American Academy of Pediatrics](https://illinoisaap.org/) (AAP) in Illinois will adapt the [Training, Education, Assistance, Mentorship, and Support (TEAMS) model](https://www.aap.org/en/patient-care/school-health/teams-enhancing-school-health-services/), a pilot project that helped expand access to school health services. They will also develop an oral health micro-module for the [AAP Health services Assessment Tool for Schools (HATS)](https://www.aap.org/en/patient-care/school-health/teams-enhancing-school-health-services/health-services-assessment-tool-for-schools-hats/?srsltid=AfmBOorYjtHnugImwLj05fk6fUrHW63ZI6yO-ECxVan6g1FGKWf4cVyu), a tool designed to help school districts and states assess the quality and comprehensiveness of school health services, the level of infrastructure to support those services, and the strength and implementation of school health services policies and protocols. - The [Center for Oral Health in California](https://www.centerfororalhealth.org/) will support the success of the Early Smiles Program to advocate for critical policy reforms at local and state levels in California. The program seeks to expand and enhance oral health services provided through its school-based program, which has demonstrated significant impact in Sacramento, Yolo, Alpine, and Trinity Counties in California. - [EXCELth, Inc.](https://www.excelth.com/ "https://www.excelth.com/") in Louisiana will implement the Louisiana Smile Krewe School-Linked Initiative with the goal of increasing the number of children utilizing dental services. It will also promote widespread use of teledentistry to address barriers to oral health for rural communities. - [MCD Global Health](https://www.mcd.org/where-we-work/maine) in Maine will integrate oral health with health, dental, and school partners, and increase access to care for Maine children. School nurses will provide screenings and preventive services. - [Montana State University](https://www.montana.edu/) will launch the Youth Voice Project, which will conduct focus groups with students from seventh through twelfth grade to identify perceptions of oral health in their community. Montana State University will also pilot a same-day treatment protocol within its newly established Northern Cheyenne School-Based Health Center to disrupt the current model where students are referred to treatment more than 100 miles away in Billings. - [More Smiles Wisconsin](https://www.moresmileswi.org/) will expand oral health collaborations between schools, school-based prevention programs, and local dentists through the existing and recently established Hometown Smiles (HTS) program. Through HTS, each student served by existing school-based dental prevention programs will have a dentist who can identify dental needs and fix them before they become emergencies. - [Nicklaus Children’s Hospital Foundation](https://give.nicklauschildrens.org/home), in partnership with Borinquen Medical Center and eight elementary public schools in Miami-Dade County, will increase access to oral health care for recent immigrant children. School-based nurses will receive training to conduct oral disease assessments, increasing the application of preventive therapies and appropriate referrals. Additionally, a designated community dental health coordinator will help expand the safety net. - The [Oral Health Unit (OHU) at the Colorado Department of Public Health and Environment](https://coloradooralhealth.org/about/), in collaboration with Youth Healthcare Alliance, will work with communities to design, test, and implement school-based oral health services. They will train school nurses, increase resources to support SBOH implementation, and present findings to the Colorado Oral Health Coalition for policy considerations. - [Well Child Center](https://www.wellchildcenter.org/) in Illinois will form and convene a Community of Practice, a group of community members, to improve oral health in the second-largest school district in Illinois in the western suburbs of Chicago. Their pilot project will focus on increasing completion of dental exam school requirements before the first day of school for kindergarteners, second graders, and sixth graders. For more information on CareQuest Institute’s grants, go to [carequest.org/philanthropy](https://www.carequest.org/grantmaking). **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Take Action This Election Season: Candidates Need to Hear about Oral Health](https://carequest.org/blog/take-action-this-election-season-candidates-need-to-hear-about-oral-health/) **Published:** September 17, 2024 **Author:** Caitlin Locklear **Content:** For far too many people in this country, oral health care is too expensive and out of reach — even though we know it is critically important to overall health. And for far too long, despite strong support from voters, candidates and policymakers have consistently put “access to oral health” on the backburner. This election cycle, we need to change that. **This election cycle, we, as oral health advocates, need to educate ourselves on how to create change if we want to see policy progress. This blog post will give you the knowledge, tools, and confidence to take action — and help us** ***all*** **speak up.** Voters want action on oral health issues. They know that no one in this country should have to choose between getting the care they need, putting food on the table, or saving for retirement. In a [new national poll](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results), **voters rank Medicare dental coverage just as important as abortion and higher than the future of the Affordable Care Act (ACA).** Other key findings from the poll of 1,000 voters: - 9 in 10 voters (92%) support adding a dental benefit to Medicare. - 85% of respondents who voted for Trump in both 2016 and 2020 and 99% of those who voted for the Democratic candidate in those two elections want a dental benefit added to Medicare. - 9 in 10 voters want expanded coverage to include dental services for veterans. - 7 in 10 voters support adding adult dental benefits to Medicaid. - Additional polling in key swing states — Michigan, Ohio, and Pennsylvania — shows similar results on all of these issues. This growing, bipartisan support presents a powerful mandate for action and a clear signal to candidates to speak up on oral health. But with so much happening in this year’s election cycle, it is up to advocates to make sure this message is heard. Luckily, we’ve seen an increase in momentum to improve oral health policy in the past several years. The Biden-Harris Administration has taken incremental steps to improve oral health access in [Medicare](https://www.kff.org/medicare/issue-brief/recent-changes-to-medicare-coverage-of-dental-services-from-the-2023-and-2024-medicare-physician-fee-schedule-final-rules/) and in [ACA health coverage](https://www.cms.gov/newsroom/press-releases/hhs-finalizes-policies-make-marketplace-coverage-more-accessible-and-expand-essential-health). Congress has also increased the pace of discussion about these issues in the past several years, including a full [Senate committee hearing](https://www.help.senate.gov/hearings/examining-the-dental-care-crisis-in-america-how-can-we-make-dental-care-more-affordable-and-more-available) in May. And the recently released [Democratic Party Platform](https://democrats.org/wp-content/uploads/2024/08/FINAL-MASTER-PLATFORM.pdf) includes language to strengthen dental coverage in Medicare. So far, though, public discussion on oral health care access from the campaign trail has been lacking, even from candidates who are theoretically supportive. As oral health advocates, now is the time to ensure that all candidates — from all political parties and at every level of government — are not only aware of the importance of oral health but are also committed to taking concrete steps to improve access and coverage for all. ## Three Steps You Can Take Today [Email Presidential Candidates](https://carequest.quorum.us/campaign/email/): Use our tool to send messages directly to the presidential candidates, urging them to prioritize oral health. Your voices can help ensure that oral health is on their agendas. [Use OPEN’s Toolkit](https://www.carequest.org/sites/default/files/2024-08/OPEN%20Toolkit_Election%20Engagement%202024%20.pdf): The Oral Health Progress and Equity Network (OPEN) has developed a comprehensive toolkit designed to amplify the results of our recent poll and engage candidates at all levels of government. Use these resources to raise awareness and to advocate for oral health in your community. ![](https://carequest.org/wp-content/uploads/2025/07/Melissa-Boroughs-Web.gif)Melissa Burroughs [Share Resources](https://carequest.quorum.us/campaign/gotv/): Spread the word and share this blog post with your networks by clicking the social media buttons below. The more voices we have advocating for oral health, the stronger our impact will be. We know that everyone deserves access to quality dental care, regardless of their age, income, or background. Together, we can make oral health a higher-profile issue for the candidates who are our future policymakers. *Authored by Melissa Burroughs, CareQuest Institute Senior Director of Public Policy* **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Dr. Thanos Zavras on Improving Oral Health Care for Patients with Disabilities](https://carequest.org/blog/voices-from-the-field-dr-thanos-zavras-on-improving-oral-health-care-for-patients-with-disabilities/) **Published:** September 24, 2024 **Author:** Caitlin Locklear **Content:** Thanos Zavras, DDS, MS, DMSc, knows that dentistry is not a one-size-fits-all treatment, especially for people with disabilities. “While the art and science of dentistry has made significant progress, along with major technological breakthroughs such as digital imaging, digital dentistry, and so much more,” he says, “access to dental care for people with intellectual and developmental disabilities (IDD) remains problematic.”![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0.jpg) Zavras is a coauthor of a new article, “[Oral Health Care for Individuals with Intellectual and Developmental Disabilities: A Statewide Model](https://onlinelibrary.wiley.com/doi/10.1111/scd.13046),” which explores a model that improves access to oral health care for individuals with IDD in Massachusetts. The article, also coauthored by John Morgan, DDS, MS, professor emeritus in Public Health and Community Service at [Tufts University School of Dental Medicine (TUSDM)](https://dental.tufts.edu/), appears in Special Care in Dentistry. It is the only journal published in North America devoted to improving oral health in people with special needs. “We are trying to address a very serious problem,” Zavras says. “It’s a problem that sometimes remains hidden from society, so it’s an enormous challenge.” Zavras is the endowed Delta Dental of Massachusetts professor at TUSDM, chair of public health and community service, and assistant dean for faculty advancement with oversight of the [Tufts Dental Facilities (TDF)](https://dental.tufts.edu/patient-care/specialty-clinics/tufts-dental-facilities) program. TDF, a partnership between TUSDM and the Commonwealth of Massachusetts, provides comprehensive dental care for adults and children with developmental disabilities living in the state. It is a network of seven dental clinics that are specifically designed to meet the oral health needs of individuals with IDD. The program, which began in 1976, also provides training in special care dentistry for dental residents and predoctoral dental students. A grant from CareQuest Institute helped TDF evolve the model of oral health care for adults with medical complexity and/or IDD by developing a patient- and family-centered approach to care and by testing an interprofessional team and the use of teledentistry. “For the first time, we had the ability to hire the coordinating team, a hygienist, and a social worker,” Zavras says. “And for the first time, we started having teledentistry sessions at home with caregivers and patients. This important demonstration project would not have been possible without the help of CareQuest Institute.” Below, Zavras explains more about the challenges patients with IDD face when trying to get oral health care — and how the evolving model helps break down those barriers. **What are the barriers to care for people who have an IDD?** ![](https://carequest.org/wp-content/uploads/2024/09/Zavras_Cropped.jpg)Thanos Zavras, DDS, MS, DMSc There are individual barriers, family barriers, financial barriers, and health care system barriers. At the individual level, it really depends on the degree of functionality. There are people with intellectual disabilities who are high functioning. They live in group homes. They work. And so they have needs that are different than others with profound disability. At the level of the family, it is usually a dedicated member of the family who cares for a loved one, often full time. Such level of care inhibits employability, resulting in a significant financial burden. And that affects so many areas of someone’s life, including access to dental care. On the health care side, one of the barriers has to do with the workforce. Statistics show that not a lot of dentists see people with disabilities. When discussing with colleagues trying to get to the root of the problem, we realize that dentists do not feel comfortable or confident. They also may not have the team with appropriate training and expertise to manage varying behaviors. The easiest solution is just to say, “No, I cannot. I’ll refer you somewhere else.” **Can you tell us more about the changes you were able to test with the CareQuest Institute grant?** We learned that listening to and trusting the parents and caregivers is critical. A family-based model considers parents as partners. Parental and caregiver input was requested at each decision point, and their feedback was evaluated and taken into consideration. This dynamic group, we learned, is engaged, cares deeply for the well-being and quality of life of their loved ones, and is not shy to share their opinions and recommendations. Equally important was the realization that providing dental care to people with IDD is often intimidating to dental teams, who feel they are not adequately trained or prepared to provide high-quality care. The natural response of humans is to avoid what makes us uncomfortable. By creating a specialized team of colleagues who are trained together and work together — we call this team the Advanced Response for Complex Treatment and Integrated Care (ARCTIC) at Tufts — we hope to offer support for general dentists who wish to treat people with disabilities. In the future, we envision those dentists calling this specialized team to obtain advice. Those dentists can call this specialized team we have and say, “Let me talk about this case. Let me share what I see in the mouth, and let me know what you think.” Realizing this limitation and addressing it appropriately may lead to a higher number of dentists who are confident and comfortable with their approach. **How does this evolved model help expand access to more people with IDD who need a different level of care?** Expanding access to more people with IDD is an ongoing concern. For example, one of the lessons we learned by engaging parents and caregivers is that there is a specific group of people who we do not usually see at TDF: individuals with profound autism who have not seen a dentist for more than 10 years due to fear and inability to cope with the dental environment. This group requires a different approach, one that minimizes unwanted stimuli. They need the care to be brought to their home because their home is their sanctuary. Having a dental hygienist and a social worker visit the house offers so many advantages. It allows the health care team to interact with the parent, to observe how the patient interacts with family members, and to study the living environment. Assessing the condition of the caregiver and the support that might be needed (psychological, emotional, financial, etc.) is one of the tasks of the social worker along with making appropriate referrals and identifying supporting programs. It also creates a psychological bridge for subsequent teledentistry visits. **How can this new article help people with IDD get access to oral health care?** This publication aims to help dentists, organizations, and ultimately patients by providing a sustainable set of instructions for creating a system of care that can address long and persistent problems and access barriers. By publishing the mechanics of this university/state partnership, we hope that more states will consider building similar infrastructures. Sharing the TDF experience offers the perspective of a unique long-term model of comprehensive statewide oral health services designed to improve the oral health quality of life for individuals with IDD. **What’s next for you and TDF?** The next phase of the project calls for further improvements in TDF operations, including the application of artificial intelligence, along with broad dissemination of the findings and a further expansion of this demonstration project to additional families. Our patients deserve it. Stay tuned! **Categories:** Blog **Tags:** Special Patient Care --- ### [By the Numbers: Four Trends from the 2024 Healthcare Data and Analytics Association Conference](https://carequest.org/blog/by-the-numbers-four-trends-from-the-2024-healthcare-data-and-analytics-association-conference/) **Published:** October 3, 2024 **Author:** Caitlin Locklear **Content:** Data analytics — the process of converting data into useful insights — may not be on the top of your to-do list every morning. But for the more than 350 people who attended the [2024 Healthcare Data and Analytics Association (HDAA) Annual Conference](https://www.hdwa.org/hdaa-2024-conference-promotion) in Chapel Hill, North Carolina, the topic filled three engaging days of learning in mid-September. A few weeks later, our minds are still racing about how all of it applies to the oral health industry. ![](https://carequest.org/wp-content/uploads/2024/10/MadisonCaroline_October2024.jpg)Caroline McLeod, RDH, MS, and Madison Vinson, MSHI The conference brought together health care organizations from across the country to discuss how health data and analytical tools drive high-quality, accessible care at lower costs. We believe dentistry is a crucial part of that conversation. Health data is foundational to the practice of dentistry as it: - Gives insight into patient population, practice operations, and care delivery, quality, and cost - Helps determine opportunities for improvement - Informs responsible decision making at the clinical, organizational, and policy levels - Supports health care innovation through research (e.g., clinical trials) As a part of the modern, technology-forward health care industry, dentistry must keep up with what’s happening in the rapidly evolving field of data analytics. How? In what disciplines? These four areas, along with a lesson from each, stood out to us: 1\. Data Governance Many presentations demonstrated strategies for wide-scale adoption of [data governance](https://www.databricks.com/discover/data-governance), or management of data security, quality, and compliance. Approaches adhered to similar core workflows, including the formation of data governance and compliance teams, extensive documentation of standards and best practices, and gradual rollout of self-service analysis and data visualization capabilities. **Our first lesson learned: Many organizations noted that tailored and frequent training opportunities to enhance data literacy were a key to success.** 2\. Data Literacy With the use of health data by a wide range of individuals in an organization, it is critical that everyone knows how to responsibly use data. Thus, **our second key takeaway: Many organizations are implementing data literacy programs/training aimed at bolstering data skills and compliance and fostering a data-driven culture that drives decision-making and action**. These programs included e-learning, in-person training, feedback opportunities, and practice with self-service data tools. 3\. Health Equity Data present a powerful opportunity to identify and improve inequities in health care utilization and practice. **The third lesson we left with: Many organizations are using data to take a closer look at what groups of people access care, what needs individuals have beyond clinical care, and how certain operational practices affect workforce capacity.** For example, [Eskenazi Health](https://www.eskenazihealth.edu/programs/food-as-medicine/fresh-for-you-market) in Indianapolis, Indiana, completes patient screenings for food insecurity, provides vouchers for groceries and basic cooking needs at their hospital fresh market, and tracks redemption rate and need for follow-up in their electronic health record. Strong data tracking has supported addressing food insecurity and expansion of access to fresh food in their local communities. 4\. Technology The conference offered a deep dive into the latest trends and innovations in technology to support data usage. Topics included architectural design practices for building robust analytics solutions, signal-detection methods for emerging health care trends, practical use cases featuring synthetic data to simulate real-world scenarios, and leveraging machine learning and cloud computing for scalable solutions. Speakers highlighted the development of data governance plans for generative artificial intelligence (AI) as critical areas of improvement, alongside discussions on the [Observational Medical Outcomes Partnership (OMOP) Common Data Model](https://www.ohdsi.org/data-standardization/) standard and master data management. **Our fourth insight: Leveraging technology for data needs supports the development of more personalized care strategies, identifies trends in patient populations, and promotes evidence-based improvements in clinical practices.** Dentistry must recognize how health care data, technology, and associated processes shape operational decisions and enhance patient care. Beyond improving outcomes at the practice level, data facilitates a more holistic approach to health care by fostering effective collaboration between health care teams and community-based organizations. Many organizations at the conference shared this sentiment as a key to their success. This collaboration, which often includes dentistry, enables the integration of oral health into overall patient care, ensuring that care is comprehensive and reflective of a patient’s full health needs. Want to put some of these conference concepts into practice? See our previous blog post where dental practices participating in a CareQuest Institute program in North Carolina [share their advice on using data to transform dental practice](https://www.carequest.org/about/blog-post/how-quality-data-transforming-oral-health-care-north-carolina). *Authored by Madison Vinson, MSHI, Data Engineer, and Caroline McLeod, RDH, MS, Value-Based Solutions Manager, CareQuest Institute* **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration --- ### [7 Questions on Improving Access and Care for Hispanic and Latino Communities](https://carequest.org/blog/7-questions-on-improving-access-and-care-for-hispanic-and-latino-communities/) **Published:** October 10, 2024 **Author:** Caitlin Locklear **Content:** It’s essential to meet patients where they are — whether that means bringing a mobile clinic to their school or making an effort to understand their language. ![](https://carequest.org/wp-content/uploads/2024/10/CristinaGodoy_Headshot-scaled.jpg)Cristina Godoy, DDS, MPH, CCRP That was one theme from a recent webinar, “Advancing Equity in Hispanic and Latino Communities: Strategies to Integrate Compassionate Care,” from CareQuest Institute and the Hispanic Dental Association (HDA). The webinar, which drew nearly 500 learners, covered innovative approaches to serving Latino and Hispanic populations, leadership development within these communities, and the importance of cultural humility. Moderated by Cristina Godoy, DDS, MPH, CCRP, interim dean of research, Nova Southeastern University, the webinar featured Carlos Sanchez, RDH, BSDH, MPH, clinical associate professor, Dentistry School Herman Ostrow School of Dentistry of University of Southern California, and Esther Lopez, DDS, MPH, Healthy Tooth Dental, adjunct professor, UIC – College of Dentistry and lead dentist, RefugeeOne. Their presentations were followed by a vibrant Q&A session, highlighted by seven thought-provoking questions summarized below. (Note: You can view the [full webinar](https://www.carequest.org/education/webinars/advancing-equity-hispanic-and-latino-communities-strategies-integrate), including the Q&A, in the CareQuest Institute webinar library.) **1. From the perspective of a dental school, what’s the best way to start a mobile dentistry program?** ![](https://carequest.org/wp-content/uploads/2024/10/EstherLopez_Headshot.jpg)Esther Lopez, DDS, MPH First, you need to research state laws to determine what is permitted in your state. It’s important to know your scope of practice. In California, for example, the scope of practice for a registered dental hygienist (RDH) is somewhat broader than in many other states — a policy that was intended to facilitate providing care in rural and underserved areas. It’s helpful to partner with like-minded individuals. If you are in a school environment, talk to faculty members and administrators to gauge interest in starting a mobile clinic. You might emphasize that it’s a valuable resource for students in dental programs. Raising funds might be necessary, too. **2. How do you do that? How do you raise funding for mobile dental clinics and identify community partners?** The program I \[Professor Sanchez\] help run at USC is grant funded, and the program partners with the Los Angeles Unified School District. Schools can make excellent partners, and they are a great place to reach young people in need of dental care. Finding funding sources can be a challenge. You will need to search widely for grants that might be available. Wealthy individuals sometimes wish to donate. And churches and nonprofit organizations are other possibilities as community partners. **3. Some mobile providers don’t feel they have the full support of local dentists. Any recommendations to improve those relationships?** Some dentists might feel competitive with mobile clinics, as though they pose a threat. But in reality, there’s room for both to coexist. For the most part, the mobile clinics reach patients who would not otherwise receive oral health care. It can help to reach out to dentists in the community and educate them on the role of the mobile clinics. **4. Do you think school-based programs or the mobile clinics can become a new career path for younger dentists?** ![](https://carequest.org/wp-content/uploads/2024/10/CarlosSanchez_Headshot.jpg)Carlos Sanchez, RDH, BSDH, MPH Working at the mobile clinics can be extremely fulfilling. It’s not for everyone, but it provides an opportunity to make a positive difference in people’s lives. It falls under the bigger umbrella of public health and community-based dentistry. **5. How do you navigate different Spanish dialects? Some words have different meanings in different countries.** Start with establishing a trusting relationship. If you use a word in a way that’s “incorrect” in their dialect, patients will know that your intentions are good. Treat the differences as an opportunity to learn. See your patients as your teachers. It’s empowering to them to be able to impart knowledge. **6. In some programs, such as school-based sealant programs, we see low consent rates for Latino parents. What is the best way to communicate the safety and efficacy of the programs?** Among disenfranchised communities, distrust of official channels is common. An additional factor may be immigration status, which can affect people’s comfort levels with any programs that require paperwork. By and large, the preferred method for learning new information is word of mouth — hearing from neighbors, aunts, and other trusted sources. Try to reach people through these informal channels. One option is to hold a town hall meeting, recruiting someone from the community to explain so it’s a little less scary and they understand the process. **7. How can a foreign-trained dentist be of help to the HDA?** The HDA has amazing international dentists as members. They recently held a panel discussion with international dentists who discussed their career paths. One student focused exclusively on a platform where they discuss how to get into dental school. Foreign-trained dentists can start by [contacting HDA](https://hda.memberclicks.net/index.php?option=com_mcform&view=ngforms&id=2036772#!/) to learn more about the community leadership fellowship program, which gives them the opportunity to explore different ways of practicing. *Editor’s Note:* [*Watch the full webinar and access presenter slides*](https://www.carequest.org/education/webinars/advancing-equity-hispanic-and-latino-communities-strategies-integrate) *in the CareQuest Institute webinar library.* **Categories:** Blog **Tags:** Health Equity --- ### [License Portability Is Here. Is Your State on Board with Dentist and Dental Hygiene Compact Privileges?](https://carequest.org/blog/license-portability-is-here-is-your-state-on-board-with-dentist-and-dental-hygiene-compact-privileges/) **Published:** October 17, 2024 **Author:** Caitlin Locklear **Content:** Five years ago, license portability was only a dream for many dentists and dental hygienists who needed to practice in more than one state. No matter the reason — a need to relocate or the desire to volunteer at an out-of-state event — oral health providers were either unable to practice or had to find the time and patience to navigate the new state’s sometimes-expensive licensure process. This led to frustrated clinicians and contributed to a shortage of staff, which hurt access to critical preventive care. The times, they are a-changin’. Now, don’t pack your bags and move to a new state just yet. Yes, it is true that the [Dentist and Dental Hygienist Compact](https://ddhcompact.org/) has been activated, but there are a few more things that need to happen before compact privileges are issued. To start, privileges must be issued by the state where you are seeking to practice, not your existing state. (It’s not like a driver’s license, where a license from your home state makes it legal for you to drive in the other 49 states.) There are a few other things you need to know right away if you’re looking to practice in a new state: 1. You must have a valid dentist or dental hygiene license in a compact member state and be in good standing. 2. The state you want to work in has to be signed on to the compact. 3. You have to apply to the Dentist and Dental Hygiene Compact to gain privileges to practice in another compact state. Right now, most states are not signed on to the compact. (You can check to see if your state has active legislation on the [Dentist and Dental Hygienist Compact map](https://ddhcompact.org/compact-map/).) To make it easy for states, the National Center for Interstate Compacts has published model legislation on the [Dentist and Dental Hygienist Compact](https://ddhcompact.org/) webpage. Jessica Thomas, senior policy analyst with the Council of State Governments (CSG), clarified that although her organization helps states sign on to the compact, it does not tell states what to do or pressure them into signing. “\[The dental compact\] reached seven states this year, and since then, we’ve gotten three more. So, there are 10 states at this time that are part of the compact,” Thomas said. “It typically takes 18 to 24 months to get the compact’s commission set up, get the data system in place, set the rules, and then have an application ready for people to apply to those compact privileges. We’ve done this several times before \[with other professions\], so there’s hope that it could be a little faster this time around.” How Did We Get Lost with Licenses? [If you’ve found yourself trying to get a license](https://www.carequest.org/about/blog-post/push-portability-latest-dentist-and-dental-hygiene-compact-privileges) to practice in another state, you know the frustration. The process can include retaking the written boards exam, retaking the clinical exam, and providing proof of qualifying education and work experience. It can be expensive and time-consuming. Depending on the responsiveness of the individual state’s dental examining board, it can take three to six months after all requirements have been met before the new state license is granted.![](https://carequest.org/wp-content/uploads/2024/10/iStock-1296453160-1.jpg) How did we get here? As early as 1969, when the Northeast Regional Board of Dental Examiners was founded (now the Commission on Dental Competency Assessments), oral health providers have been working to standardize oral health education and oral health provider testing for licensure. However, states still do not agree on the education requirements oral health professionals should follow to maintain their licenses, making maintaining multiple licenses challenging and costly. Since November 2020, several entities have been working together to reduce barriers related to working in other states, including the Department of Defense (DoD), the American Dental Association (ADA), the American Dental Hygienists’ Association (ADHA), and the CSG. Wisconsin, my home state, joined the compact in 2023. Dr. Chris Hansen, president of the Wisconsin Dental Association, was quick to point out the benefits. “The licensure compact will streamline the licensure process and will work to attract dentists and dental hygienists from nearby states through participation in the compact,” he said. “License portability is an important issue with younger dentists and dental hygienists and will encourage the migration of dental professionals from neighboring states to Wisconsin.” ## Seven Key Questions about the Dentist and Dental Hygienist Compact Thomas, who has worked at CSG for almost three years, was kind enough to take a few minutes to provide more details about the process of enacting the compact and what the process will look like for dentists and dental hygienists who are interested in gaining privileges to practice in other states. **1. What will the process look like for dentists or dental hygienists who want to work in other states? How do they get started?** On the Dentist and Dental Hygienist Compact website, we have a new tab about the compact commission that will show the representatives from each state that are in the compact. Their commissioner, the meeting minutes, agendas — everything like that — will be on there. When an application is ready, that will be on that website as well. So, they won’t have to go through their individual state boards anymore; they’ll go through that compact commission and apply for privilege that way. **2. Do the individual states stay involved with the Compact, or is their role done after they sign on?** No, no, they’re very involved after the fact, too. It’s all really up to the states and up to those members. We don’t make any decisions. There will be one compact commissioner from each state that will get a vote on the commission and that will come from the regulating board. Then those commissioners will come together to establish the data system and the application process. Each state gets one vote, and then as far as like the chair and the executive board, they’ll vote on those people, too. They’ll nominate somebody, and then they’ll vote to elect the executive committee. **3. Have you had any feedback from individual dentists or dental hygienists about this? Do you hear directly from those who are going to be affected the most?** Sometimes we hear from people, mostly if they’re giving an educational presentation, but I know that a lot of people are pretty excited about it. When the seventh state joined, we got a lot of questions about “how do I apply?” Of course, it’s not automatic, so it’s kind of disappointing to hear that you have to wait a little longer. People are excited in the compact states and ready to use it, for sure. **4. Once the application process is ready, do you have an expected timeline for how long it will take from application submission to practice privilege?** It’s kind of impossible to predict right now about how fast that application process will go. From other compacts, we know the process is faster than if you had to apply to each state individually, but that whole process is going to be laid out by the commission. So there isn’t really anything set up for it yet. If you look at other professions, like the physical therapy compact, for example, they can issue a compact privilege in a matter of minutes. It’s our goal that DDH have that same level of ease of use. **5. Can you talk more about the difference between having a license in one state and the privilege to practice in another state?** The language gets a little confusing, but for all intents and purposes, a privilege is a license. We have to call it something different so it doesn’t get too confusing when you’re applying for different things, but \[dentists and dental hygienists\] should be able to do everything in that state that a licensed holder can do. The state that you’re practicing in, that is the scope of practice that you follow. And those are the laws that you follow. We like to compare compacts to \[a\] driver’s license because everyone’s so familiar with “when you drive in a different state, you have to follow that state’s rules while you’re there.” **6. Once a state does sign on to the compact, are neighboring states more inclined to also sign on?** We sometimes see this happen in regions because, like you talked about with border states, it really is a big advantage to have the states around you also join. It also sometimes happens where some states kind of wait and see. So, the states around them will join, and then they’ll say they won’t want to miss out on the benefits that they’re seeing and they’ll hop on. **7. Is there anything else that you think is important for people to know about where we are today with the compact?** We talked about advocating for the compact and reaching out to your state associations. People can also reach out directly to their legislators if they’re so inclined. We hear a lot of stories from individuals about how the compact can benefit them at a personal level, and I know those can really resonate. So just sharing those stories can be helpful if having licensure portability is important to you. ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH If you would like more information on the [Dental and Dental Hygienist Compact](https://ddhcompact.org/compact-commission/), the website is full of information for states who are interested in signing onto the compact and individuals who are interested in applying for licensure privileges. If the website doesn’t have the answer you are seeking, reach out to . *By Kelly Schroeder, RDH, MS, Evaluation Specialist, CareQuest Institute* **Categories:** Blog **Tags:** Clinical Practice --- ### [The Urgent Case for Improving Veteran Oral Health](https://carequest.org/blog/the-urgent-case-for-improving-veteran-oral-health/) **Published:** November 4, 2024 **Author:** Caitlin Locklear **Content:** They’ve served our country, putting their lives on the line, yet many can’t even access basic, necessary oral health care services. ![](https://carequest.org/wp-content/uploads/2024/11/ECU-Smiles-for-Vets-5-scaled.jpg)Photo from ECU School of Dental Medicine “One veteran was preparing to have to make a choice to either pay for the dental procedure he needed or buy Christmas presents for his grandchildren,” says Rob Tempel, DDS, retired US Army Major General and now associate dean for extramural clinical practices at [East Carolina University (ECU) School of Dental Medicine](https://dental.ecu.edu/) in North Carolina. “Another veteran pulled his own tooth out, seeing no other option.” And, unfortunately, veterans in North Carolina aren’t the only ones who have to make those drastic decisions. Many veterans across the country have oral health problems. “A US Army veteran who came to [Everyone for Veterans (E4V)](https://www.everyoneforveterans.org/) was dealing with shame and embarrassment from a missing tooth that had been pulled two years ago,” says Jessica Elwell, the executive director of E4V, a national organization that provides veterans with resources, support, and comprehensive dental care. “That veteran wrote a letter to E4V saying, ‘I would find myself feeling embarrassed every time that I was in public or when my grandchildren asked me why I had a missing tooth.’” To help find solutions for the thousands of stories like these in communities across the country, in August CareQuest Institute funded 10 projects that aim to improve access to oral health care for veterans. Each project selected received $125,000 each, for a total investment of $1.25 million. The Institute will also share best practices with those selected organizations, connect them with resources, and create a community dedicated to improving the oral health of veterans. ## The Battle to Advance Veterans’ Oral Health Care ![](https://carequest.org/wp-content/uploads/2024/11/01.E4V-scaled.jpg)Photo from E4V There are multiple reasons — from financial to educational barriers — why many veterans can’t get access to oral health care. Many of those reasons are systemic, meaning they aren’t quick fixes that can happen overnight. “Many veterans [do not qualify for consistent dental care through the Veterans Affairs (VA) hospital](https://www.carequest.org/veteran-oral-health) or VA Community Care Network partners, unless they are 100% service-connected disabled,” says Frank Lombard, the UP veterans program manager at [Upper Peninsula Commission for Area Progress (UPCAP)](https://upcap.org/), an organization that provides services and support to Upper Peninsula residents in Michigan. “Veterans have reported not visiting a dentist in many years, and some only do once they have a crisis requiring major dental care or complete removal of all their natural teeth.” Additionally, Medicare only pays for certain dental services patients receive in the hospital, and Medicaid provides limited or no adult dental benefits in several states. ![](https://carequest.org/wp-content/uploads/2024/11/Smiles-for-Veterans.png)Photo from ECU School of Dental Medicine The organizations selected for CareQuest Institute’s grants — including ECU Dental School of Medicine, E4V, and UPCAP — will use their funding to remove barriers and make care more convenient for veterans. “When people are informed about ways they can get involved, it creates opportunities for meaningful change,” Elwell says. “With this grant, we hope to inspire more participation in providing care and support to our nation’s veterans, ensuring they receive the services and support they deserve.” Here’s how all 10 organizations plan to use CareQuest Institute’s funding to drive change to improve veterans’ oral health. - [Dentistry 4 Vets (D4V)](https://www.dentistry4vets.org/) in California will address system-level barriers to oral health and increase veteran utilization of dental care by modeling their unique methods of establishing authentic relationships with veteran patients, including personalized care plans, regular follow-ups, and tailored communication. - [East Carolina University (ECU) School of Dental Medicine](https://dental.ecu.edu/) in North Carolina will make policy change efforts by demonstrating the need for models of care that make use of multidisciplinary teams that facilitate whole-person care for veterans with chronic illnesses and disabilities that include diabetes, hypertension, and cardiovascular disease. The goal is to demonstrate reduced net costs and improved quality of life through care integration focused on prevention and early intervention for optimizing oral health among veterans. - [Everyone for Veterans (E4V)](https://www.everyoneforveterans.org/), a national organization, will offer training for dental schools and students on veteran-specific oral health care, with a trauma-informed approach to address PTSD and anxiety. They’ll also engage the dental community through speaking engagements that focus on the voices of veterans to show the difference between civilians’ and veterans’ dental needs, and advocate for veterans’ oral health and awareness among government leaders and change-makers. - [Family Medicine Education Consortium](https://www.fmec.net/), a national organization, will work to make changes in how primary care providers approach the oral health care of patients, with a focus on access to appropriate and comprehensive care for veterans. - [Marshall University (MU) Research Corporation](https://www.marshall.edu/murc/) in West Virginia will improve access to care for veterans by developing a comprehensive report focused on veteran oral health in the state. MU Research Corporation will collect quantitative and qualitative data from a variety of stakeholders, including dental and medical health care providers, veterans, nonprofit organizations, and government agencies. The final report will include a summary of the oral health and overall health of West Virginia veterans, access to oral health services, and existing barriers to care. - [Mercy Foundation (MF)](https://mercygiving.org/) in Oregon will address the oral health needs of local veterans admitted to Mercy Medical Center. MF will use an expanded practice dental hygienist and dental assistant to provide patients with preventive care, including assessment, fluoride varnish, silver diamine fluoride, sealants, and education. When they leave the medical center, MF will provide patients with a care plan and connection to a dental home for additional treatment and ongoing preventive care. - [Missouri Coalition for Oral Health (MCOH)](https://www.oralhealthmissouri.org/) will gather and apply data-driven and lived experience insights to better understand and address the unmet dental needs of Missouri veterans while elevating the importance of veteran oral health among MCOH members, partners, and stakeholders. The desired outcomes of the project include identifying specific gaps in dental care services for veterans in the state, raising awareness of these challenges, and collaborating with veterans and partners to identify strategies for policy change to improve access to quality dental care. - [Missouri Office of Dental Health (ODH)](https://health.mo.gov/living/families/oralhealth/) will evaluate the Missouri ODH’s current work with AT Still University’s dental clinic where their dentists and dental students provide dental care to veterans through the Smiles for Vets program. The goal of the evaluation is to learn why veterans seek dental treatment, how dentists can improve care they provide, why dental students want to provide care in clinic to veterans, and what would make them continue that care to veterans upon graduation. - [University of Texas Health Science Center](https://www.uth.edu/) at Houston will conduct a pilot study that will investigate the impact of dental care in behavioral health treatment among veterans and the use of digital dentistry in expanding access to dental care among veterans. - [Upper Peninsula Commission for Area Progress (UPCAP)](https://upcap.org/) in Michigan will conduct community forums in multiple locations to engage veterans, service members, families and caregivers, dental providers, insurers and health plan providers, and federal and state policymakers regarding the state of veteran oral health care and barriers to access. They will create and distribute communications to media outlets about veterans’ oral health and present a public report on the findings to inform programming and policy suggestions. For more information on CareQuest Institute’s grants, go to [carequest.org/philanthropy](https://carequest.org/philanthropy). **Categories:** Blog **Tags:** Dental Coverage --- ### [11 Questions on Providing Minimally Invasive Dentistry for Pediatric Patients](https://carequest.org/blog/11-questions-on-providing-minimally-invasive-dentistry-for-pediatric-patients/) **Published:** November 12, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2024/11/Protective-Glasses.jpg)Child in dental chair gets fluoride varnish treatment Minimally invasive dentistry (MID) is a philosophy of care that emphasizes prevention and seeks to preserve as much healthy tooth structure as possible. And it’s growing in popularity. In a recent CareQuest Institute webinar, “Innovative Pediatric Dental Care: Exploring Minimally Invasive Procedures,” panelists described their approach to MID, specifically for pediatric patients. They discussed important tools such as fluoride, silver diamine fluoride (SDF), glass ionomer applications, and Hall crowns, as well as effective communication strategies. ![](https://carequest.org/wp-content/uploads/2024/11/elizabeth-powell.jpg)Elizabeth Powell, DDS, MPH “\[I learned some\] great options for arresting/restoring primary teeth,” one attendee shared after the webinar. “It’s so much less traumatizing to a child.” Elizabeth Powell, DDS, MPH, assistant professor, Clinical Pediatric Dentistry and Community Oral Health, University of Pennsylvania School of Dental Medicine, moderated the webinar, which drew more than 600 learners. The presenters were both professors and pediatric dental providers: - Sofía Iribarren, DDS, MS, assistant professor, University of Nebraska Medical Center - Jean Star, DDS, MPH, assistant professor of Clinical Orofacial Sciences, Pediatric Dentistry, University of California San Francisco The presentations were followed by a lively Q&A session that primarily focused on SDF, which can arrest caries lesions but can also permanently stain teeth. ![](https://carequest.org/wp-content/uploads/2024/11/SofiaIribarren_Headshot.jpg)Sofía Iribarren, DDS, MS “Excellent presentation and Q&A session,” another attendee shared. “Hats off to the presenters and facilitators.” ![](https://carequest.org/wp-content/uploads/2024/11/JeanStar_Headshot.jpeg)Jean Star, DDS, MPH Below, we’ve provided an edited summary of the questions and answers. (Note: You can [view the full webinar](https://www.carequest.org/education/webinars/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy), including the Q&A, in the CareQuest Institute webinar library.) **1. Can you explain how the SDF interacts with the teeth to arrest caries?** The silver component has a direct bactericidal effect interfering with bacteria metabolism while fluoride is present in sufficient concentration to promote remineralization. **2. Can you apply SDF to teeth that present with moderate to severe caries?** You can use SDF on any teeth. However, we do not want to apply SDF to a large carious lesion that may be into the pulp and so it is not advisable to apply SDF to teeth that have necrosis or irreversible pulpitis. That usually means teeth that have spontaneous pain or signs of infection. For moderate to severe caries, you can use the SMART technique (silver modified atraumatic restorative technique). This involves applying the SDF, which will arrest and kill the germs, and then placing the glass ionomer on top of the SDF. The glass ionomer seals off the caries, so that food and germs cannot get stuck there. The combination of SDF and glass ionomer is the best way to treat moderate to severe caries that do not cause pain. **3. What do I need to worry about when it comes to staining and SDF?** SDF stains some things permanently — caries, clothing, the countertop in your office. SDF does not stain the gingiva or healthy tooth structure. SDF can stain skin, but not permanently. It takes about a week to fade. If a patient is squirming a lot, you can apply a little layer of Vaseline around the child’s extra-oral area to serve as a barrier and prevent staining. If the SDF does stain the skin, parents can remove it by rubbing it with a salt scrub at home. **4. How important is isolation in maintaining a dry field for SDF? Is it still effective if I can’t keep it dry?** It’s more effective if you can keep it dry. The goal is to increase the concentration of SDF liquid in the area. If you have SDF mixed with saliva around the tooth, the SDF will be diluted. If you’re able to insert cotton rolls and keep the area dry, then there’s a high concentration of SDF liquid in the area. However, with some young children who have trouble staying still, that can be difficult. Just do your best. It can still be effective even if it’s less dry. **5. Do you recommend that primary care providers apply fluoride varnish during well-child visits to promote early intervention and prevention in the medical setting, especially since children see the pediatrician much more than they see the dentist?** Absolutely. In addition to applying the varnish, pediatricians can talk about oral hygiene instruction and introduce parents to concepts like the importance of diet for oral health. There are continuing education (CE) courses for medical providers that discuss dental integration in the medical setting. One popular example is [Smiles for Life](https://www.smilesforlifeoralhealth.org/all-courses/). **6. If we perform a sealant on an incipient occlusal lesion, will the cavity be arrested?** Yes, sealed incipient caries become arrested (inactive) once the bacteria are starved of the carbohydrate substrate necessary to get worse/deeper. **7. Do you have to continually apply SDF like biannual fluoride?** The American Dental Association (ADA) [published guidelines regarding the effectiveness of silver diamine fluoride (SDF) for treating cavitated lesions](https://www.ada.org/resources/ada-library/oral-health-topics/silver-diamine-fluoride) on coronal and root surfaces. Research involving primary teeth demonstrated that applying 38% SDF twice a year is more effective at arresting advanced cavitated lesions compared to applying 5% sodium fluoride (NaF) varnish weekly for three weeks. Additionally, 38% SDF applied once a year is less effective than the biannual treatment. The ADA recommends using 38% SDF biannually as the first line of care for arresting carious lesions in primary teeth. Furthermore, the ADA has extrapolated these findings to suggest that 38% SDF may also be beneficial for treating advanced cavitated lesions in adult teeth. **8. Are 3 to 4 applications of SDF per year any more effective than 2 applications?** The effectiveness of one-time SDF application in arresting dental caries ranges from 47% to 90%, depending on the size of the lesion. However, reapplication may be necessary to sustain arrest. Increasing frequency of application can increase caries arrest rate. Biannual application of SDF increased the rate of caries lesion arrest compared to annual application. Some studies revealed that [three applications per year led to higher arrest rates](https://pubmed.ncbi.nlm.nih.gov/29070149/). Frequency of application after baseline has been suggested at three-month follow-up, and then semiannual recall visits over two years. If the setting allows, monitor caries lesion arrest after a two-to-four-week period and consider reapplication as necessary to achieve arrest of all targeted lesions. Provide re-care monitoring based on patient’s disease activity and caries risk level (every three, four, or six months). **9. At what level of cavity progression is it not appropriate to place a restoration over an active caries lesion?** Dental school drills that all decay must be removed before placing a permanent restoration. Management of dental caries should include identification of an individual’s risk for caries progression, understanding of the disease process for that individual, and active surveillance to assess disease progression and intervention with appropriate preventive services, supplemented by restorative therapy when indicated. Decisions for when to restore caries lesions should include, at the least, clinical criteria of visual detection of enamel cavitation, visual identification of shadowing of the enamel, or radiographic recognition of progression of lesions. For more definitive guidance on managing deep caries lesions, please reference the [AAPD Pediatric Dentistry Restorative Dentistry Best Practices](https://www.aapd.org/globalassets/media/policies_guidelines/bp_restorativedent.pdf). **10. Is it okay to recommend the second dose of SDF in three months instead of six months?** Yes, although the impact of SDF on cavitated lesions and primary teeth is well established, evidence that application of 38% SDF is effective for preventing new smooth surface lesions is increasing. **11. Is it necessary to use cavity conditioner when implementing the SMART technique?** Yes. The conditioner helps with increased retention for the glass ionomer. However, it’s better not to apply the conditioner directly after the SDF. If you apply the SDF and glass ionomer on the same day, there’s also the possibility that the glass ionomer will stain; it can turn the restoration in the tooth a grayish color. The ideal process is to apply the SDF, then schedule a return appointment (any time from the next day to a month later). At the follow-up appointment, isolate, apply the conditioner, rinse it, gently dry but don’t desiccate, and then fill the hole with the glass ionomer. *Editor’s note: You can* [*view the full webinar*](https://www.carequest.org/education/webinars/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy)*, including the Q&A, in the CareQuest Institute webinar library.* **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [What Does LinkedIn Think About . . .](https://carequest.org/blog/what-does-linkedin-think-about/) **Published:** November 19, 2024 **Author:** Caitlin Locklear **Content:** We feel fortunate to have nearly 28,000 [CareQuest Institute for Oral Health LinkedIn](https://www.linkedin.com/company/carequest-institute/mycompany/) followers. And because our mission is to improve the oral health of all, we have a wide range of followers — everyone from dentists, dental hygienists, and students to policymakers, researchers, and countless stakeholders who want to see a better oral health system. To learn more about our LinkedIn audience and how it feels about various issues within oral health and health care, we invite our followers to participate in a quick poll every two weeks. As we approach the end of the year, we thought this was the perfect time to look back and see the oral health community’s perspective and experiences on . . . ![](https://carequest.org/wp-content/uploads/2024/11/Poll-1.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-2.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-3.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-4.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-5.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-6.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-7.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-8.png)![](https://carequest.org/wp-content/uploads/2024/11/Poll-9.png)If you don’t follow CareQuest Institute on LinkedIn, [we invite you to join here](https://www.linkedin.com/company/carequest-institute/mycompany/). We’ll have another poll out soon! **Categories:** Blog **Tags:** Medical-Dental Integration, Value-Based Care --- ### [Voices from 2024: 11 Quotes about Changes and Challenges in Oral Health](https://carequest.org/blog/voices-from-2024-11-quotes-about-changes-and-challenges-in-oral-health/) **Published:** December 9, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/2024-Impact-Report.png)2024 CareQuest Institute Impact Report As 2024 comes to an end, the road to creating a better oral health care system continues. Yes, we saw roadblocks and detours, but we also made tremendous progress as a community committed to change. There were several memorable stops and milestones along the way: - This year, CareQuest Institute joined other oral health leaders and organizations in Washington, DC, to testify about how oral health care is out of reach for millions of people who live in the US. - CareQuest Institute provided more than $12 million in funding to organizations who are trying to improve oral health care access to underserved populations — like children, rural communities, and veterans. - The Institute also delivered more than 20,000 hours of education — giving dental and medical professionals the knowledge and skills they need to improve their individual practices and contribute to the broader transformation of our oral health care system. - Within all that work, 11 quotes from CareQuest Institute and CareQuest Innovation Partners — a for-profit subsidiary of CareQuest Institute — stood out as the most memorable. Below, we invite you to share in some of the successes and examine some of the issues that need attention in 2025. **1. “The more awareness we have, the more likely we can break down barriers to care, provide more inclusive care, and create a more trusting environment.”** — Robert MacArthur, DMD, dentist, Boston Health Care for the Homeless Program Robert MacArthur identifies as a cisgender gay white male and understands the value of having a dentist you can trust. But even though he’s a member of the LGBTQIA+ community, he says he still has a lot he can learn about creating a space where patients — especially from underserved communities — feel welcome. MacArthur attended the CareQuest Institute webinar “LGBTQIA+ Oral Health: Creating Inclusive Environments,” [where he learned about inclusive language, proper pronoun usage, and different forms of gender expression](https://www.carequest.org/about/blog-post/inclusivity-oral-health-its-good-be-reminded-how-invasive-dentistry-can-be). **2. “My dental care experience turned out to be much more expensive, invasive, and painful than it needed to be. And it was because while my doctors had recognized that oral health is part of the overall larger picture, my insurance didn’t.”** — Paul Gibbs, volunteer member, Utah Consumer Health Coalition In 2009, Gibbs needed a kidney transplant, but his doctors said first he needed to get a dental exam — which was not covered by Medicare or Medicaid. Gibbs was able to raise the funds for the exam through donations from friends and family, but his dentist found other issues Gibbs would have to address over the next few years after the transplant. By the time he got dental insurance, some of his teeth had disintegrated and some had to be extracted.Gibbs is [now part of the Utah Health Policy Project’s Oral Health Consumer Coalition Committee, where he and other volunteers share their stories](https://www.carequest.org/about/blog-post/how-community-voices-are-improving-oral-health-utah) with legislators, hoping to improve oral health in their state. **3.“Far too many people in this country have discovered that oral health care is too expensive and out of reach. Yet this issue has been really on the back burner when it comes to policy conversations and the political commitment to addressing it.”** — Melissa Burroughs, Director of Public Policy, CareQuest Institute The *USA Today* article “Dental Coverage for Seniors Is Wildly Popular. Why Don’t Candidates Discuss It?” [references a CareQuest Institute poll result that showed that about 9 in 10 voters support adding a dental benefit to Medicare](https://www.usatoday.com/story/news/health/2024/09/22/dental-insurance-medicare-popular/75054735007/). Adding dental coverage to Medicare ranked the second-most important topic in that poll, ahead of abortion rights and the future of the Affordable Care Act. Despite that, neither Vice President Kamala Harris or former and future President Donald Trump mentioned extending dental coverage in their platforms or major speeches leading up to the 2024 election. **4. “Through the SMILE Health validation studies . . . we now understand other avenues and opportunities in which we can provide oral health and nutrition information in a way that is accessible and reaches low-income communities.”** — Shireen Abdullah, MBA, PMP, founder and CEO, Yumlish Six oral health startups are [now graduates of CareQuest Innovation Partners’ 2024 SMILE Health Cohort](https://carequestinnovation.com/smile-health-reveal-day-unveils-innovations-advancing-medical-dental-integration/). SMILE Health, currently in its third year, is a 12-week semivirtual program that connects diverse innovators with a network of mission-aligned industry partners who help advance their solutions and road maps, in partnership with MATTER. As part of the 2024 program, startups receive a $10,000 stipend, take part in data-driven validation studies, receive mentorship, and participate in curriculum and networking. **5. “We’d get local anesthetic and two aspirin. After we left, we couldn’t have any more than two aspirin. And of course, that was kind of traumatic. I’ve probably had about four extractions while I was incarcerated.”** — K. C. Uber, Oral Health Care Advocate According to a CareQuest Institute Report, Oral Health in Incarcerated People, 50% of incarcerated individuals reported having a dental problem during the time they were imprisoned. Care for those patients typically means tooth extractions. [For Uber, that’s the oral health care he received while incarcerated.](https://www.carequest.org/resource-library/oral-health-incarcerated-persons) Uber is now more than $11,000 in debt to pay for the implants that improved his oral health. He makes too much to qualify for Medicaid, and his insurance only covered cleanings. **6. “This is an issue that is not talked about anywhere nearly enough.”** — Senator Bernie Sanders (I-VT), Chair, Senate Committee on Health, Education, Labor, and Pensions In May, Myechia Minter-Jordan, MD, MBA, senior advisor to CareQuest Institute, testified on a panel of medical and dental professionals before the Senate Committee on Health Education, Labor, and Pensions. The hearing was in response to millions of people in the US struggling to get access to the oral health care they need — most often because they cannot afford it.Sanders introduced the Comprehensive Dental Reform Act of 2024 to try to expand Medicare, Medicaid, and Veterans Health Administration benefits to provide comprehensive coverage to seniors, veterans, and low-income families. **7. “I was in a crosswalk and struck by a bus. With dental, you’ll go to the emergency room, and they’ll treat anything but your teeth. And your teeth can be hanging, and they will give you antibiotics and tell you, ‘Go to a dentist.’ The only thing they will do for emergency dental is pull your teeth, but then I’d be walking around with no three front teeth. This isn’t appearance, this is health. Teeth are your health.”** — Janessa, insured through Arizona Medicaid Janessa is one of many people in the state who have a story about barriers to accessing oral health care. She is insured through Arizona Medicaid, but the state’s adult dental benefits only cover emergencies and are capped at $1,000, with very few exceptions. The Arizona Oral Health Coalition (AZOHC), with the support of grants from CareQuest Institute, is [working to show legislators in the state the importance of oral health](https://www.carequest.org/about/blog-post/strength-stories-arizonas-journey-expand-medicaid-adult-dental-benefits), its relationship to overall health, and the need for a comprehensive benefit. **8. “I appreciate all the ideas \[from\] the variety of presenters that I have seen and appreciate the online accessibility, especially living in a rural area where in the past I had to pack/drive/hotel for 3 days to take classes, so the low cost and convenience is amazing.”** — Anne Premont, RDH, MS, MA, geriatric fellow Premont is just one of thousands who [attended CareQuest Institute webinars in 2024](https://www.carequest.org/education). Topics included oral health and pregnancy, new patient shielding recommendations, and oral health and cannabis. The Institute also offers self-paced courses featuring leading experts from across the oral health care field. **9. “There is such a pride in being able to do something that nobody else can do in dentistry. We really feel responsible to dentistry at large to make sure that things are done correctly because we know we’re in the spotlight.”** — Bill Milner, DDS, MPH, founder, Access Dental Care Access Dental Care, [a nonprofit organization in North Carolina, participated in CareQuest Institute’s Community Oral Health Transformation (COrHT) Initiative](https://www.carequest.org/about/blog-post/providing-equitable-care-special-populations-north-carolina) in 2023. Through collaboration and networking, COrHT enabled teams to share insights and experiences to support each other. Milner was a peer mentor to other clinics since Access Dental Care had been providing care for special populations and using teledentistry for years prior to joining the initiative. Work with the Institute also helped Access Dental Care record value-based services that the organization hasn’t always had a way to track. **10. “We really wanted to promote the one-stop-shop, under-one-roof, collaborative care with the medical providers and really dig into why they weren’t seeking dental care at all or were going elsewhere.”** — Rebecca Cornille, DDS, chief dental officer, Vista Community Clinic (VCC) VCC, a Federally Qualified Health Center (FQHC) in southern California, was looking for a way to get pediatric medical patients to also go to their dental department. The FQHC had hired an integration coordinator for patients with diabetes in 2021, and Cornille says that inspired the idea of [hiring an integration coordinator for their pediatric patients](https://www.carequest.org/about/blog-post/making-connections-how-community-clinic-integrating-dental-and-overall-care). VCC didn’t have the budget for the position, so it applied for — and received — a $125,000 CareQuest Institute of Oral Health grant as part of the Institute’s Community and Care Transformation initiative. Cornille says she’s hopeful the integration coordinator proves to be a financially sustainable and recognized position within the care team. **11. “It’s our intention to invest in communities that have been historically marginalized that haven’t had a seat at the table.”** — Trenae Simpson, MBA, grants and programs director, CareQuest Institute People who live in Connecticut, like many who live in the US, struggle with equal access to oral health care. In this video, oral health advocates, many at organizations funded by CareQuest Institute grants — like the Ministerial Health Fellowship, the Connecticut Oral Health Initiative (COHI), and the Connecticut Department of Social Services — [explain how they work closely with the community to improve oral health and overall quality of life](https://www.youtube.com/watch?v=yctFoCkPmIg). **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Research Recap: The Five Most Popular CareQuest Institute Publications of 2024](https://carequest.org/blog/research-recap-the-five-most-popular-carequest-institute-publications-of-2024/) **Published:** December 17, 2024 **Author:** Caitlin Locklear **Content:** Oral health *is* overall health. It’s more than a mantra, and nothing drives that fact home more than the research done in 2024 by CareQuest Institute. A few key findings from popular reports published this year show: - Among children with a heart condition, about one in six have at least one sign of poor oral health. - Tooth loss from gum disease or tooth decay is linked with a higher risk of being diagnosed with Alzheimer’s disease and related dementias (ADRD). - More adults with attention-deficit/hyperactivity disorder (ADHD) reported visiting an emergency department for dental care in the prior year compared to adults without ADHD (13% vs. 2.3%). In 2024, the Institute produced 24 publications — from white papers to visual reports. Based on what you, our readers, found most interesting, these are the top five publications of the year: **1. [The Heart of the Matter: Links Between Cardiovascular Health and Oral Health](https://www.carequest.org/resource-library/heart-matter) (June)![](https://carequest.org/wp-content/uploads/2024/12/Check-Up_Resized.jpg)** In this visual report, researchers explore the relationship between heart disease and gum disease, which are both extremely common in the US, in both adults and children. Individuals with gum disease have two to three times the risk of experiencing a heart attack, stroke, or a severe cardiovascular event. The authors write that collaboration between dental and medical providers is critical to improving health outcomes. Dental professionals can screen for heart disease risk indicators, like high blood pressure, and teach patients about the links between oral and heart health. Medical professionals can encourage their patients to receive routine dental cleanings. **2. [Poor Oral Health May Contribute to the Risk of Dementia](https://www.carequest.org/resource-library/poor-oral-health-may-contribute-risk-dementia) (April)** ![](https://carequest.org/wp-content/uploads/2024/12/Elderly-Man-1-scaled.jpg) Experts estimate that by 2040, the number of individuals with Alzheimer’s disease and related dementias (ADRD) in the US could reach 12 million. That means it’s critical to determine whether improvements in oral health may prevent or reduce the symptoms of this disease. This report highlights research showing that poor oral health is linked to being diagnosed with ADRD. **3. [Attention to Detail: ADHD and Oral Health](https://www.carequest.org/resource-library/adhd-and-oral-health) (October)** Findings from CareQuest Institute’s national State of Oral Health Equity in America (SOHEA) survey (see publication no. 4 below) suggest that adults with attention-deficit/hyperactivity disorder (ADHD) — nearly 9 million individuals in the US — face more risks to their oral health than adults without ADHD. In this report, researchers also note the importance of oral health professionals being aware of the potential oral health risks associated with ADHD and collaborating with their patients to help them achieve optimal oral health. For example, medications used to treat ADHD may produce side effects, which can lead to increased tooth decay, gingivitis, and other oral health issues. **4. [State of Oral Health Equity in America (SOHEA) 2024](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024) (September)![](https://carequest.org/wp-content/uploads/2024/12/Dentist-Checkup_Resized.jpg)** CareQuest Institute’s annual SOHEA is the largest nationally representative survey, surveying 9,000 adults in the US, focused on adults’ attitudes, experiences, and behaviors related to oral health. This infographic highlights the initial key findings from that survey, including how many adults reported seeing a dentist in the prior year and how many adults reported seeking dental care in an emergency department in the past year. **5. [Oral and Mental Health During and After Pregnancy](https://www.carequest.org/resource-library/oral-and-mental-health-during-and-after-pregnancy) (October) ![](https://carequest.org/wp-content/uploads/2024/12/Pregnant-Woman-at-Appointment_Resized-300x200.jpg)** Medical-dental integration is essential to addressing whole-person health throughout the entire lifespan, and the pregnancy and postpartum periods are particularly important to the health of birthing parents and their newborns. This finding is just one of many in the CareQuest Institute report, based on the 2024 SOHEA survey, that explores the links between pregnancy, oral health, and mental health. To explore other reports, white papers, poster presentations, and infographics on topics ranging from medical-dental integration to teledentistry, visit our [Resource Library](https://www.carequest.org/resource-library). **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [How a New Fact Sheet Can Help Drive Oral Health Innovation](https://carequest.org/blog/how-a-new-fact-sheet-can-help-drive-oral-health-innovation/) **Published:** December 17, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2024/12/CQ_Ask-The-Experts-300x300.png)Although the medical industry has used electronic data interchange (EDI) for years to share patient health information among health care providers, systems, and organizations, the dental industry is still lagging. But a recently released fact sheet from [Workgroup for Electronic Data Interchange (WEDI)](https://www.wedi.org/) represents a significant step forward in addressing the challenges of interoperability and efficiency in secure information exchange within the dental industry. WEDI, founded in 1991, promotes the use of health IT to improve patient care. (The organization played a pivotal role in the implementation of HIPAA standards by serving as a key advisor to the US Department of Health and Human Services.) The new fact sheet, “[Healthcare Transactions Used in Dentistry](https://www.wedi.org/2024/11/08/health-care-transactions-used-in-dentistry/),” is a valuable resource and the result of [hard work and dedication from the organization’s Dental Subworkgroup (Dental SWG)](https://www.wedi.org/workgroup-community/dental/). Below, I explain more about EDI and the fact sheet and offer some answers about how this new tool can help foster systems-level change to improve access to care and enhance patient outcomes: **What is EDI?** EDI is the secure transfer of structured data between systems, replacing manual, paper-based processes. EDI streamlines workflows such as claims submission, eligibility verification, and payment processing, reducing errors and saving time. **What is inside the fact sheet?** Within the fact sheet, readers can expect: - A clear explanation of EDI and its role in health care - A detailed overview of common dental transactions like eligibility verification, prior authorizations, and claims processing - Practical steps to integrate EDI into dental practices for cost savings and operational efficiency - Insights into how electronic transactions can improve patient experiences **Why is the fact sheet valuable?** The fact sheet highlights the transformative potential of EDI in dental care. By adopting standardized electronic transactions, dental practices can save time, reduce costs, and enhance accuracy. With potential industry-wide savings of nearly $2 billion annually, according to the [2023 CAQH Index Report](https://www.caqh.org/insights/caqh-index-report), the fact sheet serves as a road map to achieving administrative simplification and aligning dental workflows with current health care practices. **Why should oral health providers care about EDI?** EDI adoption delivers significant benefits to oral health providers, including: - Lower administrative costs - Faster payments and improved cash flow - Fewer errors in claims and patient data - More time to focus on patient care rather than paperwork **How would EDI improve the patient’s experience?** Patients would experience: - Faster claims approvals - Better care coordination and communication among providers - Transparent and accurate billing **Would industry stakeholders benefit from full adoption of EDI in dentistry?** Yes, the dental industry would benefit from full EDI adoption. For stakeholders like providers, patients, payers, regulators, policymakers, clearinghouses, and technology vendors, full EDI adoption: - Reduces manual processes such as faxing and translating from paper claims - Reduces the dependency on paper checks - Automation of eligibility verifications, claims submissions, and remittance functions - Visibility of a clam status across the lifecycle of a claim **Why has the dental industry not embraced EDI yet?** The dental industry’s current system evolved without consistent standards, resulting in fragmented workflows and limited interoperability. The WEDI Dental SWG aims to address these issues by promoting and encouraging the use of industry-wide standards in dentistry. **Why is CareQuest Institute part of the WEDI Dental SWG?** The fact sheet emphasizes data exchange standards as a foundational tool to promote interoperability and collaboration among stakeholders, aligning with CareQuest Institute’s mission to advance innovative solutions for an equitable health care delivery system. Integrating these standards into dental record systems and workflows directly supports the Institute’s efforts to foster systems-level change that will improve access to care and enhance outcomes for underserved populations. **How can industry stakeholders get involved in this work?** Stakeholders can contribute by: - Joining WEDI and participating in workgroups - Supporting standards organizations like HL7 and ASC X12 - Advocating for interoperability and standards compatible technology adoption - Participating in educational initiatives and industry discussions Exploring organizations like HL7 ([HL7.org](https://www.hl7.org/)), ASC X12 ([X12.org](https://x12.org/)), and ASTP/ONC ([HealthIT.gov](https://www.healthit.gov/)) provides deeper insights into the standard development process, including ways to get involved and contribute to ongoing efforts in health data exchange. To learn more, visit WEDI’s official website ([wedi.org](https://www.wedi.org/)) for information on workgroup opportunities and available resources. ![](https://carequest.org/wp-content/uploads/2025/06/Renee-Clark-2025-200x300.jpg)Renee Clark Read more Transforming Oral Health: Ask the Experts blog posts, covering topics like health equity and interoperability, at [carequest.org/latest-news/blog](https://www.carequest.org/latest-news/blog). *Authored by Renee Clark, Care Coordinator & Interoperability Manager, CareQuest Institute* *Editor’s note: Renee has more than two decades of experience supporting inpatient, emergency department, and outpatient care settings. Throughout her career, Renee has directed various health care IT initiatives including meaningful use, integration, and interoperability with client EHR systems. Notable achievements include leadership on a statewide CMS meaningful use project to assist providers, as well as serving as interoperability consultant for the Office of the National Coordinator for Health Information Technology on their vendor EHR certification program.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [What Do the Changes in DC Mean for Oral Health Policy?](https://carequest.org/blog/what-do-the-changes-in-dc-mean-for-oral-health-policy/) **Published:** January 21, 2025 **Author:** Caitlin Locklear **Content:** For far too many people in America, good oral health is too expensive and out of reach. Too many families must make impossible trade-offs between getting the care they need and going into debt or putting food on the table. As we head into 2025, we need to ensure that policymakers understand the importance of oral health and its impact on our overall health and on our finances. When we look at major themes coming out of this last election, like cost of living and job opportunities, it’s clear that oral health is an important part of the equation. Oral health can impact everything from [diabetes to heart disease to birth outcomes to Alzheimer’s](https://www.carequest.org/resource-library/beyond-nice-smile). Poor oral health can lead to expensive health and dental care or even [missed job opportunities](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs). Now, more than ever, our nation needs policy changes that improve oral health — and we also need to ensure that the progress we have made is not put at risk. **With a new Congress and administration, these are key action items to advance and protect strong oral health policy in 2025:** **Revitalizing Medicare and Medicaid Dental Coverage Efforts** For decades, oral health advocates have worked to influence federal policy changes that would add comprehensive dental benefits in both Medicare and Medicaid. We’ve seen [incremental gains](https://www.kff.org/medicare/issue-brief/coverage-of-dental-services-in-traditional-medicare/) and [meaningful momentum](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results), especially in the last few years. This year, however, many of the policymakers who have championed these issues either lost elections or retired. While we aren’t likely to pass legislation on these issues in the next few years, it will be important to build up new champions and refresh our long-term efforts. **Defending Against Medicaid Cuts** As the new Congress and administration take office, they are [considering cuts and changes to the Medicaid program](https://thehill.com/policy/healthcare/5000935-medicaid-cuts-potential-next-congress/) to pay for tax cuts and other priorities. Many of these proposals would result in cuts to Medicaid dental benefits. Proposed policies include changing the way state Medicaid programs are financed — through block grants or per capita caps — which effectively force states to cut all optional services, including dental. The new administration is also [likely to take direct actions to change Medicaid](https://www.kff.org/policy-watch/what-administrative-changes-can-trump-make-to-medicaid/), including allowing states to implement certain program features such as work reporting requirements through Medicaid waivers, which can unnecessarily kick people off their insurance coverage or require them to “earn” their dental benefits. As these discussions progress, oral health advocates will be an important voice, alongside many other health stakeholders, in defending the Medicaid program from cuts. **Strengthening Veteran Access to Dental Care** Only some veterans who receive medical care through the VA [also qualify for VA dental care](https://www.va.gov/health-care/about-va-health-benefits/dental-care/) services. Even veterans who qualify for oral health care may not be able to access it due to issues such as limited provider locations and long wait times. The new Congress and the administration have both [indicated an interest](https://www.pbs.org/newshour/show/what-trumps-second-term-could-mean-for-military-members-and-veterans) in addressing veteran’s health issues, especially improving access to care for veterans who already qualify for care. We may not see massive reforms in the current political environment, but there could be important opportunities for incremental improvements in how oral health care is delivered. Oral health advocates should be prepared to talk about the importance of improving oral health care for veterans and the barriers to getting oral health care in the first place **Supporting Water Fluoridation** [Decades of research](https://www.cdc.gov/fluoridation/about/statement-on-the-evidence-supporting-the-safety-and-effectiveness-of-community-water-fluoridation.html) show that fluoride plays a critical role in good oral health, and that our nation’s oral health crisis could be far worse if it were widely removed from drinking water. Oral health advocates have an important role to play in ensuring that their communities and law makers receive accurate information about water fluoridation amid reinvigorated debates on the topic. Efforts to roll back water fluoridation also make it even more important to advance policies that improve access to oral health prevention and care. **Prioritizing Oral Health Prevention and Research** The incoming Congress and administration have indicated interest in restructuring or cutting funds to agencies such as [NIH](https://www.scientificamerican.com/article/health-research-could-face-severe-cuts-and-changes-under-trump/), [CDC](https://www.npr.org/sections/shots-health-news/2024/11/14/nx-s1-5186971/cdc-cuts-restructuring-trump-2024-election), HRSA, and others — all of which conduct or fund oral health research and programs. At the same time, there has also been discussion about a renewed focus on [chronic disease](https://www.politico.com/newsletters/politico-pulse/2025/01/06/trumps-chronic-disease-divide-00196542) and [nutrition](https://www.bbc.com/news/articles/cze391y17z7o) that could tie into oral health prevention work. It will be important for oral health advocates to educate policymakers about the importance of programs in their state and the need for data and research to ensure we’re preventing oral health problems rather than paying for them later. ![](https://carequest.org/wp-content/uploads/2025/07/Melissa-Boroughs-Web.gif)Melissa Burroughs These are some of the most defined issues we’ll be watching this year, but they won’t be the only ones. For example, we’re likely to see continued discussions around the health care workforce and telehealth that could have oral health implications. As the year progresses and policy discussions unfold, CareQuest Institute for Oral Health and the [Oral Health Progress and Equity Network (OPEN)](https://www.carequest.org/content/open) will continue to share on how advocates can get involved, speak up, and make a difference. *Authored by Melissa Burroughs, Senior Director, Public Policy, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Despite Progress, Millions Still Face Barriers to Adequate Oral Health Care](https://carequest.org/blog/despite-progress-millions-still-face-barriers-to-adequate-oral-health-care/) **Published:** January 27, 2025 **Author:** Darren Edwards **Content:** Discrimination. Cost. Education. Employment. Together, they are four powerful socioeconomic factors that act as barriers to adequate oral health for millions of adults in the United States. The newest CareQuest Institute report, [*Does Our Oral Health Care System Welcome Everyone?*](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone) dives into those factors in great — and concerning — detail. The report features findings from CareQuest Institute’s annual [State of Oral Health Equity in America 2024 (SOHEA) survey](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024), which examined the oral health attitudes, experiences, and behaviors of more than 9,000 adults. “In this year’s report, we had more than 9,000 people complete the survey, compared to a little more than 5,000 people in previous years,” said Lisa Heaton, PhD, science writer at CareQuest Institute. “This larger sample size allows us to dive deeper into more areas of interest and draw more conclusions than we could with data from a smaller group of respondents.” Heaton, one of the authors of the report, explains more about the findings and what actions organizations and people can take to break down those barriers. **1. What would you say are the biggest takeaways from the report?** While the oral health care system works well for some to achieve and maintain good oral health, many adults are still unable to receive adequate oral health care. For example, just under one third of adults surveyed say they haven’t visited a dentist in the last year, and more than 1 in 10 say they do not plan to see a dentist in the coming year. As [poor oral health is linked to myriad chronic health conditions](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) — such as heart disease, diabetes, and dementia — adults who are not able to access oral health care are at increased risk of other health conditions. We also learned that within the prior year, approximately 10 million people lost dental insurance. It is important to keep track of these numbers so we can better understand how people’s oral health can change as their dental insurance coverage also changes. **2. Do any findings show a significant change in adult oral health status in the last year?** On a positive note, the percentage of adults who report having ever experienced discrimination in an oral health care setting decreased from 7% in 2023 to 4% in 2024. However, while this overall number is relatively low, the percentage of those who said they both experienced and had been denied oral health care due to discrimination increased slightly from 22% in 2023 to 27% in 2024. This finding shows that there is still work to do for oral health care to be more inclusive and welcoming of all individuals. **3. Did your research focus on anything new this year?** For the first time in 2024, we asked adults how important they feel it is for the dental setting to be a diverse and inclusive place. For example, nearly half of adults in the sample overall (47%) say it is important to them that their dentist embraces their cultural preferences. This suggests that many adults prefer to seek care in dental settings that represent diversity and inclusivity. **4. Did anything surprise you in the report?** Something we found surprising is that almost half of adults continue to have experienced at least one oral health problem in the previous year (48%), such as toothache (18%), cracked or broken teeth (17%), frequent dry mouth (15%), and swollen or bleeding gums (15%). The consistency of this finding year after year (51% in 2023) highlights how important preventive oral health care is to prevent larger problems **5. What actions do you hope readers — providers, oral health advocates, policymakers — take after reading the report?** We hope these findings emphasize that when the dental team gets to know and respect their patients as individuals, they’re providing care that their patients really appreciate and value. With regard to advocacy and policymaking, while the oral health care system is working for many people, there are still many adults who are being left out of the opportunity to achieve and maintain optimal oral health. Several US states have enhanced [adult dental benefits in their Medicaid programs](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups). That said, with 69 million adults still without dental insurance in 2024, there is still a lot of work to do to create an oral health care system that is accessible, equitable, and integrated for everyone. **6. What direction do you see the survey taking in the future? Which areas do you feel need more research or attention?** ![](https://carequest.org/wp-content/uploads/2025/01/Lisa-Heaton-Web-250x300.gif)Lisa Heaton Starting in 2025, we plan to offer the survey in both Spanish and English. About one third of adults surveyed in 2024 said it was very important or important to them that their dentist offer translation services. However, we couldn’t draw any conclusions about adults’ preferences for translation services who aren’t able to participate in an English-language survey. We also added a question for 2025 about the importance of dentists speaking the same language as their patients, which will help us to better understand language-related oral health care barriers. We’re also adding about 20 new questions to the 2025 survey, including about [dental tourism](https://www.todaysrdh.com/dental-tourism-making-patients-aware-that-the-bargain-could-be-a-big-mistake/), [underground dentistry](https://www.todaysrdh.com/street-dentistry-the-unlicensed-underground-practice-of-dentistry/), and whether adults have ever had to delay medical care — [such as cancer treatment](https://www.mouthhealthy.org/all-topics-a-z/cancer-dental-health#:~:text=Infections%20and%20other%20dental%20issues,of%20the%20cancer%20care%20team.) — due to untreated dental problems. *Authored by Lisa Heaton, PhD, CareQuest Institute Science Writer* *Editor’s note: For more information on CareQuest Institute publications and reports, go to our* [*Resource Library*](https://www.carequest.org/resource-library)*.* **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [Dental Therapy Demystified: 11 Questions on Capabilities, Employment, and Education](https://carequest.org/blog/dental-therapy-demystified-11-questions-on-capabilities-employment-and-education/) **Published:** January 31, 2025 **Author:** Caitlin Locklear **Content:** Dental therapy is expanding as more states authorize dental therapists to practice. But there are still a lot of questions when it comes to dental therapists’ capabilities, employment, and education. ![](https://carequest.org/wp-content/uploads/2025/01/LauraBrannon_Headshot.jpg)Laura Brannon During a recent CareQuest Institute webinar, “[Dental Therapy: Examining the Misconceptions and Opportunities](https://www.carequest.org/education/webinars/dental-therapy-examining-misconceptions-and-opportunities),” panelists discussed the current legislative landscape and scope of practice for dental therapists in the US. They also set the record straight on common misconceptions about dental therapy and evaluated the potential impact of dental therapists on improving patient outcomes and expanding care in underserved communities. “Very impressive speakers that have such passion about dental therapy,” noted an attendee after the webinar. ![](https://carequest.org/wp-content/uploads/2025/01/SarahWovcha_Headshot.jpg)Sarah Wovcha, JD, MPH [Community Catalyst](https://communitycatalyst.org/) Dental Therapy Senior Project Manager Laura Brannon and Executive Director Sarah Wovcha, JD, MPH, of Children’s Dental Services in Minneapolis, Minnesota, presented to approximately 700 learners from the oral health community. Below, we’ve provided an edited summary of the questions and answers about dental therapy. ## The Capabilities of Dental Therapists **1. Are there any states that allow credentialed dental therapists to open their own practices?** Yes, kind of. [All states require dental therapists to work under the supervision of a dentist](https://oralhealthworkforce.org/infographics/authorization-status-of-dental-therapists-by-state/).[Colorado does let dental hygienists and dental therapists own their own practices](https://dpo.colorado.gov/Dental/Laws), but therapists still have to work under the supervision of the dentist. **2. What is the supervision of a dental therapist? You mentioned dental therapy in emergency rooms; is the supervision medical, then? A dentist won’t be supervising in an emergency or medical setting.** Dental therapists have to work under the supervision of a dentist but can work under general supervision via a collaborative agreement without the dentist on-site or without the dentist examining the patient first. **3. Can dental therapists write a prescription? Can they do anesthesia? Can they drill and fill? Can they diagnose?** They can administer and dispense, but generally, they cannot prescribe. There have been some questions asking if dental therapists can prescribe topical fluoride or something like that. It might be a really good idea to add that into the scope, but historically they have not been able to. Yes, they can give local anesthesia. Yes, they can prepare and place fillings. Most states don’t use the word diagnose. Dental therapists can do an exam and create a treatment plan. For political reasons, most states do not use the word *diagnosis*. In Minnesota \[where Wovcha works\], the language of the law says that dental therapists can do a full comprehensive exam. However, when it came to slicing and dicing through the whole legislative rulemaking process, dental therapists ended up unable to be reimbursed for more than a limited exam. But they’re still able to do one. ## What Employment Looks Like for Dental Therapists **4. Do you know roughly how much a dental therapist is paid?** It varies by state and practice setting, but generally about one-third to one-half of what dentists make in that same setting. **5. How do you see dental therapists impacting employment opportunities for dental hygienists and dentists? Are they a threat to those professions?** I don’t think so. Fewer than half the people in the US can get dental care every year. [We have so many people in this country who need care.](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone) We have a massive shortage of hygienists and dental assistants right now. We need all the providers we can get, and I don’t see that changing. [Dental therapists can help dental practices be more effective and make more money](https://www.americandentaltherapyassociation.org/get-the-facts). For private practices, that is more profit. For nonprofit clinics, that is more money that is going back into patient care, which means more patients getting care. ## Training and Education to Become a Dental Therapist **6. What exactly are the education requirements for dental therapists?** Most states just require completion of a Commission on Dental Accreditation (CODA) program, but some do require that dental therapists hold a specific degree (BS or MS) or a dental hygiene degree. **7. To become a dental therapist, do you have to go to undergraduate school prior to dental therapy school, or is it a total of three years?** [Requirements vary by state and program](https://www.americandentaltherapyassociation.org/get-the-facts), but the national standards only require a program of a minimum of three academic years. **8. What are continuing education requirements for dental therapists? Is there a recertification requirement?** It varies by state but is generally a similar requirement to the state’s other dental professions. **9. Are there bridges from dental hygiene to dental therapy, or from expanded function dental assistance to dental therapy? If you are already either a dental hygienist or an expanded function dental assistant, will any of that education that you received count toward the dental therapy program?** There are bridge programs for dental hygiene to dental therapy. The accreditation allows programs to give advanced standing. It’s up to the program to decide how they want to do that.Minnesota has been the leader in showing how to do that for dental hygienists. At this point, I think all the programs either do dual training or advanced standing in Minnesota. This varies by state. It’s not required by the national accreditation standard. Some states require dual licensure. Most don’t. But I think it’s actually an amazing option because we know so many dental assistants and dental hygienists have left the workforce in the last couple of years — and most of them leave because they don’t feel like there’s an opportunity for advancement. So, this is an opportunity for dental hygienists to come back and learn some more skills. Right now, there aren’t any programs that offer advanced standing for dental assistants, but we’re hoping those will be developed. **10. Do dental therapists have to pass a board exam that is limited by each state that allows dental therapy?** Most states require a board exam. [CDCA-WREB-CITA](https://adextesting.org/dental-therapy/) and [CRDTS](https://www.crdts.org/DentalTherapy) both offer dental therapy exams; which one is required varies by state. ## Moving Forward to Advance Dental Therapy **11. What can we do to get dental therapy approved in our state?** Gather your friends, call your legislators, get over to the \[state capitol building\] often, tell stories, and give Children’s Dental Services a call. We’re happy to help testify. You can also go to dentaltherapy.org, the National Partnership for Dental Therapy. We have a ton of great resources.I really think that dental therapists are like nurse practitioners, and they are the wave of the future. It makes public health sense and economic sense. Boots-on-the-ground advocacy can get us there — and the incredible resources that we have from Community Catalyst, CareQuest Institute, and others. *Editor’s note: You can* [*view the full webinar*](https://www.carequest.org/education/webinars/dental-therapy-examining-misconceptions-and-opportunities)*, including the Q&A, in the* [*CareQuest Institute webinar library*](https://www.carequest.org/education/webinars/past)*.* **Categories:** Blog **Tags:** Person-Centered Care --- ### [Trauma-Informed Care: Creating a Safe Space for Dental Patients](https://carequest.org/blog/trauma-informed-care-creating-a-safe-space-for-dental-patients/) **Published:** February 24, 2025 **Author:** Caitlin Locklear **Content:** Leaning the chair back. The sounds of dental instruments. Closing the door to the room. These may seem like normal experiences at a dental office, but for some patients who have experienced trauma, they can trigger stress and anxiety. And if those triggers are ignored by the dental team, the patient could be retraumatized. [Trauma is an event or set of events](https://www.apa.org/topics/trauma#:~:text=Trauma%20is%20an%20emotional%20response,from%20Recovering%20emotionally%20from%20disaster) that were harmful or life-threatening that a patient witnessed or experienced directly, impacting their well-being and creating lasting adverse effects. It can include anything from automobile accidents to domestic violence to discrimination. ![](https://carequest.org/wp-content/uploads/2025/02/Mana-Mozaffarian_Headshot-325-x-400-headshot-speaker-2-244x300.png)Mana Mozaffarian, DMD How can oral health providers help patients who have experienced trauma feel safe in the dental chair? In a CareQuest Institute webinar, “[Trauma-Informed Care: Creating a Psychologically Safe Environment in the Dental Setting](https://www.carequest.org/education/webinars/trauma-informed-care-creating-psychologically-safe-environment-dental-setting),” experts explained how trauma can manifest in both patients and dental team members, the principles of trauma-informed care (TIC), and how those principles can be applied in oral health care. Trauma-informed care, the experts explained, considers and accounts for trauma that patients have experienced, regardless of when or how the trauma occurred. The experts believe protocols for trauma-informed care need to be universal and applicable to both dental teams and their patients. “Something like leaning the chair back — some patients get startled that they’re going to fall off,” Mana Mozaffarian, DMD, integration consulting dentist and former chief dental officer of Pennsylvania, said. “So, giving them a heads-up is very helpful.” She also created a list that offered practical strategies to reduce patient anxiety and improve workplace culture: - Before every appointment, remind patients to bring in objects (or people who will support them) that give them a sense of security or stress relief, such as stress balls, heavy blankets, etc. - At the beginning of every appointment, remind the patient that they have control to stop the procedure for any reason by raising their hand. - During the appointment, avoid surprises and provide cues for the steps of the procedure that create different sensations (e.g., changing the angle of the chair or using an instrument that creates a different sound or vibration). Learners shared their questions in a brief Q&A session toward the end of the presentation — an edited summary follows below. The [full webinar](https://www.carequest.org/education/webinars/trauma-informed-care-creating-psychologically-safe-environment-dental-setting?check_logged_in=1), including the Q&A, is available in the CareQuest Institute webinar library. **1. What is physically required in a dental office to make patients feel safe?** Having a sterile environment is crucial for patient safety, but psychologically speaking, patient safety is about more than just clean instruments and clean surfaces. Trauma-informed care tells us that we need to pay attention to the physical space. A calm atmosphere makes a big difference. For example, avoid stressful TV programs, display plants and images of nature, and play soothing music. **2. What do you do about patients who repeatedly fail to come to appointments?** Dental staff may think these patients are disrespectful of the clinic’s time, but that’s often a misunderstanding. For patients dealing with trauma, a missed appointment is often a sign of the challenges of navigating daily life. Trauma significantly affects executive functioning skills. Time management may be challenging for patients who are struggling with trauma. This is in addition to social drivers of health. A patient may miss an appointment because of a bus that never arrived or child care that fell through. Of course, dental anxiety can contribute to the problem. Implementing the strategies discussed above can help improve patient attendance. When patients start to have more control, choice, and less-stressful experiences, they may be more likely to attend their appointments. Finally, it’s important to reconsider the term “no-show”; especially when used as a noun to refer to a person, it can be dehumanizing. Reframing missed appointments as “gaps in care” is more respectful and productive. **3. What’s your take on percussive or somatic therapy?** Any type of care you have been certified in, and you feel comfortable offering patients, can be helpful. But there is a boundary between dental care and mental health care. The most sensible course might be to refer patients to a mental health care provider to teach them techniques for reducing anxiety, and then the patient can use these techniques during the appointment. The advantage of integrated practices is that you can address the needs of the whole person. One practice within a federally qualified health center (FQHC) implemented a dental anxiety screener, which was essentially just the [PHQ-9](https://www.apa.org/depression-guideline/patient-health-questionnaire.pdf), a common diagnostic instrument for mental health. They ended up identifying suicidal individuals, who were then referred to inpatient treatment. So, asking questions in preparation for the dentist appointment identified an urgent need. At an integrated practice, there may also be the opportunity to have a mental health care provider come to the dental clinic and provide coaching or engage in breath work with the patient to reduce dental anxiety before an appointment. *Editor’s note: You can* [*view the full webinar*](https://www.carequest.org/education/webinars/trauma-informed-care-creating-psychologically-safe-environment-dental-setting)*, including the Q&A, in the* [*CareQuest Institute webinar library*](https://www.carequest.org/education/webinars/past)*.* **Categories:** Blog **Tags:** Person-Centered Care --- ### [Voices from the Field: Dr. Jessica Robertson on Providing Care in Rural Areas](https://carequest.org/blog/voices-from-the-field-dr-jessica-robertson-on-providing-care-in-rural-areas/) **Published:** March 18, 2025 **Author:** Caitlin Locklear **Content:** For Jessica Robertson, DMD, relocating from Southern California to rural Arizona has taken some adjusting. “Moving to a small town was quite different,” she says, “not having a mall just around the corner or the amusement park an hour away.” Some of the clinics where she provides care are even farther.![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg) Robertson is a board-certified pediatric dentist at Around the Mountain Pediatric Dentistry, which has three clinics in rural Arizona: Cottonwood, Pinetop-Lakeside, and Flagstaff. She is also Chair of the ADA Council on Advocacy for Access and Prevention and served as an expert panelist on CareQuest Institute’s recent webinar “[Starting Strong: The Importance of the Age One Dental Visit](https://www.carequest.org/education/webinars/starting-strong-importance-age-one-dental-visit).” Robertson and Nick Rogers, DDS, shared why dental visits at age 1 are critical to promoting oral health and minimizing the risk of early childhood caries. ![](https://carequest.org/wp-content/uploads/2025/12/Jessica-Robertson-Headshot-241x300.jpg)Jessica Robertson, DMD During the webinar, Robertson mentioned that she drives up to three hours to get to her Pinetop-Lakeside clinic. The commute is even longer for some of her patients. “We have some patients who are local — and some who drive from four to six hours one way,” she says. This distance from places like dental offices and grocery stores makes it challenging for patients in rural Arizona to have good oral health. Patients are “only coming into town once a month to get their groceries,” Robertson explains. “So, their perishables will be done and over with within the first two weeks. And then the next two weeks are just ultra-processed foods, which are high in sugar and salt.” And the consequences of that option-free diet are apparent in the mouths of the children she sees daily. “I wish I could see every kid by age 1, but there are still a lot of kids at age 1 who are getting a lot of cavities,” she says. A [joint study in 2022 by CareQuest Institute, Arizona Oral Health Coalition, and Children’s Action Alliance](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children) found that despite recommendations that children see a dentist by their first birthday, less than 1% of Medicaid-enrolled children had a dental claim before the age of 1. The authors also wrote, “Arizona struggles with recruiting and sustaining dentists, particularly in rural and low-income areas.” Below, Robertson goes into greater depth about the barriers patients in rural Arizona face in accessing oral health care, why the area struggles to gain and retain providers, and what oral health providers can do to improve access for their patients. **Can you tell us about your patient population and what oral health problems they have?** We are probably 60/40 in terms of Medicaid to private insurance fee-for-service. We also see a lot of pediatric patients from the reservation as well. We’re seeing a lot of kids at 5 and 6 years old, and it’s not fillings that we’re doing — it’s crowns and extractions and spacers. ![](https://carequest.org/wp-content/uploads/2025/03/Jessica-Robertson-VFTF-Photo-4-300x235.jpg)“We’re seeing a lot of kids at 5 and 6 years old,” Robertson says, “and it’s not fillings that we’re doing — it’s crowns and extractions and spacers.” We’re doing a lot of sedations. We’re doing a lot of general anesthesia appointments. We’re doing a lot of silver diamine fluoride (SDF) on those individuals because we’re not going to see them under general anesthesia or sedation until they’re at least 2 years old and 25 pounds. With SDF, we’ve been able to push it to 3 years old and 30 pounds. Seeing a child closer to 3 ensures all the baby teeth have come in and decreases the chances of additional sedations in the future. **What does a typical day look like for you?** From my home in Cottonwood, it’s a three-hour drive to the Lakeside clinic. I go once a month because there are four practitioners, and we each cover a week. I see about 35 to 45 patients a day. I know there are other practices that see close to 100 patients a day, but our patients are coming from far away. We want to make sure we have time for them. Also, [in the state of Arizona, you have certain parameters with Medicaid that if a patient is in pain](https://www.medicaid.gov/medicaid/benefits/dental-care/index.html) and it’s an emergency (potentially life-threatening), you need to see them that day. If they’re in pain but it’s not an emergent, we must see them within 24–48 hours. **What is one of the biggest barriers your patients face?** Food deserts. How do you tell your patients who are coming into town to shop for groceries once a month that sugary cereal is not a good idea? “Let’s get some eggs.” Well, the cost of eggs is $10 a dozen now. How do you keep those fresh? Maybe they could get chickens, but it’s hard to keep those chickens fed in a desert. In the Native American population, [a major health risk is diabetes](https://www.mayoclinicproceedings.org/article/S0025-6196(15)00268-2/fulltext#:~:text=Abbreviations%20and%20Acronyms&text=Forty%20percent%20of%20the%20American,of%20diabetes%20in%20the%20world.&text=Both%20genetic%20and%20nongenetic%20factors,in%20the%20American%20Indian%20population.&text=Recent%20studies%20suggest%20that%20intake,diabetes%2C%20and%20chronic%20kidney%20disease.), and you can understand the challenges they face when you’re driving across the reservation and how remote everything is. We’ve had to drive to Durango, which from Flagstaff is about a five-hour drive, and we drive right through the reservation. I remember stopping at one of the fast-food restaurants to grab something to eat. A popular menu item? Hot Cheetos with Kool-Aid powder on top. When processed foods that are high in sugar are among the only choices, it’s no surprise that diabetes and dental disease rates are so high. **What other barriers to accessing care do pediatric patients and their families face?** You sometimes have grandparents — and even great-grandparents — raising kids because the parents may have a drug addiction or are in prison. The parents are just not present. So, we’re having older, mature folks taking care of young kids who are energetic. And then they’re just trying to do their best and feed them on a very limited diet because they are out in remote areas. Another huge barrier for some of our individuals who are not on Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid program, or Medicaid is the cost of care, and families have a hard time coming up with the funds. **Why aren’t providers moving to the area?** A few reasons: - Flagstaff is an expensive area to live in because there are a lot of second homes in Flagstaff and Lakeside-Pinetop. So, you’re having individuals who are buying up all these properties and driving up the prices, and then the local individuals can’t afford to live there. In other locations, like Cottonwood and Show Low, it shouldn’t be as expensive, but it is. - I also think the debt load is a barrier for students these days because it’s so high. They just don’t think they can afford living there or purchasing a practice. But it is very doable. It’s just sitting down with them and their situation and doing the numbers for them. - Sometimes their spouse does not want to live in a small community. You could have a successful practice, but if the spouse isn’t willing to be in a small town, it’s just not going to work. - We also don’t have a mall in Lakeside-Pinetop or in Cottonwood. So, when somebody’s looking for a place and they can only shop at Walmart, that could be a barrier. **So, what can we do about this? As Chair of the ADA Council on Advocacy for Access and Prevention, what are your goals to improve access to oral health care?** This year, it has been difficult to move the needle forward because we’re getting so many challenges about fluoride. You can only spread yourself so thin, and a lot of resources are going toward education of the importance of fluoride. Without fluoride in drinking water, you’re affecting individuals who are at higher caries risk — like these kids in rural areas— who should be on fluoridated water but can’t be because they’re in food deserts with no access to clean drinking water. They are coming into town to get their five-gallon water jugs and then taking them back. If they had access to fluoridated water in town, they would have some protection. Unfortunately, they are not, and we are fighting an uphill battle. They’re also buying drinks like juice and soda at the store that don’t expire, instead of the milk or just regular water, because buying water is still expensive. We want to target and educate those who can’t get access to dental care. We are also trying to reduce sugar intake in the US. Sugar is a toxin, and we have too much of it. The entryway to the rest of the body is the mouth, and so one of the first things that you’re going to see in individuals with high sugar intake is cavities, and then down the road, they are going to develop diabetes. Then they’re going to see heart issues and brain issues because they’re going to start to develop type 3 diabetes with neurocognitive effects. And it all starts in the mouth, and if we can stop the infection and inflammation in the mouth, then we can help the whole entire body. **What can any oral health provider, no matter where they live, do today to help their patients?** We need to continue teaching it forward that oral health is the start of a healthy lifestyle and a healthy life. We need to be that investigative reporter to figure out why are you, as an individual, getting all these cavities? Is it because of your diet? Is it because you have acid reflux? Is it because you have huge tonsils and you’re a mouth breather? It’s all related. We get to practice a whole-practitioner approach in Northern Arizona because we don’t always have those primary care practitioners. We need to make sure families are aware that oral health affects the whole body. **Categories:** Blog **Tags:** Dental Coverage --- ### [One Word and Three Takeaways from NOHC 2025](https://carequest.org/blog/one-word-and-three-takeaways-from-nohc-2025/) **Published:** April 11, 2025 **Author:** Caitlin Locklear **Content:** Uncertainty? Yes, plenty of that. Apprehension? A bit. Anxiety? There was some of that too. None of those words, though, sum up the mood, feeling, and spirit of the 2025 National Oral Health Conference (NOHC). ![](https://carequest.org/wp-content/uploads/2025/04/Image-6.jpg)Rebecca Preston and Hannah Cheung, MPH, MS, RDH, talking to people at CareQuest Institute booth The word that does? Resilience. “Some people are more optimistic in times of change,” said Lyubov Slashcheva, DDS, MS, DABDPH, FABSCD, Research Director at Apple Tree Dental in Minnesota. “Like one of my policy colleagues, Dr. John Pournoor, says, ‘Never let a good crisis go to waste.’” More than 650 optimistic oral health stakeholders — providers, policymakers, researchers, payers, educators, and students — spent a few days in Orlando earlier this week to share lessons about work they and their colleagues are doing to improve the oral health system in the US. The current and potential crises for the industry — [the elimination of the Centers for Disease Control and Prevention’s (CDC) Division of Oral Health](https://adanews.ada.org/ada-news/2025/april/cdcs-division-of-oral-health-gutted-amid-federal-restructuring/) and the [potential cuts to programs like Medicaid](https://www.abc10.com/article/news/local/fedral-funding-freeze-medical-dental/103-6b77a1e3-75f2-4bf9-9689-4f4ed90a64cf) — were top of mind for many, as expected. Some attendees talked with frustration about canceled grants; others talked about feeling lucky to be unscathed. Together, though, a spirit of gratitude and a desire to help permeated the conference space. The dynamic presentations, the lightbulb moments of connection, and the stories and examples of progress emerged as the lasting takeaways. “The mood?” Slashcheva thought for a moment before answering. “Resolute.” ![](https://carequest.org/wp-content/uploads/2025/04/NOHC3.jpg)Josefine Ortiz Wolfe, PhD, MBA, MPH, RDH, and Lisa Heaton, PhD, presenting at NOHC ## Session Highlights: Seeking Innovations in Oral Health The work of “finding innovations in oral health,” the theme of the conference, was on display on Monday and Tuesday, with nearly 40 educational presentations and a collection of roundtable discussions — several of which featured thought leaders from CareQuest Institute. They ran the gamut from incorporating oral health education into soccer programming and teledentistry in schools, to community water fluoridation updates and accommodating neurodivergent conditions in oral health. In the latter presentation, CareQuest Institute’s Lisa Heaton, PhD, and Josefine Ortiz Wolfe, PhD, MBA, MPH, RDH, shared a mix of research and personal stories that captivated a roomful of more than 80 learners on Monday morning. “When we think about neurodivergence in the dental field, it’s important to address it because we want to provide the best care possible,” Ortiz Wolfe said. “Developing consistent provider-patient relationships is probably the most important thing of all because of the trust that builds.” Heaton, a clinical psychologist by training, went a step further, sharing a practical piece of advice about trust-building: “Normalize actions as a way to help people advocate for themselves. Say things like ‘Lots of people like to use those dark glasses, or not everyone likes that feeling.’ Showing you’re willing to talk about those things will make patients more comfortable.” In “Developing a Culture of Patient Safety in Dentistry and Why It Matters,” Clifford G. Lisman, DMD, MS, FACD, FAAPD, MBA, and Becky Parnian, DHSC, MPH, RDH, CDA, discussed the pillars of creating a culture of safety in dentistry on Monday afternoon. “I shared errors I have made in my career,” Lisman said. “My motivation is I don’t want to see it ever happen again. I would encourage you to be open and transparent. It doesn’t diminish you; it elevates you. Transparency and humility go a long way.” ![](https://carequest.org/wp-content/uploads/2025/04/Image-5-scaled.jpg)CareQuest Institute colleagues holding white paper at NOHC Parnian shared data from a survey of New Jersey dental professionals about the knowledge of and attitudes toward patient safety. She helped uncover several recommendations with her research: - Stronger safety policies - Streamlined reporting guidelines - Improved communication - Mandatory training - Simplified reporting system In a very popular session on Monday afternoon called “10,000 People Turn 65 Every Day: What Oral Health Policies Are Needed?” speakers discussed the applicability of the Association of State and Territorial Dental Directors’ Health Aging Committee workgroup’s policy recommendations. Why are older adults at greater risk? The experts highlighted the use of medications that lead to a reduction in saliva flow, reduced efficacy of oral hygiene due to dexterity and cognitive changes, and greater exposure of root surfaces. Deborah Jacobi, RDH, MA, of Apple Tree Dental shared some of her organization’s work in long-term care settings that have been beneficial: - On-site collaborations with nurses, physical and occupational therapists, and other team members - Care planning with nursing staff, including writing daily mouth-care plans - Admission screenings and completing the oral and nutritional sections of the minimum data set - Physician consultations and coordinated care planning In Tuesday’s popular keynote, “The Invisible Population: Oral Health Care in US Correctional Facilities,” the speakers helped attendees understand the correctional system and the gaps in the oral health needs of the population. Morton K. Rosenberg, DDS, homed in on the levels of dental disease for incarcerated individuals: - Not much different than what is seen in low-income/medically indigent communities - Majority of patients did not have access to oral health and utilized emergency departments - More likelihood of drug abuse - Higher incidence of oral maxillofacial trauma “The most important thing we can do in the prison system is to treat today’s patient today,” he said. “Don’t kick the can down the road. Nothing good happens from that.” ![](https://carequest.org/wp-content/uploads/2025/04/NOHC4-225x300.jpg)CareQuest Institute colleagues participating at roundtable sessions ## Three Topics Took Center Stage The sessions at NOHC covered multiple aspects and angles of oral health innovation. Here are three that rose to the top: **Integration continues to gain momentum.** Connecting mental health and oral health. The role of school nurses in facilitating follow-up dental care. Integrating oral health into long-term care. Vaccinations in dental clinics. There were myriad ideas and learnings related to integrating oral health into other aspects of health care to improve care for patients. ![](https://carequest.org/wp-content/uploads/2025/04/NOHC2-scaled.jpg)John O’Malley, MHI, MS, presenting at NOHC **Special populations need time and attention.** From “10,000 People Turn 65 Every Day: What Oral Health Policies Are Needed?” to “The Invisible Population: Oral Health Care in US Correctional Facilities,” the needs of unique populations were on center stage. Ortiz Wolfe, in her presentation on neurodivergence, noted that the focus on special populations can help with all patients. “When we have people who are neurodivergent in our space, it makes us better providers, better orhealth teams,” she said. **Data is a key that can unlock many doors.** On Tuesday afternoon, CareQuest Institute’s John O’Malley, MHI, MS, unveiled the updated National Oral Health Data Portal, an interactive website designed to help public health stakeholders and the public find the information they need and want about the oral health system. The new portal highlights expanded capabilities, like allowing people to compare measures across sociodemographics and social determinants of health. [The beta version is live](https://www.carequest.org/content/national-oral-health-data-portal), O’Malley announced to the full conference room, and there’s a full launch planned for later this year. Said simply, it’s all the oral health data you want in one place. “We found a way to take all different types of measures and all different types of scales and combine them into one spreadsheet,” O’Malley said, noting that enhancements are ongoing. “We are looking to integrate emergency department data and insurance claims. If you know of any data sets we should include, please let us know.” **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Nine Questions on Using Caries Management by Risk Assessment](https://carequest.org/blog/nine-questions-on-using-caries-management-by-risk-assessment/) **Published:** April 2, 2024 **Author:** Caitlin Locklear **Content:** Caries Management by Risk Assessment (CAMBRA) has existed for more than 20 years. But many oral health providers may be unfamiliar with why or how to use it. To help, Care Quest Institute and the American Dental Therapy Association recently partnered in an [expert-led webinar](https://www.carequest.org/education/webinars/utilizing-caries-management-risk-assessment-deliver-person-centered-care) about applying this valuable tool. **Erinne Kennedy**, DMD, MPH, MMSc, assistant dean for curriculum and integrated learning at College of Dental Medicine, Kansas City University, and **Kari Ann Kuntzelman (Chickasaw Nation)**, dental health aide specialist and dental therapist at Northwest Portland Area Indian Health Board and president of the American Dental Therapy Association, provided education on the tool and personal stories on why CAMBRA is such a valuable and patient-centered tool. Nearly 500 oral health professionals joined the call and asked a variety of thoughtful questions about integrating CAMBRA into practice. Here are the top nine questions (and abbreviated answers from the experts) that arose during the webinar. **1. What is CAMBRA?** CAMBRA is an evidence-based disease management strategy to assess a patient’s risks and protective factors for developing caries, the disease that causes tooth decay. Patient supports and barriers can be identified at the individual level, such as diet or tobacco use, and the community level, such as water fluoridation or other social determinants of health. Providers use risk assessments to design an individually tailored treatment plan focused on minimally invasive care and supporting a patient’s behavior change. ![](https://carequest.org/wp-content/uploads/2024/04/iStock-1454469186.jpg) **2. What does research say about using CAMBRA in clinical care?** Studies show that CAMBRA improves patients’ oral health: - Patients at high risk for caries lowered their likelihood of disease [by 24%](https://pubmed.ncbi.nlm.nih.gov/29355423/) after two years of CAMBRA. - CAMBRA helps identify low, moderate, and high risk of dental decay [with validity](https://pubmed.ncbi.nlm.nih.gov/29355423/). - Combination therapy (using both antimicrobial and fluoride treatments), which CAMBRA may suggest, [is very effective](https://pubmed.ncbi.nlm.nih.gov/29355423/) in lowering patients’ risk of decay. Other notable research can help clinicians adopt CAMBRA. They include a [systematic review](https://pubmed.ncbi.nlm.nih.gov/30412330/) of risk assessments and their measurement properties, and [a comparison](https://pubmed.ncbi.nlm.nih.gov/35048004/) of four types of risk assessments. **3. How does CAMBRA support patient-centered care?** With CAMBRA, providers have an evidence-based process to determine the right care for each patient based on their individual dental needs and oral health barriers in their daily life. It promotes treatment plans that fit each patient — rather than using a “one-size-fits- all” approach. CAMBRA also emphasizes patient education and setting goals to improve their oral health over time. **4. Does CAMBRA play a role in advancing oral health equity?** This strategy invites providers to have curious, rather than judgmental, conversations with patients about dental disease. This is especially important for people who have faced racism and other inequities in health care. For example, due to how providers delivered treatment, American Indian and Alaska Native communities have generational trauma with dental care. Historically, [they have the highest rates of dental disease compared to other US populations](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral). Taking time to listen to patients’ experiences and needs builds trust. Over time, trust can make a difference in preventing cavities and promoting oral health equity. **5. Do I need certain tools to integrate CAMBRA in my practice?** Whether you are one clinic or have multiple offices, providers will need to adopt routine processes and forms: - **Develop standardized processes** for patient intake, especially for taking medical history and using a notes template for continued information gathering. A standard process helps ascertain details that are key to guiding individualized care. - **Choose a standard caries risk assessment form** (digital or paper), including codes and documentation procedures. You can adapt existing forms to fit your practice or program. - **Use caries risk assessment calibration exercises to align your team.** They have been [shown to improve](https://pubmed.ncbi.nlm.nih.gov/28572412/) assessment accuracy. **6. What does motivational interviewing have to do with CAMBRA?** Motivational interviewing is a form of coaching for behavior change. It doesn’t work for providers to tell patients what to do or what they’re doing wrong. It is more effective to ask patients open-ended questions to reflect on their oral health and then help them choose their own specific, obtainable action step for improvement. For example, one goal could be brushing one more day per week between this and the next dental visit. Another example may be swapping the practice of sipping on coffee all day to drinking coffee only with meals. Providers can support adults and children with education on dental disease and impactful behaviors. Offering affirmation and encouragement for patients’ commitment to their oral health is another critical part of the process. **7. How can I ensure CAMBRA works for my patients?** Providers can use a variety of resources to support patient success: - **Oral health education materials**, such as visuals explaining the disease process, help patients better understand their oral health. - **Resources for nutrition and habit coaching** can empower patients toward change. Motivational interview aides might include an illustrated menu of possible risk-reducing behaviors. - **Microbiome management tools** can both treat and teach patients about dental disease. Discuss oral bacteria and antimicrobials. Show patients their mouth pH level and how to modify it with accessible items such as baking soda rinses. - **Take-home reminders**, such as post-its or window clings, can help patients achieve their self-management goal by writing it down and putting it up at home. **8. If CAMBRA is new to my practice, what strategies can help us be successful?** Practice and share feedback with colleagues. For example, motivational interviewing is effective for driving patient behavioral change, but it can be difficult to do well. Conducting role-plays with colleagues is a good way to get comfortable asking open-ended questions and taking good chart notes. You can also place yourself in your patients’ shoes. Ask your own provider to use CAMBRA with you and apply lessons learned in your care delivery. **9. Where can I learn more about CAMBRA and stay up to date on similar techniques?** CareQuest Institute is launching a Kit for Dental Education on Caries, which will include a CAMBRA protocol curriculum. It will have a range of resources for providers to use in dental team trainings, study clubs, and other continuing education efforts. Additional opportunities for collaborative learning and support include: - [CAMBRA Coalition](https://www.cambracoalition.org/about/about-cambra-coalition) - The [ADEA Section on Cariology ](https://www.adea.org/for-members/member-communities/ADEA-Council-of-Sections/adea-sections) - American Dental Therapy Association [Annual Conference ](https://www.americandentaltherapyassociation.org/adta-annual-conference-2024) *Watch the full webinar and access presenter slides* [*online here*](https://www.carequest.org/education/webinars/utilizing-caries-management-risk-assessment-deliver-person-centered-care)*.* **Categories:** Blog **Tags:** Clinical Practice, Minimally Invasive Care --- ### [Hearing from Dental Hygienists: Unique Paths, Mission-Driven Work, and Career Advice](https://carequest.org/blog/hearing-from-dental-hygienists-unique-paths-mission-driven-work-and-career-advice/) **Published:** April 9, 2024 **Author:** Caitlin Locklear **Content:** Happy National Dental Hygienist week! The second week of every April, we celebrate the outstanding, dedicated, and selfless work dental hygienists do — inside and outside of clinical settings — to improve the oral health system. Here at CareQuest Institute, we’re fortunate to have several RDH colleagues who bring their vast knowledge of dentistry to our work to make the oral health system more accessible, equitable, and integrated. In a word, they are all invaluable. And we wanted to hear, in their words, what brought them to a career in dental hygiene, why they value CareQuest Institute’s work, and what advice they have for others considering a career in oral health. ***Caroline McLeod, MS, RDH, Value-Based Solutions Manager*** ![](https://carequest.org/wp-content/uploads/2024/08/Caroline-Mcleod-High-Res.jpg)Caroline McLeod, MS, RDH **Why did you initially pursue a career in dental hygiene?** My lifelong desire to support and care for others and a natural fascination with science, combined with an interest in dentistry founded by my grandparents, manifested itself into pursuit of a career in dental hygiene. It felt like a suitable place to explore my interests while complementing my personality and core values. **How do you see your work at CareQuest Institute improving the oral health system?** As a part of the Health Transformation team, I have the pleasure of working directly with stakeholders that play key roles in improving the oral health system. Sharing resources, educating, and developing solutions with clinicians, payors, advocates, and communities are impacting oral health system one step at a time. **What one piece of advice would you give to anyone considering a career in dental hygiene?** Dental hygiene is a gratifying profession, grounded in community, with a variety of opportunities to support your interests and career development. I would highly recommend talking with dental hygienists in different roles (e.g., clinical, teaching, research, public health) to understand what we do. ***Stephanie Clester, MA, RDH, Clinical Content and Support Specialist*** ![](https://carequest.org/wp-content/uploads/2024/06/Stephanie-Clester-Web-250x300.gif)Stephanie Clester, MA, RDH **Why did you initially pursue a career in dental hygiene?** I started my career in the dental field as a dental assistant. Dental hygiene was a natural next step for me — seeing all the restorative treatments made me want to help patients prevent the problems rather than react to them. **How do you see your work at CareQuest Institute improving the oral health system?** The work we are currently doing on the Health Transformation team is amplifying the need for a more equitable oral health system by providing education and advocacy resources to empower dental practices to address systemic barriers to care. Sometimes I do miss the one-on-one relationships I had with my patients when I was in clinical practice, but I enjoy being a part of CareQuest Institute’s bigger picture to reach more patients by transforming the oral health system of the future and to improve oral health for all. **What one piece of advice would you give to anyone considering a career in dental hygiene?** Find your passion within the field. If you keep this as a guiding point, you will be a better clinician because you are providing care with a servant’s heart. ***Kelly Schroeder, MS, RDH, Program Evaluation Specialist*** ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH **Why did you initially pursue a career in dental hygiene?** Initially, I went to college to study communicative disorders, the undergrad requirement for speech language pathology and audiology. As a first-generation college student, I was not prepared at that time to tackle a master’s program due to limited resources and support. After starting a family, a career in dental hygiene just made sense for me and my family. The degree I already had was a perfect complement to the science and rigor of the dental hygiene degree, and there was a dental hygiene program within 10 miles. Mostly, I wanted to be a dental hygienist because I care about people and helping them to be well. **How do you see your work at CareQuest Institute improving the oral health system?** CareQuest Institute is bringing awareness about the inequities tied to accessing oral health care, the social constructs that create barriers to care. It is about getting evidence-based, quality care to those who don’t have that access. I love that we are doing work that brings awareness about treating the cause of a tooth infection (minimally invasive care) rather than just doing surgery on a tooth (restoration). And I love that our CEO and President Myechia Minter-Jordan is bringing awareness about children who are being put under general anesthesia to have dental caries treated and the risks associated with that practice. In other words, CareQuest Institute is bringing accountability to oral health care. **What one piece of advice would you give to anyone considering a career in dental hygiene?** Love clinical dental hygiene for as long as it makes sense for you. Take your knowledge and experience and share it with the masses. ***Hannah Cheung, MPH, MS, RDH, Health Sciences Specialist*** **Why did you initially pursue a career in dental hygiene?** I wanted to be in a profession where I could help people. Dental hygiene allowed me the opportunity to combine my interests in education, prevention, and direct clinical care to improve the oral health condition of individuals. ![](https://carequest.org/wp-content/uploads/2024/08/Hannah-Cheung-Web.jpeg)Hannah Cheung, MPH, MS, RDH **How do you see your work at CareQuest Institute improving the oral health system?** In my role, I am able to be involved in research that highlights existing gaps in the oral health system and offers possible solutions to improving inequitable access to care. I feel more fulfilled as an oral health professional when I am part of these projects that I know are helping to change the current narrative and current oral health system. **What one piece of advice would you give to anyone considering a career in dental hygiene?** Find a good mentor, ask questions, and be brave. If you want to grow in or beyond your chairside career, a good mentor will help guide you and advocate for you. Don’t be afraid to challenge yourself and always ask questions. This is how you will experience the most growth, whether it is within or beyond clinical dental hygiene. **Categories:** Blog **Tags:** Clinical Practice --- ### [Four Actions We Can Take Now to Improve Black Maternal Health](https://carequest.org/blog/four-actions-we-can-take-now-to-improve-black-maternal-health/) **Published:** April 15, 2024 **Author:** Caitlin Locklear **Content:** “Kira Johnson lost her life to the Black maternal health crisis not because she was unhealthy, uninsured, or unlucky, but because she was unheard,” said U.S. Congresswoman Alma S. Adams, who represents North Carolina’s 12th Congressional District.![](https://carequest.org/wp-content/uploads/2024/04/Pregnant-Woman-Holding-Belly-1-1.jpg) This week — Black Maternal Health Week — marks the eighth anniversary of Kira’s death following a hemorrhage just hours after delivering her second son. Kira was an entrepreneur, world traveler, mother, and a healthy Black woman. Regardless of social and economic status, Black women are still [three times more likely to die from pregnancy-related complications](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes) than white women. Eighty percent of these maternal deaths are preventable. Adams, co-founder and co-chair of the Black Maternal Health Caucus, and Myechia Minter-Jordan, MD, MBA, Senior Advisor and former President and CEO of CareQuest Institute, discussed the Black maternal health crisis during the latest episode of *Chew On This: A Conversation with Representative Alma S. Adams*. They also talked about the connection between Black maternal health and oral health and what we can do to advance meaningful health equity policies in the US. Here are some highlights from their conversation. ([Visit carequest.org to watch the full episode.](https://www.carequest.org/education/webinars/chew-conversation-representative-alma-s-adams)) **Minter-Jordan:** Can you tell us more about your work as co-founder and co-chair of the Black Maternal Health Caucus? ![](https://carequest.org/wp-content/uploads/2024/04/Rep-Alma-Adams-headshot-blog-post.jpg)US Congresswoman Alma S. Adams (NC-12) **Adams:** Black women in America are dying at a rate much higher than other wealthy nations. We’re among only 13 countries in the world where the rate of maternal mortality is worse than it was 25 years ago. Inequities in our health care system have stolen countless moms. In response, we developed the Black Maternal Health [Momnibus Act](https://blackmaternalhealthcaucus-underwood.house.gov/Momnibus), a collection of 13 bills that provides a road map so that our health care systems will finally make Black maternal health and infant health a priority. **Minter-Jordan:** We know from [CareQuest Institute research](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum) that approximately 60–75% of pregnant people experience oral health issues that raise the likelihood of poor birth outcomes and major complications. How does oral health access factor into maternal health access and outcomes? **Adams:** Oral health has a huge impact on maternal and infant health outcomes, and we haven’t talked about it enough. [Gum disease may be linked to preterm birth and low birth weight.](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) We need to continue to have these conversations, spread awareness, and advocate for dental coverage for everyone. In my home state of North Carolina, for example, they extended postpartum Medicaid coverage from two months to a full year. **Minter-Jordan:** You’re a primary sponsor of the Kira Johnson Act, a bill that aims to confront the Black maternal mortality crisis head-on. Can you tell us more about the legislation and the community-based organizations involved? ![](https://carequest.org/wp-content/uploads/2024/04/Myechia-Minter-Jordan-Blog-Post-Picture.jpg)Myechia Minter-Jordan, MD, MBA Senior Advisor and former President and CEO of CareQuest Institute **Adams:** The [Kira Johnson Act](https://adams.house.gov/media-center/press-releases/kira-johnson-act-gains-momentum-congress-adams-urges-passage) funds grant programs to implement racial bias training and community- based organizations that support doulas, midwives, and other prenatal health workers. It’s going to address social determinants of health, like housing, transportation, and nutrition. And it will fund respectful maternity care programs in hospitals, where pregnant and postpartum parents can report instances of racial bias. I believe Kira’s care team needed this training. **Minter-Jordan:** As a member of the Committee on Agriculture, what are your thoughts on the connection between food insecurity and oral health? **Adams:** You can’t be healthy if you’re hungry. SNAP and other programs ought to ensure that participants can have a greater benefit and buy more nutritious food. The [Closing the Meal Gap Act](https://adams.house.gov/media-center/press-releases/adams-gillibrand-introduce-landmark-anti-hunger-legislation) ensures that a higher amount of income can be spent on medical care and not count against calculating SNAP benefits. SNAP benefits ($6 a person per day, only $2 per meal) also need to realistically reflect the current cost of buying nutritious food. When moms have access to nutritious foods, they are able to have a healthier pregnancy, and their children are able to have a healthier life. That’s what we want — healthier communities. ## How to Improve Black Maternal Health Throughout the conversation, Adams and Minter-Jordan highlighted four ways stakeholders can take action to improve Black maternal health — now: 1. Constituents: Put pressure on lawmakers to act urgently and address the crisis — tell your representative to pass the full Momnibus package into law. 2. Advocates and policymakers: Work in the state legislatures to continue the [expansion of Medicaid coverage to pregnant and postpartum people](https://www.carequest.org/resource-library/medicaid-adult-benefits-during-pregnancy-and-postpartum-and-birth-outcomes-state). 3. Philanthropists: Empower and fund community organizations that are already doing good work and seeing positive results improving Black maternal health. 4. Health care providers: Increase awareness and education about [racial bias](https://www.liebertpub.com/doi/10.1089/jwh.2020.8874) and the connection between oral health and pregnancy outcomes. [Only one-third (35%) of obstetricians and nurse midwives discuss oral health with their pregnant patients](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum), and 77% of obstetricians report that some patients had been “declined” treatment by dentists, although dental care during pregnancy is safe. Editor’s note: To learn more about the topic, [register for our upcoming webinar](https://www.carequest.org/education/webinars/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy), *Exploring the Myths and Misconceptions about Oral Health and Pregnancy.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Answers to 11 Questions about New Recommendations for Patient Shielding](https://carequest.org/blog/answers-to-11-questions-about-new-recommendations-for-patient-shielding/) **Published:** April 18, 2024 **Author:** Caitlin Locklear **Content:** Many patients are used to donning large, heavy aprons when getting a dental X-ray. Since the 1950s, providers have thought it was vital to cover a patient’s body and throat for fear of exposing their reproductive organs, thyroid gland, and pregnancy to dangerous levels of radiation. ![](https://carequest.org/wp-content/uploads/2024/04/ErikaBenavides_Headshot-Blog-Post.jpg)Erika Benavides, DDS, PhD Over the last decade, however, evidence about this practice has grown. This year, the American Dental Association (ADA) released [new data](https://jada.ada.org/article/S0002-8177(23)00734-1/fulltext) showing: - It’s safe for patients of all ages and conditions, including pregnancy, to “[shed the shields](https://news.dent.umich.edu/2024/03/05/university-of-michigan-school-of-dentistry-faculty-member-helps-develop-new-ada-recommendation-for-significant-change-related-to-dental-x-rays/)” during maxillofacial imaging. - Better diagnostic images can be captured without lead aprons and thyroid collars. CareQuest Institute collaborated with the ADA [on a webinar featuring one of the experts](https://www.carequest.org/education/webinars/exploring-new-recommendations-patient-shielding-during-imaging) who jointly developed the 2024 guidelines. Erika Benavides, DDS, PhD, diplomate, American Board of Oral and Maxillofacial Radiology, clinical professor at the University of Michigan, shared insights on implementing these recommendations. Here are answers to 11 audience questions (edited for space): **1. If a parent or caregiver must stay in the room while their child gets an X-ray, should they be shielded?** Ideally, everyone but the patient should be out of the exam room during an X-ray. However, caregivers should be shielded if they must stay to support a patient. **2. Some patients with heart monitors cannot undergo X-ray screenings at the airport. Are dental X-rays safe for them?** Yes, dental imaging is safe for patients who have any kind of cardiac device. **3. Should dental team members wear their own shields when operating NOMAD portable X-rays?** It is important to recognize that the new recommendations only focus on ending patient shielding. They don’t change guidelines on protection for clinicians. In general, providers operating handheld dental X-rays should always follow manufacturer’s instructions. On a more detailed note, providers should be aware that: - NOMADs do have a built-in radiation backscatter shield. - NOMADs come with strict manufacturer instructions that are important for clinicians to follow. For example, providers should hold the device with its arm at a 90-degree angle, away from their body. - If the NOMAD operator cannot follow its strict handling instructions, they should wear a lead apron. **4. In offices that still use circular collimators on their X-rays, should patients continue wearing radiation shields?** The short answer is no, patients do not need to wear shields even when a collimator is round. However, the National Council on Radiation Protection and Measurements recommends using rectangular collimators as one way to limit patients’ radiation exposure. To align with these best practices, consider adding a beam-guiding device on machines with circular collimators. Some beam-guiding devices have their own rectangular shield at the open end of the ring, which can be attached to round collimators to allow rectangular collimation. **5. What are the differences in radiation risk for children and adults? ![](https://carequest.org/wp-content/uploads/2024/04/Patient-Shielding.jpg)** Data show varying levels of risk for thyroid cancer depending on a patient’s age: - Young people aged 19 and under have thyroid glands that are generally more sensitive to radiation than adults. - Children between 10 and 19 years old have thyroids that are three times more sensitive to radiation than adults. - The thyroid gland in preschoolers and younger children, between 3 and 10 years old, is 10 times more sensitive to radiation than adults. When taking X-rays of the youngest patients, providers should follow protocols to reduce radiation exposure as much as possible, such as with digital sensors and rectangular collimation. **6. Are there any unique concerns facing patients who have cancer, including thyroid cancer, or people undergoing radiation therapy for cancer?** It is safe for cancer patients to get dental X-rays. Dental radiography delivers a negligible dose of radiation compared to their cancer treatment. When caring for patients undergoing radiation therapy, a greater concern is the tissue in their mouth. It may be much more sensitive than normal due to cancer treatment. Providers should be very careful to avoid wounding a patient when placing sensors in their mouth. **7. Can you comment on providers who, when working with children, may need to hold the radiograph?** If a child needs support holding a digital sensor or plate in their mouth, providers should recruit their parent or caregiver for assistance. Clinicians should never be the one to hold these devices in a child’s mouth. **8. Does wearing a lead apron hold radiation on the body or promote scatter?** Internal scatter radiation is when radiation interacting with one area of a patient’s body travels to another — for example, from their chest to their abdomen. Lead shields do not hold radiation on the patient or cause internal scatter, nor do they protect against it. **9. Will state laws need to catch up with the new guidance and when might that happen?** Some states, such as Michigan, do not currently require patient shields during dental X-rays. In similar states, dental teams should be able to implement the new recommendations immediately. In other states, such as California, lead aprons are required. While we would hope regulatory changes would take no longer than 6–12 months, updating rules can take some time. **10. How often should radiography equipment and lead aprons be replaced?** X-ray machines do have a lifecycle. Factors to consider for replacing them include: - Machines that use an alternating current should be replaced with ones that have a direct current. - Intraoral X-ray equipment should have a relatively high kVp. For lead aprons, their lifecycle depends on: - How often patients use them - If providers consistently handle them properly, such as storing them on hangers Visible damage is a sign that it’s time to replace an apron. **11. Is there written guidance urging dentists to order radiographs based on exams rather than set intervals?** The ADA’s new priority recommendations include: - Providers should order radiographs based on diagnostic and treatment planning needs, not on a set frequency. - Dentists should make a good faith attempt to obtain radiographs from previous exams. However, there is a recommended frequency for recalled bitewings. Providers should keep in mind two important points: - Rather than a set interval, the ADA advises a range of time, such as between 12 and 24 months or between 24 and 36 months. - This frequency is just a recommendation. Each patient may be different. Recalled bitewing radiographs should be based on each patient’s circumstances, such as their age, specific caries risk, or findings from a clinical exam. This aspect of care should be a patient-centered decision. **Categories:** Blog **Tags:** Clinical Practice --- ### [Memorable Sessions, Hot Topics, and Three Key Takeaways from the 2024 National Oral Health Conference](https://carequest.org/blog/memorable-sessions-hot-topics-and-three-key-takeaways-from-the-2024-national-oral-health-conference/) **Published:** April 23, 2024 **Author:** Caitlin Locklear **Content:** Last week, the [National Oral Health Conference](https://www.nationaloralhealthconference.com/1150-2/) (NOHC) celebrated its 25th joint meeting of the [Association of State and Territorial Dental Directors](https://www.astdd.org/) (ASTDD) and the [American Association for Public Health Dentistry](https://www.aaphd.org/) (AAPHD) in St. Louis, Missouri. The conference is considered a “premier meeting for dental public health” — and CareQuest Institute was proud to be the Platinum Sponsor of this year’s event. With a total of 9 weekend workshops, 46 oral sessions, 48 round table presentations, and 78 poster presentations, the 2024 NOHC provided the opportunity for 750 attendees — including oral health professionals, researchers, and all interested in dental public health — to connect and engage in enriching discussions of how to lead efforts toward improving the oral health of the public. ## What Was Everyone Talking About? The Welcome & Plenary session, *Advancing Oral Health Equity: Perspectives from the Federal Front*, set the tone of the conference, highlighting current agency-based strategies and initiatives advancing oral health equity across the lifespan. This well-attended session affirmed the collective acknowledgment from the federal front of the connection between oral health, physical, and behavioral health, and the continued work necessary to advance oral health equity. ![](https://carequest.org/wp-content/uploads/2024/04/Kelly-and-Hannah-at-the-Booth-scaled.jpg)Hannah Cheung and Kelly Schroeder at NOHC A recurring theme of several sessions included the importance of community engagement in oral health systems, data collection, and research. CareQuest Institute’s very own Kelly Schroeder, RDH, MS and Hannah Cheung, MPH, MS, RDH, presented alongside Scott Darius, JD, in a session entitled *Equitable Data Collection, Analysis, and Dissemination: Creating Standards and Protocols*. These presenters discussed the importance of community input in data collection and storytelling. This well-attended, interactive session introduced the topic of equitable data collection — a framework used to better recognize the perspectives and experiences of communities to improve barriers to oral health. Speakers emphasized the role of community voice in providing a more accurate and complete picture to determine what is most needed to support community members. Annaliese Cothron, DHS, from the American Institute of Dental Public Health (AIDPH) reiterated similar messaging in *Dismantling Disparities and Empowering Marginalized Communities in Oral Health Research*. Cothron discussed the benefits of a community-engaged oral health research approach and introduced the AIDPH Oral Health Community Advisory Board — an effort to engage historically marginalized community members with valuable insights to better inform patient-centered outcomes and comparative effectiveness research. ![](https://carequest.org/wp-content/uploads/2024/04/NOHC2024_Welcome-Poster.jpg)NOHC 2024 ## A Focus on Innovation and Integration It was exciting to hear many speakers emphasize that expanding access to oral health coverage (e.g., through Medicaid or Medicare) is necessary, but not sufficient, to making oral health care more accessible, equitable, and integrated for all. Even if all children and adults had some type of coverage for oral health care, there still exist barriers to receiving oral health care that create inequities. Nearly [70 million individuals in the US live in a dental health provider shortage area](https://www.ncsl.org/health/workforce-strategies-to-improve-access-to-oral-health-care#:~:text=Nearly%2070%20million%20Americans%20live,high%20needs%20in%20the%20community.), requiring those individuals to travel long distances and [miss time away from work or school](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs) to receive oral health care. Adults who experience [discrimination in the oral health care setting](https://www.carequest.org/resource-library/discrimination-and-dignity-experiences-prior-oral-care-visits-predict-racialized) are less likely to plan to see a dentist for preventive care. Further, only about [one-third of dentists](https://www.ada.org/en/resources/research/health-policy-institute/coverage-access-outcomes/dentists-in-medicaid) in the US treat patients with Medicaid dental insurance. In an effort to address some of these factors, NOHC included exciting discussions about innovative care delivery methods and systems such as [teledentistry](https://www.carequest.org/topics/teledentistry), [virtual dental homes](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477859/), and integrating oral health care into primary care and behavioral health settings. As an example, speakers from the Children’s Health Alliance of Wisconsin discussed a successful program in which, to date, 18 dental hygienists have been fully integrated into pediatric and obstetric clinics across 11 health systems. This program is made possible by [Direct Access](https://www.adha.org/advocacy/scope-of-practice/direct-access/), or the ability of a dental hygienist to provide care without the specific authorization or supervision of a dentist. As of 2021, 42 US states permit direct access to dental hygienists, making integrating dental hygienists into non-dental settings a feasible option in most states. Of note, CareQuest Institute was cited in many presentations throughout the conference as a key reason an organization or group was able to turn an idea for a research project or program into a reality. Examples of this include the [MOTIVATE at Home Program](https://lunderdineen.org/program/motivate-at-home-portal/), an oral health education program designed particularly for care partners of older adults, in addition to the [Schuyler Center’s Future Oral Health Workforce Project: Oral Health Equity Through Workforce Design](https://scaany.org/oral-health/oral-health-workforce/). ## Top 3 Takeaways from St. Louis What are the top three learnings we’re taking back as we focus on the work ahead in 2024? ![](https://carequest.org/wp-content/uploads/2025/01/Lisa-Heaton-Web.gif)Lisa Heaton, PhD 1\. Truly integrating medical care, oral health, and behavioral health requires buy-in, adaptability, and ongoing support from multiple stakeholders. We may think of this type of integration as something decided upon and decreed by organizational leadership. However, these efforts will likely not be implemented successfully, and most certainly will not be sustained, without full participation and enthusiasm from funders, health care providers, staff members, communities, patients, and patients’ caregivers. True integration requires a collective, sustained effort to produce meaningful change in individuals’ oral, behavioral, and overall health. 2\. When considering interventions to improve a community’s health, researchers must engage with the community from the very start to establish collaborative efforts, centering the community and its needs and desires. While researchers may have expertise in designing oral health interventions, the members of the community most impacted by inequities are most knowledgeable about what is most needed by the community and what types of interventions would be most relevant and acceptable to its members. The lived experience of community members is just as important as the technical expertise of the researchers in developing effective and sustainable efforts to improve a community’s health. ![](https://carequest.org/wp-content/uploads/2024/04/Paige_Martin_FINAL.jpg)Paige Martin 3\. Data collection must expand beyond what is considered “standard” in the research world. Equitable data collection should accurately reflect the communities in which it is used, rather than employing a few broad response categories that can mask true inequities. Additionally, storytelling is another form of data collection that provides rich, descriptive material that adds to the understanding of a community and its needs. We cannot change what we cannot identify. Using community input to most accurately reflect the identities and needs of their members is critical to helping a community design efforts to improve their health. *Authored by Lisa J. Heaton, PhD, and Paige Martin, science writers at CareQuest Institute* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Addressing an Unmet Need: Providing Oral Health Care for Adults with Disabilities](https://carequest.org/blog/addressing-an-unmet-need-providing-oral-health-care-for-adults-with-disabilities/) **Published:** April 29, 2024 **Author:** Caitlin Locklear **Content:** As a clinical assistant professor and dentist at the University of Florida (UF) College of Dentistry, Bryan Smallwood, DMD, MPH, CPH, has cared for thousands of patients. One in particular stands out to him. “I have a patient who had been to the operating room many times because other dentists couldn’t treat him,” Smallwood says. ![](https://carequest.org/wp-content/uploads/2024/04/UF-at-the-Arc-Blog.jpg)Bryan Smallwood, DMD, MPH, CPH, provides care at the Arc of Alachua County. That patient was an adult who had developmental differences and was very anxious when he received dental care. “I had a long chat with \[one of his family members\], and it turns out that he just wanted to see what was going on in his mouth,” Smallwood says. “And as long as he could see, he would sit there forever.” Smallwood says his patient is just one of many adults with an intellectual or developmental disability who struggle with accessing oral health care — a struggle exacerbated for people in northern Florida after the state government stopped funding outpatient dental services at Tacachale Developmental Disability Center in 2022. The center provided residential care and outpatient dental services for adults with developmental disabilities. Patients and caregivers were driving more than two hours to Orlando or Jacksonville just for a dental cleaning and facing long wait lists. “That created an even greater unmet need locally, and actually regionally, because there were so many people that were served there,” says Dan McNeil, PhD, the chair of the Department of Community Dentistry and Behavioral Science at the UF College of Dentistry. “But this is a pressing need across the country as well.” McNeil decided it was time for action. He applied for a CareQuest Institute grant, aimed at organizations working to address systemic barriers to oral health for people with disabilities. McNeil began assembling a team that includes Smallwood; Olga Ensz, DMD, MPH, clinical assistant professor and director of community-based outreach with the UF College of Dentistry; and Reeva Morton, PhD, BCBA-D, NCSP, and a board-certified behavior analyst and licensed and certified school psychologist at the UF College of Medicine and College of Dentistry. The team also includes Tim Garvey, DMD, a UF faculty dentist who has provided care to people with disabilities for decades; Whitney Haley, RDH, BASDH, a dental hygienist in the Department of Community Dentistry and Behavioral science who works in a UF-based statewide program for people with disabilities funded by the Special Day Foundation; and Frank Catalanotto, DMD, faculty dentist, and former dean and chair, who supports the team regarding its public health impact. ![](https://carequest.org/wp-content/uploads/2024/04/McNeil_Daniel_W._Headshot_2024-scaled.jpg)Dan McNeil, PhD “The CareQuest Institute grant helped us organize a group of people at UF and in the community to come together to say, ‘Okay, there’s this problem. Let’s work together,’” McNeil says. The $125,000 grant has allowed the College of Dentistry to collaborate with the Arc of Alachua County, an organization that supports adults with special health care needs. The Arc helps connect those adults with community services and make sure they have housing. Through UF’s new program, the Arc now also connects patients to dental services. And dentists have the time to dedicate to their patients there. “It takes that pressure off so we can really focus on providing the best care for these patients,” Smallwood says. “And we’re doing it on their timeline, not ours.” ## Taking the Time to Treat Special Populations Adults with intellectual and developmental disabilities face numerous challenges to accessing care. One of them is cost. Once they turn 21, public insurance payments typically are more limited. Many of them end up in the emergency room or operating room for dental emergencies. ![](https://carequest.org/wp-content/uploads/2024/04/Dr.-Smallwood-200x300.jpg)Bryan Smallwood, DMD, MPH, CPH With the help of the CareQuest Institute grant, Smallwood and the rest of the UF team started bringing in mobile dentistry equipment to the Arc in mid-April to treat those patients in that predicament. Each patient and parent/caregiver has a teledentistry appointment first, including an initial phone screening, where the dental team members can identify the patient’s dental treatment history and get a good idea of what to expect during an office visit. The dental team then sees the patient at the Arc on specified days to do an assessment of the patient’s mouth, address behavioral concerns by creating a task analysis, and figure out how to provide safe dental care. The team hopes to see between four and eight patients a day. “It’s a great technique for us to go out into the community, into places where specialty patients are comfortable, and see them,” Smallwood says. ## Training Dental Students for Special Care But it’s not just getting adults with an intellectual or developmental disability to the dentist — it’s also about finding a dentist that will care for that patient. That’s where Ensz and Morton come in, along with McNeil. ![](https://carequest.org/wp-content/uploads/2024/04/UF-at-the-Arc-2-181x300.jpg)Olga Ensz, DMD, MPH, (left) and another dental team member comfort a patient. Ensz and Morton, who focus on public health and behavioral health, are advisors on the grant. They say individuals with intellectual and developmental disabilities may communicate using nonverbal communication strategies, some may have sensory sensitivities, and others may have mental health diagnoses, such as anxiety, about going to their dental appointment. Ensz says there are many ways [dentists can help patients have a better experience in the chair](https://www.carequest.org/education/course/providing-oral-health-care-autistic-individuals/overview). “Providing things like social stories that show visual cues of what to expect,” she says. “Using things like rhythmic counting, providing distractions with different sensory items, weighted blankets, dimming the lights, seating them in a quieter room, playing soft music.” Ensz says part of the work she does is educate dental students to be able to treat patients of all ages with disabilities. ![](https://carequest.org/wp-content/uploads/2024/04/Olga-Ensz.jpg)Olga Ensz, DMD, MPH “It is challenging for many oral health providers — dental school is four years, and you have a lot of stuff jam-packed into that,” she says. “Sometimes the clinical training in working with special populations might involve very few of these sorts of opportunities, or it might be purely observational versus hands-on. So this is something that when I have dental students or dental hygiene students on a community-based dental outreach rotation, I want them to experience and learn.” Morton and McNeil are also able to use their experiences and education to show dentists how to care for special populations. “As a board-certified behavior analyst and licensed school psychologist, I’m able to implement some of the behavioral strategies that we are taught in the ABA classes, in combination with using the behavioral consultation models that we learned in psychology, to service the need of the patient,” Morton says. “The behavioral strategies vary for each patient including verbal statements that praise their cooperation, weighted blankets, taking breaks, visual schedules, or social stories. Then, after seeing how some positively respond to those behavioral strategies, I’m able to motivate the dentists to continue to incorporate those practices \[every day\] while they’re providing oral health care.” ![](https://carequest.org/wp-content/uploads/2024/05/Reeva-Morton-1.jpg)Reeva Morton, PhD, BCBA-D, NCSP McNeil, a clinical health psychologist, emphasizes the importance of desensitization, helping patients gradually cope with those aspects of dental care that they find anxiety-provoking. “Teaching dental students and providers about the psychological basis of desensitization, and how to implement it in the dental operatory with patients with disabilities, gives them a powerful method to help patients learn to be more comfortable with the novelty of dental care,” McNeil says. Smallwood says dental students rotate through a UF pediatric dentistry clinic, where they learn about treating children with special needs, but those patients can’t be seen after they age out. Dental students also need this training with adults with special needs. With this program the grant is providing, the goal would be to have every dental student spend a few weeks treating adults with special needs at the Arc. “We are a teaching institution, and everything we do we want to have some level of education involved with it,” Smallwood says. Ensz agrees. “I feel like as the only state-funded dental school, we have a responsibility to the community,” Ensz says. “Sometimes we’re the only place where people can go, and I think it’s important that we have a dedicated space because that’s what’s needed to provide care.” ## Expanding Better Care for Individuals with Disabilities The issue of finding care for adults with intellectual and developmental disabilities is not just a problem in Alachua County; it’s national. But Smallwood says this program the UF team has started is a step in the right direction to help people who live in and around the county. “This is the beginning of our answer to dealing with that problem,” Smallwood says. He and the rest of the UF team aspire to grow the program into a permanent place in Alachua County. “I hope that this grant is the foundation for building something that becomes a clinic that allows us to educate not just future dentists but also hygienists and other people on how to treat patients with special needs,” Smallwood says. “And hopefully one day it increases the access to care as oral health providers enhance their knowledge and skills in caring for patients with special needs.” **Categories:** Blog **Tags:** Special Patient Care --- ### [Voices from the Field: Dr. Reeva Morton on Integrating Behavioral Health with Oral Health](https://carequest.org/blog/voices-from-the-field-dr-reeva-morton-on-integrating-behavioral-health-with-oral-health/) **Published:** May 6, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)As a licensed and nationally certified school psychologist and board-certified behavior analyst, Reeva Morton, PhD, BCBA-D, NCSP has her feet in two places at once: the University of Florida’s (UF) College of Medicine and the College of Dentistry. “With projects in the College of Dentistry, I’m a behavioral consultant, which I love because I’m able to tie all my hats together with the goal to support children with special needs, whether it be a dentist, parent, or teacher,” Morton says. “I’m able to support them by using a collaborative team approach. I provide the caretakers with information on making the oral health experience a little easier for everyone, especially for those who may need some extra support.” She is now able to merge those two worlds even further as an advisor on a $125,000 grant to the UF College of Dentistry provided by CareQuest Institute. With that funding, the college uses [mobile dentistry equipment to provide oral health care to adults with intellectual and developmental disabilities](https://www.carequest.org/about/blog-post/addressing-unmet-need-providing-oral-health-care-adults-disabilities) at the Arc of Alachua County, an organization that supports adults with special health care needs. Providing this oral health care was UF’s answer to a problem that developed in 2022 when the state government stopped funding outpatient dental services at the Tacachale Developmental Disability Center, which provided residential care and outpatient dental services for adults with developmental disabilities. This left hundreds of adults with disabilities and their caregivers driving more than two hours away from Alachua County just to get a dental cleaning. “\[The grant’s\] even more important because with the Arc, a lot of the patients are what we would call ‘of age,’” Morton says, “so they’re over 18. They’re legally adults. Adults in general likely do not have an opportunity to receive oral health care \[through Medicaid\], and for an adult who has special needs, the chances are even smaller because they also cannot find a provider who will see them. So, with this grant, we’re able to tackle both areas of need.” Morton took a few minutes out of one of her busy days to share more about why the integration of behavioral and oral health care is critical to help people with developmental differences. **What kind of special care do people with intellectual and developmental disabilities need at the dentist?** It varies for each person. Some individuals with developmental differences have sensory needs, for example. ![](https://carequest.org/wp-content/uploads/2024/05/Reeva-Morton-1-278x300.jpg)Reeva Morton, PhD, BCBA-D, NCSP There are things they may avoid, but there are also things they seek. A dentist shining a bright light in their face when they’re laying back in the chair may be super uncomfortable, and some individuals may not have a way to communicate those sensory aversions or be able to tolerate the distress. Or they may really like the light, so turning the light off may make them upset and never move out of the chair. Some individuals may focus on certain things because they really like those visual stimuli. So, putting on glasses may not be something that an individual with a developmental difference is able to do as easily as someone who does not have those sensory needs. Or it could be the taste or the texture of something. If someone does not like the texture of the bib or the taste of the fluoride, they may just rip it off or spit it out and then never visit the dentist again because they associate the dentist with this sensory aversion. **Are there differences in communication style?** For some individuals with developmental differences, communication may be nonverbal. That could be in the form of eye contact or pointing, or very short two-word phrases, or it may be using a device to communicate. Others can communicate verbally but are not able to say how they specifically feel or what they need to feel comfortable at the dentist. **What was the moment you realized oral health and behavioral health were connected?** Before I came to UF, I was working in a private practice, and there was a family that I had seen for years, and their little girl was diagnosed with autism. The family told me the girl, who was younger than 5 at the time, had never been to the dentist before. I knew that all children should have an opportunity to go to the dentist, but I also knew the barriers that many families with developmental differences experience. She would put everything in her mouth. She also didn’t like wearing certain textures of clothes, would scream when she was upset, and she had a lot of what some clinicians would call “challenging behaviors.” But I’m the type of clinician who says, “Shoot for the stars.” So, that day, I searched on Google to find dentists in the area who see individuals with special needs, and I found one. I was excited but also curious to see how my little girl would be treated, so I volunteered to go with her, and the dental office was awesome. About every month we’d go to that dentist just to practice walking through the door, waiting for our turn, and sitting in the chair. She had to get used to the lights and someone covered in a mask. Now she’s able to open her mouth, lie back if we hold her, and the dentist can count her teeth. This experience taught me that I could collaborate with dentists on using behavioral strategies with a patient during a dental visit, and, in turn, the dentist could teach me things the patient and I could practice in between visits. We came up with innovative solutions to serve the little girl, and from that experience I realized that neither one of us in either expertise was able to meet her needs individually. We had to collaborate and work as a team. To this day I still refer families to that dentist. **As an advisor for the CareQuest Institute grant-funded initiative, how do you educate dentists on providing and accessing oral health care for people with developmental differences?** As a board-certified behavior analyst, I’m able to understand some of the strategies that we’re taught in the field of behavior analysis. I also have a background in psychology, so I’m also trained in human development, school- and community-based systems, neurodiversity, many types of consultation models, and effective treatment approaches. I combine both of my backgrounds and use behavioral consultation to approach this collaboration. Specific techniques I have used include tell, show, do; task analyses; first/then statements; positive reinforcement; visual contingencies; sensory breaks; social stories; and the importance of environmental changes. I’m able to show dentists how to incorporate those practices in their everyday setting while they’re providing care. **How about caregivers?** I can also provide caregivers and parents with support. That’s where my school psychology background comes in, because I can make sure the caregiver feels safe to bring their loved one in for oral health care visits and help break any barriers they may experience. I let parents know that even though their loved one may have Down syndrome, or autism, or cerebral palsy, or any other need, this does not mean that their oral health is not a priority. Oral health is just as important as mental or physical health. I usually can sense when others are apprehensive, so I can support the parent or the caregiver with psychoeducation and reassurance. Sometimes, they just want someone in their corner. **What is your hope for the future of this work?** Right now, through the grant, we’re providing oral health care with a mobile unit. We don’t have to have people come to the UF campus; we’re able to meet them in their community. But that mobile clinic is at the Arc of Alachua County and mainly focused on adults. Ideally, I would want to spread the interdisciplinary concept and include children in the community. Children and special needs have always been my focus. I completed my doctoral program in rural Mississippi and then interned in rural Nebraska. My family is in Mississippi, and I know so many people there who could benefit from a mobile clinic. It would also be nice to eventually serve people in rural areas and train dentists there on how to use these skills. We know there are people who live two to three hours away who definitely aren’t going to the dentist, and they may not even be able to go to the Arc. It would be really inspiring to reach those rural communities and maybe other states, or larger cities, would be able to model this outreach clinic. Some of those rural community members also have developmental differences. All in all, it is important for clinicians to continue to shed light on the concept of intersectionality and how that looks for each family. A verbal Black boy with autism who is wheelchair bound and does not have transportation is likely going to have a different experience than a nonverbal Asian girl with a rare genetic disorder, even though they both need oral health care. So, my idea for the future is making sure that the needs of all children are met, and oral health providers feel equipped to service them. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [What Do We Mean by Interoperability in Oral Health?](https://carequest.org/blog/what-do-we-mean-by-interoperability-in-oral-health/) **Published:** May 14, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2024/12/CQ_Ask-The-Experts-300x300.png)Welcome to the first installment in our blog series about transforming oral health! Every month, an expert from our Health Transformation team at CareQuest Institute will tackle a question from the oral health community covering one of three topics: - How care is provided - How payment is designed and delivered - How data and reporting are shared and utilized Making changes within these three areas will help move oral health toward value-based care, a system that ultimately rewards the quality of patient outcomes instead of the quantity of services delivered. ## I am hearing more and more about interoperability in oral health. What exactly does interoperability mean? ## Over the past few years, technology has changed the way we access and receive health care services. Behind the curtain, there is one key factor that makes it possible to share health care data: [interoperability](https://www.healthit.gov/public-course/interoperability-basics-training/HITRC_lsn1069/wrap_menupage.htm). When I think about interoperability, I think about “effective communication.” What is effective communication? It is the ability to listen, receive information, understand the information, process the information received, and formulate the proper response when necessary. The more effective the communication, the more both parties involved will have a higher chance of accomplishing the desired outcome they both seek. [Applying this principle to health care,](https://www.himss.org/interoperability-and-health-information-exchange) interoperability is the ability for different systems, applications, and devices to connect and share data bidirectionally. In addition, each system should be able to use the data in an effective, seamless, and coordinated manner without the need for user intervention. The seamless exchange and sharing of data among systems facilitates: - Improved care coordination - Fewer errors - Faster access to care - Fewer duplicate tests The ultimate result should be an enhanced patient experience and a more effective outcome. ## Interoperability in Action Let’s look at a scenario to see interoperability in action in an oral health setting: Dental offices regularly take X-rays to check for cavities and monitor our gums. (Sidenote: Guidance around dental X-rays has changed recently, [something we covered on a recent CareQuest Institute webinar](https://www.carequest.org/about/blog-post/answers-11-questions-about-new-recommendations-patient-shielding).) If you develop tooth pain and are referred to see a specialist — especially if that specialist is in a different network — it’s a challenge to share those X-rays. But what if there were a reliable way to share the X-rays with that specialist for review *before* you arrived for your appointment? With interoperability, your dentist can do just that, helping facilitate the creation of a proactive treatment plan to provide you with the best care. This can help to expedite diagnostics for the specialist, provide deeper context for the patient referral, and ultimately accelerate information sharing to minimize effort and provide a better patient experience. Unfortunately, faxing is still the most common method used to share X-rays and dental records with other specialists. Based on the fax machines being used, the received copy of an X-ray may not be legible, which means the imaging shared may be useless and require the specialist to retake X-rays before moving ahead with a treatment plan. But there is good news! As technology and interoperability continue to advance, and the implementation of DICOM standards (Digital Imaging and Communications in Medicine) increases in dental offices, sharing X-rays electronically is expected to become more prevalent. ## A Milestone — and the Journey to Better Care Coordination The 21st Century Cures Act was signed into law on December 13, 2016. In realizing the importance of interoperability, Congress included a provision for the [Office of the National Coordinator for Health Information (ONC)](https://www.healthit.gov/topic/about-onc) to develop and support a secure and trusted exchange framework to enable health information networks to share data at the national level. To achieve this, the [Trusted Exchange Framework and Common Agreement (TEFCA)](https://www.healthit.gov/sites/default/files/page/2023-11/TEFCA_2-Pager_Digital_508.pdf) was established by the [ONC](https://www.healthit.gov/topic/about-onc) and went live with the first set of qualified networks on December 14, 2023. The [Common Agreement version 2.0](https://www.healthit.gov/topic/interoperability/policy/trusted-exchange-framework-and-common-agreement-tefca) for TEFCA was recently released on April 22, 2024; it includes requirements to support Health Level Seven (HL7)– and Fast Healthcare Interoperability Resources (FHIR)–based exchanges to further the advancement of interoperability. TEFCA marks a significant milestone in advancing interoperability in health care by establishing the infrastructure for nationwide connectivity to support secure and seamless data sharing. Furthermore, this will enable data sharing across regional and state line boundaries to better support care coordination. As technology continues to evolve in oral health and in other specialties, I am confident that interoperability will make a profound impact on health care services, providers, payors, and patients by enabling different systems to communicate effectively and work together seamlessly. At CareQuest Institute, we will [continue to drive interoperability](https://www.carequest.org/topics/care-coordination-and-interoperability) by promoting inclusion of dentistry in data standardization, supporting health information exchange (HIE) initiatives, advancing policy and advocacy efforts, facilitating collaborative partnerships via grantmaking, and promoting innovation and best practices through education. ![](https://carequest.org/wp-content/uploads/2025/06/Renee-Clark-2025-200x300.jpg)Renee Clark *Authored by Renee Clark, Care Coordination & Interoperability Manager at CareQuest Institute* Editor’s Note: *Renee has more than two decades of experience supporting inpatient, emergency department, and outpatient care settings. Throughout her career, Renee has directed various health care IT initiatives including meaningful use, integration, and interoperability with client EHR systems. Notable achievements include leadership on a statewide CMS meaningful use project to assist providers, as well as serving as interoperability consultant for the Office of the National Coordinator for Health Information Technology on their vendor EHR certification program.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Pregnancy and Oral Health: 8 Answers that Cut Through the Myths](https://carequest.org/blog/pregnancy-and-oral-health-8-answers-that-cut-through-the-myths/) **Published:** May 16, 2024 **Author:** Caitlin Locklear **Content:** Medical and oral health experts have long agreed that dental care in pregnancy is safe, effective, and important. Untreated dental disease can lead to pregnancy complications and raise the risk of cavities in childhood. However, [more than 8 in 10 obstetricians don’t use oral health screenings in prenatal visits](https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan). And some dental providers may also still hesitate to treat pregnant people. To clarify the facts, CareQuest Institute for Oral Health and the American College of Obstetricians and Gynecologists (ACOG) [held a webinar that drew nearly 1,000 learners](https://www.carequest.org/education/webinars/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy). Moderated by Jane Grover, DDS, MPH, senior director, Council on Advocacy for Access and Prevention, American Dental Association (ADA), the webinar’s panelists included an obstetrician-gynecologist (OB-GYN) and a dentist:![](https://carequest.org/wp-content/uploads/2024/05/Pregnant-Woman-at-Doctors-Office-Blog-Post-1.jpg) - Hector Chapa, MD, FACOG, Assistant Clinical Professor, OBGYN, Texas A&M University, 2024–25 ACOG Fellow At Large, Texas A&M Health, ACOG - Elizabeth Vi Simpson, DMD, General Dentist, Chair of the Council on Advocacy for Access and Prevention for the ADA After robust presentations, the experts answered several thought-provoking questions for the learners. Here are the top eight. (Note: The answers have been summarized; you can [view the full webinar](https://www.carequest.org/education/webinars/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy), including the Q&A, in the CareQuest Institute webinar library.) **1. How do you approach caring for someone who has lacked consistent dental services in the past and now has dental insurance limited to the duration of their pregnancy?** First, start by welcoming the patient. Providers might begin by saying, “I’m so glad you’re here. I’m so glad you realize the importance of getting dental care.” Then, assess their needs to create a treatment plan to progress through the time limitation of their insurance coverage: - For patients with relatively good oral health who are symptom-free, prioritize treatment from the smallest to the largest areas of concern. - For patients with more urgent oral health needs, address the most time-sensitive needs first. Share that you want to address all serious concerns while they have coverage, offering to schedule back-to-back appointments if they are willing to come in. As the patient’s coverage comes to a close, refer them to local community health centers where they can receive dental services on a sliding-fee scale. **2. What defines a high-risk pregnancy, and when should dental providers seek guidance from the OB-GYN?** A “high-risk” pregnancy is a broad designation. Chronic diseases such as diabetes or asthma may lead to high-risk pregnancies, but they won’t impact oral health unless they are uncontrolled. Some specific heart conditions may have the greatest dental implications: - Endocarditis, a dangerous infection of the heart’s lining - Uncorrected cyanotic heart disease, which lowers the oxygen level in the blood - Prosthetic heart valves or uncorrected heart valve issues Dental providers can collaborate with a patient’s obstetrician and cardiologist to manage these illnesses. While patients carrying twins or triplets may not be high risk, they could need other dental care accommodations. For example, they may have difficulty lying down due to pressure on their organs. Adapting chair inclines and using rolled blankets can give relief. In every case, providers should address pregnant patients’ dental needs as soon as possible. [One study in *Infectious Diseases in Obstetrics and Gynecology*](https://www.hindawi.com/journals/idog/2006/051931/#abstract) recounts how a pregnant woman’s cracked tooth caused a life-threatening infection, requiring emergency surgery. **3. Is it safe to use local anesthesia when treating people who are pregnant?** In most cases, yes. Unless a patient’s obstetrician advises otherwise, one or two carpules of local anesthetic that contain epinephrine, for example, is usually standard practice and can be well tolerated. Local anesthetic is also often used to treat pregnant people for non-dental procedures, such as for oral biopsies where cancer may be a concern. **4. If members of our dental team are pregnant, should they take precautions when it comes to giving patients nitrous oxide?** Nitrous oxide is a safe analgesic to use in sporadic, therapeutic doses during pregnancy. It is given to some patients during labor. However, in dental practices using it routinely, pregnant oral health providers should leave the room to reduce their own repeated exposure. **5. What should providers tell patients who want their teeth whitened during pregnancy?** While teeth whitening and other cosmetic procedures may not pose any real risk to a patient’s pregnancy, providers should encourage people to consider postponing these services until after they give birth. It may be in their best interest to wait, since teeth sensitivity, nausea, and similar conditions are already an issue for most pregnant people. **6. Can you comment on the new ADA guidelines recommending that patients no longer use lead aprons to shield their pregnancy when getting dental X-rays?** CareQuest Institute and the ADA explored this guidance in a [recent joint webinar](https://www.carequest.org/education/webinars/exploring-new-recommendations-patient-shielding-during-imaging). Some states still require use of lead shields. Providers should follow their state’s mandates. In states that no longer require shielding, providers should engage in shared decision-making. Discuss the new recommendations with patients. If getting an X-ray without a shield will cause them undue anxiety — whether or not they are pregnant — there is little harm in letting them use a lead apron. Doing so can calm anxiety and benefit their mental health. **7. Some pregnant patients may have bleeding gums, especially if they have not had regular access to dental care. What could be some reasons for this symptom, and how should providers treat it?** Pregnant patients may likely have gum disease and need scaling and root planing if one or more of the following are true:**![](https://carequest.org/wp-content/uploads/2024/05/Pregnancy-Ultrasound-Blog-Post.jpg)** - Their gums bleed easily after being probed. - They have bone loss, which may be indicated by tooth mobility. - They have such severe plaque/tartar buildup that it can be seen on a radiograph in many locations. Unless a pregnant person is immunocompromised or high risk, regular periodontal (gum disease) treatments and devices are safe to use. The small amounts of bacteria potentially entering their bloodstream from this treatment are typically well tolerated by most patients. It’s critical to address their gum disease to avoid infection later in pregnancy. **8. Should oral health providers always seek a letter of clearance from a patient’s OBGYN or pursue a standing order?** Both the ACOG and the ADA agree that dental care is safe during pregnancy. But it’s always okay to reach out to the OB-GYN. Dental providers can ask, “Is there anything else this patient is being treated for within their pregnancy that I should know about?” This is also an opportunity to establish a working collaboration with that office for consistent communication. Providers should feel free to request a letter of clearance. But first consider if the letter will become an obstacle to care, and where providers’ concern is coming from. Chances are it is to allay legal fears, rather than medical concerns. Oral health providers should feel confident treating pregnant patients. *Editor’s note: You can* [*view the full webinar* ](https://www.carequest.org/education/webinars/exploring-myths-and-misconceptions-about-oral-health-and-pregnancy)*in the CareQuest Institute webinar library.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [The Strength of Stories: Arizona’s Journey to Expand Medicaid Adult Dental Benefits](https://carequest.org/blog/the-strength-of-stories-arizonas-journey-to-expand-medicaid-adult-dental-benefits/) **Published:** May 20, 2024 **Author:** Caitlin Locklear **Content:** Nearly all Arizonans say oral health is important to them. But not all Arizonans have an easy time accessing care — especially those individuals without dental coverage. Arizona Medicaid adult dental benefits only cover emergencies and are capped at $1,000 with very few exceptions. For almost a decade, the [Arizona Oral Health Coalition (AZOHC)](https://azohc.org/) has been working to change that and expand the Medicaid adult dental benefit in the state. Stories have been at the heart of that work — stories like Janessa’s. “I was in a crosswalk and struck by a bus,” Janessa, who is insured through state Medicaid, told AZOHC. “With dental, you’ll go to the emergency room, and they’ll treat anything but your teeth. And your teeth can be hanging, and they will give you antibiotics and tell you, ‘Go to a dentist.’ The only thing they will do for emergency dental is pull your teeth, but then I’d be walking around with no three front teeth. This isn’t appearance, this is health. Teeth are your health. You get an infection. You can get very ill. It can be deadly.” Another Arizonan, Kenard Uber, testified in front of a Senate committee meeting about his struggles in accessing oral health care. “My perspective on this matter comes from lived experience, as someone who has navigated substance use recovery while relying on Medicaid and facing dental adversities,” Uber testified. “In the realm of recovery, I’ve witnessed numerous individuals grappling with untreated dental issues and oral pain due to financial constraints. Many of these individuals are currently reliant on Medicaid for their health care needs. Let’s focus on the significance of addressing emergency dental pain. This type of pain often becomes a catalyst for opioid addiction and relapse. Comprehensive dental services could play a pivotal role in mitigating this issue.” With the support of grants from CareQuest Institute, AZOHC is working to show legislators in the state the importance of oral health and its relationship to overall health. Brianna Miller, coordinator for AZOHC, continues to lead the effort. “A really important aspect of the development of that campaign started with an understanding that data and numbers around cost savings are important,” Miller says. “But the true power lies in the experiences of Arizonans who have been most impacted by oral health disparity.” ## Progress and Persistence to Fund a Dental Benefit ![](https://carequest.org/wp-content/uploads/2024/05/1000011128-1-scaled.jpg)Man wearing AZOHC shirt organizes shirts outside Capitol In 2019, AZOHC first advocated for a dental benefit that would help pregnant people. “But ultimately, because of the cost as well as a sort of general unwillingness to expand Medicaid or some very fiscally conservative politics, we never saw that bill cross the finish line,” says Miller. In 2020, CareQuest Institute helped facilitate an agreement between AZOHC, a grantee, and another grantee, Children’s Action Alliance, to work together on a shared vision of oral health advocacy. Through this partnership, the coalition started to develop a campaign called “Oral Health Is Essential Health” to begin advocating for a comprehensive benefit at the state legislature. “We set out to talk to Arizonans living in rural areas, BIPOC Arizonans, veterans, pregnant women, those with disabilities, foster youth. We tried to capture as many diverse voices as we could,” Miller says. “And we’re able to hear their stories and their experiences on being able to access or not being able to access oral health care in Arizona.” In 2023, with the help of the campaign and personal experiences from people like Kenard and Janessa, AZOHC made some progress. “We saw a preventive benefit,” Miller says. “So, this benefit was not fully comprehensive, but it was looking at providing some very basic benefits — two exams, one X-ray, and two basic cleanings per year.” It passed through the state House and Senate, but it wasn’t funded in the budget. “But that was really encouraging as we hadn’t seen an oral health bill make it that far in a while,” Miller says. This year, they tried again — this time with a comprehensive bill. “This comprehensive bill is a simple bill: It just changes the word prevent\[ive\] to comprehensive. So of course, the different services and things that would be included in that would be worked out through rulemaking administratively,” Miller says. The bill passed in the Senate with bipartisan support, but also, like the last bill, will be tied up in the budget. “There’s a pretty steep deficit this year, so we knew that going into this year we likely wouldn’t see something pass,” Miller says. Still, voices matter. And the volume is growing. “We brought over 50 oral health advocates out to educate lawmakers \[during Lobby Day\],” Miller says. “We were able to leverage some pretty compelling data this year — which was also supported by CareQuest Institute — on the long-term cost savings that are associated with an adult dental benefit. And I think we’ve secured a pretty solid pathway for future success when we see some budget windfalls.” What’s next for AZOHC? “We hope to continue educating lawmakers,” Miller says, “and build momentum around a comprehensive benefit, which we know will benefit the majority of Arizonans that need this oral health care.” **Categories:** Blog **Tags:** Dental Coverage --- ### [Oral Health and Aging: Improving Access to Care for Older Adults](https://carequest.org/blog/oral-health-and-aging-improving-access-to-care-for-older-adults/) **Published:** May 30, 2024 **Author:** Caitlin Locklear **Content:** More and more baby boomers turn 65 every day, the magic age of Medicare eligibility. Recent estimates predict that [95 million](https://www.carequest.org/resource-library/push-add-dental-coverage-medicare) seniors and people with disabilities will count on Medicare for their health insurance by 2060. But gaps in oral health coverage and care delivery for people enrolled in Medicare suggest the nation may not be ready to meet their needs — [millions of adults](https://www.carequest.org/resource-library/snapshot-765-million-americans-without-dental-insurance) who use Medicare lack adequate dental coverage. The program still excludes routine dental care as a standard benefit, and coverage varies in Medicare Advantage plans. Oral health coverage opens a critical door to timely care. Without access to care, adults face far-reaching health and economic consequences. Existing dental problems and medical conditions can worsen, becoming more dangerous and expensive to treat. Improving access to care is also a matter of health equity. These consequences most harm seniors of color, those in rural communities, and others. Policymakers, health care leaders, and advocates can bring needed relief to Medicare-enrolled adults by advancing solutions to this deep-rooted challenge. Strengthening coverage and adopting medical-dental integration (MDI) are opportunities to promote equity, reduce costs, and improve older adults’ well-being — today and in the future. ## The Importance of Dental Care for the Elderly At every [stage of our lives](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), oral health is connected to our overall health. It’s especially important for older adults because the risk of dental concerns increases with age. In addition, over half of seniors live with at least [two chronic conditions](https://www.carequest.org/resource-library/beyond-nice-smile), such as high blood pressure and diabetes. Poor oral health can make these illnesses harder to manage.![](https://carequest.org/wp-content/uploads/2024/05/Toothache.jpg) Dental problems can also increase the risk of other [serious health challenges](https://www.carequest.org/system/files/CareQuest-Institute_Beyond-A-Nice-Smile_Older-Adults_patients.pdf): - Adults with fewer teeth are more likely to develop memory loss, Alzheimer’s disease, and [greater overall disability](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach). - Seniors with dental disease are at [higher risk of cancer](https://www.carequest.org/resource-library/beyond-nice-smile), including of the mouth, breast, and prostate. - Poor dental health is also [tied to pneumonia](https://www.carequest.org/future-medicare-and-oral-health) and cardiovascular disease, risks that grow with age. Many of these illnesses disproportionately hurt seniors of color, adults with low incomes, and people in rural areas. They face steeper barriers to dental care than their peers. The good news is that using dental care [can decrease](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) these harms as we age: - Among middle-aged adults, non-invasive treatment for gum disease is tied to a [reduced risk](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) for heart disease. - Elderly adults between 75 and 80 years old were [less likely](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) to develop dementia upon receiving five or more treatments for gum disease. Unfortunately, access to care remains elusive for too many. Lacking dental coverage when they’re most at risk of illness, seniors now face a spike in unmet dental needs. ## ![](https://carequest.org/wp-content/uploads/2024/05/Senior-Man-X-Ray-scaled.jpeg) ## The Gaps in Access to Oral Health Care While many adults have dental insurance through their job or union, [many older adults don’t have that option](https://carequest.org/resource-library/uninsured-and-need). A 2023 [nationwide study](https://www.carequest.org/resource-library/uninsured-and-need) from CareQuest Institute revealed the extent of gaps in dental coverage among seniors: - Adults aged 60 and older are more likely than younger populations to lack dental insurance. - One in three older adults enrolled in Medicare do not have dental coverage. Without adequate coverage, the cost of dental care is often an [insurmountable obstacle](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare). Other hurdles to getting dental care include lack of transportation, too few oral health providers in a community, and discrimination in the health system. The COVID-19 pandemic [exacerbated these barriers](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic). Recent data show how inequitable access to care has long harmed seniors enrolled in Medicare: - Overall, [1 in 4 adults aged 65 and older](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) has not had dental care in more than two years. - [7 in 10 Black seniors and 6 in 10 Hispanic seniors](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) have gone without dental care for over a year. - About [1 in 5 older adults](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) in rural communities has not seen a dental provider in more than five years. Placing care out of seniors’ reach puts them at greater risk for a range of [dangerous conditions](https://www.carequest.org/resource-library/beyond-nice-smile). These diseases not only take a toll on adults’ quality of life, but often require treatment that is more costly than routine dental services. ## Improving Adult Dental Care: Coverage, Costs, and Integration Leaders can effectively address the shortcomings in access to care for people enrolled in Medicare. Many solutions are within reach, including policy and systems-level change: **1. Federal policymakers can advance measures to add a dental benefit to Medicare knowing the public strongly supports it.** CareQuest Institute research reveals [strong public consensus](https://www.carequest.org/resource-library/push-add-dental-coverage-medicare) for Congress to pursue Medicare dental coverage: - A [majority of adults](https://www.carequest.org/resource-library/push-add-dental-coverage-medicare) (94%) agree with adding a dental benefit to Medicare. - A new Medicare dental benefit has [broad support](https://www.carequest.org/resource-library/push-add-dental-coverage-medicare) from adults across racial and demographic lines and across the political spectrum. - People with unmet dental needs and poor oral health want better access to care. With an advocate-led movement behind them, federal lawmakers have renewed momentum to advance a dental benefit in Medicare. Current legislation proposing this solution is the Medicare Dental Benefit Act, championed by Rep. Nanette Díaz Barragán (D-CA) and Senator Ben Cardin (D-MD). **2. Health industry leaders can strengthen medical-dental integration (MDI) to benefit adults’ health and lower costs.** Two unique examples illustrate MDI’s promise to improve people’s well-being and protect adults’ economic security: - When pediatricians conduct an oral health assessment during an annual well-child visit, children are [more likely](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) to later have a preventive dental visit. This can set them up for good oral health as they age. - MDI can also reduce costs. [Studies suggest](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) that diabetic patients who get treated for active gum disease could save an average of $5,904 in health expenses. Success with MDI depends on several factors. One critical aspect is ensuring health partners follow a [life-course approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), where care teams respond to our oral and systemic health throughout our lives. Other success strategies include: - Supporting [provider education](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) and training - Investing in critical infrastructure to share patient information, such as adopting integrated [electronic health records](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) - Understanding this approach requires a [shift across organizations](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), leadership buy-in, and ongoing work to close medical-dental referral loops **3. Advocates and providers can educate patients about MDI and their ability to speak out for stronger Medicare coverage.** Oral health leaders, older adult advocates, and those enrolled in Medicare can talk with lawmakers about [why adding](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) a dental benefit to the program is critical. Advocates [can educate](https://www.carequest.org/advocacy) Congress about the links between oral and overall health. Individuals can make all the difference by sharing personal stories about what better coverage would mean to your life or that of a loved one. By taking these steps, we can get closer to creating a future that meets the oral health needs of all older adults. **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [How Can You Promote Health Equity in Your Organization?](https://carequest.org/blog/how-can-you-promote-health-equity-in-your-organization/) **Published:** June 11, 2024 **Author:** Caitlin Locklear **Content:** As dental professionals and health care providers, we should recognize that every patient is unique in their care needs and will have specialized, unequal, treatment plans. In other words, dental clinics should promote health equity.![](https://carequest.org/wp-content/uploads/2024/12/CQ_Ask-The-Experts-scaled.png) What is health equity? Oral health equity ensures that all individuals have fair and just access to oral health care regardless of their race, ethnicity, geographic location, socio-economic status, and numerous other social drivers of health that impact how individuals can access oral health care. But health equity is not the same as health equality. Health equality refers to a state where everyone is provided the [same opportunities, care, and services](https://www.medicalnewstoday.com/articles/health-equity-and-health-equality). **So, promoting health equity in your dental clinic means recognizing that different patients, staff, and communities all have unique needs and may not benefit from getting equal treatment.** Thus, the actions you take and the resources you provide may not be equal, but they are instruments of equity all the same. For example, equal treatment would be to provide translation services for all your patients regardless of their needs. However, providing translation services for patients who do not speak English or are hearing impaired is equitable. ## Recognizing Patients’ Barriers to Care, Health Disparities, and Cultural Differences In addition to understanding what health equity means, recognizing privilege will also provide an opportunity to identify gaps in care. But it is much easier to identify gaps that you have personally experienced rather than the disadvantages that some of your patients face. Ask yourself some questions to identify those privileges: 1. Do I have a home? 2. Am I worried that I won’t be able to eat dinner tonight? 3. Am I worried about transportation? Your answers and those of your patients could be very different. Now that you are aware of your privileges, evaluate how your dental clinic may be able to help patients who do not have that same privilege. Is there something you can modify in your dental clinic workflow that would make care more accessible for patients who encounter barriers such as finances, transportation, location, or language? Additionally, health disparities related to racial, ethnic, and socioeconomic backgrounds are prominent issues in our health care system. Overcoming these barriers begins with recognizing what you don’t already know. In a setting of working with diverse groups of patients, it is best to practice [cultural humility](https://www.carequest.org/education/webinars/connecting-caries-risk-assessments-and-cultural-awareness) — being open-minded and understanding that just because other’s ways are not your ways does not make them wrong. Sometimes you might be uncomfortable asking about cultural differences because you are afraid of offending a patient, but in our experience, most people appreciate the attempt to respect preferences and improve communications. Let patients know why you are asking these questions. You can simply say, “Our organization is trying to enhance its cultural awareness and learn more about you and your needs.” Asking about language preferences is usually an easy and comfortable way to jump into cultural discussions as well. Be sure to provide literature on health education materials targeted and tailored to the diverse populations you serve. Take the time to build relationships with your patients and make the effort to learn some simple phrases in their language; saying, “Hello,” and “Thank you,” in a patient’s preferred language goes a long way to show you care. By valuing diversity and acquiring cultural knowledge, you send a message of awareness and sensitivity. Intercultural communication requires understanding attitudes and perceptions of personal space, physical gestures, eye contact, and communication styles that lead to improved communication and trust. When you have a clearer picture of the patients and integrate cultural humility, you build an appreciation for differences in worldviews to better understand perceptions of dental-related illnesses as well as insights into how health decisions are made. ![](https://carequest.org/wp-content/uploads/2024/06/Wai-Sum-Leung-FINAL-scaled.jpg)Wai-Sum Leung, MS, RDH Our work at CareQuest Institute is grounded in health equity. From the education we provide to the research we do to the community organizations that we fund, we aim to dismantle unjust structures and systems that drive entrenched disparities. We invite you to learn more about [our work](https://www.carequest.org/topics/health-equity) and [explore past webinars](https://learning.carequest.org/#/catalog/e1597e24-1823-43fb-b6c5-4319bd2b8259) that focused on various aspects of health equity. *Authored by Wai-Sum Leung, MS, RDH, and Stephanie Clester, MA, RDH* Editor’s Note: *Wai-Sum Leung, MS, RDH, was born in Hong Kong and immigrated to the United States as a young child. Her experience in life has been significantly influenced and shaped by her identity as a person of color and an immigrant with English as a second language. She has had to balance the two cultures she grew up with and witness the struggles of her family navigating the US health care system with limited English proficiency. She is a project coordinator at CareQuest Institute, working to increase oral health access for disadvantaged and underserved populations. Her lived and professional experience drives her passion to promote health equity of all.* ![](https://carequest.org/wp-content/uploads/2024/06/Stephanie-Clester-Web.gif)Stephanie Clester, MA, RDH *Stephanie Clester, RDH, MA, serves as a clinical content and support specialist for CareQuest Institute. In this role, she focuses on utilizing research-supported and data-driven decisions to enhance educational projects aimed at supporting dental public health improvement programs, particularly in value-based care (VBC). With more than 30 years of experience in dentistry, Clester’s background includes clinical dental hygiene practice, VBC coaching, and a tenured position as a dental hygiene professor with a focus on health equity in public health, ethics, and health policy and advocacy courses.* **Categories:** Blog **Tags:** Health Equity --- ### [A Seat at the Table: Improving Oral Health in Wisconsin](https://carequest.org/blog/a-seat-at-the-table-improving-oral-health-in-wisconsin/) **Published:** June 17, 2024 **Author:** Caitlin Locklear **Content:** *“If they had a job, they could get real insurance and afford to get their teeth fixed.”* *“People are lazy if they have state insurance. They’re not as educated as others.”* *“Anyone could go to the dentist if they wanted to. They are choosing not to or not prioritizing it.”* These are common perceptions about patients who struggle to access oral health care — a frequent topic during Wisconsin Medical-Dental Integration (MDI) Advisory Council quarterly meetings. “It’s a lot of negative assumptions about people that are not true, and so it’s figuring out how to challenge that,” says Constance Gundacker, MD, MPH, an assistant professor at Medical College of Wisconsin (MCW). “How do you show that’s not actually the reality?” ![](https://carequest.org/wp-content/uploads/2024/06/Jenna-Linden.jpg)Jenna Linden, BSDH, RDH The council formed in 2019 thanks to funding from Delta Dental of Wisconsin and the Advancing a Healthier Wisconsin endowment at MCW to support the [Wisconsin MDI program](https://www.chawisconsin.org/initiatives/oral-health/wisconsin-medical-dental-integration/), a model that works to incorporate dental hygienists into pediatric and prenatal clinics and health systems. The program was created by MCW and the Children’s Health Alliance of Wisconsin. The Alliance is a grantee of CareQuest Institute. “\[The council\] includes stakeholders such as representatives from medical and dental professional associations, the state oral health program, health systems and centers, funding organizations and Medicaid managed care organizations,” says Jenna Linden, BSDH, RDH, the program leader for the Oral Health Initiative at the Alliance. “It has been there from the beginning to help inform and form the progress and change of MDI to hold us accountable.” It also serves to elevate voices that are often unheard. “Part of what we were doing with this CareQuest Institute funding is analyzing who we have at the table currently, and what experience they bring that we might not be aware of as far as their relationship to oral health disparities,” Linden says. “And then see where there are potential gaps that we need to fill.” ## Elevating Voices of People with Lived Experiences This year, the Alliance grant funds are focused on advancing the work of its Wisconsin MDI Advisory Council. Using [racial equity toolkits](https://collectiveimpactforum.org/wp-content/uploads/2023/02/Racial-Equity-Toolkit.pdf), resources, and mental models, and CareQuest Institute’s Continuum of Community Engagement, the council analyzed stakeholder perspectives and established a foundational understanding of what community engagement looks like and why it is a crucial part of informing the Wisconsin MDI model’s progress. ![](https://carequest.org/wp-content/uploads/2024/06/Connie-Gundacker.jpg)Constance Gundacker, MD, MPH Patient satisfaction and engagement was a part of the initial driver diagram for the Wisconsin MDI program. However, during the first few years of the program, participating clinics expressed a desire to improve understanding of patient satisfaction, and the Alliance and MCW learned there were varying levels of understanding of what community engagement means. With that knowledge, the organizations have been exploring what community engagement means so that all council members have the same foundational understanding. Council members say this is information they can take back to their respective organizations. At a council meeting in October 2023, the council was introduced to an exercise called “[Who Is At Your Table?](https://detroitfuturecity.com/wp-content/uploads/2021/06/CENTERING-COMMUNITY-VOICE-A-BLUEPRINT-FOR-INCORPORATING-LIVED-EXPERIENCE-INTO-THE-GRANTMAKING-PROCESS-rev.pdf)” to analyze who already had a literal seat at the council table and how to incorporate more community voices. Council members were asked to fill out a survey filled with questions from that exercise and other toolkits. They quickly concluded that they needed to add the voices of people with lived experience, such as caregivers of pediatric MDI patients or prenatal MDI patients. “One of the goals with this is to be able to make sure we integrate caregivers into the committee and give them a sustainable voice on our leadership committees throughout the state,” Gundacker says. With the input of those with lived experiences, MCW and the Alliance are making positive changes to the Wisconsin MDI program through: 1. Creating opportunities for community members to shape the direction of MDI efforts in clinics and health systems in ways that are tailored to the unique conditions of the communities they serve, and 2. Identifying and challenging some people’s negative perceptions of the struggle for underserved populations to access oral health care. “There are structural issues that are impeding people from getting here,” Gundacker says. “And we really need to work together to make those structural changes.” ## The Need for Medical-Dental Integration ![](https://carequest.org/wp-content/uploads/2025/10/portableDhcaddy_blog-rotated.jpg)A portable caddy is used by dental hygienists to assess patients The Wisconsin MDI program has worked on incorporating MDI into health systems for years. The need for MDI was driven by persistent oral health disparities in Wisconsin communities and the urgency to introduce dental prevention to children at a younger age. “I think it was partly just looking at the data and where there were gaps in care within Wisconsin,” Linden said. “For example, in 2017, data showed that there were 100,000 children ages zero to five years who were enrolled in Medicaid who were seeing their primary care physician for medical care, but never saw a dentist. So, we were seeing that gap and that huge opportunity that existed within the primary care visit where patients already were accessing care, or their families were. How could we leverage that opportunity?” In 2017, the opportunity to include dental hygienists in medical teams emerged following legislative adjustments that allowed dental hygienists to work independently in settings such as medical offices and nursing homes. “The nurse assesses the patient, followed by the doctor or pediatrician’s time in the room and their exam,” Linden says. “Then, typically, the dental hygienist would be next for about 5–10 minutes as part of that appointment in the exam room.” It’s a busy 5–10 minutes. “During that timeframe, they’ll do a dental hygiene assessment, fluoride varnish — they’ll apply silver diamine fluoride if it’s indicated,” Linden says. “They’ll provide anticipatory guidance and then identify the need for follow-up care.” The first large health system that enrolled in the program had a hospital that was spending significant amounts of time and money on general anesthesia operating room (OR) cases for kids who had rampant caries. “They also had surgeons who were wanting OR time for other surgeries beyond treating a mouthful of caries, and so that, too, was another turning point,” Linden says. “I think part of it’s a shift: We’re making an investment in prevention right now within this population, so that we can prevent these long-term costs and all of the ripple effects that are associated with children having caries.” The program has grown and now has integrated 13 dental hygienists into teams across five Federally Qualified Health Centers, two large health centers, and one nonprofit clinic in the state. On top of improving the council, MCW and the Alliance are also working on making the billing system more equitable, so that hygienists can bill insurance companies directly, no matter whether that patient has private insurance or state insurance. “Just trying to work through how we can better address billing challenges and inefficiencies, pinpointing what are the issues, and how can we brainstorm and test solutions to support sustainability and spread of the model,” Linden says. **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration --- ### [Voices from the Field: Dr. Lauren Gritzer on Conducting a Needs Assessment for a Native American Tribe](https://carequest.org/blog/voices-from-the-field-dr-lauren-gritzer-on-conducting-a-needs-assessment-for-a-native-american-tribe/) **Published:** June 27, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)In November 2020, Martha’s Vineyard Hospital (MVH) Dental Clinic, the only clinic on the island accepting Massachusetts Medicaid (MassHealth), closed, worsening health care disparities for the Wampanoag Tribe of Gay Head (WTGH). For many tribe members, including elders, removing local access to oral health care highlighted broader issues of limited provider availability, geographical isolation, and the challenges of traveling off-island for care. Lauren E. Gritzer, DDS, MPH, a dental public health resident at UCSF School of Dentistry, was spurred to action. “Driven by a desire to enhance access to health care and address the specific health needs of the tribe, who have historically faced significant inequities, I was compelled to undertake a needs assessment project,” she said. “It is essential for properly planning community-based initiatives.” ![](https://carequest.org/wp-content/uploads/2024/06/Lauren-Gritzer-1-296x300.jpeg)Lauren Gritzer, DDS, MPH Gritzer completed the assessment last year and earned the Leverett Graduate Student Merit Award for Outstanding Achievement in Dental Public Health. Her poster was on display at the recent [National Oral Health Conference in St. Louis](https://www.carequest.org/about/blog-post/memorable-sessions-hot-topics-and-three-key-takeaways-2024-national-oral-health). “This recognition underscored the potential of our project to bring meaningful change, especially for underserved communities like the WTGH,” she said. “Winning this award also increased the visibility of the project’s findings and recommendations, paving the way for broader policy changes and the implementation of similar health initiatives in other communities.” Below, Gritzer shares more about the project and the next steps. **Briefly, how did you go about the research?** The Wampanoag Community Needs Assessment (WCNA) aimed to comprehensively understand the oral and overall health needs of the WTGH, addressing challenges from individual to policy levels. It focused on evaluating oral health care access and utilization, identifying barriers, and developing targeted interventions to enhance health outcomes for the tribe. Martha’s Vineyard (MV) is considered a Health Professional Shortage Area by the Health Resources and Services Administration, with a score of 11. The WCNA was conducted using a comprehensive mixed-methods approach, combining qualitative and quantitative techniques to thoroughly understand the tribe’s healthcare needs. **How did you better understand the tribe’s needs?** Collaboration with stakeholders was essential. Key stakeholders such as the chairwoman, tribal chief, tribe council, and community members ensured the assessment was informed by those with a deep understanding of the tribe’s needs. To further our understanding and build trust, we attended tribal powwows. These gatherings allowed direct engagement with tribe members, providing vital insights for tailoring our approach to the tribe’s specific needs and values. We also: - Ensured we had an understanding of community assets and available resources - Reviewed previous needs assessments done from 2016 to 2019 - Conducted stakeholder interviews with 14 individuals - Completed a concept mapping exercise to visually explore the issues - Conducted a self-reported survey with questions from sources such as NHANES and PHQ-2 - Conducted a medical billing code analysis to assess expenditures and identify common health issues - Considered the ethical implications of our work to ensure we maintained trust and integrity **What were the results of the needs assessment? What did you find?** - **Access and Transportation Issues:** Ninety-one percent (91%) of WTGH reported having an oral health issue in the last year. In terms of WTGH adults, 73% encountered challenges in accessing oral health care, primarily due to lengthy wait times (39.7%) and high costs (34.9%). Regarding the children of WTGH, 76.5% faced access issues, notably the absence of a pediatric dentist and lengthy waits for appointments, each affecting 44.4%, alongside transportation difficulties. - **Service Availability and Insurance Challenges:** Participants noted the closure of the MVH dental clinic and the absence of a dentist at the island’s federally qualified health center as major barriers. The closure of the only clinic accepting public insurance underscored the tribe’s reliance on external health facilities. Stakeholder interviews revealed general dissatisfaction with local oral health service availability and quality. - **Economic Factors and Insurance Complexities:** Many faced upfront payment issues and delays in the tribe’s medical reimbursement system, with 57.1% finding it somewhat or not convenient. - **Community and Cultural Engagement:** There is a need to emphasize cultural competence in health services and develop programs sensitive to the cultural specifics of the WTGH. - **Concept Mapping Results:** Key themes from concept mapping included limited availability of services, accessibility and transportation issues, difficulties using insurance, lack of a centralized database, tribal/national policy, and health-related self-sufficiency. **Did anything surprise you about the research?** The closure of the MVH dental clinic significantly worsened access issues, highlighting the community’s heavy reliance on off-island services and exposing a vulnerability in the health care infrastructure. Transportation and geographical isolation also emerged as major barriers, with nearly half of adults and children citing them. Service gaps across all age groups, coupled with the absence of essential services like a resident dentist, severely hindered comprehensive care. Additionally, insights into cultural engagement underscored the need for culturally competent care, emphasizing its crucial role in improving effectiveness and fostering community trust. **What recommendations did you offer?** Through concept mapping, self-reported surveys, and analysis of medical billing codes, we identified seven key priorities to enhance health-related self-sufficiency within the WTGH community: access to care, transportation, streamlined reimbursement systems, implementation of an electronic health records system, health literacy materials, a coordinated referral system, and utilization of medical records applications. Additional recommendations included fluoridating the area of the island occupied by the tribe. **Could you highlight one or two recommendations and share a bit about why you chose them?** Two standout recommendations from the WCNA are the development of a portable oral health clinic and the implementation of a community-based clinical education (CBCE) program. These initiatives were chosen for their ability to directly address access barriers and improve healthcare delivery for the WTGH community. With the MV hospital dental clinic closure, for example, there’s an urgent need for a flexible solution to bring oral health services directly to the tribe. A portable oral health clinic allows for on-site care at homes and community locations, minimizing travel barriers. It’s especially beneficial for elders with mobility issues, ensuring they can access oral health treatments conveniently. The recommendation to implement a CBCE program involves formalizing partnerships between tribal health services and dental schools. This initiative was chosen for its dual benefit of improving access to care while enhancing oral health education. Dental students and residents can provide supervised care. This exposure enhances students’ skills and cultural competence, preparing them for diverse health care settings. Engaging students in CBCE encourages future health care providers to consider community health careers, potentially leading to sustained improvements in underserved areas. Both recommendations aim to strengthen the health care infrastructure for the WTGH by integrating educational and community resources. This scalable solution could benefit other Native American tribes with similar challenges, inspiring broader adoption across different tribal settings. By addressing the tribe’s unique challenges, these initiatives lay the groundwork for comprehensive healthcare solutions benefiting other Native American communities. **What are the next steps to put the recommendations into action?** To implement the WCNA recommendations, structured steps are in place, focusing on partnership establishment, formal agreements, and program implementation. Program design, implementation, and evaluation methods have been finalized, with all equipment acquired for the portable oral health clinic. The pending step is the signing of the memorandum of understanding by the Harvard School of Dental Medicine, marking the final stage before launching the initiatives. **More broadly, what are the implications of your research for the future of dental care? Can you say more about the need to “go to the patients”?** The research conducted for the WTGH has broad implications for the future of oral health care, especially for aging and vulnerable populations. With a substantial portion of the WTGH being elders, the study emphasizes the need to tailor care delivery to meet the needs of aging individuals. This population often experiences mobility issues, higher rates of chronic conditions, and increased vulnerability to oral health and health problems. The concept of “going to the patients” involves delivering health care services directly to the homes or community settings where elderly and vulnerable populations reside, reducing transportation barriers and providing care in a comfortable, familiar environment. This approach has shown success, particularly with geriatric and special needs populations, highlighting its effectiveness. Implementing mobile and portable clinics equipped to offer comprehensive oral health care is a practical solution that can be replicated in various rural and isolated communities. These clinics, along with mobile health technologies, provide a flexible approach to health care tailored to the specific needs of different populations, addressing disparities in access to care. The findings from this research could inform policy decisions to enhance health care accessibility for underserved populations. This might involve funding mobile health units, incentivizing providers to work in underserved areas, and improving infrastructure to support mobile health care delivery. Integrating mobile services into the health care system requires systemic changes to ensure their support and integration into existing networks and reimbursement systems. **How did your perspective on the Wampanoag Tribe (and the health of that community) change from before the project to after the project?** Initially, my understanding of the WTGH’s health needs and cultural aspects was limited and shaped by broad stereotypes. Through direct interactions with WTGH members and key stakeholders, as well as participation in community events like powwows, I gained a nuanced understanding of the tribe’s unique cultural practices, values, and health concerns. After the project, I developed a deeper appreciation for the complexities of health care delivery in isolated settings. With this understanding, my future work in public health will focus on advocating for community-specific, culturally sensitive health care models that can be adapted to communities that have issues with access to care. **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [How Community Voices Are Improving Oral Health in Utah](https://carequest.org/blog/how-community-voices-are-improving-oral-health-in-utah/) **Published:** July 9, 2024 **Author:** Caitlin Locklear **Content:** As a filmmaker, Paul Gibbs tells other people’s stories for a living. He didn’t know his own story — about trying to access oral health care — would have such a profound impact. “My dental care experience turned out to be much more expensive, invasive, and painful than it needed to be,” Gibbs says. “And it was because while my doctors had recognized that oral health is part of the overall larger picture, my insurance didn’t.” In 2009, Gibbs needed a kidney transplant because of ongoing issues. That transplant was covered by Medicare and Medicaid, but first he would need to get evaluated. ![](https://carequest.org/wp-content/uploads/2024/07/Paul-and-Timmy.jpg)Paul Gibbs speaks to audience while holding son “The workup of my heart, lungs, brain, and everything else was covered by Medicare and Medicaid,” he says. “But they required a dental exam, which wasn’t covered.” Through donations and help from friends and family, he was able to raise the funds for the exam and was eventually approved for the transplant. But the dentist found other issues Gibbs would have to take care of over the next few years. “By the time I actually had dental insurance to get them dealt with, I had teeth literally falling apart in my mouth,” Gibbs says. “And when I was able to get dental care for some of them, I ended up having to have a couple of teeth extracted. One had become fused to the bone, and it was an extremely painful extraction.” Gibbs’s story is unfortunately not a rare one. He and many others have shared their oral health care experiences with [Utah Health Policy Project (UHPP)](https://www.healthpolicyproject.org/), a health care policy and advocacy organization that focuses on physical, behavioral, and oral health care. UHPP, which receives funding from CareQuest Institute, is focused on ensuring there is a smooth rollout for the state’s Medicaid dental coverage this year. ![](https://carequest.org/wp-content/uploads/2024/07/Pushyami-2-scaled.jpg)Pushyami Ajjarapu “The vision and the mission of UHPP strongly resonates with what CareQuest Institute does,” says Pushyami Ajjarapu, oral health policy fellow at UHPP. “We see behavioral, oral, and general health all as a single entity.” Earlier this year, UHPP formed the Oral Health Consumer Coalition Committee to get feedback from people who face barriers to accessing oral health care, like Gibbs. The group also passes along one-pagers to legislators on the significance oral health has to a healthy lifestyle, highlighting the need for accessible dental care and dental coverage. “We try to hear the community’s voice — hear from them on how they are facing difficulties or finding it hard to find a dental provider, or get dental coverage, or know about the resources they have around them to get access to dental care,” says Ajjarapu. ## The Push for Medicaid Dental Benefit Expansion in Utah In 2023, UHPP was one of the organizations that supported a bill to [expand the state’s Medicaid dental coverage](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) to include all adults older than 21. Previously, only adults [who were pregnant, were blind or had other disabilities, or were age 65 or older were eligible for those benefits](https://medicaid.utah.gov/medicaid-dental-benefits/). State lawmakers passed that bill into law, and implementation of the benefit expansion is expected to roll out this summer. That process won’t be simple, though, and UHPP wants to make sure individuals who will now be covered have the opportunity to speak up. Daniel Sloan, health policy analyst at UHPP, is helping to lead that effort. ![](https://carequest.org/wp-content/uploads/2024/07/Daniel-Sloan.jpg)Daniel Sloan “A lot of people in the group who attended \[one of our meetings\] were talking about how they’re on Medicaid or they have children,” says Sloan. “Some participants are concerned about their family being able to have access to good dental care. They want to be able to have an input in Utah’s policies, made by the state Medicaid program and by the legislature, on how to expand and access dental care in the state.” ![](https://carequest.org/wp-content/uploads/2024/07/Matt-Slonaker.jpg)Matt Slonaker Experiences from the committee members, like Gibbs’s, provide lawmakers with a better understanding of why the expansion of Medicaid dental benefits is so important. Matt Slonaker, the executive director of UHPP, emphasizes the need for two-way communication. “The goal is to have a robust feedback loop from people facing real challenges,” he says, “especially looking at folks from underserved populations and being able to ensure that we can effectively communicate those challenges through whatever resources might move the needle.” ## Encouraging Others to Tell Their Stories Gibbs’s own experience with dental insurance has led him to want to help others in similar situations. “My role is largely to help organize the committee, finding people who have these kinds of stories and these kinds of experiences . . . and discussing what the barriers are to oral health care and what we might be able to do to help with that,” he says. UHPP team members say they were inspired to create the committee from the work of Federally Qualified Health Centers, which are required to have consumer advisory boards. Ajjarapu created flyers and bookmarks to spread the word about the committee and encourage people to tell their own personal stories, with the help of health access assisters (HAAs) at Take Care Utah (TCU). UHPP houses TCU, a program that helps Utahns access health insurance coverage and navigate the health care system. TCU has more than 30 HAAs who provide one-on-one services virtually or in-person throughout Utah. Those HAAs can (1) provide application assistance in multiple languages for Medicaid, CHIP, or Marketplace; (2) conduct case management throughout the eligibility process; (3) provide guidance in selecting health plans; (4) provide insurance literacy education after enrollment to ensure benefits can be accessed; and (5) provide ongoing assistance with renewals or reviews to maintain coverage. “The HAAs can share information about the committee to those patients, and they’ll connect them with me,” Ajjarapu says. “And I can share resources with those patients, like finding them coverage options or looking into which dental clinics or providers accept their current coverage, and ask them about their interest in being on the committee. Many are hesitant to be on the committee and come to the office. But there are a few people who agree, and we are lucky to have them on the committee right now.” Gibbs says sharing his own story gives him credibility and can help others who may be nervous to share their personal experiences. And the goal is to have those stories shape the future of oral health care in Utah. “People are obviously far more willing to be vulnerable around somebody who treats them well and who genuinely respects them, and I really do have a lot of respect for anybody who is willing to make that kind of sacrifice and put themselves on the line to help with something this important,” Gibbs says. “And the people who are willing to do it have a strong desire to make a difference, and that’s really what it comes down to — finding the right people who really care about making a change.” **Categories:** Blog **Tags:** Dental Coverage --- ### [Medicaid Adult Dental Benefits Are on the Move in 2024](https://carequest.org/blog/medicaid-adult-dental-benefits-are-on-the-move-in-2024/) **Published:** July 16, 2024 **Author:** Caitlin Locklear **Content:** Oral health has been in the national spotlight recently thanks to a May 16 hearing of the Senate Committee on Health, Education, Labor, and Pensions (HELP). The focus of the hearing was the dental crisis facing the US and how to make dental care more affordable and available to all. State policymakers and advocates are also recognizing the crisis our country is facing — and they are not waiting for federal action to make change. As we’ll explore below, Medicaid adult dental coverage has continued to gain traction, as the number of states that are expanding adult dental benefits continues to grow! For anyone newer to the topic of Medicaid dental coverage, states are required to provide comprehensive dental benefits for children covered by Medicaid and the Children’s Health Insurance Program (CHIP). For adult Medicaid beneficiaries, however, dental coverage is optional, and states can limit the type or number of services and beneficiary groups they will cover. States can also exclude adult dental services entirely. As a result, there is wide variation in Medicaid adult dental benefits across states — even across beneficiary groups within some states. This landscape changes every year as states add to or reduce their coverage offerings. At CareQuest Institute, we are pleased to release the [2023 Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), which shows the landscape for Medicaid adult dental benefits and can inform both federal- and state-level policymaking conversations. What have we learned? That’s what we’ll break down below. ## New Benefits Data Paint a Promising Picture As we [noted at this time last year](https://www.carequest.org/about/blog-post/five-key-takeaways-about-medicaid-adult-dental-benefits-2023), the period between 2020 and 2022 marked one of the most significant expansions of Medicaid adult dental benefits in recent decades. This expansion continued into 2023, as illustrated by the newly updated Medicaid Adult Dental Coverage Checker (Coverage Checker). ![](https://carequest.org/wp-content/uploads/2024/07/Dental-X-Rays.jpg) For those unfamiliar with the Coverage Checker, it is an interactive tool designed for policymakers, administrators, and advocates to better understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories. It allows stakeholders to self-identify areas for improvement and expansion, while charting a course for the additional benefits. The Coverage Checker includes data self-reported by state Medicaid dental programs in a survey developed by the American Dental Association Health’s Policy Institute (ADA HPI), the Center for Health Care Strategies (CHCS), and an advisory committee of state and national leaders. The Coverage Checker now includes data from surveys completed in 2020, 2022, and 2023. Let’s dive into the most notable takeaways from the newest data: **1. The number of states that offer an extensive Medicaid adult dental benefit to all adult beneficiaries has increased again.** In 2020, the first time we collected data through the Coverage Checker, three states and the District of Columbia provided an extensive dental benefit to the largest group of Medicaid adult beneficiaries ages 21–64. Today, that number has grown to nine: Alaska, Hawaii, Iowa, Maine, Montana, New Jersey, Tennessee, Wisconsin, and the District of Columbia. **2. New and significant expansions of benefits went into effect in 2023.** Between 2020 and 2023, 26 states expanded their dental benefit offerings. Four states (Kansas, Michigan, North Dakota, and South Dakota) expanded their benefits twice during that time. As the Coverage Checker now shows, 12 states expanded their benefit offerings by one or more services in 2023 (e.g., cleaning, periodontal services, complete dentures), with the largest expansions taking place in seven of these states. These seven states — Hawaii, Kansas, Kentucky, Maryland, Michigan, New Hampshire, and Tennessee — implemented significant improvements in benefits for all of their adult members in 2023. As a result of the improvements, Hawaii and Tennessee now provide an extensive benefit to all adult beneficiaries. The benefit improvements are outlined below to demonstrate the variety of policy and advocacy pathways that can advance significant benefit improvements. Each of these wins is the result of years of relentless advocacy by countless local and state champions, including advocates, beneficiaries, caregivers, service providers, health professionals, academics, state officials, and lawmakers. **Hawaii** On January 1, 2023, [Hawaii implemented its new Medicaid adult dental benefit](https://www.carequest.org/about/blog-post/decade-making-how-hawaii-oral-health-advocates-reinstated-adult-dental-coverage), which was included in the state’s FY2023 budget. Focusing on prevention and control of oral disease, a full range of services are now provided, including X-rays, examinations, cleanings, application of fluoride, fillings, crowns, root canals, periodontal services, dentures, and extractions. This is a considerable improvement in benefits, as the state had only covered pain management and tooth extractions for adult beneficiaries since 2008. **Kansas** As of 2023, Kansas covers a wide range of services including fillings and crowns, periodontal care, silver diamine fluoride, full and partial dentures, and denture repairs. In both 2022 and 2023, Kansas policymakers included funding in the state budget to extend dental benefits. In addition to what is reflected in this year’s Coverage Checker, Kansas will implement a further [expansion of its benefits package](http://www.oralhealthkansas.org/WWU/pdf/5-1-2024.pdf) to include examinations and cleanings later this year (anticipated around July 1, 2024). These wins build on several years of [incremental improvements to strengthen the adult dental program](https://kansasreflector.com/2024/02/08/expansion-of-medicaid-adult-dental-benefits-in-kansas-a-win-for-all/). These improvements will greatly benefit Kansans who rely on Medicaid, as the state only offered emergency extractions since eliminating dental benefits in 2010. **Kentucky** Effective January 1, 2023, Kentucky Medicaid has covered for a range of new dental services, including cleanings, crowns, root canals, and dentures for all adult beneficiaries. Previously, the state provided only diagnostic services, limited preventive and restorative services, and extractions. On October 20, 2022, Governor Andy Beshear announced a [new initiative](https://www.kentucky.gov/Pages/Activity-stream.aspx?n=GovernorBeshear&prId=1541) to help boost workforce participation by improving health coverage of dental-, vision-, and hearing-related care. While the Kentucky legislature challenged this new coverage because it originally took effect through emergency regulations, these benefits are still [active](https://apps.legislature.ky.gov/law/kar/titles/907/001/126/) and Medicaid beneficiaries are eligible for the expanded dental benefits. **Maryland** Effective January 1, 2023, all of Maryland’s Medicaid adult beneficiaries now have access to diagnostic, preventive, restorative, endodontic, periodontal, and oral surgery services. The Maryland Legislature approved [SB150](https://legiscan.com/MD/bill/SB150/2022) on April 6, 2022, creating a Medicaid dental benefit for all adults. This benefit expansion built upon the state’s successful [Adult Dental Pilot program](https://www.mdac.us/file_download/inline/c9b60298-2f63-43fc-9863-d6e5f055056a) for adults ages 21–64 dually eligible for both Medicaid and Medicare, as well as its expanded benefits for [pregnant and postpartum adults](https://dlslibrary.state.md.us/publications/Exec/MDH/SB100Ch600HB368Ch599%282021%29_2022%28f%29.pdf). **Michigan** Effective [April 1, 2023](https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2023/04/03/medicaid-dental-redesign), Michigan Medicaid implemented adult dental benefits that now include coverage for X-rays, cleanings, fillings, crowns, root canals, periodontal services, dentures, and extractions. In October 2022, the Michigan Department of Health and Human Services (MDHHS) submitted a [proposal to the legislature](https://stateofreform.com/featured/2023/04/michigan-continues-to-expand-medicaid-dental-coverage/) to redesign the Medicaid adult dental benefit. The Legislature approved the redesign in December 2022, and MDHHS began rolling out improvements in January 2023 with a significant increase in provider reimbursement rates. **New Hampshire** Starting April 1, 2023, New Hampshire implemented a [new adult dental benefit](https://www.dhhs.nh.gov/programs-services/medicaid/medicaid-dental-services-new-hampshire-smiles-program-adults) that includes diagnostic, preventive, restorative, and oral surgery services, as well as dentures (for certain adults) with an annual benefit maximum of $1,500. The state has historically offered an emergency-only Medicaid dental benefit to its adult beneficiaries. In 2019, Governor Chris Sununu signed [legislation](https://legiscan.com/NH/text/HB692/2019) removing a provision that prohibited a mandatory dental benefit within New Hampshire’s managed care model. The legislation also directed the New Hampshire Department of Health and Human Services to create a designated working group to develop comprehensive adult dental benefits for incorporation into a value-based care platform. After years of work to craft the benefit and [sustained advocacy](https://www.sentinelsource.com/news/local/statehouse/nhs-new-dental-benefit-for-adults-on-medicaid-rolls-out-saturday/article_269a4fef-41fd-5023-a133-cd1e822d1ac8.html) to implement it, the state began offering an expanded benefit for all adults. **Tennessee** Effective January 1, 2023, adult beneficiaries in Tennessee now have access to diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and oral surgery services, including extractions. Historically, the state had not offered a dental benefit to adult beneficiaries. In January 2022, the state Medicaid agency announced it would begin providing extensive dental coverage to pregnant and postpartum beneficiaries beginning on April 1, 2022. A year later, the state expanded benefits again to all adults. **3. States are increasing their annual benefit maximums on dental services or eliminating them entirely.** As of 2023, 34 states place no dollar limit on dental services that each Medicaid member can receive each year (up from 32 in 2022). There are 14 states that have an annual benefit limit of $1,000 or greater (up from 4 in 2022), and 2 states continue to have an annual benefit limit of less than $1,000. **4. States continue to provide enhanced coverage to certain groups of adults.** Recognizing the distinct oral health needs of certain groups of adult beneficiaries, some states have opted to provide additional or enhanced services to these groups — most notably pregnant and postpartum adults, those with certain health conditions, adults with intellectual and/or developmental disabilities, and those utilizing long-term care. In 2023, 20 states reported that they offer different coverage to specific groups of beneficiaries than they offer to other adult beneficiaries ages 21–64. Check out our report on [coverage offered to specific beneficiary groups](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups) as of December 2022, and keep your eyes open for an updated report later this summer. **5. Expansions and improvements to Medicaid adult dental benefits have continued into 2024.** The survey used to inform the Coverage Checker is a point-in-time survey, and this year’s survey assessed coverage in place as of December 31, 2023. Yet states are continually making updates to their adult dental coverage; six states — Connecticut, Kansas, Minnesota, Nebraska, Utah, and West Virginia — either implemented improvements on January 1, 2024, or plan to do so later in the year. Other states are still considering legislation that may result in benefit improvements in the near future. The Coverage Checker page details these ongoing improvements, which will be reflected in next year’s survey. ![](https://carequest.org/wp-content/uploads/2025/09/Stacey-Auger-topaz.jpg)Stacey Auger, MPH *Authored by Stacey Auger, MPH, policy consultant, CareQuest Institute* *Editor’s Note: You can find more details about these changes on the* [*Coverage Checker*](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) *web page. We’ll be updating the page as the year goes on with additional state updates and new reports based on our findings, so be sure to check back regularly.* **Categories:** Blog **Tags:** Dental Coverage --- ### [Should We Say ‘Social Determinants of Health’ or ‘Social Drivers of Health’?](https://carequest.org/blog/should-we-say-social-determinants-of-health-or-social-drivers-of-health/) **Published:** July 29, 2024 **Author:** Caitlin Locklear **Content:** As we began creating self-paced courses for CareQuest Institute, we took a closer look at terminology in oral health care — terms like “value-based payment,” “fee-for-service,” “interoperability,” and “care coordination.” One phrase continued to give us pause and generate thoughtful discussion: social *determinants* of health.![](https://carequest.org/wp-content/uploads/2024/12/CQ_Ask-The-Experts-scaled.png) First, a definition: The phrase “[social determinants of health](https://www.carequest.org/about/blog-post/transforming-community-health-incorporating-social-determinants-dental-setting)” refers to external factors that impact the quality of care a person receives. [Eighty percent of a person’s health outcomes](https://www.commonwealthfund.org/blog/2023/lets-get-it-right-consistent-measurement-drivers-health) and quality of life are driven by these factors — where they live, access to housing, education, and transportation. While those factors are well known and researched, and their impact on the lives of marginalized populations are immense, the very word used to group them together is troubling. The word “determine” means to completely terminate, limit, and fix the bounds of. This paints a picture of a sealed fate, something that people and communities can’t change no matter how hard they try. It falsely implies a lack of power by advocates and communities to alter, overcome, or reposition those very factors. It mentally draws a fixed outline of a map of the system that has perpetuated inequities and needs change. Through [advocacy, research, health transformation, philanthropy, and education](https://www.carequest.org/how-we-work), CareQuest Institute is working to create a more accessible, equitable, and integrated oral health care system. To do that, we need to empower communities to make changes so they can overcome barriers to accessing oral health care, like social determinants of health. Together as a team, we worked together to figure out how to change that word and the biases that come with it. ## Acknowledging the Power, Agency, and Resilience of Communities The factors that make up social determinants of health are real. Inequities in health outcomes that are caused by them are real. Communities that contend with them every day are also real. The factors, however, don’t determine the inequities and set them in stone. Rather, those factors **drive** the inequities. They are drivers in inequities in access to oral, behavioral, and physical care, in life expectancy, maternal health, childbirth, and survival rates, substance use, and other behavioral health disorders. Advocates and communities have the agency, knowledge, and resilience to overcome these drivers and have demonstrated the ability to do so. From now moving forward, we as CareQuest Institute will refer to factors like zip code, access to housing, education, and transportation as social drivers of health to acknowledge the power, agency, and resilience our communities have shown in overcoming them, despite their magnitude and impact. These drivers are movable, mitigable, and transient. We are changing this term to show that nothing determines the fate of our communities other than our communities themselves. *Authored by Kaz Rafia, DDS, MBA, MPH, Chief Dental Officer and Executive Vice President of Health Equity, CareQuest Institute* *Editor’s Notes: In his role, Rafia spearheads strategic initiatives to foster and advance engagement and access to integrated oral health care for the underserved and for underrepresented communities. Rafia 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.* Read more Transforming Oral Health: Ask the Experts blog posts, covering topics like [health equity](https://www.carequest.org/about/blog-post/how-can-you-promote-health-equity-your-organization) and [interoperability](https://www.carequest.org/about/blog-post/what-do-we-mean-interoperability-oral-health), at [carequest.org/latest-news/blog](https://www.carequest.org/latest-news/blog). **Categories:** Blog **Tags:** Health Equity --- ### [4 Things to NOLA from the ADHA Conference](https://carequest.org/blog/4-things-to-nola-from-the-adha-conference/) **Published:** August 1, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2024/08/IMG_1808-scaled.jpeg)Hannah Cheung, MPH, MS, RDH, and Caroline McLeod, MS, RDH, at ADHA conference With their expertise in the mouth-body connection, clinical skills, evidence-based practice, and position to influence to address health equity, dental hygienists are a key part of the health care team. Dental hygienists — and those topics — took center stage last week at [adha24](https://www.adha.org/), the American Dental Hygienists’ Association’s annual conference in New Orleans, Louisiana, aka “NOLA.” The conference, which was sponsored by several leading oral health organizations, including CareQuest Institute, explored topics that are shaping the future of the oral health industry and profession. What were the experts in preventing and managing oral disease discussing? These are four key themes that rose to the top during the event: **1. Oral health is a core component of overall health.** Conference participants spent the weekend discussing how the health of the mouth and the health of the body are intertwined — for example, how [severe caries during childhood](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) is linked to poor nutrition, weight loss, and iron-deficiency anemia and how [periodontal disease](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach) has been linked to adverse pregnancy and birth outcomes, cardiovascular disease, and diabetes — and the [role dental hygienists play](https://jdh.adha.org/content/jdenthyg/98/3/8.full.pdf) in caring for overall health. The conference spotlighted the link between [mental and oral health](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) through education about mental signs/symptoms and prevention/management strategies for dental hygienists and their patients. **2. We view our work through a lens of health equity.** ![](https://carequest.org/wp-content/uploads/2024/08/IMG_5830-scaled.jpeg)CareQuest Institute team members at ADHA conference Health equity took center stage throughout the conference. CareQuest Institute Health Sciences Specialist Hannah Cheung, MPH, MS, RDH; Clinical Content and Support Specialist Stephanie Clester, MA, RDH; and Program Evaluation Specialist Kelly Schroeder, RDH, MS, presented “What Does Equity Look Like in the Dental Setting?” discussing best practices to address health equity in the dental office. They explored the importance of comprehensive patient data collection, addressing social drivers of health, and practicing with [cultural sensitivity](https://www.carequest.org/education/webinars/connecting-caries-risk-assessments-and-cultural-awareness). Additional applications of health equity during the conference in other sessions included education on oncology patients, caring for populations with special needs, and partnering with patients to determine care plans. Another path to improving access and equity? Participants also discussed the potential of the [Dentist and Dental Hygienist Compact ](https://ddhcompact.org/)that will soon allow dentists and dental hygienists to transport their license to states that have legally adopted the compact. (Check out [our blog post](https://www.carequest.org/about/blog-post/push-portability-latest-dentist-and-dental-hygiene-compact-privileges) on the compact!) **3. Care must always be evidence based.** All health care providers must make care decisions with their patients based on the best available evidence and research, and that includes dental hygienists. We have the unique opportunity to make self-care recommendations, rooted in evidence of effectiveness, that support patients’ health goals. A panel discussion on a recent International Federation of Dental Hygienists [white paper](https://ifdh.org/wp-content/uploads/2023/10/IFDH-White-Paper-FINAL-2023.pdf) highlighted how dental hygienists can provide personalized care through creating customized oral hygiene self-care recommendations. Attendees had the opportunity to further their knowledge on evidence-based recommendations by discussing provider and systems level impacts on patient oral health literacy with Hannah, Stephanie, and Kelly during their presentation, “Recognizing and Overcoming Barriers to Oral Health Literacy for the Dental Hygiene Patient.” **4. Technology is the present and future of health care.** As dental hygienists work with other health care providers and health disciplines, technology will facilitate comprehensive, coordinated care that can improve patients’ overall health. Attendees explored technologies such as artificial intelligence, teledentistry, diagnostic imaging tools, and electronic health records. They also engaged with a wide range of vendors in the exhibit hall to examine these technologies hands-on. The palpable excitement around improving patient care and advancing the profession coursed through the event. And it drives us at CareQuest Institute to continue to collaborate with dental hygienists to evolve the health care system to one where everyone can achieve excellent health. *Authored by Caroline McLeod, MS, RDH, Value-Based Solutions Manager at CareQuest Institute* **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration --- ### [How to Advocate for Oral Health During the 2024 Election Season](https://carequest.org/blog/how-to-advocate-for-oral-health-during-the-2024-election-season/) **Published:** August 8, 2024 **Author:** Caitlin Locklear **Content:** Last month, the Oral Health Progress and Equity Network (OPEN) brought together 170 oral health advocates to discuss how to engage with candidates and the media this election season and raise oral health as a key issue. Experts in advocacy, community engagement, and media shared their insights and tips with attendees at the 2024 OPEN Advocacy Assembly. “It’s tough to find an issue like this in today’s America that has broad popularity,” said Peter Mitchell, chief insights officer at Marketing for Change. Mitchell shared new [national voter poll results](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results) that showed strong support across the political spectrum for dental coverage in Medicare, Medicaid, and for veterans: - 9 in 10 voters nationwide support adding a dental benefit to Medicare. - 9 in 10 voters want expanded dental coverage for veterans. - 3 in 4 voters support adding adult dental benefits to Medicaid.![](https://carequest.org/wp-content/uploads/2024/09/Voting-Station.jpg) What’s next? As we look ahead to this fall’s elections, how do we keep the spotlight on the importance of oral health? Experts had plenty of valuable advice: - Roy Miller, founder and president of American Children’s Campaign, shared his 50/50 rule for written materials to leave behind with your legislative candidates: At least half the space should be dedicated to compelling images. Use pictures and stories to build emotion. Strong polling data is an asset, but it’s equally important to get human stories to legislators, he added. - Maya Goldman, health care reporter for Axios, noted that doing a little research on a reporter increases the chances your story will get picked up by media outlets. Find out what they’ve been writing about, she added, and make sure you’re aligned. Reach out to the reporter through email first and keep it short — just a couple of bullet points. The first bullet point should be why the story matters. Additional advice on sharpening your advocacy skills included the following: - Center on the issue. - Talk to all candidates — not just one political party. - Be confident. Remember, you know more about your issue than the person you’re talking to. - August is the perfect time to reach out to your candidates. During the Congressional recess, candidates are more likely to hit the campaign trail, host events, and engage on social media. Visit [OPEN’s Take Action Center](https://carequest.quorum.us/open/) to find tools to help you advocate for oral health this election season. Unsure if oral health is on your candidate’s agenda? “Oral health is a conversation that can be had in every state because all House seats are open,” said Bailey Reavis, manager of federal relations at Families USA. “Now is the time to help new members set their agenda and build champions for oral health.” Javier Morales, executive director of the Praxis Project, emphasized getting communities to the table as early as possible and asking for their help: “We have to work as a collective and coalition to be able to match the power that industry has.” **About the Oral Health Progress and Equity Network (OPEN)** OPEN, an initiative of CareQuest Institute for Oral Health, is a diverse network of individuals and entities who are taking on America’s oral health challenges so that everyone has a chance to thrive. OPEN members use their unique experiences, knowledge, and skills to lead network activities every year, creating collective energy that is driving large-scale change. **Categories:** Blog **Tags:** Dental Coverage --- ### [Inclusivity in Oral Health: ‘It’s Good to Be Reminded How Invasive [Dentistry] Can Be’](https://carequest.org/blog/inclusivity-in-oral-health-its-good-to-be-reminded-how-invasive-dentistry-can-be/) **Published:** August 13, 2024 **Author:** Caitlin Locklear **Content:** Robert MacArthur, DMD, is well aware of how a patient could feel uncomfortable sitting in a dental chair. “Dentistry is an extremely invasive profession,” MacArthur says. “It requires a lot of trust, and it’s really humbling when I put myself in the dental chair at least twice a year just for a regular cleaning. It’s good to be reminded of how invasive it can be.” ![](https://carequest.org/wp-content/uploads/2024/08/Robert-MacArthur2.jpg)Robert MacArthur, DMD MacArthur identifies as a cisgender gay white male, so he also understands that being part of the LGBTQIA+ community can make going to the dentist even more stressful and uncomfortable — and the value of having a dentist you can trust. “Patients have come up to me after an appointment and said it’s important to find an inclusive dentist where they feel comfortable enough to reveal their complete medical history, which includes their sexual identity and orientation. And I can relate with them, as it took me a while to find an inclusive primary care provider,” he says. “Some patients might not disclose this information for fear of being turned away or maybe being outed to other people, especially if it’s a small community or if they are not ready to come out.” Although he’s a member of the LGBTQIA+ community, MacArthur says there’s still a lot he can learn about creating a space where patients — especially from underserved communities — feel welcome. So, when his boss sent over an email with a link to a [CareQuest Institute webinar about creating inclusive environments for the LGBTQIA+ community](https://www.carequest.org/education/webinars/lgbtqia-oral-health-creating-inclusive-environments), he was more than happy to attend. “I admit there was some terminology, proper pronoun usage, and different forms of gender expression I needed to learn more about,” he says. “I was curious and trying to stay abreast of current terminology.” Education from the webinar, MacArthur knew, would be immediately applicable — and not just for him. He took what he learned from the session and passed it along to his family, which includes several professionals in the medical field. “Just like with Pride Month in general, the more awareness we have, the more likely we can break down barriers to care, provide more inclusive care, and create a more trusting environment,” he says. ## The Importance of Meeting Communities Where They Are MacArthur grew up in rural Tennessee and worked in rural Alaska for the last eight years. For the past few months, he has worked as a dentist at the Boston Health Care for the Homeless Program. There, he provides medical and dental care for the unhoused. “The organization does a fantastic job on being an inclusive work environment, but also equipping providers with continuing education to address care that is inclusive and addresses current issues,” he says. Keeping providers aware of current issues was one of the goals of the webinar, which featured Harold Jennings Jr., RDH, MA, associate director at Plaza College, and Alex Barrera, DDS, director of dentistry at Avenue 360 Health and Wellness. Kasey Wilson, MSW, senior policy analyst at Community Catalyst, served as moderator. The trio covered topics ranging from the unique challenges and oral health inequities LGBTQIA+ communities face to applying inclusive language and best practices in daily patient interactions. ![](https://carequest.org/wp-content/uploads/2024/08/HaroldJennings_Headshot.jpg)Harold Jennings Jr., RDH, MA “I think there are some long-standing access issues that are associated with discrimination that the community faces,” says Jennings. “So, if we look at medicine, they’re \[members of the LGBTQIA+ community\] less likely to have health insurance. And so that also relates to dental care as well. It’s kind of across the board in that they may personally experience more fear, and through the discrimination that they face, experience barriers to care.” Jennings says because of that discrimination, it’s a dental professional’s responsibility to meet patients where they are to help overcome those barriers. “Coming out isn’t an event,” Jennings explained during the webinar. “It’s a process. So, we should be aware of that in these humanistic conversations that we have and the relationships that we build with our patients.” Jennings says one way to do that is through inclusive language — for example, using words like “transgender” instead of “transsexual” and “lesbian” or “gay” instead of “homosexual,” and not assuming what pronouns a person uses, something that resonated with MacArthur. “It’s leading the conversation and saying to patients, ‘Hi, my name is Dr. Mac, or Robert, and I use the pronouns he/him. What pronouns do you prefer?’,” MacArthur says. “Or perhaps another approach that wouldn’t put someone on the spot could be, ‘If you are comfortable with talking about the pronouns you prefer to use, please let me know.’” During the webinar, Jennings also explained how it’s okay to ask when you don’t know what pronoun to use, and if you make a mistake, apologize and move forward. “And the other thing that I really hope is a takeaway is that allyship implies action,” Jennings says. “So just agreeing with what someone is saying doesn’t make you an ally, not holding biased views doesn’t make you an ally. An ally is someone who is advocating for the community.” Jennings says even though the significance of barriers to accessing care for LGBTQIA+ people needs to be further researched, knowing that his teachings made an impact on even one person makes all the difference to him. “I think it’s wonderful to hear that people responded really well to the presentation, specifically around language,” Jennings says. “If we want to stay involved, we also have to stay engaged in language in accepted and approved terms. And that’s not just for this \[LGBTQIA+\] community. It’s for all communities.” **Categories:** Blog **Tags:** Health Equity --- ### [Double the Care: How Medical-Dental Integration Is Expanding Access in Ohio](https://carequest.org/blog/double-the-care-how-medical-dental-integration-is-expanding-access-in-ohio/) **Published:** May 16, 2023 **Author:** Caitlin Locklear **Content:** Taiwo Ngo, DDS, has witnessed how medical-dental integration can help more people get the health care they need. ![Kehinde Obeto, MD, and Taiwo Ngo, DDS](https://carequest.org/wp-content/uploads/2023/05/Dr.-Ngo-and-Dr.-Obeto-300x287.jpg)Kehinde Obeto, MD, and Taiwo Ngo, DDS “I had a patient — a child — that Dr. Obeto referred to me,” Ngo says. “And they didn’t call, and so I called \[the child’s guardian\] to make the appointment.” Ngo gets dental referrals frequently at Midwest Dental Center in Toledo, Ohio, for children who don’t have a dental home or who need access to care as part of her work with CareQuest Institute’s [MORE CareTM](https://www.carequest.org/how-we-work/health-improvement-programs/more-care) pilot program. Quite a few of Ngo’s referrals come from Kehinde Obeto, MD, a pediatrician at Nationwide Children’s Hospital, also in Toledo, Ohio. “\[The guardian\] asked, ‘Who is this?’” Ngo continues. “I replied, ‘I am Dr. Ngo, a dentist. I’m trying to make an appointment. Your child was referred to me.’” Ngo says the guardian was excited by the recommendation from Obeto and willing to schedule an appointment for their child. Ngo and Obeto have a very close relationship that goes beyond patient referrals: They are twin sisters from Nigeria who help underserved populations in the northwestern part of Ohio. Even though Ngo and Obeto have referred patients to each other in the past, it is more formalized now that they are both participating in MORE Care™, which stands for Medical Oral Expanded Care. The initiative aims to integrate oral health competencies and capabilities into primary care practices and build patient-centered referral networks with local dental providers to improve oral health and overall health within communities. Obeto says, “Sometimes if I see a kid who has caries, or I see a kid whose mom says, ‘Oh, he has a cavity, and we are trying to get him into the dentist, but they don’t have any openings for six months.’ And since I see the kid is in pain, sometimes I’ll call Dr. Ngo and say, ‘Look, I have this patient. Is this someone you can see right away?’” ## The Goals of the MORE Care Pilot The MORE Care Ohio pilot kicked off in November 2022 as a collaboration between CareQuest Institute and [Oral Health Ohio](https://www.oralhealthohio.org/), a coalition of statewide partners who educate and advocate to improve the state’s oral and overall health. MORE Care Ohio provides four participating care teams — each made up of one dental practice and one medical practice — with support in integrating oral health into primary care and coordinating referrals. “MORE Care looks at the whole picture and doesn’t just break it up into slices,” Ngo says. “So now both the dental and the primary care providers approach the diagnosis and treatment of the patients together — a more integrated approach.” A major reason CareQuest Institute was drawn to incorporating MORE Care in Ohio was because early childhood caries is the [most common, preventable infectious disease](https://www.carequest.org/about/news/jada-association-between-first-oral-examination-characteristics-and-dental-treatment) among children in the US, and in Ohio, one out of every four children have not had an annual dental visit. Historically, [MORE Care programs in other states have shown significant improvements](https://onlinelibrary.wiley.com/doi/full/10.1111/jphd.12407) in preventive oral health outcomes for pediatric patients. These include increases in pediatric patients receiving oral health risk assessments, reviewing self-management goals relating to oral health, and receiving fluoride varnish. Participants are hoping for similar improvements in Ohio. The four participating teams serve more than 32,000 patients — most of them either uninsured or enrolled in Medicaid. That’s the case for many of Ngo’s and Obeto’s patients, too. And even for their patients enrolled in Medicaid, it can be a struggle to find a dentist who will accept it. If a patient does eventually find a dentist, it can take weeks or even months to book an appointment. “Here in Toledo now, the number of dentists who take the Medicaid population is about 1% or 2%,” Ngo says. “A lot of them don’t. So those who do are kind of overburdened and overwhelmed with the system.” According to [research from the American Academy of Pediatrics](https://publications.aap.org/pediatrics/article/151/1/e2022060417/190307/Maintaining-and-Improving-the-Oral-Health-of-Young), parents take their children to the pediatrician more often than the dentist at an early age, so it makes sense for pediatricians to integrate dental health into their practices. Obeto says most parents don’t even know they should take their child to the dentist around their child’s first birthday or start using fluoride toothpaste when their child’s first tooth appears. “Now part of the medical-dental integration, a part of our well-child visit has an integrated template for oral health,” Obeto says. “So we actually look at the child’s teeth and see if there’s any caries formation, and we also check to see if they’ve ever seen a dentist or if they’ve ever had fluoride varnish applied.” Oral Health Ohio also connected participating medical teams with a fluoride varnish vendor that provides hands-on training. So now, pediatricians like Obeto are encouraged to apply fluoride varnish to patients’ teeth. With MORE Care and the help of her twin, Obeto can also easily get her patients into a dental home right away. Ngo says, “This way we are introducing the children into the practice and the preventive visits are earlier, and so that means they are not as scared and they are used to it. Because now they’re coming in at an earlier age and getting things checked out and not having a problem.” ## Integration Benefits Patients and Providers One major benefit of medical-dental integration is it can help reduce costs to patients in the long run. “By being healthy, you just need to see your doctor for the well visits and preventive visits,” Ngo says. “Money is not being spent on medications for different things or surgeries or different situations that could have been avoided.” Ngo and Obeto say medical-dental integration is a big plus for providers, too — helping them stay connected without obstacles to communication or referrals. “It allows different providers to come up with a comprehensive care plan for the same patient,” Ngo says. “So that way, it’s not just you looking at the patient and trying to find somebody for the patient to go to.” It often works in both directions. “It’s not just the dentists looking at the mouth and saying, ‘You need this,’” Obeto says. “If the dentist sees that there is a problem somewhere else, then they’ll refer the patient over to the medical side. And if the medical side sees there’s a dental problem, then they refer them to the dental side. So they take care of the patient as a whole.” That connection between primary care providers and dentists — and in this case between twin sisters — can benefit that patient’s overall health. “I recommend that \[other providers\] get involved \[with MORE Care\] because it’s a wonderful program,” Obeto says. “The mouth and the rest of the body are all related, so it’s a good way to make sure that everything is taken care of in one place.” Just like it was for the guardian on the other end of the call with Ngo. When the guardian heard that they could get their child in for an appointment the very next week, they wanted to make the most of the opportunity and asked if they could bring in more of their children. Ngo told them to all come in at the same time the following week. “I saw them and saw \[the guardian\],” Ngo says. The guardian was so impressed by the dental services that they recommended other family members to call and make an appointment with Ngo. And they did. “So, from that one appointment Dr. Obeto referred,” Ngo says, “I think I’ve cared for about 50 patients.” **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Teledentistry and Community Learning Help Kids Get Care in North Carolina](https://carequest.org/blog/teledentistry-and-community-learning-help-kids-get-care-in-north-carolina/) **Published:** May 30, 2023 **Author:** Caitlin Locklear **Content:** In just one school year, Blue Ridge Health in North Carolina has helped more than 1,200 children get the dental care they need through teledentistry. But that help comes with its challenges. “Internet connectiv . . .” says Ben Cozart, DDS, the dental director at Blue Ridge Health, cutting out, on cue, as he was explaining the program during a phone call. ![](https://carequest.org/wp-content/uploads/2023/05/Teledentistry-Bus-4.jpeg)Blue Ridge Health dental hygienist takes pictures of child’s mouth in mobile dental services bus “The cell phone service,” he continues, rejoining the call. “If you’re in between two mountains, sometimes the signal is not great. And of course, a lot of the schools that have the highest need are more remote, rural schools that are deeper in the mountains.” Blue Ridge Health is a Federally Qualified Health Center (FQHC) in Brevard — a city surrounded by mountains —that mostly serves patients who are enrolled in Medicaid or uninsured. Digital interruptions can be a challenge, but the team doesn’t let them stand in the way of growing its school teledentistry program. Cozart says the internet connection needs to be strong enough to run dental software and transfer information, like digital x-rays, and the FQHC has found a solution. “We found out after trying different things that the best thing is just to use the school’s guest internet networks,” he says. “Luckily, we have a good IT team that contacts the school ahead of time to make sure that security and all those necessary things are taken care of ahead of time.” Joining CareQuest Institute’s Community Oral Health Transformation (COrHT) Initiative has given the program a boost, too. ## COrHT Support in North Carolina Teledentistry was what intrigued Cozart the most about COrHT when he heard about the initiative. The FQHC first got its teledentistry program up and running in early 2022, when it was involved in an initiative with The Duke Endowment and Blue Cross Blue Shield of North Carolina Foundation. Later that year, it joined COrHT. “The CareQuest Institute team has been great, and I think what I always enjoy the most from these things are the in-person conferences — gatherings — because it’s just a really rewarding feeling to be in the room with so many different people who are ultimately trying to do the same thing and help their communities,” Cozart says. COrHT features a learning community for dental care teams. The initiative reimagines efficient, equitable oral health care and promotes the imminent shift toward [value-based care (VBC) in dentistry](https://www.carequest.org/education/course/introduction-value-based-care-oral-health-moving-volume-value/overview). CareQuest Institute’s [Three Domain Framework](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) — which focuses on 1) teledentistry, 2) minimally invasive care (non-surgical treatment of disease), and 3) integration of oral health with overall health care — serves as the foundation for the learning. ![](https://carequest.org/wp-content/uploads/2023/05/Teledentistry-Bus-Blog-1.jpg)Ben Cozart, DDS, applies fluoride varnish to child’s teeth During the early work with COrHT, according to Stephanie Clester, clinical content and support specialist at CareQuest Institute, dental teams completed training in areas to help them implement and succeed in a variety of areas aligned with the transition to VBC, including teledentistry. “By implementing this technology, dental providers now can reach more patients to reduce the burden of oral disease for those who need it most, making teledentistry a tool to achieve accessible and equitable oral health,” says Clester. “The COrHT Initiative is an opportunity for innovative dental professionals to lead the charge to transition toward VBC.” The COrHT Initiative, a partnership between CareQuest Institute; the [Blue Cross Blue Shield of North Carolina Foundation](https://www.bcbsncfoundation.org/); and the [North Carolina Oral Health Collaborative](https://oralhealthnc.org/) (NCOHC), a program of the [Foundation for Health Leadership & Innovation](https://foundationhli.org/) (FHLI), launched last year in North Carolina. Cozart knows the state — and his area — well. He grew up about half an hour from Blue Ridge Health. “I first was aware of Blue Ridge Health when I was a rising fourth-year dental student at University of North Carolina. I did a rotation at Blue Ridge Health,” he says. “So, I saw patients there for a month, and that kind of opened my eyes to community health dentistry. I really didn’t know much about it. I didn’t know that it existed.” He started working there straight out of dental school in 2014 and has been there ever since — working his way up from staff dentist to dental director. “The department has grown a whole lot in different directions than when I first came on,” Cozart says. “It has been fun to see that and contribute to that growth.” ## Providing Oral Health Care Through Teledentistry in Schools Cozart says many times children miss out on dental appointments because their parents don’t want to take off work and take their children out of school, and the COVID-19 pandemic didn’t help. ![](https://carequest.org/wp-content/uploads/2023/05/Teledentistry-Bus-1.jpeg)Blue Ridge Health Mobile Dental Services travels to schools three days a week “Like many things that got put on hold — school for example — a lot of patients of all different ages didn’t go to the dentist,” Cozart says. “And unfortunately, a lot of the kids that we see were included in that.” Cozart says Blue Ridge Health owns two mobile units, or buses, that go to the elementary schools three days a week. “You walk on the bus, and there are two dental laboratories that look like just a smaller version of a dental office,” he says. “It’s the hygienist and the assistant. The asynchronous teledental aspect is the dentist looking at the end of the day through all those exams, and then we have the team contact the parents to let them know what’s needed.” A [2020 update to a North Carolina law](http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2016%20-%20dental%20examiners/subchapter%20w/subchapter%20w%20rules.pdf) gave dental hygienists the opportunity to get a public health endorsement on their license, which allows them to perform preventive procedures in nontraditional settings if they have written permission from a dentist, rather than a dentist examining the patient in person. “They can go out without a dentist being on the bus or on the property and actually provide an assessment, which is bitewings and radiographs, prophy, fluoride, and intraoral images and sealants,” Cozart says. It’s a win for all involved: The children get access to oral health care but also don’t miss too much time in the classroom. The parents don’t have to miss work. And the dentists can oversee care for more patients. “It’s sort of allowed us to do two things at once,” Cozart says. ![](https://carequest.org/wp-content/uploads/2023/05/Teledentistry-Bus-3.jpeg)Dental hygienist cleans child’s mouth in Blue Ridge Health Mobile Dental Services bus Cozart says he’s appreciative that the COrHT Initiative has helped provide Blue Ridge Health patients and providers in the community with the support they need, especially through teledentistry. “We’re always trying to look at ways to evolve and grow our standard of care, and so the goal of COrHT and working with CareQuest Institute was really just to continue to develop quality-driven evidence-based dentistry,” he says. Building relationships with other organizations has been important, too. Clester points to the peer-to-peer learning as one of the most valuable takeaways for participants. “Cozart’s previous experience with teledentistry prior to the COrHT Initiative has made him a resource for others who only recently implemented teledentistry,” Clester says. “His support for his colleagues to answer questions and guide them demonstrates how a supportive community has a ripple effect to reach even farther.” The COrHT Initiative in North Carolina wraps up in September. NCOHC and CareQuest Institute will later develop a comprehensive impact report to help participating safety net clinics sustain their work and influence long-term reform, something from which Cozart believes Blue Ridge Health will benefit. “And of course,” he says, “we want to improve the overall quality of our dental care.” Part of improving that care is looking ahead to evaluate what their next steps are after students leave the classrooms in the next month. “We’re finishing out the end of the school year,” he says. “And we want to finish strong and take the summer to reassess which areas we can improve on and if there are different directions we should look toward.” **Categories:** Blog **Tags:** Practice Management, Value-Based Care --- ### [How Oral Health Affects Overall Health — and How to Improve Both](https://carequest.org/blog/how-oral-health-affects-overall-health-and-how-to-improve-both/) **Published:** June 6, 2023 **Author:** Caitlin Locklear **Content:** Tooth decay and gum disease can make it difficult to eat, talk, and concentrate. But the damage they do can go beyond our mouths. Oral health affects our [overall health](https://www.carequest.org/resource-library/impacts-beyond-mouth). Poor oral hygiene can raise the risk of several diseases elsewhere in our body, from diabetes to dementia. Fortunately, preventive care can help. And both policy and health care leaders can take several actions to prioritize preventive care and improve communities’ oral health and overall well-being. Key strategies include: - tailoring dental hygiene guidance for patients - supporting greater access to dental care - better integrating medical and dental services ## The Relationship Between Oral Health and Overall Health Evidence increasingly shows the [strong relationship](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) between oral health and systemic disease. Untreated gum disease can make chronic conditions, such as diabetes and heart disease, harder to manage. To effectively care for people with these conditions, providers must also treat their dental problems. A CareQuest Institute [infographic](https://www.carequest.org/resource-library/impacts-beyond-mouth) spotlights the far-reaching consequences of dental health on the rest of your body. ## ![](https://carequest.org/wp-content/uploads/2023/06/Mentalhealth_052223-scaled.jpg) Recent research even shows connections between [oral health and mental health](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health). Dental disease can deepen mental health challenges, and vice versa: - People with poor mental health are more likely than their peers to have untreated tooth pain and other unmet dental needs. - Those with poor mental health are nearly four times more likely than others to say they feel embarrassed about their teeth, mouth, or dentures. - Anxiety can influence our dental care experience. [Nearly 50%](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) of those with poor mental health say they were nervous at their last dental appointment, compared to 27% of their peers. ## How Poor Oral Hygiene Can Harm Our Overall Health Practices to keep your mouth healthy, such as brushing your teeth, matter to your systemic health. Poor oral hygiene can harm your body as you age: - It can [harm your vision](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health). Having higher levels of bacteria in your mouth, losing more of your natural teeth, and experiencing gum disease can all increase your risk of glaucoma. - Delayed dental care in young adulthood makes it more likely that you will develop [strong relationship](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) later in life. - Oral health and diabetes influence each other. While gum disease makes it harder for people with diabetes to manage their blood sugar, diabetes can increase your risk of [developing gum disease](https://www.carequest.org/resource-library/impacts-beyond-mouth) by 86%. Dental disease can also raise your risk of oral cancer — another threat to your overall health. Most [throat cancers](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) are triggered by the human papillomavirus (HPV), a common sexually transmitted infection. Poor dental health is a risk factor of oral HPV infection. However, the [HPV vaccine](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) can prevent more than 90% of cancers caused by the virus. ## Solutions That Prioritize Oral Health Can Lead to Healthier Communities Promoting good oral health through policy and clinical practices can encourage better overall health. One effective approach is to advance personalized guidance that supports good dental hygiene. CareQuest Institute researchers [recently examined](https://www.carequest.org/resource-library/oral-hygiene-home-care-practices-america) adults’ dental habits, gathered from responses to the [State of Oral Health Equity in America survey](https://www.carequest.org/SOHEA2022). They found knowledge gaps about what shapes oral health and leads to variation in dental hygiene routines. For instance: - Women are [more likely](https://www.carequest.org/resource-library/oral-hygiene-home-care-practices-america) than men to recognize that food and drink impacts their teeth. As a result, women brush more often or more carefully. - People who use tobacco daily are less likely to brush and floss once or more per day than those who don’t use tobacco. Given the many factors that influence oral health, this study underscores the value of providers offering tailored guidance on home care and lifestyle habits, based on each patient’s awareness and circumstances. Another solution to promote better oral and overall health is addressing social determinants of health. That is, removing barriers that limit access to care. Veterans offer a positive case study in using this strategy: - Veterans face many obstacles accessing dental care. - They also suffer [poor oral health and chronic illness](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health), including diabetes and heart disease, more than their civilian peers. - Improving veterans’ access to dental care could yield [$7 billion in health savings](https://www.carequest.org/resource-library/veteran-dental-care-stimulates-economy-and-improves-overall-health) nationwide, largely by helping them better manage those chronic conditions. Sarah A. Sherman, director of strategic partnerships at the Maine Bureau of Veterans’ Services, recently assessed [veterans’ oral health needs](https://www.carequest.org/about/blog-post/voices-field-sarah-sherman-improving-rural-veterans-oral-health-access). She found multiple hurdles constraining dental care access. Nationally, many veterans can’t get dental services through the Veterans Administration due to narrow eligibility rules. At the state level, Sherman explains, “barriers to oral health care include cost, transportation, and, relatedly, the distance someone may need to drive to receive care.” Sherman developed the Maine Veterans’ Dental Network (MVDN), a growing group of dental providers serving veterans statewide. It has [eased access](https://www.carequest.org/about/blog-post/voices-field-sarah-sherman-improving-rural-veterans-oral-health-access) to care, helping veterans overcome structural challenges like lacking transportation. “The MVDN model works, and I would like to see it expanded to every state,” shared Sherman. One more way to foster good oral and systemic health is by integrating dental and medical care. Such efforts could be life-saving: - Oral health providers are well suited to examine and educate patients about diseases that can hurt their overall health. Two examples are the [mpox virus](https://www.carequest.org/resource-library/monkeypox-and-role-oral-health-providers-viruss-detection-and-prevention) and [oral cancer](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers). Both have symptoms that can appear in your mouth. - Primary care providers can support dental health by adding oral cancer screenings into routine [medical exams](https://www.carequest.org/resource-library/primary-care-providers-role-oral-cancer-screenings). They can also counsel patients on dental hygiene. - Policy leaders can enhance [Medicaid coverage](https://www.carequest.org/topics/adult-dental-benefit) of adult dental services, which varies across state programs. Regular dental cleanings lower a person’s risk of contracting [nonventilator hospital-acquired pneumonia](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired) (NVHAP) when hospitalized. NVHAP may increase the likelihood of dangerous, costly consequences, such as going into intensive care or developing [sepsis](https://pubmed.ncbi.nlm.nih.gov/35815618/). It’s clear that oral health affects overall health. With solutions such as those laid out in this post, leaders can make progress to improve both. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Voices from the Field: Drs. Taiwo Ngo and Kehinde Obeto on the Benefits of Medical-Dental Integration](https://carequest.org/blog/voices-from-the-field-drs-taiwo-ngo-and-kehinde-obeto-on-the-benefits-of-medical-dental-integration/) **Published:** June 12, 2023 **Author:** Caitlin Locklear **Content:** Taiwo Ngo, DDS, and Kehinde Obeto, MD, have quite a few things in common: They’re both from Lagos, Nigeria. They both moved to Ohio to pursue careers in health care. And they both now provide care for underserved populations in the Toledo area. They’re also twins with strong family ties to health care. “While we were in Nigeria, our dad was a pediatrician,” Obeto says. “He’s passed now, but he had his own hospital where I worked part-time before I moved to the States.” This background helped the sisters find their calling to help people get the access to care they need. Ngo and Obeto are now furthering that work by participating in the MORE Care™ pilot program in Ohio. [MORE Care (Medical Oral Expanded Care)](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), is an initiative of CareQuest Institute for Oral Health that aims to integrate oral health into primary care practices. The pilot program in Ohio is a collaboration between CareQuest Institute and [Oral Health Ohio](https://www.oralhealthohio.org/), a coalition of statewide partners that educate and advocate to improve the state’s oral and overall health. The initiative helps primary care practices build patient-centered referral networks with local dental providers to improve oral health and overall health within communities. The twins personify medical-dental integration: Ngo is a dentist at Midwest Dental Center, and Obeto is a pediatrician at Nationwide Children’s Hospital. Together, they explain how participating in MORE Care and medical-dental integration are improving the care they provide for underserved populations. ![](https://carequest.org/wp-content/uploads/2023/06/Taiwo-Ngo-Blog.jpg)Taiwo Ngo, DDS **Can you share a bit about the patient population you serve in Ohio?** Ngo: Access to dental or medical care is a challenge for a lot of people. Sometimes some of them don’t have the insurance, and whoever has insurance just ends up going to the emergency department if they have a toothache or abscess to get medication for pain. You find out a lot of them — even those who do have insurance —don’t use it. Some of them are afraid to go to the dentist. Some of them have had traumatic experiences in the past and only make it in to see the dentist when they feel like it’s the last resort. They also may not have transportation to get to a dental appointment, or they have to walk, so it’s hard for them to make it there. **Can you say more about the medical side of medical-dental integration and how that looks in practice at Nationwide Children’s Hospital?** Obeto: As part of medical-dental integration, our well-child visit now has an integrated template for oral health. We look at the child’s teeth and see if there is any caries formation, and we also check to see if they’ve ever seen a dentist or if they’ve ever had fluoride varnish applied. We go through some questions like, “Do you drink bottled water?” because bottled water doesn’t have any fluoride. We ask the parents, “Do you brush their teeth twice a day?” Some parents don’t realize that kids need to have fluoride in their toothpaste. They still believe they should use baby toothpaste that has no fluoride. So, during part of the visit, we educate the parents and tell them their children’s toothpaste must have fluoride in it. ![](https://carequest.org/wp-content/uploads/2023/06/Kehinde-Obeto-Blog-214x300.jpg)Kehinde Obeto, MD **Why are pediatricians so well positioned to play an important role in oral health?** Obeto: The [American Academy of Pediatrics has restated](https://publications.aap.org/pediatrics/article/151/1/e2022060417/190307/Maintaining-and-Improving-the-Oral-Health-of-Young) that we, as pediatricians, see kids more often than a dentist. We get to see them for their shots, and the first three years of life are when we get to see them maybe six, seven, or eight times. So, we figured it’d be a great opportunity for us to use that to integrate dental health into our practice, so we can apply fluoride varnish to protect their teeth. That way, even if they don’t get in to see a dentist, we can help prevent them from getting cavities by applying fluoride varnish and using the oral health anticipatory guidance. And if I happen to see a patient who needs to be seen \[by an oral health provider\] right away, I send the referral over to the Midwest Dental Clinic. And then at the end of every week, we fax over the referrals to the dentist so she can call them. So, the office calls the patients and says, “You have a referral to see the dentist. We’re calling to make an appointment for you.” We keep a spreadsheet so we can tell who has been seen and who hasn’t been seen. If they do come in and they have a dentist already, then we refer them to their dentist so we can keep them in their dental home. The ones I refer to Dr. Ngo are the ones who don’t have a dental home. **Does medical-dental integration benefit underserved populations?** Ngo: Here in Toledo now, the number of dentists who take the Medicaid population is about 1% or 2%. A lot of dentists, pediatric dentists, will see patients with private insurance, but they will not see Medicaid patients. So medical-dental integration helps people who are enrolled in Medicaid get access to a dentist. **How does medical-dental integration promote prevention and the shift to value-based care?** Ngo: We are trying to shift the focus of volume of service to value. It’s about treating the whole picture, not just one aspect of it. And we’re trying to reduce patients’ expenses. In the long run, you find a lot of people will spend less money, and the government will spend less money, because patients will not go into the ER for one thing or another. If a patient comes to me and I realize they need medical care, or they just moved here and don’t have a regular pediatrician, I can make them a referral to Dr. Obeto at Nationwide Children’s Hospital, and they can get the problem resolved. It’s also not just a matter of taking care of the cavity, of fixing the problem you have right now. At the end of the day, you’re spending more money doing that. The goal is to tell patients about prevention, so they don’t get the cavity in the first place. In the long run, they’re spending less money. And they’re getting the bigger picture. Now they’re thinking, “If I don’t eat as much candy or drink as much pop, then I won’t have to come in to get the shots to get a filling.” **How has MORE Care changed the way you work with your sister (and other dentists)?** Obeto: This is a formal integration even though we’ve already collaborated with each other in the past. For instance, if I have a patient who had dental caries and was in pain, and they couldn’t get in to see a dentist anywhere else, I would call Dr. Ngo and say, “Can you see this patient?” So, this is a more formalized process now, where there’s a structured framework for us to include oral health services, track referrals, and improve clinical workflows and communication. *Editor’s note: Voices from the Field is a series of blog posts that highlight individuals who are working to improve the oral health system. From providers and policymakers to advocates and patients, we provide a snapshot of the backgrounds, ideas, successes, challenges, and daily lives of people who are making oral health care more accessible, equitable, and integrated. If you know someone we should feature, please write to us at marketing@carequest.org.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [How Quality Data Is Transforming Oral Health Care in North Carolina](https://carequest.org/blog/how-quality-data-is-transforming-oral-health-care-in-north-carolina/) **Published:** June 20, 2023 **Author:** Caitlin Locklear **Content:** A picture may be worth a thousand words, but for two oral health care teams in North Carolina, it’s the numbers that are invaluable. ![](https://carequest.org/wp-content/uploads/2023/06/Dr.-Rebecca-Sykes_2.jpg)Rebecca Sykes, DDS “Data gives you a concrete picture of your practice,” says Rebecca Sykes, DDS, the dental director for [Wake County Department of Health and Human Services Dental Clinic](https://www.wake.gov/departments-government/health-human-services), a local health department, in North Carolina. Sykes has been with Wake County since 2010, when she started as a dentist, before becoming the dental director in 2017. Sykes says the clinic has been capturing data with two electronic health record (EHR) systems for years. “Typically, we would utilize the data more for operational decisions, like if we needed expansion requests for additional positions, or things of that nature,” Sykes says. Although gathering and analyzing data is not a new concept in Wake County, CareQuest Institute’s Community Oral Health Transformation (COrHT) Initiative has shown the clinic how it can use certain data to further improve patient care. The initiative is a partnership between CareQuest Institute, the [Blue Cross Blue Shield of North Carolina Foundation](https://www.bcbsncfoundation.org/) and the [North Carolina Oral Health Collaborative](https://oralhealthnc.org/) (NCOHC), a program of the [Foundation for Health Leadership and Innovation](https://foundationhli.org/). COrHT kicked off last year in North Carolina and runs through September of this year. When each of the 13 teams joined the cohort, they met with CareQuest Institute data specialists to explore initiative quality measures; what clinical, demographic, and financial data fields were available in their electronic dental or health records; and how regular data reporting is foundational for quality improvement and transition to equitable, value-based care. “Some of the data that COrHT was interested in showed that, yes, those operational decisions are important,” Sykes says. “But you can also use the data to help drive treatment approaches and clinical decisions on a more personalized level for your patients.” ## Crunching Numbers with CareQuest Institute COrHT features a learning community for dental teams that helps them share best practices, discuss ongoing challenges, and collaborate on solutions. With a focus on the shift to value-based care (VBC) in dentistry, the initiative focuses on teledentistry, minimally invasive care (non-surgical treatment of disease), and integration of oral health with overall health care. “Implementing this care model requires dental teams to make incremental steps toward value,” says Caroline McLeod, RDH, MS, the value-based care solutions manager at CareQuest Institute. “Data collection supports exploration of opportunities for improvement, evidence-based decision-making, and progress toward goals that improve health outcomes.” Through this learning community, CareQuest Institute asks COrHT participants to review clinical, demographic, and financial and operational data. This combination of data allows participants to understand how changes made in clinical care processes affect their operations, bottom line, and — most importantly — their patient population. “To impact change and drive insights with clinical decision-making, we needed to collect data at the most granular level from the EHR,” says Dustin Holloway, MPH, health informatics manager at CareQuest Institute. “By working with strong clinic champions, we were able to analyze data at the tooth level to better understand the procedure codes used and to provide a feedback loop for COrHT participants and CareQuest Institute.” Those connections helped the clinic discover data they hadn’t looked at in the past. “Based off the two frameworks in COrHT, the integrated and personalized care and the minimally invasive care, one thing we started implementing was caries risk assessments for all of our recall patients and new patients,” Sykes says. The county can use the data to analyze patterns of disease risk in the community. “You’re able to see the procedures you’re providing, the frequency of those procedures, along with any other trends you’re interested in,” Sykes says. And, in turn, providers can give patients better care. “Based on those caries risk assessments, we can modify treatment approaches to get better long-term outcomes,” Sykes says. “So, because of that, our use of [silver diamine fluoride](https://www.carequest.org/topics/minimally-invasive-care) in our practice has increased since participation in COrHT. If a patient is a high caries risk, we ask what we can do minimally invasive-wise to get them to a caries control state so that we can focus some attention on behavior modifications — whether it’s improvements in their oral hygiene or dietary changes that they need — before we just drill, fill, recurrent caries, drill, fill. That’s one thing, from a clinical approach, COrHT has helped with.” ## Data Shapes Change [AppHealthCare](https://www.apphealthcare.com/) in Jefferson, another safety net clinic in rural North Carolina, is also participating in COrHT. Like Wake County, AppHealthCare was collecting some data, but it wasn’t collecting it in an efficient and effective way. “It wasn’t really doing anything for us,” says Alexandria Barker, the office administration specialist at AppHealthCare. Barker formerly worked at AppHealthCare as a dental assistant. She says the health center would only run reports to look at their data every couple of months. “Through COrHT, we learned that doing them monthly has been helpful,” Barker says. “Also, having a dashboard . . . where we can visually see what that trend looks like has been great.” Barker says the numbers AppHealthCare collects help tell a story — one that can be told to their funders and community. “Our board members have enjoyed seeing the data and seeing where we were, where we are now, and where we hope to be,” Barker says. “It’s a better flow and track of that versus, whenever someone asks us a question, trying to run that report and then figure that part out.” She also appreciates the data from patient surveys. “What was good for a patient? What worked well? What made them more comfortable? Because there’s little things that we do throughout an appointment that we probably don’t realize we’re doing,” Barker says. “Then we can be more intentional whenever we’ve read a review.” ## Data Advice for Any Organization Both Sykes and Barker recognize that not every health center is at the same stage in their data journey. “As safety nets, we have tremendous support from other health centers, whether they’re Federally Qualified Health Centers, nonprofits, or local health departments,” Sykes says. “We have a strong network of colleagues, and that’s been another valuable asset of COrHT.” They have advice for health centers who don’t have the setup or the staff to collect and use data the way they’d like to. “Don’t get discouraged,” Barker says. “It’s a journey.” Sykes adds, “Reach out to colleagues, because maybe they’ve been through similar struggles and they can share with you what’s worked for them. And then be willing to get creative. If it’s funding or finances that are the hurdle, there might be a [grant opportunity](https://www.carequest.org/grantmaking) that you qualify for. Look at the data that you’re wanting to collect and capture because that’s going to allow you to make the most educated decision regarding which systems will best meet your clinic’s needs.” The COrHT Initiative in North Carolina wraps up in September. NCOHC and CareQuest Institute will later develop a comprehensive impact report to help participating safety net clinics sustain their work and influence long-term reform. Barker adds that following participation in COrHT, she’ll have more than just a better understanding of how to use data. “It’s been a great networking experience,” Barker says. “I have learned a lot, met a lot of really great people who I feel like I’ll be able to reach out to after the initiative.” Sykes agrees on the value of camaraderie and shared learning. “It was refreshing to have that networking opportunity with other clinics that faced the same or similar challenges because we can all learn from each other,” Sykes says. “Even if your approaches are slightly different, it’s nice to know that you’re not facing things alone, and that other clinics are facing similar situations. You’re not on an island by yourself.” **Categories:** Blog **Tags:** Clinical Practice, Value-Based Care --- ### [Caring for LGBTQ+ Patients: Five Tips and a Look at the Latest Data](https://carequest.org/blog/caring-for-lgbtq-patients-five-tips-and-a-look-at-the-latest-data/) **Published:** June 22, 2023 **Author:** Caitlin Locklear **Content:** When patients fill out a form at a dentist’s or doctor’s office, do they see themselves represented? For individuals who are lesbian, gay, bisexual, transgender, queer, or have other sexual orientations or gender identities (LGBTQ+), the answer can sometimes be a hard “no.” And it’s an example of a larger problem in oral health: Structural bias and stigma around gender, gender expression, and sexual orientation can deepen LGBTQ+ oral health inequity. New research from CareQuest Institute, drawn from the newest [State of Oral Health Equity in American survey](https://www.carequest.org/SOHEA2022) data, affirms the persistence of LGBTQ+ disparities in oral health. What does that mean for anyone working in a dental setting? No matter your role — dentist, hygienist, assistant, manager, technician, therapist — you can reduce disparities by showing up as an ally, offering meaningful support to shift policy and culture. ## A Snapshot of LGBTQ+ Oral Health Annually for the last three years, CareQuest Institute has conducted the State of Oral Health Equity in America survey to identify current gaps in oral health and inform solutions. Surveying more than 5,000 adults in the United States, it is the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. ![](https://carequest.org/wp-content/uploads/2023/06/LGBTQ-Couple-Brushing-Teeth.jpg) Findings, which will be released in reports in the coming weeks, illustrate that the LGBTQ+ community continues to experience greater levels of dental disease. For example: - Nearly 3 in 5 LGBTQ+ people say they had one or more oral health symptoms this year, compared to just under 1 in 5 non-LGBTQ+ individuals. - More than 1 in 3 LGBTQ+ adults say they have fair or poor oral health, compared to about 1 in 4 of their non-LGBTQ+ peers. Dental pain can interfere with employment and academic success. Untreated symptoms can eventually turn into a crisis, when services often [cost more](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions). Over the long term, financial hardship can be greater if you lack dental coverage. Data show, too, that these consequences fall harder on those who identify as LGBTQ+: - LGBTQ+ adults are nearly twice as likely to say they lost dental insurance in the past year, compared to their non-LGBTQ+ peers. - At 12.2%, more LGBTQ+ individuals say they missed school or work due to an unexpected dental appointment than 7.4% of non-LGBTQ+ people. ## Anti-LGBTQ+ Bias Can Push Care Out of Reach Individuals who identify as LGBTQ+ have long faced discrimination in health care and other sectors. Studies show experiencing bigotry acts as a [roadblock to care](https://www.americanprogress.org/article/state-lgbtq-community-2020/), leading LGBTQ+ people to delay needed services in the future. Data from the State of Oral Health Equity survey underscore that reality. In short, the data reveal LGBTQ+ gaps in access to dental care. More specifically: - Almost 3 in 10 LGBTQ+ patients say they don’t have a regular source of dental care, compared to just under 2 in 10 of non-LGBTQ+ people. - More than 2 in 5 LGBTQ+ people say their last dental appointment was more than a year ago. Less than 1 in 3 of their non-LGBTQ+ peers say the same. - People who are LGBTQ+ are nearly twice as likely as non-LGBTQ people to say they don’t plan to see a dental provider in the next year for a checkup or preventive care. ## Unique Systems of Oppression Hurt LGBTQ+ People In [a 2022 CareQuest Institute webinar](https://www.carequest.org/education/webinars/becoming-ally-creating-inclusive-environment-lgbtq-patients), Alex Barrera, DDS, addressed some of the social structures that uphold anti-LGBTQ+ bias. Barrera is president of [Houston Equality Dental Network](https://pages.ada.org/en/covidmonograph/the-houston-equality-dental-network) and a community health dentist at [Legacy Community Health](https://www.legacycommunityhealth.org/). “The major reason that discrimination against the queer community exists is because of heteronormativity,” explains Barrera (using “queer” as an accepted term encompassing all LGBTQ+ people). “It’s the assumption that everyone is heterosexual and that heterosexuality is superior to all other sexualities.” It functions as a system of oppression against LGBTQ+ people, he said. “What it’s all about is control,” says Barrera. “It’s very easy to control people when there are only two boxes they can fill.” ## Five Ways to Be an Ally to LGBTQ+ Patients Toward the end of his presentation, Barrera offered five strategies for oral health providers to make dental care experiences more inclusive for LGBTQ+ patients. **1. Recognize your privilege and use it for good.** If you are not LGBTQ+, reflect on how you may benefit from heteronormativity. Are there assumptions people make about you that you don’t have to correct? Consider how this belief system appears in your practice. Interrupt discrimination when you see it and encourage colleagues to do the same. ![](https://carequest.org/wp-content/uploads/2023/06/alexander-grey-IDxuUey3M5E-unsplash.jpg) **2. Learn and use inclusive language.** There are a range of terms LGBTQ+ people use to describe aspects of their identity. Some have evolved over time. For example, many people today prefer “gay” over “homosexual.” Talk with LGBTQ+ patients and respect the language they use. **3. Create a safe space for patients.** Providers can affirm LGBTQ+ people with policy and cultural shifts. Enact nondiscrimination policies protecting LGBTQ+ patients and colleagues. Celebrate Pride Month. Advertise your practice on queer websites. Share your pronouns with patients and ask for theirs. Consider making them visible, such as on name tags. **4. Update intake forms and electronic dental records.** Create space on forms and records for patients to share their pronouns and gender identity, including options not to list a gender. Ask patients about their correct name — and use it. This is especially important to support transgender patients, who may not use their legal name. **5. Don’t minimize anyone’s queerness.** Allow patients to talk about who they are. Be open to hearing about their friends, family, and identities, which may look different from yours. These actions can start creating safer environments for LGBTQ+ people, lowering barriers to care, and advancing oral health equity. **Categories:** Blog **Tags:** Health Equity --- ### [Easing Anxiety: Helping Afghan Refugees Access Oral Health Care](https://carequest.org/blog/easing-anxiety-helping-afghan-refugees-access-oral-health-care/) **Published:** June 28, 2023 **Author:** Caitlin Locklear **Content:** In early 2022, 700 Afghan refugees arrived in central Iowa, trying to settle into a community unlike any they’d ever seen. A strange landscape. A sea of unfamiliar faces. A new life. And they had 90 days to get settled. ![](https://carequest.org/wp-content/uploads/2023/06/Mary-Kelly-Head-Shot-scaled.jpg)Mary Kelly, RDH “The resettlement agencies had care coordination for 90 days — and that’s a federal guideline — when they’re funded to help them find housing and help them get into the community,” says Mary Kelly, RDH, a former care coordinator at [Broadlawns Medical Center](https://www.broadlawns.org/), a safety net clinic in central Iowa. “And in that time, they \[the refugees\] have to get medical and housing, know how to get transportation, and essentially get used to whatever environment they’re living in — and know how to access the community after that.” In addition to that long list, there’s another task that many refugees need to complete in those 90 days: setting up a dental appointment. Many Afghan refugees are in desperate need of oral health care. Making the situation even more challenging, many of them don’t know English and have never set foot inside a dental office. “It was either that they didn’t have access to \[oral health\] care ever, or they just hadn’t had it,” says Kelly. “Unlike other refugees — a lot of refugees camped for 10 years. Afghans didn’t because they had an immediate evacuation. So, it’s not like they had time to get dental work done in a camp.” Kelly says she wishes she had known about — and implemented — the strategies on how to ease Afghan refugees’ anxiety that she gained from a CareQuest Institute webinar, “Understanding and Providing Trauma-Informed Oral Health Care.” (The webinar is now available as a [self-paced course](https://www.carequest.org/education/course/understanding-and-providing-trauma-informed-oral-health-care/overview) that includes strategies to help providers sensitively interact with trauma survivors.) “I probably would have prepared something that says what to expect from your first dental visit,” says Kelly. “And maybe even taken them into the clinic and shown them what the chair was.” Ongoing education and support from community-centered grants can help improve the situation for future refugees. CareQuest Institute offers both education and grants, and partners with dozens of organizations across the country to expand access for underserved populations. Improving access to the oral health system is a complex and multifaceted problem, Kelly adds, that will take new ways of thinking and new solutions. “It’s not just Afghans, it’s all refugees,” Kelly says. “The solution — there really isn’t one, because the solution is bigger than just the refugees, unfortunately. It’s the dental provider network and access to care generally.” ## When Oral Health Isn’t a Top Priority Since the US withdrew its military from Afghanistan in August 2021, tens of thousands of Afghans have evacuated to the US to escape the Taliban. Refugees often experience nutritional deprivation, inadequate living conditions, and a lack of access to basic dental care before they arrive in the US. Those refugees are now working to resettle — with help from state and federal governments — in a country where they must quickly find housing, transportation, and employment to try to support their families. Resettlement may bring additional health challenges related to a lack of familiar foods and challenges navigating the US health care system.![](https://carequest.org/wp-content/uploads/2023/06/iStock-1012651370-scaled.jpg) Fortunately, there are organizations that help ease the transition. Broadlawns Medical Center, Kelly’s employer at the time, received a six-month grant from [Delta Dental of Iowa](https://www.deltadentalia.com/) to help some of those Afghan refugees access oral health. Another health center in the area, [Dental Connections](https://dentalconnectionsonline.com/), a private, nonprofit community organization that strives to be a dental home for people who experience barriers to accessing dental care, also received a grant to help all refugees, not just Afghans. “These refugees have fled their home country because of violence or persecution and often spend years stuck in refugee camps overseas,” says Carly Ross, the executive director of Dental Connections in Iowa. “In these environments, most refugees do not receive oral health care.” The need for care, Ross adds, is clear. “Once in the US, the dental needs of new refugees are often extensive,” she says. “New refugees also need oral hygiene instruction and education on healthy behaviors.” ## Challenges and Complications of Providing Care “Dental Connections and Broadlawns Medical Center made a concerted effort to streamline refugees in general and give them a higher priority and more care coordination,” Kelly says. After the 90 days of care coordination with resettlement agencies expired, the grants allowed both organizations to continue to help Afghan refugees access oral health care. “They would come in, and I’d reaffirm all the paperwork that they needed, all the registration,” Kelly says. “After registration, each refugee patient would be seen by the dentist for a complete oral exam, including all the x-rays . . . and explain the treatment plan.” Often, the need for care was urgent. “We worked with the University of Iowa. They have a lot of dental students, and they would rotate through Broadlawns to provide dental treatment,” Kelly says. “So if there was ever an urgent need, pain or swelling diagnosed at the comprehensive exam visit, the Broadlawns dentist would try to have a dentist or dental student get that urgent need taken care of at the same visit. Sometimes it worked, and sometimes it didn’t. They \[the refugee patients\] were usually seen within a day if they had anything that couldn’t be done at the comprehensive exam that was really needing care.” Just scheduling the appointment can be a complicated process. “All these refugees have Medicaid for at least a year in Iowa,” Kelly explains. “Iowa has [extensive Medicaid benefits for adults](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). So, they all had Medicaid, but when I would look them up in the computer, sometimes they were already at another dental clinic. Sometimes their names and birthdays didn’t match up. I’d find them, but their birthday was different than their refugee identification. Their names were merged sometimes instead of separated. It was nearly impossible. Each person took a minimum of 45 minutes to make one appointment.” And after those first 90 days are up, many refugees still struggle to find transportation or childcare to go to the scheduled appointment. The language barrier was yet another hurdle. “They need a lot of extractions,” Kelly explains. “And they want to keep their teeth, so it was really difficult to explain. They didn’t know what a cavity was, but they knew what an implant was. They’d rather keep that infected tooth. Their bone was diseased enough they couldn’t get implants.” ## Oral Health Grants Expanding Access to Care CareQuest Institute’s philanthropic strategy is focused on addressing complex and upstream drivers of oral health disparities like the ones facing many refugees. The Institute recently issued a grant for $50,000 to Dental Connections to continue its program to improve oral health care coordination and public health partnerships for refugee communities. The Institute also issued a grant for $128,000 to [New Mainers Public Health Initiative](https://nmphi.org/) (NMPHI) to serve the needs of the immigrant and refugee communities in Maine and help create a community outreach program. John Gabelus, grants and programs associate at CareQuest Institute, highlights the need for this attention and support. “With these grants, resources, and new partnerships, we are working to make sure that everyone, no matter how long they’ve been in the United States or their reason for coming, has an opportunity to access oral health care and learn about its impact on overall quality of life,” he says. “More importantly, these grants create a pathway and opportunities for immigrant and refugee communities to participate actively in our collective effort to transform the oral health system in ways that respond to their needs and the needs of immigrant and refugee communities in the future.” Although grants can support clinics in helping refugees make dental appointments and get access to the oral health care they need, Kelly says the system is far from perfect. Because the process was new to the refugees, many would show up at the wrong clinic, not realizing there was a difference between Broadlawns Medical Center and Dental Connections. Some would get a referral to one clinic but then move on to different clinics and book additional appointments. They were trying to get seen earlier but not understanding that they needed to go to the appointment they were referred to, she says. “Everyone is in desperate need of care,” she says. Although a lot is out of Kelly’s control, she says it is important to make those refugees [feel as comfortable as possible before they get in the dental chair](https://www.carequest.org/education/course/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help/overview). “Here, they say laying down and having someone in a more dominant role can be traumatic,” Kelly says. “I think I would’ve been more aware of that type of orientation of the dental clinic beforehand.” She plans to share the information she learned from the webinar with others to help refugees in any way they can. “I am definitely going to incorporate it into the report that I’m doing for all Afghans,” Kelly says. “And I’ve already referred that webinar to several people, including all the people in my clinic.” **Categories:** Blog **Tags:** Health Equity --- ### [Five Key Takeaways about Medicaid Adult Dental Benefits in 2023](https://carequest.org/blog/five-key-takeaways-about-medicaid-adult-dental-benefits-in-2023/) **Published:** July 10, 2023 **Author:** Caitlin Locklear **Content:** Public understanding of the [connection between oral health and overall health](https://www.carequest.org/resource-library/beyond-nice-smile) has steadily grown in recent years. There is also widespread and accumulating research that shows increasing dental coverage allows for [more equitable access to dental care](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2021.01191) across communities, [lowers overall health care spending](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/whitepaper_0721.pdf) on chronic disease management and emergency department usage, positively impacts [oral health outcomes](https://www.carequest.org/resource-library/expanding-dental-benefits-good-states) for patients, and increases employment opportunities. What’s more, [the public is highly supportive](https://www.carequest.org/resource-library/dental-insurance-out-reach-many) of providing comprehensive dental benefits within Medicaid. Fortunately, this research and the work of tireless oral health advocates are improving access to care for thousands of individuals in the United States. The period between 2020 and 2022 marked a significant expansion of Medicaid adult benefits across the country — one of the most significant in recent decades. Nearly half of all states expanded their Medicaid adult dental benefit offerings, five states increased the amount of per member spending, and three states implemented benefits for the first time to some or all of their adult beneficiaries. In total, according to the just updated [Medicaid Adult Dental Coverage Checker, eight states now offer an extensive Medicaid adult dental benefit](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). And the momentum has continued into 2023, as new or expanded benefits have taken effect in five additional states: Hawaii, Maryland, Michigan, New Hampshire, and Tennessee. You can find [more details about these changes on the Coverage Checker webpage](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). (Kentucky also enacted an expansion of Medicaid adult dental benefits via administrative regulation on January 1, but the benefits were rescinded on March 29.) Because the Coverage Checker shows benefits in place as of December 31, 2022, these benefits are not reflected on the updated dashboard. Originally released in 2022, the Coverage Checker is an interactive tool for policymakers, administrators, and advocates to understand where a given state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories. The Checker includes data self-reported by state Medicaid dental directors or their staff in a survey developed by the American Dental Association Health Policy Institute (ADA HPI), Center for Health Care Strategies (CHCS), National Academy for State Health Policy (NASHP), CareQuest Institute, and advisory committee members. [The updated Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) highlights the progress advocates and policymakers have made to expand adult dental benefits in the past few years. Here are the five most noteworthy takeaways: **1. The number of states that offer extensive Medicaid adult dental benefits has increased since 2020.** Although states are required to provide comprehensive dental benefits for children covered by Medicaid and the Children’s Health Insurance Program (CHIP), dental coverage for adult Medicaid beneficiaries is optional for states.![](https://carequest.org/wp-content/uploads/2023/07/Number-of-States-Providing-Medicaid-Adult-Dental-Benefits.png) As a result, states have the option to limit the type or amount of services and beneficiary groups they will cover. States can also exclude adult dental services entirely. In 2020, when data were collected for the original Coverage Checker, three states (Alaska, Nebraska, and Wisconsin) plus the District of Columbia provided an extensive dental benefit to the largest group of Categorically Needy Medicaid adult beneficiaries ages 21–64. ([Categorically Needy](https://www.medicaid.gov/sites/default/files/2019-12/list-of-eligibility-groups.pdf) is a term used by the Centers for Medicare and Medicaid Services.) As of December 31, 2022, this number grew to the District of Columbia and seven states — Alaska, Iowa, Maine, Montana, New Jersey, Oregon, and Wisconsin — providing extensive dental benefits to the largest group of Categorically Needy Medicaid adult beneficiaries. (Note: Nebraska noted a reduction in their annual benefit maximum and coverage of partial dentures.) **2. Six states implemented adult dental benefits for the first time or significantly expanded their existing benefits.** Delaware, most notably, implemented a Medicaid dental benefit for all adult beneficiaries in October 2020. Prior to this, adult beneficiaries had no dental coverage in the state. Five states — Kansas, Maine, Oklahoma, Virginia, and West Virginia — significantly expanded benefits to all adult members between 2020 and 2022. More specifically: • In Kansas, Medicaid dental benefits were eliminated for all adults in 2010. (Between 2010 and 2022, Kansas provided emergency extractions to its adult Medicaid members. Some additional dental services were later offered through the state’s Managed Care Organizations as value-added benefits.) In 2013, the state’s three Medicaid-contracted managed care organizations (MCOs) began providing limited dental services to its adult members as “value-added services” at no cost to the state. They expanded those in 2018. In April 2022, the state budget was finalized and included funding for the restoration and expansion of Medicaid adult dental benefits. The new benefit (effective July 1, 2022) includes fillings, crowns, and periodontal treatment. The state’s MCOs continue to cover examinations and cleanings. • In Maine, the state’s FY 2022 supplemental budget included funding to create an extensive Medicaid adult dental benefit. The benefit (effective July 1, 2022) provides coverage for diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and adjunctive services as well as oral surgery. Prior to 2022, adult beneficiaries were covered only for emergency dental services. • In Oklahoma, the state approved a Medicaid expansion ballot initiative in June 2020. As part of its implementation on July 1, 2021, the state also reinstated its Medicaid adult dental benefit. The benefit is available to all adult beneficiaries and includes preventive and restorative services, full and partial dentures, and extractions. • In Virginia, in 2015, the state began providing an expansive dental benefit to pregnant adults. In 2019, the state enacted Medicaid Expansion, providing the state’s emergency-only Medicaid adult dental benefit to approximately 400,000 new enrollees. In November 2020, the state’s budget was finalized and included funding for an expanded Medicaid dental benefit for all adult beneficiaries, including diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, extraction, oral surgery, and adjunctive services. • [In West Virginia](https://bms.wv.gov/), in March 2020, the governor signed SB 648 into law, creating a limited Medicaid adult dental benefit. Coverage (effective January 1, 2021) is provided up to $1,000 per year and includes diagnostic, preventive, and restorative services. **3. Four states began providing an enhanced package of benefits to certain groups of adult beneficiaries.** Since the release of the original Coverage Checker, four states — Alabama, Louisiana, Maryland, Tennessee — began providing an enhanced benefits package to certain adult beneficiary groups between 2020 and 2022. Historically, Alabama, Maryland, and Tennessee have not provided dental benefits to their adult members. The expansion of benefits in these states marks a very significant change and, in Maryland and Tennessee, paved the way for an expansion of benefits to all adults in 2023.Of note, prior to January 1, 2023, Maryland Medicaid did not cover dental services for adults 21 years or older, except for pregnant and postpartum women, individuals enrolled in the Rare and Expensive Case Management, individuals enrolled in the Adult Dental Pilot Program, and emergency services for dental problems provided in a hospital emergency department.![](https://carequest.org/wp-content/uploads/2023/07/State-Effective-Date.png) Beginning April 1, 2022, Maryland began [providing dental benefits for postpartum women](https://dlslibrary.state.md.us/publications/Exec/MDH/SB100Ch600HB368Ch599%282021%29_2022%28f%29.pdf). Learn more about the [Adult Dental Pilot Program in the state](https://www.mdac.us/file_download/inline/c9b60298-2f63-43fc-9863-d6e5f055056a). According to the survey that serves as the foundation for the Coverage Checker, 17 states reported that they offer different coverage — different amounts, durations, and scopes — to specific groups of beneficiaries than they offer to the largest group of Categorically Needy Medicaid adults ages 21–64. Within those states, the beneficiary groups most commonly covered are pregnant and postpartum adults, adults with developmental and/or intellectual disabilities, and adults utilizing long-term care. Additionally, some states offer coverage to adults with blindness (Missouri and Utah), those experiencing homelessness and/or substance use disorder or mental health conditions (Utah), former foster youth (Maryland), and adults who are dually eligible for Medicaid and Medicare (Maryland). Later this year, CareQuest Institute plans to publish a separate report detailing those groups of adult beneficiaries. **4. Nearly 40% of states have expanded benefits since 2020.** Twenty states expanded their benefits between 2020 and 2022.![](https://carequest.org/wp-content/uploads/2023/07/Number-of-States-that-Added-Covered-Services.png) Four added at least one service (e.g., cleaning, periodontal services, or complete dentures), twelve added between two and six services, and four states added seven or more services. The most commonly added services were: - Complete dentures - Chairside or laboratory reline of complete dentures, and rebase - Periodontal scaling and root planing, and periodontal maintenance - Resin-based partial dentures - Amalgam and resin-based composite restorations - Prophylaxis 5\. **Sixty-two percent of states have no annual limit on dental services spending per member.** Thirty-two states place no limit on dental services spending per member per year. Four states have an annual benefit limit of less than $1,000, and another four have an annual benefit limit of $1,000 or greater. ![](https://carequest.org/wp-content/uploads/2025/10/Stacey-Auger-topaz-202x300.jpg)Stacey Auger, MPH Between 2020 and 2022, five states (Iowa, Oklahoma, Kansas, South Dakota, and Vermont) increased their annual benefit maximum. *Authored by Stacey Auger, MPH, policy consultant, CareQuest Institute* *Editor’s note: [Explore the full Adult Dental Medicaid Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) and state-by-state details in the interactive dashboard. There, you can also learn more about the survey that assesses the effectiveness of* **Categories:** Blog **Tags:** Dental Coverage --- ### [Barriers to Care Are Driving Oral Health Disparities. These Four Solutions Can Help.](https://carequest.org/blog/barriers-to-care-are-driving-oral-health-disparities-these-four-solutions-can-help/) **Published:** July 17, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/medical-dental-integration_exam-masks2.jpg)Without regular, preventive dental care, early tooth decay or gum disease can worsen, hurting [our overall health](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) and increasing treatment costs. But many people can’t access the preventive services they need. Policy and structural barriers — from inadequate dental coverage to a lack of providers in their community — stand in their way, creating [broad oral health disparities](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health). Those barriers present real and daily challenges, but they are not insurmountable. Changing where and how dental services are delivered, increasing the use of technology, strengthening dental coverage, and continuing community-based advocacy efforts can help more people regularly access critical preventive care. ## Why the Emergency Department Isn’t Part of the Solution When dental problems fester, they can quickly and unexpectedly turn unbearably painful. The only option for many people, especially those without access to regular dental services, is to seek treatment at a local hospital’s emergency department (ED). But EDs are ineffective at resolving dental health crises, as they’re ill-equipped to treat the root cause of oral disease. Recent research by CareQuest Institute for Oral Health shows that, after visiting an ED for dental concerns in 2021, [57% of adults were referred to an oral health provider](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) because the department could only offer temporary relief. And more than [6 in 10 adults were prescribed painkillers](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) during or after being seen at the ED. Related research finds that people [more likely to use the ED](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) for dental concerns share many characteristics, including the following: - They live in a rural area. - They tend to have lower incomes. - They are often uninsured or enrolled in Medicaid coverage. The lack of adequate insurance is a particularly big hurdle — and a common reason for an ED visit for a non-traumatic dental condition. In 2019, [among those under age 44 who went to the ED for dental problems, 7 in 10](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) were enrolled in Medicaid or not insured. In addition to not resolving patients’ underlying dental needs, [ED visits for dental concerns are more expensive](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) than other care options. In 2019, they cost the health system [$3.4 billion](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) to treat. ## Oral Health Disparities Continue to Hurt the System Uneven access to care means some communities face a greater risk of dental disease and struggle with related financial consequences. [People with low incomes are among those hit hardest](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families), while racism compounds the harm. ![Dentist talking to family](https://www.carequest.org/sites/default/files/2023-07/Dentist%20with%20Family2.jpg)Dentist talking to family Examples of economic and racial disparities from recent CareQuest Institute research include the following: - Adults earning $100,000 or more a year were [much more likely to rate their oral health as excellent](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), very good, or good (87%), compared with 60% of those making less than $30,000 per year. - [Homeownership was linked to higher rates of having a dental home](https://www.carequest.org/resource-library/cost-race-and-persistent-challenges-our-oral-health-system), better self-rated oral health, and more regular dental visits, compared with renting or occupying a home without payment. - Children and adults of color have [greater rates](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health) of untreated tooth decay than white children and adults. - Black adults are [two and a half times](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health) more likely to visit an ED for dental pain than their Asian, Hispanic, or white peers. Other structural barriers include geographic isolation and poor dental coverage. Veterans, for example, feel the impact of both hurdles. Nearly [one in four veterans live in rural areas](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity), where routine dental care is harder to obtain. They face higher rates of tooth decay and gum disease and need more restorative dental care than civilians. And [dental insurance options for veterans are also narrow](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity). Accessing care often depends on being able to pay out of pocket. Medicare and Medicaid are similarly limited. Neither program guarantees adult dental benefits in federal policy. For the nearly 60 million individuals enrolled in Medicare, [the absence of coverage takes a huge toll](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled): - Adults enrolled in traditional Medicare plans are stuck [paying for 79%](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled) of their dental care out of pocket. - Many seniors say [that cost is a primary reason](https://www.carequest.org/resource-library/burden-out-pocket-expenditures-dental-care-medicare-enrolled-elderly-and-disabled) for delaying needed care. ## Four Solutions That Can Help Fortunately, there are some systemic solutions that can boost access to dental care and reduce oral health disparities. Here are four top strategies that policymakers, oral health advocates, and other industry and community leaders can use to make progress: **1. Using [school-based dental services ](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant)(SBDS).** Many students see dental providers at school for dental cleanings, diagnostic services, and preventive care, including fluoride treatment and dental sealants. [Studies show that sealants offered through SBDS](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant) reduces tooth decay among otherwise underserved students. In a recent [CareQuest Institute webinar](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant), experts noted that sealant programs were scaled back during the COVID-19 pandemic, likely harming children’s health and school success. It is important to [reinvigorate such programs today](https://www.carequest.org/about/blog-post/process-rebuilding-school-based-dental-sealant-program), as they position more children for a healthier future. **2. Expanding [teledentistry](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina).** Harnessing telehealth is already expanding access to care for adults and children, and it has the potential to do much more. It can be particularly valuable in helping to overcome geographic isolation and may be part of SBDS. For instance, in North Carolina, a Federally Qualified Health Center [utilized a mobile clinic](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina) to partner with a rural school to expand care. There, dental hygienists provided care to 1,200 students in just one year. CareQuest Institute’s Community Oral Health Transformation (COrHT) Initiative is helping oral health teams learn about and use teledentistry, among other solutions, to bring dental care to people experiencing access barriers. **3. Strengthening Medicaid adult dental coverage.** Today, [most states](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) don’t offer the extensive benefits adults need to experience excellent oral health. In states where Medicaid covers adult dental care, [policymakers frequently cut benefits](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-increase-access-and-reduce-out-pocket-expenditures) when facing budget shortfalls. Bolstering Medicaid dental coverage is [proven to significantly strengthen](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-increase-access-and-reduce-out-pocket-expenditures) adults’ access to and use of dental care. It also reduces out-of-pocket costs for patients and ED visits, conserving health system resources. **4. Continuing community-based advocacy efforts.** Working to lift barriers to access is challenging but crucial work — and oral health advocates do much of it. In 2022, CareQuest Institute invested more than $14 million in 86 grantee organizations, 33% of which are BIPOC-led. That work has continued in 2023 with [$2.7 million ](https://www.dentistrytoday.com/carequest-institute-awards-2-7-million-in-grants-to-help-advance-health-equity/)in awards in the first quarter of the year. Organizations across the country work in their communities to reduce racial and economic disparities, working to ensure that benefits and care reach everyone in need. **Categories:** Blog **Tags:** Health Equity --- ### [Voices from the Field: Dr. An Nguyen on “Third Cultures” and Quality Improvement](https://carequest.org/blog/voices-from-the-field-dr-an-nguyen-on-third-cultures-and-quality-improvement/) **Published:** August 16, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)As a public health dentist, An Nguyen, DDS, MPH, spends a lot of time thinking about the impact that place and space have on health outcomes. For her, the social determinants of health — the conditions in the environments where people are born, live, learn, work, play, worship, and age — shaped her path in three major ways: - She is a part of a family of refugees. “At seven months pregnant, my mom and dad escaped Vietnam on a boat and, after 11 days at sea, were found and taken to a refugee camp in Hong Kong, where I was born,” she says. - She is a southerner. “After the refugee camp, we were sponsored in Little Rock, Arkansas, which became my childhood home,” she says. “In Arkansas, Chelsea Clinton was my classmate in the public school system, but it’s also where I learned English as a second language and received charity care from a privately practicing dentist.” - She describes herself as a “third culture” kid. “I have close ties to my parent country but also feel strongly assimilated into my new homeland, identifying as something culturally unique to both,” she says. Nguyen is the chief dental officer at [Clinica Family Health](https://www.clinica.org/) in Colorado. She brings her unique background and lens to her work every day, connecting dots that might not be apparent to others. She also brings a passion for quality improvement and a formalized, data-driven approach to improving care and systems that surround our work and lives. (In July, Nguyen was a panelist on “[Using a Quality Improvement Approach to Improve Oral Health Outcomes](https://www.carequest.org/education/webinars/using-quality-improvement-approach-improve-oral-health-outcomes),” a CareQuest Institute–National Network for Oral Health Access (NNOHA) webinar.) Nguyen found some time after the program to tell us more about her journey into public health dentistry and to offer advice and inspiration for anyone interested in learning more about quality improvement. ![](https://carequest.org/wp-content/uploads/2023/08/An1-1-scaled.jpg)An Nguyen, DDS, talks to patients **How does your background influence the way you approach your work?** I tend to be more aware of other “third cultures” around me — those who don’t quite fit the norm yet seek to be and must be integrated into the whole. So, when I found myself on a prehealth professions track in college and an advisor said, “You don’t ask questions typical of a health care provider; have you considered public health?” it took very little for me to integrate into the third culture of public health dentistry. Today, my work centers on third cultures in many ways — as a clinical provider for underserved patients, an equity champion for marginalized populations, and a systems designer to support the diverse needs of the American melting pot. It is my belief that when we support those most challenged to engage with prevailing systems, we create environments where all third culture people find inclusivity, and these are spaces and places that allow all of us to thrive. **What does an average day as the Chief Dental Officer at Clinica Family Health look like?** The essence of my work is fairly straightforward: I connect dots. In the decade plus that I have served in leadership at Clinica, listening and reflecting are the tools I use most to support growth of our access, integration of our systems, and improvement of our quality of care. They are the tools that allow me to thread together what I always hope are accurate, coherent stories of the realities that we face in health care and to promote sensitivity for the marginalized people receiving care within it. I frequently have the opportunity to share those stories and experiences in many different forums — from leadership of my dental team to executive oversight at Clinica to advocacy in state and national professional and policy groups — all of it influenced by my “third culture kid” lens and by the honor of hearing my patients’ stories as I sit chairside. **On the webinar, you spoke passionately about your appreciation for quality improvement. Where did that appreciation originate?** ![](https://carequest.org/wp-content/uploads/2023/08/An3.jpg)An Nguyen, DDS, MDH, gives US Senator Michael Bennet a tour of a dental clinic For me, quality improvement is the intersection of SCIENCE + HUMANITY. There is rigor and evidence behind quality improvement (a scientific field with origins in physics and engineering), but they are inherently designed with people in mind — both the people who work within the system seeking improvement and the people who are on the receiving end of the system itself. Early in my career, I vividly remember the huge dopamine hit after participating in my first PDSA (or Plan-Do-Study-Act cycle, a quality improvement process designed for small tests of change). I saw how it could become an outlet to process the observations and ideas that frequently only lived in my head. As an introvert and internal processor, participating in QI activities supported me to share my voice, and I immediately saw how powerful it could be for promoting equity. I have been hooked since. **Why do you think quality improvement is a valuable tool in dentistry?** Something universal that I believe connects all of us who have found dentistry as a profession is our appreciation of our connection to others. Regardless of our role in the profession, we all arrive and stay to work in dentistry because we care about helping others, and we care about making things better for the people we serve. A quality improvement approach is complementary to these aspirations. As a public health dentist, I consider quality improvement as critical . . . a tool in my toolbox as my ability to properly diagnose and treat a cavity or to plan and evaluate a health promotion program. ![](https://carequest.org/wp-content/uploads/2023/08/An2.jpg)An Nguyen, DDS, MPH, in front of Clinica’s latest dental clinic build **Can you share an example of a project that illustrates the value of quality improvement?** One of the first questions I asked when I arrived at Clinica was “How does a patient get a dental appointment?” This resulted in a list of steps that helped us see the patient’s journey, which helped us see that changes were needed to support a better patient experience. The team had lots of ideas for how we could make things better, and we tested many of them using PDSA cycles, which allowed us to identify which ideas to abandon and \[which\] to adapt and scale up with more testing. Ultimately, that work allowed us to increase the rate at which our patients could complete their treatment plans from dots that would barely register on a run chart (a graph of data over time) to consistently above 70% within our first three years of focus. This has resulted in significant improvement in our patients’ experience with our system, their clinical outcomes, and staff satisfaction. [This is the story that started our dental quality journey at Clinica](https://drive.google.com/file/d/11nxscpHLFGYc7dxf0vLJs7PY5Eju5OqS/view), on which we have never looked back. **If someone is interested in dipping their toe into quality improvement, where should they start?** Start with an idea; all teams have them! With relatively little formal training, it’s possible to move that change idea into a PDSA cycle that could be tested tomorrow. Even if the test is ultimately unsuccessful, the cycle will quickly generate invaluable information about the system to inform the next test cycle that can lead to incremental improvement. A PDSA is a low-cost, low-commitment way to get invaluable data while also fostering team engagement and supporting change management. There are also several organizations important to my journey where a new learner of QI — especially one in the oral health space — can get support, including [NNOHA](https://www.nnoha.org/pages-1/resources-%7C-quality-improvement-%26-value-based-care) and the [Institute for Healthcare Improvement](https://education.ihi.org/topclass/topclass.do?expand-OfferingDetails-Offeringid=15368). **Lastly, what one change would you make to improve the oral health system overnight?** Integrate — everywhere. There are so many real and perceived siloes that get in our way of improving the system. In dentistry, how might we integrate payment systems to better support outcomes-based care? I see a tremendous amount of opportunity in value-based payment systems, for which a quality improvement approach is critical for success. From a public health lens, integration of oral health in systems that are not conventionally considered as “dental” is critical to normalizing basic health-promoting behaviors and preventive care receipt. I envision making oral and general health wellness a part of basic education and public dialogue. *Editor’s note: Hear more about quality improvement and Dr. Nguyen’s work on the recording of “[Using a Quality Improvement Approach to Improve Oral Health Outcomes](https://www.carequest.org/education/webinars/using-quality-improvement-approach-improve-oral-health-outcomes).”* **Categories:** Blog **Tags:** Practice Management --- ### [KINDness in Action: A Colorado Nonprofit Is Empowering Community Access to Oral Health Care](https://carequest.org/blog/kindness-in-action-a-colorado-nonprofit-is-empowering-community-access-to-oral-health-care/) **Published:** August 23, 2023 **Author:** Caitlin Locklear **Content:** Anid Naranjo, EDDA, a community dental health coordinator (CDHC) at [Kids In Need of Dentistry](https://kindsmiles.org/about/) (KIND), sees a lot of people in need of oral health care in Colorado. Sometimes, she can’t believe her eyes. “It was a young family that traveled through the jungle,” says Naranjo. “It just broke my heart to see.” Naranjo was able to help the family get to a clinic and have a doctor look them over. “Mom showed me her feet. No shoes. Just the clothing they had on,” she says. “It was hard for them to get here. And that story is forever going to stay with me.” ![](https://carequest.org/wp-content/uploads/2023/08/KIND-Volunteer-and-Patient-photos-collage.png)Collage of photos from KIND On top of that, Naranjo says the family was in desperate need of oral health care. “One child had to have multiple teeth removed from abscesses,” she adds, noting the child had to be sedated for the procedure. Through KIND, and a helping hand with funding from CareQuest Institute, Naranjo was able to get that family access to the oral health care they needed and give them the tools to get back on their feet. But she knows there are so many other people in her community who continue to face barriers to accessing oral health care. The same is true in many communities — especially rural communities — across the US. CareQuest Institute’s philanthropy work aims to change that, providing collaborative, capacity-building support to help organizations improve the health of their communities. “It has been exciting to support KIND’s strategic evolution to not only meet the urgent oral health care needs of their clients, but also to shift the way care is delivered and made accessible to those community members,” says Christina Castle, the grants and program associate for CareQuest Institute. ## Creating a Thriving Promotora Program In the past two years, CareQuest Institute has provided two grants to KIND to help fund [its promotora program](https://kindsmiles.org/kind-hearts-promotoras/). “I think our first iteration of it went to the CDHC role, which is Anid’s role, and she has developed this program and built it,” says Ellie Burbee, the executive director of KIND. “Now we have another [lead promotora](https://www.youtube.com/watch?v=68_i2FzrKGQ) alongside her. \[Anid\] has really been the driving force behind \[the program\]. It has just morphed into what it is today, and that’s with CareQuest Institute’s support.” ![](https://carequest.org/wp-content/uploads/2023/08/Ellie-Burbee-265x300.jpg)Ellie Burbee Burbee describes the promotora program as a mentorship and apprenticeship program with the goal of producing a cohort of professional oral health care providers who are representative of the community KIND serves. Bilingual CDHCs like Naranjo provide services addressing social determinants of health. “It’s about how we can provide opportunities for these community members to grow as leaders, and organically that benefits KIND,” Burbee says. “We are learning when they learn. When they’re empowered, we can provide more support and services. But really the focus is on empowering community members versus empowering KIND.” KIND doesn’t receive federal and state funding for the promotora program, so Burbee says CareQuest Institute has provided a critical helping hand. The first grant CareQuest gave KIND for its promotora program was for $10,200; the second was for $137,500. That grant was made through the Oral Health Fund, with funds from CareQuest and vVARDIS. “CareQuest has been a partner that has been willing to say, ‘This seems right: We should be asking our communities to lead in their own solutions. To tell us what they need instead of telling them what they need,’” Burbee says. Through that funding, Naranjo and other CDHCs can give community members the tools to be their own advocates, become stronger leaders in their communities, and even step into oral health career pathways. “Empowering their families to make good decisions around oral health, to be able to have better access to oral health \[is important\],” Burbee says. “Whether it’s increasing knowledge or increasing their confidence to speak up and share their needs so there’s systematic change around oral health care — all these different things that have to be a bigger-picture change.” ## Drawing on the Power of Lived Experience ![](https://carequest.org/wp-content/uploads/2023/08/Anid-Naranjo2-241x300.jpg)Anid Naranjo, EDDA Change often starts in small ways, with dedicated individuals. That’s true of Naranjo, too. For her, [the work is personal](https://kindsmiles.org/wp-content/uploads/2022/06/KIND-2021-Annual-Report-FINAL.pdf): In addition to witnessing other people’s struggles with accessing care, she has experienced them herself. “I grew up in Colorado, but I was born in Mexico,” she says. “A lot of families do not go to the dentist. They prefer to have food on their table than go to the dentist. So, it was a big thing when we came to the United States to know that we could go to the dentist and have our teeth fixed. My first dental appointment was when I was 15 years old.” The struggles Naranjo faced firsthand, her colleagues at KIND, and KIND’s mission all drew her to the organization. KIND’s mission is to increase the oral health and happiness of Colorado children in need by eliminating dental disease through treatment and education. KIND served about 8,800 children in 2022, providing more than $1 million in free or reduced cost dental treatments. Burbee says the organization is on pace to serve about 10,000 children in 2023. “When a family is struggling with poverty or food insecurity or housing or mental health, those tend to be lifelong battles they may be fighting, unfortunately,” Burbee says. “But it’s really amazing that KIND does something that can change a kid’s life in one day. It makes a difference. You can see a kid change just from a single dental procedure.” ## Focusing on Community-Led Solutions Through its work, KIND aims to (1) improve perceptions of dentistry by embedding oral health as integral to a child’s overall well-being, (2) increase health equity for youth in underserved communities through collaborative models of care, and (3) actively empower oral health advocacy in and by the communities KIND services through education. ![](https://carequest.org/wp-content/uploads/2023/08/IMG_0012-3.jpg)A promotora workshop in February to build KIND’s apprenticeship program structure Naranjo says the two largest barriers to care for people in the community are transportation and working hours. “Two parents are trying to work, and they’re not able to get their kids to appointments during those work hours, so it’s after hours that they need appointments,” Naranjo says. “It’s hard for them. And then in a lot of the communities, only one parent drives. So, the parent that goes to work is the one that has the car, and the other one just has to wait and see when that person is available.” And the longer the parents wait to take the child to the dentist, the worse the oral health issue can become. “I’m Hispanic, and the Hispanic community will wait until that tooth is ready to just explode before they try to get that kid to the dentist,” Naranjo says. “There are home remedies that they use, so it kind of calms the tooth for a little while, but it’s just making it worse, and they don’t come in until last minute.” KIND wants to do more than help limit barriers to access. They want to give people in the community the tools to be able to do that themselves so that they can get help before it’s too late. “Ultimately, our goal with the promotora program is to build power within our served communities, to be part of a solution versus KIND providing treatment, treatment, treatment and never addressing the root cause of the problem we exist to solve,” she says. “There needs to be community-led solutions.” **Categories:** Blog **Tags:** Health Equity --- ### [Answers to 12 of Your Questions About Caries Management](https://carequest.org/blog/answers-to-12-of-your-questions-about-caries-management/) **Published:** August 23, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Dentist-looks-into-patients-mouth.jpg)Avoiding a “one-size-fits-all” approach to caries management is critical as new evidence, new treatments, and new innovations continue to develop and shape the way dental teams manage the disease. CareQuest Institute, in collaboration with Kansas City University and the American Association of Public Health Dentistry, held a webinar, “[Managing Dental Caries: Evolving Strategies and Proven Techniques](https://www.carequest.org/education/webinars/managing-dental-caries-evolving-strategies-and-proven-techniques),” where experts shared various strategies for managing dental caries and provided guidance on nonsurgical and nonrestorative protocols and implementation. But because the webinar was only 60 minutes, those experts — Sandra Guzman-Armstrong, DDS, MS, clinical professor and advanced education program director at the University of Iowa College of Dentistry and Dental Clinics; John Frachella, DMD, a pediatric dental consultant; and Erinne Kennedy, DMD, MPH, MMSc, assistant dean for curriculum and integrated learning, College of Dental Medicine, Kansas City University — didn’t have time to answer all the questions surrounding the topic. As a bonus for webinar participants and a resource for anyone interested in caries management, the speakers took the time to answer those questions after the event: **1. Is there a concern about occlusion when using the Hall technique on children?** No, there is no concern. The Hall technique is designed for children. There are plenty of studies showing that the occlusion self-resolves, and that children, parents, and dental teams prefer the experience over traditional restorations. The Hall technique temporarily opens the bite. Some dental teams advise that the child should have soft foods for about three to four weeks afterward and pay attention to their diet. Kids get used to it while the high occlusion of Hall self-resolves, but the bite will not self-resolve in adults. To be clear, on kids, even into the mixed detention, not just in a 100% primary dentition, it self-resolves. **2. Is the Hall technique (and similar techniques) considered a procedure that registered dental hygienists (RDH) can do?** Dental hygienists should consult their state’s dental practice act to determine which procedures are allowed within their scope of practice. While some states permit dental hygienists to place certain types of restorations, it’s essential to note that regulations vary by state. For instance, while the Hall technique may not necessitate the removal of tooth structure, guidelines regarding its application by dental hygienists may vary by state. **3. Are hygienists permitted to place glass ionomer sealants if they are permitted to place resin sealants?** Absolutely, yes. Hygienists are permitted because the CDT code book identifies glass ionomer as “composite” because glass ionomer is a “composite of materials.” Thus, glass ionomer sealants (whether pure glass ionomer cement or resin-modified glass ionomers) are equal to resin sealants, according to the American Dental Association (ADA). The Centers for Disease Control and Prevention (CDC) sealant programs recently opened to use glass ionomer as well. **4. For glass ionomer sealants, we know this releases fluoride but for how long? Is it days, weeks, months, years?** Glass ionomer sealants are like a car battery. They leech out their energy, and they need to be recharged. Using fluoride toothpaste is always a good idea for a lot of reasons, but one is that it recharges the glass ionomer sealants. It’s going to get in there, the glass ionomer recharges, and then it releases and continues to release. Studies show this fluoride reabsorption and release continues for years. **5. When we place glass ionomer sealants, should we disinfect the occlusals before sealing?** Use povidone-iodine as opposed to SDF as a disinfectant before glass ionomer sealants because it won’t stain. **6. Should SDF be followed with fluoride varnish? Or is this not necessary?** Combination therapy with caries arresting and preventive treatments like SDF and fluoride varnish work better than single-agent therapies used alone in all the current trials. Reported outcomes in studies of SDF and fluoride varnish together have better outcomes than when SDF is used alone. Most notably, studies by Steve Duffin, DDS (*Journal of the California Dental Association*, 2012), and Margherita Fontana, DDS, PhD, and colleagues (*Journal of the Canadian Dental Association*, 2020) show 96% of caries arrest with SDF and fluoride varnish, which is much higher than in trials with SDF used alone (though they were not compared to SDF-only or fluoride varnish-only groups). To be clear, we do not need the fluoride varnish for “more fluoride,” but it seems very useful to 1) protect the SDF from immediate dilution by saliva because SDF arrest has been shown in trials to be directly related to Ag+ ion concentration. And, as a bonus, 2) fluoride varnish helps mask the taste of SDF. Trials on toxicity show no danger of fluoride toxicity with SDF and fluoride varnish in children or adults. **7. What about applying povidone-iodine before sealing?** Why not, and why not all the way upstream for infants? Remember though, it’s not just povidone-iodine that does the magic, it’s iodine and fluoride prevention combination therapy that has the best outcomes for prevention. But don’t use fluoride varnish after povidone-iodine if using the povidone-iodine to disinfect before the glass ionomer sealants because the fluoride varnish will adversely affect glass ionomer sealant adhesion. **8. Can you discuss the application of SDF on adults in more detail?** You can use SDF in root caries and areas that are cleansable. I would not recommend use in cavitations under crown margins because the patient cannot keep the surface clean, and SDF would not have the same efficiency. You can apply SDF to root surfaces of teeth that you cannot restore for many reasons (the patient is medically and/or mentally compromised, has financial concerns, is having an interim restoration while waiting to go back for further restorations, etc.). **9. Why are we still promoting resin-sealing white spot lesions (WSL)? Is there any research on the ability of the tooth to be remineralized years after the infusion?** There does not appear to be any health benefit for using resin over glass ionomer for sealing WSL (initial caries lesions). One large clinical trial (Cagetti and colleagues, 2014) shows one-third fewer new cavities on nearby teeth when using glass ionomer instead of resin. We do not know of studies assessing remineralization under resin sealants, but there are plenty of studies showing that sealing initial lesions with glass ionomer cement or resin-modified glass ionomer (RMGI) prevents cavitation. To be able to remineralize a WSL, we need time and compliance from the patient. If we seal an occlusal WSL, it will arrest without the need to depend on the compliance of the patient. Even if SDF is used to remineralize, the patient needs to remove plaque and be compliant with hygiene and biofilm removal, so sealants are a very good material to arrest the lesion. **10. Are there any good patient education videos that we could show on a tablet or phone that are brief? Because this is new, sometimes there’s inconsistent messaging from various team members, and having something standardized and well-made would be super helpful.** This is a [helpful resource related to ](https://www.youtube.com/watch?v=a0HH7GifdM4)[SDF](https://www.youtube.com/watch?v=a0HH7GifdM4)[.](https://www.youtube.com/watch?v=a0HH7GifdM4) If you’re looking to learn more about Silver Modified Atraumatic Restorative Treatment (SMART), [this resource](https://www.youtube.com/watch?v=grZ0PsyG7Ck) can help. And check out [this resource on the Hall technique](https://www.youtube.com/watch?v=DinpPCYf3gk) if you’d like to learn more about that. Lastly, we should highlight the resource (for providers) that we mentioned several times during the webinar: [The Non-Invasive Caries Therapy Guide.](https://www.carequest.org/content/non-invasive-caries-therapy-guide) **11. What about payment for these treatments? Does Medicare/Medicaid pay? Or is that a hurdle, too?** It’s a hurdle, too. We need to advocate on all fronts, including private insurance and Medicaid. Keep in mind that state-to-state differences in payment are hugely varied. The new CPT code for use of SDF by medical teams opens a new dimension for reimbursement. **12. It’s challenging to get my practice to buy-in and deliver minimally invasive care. Do you have any tips?** Guess who it is not hard to get buy-in from? Patients. It is not hard to get buy-in from the parents who watch you treat their children and then say, “Wait a minute. I know you’re a children’s dentist, but won’t you treat me? And won’t you treat my neighbors?” The buy-in that we’re not getting is from dentists. Well, that’s the problem. The patients are the ones who end up paying if there’s any extra payments. And when you educate the patient, and when there is clear information on what the benefits are of prevention, the patients will go for it. I think you need to take the time to not only educate the patients but also educate your entire team. It’s your hygienist, it’s your assistants, it’s your manager; they should be in tune with the whole philosophy more than anyone else. So, you’re losing time because you need to do that education, which is critical. But you gain that time in spades on the other end by being able to treat so many more patients, adults, and children, in the same amount of time because you’re not waiting for teeth to get numb, you’re not behavior managing the kid that’s crying, you’re not having to make the decision to send them to the hospital. No, you’re putting a person in the office because you’re going to have to hire somebody to cancel all those dental general anesthesia appointments. I’m not saying you’re going to eliminate them. We aren’t taking anything out of the toolbox. But what we’re trying to do is use the right tools for the right jobs. *Editor’s Note: To view the full recording of the webinar, “[Managing Dental Caries: Evolving Strategies and Proven Techniques](https://www.carequest.org/education/webinars/managing-dental-caries-evolving-strategies-and-proven-techniques),” visit the CareQuest Institute webinar library.* **Categories:** Blog **Tags:** Clinical Practice, Minimally Invasive Care --- ### [Join Us in Helping Maui Wildfire Victims](https://carequest.org/blog/join-us-in-helping-maui-wildfire-victims/) **Published:** August 25, 2023 **Author:** Caitlin Locklear **Content:** CareQuest Institute has pledged $150,000 in donations to help support recovery efforts and fire victims in Maui, where thousands have been displaced and much of the town of Lāhainā has been destroyed. CareQuest Institute will make contributions to the following trusted organizations. Please consider donating and spread the word to help relief efforts. **Organizations** [Maui United Way](https://mauiunitedway.org/disasterrelief), a nonprofit organization rated four stars on Charity Navigator, has created the Maui Relief Fund, which will go directly toward efforts supporting victims of the fires. Maui United Way is responding to immediate needs via daily grant approvals to existing grassroots organizations that are local and focused on basic needs. [Maui Food Bank](https://mauifoodbank.org/donate/), rated four stars on Charity Navigator, is providing meals for thousands of displaced residents. [The Council of Native Hawaiian Advancement](https://www.memberplanet.com/campaign/cnhamembers/kakoomaui) (CNHA) is partnering with Kamehameha Schools, Alakaʻina Foundation Family of Companies, and Kākoʻo Haleakalā to match up to $1 million in community donations for Hawaiians impacted by the devastating wildfires on Maui. Funding will support evolving needs, including shelter, food, financial assistance, and other services as identified by their partners doing critical work to support Maui. [Hawai‘](https://www.hawaiicommunityfoundation.org/maui-strong)[i Community Foundation](https://www.hawaiicommunityfoundation.org/maui-strong) (HCF), rated four stars on Charity Navigator, is providing financial resources that can be deployed quickly, with a focus on rapid response and recovery for the devastating wildfires on Maui. One hundred percent of the funds will be distributed for community needs. [GlobalGiving](https://www.globalgiving.org/projects/hawaii-wildfire-relief-fund/?rf=learn_tips_hawaiiwildfires_fastfacts), has a four-star rating on Charity Navigator, has provided relief programs since 2004 with $225 million in disaster donations. Donations to this fund will support wildfire relief and recovery efforts in Hawai‘i. Initially, the fund helps first responders meet survivors’ immediate needs for food, fuel, clean water, medicine, and shelter. As needs emerge, donations will support longer-term recovery efforts run by vetted local organizations in impacted areas, particularly those working with low-income, historically underserved communities. [The Center for Disaster Philanthropy](https://disasterphilanthropy.org/donate/support-the-hawaii-wildfires-recovery-fund/) is a nonprofit organization with a four-star rating on Charity Navigator and Candid’s Platinum Transparency seal. Donations will help better position communities to recover and help address the gaps that will emerge after the initial response has passed. **Additional Organizations Helping with Relief Efforts** Please consider supporting any of the organizations above or these additional organizations as they support the local Maui community with relief and rebuilding efforts. The [American Red Cross](https://www.redcross.org/local/hawaii/get-help/hawaii-wildfires-response-.html), has a four-star rating on Charity Navigator. With more than 380 trained disaster workers responding to the wildfires on Maui, the American Red Cross is working tirelessly to deliver compassionate and equitable care to the many who are picking up the pieces following the heartbreaking wildfires in Hawaii. Alongside the Hawaii Emergency Management Agency and the Federal Emergency Management Agency, the Red Cross is helping transition displaced residents from congregate shelters to hotels. [Direct Relief](https://www.directrelief.org/emergency/hawaii-fires/), rated four stars on Charity Navigator, is working hand in hand with local health care providers and emergency response agencies, ensuring they have the supplies and support needed to care for the injured and those suffering from smoke-related health issues. **Categories:** Blog --- ### [The Connections Between Periodontal Disease and Overall Health](https://carequest.org/blog/the-connections-between-periodontal-disease-and-overall-health/) **Published:** September 5, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/value-based-care-zoomed-in-teeth.jpg)It’s no secret that many people confront chronic illnesses, from heart disease to dementia, as they get older. We often hear about the importance of regular exercise and well-balanced diets to help us stave off these illnesses and stay healthy as we enter our seventh, eighth, and ninth decades. Healthy gums can help, too. The benefits of periodontal health go far beyond our mouths — especially as we age. Periodontal disease (PD) has a bidirectional relationship with several systems, diseases, and conditions throughout our body. Policy and health care leaders can highlight those relationships — and promote periodontal health — this September during National Gum Care Month to improve adults’ overall health. They can work to expand access to insurance that covers preventive dental care, which, in the long run, will reduce Medicaid and Medicare spending and help reduce costs across the health care system. First, let’s dive deeper into the connections, starting with the heart. ## The Relationship Between Periodontal Disease and Heart Health Periodontal disease can raise our risk of heart disease. More specifically: - People who have PD are [28% more likely](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) to suffer a heart attack than those with better gum health. - Studies show that our periodontal health [in childhood](https://www.carequest.org/resource-library/getting-heart-it) can impact our heart health later in life. - Children who have cavities or other dental infections are more likely than others to face [clogged arteries in adulthood](https://www.carequest.org/resource-library/getting-heart-it) — a dangerous symptom of cardiovascular disease. The data speak to the importance of having access to preventive care early in life and throughout our lives. ## Other Health Problems Associated with Periodontal Disease PD is also tied to systemic conditions such as diabetes, dementia, and glaucoma. When it comes to diabetes, being able to care for your gums is particularly critical. Data show: - Diabetes can increase a person’s risk of PD [by 86%](https://www.carequest.org/resource-library/beyond-nice-smile). - When people with diabetes have PD, it is more severe than for their peers without diabetes. In a [CareQuest Institute video](https://www.carequest.org/resource-library/connection-between-oral-health-and-diabetes), Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, explains how PD and diabetes influence each other. “Diabetics who have good oral health have it easier to control their blood sugar,” he says. Meanwhile, poor oral health can make diabetes harder to manage. When someone with diabetes has poor gum health, Deutchman affirms that treating PD will “improve their diabetic care.” Preventing PD and other dental disease is also crucial to our cognitive health. Numerous studies point to the connection between dental health and dementia. Key findings highlight that: - Losing teeth can raise a person’s [risk of dementia](https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.14791), including Alzheimer’s disease. - Tooth loss may even help providers [predict](https://pubmed.ncbi.nlm.nih.gov/30126407/) that someone will develop dementia. In addition to our neurological health, the state of our teeth and gums can impact our eyesight. Having PD can increase the likelihood of [developing glaucoma](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health). Studies also find that eye disease can signal dental disease. Factors leading to poor vision can worsen our [oral and overall health](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health): - Chronic conditions in other parts of the body, such as diabetes and heart disease, can cause visual impairment. - These [systemic diseases](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health) lead to poorer health overall and interfere with our dental health. ## Preventing Periodontal Disease Can Save Money Periodontal therapy is [not a covered benefit](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired) in most state Medicaid programs. It’s a [gap in benefits](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) that unnecessarily increases health care spending. In a review of Medicaid and private insurance claims of people with diabetes, CareQuest Institute researchers found that access to periodontal care led to greater savings for patients enrolled in Medicaid than those with commercial coverage: - Diabetic patients enrolled in Medicaid who had PD treatment over two years saw [14% lower](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs) overall health care costs. - Among privately insured people with diabetes, having PD treatment over two years [reduced their health care costs by 12%](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs). Further CareQuest Institute analysis [reveals cost savings](https://www.carequest.org/resource-library/2022-diabetes-treatment-costs-decrease-after-periodontal-therapy-medicaid-and) for both inpatient and outpatient care among diabetics who obtained periodontal treatment, compared to those who did not receive such care. Another example of how dental care generates cost savings comes from research on people in the hospital who are enrolled in Medicaid. About [1 in 100 people](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired) get nonventilator hospital-acquired pneumonia (NVHAP) when they are admitted to the hospital, which can lead to sepsis and even death. Recent studies report that getting preventive dental care before a hospitalization can [reduce the risk](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired) of acquiring this infection. Among those covered by Medicaid who have been hospitalized: - A patient is [30% less likely to get NVHAP](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired) if they had periodontal therapy in the six months before being admitted. - People are [10% less likely](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired) to become infected if they had preventive dental treatment within a year before being hospitalized. Preventing infections leads to [cost savings](https://www.carequest.org/resource-library/association-between-accessing-dental-services-and-nonventilator-hospital-acquired): - Treating NVHAP can cost $28,000–$40,000 per person. - Providing periodontal therapy costs only about $500 per person. ## Strengthening Periodontal Coverage under Medicaid Is a Cost-Effective Solution From childhood throughout our adult lives, good periodontal health reduces the risk of myriad chronic conditions. Research on preventable infections, like NVHAP, adds to the evidence that a healthy mouth is vital to our overall health. Yet limited periodontal benefits in programs like Medicaid and Medicare mean that people who have fewer resources often have a higher risk of illness. And that comes with greater health costs. While improved access to dental care is important to everyone, the health and economic gains [stand to be greater](https://www.carequest.org/resource-library/2022-diabetes-treatment-costs-decrease-after-periodontal-therapy-medicaid-and) for people with lower socioeconomic status. Expanding dental coverage in public programs is a clear and important solution. More preventive care will lead to healthier gums, healthier communities, and lower costs for the health system. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [A Health Center in Michigan Shows the Path to Value and Sustainability](https://carequest.org/blog/a-health-center-in-michigan-shows-the-path-to-value-and-sustainability/) **Published:** September 12, 2023 **Author:** Caitlin Locklear **Content:** Many of the patients Lauren Rush, DDS, sees at MyCare Health Center in Michigan have to choose between taking care of their own personal health or putting food on the table for their family. That’s because at [MyCare Health Center](https://www.mycarehealthcenter.org/), a Federally Qualified Health Center (FQHC), most patients are enrolled in Medicaid. That means they have issues accessing oral health care, whether it’s due to finding reliable transportation, getting childcare so they can go to their appointment, or getting time off work. “One of the biggest challenges that we’ve faced is, of course, no-shows and broken appointments,” says Rush, MyCare Health Center’s chief dental officer. But Rush, MyCare Health Center’s CEO Karen Wood, RD, and their team have made improvements that [prioritize value over volume](https://www.carequest.org/content/value-based-care-readiness-screener). In the process, they have decreased their cost per visit, decreased their no-show rates, and increased their net revenue. Danielle Apostolon is the program manager at CareQuest Institute. She notes that MyCare Health Center is “not only able to survive, but thrive.” Some of the health center’s improvements were made when the FQHC started participating in CareQuest Institute’s [Community Oral Health Transformation](https://www.carequest.org/how-we-work/health-improvement-programs/corht) (COrHT) initiative. The initiative provides a framework for safety net dental clinics to help transform oral health care delivery so that it is accessible, focused on prevention and minimally invasive care, and integrated with medical care. More specifically, since joining COrHT in June 2022, MyCare Health Center has been able to: - Increase the bottom line by $64,000 - Increase access by 200 additional visits - Reduce the cost per visit by $68 - Decrease the no-show rate by 2% - Improve on preventive metrics Apostolon says those improvements are also the result of MyCare Health Center’s leadership team working together. She adds, “From experience, I have seen many FQHC dental programs struggle because of a disconnect with leadership and how it impacts sustainability and quality of care.” And the FQHC plans to continue that upward trajectory — by expanding. “We’ve recently opened a new dental center,” Rush says. “What’s next on our immediate radar is continuing to use some of the best practices that we’ve learned in order to help grow our volume at that site. And we still, although we feel like we’ve been successful with this COrHT initiative and some of the goals we’ve set, there are still quite a few that are ongoing.” Watch [this video](https://www.youtube.com/watch?v=Guzi29QIssc) to hear more about MyCare Health Center’s journey to creating a system that provides value for patients and sustainability for the organization. **Categories:** Blog **Tags:** Value-Based Care --- ### [Expanding Integration and Access for Children’s Dental Health](https://carequest.org/blog/expanding-integration-and-access-for-childrens-dental-health/) **Published:** September 27, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/09/health-equity-child-dental-exam.png)Early childhood caries remains the most common, preventable infectious disease among children in the United States. Preventing them is not always easy, though. Many families, often those who are facing financial hardships or living in rural areas, struggle to connect their children to timely dental care. Barriers to access— including geographic location, language, cultural, and education — are a particular burden for families and children who would often benefit the most from the care. But leaders in oral and primary care can and need to play an essential role in bridging gaps in access to care. For example, dental providers can partner with schools to deliver dental care to underserved students. Medical teams and dental teams can work together [to integrate oral health](https://www.carequest.org/topics/medical-dental-integration) in pediatric primary care. These solutions, and others like them, can improve children’s dental access and advance equity, giving all kids a strong start. ## Why Access to Children’s Dental Health Care Is Important Major health organizations agree that dental care is especially crucial for babies. The American Dental Association, American Academy of Pediatrics, and American Academy of Pediatric Dentistry all advise that every child has a dental exam [by the time they are 1 year old](https://www.carequest.org/resource-library/age-first-oral-health-examination-and-dental-treatment-needs-medicaid-enrolled). Despite this guidance and best intentions, many kids don’t have adequate dental care in their first few years. Recent CareQuest Institute research found: - Most children enrolled in Medicaid don’t have their first dental [exam until they are 3 years old](https://www.carequest.org/resource-library/age-first-oral-health-examination-and-dental-treatment-needs-medicaid-enrolled). - About [1 in 5 children](https://www.carequest.org/resource-library/association-between-first-oral-examination-characteristics-and-dental-treatment) with private insurance are 3–4 years old before their first oral exam. In an August 2023 [CareQuest Institute webinar](https://www.carequest.org/education/webinars/connecting-caries-risk-assessments-and-cultural-awareness), Francisco Ramos-Gomez, DDS, MS, MPH, director, UCLA Pediatric Dentistry Advanced Clinical Training Program, shared another glaring statistic: Among 4-year-olds today, [nearly 7 in 10 children](https://www.carequest.org/education/webinars/connecting-caries-risk-assessments-and-cultural-awareness) have dental disease. When a child doesn’t get their first dental screening until their toddler years, they’re more likely to [need restorative treatment](https://www.carequest.org/resource-library/association-between-first-oral-examination-characteristics-and-dental-treatment), which is often more costly and invasive. “The disease is so massive that you need to have a very specific specialist,” Ramos-Gomez explains, saying young children also need “all the things that require sedation . . . to really pursue treatment.” Families and parents, of course, don’t foresee or want those situations. But a dental appointment can get skipped when inflexible occupations, transportation challenges, and priorities for other children in the family are added to the mix. ## Emergency Departments Cannot Provide Adequate Dental Care When a child experiences extreme pain from dental disease, families with limited access to dental care often turn to a hospital’s emergency department (ED). This happens most frequently in Florida, where data were available, according to a 2023 [CareQuest Institute analysis](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions) of nationwide ED visits by children under age 14 with non-traumatic dental conditions. This study highlighted economic and racial disparities in Florida for such ED visits, which parallel [national trends](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions): - More than [8 in 10](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions) child ED visits for dental pain in Florida were for children enrolled in Medicaid. - In Florida, [children who were Black](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions) had more ED visits for dental symptoms than their peers of other racial groups. However, EDs nationwide are ill-equipped to treat dental disease, whether for children or adults. As Stacey Auger, a policy consultant at CareQuest Institute, describes in [this video](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions), while “folks leave the ED with a prescription for a pain medicine . . . the actual source of the trouble . . . is not met.” Finding ways to improve access to dental care could prevent early childhood caries, reducing ED visits. Doing so would relieve already-strained health systems in communities and improve children’s well-being. ![](https://carequest.org/wp-content/uploads/2023/09/Child-Fluoride-Varnish-Dental-Fear-300x300.png)Fluoride varnish applied to child’s teeth ## The Importance of Medical Well-Child Visits and Preventive Dental Visits Primary care providers can have a critical impact on children’s dental health. CareQuest Institute research examining [Medicaid claims data](https://www.carequest.org/resource-library/medical-well-child-visits-and-preventive-dental-visits) for children under age 4 found: - Children who have a medical well-child visit [are more likely](https://www.carequest.org/resource-library/medical-well-child-visits-and-preventive-dental-visits) to get preventive dental care. - Compared to other children, however, 1-year-olds [still have the fewest](https://www.carequest.org/resource-library/medical-well-child-visits-and-preventive-dental-visits) preventive dental visits. Other recent analysis of more than [3 million Medicaid claims](https://www.carequest.org/resource-library/effect-well-child-visit-location-preventative-dental-visit) also found that medical-dental integration benefits children’s oral health: - Most children covered by Medicaid get their well-child visit [at an office and hospital](https://www.carequest.org/resource-library/effect-well-child-visit-location-preventative-dental-visit), not a Federally Qualified Health Center (FQHC) or a rural or public health clinic. - The study also validates that children are [more likely](https://www.carequest.org/resource-library/effect-well-child-visit-location-preventative-dental-visit) to access preventive oral health care upon receiving this primary health care. Medical-dental integration is clearly an effective approach to bolster child oral health. ## Strategies to Improve Integration of Children’s Dental Care Several solutions exist to increase equitable access to children’s oral health care. Here are three effective strategies that dental and medical providers can pursue. **1. Expand school-based dental sealant programs.** A 2023 [CareQuest Institute webinar](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant) spotlighted school-based dental sealant programs. Sealants are proven to prevent dental disease in children. School-based programs broaden access to them, particularly for students without regular access to care. The webinar offered success stories while highlighting a 2022 report on best practices for effective programs: • Shailee Gupta, DDS, MPH, director of dental programs, St. David’s Foundation, notes her Texas program has reached [more than 58,000 students](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant) since 1998. • Helpful [tips](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant) include assessing families’ needs, involving educators, and prioritizing schools where children are most at risk of tooth decay. For Danica Loring, EFDA, CDA, dental practice director at Penobscot Community Health Care, school-based dental sealant programs have been a [crucial place to begin](https://www.carequest.org/about/blog-post/process-rebuilding-school-based-dental-sealant-program) rebuilding her center’s broader school-based dental program, which closed in 2020. It offers “an opportunity to see the kids’ oral health in general” to connect them to future care. **2. Embrace teledentistry as part of school services.** For dental care teams who cannot visit students in person, teledentistry is a worthy alternative. It is especially useful to reach rural children and other communities struggling with barriers to care. One FQHC in North Carolina, Blue Ridge Health, partners with a school to run a teledentistry program. It helped [more than 1,200 children](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina) access needed dental care in one year alone. Teledentistry also [promotes oral health equity](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina). According to Stephanie Clester, RDH, MA, the clinical content and support specialist at CareQuest Institute, the technology enables dental teams to “reach more patients to reduce the burden of oral disease for those who need it most, making teledentistry a tool to achieve accessible and equitable oral health.” **3. Expand the use of oral health tools in primary care.** In July 2023, an American Medical Association [new billing code took effect](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained) that advances medical-dental integration. It compensates medical providers for applying silver diamine fluoride (SDF), a liquid that gets brushed on to teeth to stop or prevent cavities. As a non-invasive therapy, SDF can overcome barriers to dental care for children. It is especially promising for kids who [see a medical provider but not a dental team](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained). With this clinical tool in hand — plus new incentives to use it — primary care teams can do more to fight pediatric dental disease. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Voices from the Field: Dr. Lauren Rush on Community-Based Dentistry](https://carequest.org/blog/voices-from-the-field-dr-lauren-rush-on-community-based-dentistry/) **Published:** September 19, 2023 **Author:** Caitlin Locklear **Content:** Giving back to the community is in Dr. Lauren Rush’s DNA.![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg) From a young age, Rush, DDS, the chief dental officer at [MyCare Health Center](https://www.mycarehealthcenter.org/) in Michigan, watched as her parents put action behind their words when it came to helping the underserved. Her mother was a teacher in the Detroit public school system for more than 30 years, and her father was an entrepreneur who mentored the youth and volunteered for service projects. They both drove home the importance helping those in need and giving others the opportunity to live a better life. “It does no good to be blessed with talent and opportunities if I am not going to go back to try to help someone else,” Rush says. “I cannot truly be successful if my neighbors are suffering and in need.” Her parents would bring her along to volunteer and serve their community. For Rush, giving back took the form of cleaning up highways, volunteering at shelters and food pantries, tutoring, mentoring, working at health fairs, and participating in school-based dental programs. Now, Rush helps the community by working at MyCare Health Center, a Federally Qualified Health Center (FQHC). There, she has seen improvements from decreasing their no-show rate to increasing their bottom line. MyCare Health Center is a member of the CareQuest Institute’s Community Oral Health Transformation (COrHT) initiative. Rush shares more about the organization’s work and her journey. ![](https://carequest.org/wp-content/uploads/2023/09/Lauren-Rush-Headshot-1-scaled.jpg)Lauren Rush, DDS **Why have you spent your career in the Federally Health Qualified Center setting?** It felt like it was what I was supposed to be doing. Dentistry for me has felt more like a calling and an honor rather than a job, and I was not drawn to the glamour of cosmetic dentistry or private practice. There are many ways to find fulfillment in dentistry, and other practice types help a lot of people in different ways, but for me, the FQHC setting has been my niche and my form of ministry. Ministry is about giving ourselves and our time, talents, and resources to help others. That sounds like FQHC dentistry to me. My entire career has been community- and need-based, and while it has its many difficulties and challenges, it also has its rewards. **Why is community-based dentistry so important?** Every day I encounter people who have had many rough seasons in life, who feel shame, who have been treated very poorly and neglected, who have given up and had very inconsistent health care in their lives. They need someone to tell them that they are in a safe space, that they are welcome and valued, not being judged, and we’re here to help them move forward with their dental care and quality of life regardless of what they have gone through or are currently experiencing. Many people who have the greatest need in the community either do not know that they have options to receive dental care or have become very dejected or apathetic due to lapses in care and the barriers it takes for them to access that care. Community-based dentistry is important because it is our job to bridge the gaps in care and help reduce the barriers that people face in seeking treatment. There are many who think that dentistry is a luxury rather than a basic health care need, like going for an annual physical, gynecological, or eye exam. Dentistry is a need, and community-based clinics help bring the need to the communities who are at the greatest risk. **At MyCare Health Center, how do you manage to balance the need for financial success and the importance of prioritizing excellent patient care?** You’re most financially stable in a dental program when you can provide excellent care for patients. So, if I, the other providers, and our staff are providing patients with great customer service — with quality health care — then patients are going to continue to come back to us. If they continue to come back to us, then we will be able to remain financially stable. And we, of course, must make decisions that will allow us to be sustainable from a business standpoint, but I think the one benefit that we have had is that the providers and staff we’ve hired have been mission-minded and mission-focused, and they are committed to treating our patients well and providing quality care. We also do our best to hold patients accountable for their health care and educate them on how to become accountable for their oral health. That has directly impacted our financial stability. As we continue to refine those practices and keep in mind the goal of increasing our financial sustainability, we will continue to have that success. **How did your involvement in COrHT help to accelerate the efforts that MyCare is making?** COrHT really helped motivate us to be accountable to try to tackle some of our goals and some issues we face. One of those goals that stands out is integration. That is something that, since I started at MyCare, we’ve discussed we wanted to find better ways to integrate across service lines. I don’t know that it really occurred to us to create a smaller team to start to look at integration, but I think that that being the trajectory we’ve set off on has really been helpful because it minimized the number of people involved initially so that we can really focus on what the goals are. It encouraged and motivated me, the CMO \[chief marketing officer\], and our COO \[chief operating officer\] to sit down together and talk through some of these issues to try to troubleshoot before we bring in the larger team. And talking to some of the other dental directors and leadership from other health centers, they have had some successes in that regard. So, listening to what they’ve done and implementing that has been great. I think the input and the stories from other health centers and other COrHT participants was welcomed in that camaraderie, knowing that we’re not the only ones facing some of these issues, that it’s not just us, and maybe it’s an issue we don’t have the ability to solve quickly, but we know that it’s on the radar because everybody has discussed it. So, we feel supported in those efforts, and we feel like there is a team of other like-minded individuals who are all working toward similar goals. **How important is your CEO support and collaboration?** \[CEO\] Karen’s \[Wood\] support — not just with this project, but in general of myself in leadership as well as with the dental service line — is invaluable. I’ve worked in a few different health centers, and I will say that Karen’s interest in dental is unmatched. A lot of times leadership does not understand dental, and so that causes them a little angst and they shy away from really diving in to understand what’s going on and to find the best ways to be creative to make sure that dental is successful. And one thing that I feel is a true benefit to us and a great attribute of Karen’s is that if she does not understand something — let’s say I’m talking in dental language — she’ll ask for clarification. She doesn’t glaze over it. She listens to me as the chief dental officer whom she hired. So, she trusts me to do my job, and we communicate well. We also meet weekly. That’s something that I’ve never experienced before, and it’s extremely helpful. Having a supportive CEO and the rest of the executive team has made a huge difference in the success of the dental program because we feel heard because we are heard, and we feel seen because we are seen. And Karen’s active interest in what we do has been the most refreshing part of my job. We work well as a team, and I think that that is felt by the rest of my team. **What advice would you give to other organizations that want to go on a similar journey?** Collaborate first with the people on your team. It’s great to collaborate with other organizations, but having a good working relationship and good communication with the people whom you work with on a daily basis is the first step in what will be your success in COrHT or just in growth in general as a service line. There are a lot of goals and a lot of things that you can write down, and that can be a little daunting, but take one step at a time. A lot of times during this program, I felt like, “Okay, we’re not making enough progress.” But when we saw the things in black and white on the spreadsheet it really kind of put things into better perspective. We can be our own worst critic sometimes, and a lot of us in leadership have these grand expectations of ourselves. So, when you see those things, don’t be afraid to say, “Okay, we’re doing well.” Of course, we can always do more, but any progress is impactful. For more about MyCare Health Center and its involvement in the COrHT initiative, watch [this video](https://www.youtube.com/watch?v=Guzi29QIssc). **Categories:** Blog **Tags:** Value-Based Care --- ### [The Value of Minimally Invasive Care: A Provider’s Perspective](https://carequest.org/blog/the-value-of-minimally-invasive-care-a-providers-perspective/) **Published:** October 9, 2023 **Author:** Caitlin Locklear **Content:** Throughout her career, Gretchen Henson, DDS, has provided personalized prevention recommendations for patients, knowing that they all have different backgrounds and lifestyles. ![](https://carequest.org/wp-content/uploads/2023/10/Gretchen-Henson-Cropped.jpg)Gretchen Henson, DDS “I spend so much of my appointment trying to figure out what their home life looks like, so we can tailor a plan for them,” Henson says. Henson does her work as the only pediatric dentist at River Valley Health in Williamsport, Pennsylvania, without using oral sedation, general anesthesia, or an operating room. She does not have pediatric-trained dental assistants — her two dental assistants were hired to work on adults. Instead, she leans on minimally invasive care. “It’s imperative that I can work with SDF and glass ionomers because I can’t put the kids under in any way,” she says. Henson knows that not everyone in the oral health industry is using these strategies and protocols just yet. A CareQuest Institute webinar she attended, [“Managing Dental Caries: Evolving Strategies and Proven Techniques,”](https://www.carequest.org/education/webinars/managing-dental-caries-evolving-strategies-and-proven-techniques) helped reinforce what she has been doing for years — and strengthened her desire to help spread that knowledge. ## The Latest in Caries Management Strategies On the webinar, three experts (Erinne Kennedy, DMD, MPH, MMSc, assistant dean for curriculum and integrated learning, College of Dental Medicine, Kansas City University; Sandra Guzman-Armstrong, DDS, MS, clinical professor & advanced education program director, College of Dentistry & Dental Clinics, University of Iowa; and John Frachella, DMD, pediatric dental consultant) discussed how to provide personalized prevention recommendations for patients. They explored how to use various strategies for managing dental caries and how to avoid a one-size-fits-all approach by implementing nonsurgical and nonrestorative protocols. The experts were speaking Henson’s language. “I learned from \[Dr. Frachella\] about using the structure within the teeth that most dentists would cut away, keeping it as a scaffolding to build off,” Henson says. “That’s something I’ve been doing for years . . . I know it works, but it was nice to hear him say that. I liked the way that he discussed things being like chemotherapy, because chemotherapeutics may leave a void in a spot, and that’s okay. Absence of pain is a good marker, and restoring the tooth to form and function is a good marker.” Henson says she’s passionate about increasing access to care and using techniques that are safe, effective, and tolerated by children. She says dentistry traditionally has been taught to include a set of aesthetics that don’t apply, for example, to the clinical and radiographic results of a Silver Modified Atraumatic Restorative Technique (SMART) restoration. “And when well-intentioned dentists aren’t taught the chemistry behind it, then it’s really difficult to explain,” she says. “The x-ray may look like recurrent caries, but you’d say, ‘No, don’t reenter that tooth. It’s healing, or it’s healthy, or it’s stable.’” ## Henson’s Path to Personalized Prevention Before coming to River Valley Health, Henson worked for three years helping refugees in Arizona and spent six more working with patients and residents in New York. “The reason I made this jump \[to River Valley Health\] was because I have a family member who lives out here, and I knew they were in need of a pediatric dentist,” Henson says. Before she came to River Valley Health, patients were being sent to two other practices that were a one-to-two-hour drive away. The waitlist for those offices stretches to spring 2024. “One of my colleagues, Jack Dillenberg, DDS, MPH, used to say, ‘Bring dentistry to where dentistry doesn’t exist.’ And this was an opportunity to do that,” she says. Many of the children and families Henson works with are insured through Medicaid and face numerous barriers to accessing dental care. Minimally invasive care, she believes, can help improve outcomes for those children. “The general dentists in this area do not take x-rays on children, so the decay doesn’t show up clinically until they’re 7 years old or so, and then, all of a sudden, everything’s falling apart,” Henson says. “And suddenly at 6, 7, 8 years old, those interproximal lesions grow big enough that they just fall apart. So, my schedule right now, pretty much, is filled with nothing but emergencies.” Tools like brush-on therapies are critical for her. “I put SDF on almost every single emergency kid today just to buy time to get to a slot where I can work on them,” she says. “I do a lot of Hall crowns. I’ve been doing Hall crowns for more than 10 years.” Henson wants to spread the word about minimally invasive care to others in the industry, starting with a presentation to the dental hygienists at River Valley Health on pediatric dentistry. She also plans to meet with general dentists to show them what teeth that have been treated with brush-on therapies like SDF look like, and to sit down with pediatricians and talk to them about how oral health fits into overall health. She says her two dental assistants are already working hard to get up to speed on assisting when it comes to pediatric patients. “I don’t want to be the person that just puts out the fire once it’s started,” she says. “I want to help educate about prevention, too.” **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [Medicaid Adult Dental Benefits: A Progress Report and a Look to the Future](https://carequest.org/blog/medicaid-adult-dental-benefits-a-progress-report-and-a-look-to-the-future/) **Published:** October 16, 2023 **Author:** Caitlin Locklear **Content:** In July, CareQuest Institute and a group of partners and advisors released the [2022 Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). This updated interactive tool allows policymakers, administrators, and advocates to understand where a state’s Medicaid adult dental benefits package falls on a continuum from no dental benefits to extensive benefits and to identify opportunities for improvement. With two sets of data (2020 and 2022) now captured in the Coverage Checker, we can see how the coverage landscape has changed over time.![](https://carequest.org/wp-content/uploads/2025/10/Medicaid-Coverage-Checker-Web.jpg) That change, by and large, has been positive! As the Coverage Checker shows, the period between 2020 and 2022 [marked a significant expansion of Medicaid adult benefits across the country](https://www.carequest.org/about/blog-post/five-key-takeaways-about-medicaid-adult-dental-benefits-2023) — one of the most significant in recent decades. 2023 has proven to be another big year for Medicaid adult dental benefits, and it looks as though even more positive movement is on tap for 2024. In 2024, we’ll add data reflecting coverage in place as of December 31, 2023, and we anticipate seeing great movement in many of the states you will read about below. ## New Benefits Took Effect in 2023 The start of the new year ushered in significant benefit expansions in seven states: - In January, [Hawaii](https://stateofreform.com/news/hawaii/2022/06/after-over-a-decade-hawaii-to-restore-adult-medicaid-dental-benefits/) reinstated adult dental benefits that were eliminated in 2008. [Maryland](https://www.mdac.us/medicaid/medicaid.html) and [Tennessee](https://www.timesfreepress.com/news/2022/dec/18/tennessees-medicaid-adult-dental-benefits-starts/) built upon benefit packages for specific groups of adults and implemented benefit packages for all adult beneficiaries. - [Kentucky](https://kyoralhealthcoalition.org/adult-medicaid-dental-benefits-update/), following the October 2022 announcement of Governor Andy Beshear’s new initiative to boost workforce participation by improving coverage of dental, vision, and hearing, expanded Medicaid adult dental benefits to include fillings, crowns, implants, and dentures. - [Michigan](https://www.wilx.com/2023/04/03/michigan-medicaid-expands-covered-dental-services-adults/) and [New Hampshire](https://www.sentinelsource.com/news/local/statehouse/nhs-new-dental-benefit-for-adults-on-medicaid-rolls-out-saturday/article_269a4fef-41fd-5023-a133-cd1e822d1ac8.html) added new benefits for all adult beneficiaries on April 1, 2023. - In July, after a significant expansion of dental coverage in 2022, the Kansas legislature [further expanded the benefit](https://www.oralhealthkansas.org/MedicaidAdultDentalBenefits.html) in 2023 to include full and partial dentures for all adult beneficiaries. As a result of these expansions, **more than 3.2 million adults in these seven states have gained access to new or expanded benefits in 2023**. You can find [more information on the benefits packages offered in these states](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). ## Benefit Changes Coming in 2024 2023 also brought legislative victories in several additional states. As noted below, these improvements to Medicaid adult dental benefits are expected to take effect in 2024. Connecticut: Thanks to the efforts of the [Connecticut Oral Health Initiative](https://www.ctoralhealth.org/) (COHI) and its advocacy partners, the Connecticut Department of Social Service and [Dr. Donna Balaski](https://www.carequest.org/about/blog-post/voices-field-dr-donna-balaski-strengthening-connecticut-medicaid-adult-dental), and champions in the legislature, the new state budget includes funding for periodontal coverage for adults with certain medical conditions like diabetes. Using COHI’s recent [Medicaid Gap Analysis Report](https://r20.rs6.net/tn.jsp?f=001th8J5a9QpNeoLr9zAXMRwkdJghhpcWly6hbu3pl2IaNHykuwZ5JPrsNpQQ5pgxMWwFav2jhh8F88KHwufCSL36p7FeBhdL3TMy7-r8kSgCIQ6r97LfEjIljsKoDjf6n1XE2LFpGO7q71u_-xCWhDu1m-HaSONvfQu3Lw3h3fz9lkp9boFFpvyyUQGnCdihNF&c=VnaHq2s3UeDLl0IptRrANuN8VXgKeHo0wqhFUgZSzSsgwxc_EAivXA==&ch=fX30mPVQMnu5UIeDXRAmeMTHvKJ6_r1gU6wRt1urM95CySil6DqEnA==), which collected and analyzed Medicaid service utilization data, geographical information on the state’s provider network, and the experiences of Medicaid beneficiaries and providers, advocates showed that the lack of periodontal coverage within Medicaid was one of the most severe issues negatively affecting the oral health of adults in the state. The new periodontal coverage will take effect January 1, 2024, and advocacy efforts are afoot to make this benefit available to all adults in future years. Advocates will also pursue further improvements to the adult dental benefit in 2024, including the addition of a second dental cleaning, a reduction in the timeline for the replacement of prosthodontic appliances, and the modification of the annual benefit cap. Minnesota: As part of the 2023 [Health and Human Services omnibus bill](https://www.prnewswire.com/news-releases/minnesota-dental-association-successfully-leads-effort-to-expand-adult-dental-medicaid-benefit-set-301833834.html) signed in May, Minnesota will begin providing dental benefits in 2024 based on medical necessity, mirroring the benefit currently in place for pregnant women and children. Multiyear advocacy efforts catalyzed this expansion of benefits. In 2021, [periodontal services were restored](https://www.startribune.com/teamwork-bridges-dental-care-gap/600110590/) as part of a broader legislative package that also increased state investment in Medicaid dental services. The [Get to Yes](https://www.3m.com/3M/en_US/health-care-us/stories/full-story/~/beyond-funding-power-of-people-to-advance-health-equity/?storyid=c21c4522-29aa-44d6-86ac-4379e65525f0) coalition led these efforts, using stories, crafting effective messaging, and highlighting research and data. Bipartisan support in the state’s legislature and from the Department of Human Services bolstered the coalition’s work. New York: In May 2023, a settlement was reached in [*Ciaramella v. McDonald*](https://gothamist.com/news/landmark-settlement-expands-dental-coverage-for-new-yorkers-with-medicaid), a federal class-action lawsuit brought against the New York State Department of Health in 2018 on behalf of Medicaid beneficiaries in New York who were denied coverage for medically necessary dental care. The settlement will bring expanded dental coverage of root canals, crowns, dental implants, and replacement dentures to roughly 5 million Medicaid beneficiaries in the state. The new rules are expected to take effect in [early 2024](https://legalaidnyc.org/get-help/health-disability-hiv-aids/what-you-need-to-know-about-the-expansion-of-medicaid-dental-coverage-in-nys/). Utah: Signed into law in March 2023, [Senate Bill 19](https://legiscan.com/UT/bill/SB0019/2023) requires the state to seek approval from the Centers for Medicare and Medicaid Services (CMS) to expand dental coverage to all adult Medicaid beneficiaries. This expansion follows [previous incremental expansions](https://stateofreform.com/featured/2023/01/utah-bill-proposes-expanding-dental-care-coverage-to-adults-under-medicaid/) for specific population groups: individuals with disabilities and/or visual impairments, those aged 65 and older, and those enrolled in Targeted Adult Medicaid (TAM) receiving treatment for substance use disorder. As with previous legislation, SB19 requires adults to receive their care through the University of Utah School of Dentistry (UUSOD) or its associates throughout the state. Also, similar to previous legislation, this bill does not contain a fiscal note as UUSOD pays the state’s portion to receive federal matching funds to provide care. At the time of this writing, Utah’s [waiver application](https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83321) with CMS is pending. Vermont: According to the 2022 Coverage Checker, Vermont was one of five states that increased annual dental services spending per member, also known as the annual benefit maximum (ABM), between 2020 and 2022. Most recently, Vermont Medicaid implemented [three new changes](https://humanservices.vermont.gov/sites/ahsnew/files/doc_library/23-071-P-GCR-Dental-Benefit-Rate-Changes.pdf) that went into effect July 1, 2023: 1\. The ABM was increased from $1,000 to $1,500 for adults who are not pregnant or in the postpartum period, or who are not in Department of Disabilities, Aging, and Independent Living Developmental Disability Services (DDS) Waiver Program or the Department of Mental Health Community Rehabilitation and Treatment (CRT) Waiver Program. 2\. The ABM was eliminated for adults who are pregnant or postpartum as well as those in DDS and CRT Waiver Programs. 3\. Coverage of medically necessary denture services was added for pregnant and postpartum adults as well as those adults in the DDS and CRT Waiver Programs. The benefit improvements mentioned above are the result of years of relentless advocacy by countless local and state champions who are beneficiaries, caregivers, service providers, health professionals, academics, state officials, and lawmakers. For years, these advocates have worked to educate their communities about the importance of oral health and its connection to overall health, and to build public will and action for improving benefits and access to care. ## Oral Health Will Remain a Top Priority in 2024 — and Beyond Looking to build on their recent advocacy efforts and the momentum happening across the country, several states have already signaled that expanding Medicaid adult dental coverage is a top priority. To advance their work, advocates in these states are elevating community voices, relying on data, and turning policy recommendations into action. Here’s a quick peek at some of the states we’re watching: Arizona: Advocates have been making steady progress during the past several years, raising awareness of the need for an expanded adult benefit. During the 2023 legislative session, [HB 2338](https://legiscan.com/AZ/text/HB2338/2023) was filed to expand the existing dental benefit to include preventive services. While the bill successfully passed in committees in both chambers with strong bipartisan support, it did not receive funding in part of the state budget. In 2024, the Arizona Oral Health Coalition (AZOHC), along with its legislative and policymaker champions, intends to file legislation and secure funding for an expanded benefit for all adults. Leading up to the filing, AZOHC will continue to work with impacted communities and oral health stakeholders to grow the “oral health is essential” comprehensive advocacy campaign with a focus on elevating the need for a comprehensive adult dental benefit through continued lawmaker education, public engagement, and social media/media messaging. AZOHC will also use data from the recent CareQuest Institute report, “[Spotlight on Arizona: Adult Use of Emergency Departments for Non-Traumatic Dental Conditions](https://www.carequest.org/resource-library/spotlight-arizona-adult-use-emergency-departments-non-traumatic-dental-conditions),” and a [report from Grand Canyon Institute](https://grandcanyoninstitute.org/wp-content/uploads/2023/10/GCI_Policy_Fiscal-Economic-Impacts-of-Adult-Dental-Medicaid-Benefit_Oct_11_2023-.pdf) that explores some of the anticipated long-term cost savings to the overall health care system as the result of a comprehensive dental benefit. “Because of advocacy efforts at the grassroots and legislative levels, we have seen oral health elevated at the State Capitol with broad bipartisan support,” says Brianna Miller, coordinator of the Arizona Oral Health Coalition. “State Representative, and conservative newcomer, Matt Gress, called the preventive dental bill, ‘[fiscally conservative and morally right](https://www.azleg.gov/videoplayer/?eventID=2023021097&startStreamAt=9255)’ after hearing stories from Arizonans struggling to access oral health care, and gaining an understanding of the long-term health care cost savings associated with good oral health.” Delaware: Championed by Senator Sarah McBride and Representative Melissa Minor-Brown, [legislation](https://legis.delaware.gov/BillDetail?legislationId=109412) was passed in April 2022 to create a Dental Care Access Task Force. The Task Force issued its [final report](https://legis.delaware.gov/TaskForceDetail?taskForceId=445) in July 2023, in which it recommended the state expand its existing adult dental benefit by removing the annual benefit maximum and/or the emergency benefit maximum; increasing flexibility of the pre-authorization of the emergency benefit; and enhancing the benefit to cover high need services, including, but not limited to, crowns, root canals, and dentures. In the report’s opening message, Senator McBride noted that she is confident that the Task Force report represents a next step in the ongoing dialogue about how we can improve access to oral health in the state. Florida: For adults in Florida, the state’s Medicaid program covers emergency dental services to alleviate pain, infection, or both, and procedures essential to prepare the mouth for dentures. Many non-emergency dental benefits are covered by Florida’s Medicaid Dental Managed Care Organizations as value-added or “expanded benefits.” These benefits, which vary by MCO, are not required under state law and are not written into the Florida Medicaid State Plan. Advocates have routinely called for clarity about what, if any, non-emergency dental benefits are provided through the Medicaid dental MCOs. Florida Voices for Health is looking to change this. The organization is leading a statewide effort to [expand Medicaid coverage of a wide range of dental benefits](https://www.healthyfla.org/_files/ugd/f8e391_54eef5eaa5d94a47a536a7a834546265.pdf), including diagnostic, preventive, and restorative services. Providing this benefit will help Florida realize cost savings related to reduced [emergency department (ED) use](https://www.carequest.org/resource-library/adult-use-emergency-departments-non-traumatic-dental-conditions-spotlight-florida), chronic disease management, and a reduction in opioid prescribing. Through [story collection and dissemination](https://www.healthyfla.org/voices4oralhealth), the hosting of roundtable conversations and community events, and creating opportunities for engagement, Florida Voices for Health seeks to bring impacted individuals, providers, stakeholders, and lawmakers into better conversation with one another to advance change. “Our model focuses on sharing stories, data, and solutions in formats intentionally designed to meet lawmakers where they are,” says Scott Darius, executive director at Florida Voices for Health. “Consumers are at the heart of our model, and they ultimately drive which issues we elevate and which solutions we support.” Kansas: Thanks to the steadfast advocacy of Oral Health Kansas and its partners across the state, incremental improvements to strengthen the adult dental program have been made year after year in Kansas. Most recently, dental benefits were expanded in 2022 and 2023 and now cover a wide range of services including fillings and crowns, periodontal care, silver diamine fluoride, full and partial dentures, and denture repairs. Kansas is the only state to use a combination of Medicaid-provided benefits and value-added benefits (VAB) offered through the state’s three MCOs. Since 2013, when the state moved to a managed care model, all three MCOs that operate in Kansas have offered preventive dental services to adults through their VAB packages. Those VAB packages have evolved over the years, and now they each offer a benefit of $500 per year that covers exams and cleanings. The precise package offered by each MCO changes slightly every year. Driven by the voices and concerns of Medicaid beneficiaries and providers, Oral Health Kansas will continue advocating for the inclusion of exams and cleanings in the Kansas Medicaid State Plan, which will ensure a comprehensive and secure package is available for Medicaid beneficiaries regardless of the VABs available each year, streamline the benefits package, and avoid confusion. “Oral Health Kansas has worked hard to curate and collect data to complement the stories we hear in order to prove the oral health issues in our state are systemic,” says Tanya Dorf Brunner, executive director at Oral Health Kansas. “For so many years, legislators’ hesitancy to allocate funds for adult dental services has been due to the price tag associated with increased dental benefits, but by being able to show a positive offset in other medical expenses and emergency room visits we were able to gain support from legislators for an extended adult dental benefit. It was this collection of data, along with the real human stories, that showed legislators the need to invest in our state’s Medicaid dental program leading to legislative wins over the last five years.” Nebraska: For the past several years, Nebraska Appleseed has been working to identify systemic oral health care issues and solutions that are community priorities, as well as building and maintaining relationships with impacted Nebraskans who can become powerful, long-term advocates. In 2024, the organization will deepen its oral health care advocacy by building off its [Medicaid dental policy brief](https://neappleseed.org/wp-content/uploads/2023/01/NE-Appleseed-Dental-Policy-Brief-12.2022.pdf); participating in a legislative interim study focused on dental care; and monitoring the state’s removal of the Medicaid dental cap and the state’s transition to having multiple dental MCOs in the new year. North Carolina: In March 2023, North Carolina [passed Medicaid expansion legislation](https://www.ncdhhs.gov/news/press-releases/2023/09/25/nc-medicaid-expansion-will-launch-dec-1-2023). The expansion will take effect on December 1, 2023, and is expected to cover an additional 600,000 North Carolinians. North Carolina Medicaid offers dental benefits to adult beneficiaries, and it is expected that these benefits will be extended to newly eligible adults. In the year ahead, we will monitor the implementation of Medicaid expansion in the state and what it means for beneficiaries accessing dental care. Pennsylvania: In 2011, comprehensive dental benefits for adults were cut, eliminating reasonable access to covered emergency exams or services like gum disease treatment, crowns, root canals, and dentures. Since that time, advocates across the state, led by the [Pennsylvania Coalition for Oral Health](https://paoralhealth.org/), have been calling for a restoration of benefits as well as several additional [systems-based improvements](https://paoralhealth.org/wp-content/uploads/2023/02/PCOH-Policy-Paper-2022_final.pdf). At the time of this writing, advocates and legislative champions are pursuing companion bills [HB1417](https://www.legis.state.pa.us/cfdocs/billinfo/billinfo.cfm?syear=2023&sind=0&body=H&type=B&bn=1417) and [SB955](https://www.legis.state.pa.us/cfdocs/billinfo/billinfo.cfm?syear=2023&sind=0&body=S&type=B&bn=955), which would reinstate all previously eliminated dental services, eliminate the existing Benefit Limit Exception (BLE process), and allow for additional services to be covered. Pennsylvania is in the midst of a two-year legislative cycle and we’ll be watching the progression of this important piece of legislation. “With a new administration and two-year legislative session starting in 2023, Pennsylvania is primed for change,” says Helen Hawkey, executive director at the Pennsylvania Coalition for Oral Health. “Paramount to equitable access to oral health is the reinstatement of comprehensive benefits for adult Medicaid members. In 2011, benefits were cut for the state budget to save $42 million. Twelve years later, the consequences of this decision have compounded barriers for the most under-resourced Pennsylvanians. Recent projections from the state Medicaid office show the cost of restoring benefits is $176 million, demonstrating a significant increase because of the state’s neglect.” ## How to Get Involved in Expanding Benefits We’re excited to see oral health at the forefront and encouraged by the progress all stakeholders have made in recent years. It’s incredibly impressive. Still, work remains, and the weeks and months ahead will be busy ones for advocates and policymakers. If you share in our excitement and want to get involved in the advocacy to further improve Medicaid dental coverage for adults, you can: 1\. Get involved with your statewide coalition! Check out any of the advocacy links throughout the post or reach out to us and we’ll help connect you. 2\. Sign up for the [CareQuest Institute newsletter](https://www.carequest.org/latest-news) to get the latest on dental benefit expansion and progress. 3\. Explore the [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) to see where your state’s benefits package falls on the continuum from no benefits to an extensive benefit. ![](https://carequest.org/wp-content/uploads/2025/09/Stacey-Auger-topaz-202x300.jpg)Stacey Auger, MPH 4.Reach out to your elected officials to let them know you support dental benefits for all adults. Check out the “[Tools for Oral Health Advocates](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker)” section on our website for more information and links to contact your state and federal legislators. *Authored by Stacey Auger, MPH, policy consultant, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [The CPT Code for the Application of Silver Diamine Fluoride, Explained](https://carequest.org/blog/the-cpt-code-for-the-application-of-silver-diamine-fluoride-explained/) **Published:** October 23, 2023 **Author:** Caitlin Locklear **Content:** On September 15, 2022, the American Medical Association (AMA) voted to approve a new procedure code for the application of silver diamine fluoride (SDF) by medical professionals to arrest cavities. The addition of this code is a milestone in medical-dental integration and a step forward for oral health equity, providing access to this valuable treatment to millions of Americans who don’t see the dentist every year. “The AMA just created a transformative mechanism for health plans to support medical teams in controlling tooth decay with a breakthrough medicine,” said Jeremy Horst Keeper, DDS, PhD, director of clinical innovation at CareQuest Institute Partners and one of the authors of the code. “SDF is carefully brushed onto cavities and repeated periodically, stopping a great majority of them. It also 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.” CareQuest Institute, in partnership with several leading oral health and medical organizations, championed the code and submitted it for approval. Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute, supported it with the AMA.**![](https://carequest.org/wp-content/uploads/2025/10/expanded-access-sdf.jpg)** “To achieve oral health equity, we need the participation of the entire health system,” Minter-Jordan said. “The inclusion of a new CPT code for physicians to offer critical [non-invasive therapeutic oral health care](https://www.carequest.org/topics/minimally-invasive-care) to their patients is a key step toward a more accessible, equitable, and integrated health system that meets the needs of everyone.” Keeper explained how this change will benefit patients — especially underserved patients — as well as what’s next for them, for medical providers, and for dental providers. **Why is the silver diamine fluoride (SDF) code such an important breakthrough, Jeremy?** There are communities where over half of children get flown hundreds of miles to the closest dentist to get to cavity treatment under general anesthesia. But they have a local medical clinic. Arming these medical teams with this medicine sounds crazy because for hundreds of years dentists have been the only ones who can treat tooth decay, but now that we have [non-invasive therapies](https://www.carequest.org/about/blog-post/answers-17-your-silver-diamine-fluoride-questions) for cavities, many members of dental and medical teams can, too. This breakthrough is revolutionary, but it is also seriously validated: SDF was recommended by the Indian Health Service in 2017, by the American Dental Assocation (ADA) in 2018, and was added to the World Health Organization’s Lists of Essential Medicines in 2021. **So, there’s a great need for this?** Definitely. Here are some additional statistics to underscore why this is critically needed to improve access to care for all: - Most young children see a medical team but not a dental team. - Dentists generally do not care for older adults in long-term care facilities. - Non-dentist providers see patients that are either too young, too sick, or too poor to access the prevailing dental care system. - [Only 2% of children under the age of 2 have seen a dental team](https://pubmed.ncbi.nlm.nih.gov/26314607/), but the typical 2-year-old has seen a medical team 10 times. - More than 60 million people live in [dental health professional shortage areas](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis). - [Only 29% of older adults have dental insurance](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage), while nearly all have health insurance. - [One in 50 adult Medicaid beneficiaries](https://www.medicaid.gov/medicaid/benefits/downloads/adult-non-trauma-dental-ed-visits.pdf) visits an emergency department for tooth decay each year. **But SDF isn’t just for children, right?** While the only permanent solutions to dental caries are taking out the tooth or fixing a person’s diet, SDF has similar outcomes to dental fillings. So, if there is decay, SDF is an option: for kids, adults, elders, anyone. Some people even use it for their dogs, but don’t try that at home. **The code went into effect in July. Now what?** Health plans are figuring out how to structure their payments for this therapy. Since they most commonly get the bill for the sedation, anesthesia, and emergency department visits for tooth decay, they should be excited to drastically decrease costs and improve outcomes and experiences by reimbursing SDF. **What does this change mean for physicians?** The addition of this code gives physicians one more important tool in their toolbox to impact the health of their patient by providing another point of access where many do not have one. It will prevent children from needing sedation to treat a mouth full of caries, a condition that is nearly completely preventable. **Will physicians need additional training? How will they get that?** Smiles For Life (the group that created the most commonly used fluoride varnish trainings for medical teams) will create educational materials on dental caries diagnosis and SDF application. Rebecca Bernstein, MD, residency faculty at Medical College of Wisconsin and the only physician to publish on the use of SDF, and I will drive the curriculum. **What does this change mean for other members of the health care teams?** One of the challenges ahead will be figuring out how physicians can delegate this task to nurses and other medical team members. They have far more safety training and are often just as skilled in performing intricate procedures as delegated dental team members, but they do not have the language for communicating exactly where in the mouth to apply the SDF. “The gingival margin of 29 facial” means nothing to a nurse. **That communication piece seems important. Any ideas on how we can meet that challenge?** CareQuest Innovation Partners \[a for-profit subsidiary of CareQuest Institute\] is validating innovations to address this communication gap. For example, we are looking into a simple new caries indicator that will empower medical teams to have all providers work at the top of their licenses and optimize clinic flow — critical elements in transforming care to overcome health inequities. **And what about for dentists? What does this mean for them?** Most dentists and dental professionals, including the American Dental Association, support this code addition. There is growing recognition that addressing oral health inequity requires an interprofessional and integrated approach. The addition of this code will support both. It also could signal a big change in the industry. Dentists are surgeons, right? Physicians and medical surgeons have learned to work together. So, for example, when a medicine becomes available that simplifies treatment from surgical to pharmacological or topical care, surgeons hand off to physicians. SDF offers the first major advancement in caries treatment that uses pharmacological-topical approach; it is time for dentists to hand this off. **Can you say a little more about how SDF is different from fluoride varnish?** Differences between [the application of fluoride varnish and SDF](https://www.carequest.org/education/course/minimally-invasive-care-dentistry-healing-tooth-decay-brush-therapies/overview) include the diagnostic indication, the expected outcome, and the application technique. The indication for fluoride varnish is high risk of dental caries, while the indication for SDF is an actual caries lesion. The expected outcome for fluoride varnish is less new caries lesions, while that of SDF is arrest of the lesions. This might be thought of as disease prevention versus disease treatment. The application technique for fluoride varnish is to apply it to all tooth surfaces. In contrast, SDF is applied very specifically to caries lesions themselves, which commonly represent much smaller and specific areas. SDF requires much more careful attention and technique. Analogies in medicine might be that fluoride varnish is like applying a skin protection lotion for a person with eczema, while SDF is more like electrocautery/cryotherapy for warts — or using a silver nitrate stick to stop a bleed. **Is SDF FDA approved as a drug to treat dental caries?** No — like fluoride varnish, it is cleared as a device to treat dental hypersensitivity. The NIH/FDA phase III trial will soon end, and caries drug approval is expected thereafter. It was granted Breakthrough Therapy status by the FDA. We expect that drug approval will constitute a move to a Category I CPT code. **Who contributed to this work? How did it happen?** The code proposal was a collaboration led by a team focused on minimally invasive care within CareQuest Institute, which sponsored and submitted the proposal. Peter Milgrom, DDS, emeritus professor at the University of Washington Schools of Dentistry and Public Health and founder of Advantage Silver Dental Arrest, did the bulk of the early work to get this project moving. Without him, none of this would have happened. There were also key contributions from Elevate Oral Care, the Children’s Health Alliance of Wisconsin, and a group of physicians who have been using and teaching SDF themselves, including Drs. Stephen Holve, Karen Sokal-Guttierez, and Rebecca Bernstein, in particular. Support from several organizations was critical to approving the new code: American Geriatrics Society, National Dental Association, American Dental Association, American Dental Hygienists Association, Society of American Indian Dentists, Children’s Health Alliance of Wisconsin, National Coalition of Dentists for Health Equity, NorthWest Health Law Advocates, Community Catalyst, and the Center for Medicare Advocacy. **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [The Five Most Popular CareQuest Institute Publications of 2022](https://carequest.org/blog/the-five-most-popular-carequest-institute-publications-of-2022/) **Published:** December 12, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Two-women-at-desk-pointing-at-computer_0.jpg)This past year was full of positive developments in the oral health system: [expanded oral health coverage](https://www.carequest.org/about/blog-post/new-oral-health-outlook-2-million-americans) for millions of Americans, [initiatives to advance medical-dental integration](https://www.carequest.org/about/blog-post/connection-between-100-million-mouths-and-oral-health-equity), and new codes that will [increase the use of minimally invasive care](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained). But at CareQuest Institute for Oral Health, we know we still have a long road ahead to improve oral health care, especially in underserved communities.[carequest.org/…/new-oral-health-outlook-2-million-americans](https://www.carequest.org/about/blog-post/new-oral-health-outlook-2-million-americans) That’s why we’re here — to improve systems of care for patients and providers. As part of those efforts, we create and disseminate actionable research, analytics, and evaluations that providers, policymakers, and advocates can use to improve the oral health care system and better inform policy and financing decisions. Our research, powered by state- and national-level representative data sources, including health care claims data, integrated medical-dental databases, and surveys of health care experiences, yielded more than 110 publications that readers collectively viewed more than 67,000 times on our website in 2022. Which publications drew the most views from our readers who are focused on improving the oral health system? Here, based on popularity, are the top five CareQuest Institute publications from the past year. ## 1. [**Americans Are Still Not Getting the Dental Care They Need**](https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need) (April) Two years after dental care was disrupted for millions of Americans, disparities in oral health care persist and many are still not getting the dental care they need, according to [this report](https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need) based on the results of the annual State of Oral Health Equity in America survey. While some aspects of oral health have rebounded since the earlier stage of the pandemic, the report explained, several inequities persist. For example, more than half of adults (55%) reported some type of oral health problem. Further, more than half of adults with an oral health problem did not seek care, and one-quarter of them did not seek care because they could not afford it. **Spotlight statistic:** For those who had not seen an oral health provider in the last two years, 27% cited cost as a reason, 18% cited the COVID-19 pandemic, and 11% said they had no reason to go. ## 2. [**Missed Connections: Providers and Consumers Want More Medical-Dental Integration**](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration) (February) We know that oral health and overall health are inextricably linked. But despite this connection, dental care is still largely siloed from medical care. This [visual report](https://www.carequest.org/resource-library/missed-connections-providers-and-consumers-want-more-medical-dental-integration-0) examines attitudes regarding the relationship between oral health and overall health, based on national surveys of oral health consumers and providers. Both consumers and dental providers described a lack of integration between medical and oral health care and a desire for increased interprofessional collaboration. **Spotlight statistic:** 63% of consumers report their primary medical doctor “rarely” or “never” asks about their oral health, and 33% of consumers report their oral health provider “rarely” or “never” asks about their overall health. ## 3. [**Recent Trends in Hospital Emergency Department Visits for Non-Traumatic Dental Conditions**](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) (November) This [updated visual report](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) finds that in 2019, there were 1.8 million hospital emergency department (ED) visits for non-traumatic dental conditions (NTDCs), which cost $3.4 billion to treat. Hospital ED visits for NTDCs can divert critical resources and create added stress for ED personnel. Moreover, most hospitals lack the ability to provide appropriate care for NTDCs, and the typical cost of such ED visits is much higher than a patient receiving care from a dental provider. **Spotlight statistic:** Compared with white individuals, Black individuals were 44% more likely to visit an ED for NTDCs, while Native Americans were 9% more likely. ## 4. [**How Depression Is Linked to Oral Health**](https://www.carequest.org/resource-library/how-depression-linked-oral-health) (May) A growing body of research, highlighted in this [visual report](https://www.carequest.org/resource-library/how-depression-linked-oral-health), shows that our emotional state is connected to our oral health. For example, depression can be linked to poor oral hygiene, fewer dental visits, and other oral health problems. Depression is linked to higher levels of dental caries, and adults with depression are more likely to have missing teeth than adults without depression. **Spotlight statistic:** Adults with poor mental health (including depression) are more likely to have one or more unmet oral health needs and are less likely to seek care for these needs than those with better mental health. ## 5. [**Burnout among Dental Professionals Before and During a Public Health Crisis**](https://www.carequest.org/resource-library/burnout-among-dental-professionals-and-during-public-health-crisis-causes) (August) Nearly three-quarters (71%) of oral health providers said their feelings of burnout had increased since the start of the COVID-19 pandemic, according to this [visual report](https://www.carequest.org/resource-library/burnout-among-dental-professionals-and-during-public-health-crisis-causes). To learn more about the effects of the pandemic on burnout, CareQuest Institute conducted a survey of 377 dental providers in March 2021. In general, oral health providers reported increases in burnout during the beginning of the pandemic. However, this sense of increased burnout did not impact all dental providers equally, with differences by gender, age, race, and ethnicity emerging. **Spotlight statistic:** Oral health providers identifying as Hispanic were more likely (73%) to report burnout symptoms due to work compared with individuals identifying as white (63%), Asian/American Indian/Native Hawaiian/Pacific Islander (55%), or Black (35%). These are just five publications among dozens CareQuest Institute published during the last year. To explore other reports, white papers, poster presentations, and infographics on topics ranging from veteran dental care to teledentistry, visit our [Resource Library](https://www.carequest.org/resource-library). **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [19 Questions (and Answers) about Brush-On Dental Therapies ](https://carequest.org/blog/19-questions-and-answers-about-brush-on-dental-therapies/) **Published:** December 13, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dental-professional-applies-fluoride-varnish-to-childs-teeth.jpeg)Brush-on therapies have become a popular form of minimally invasive care in recent years. As an alternative to surgically managing caries, silver diamine fluoride (SDF), povidone iodine (PI), and non-staining peptide-guided enamel regeneration P11-4 offer patients and providers options that are often preferable to the “drill-and-fill” approach. Change, in this case, is happening quickly. “The adoption of SDF has been the most rapid adoption of any kind of new strategy in dentistry in its history,” said Peter Milgrom, DDS, emeritus professor of oral health sciences at University of Washington, during the latest CareQuest Institute webinar on [patient-centered brush-on therapies](https://www.carequest.org/education/webinars/sdf-and-beyond-patient-centered-brush-therapies-caries-management) for caries management. “As more students who graduate dental school use it, and as more managed care dental programs adopt care guidelines, you’ll see greater adoption of SDF as a whole.” More than 600 oral health stakeholders joined Milgrom, Jeremy Horst Keeper, DDS, PhD, and Laura Skaret, BS, RDH — both from CareQuest Innovation Partners, a for-profit subsidiary of CareQuest Institute — to explore these minimally invasive therapies and how to offer them based on patient needs. The expert panel also discussed how to empower oral health teams to use the therapies to provide patient-centered care and how to navigate future advancements. Not surprisingly, there were dozens of questions from learners — dentists, dental hygienists, educators, and others interested in the topic — throughout the webinar. As a helpful recap for anyone who attended the webinar and an introduction to the topic for anyone who missed it, here are the top 19 questions the experts answered: **1. Is silver diamine fluoride good to be used on adults?** The [American Dental Association](https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/silver-diamine-fluoride) and [World Health Organization](https://www.who.int/groups/expert-committee-on-selection-and-use-of-essential-medicines/23rd-expert-committee/a28-silver-diamine) say YES! **2. Is SDF useful for seniors, as well?** Absolutely. [The Journal of the American Dental Association](https://jada.ada.org/article/S0002-8177(18)30460-4/fulltext) (JADA) and [Caries Research](https://pubmed.ncbi.nlm.nih.gov/23392087/) have published systematic reviews showing consistent strong effects on arresting root caries. **3. What is the recommended reapplication frequency when using SDF for prevention?** [The best evidence thus far](https://pubmed.ncbi.nlm.nih.gov/30829497/) is once per year, but always consider patient factors. **4. What is the success rate of using SDF on permanent teeth?** [Meta analysis shows](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500430/) ~81% caries arrest in patients with open active advanced caries lesions. **5. Is six months payment the frequency limit or efficacy limit?** Some dental benefits plans have this limit. Usually not. There are clinical trials of \[using SDF\] 1x or 2x per year, but commonly this is exceeded based on patient-specific factors. See the case study by [Doug Young et al in JADA](https://jada.ada.org/article/S0002-8177(18)30201-0/fulltext). **6. Some products with SDF mention that it’s only FDA cleared for ages 18 and above. Can it still be used for pediatric patients?** Yes, just like a fluoride varnish. **7. What are the criteria of the lesions indicated to use SDF?** Any active caries lesion without frank pulp exposure or irreversible pulpitis. **8. Which codes should we use for SDF applications?** D1354 for treatment and D1355 for prevention. **9. How soon after application do you evaluate SDF efficiency, and how do you know it’s working?** It depends on the disease activity and caries risk. It’ll usually be three or six months. **10. Do you recommend the use of a rubber dam when applying SDF?** No. You should use cotton isolation only. **11. For patients with limited access to dental care or with dental homes, there are concerns when it comes to pulpal exposure. What might happen if the tooth abscesses after SDF treatment?** SDF does not cause abscesses. That’s been studied very thoroughly. If you have a D4 lesion where you’re using it as an indirect pulp cap, then it’s very effective at arresting caries and does not cause pain or infection. If you put it on an exposed pulp, it’ll probably sting. But the question is what were you going to do if you didn’t use that? You could make a mistake and put it on a tooth where it’s a little uncomfortable, but that tooth’s either going to have a pulp treatment or it’s going to be extracted. So, if you made a mistake, and caused someone a little bit of discomfort, you’re not really changing the outcome at all. **12. Do you have any feedback on how to help get colleagues on the dental side to start using SDF?** I think that consumers are the ones who are the most effective at changing what dentists do. As SDF becomes a drug, and there’s more direct advertising to patients, when it gets more coverage, more and more dentists will adopt it. **13. What about getting medical colleagues to use SDF?** About 20% of pediatricians already apply a fluoride varnish, and that 20% is concentrated among providers who see largely Medicaid patients where it’s very hard to be referred to a dentist. All of these people are likely to start using SDF and they will continue to try to make referrals. The good thing about that is this is going to stop this problem while they’re in line to get care from a dentist. It’s not intended as a substitute. It’s intended as a complement to keep kids out of pain and out of the emergency room. I \[Keeper\] personally believe that the medical teams will pick up SDF, whereas they’ve been slow to pick up fluoride varnish, because of its effectiveness. Prevention is boring, unfortunately. It’s a lot of what medical teams do, but you don’t see the effect of prevention. When it works, there’s no change. And fluoride varnish prevents, when done at a sufficient frequency, about 40% of cavities. When you place silver diamine fluoride, and keep placing it year over year, you’re stopping 80% of cavities. And you see it. Teeth harden, gums get healthy. So, the visible health feedback that medical teams will get, we believe, will spread like wildfire. **14. How about hygienists being able to apply SDF and being able to apply iodine?** To our knowledge, there are no rules against hygienists placing SDF. If used for prevention, it usually follows fluoride varnish rules. If used for treatment, it may require a dentist diagnosis of caries first. ADHA and the Oral Health Workforce research group have [wonderful state-by-state descriptions of detail \[of permitted functions and levels of supervision\].](https://www.adha.org/resources-docs/7511_Permitted_Services_Supervision_Levels_by_State.pdf) Povidone iodine is an over-the-counter medicine, so I don’t believe that there’s anything limiting to dental hygienists from placing povidone iodine. It’s a very common practice to put povidone iodine on the trough of an ultrasonic scaler. That’s commonly done, and there’s no regulation against that to my knowledge. **15. Does iodine stain teeth? How does it taste?** Iodine does not stain teeth, but it can stain clothes, so care should be taken near clothing. The volume is so very low that you really don’t taste much at all. If you use 400x the volume so you can swish, it’d be different (but don’t do that!). **16. Is it better to apply 10% PI with a microbrush or other mini brush?** The amount of iodine that you can absorb in one Q-tip is about the perfect dose of iodine to keep from applying too much, but you may use a microbrush as well. **17. Are PI consumer rinses effective against caries as well?** Great question; no, unfortunately not. **18. Does P11-4 work on the root surface?** Unfortunately not. **19. What do you recommend in terms of brush-on therapies for elderly patients who cannot care for their hygiene well and have root caries?** SDF. SDF has shown that if you paint it on the facial surface of the teeth that have bone loss and where the individuals have gingivitis, and place it once a week for three weeks, then that will basically completely clear the gingivitis and either arrest or prevent root caries. *Editor’s note: You can watch the full recording of the webinar — and access the accompanying slides — in the [CareQuest Institute webinar library.](https://www.carequest.org/education/webinars/sdf-and-beyond-patient-centered-brush-therapies-caries-management)* **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [10 Quotes from 2022 about the Future of the Oral Health System](https://carequest.org/blog/10-quotes-from-2022-about-the-future-of-the-oral-health-system/) **Published:** January 3, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/2023.png)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](https://www.carequest.org/about/blog-post/marylands-successful-path-securing-dental-coverage-low-income-adults) in certain states, reach [milestones in medical-dental integration](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained), and promote actions to [break barriers to care for people of color](https://www.carequest.org/about/blog-post/actions-you-can-take-advance-anti-racism-dentistry). 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: **1. “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](https://www.carequest.org/about/blog-post/marylands-successful-path-securing-dental-coverage-low-income-adults) 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. **2. “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](https://oralhealthnc.org/value-in-care/), 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](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), 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. **3. “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](https://www.carequest.org/resource-library/teledentistry-use-beyond-pandemic). But how do we move forward with teledentistry? [This report](https://www.carequest.org/resource-library/teledentistry-removing-barriers-and-moving-toward-implementation) explores a variety of state-level barriers that stand in the way of teledentistry’s continued expansion — and offers several recommendations for leaders. **4. “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,”](https://journalofethics.ama-assn.org/article/health-equity-needs-teeth/2022-01) 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. **5. “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](https://www.carequest.org/about/blog-post/voices-field-sarah-sherman-improving-rural-veterans-oral-health-access) (MBVS) [Veterans are more likely to experience worse dental health outcomes](https://www.carequest.org/about/blog-post/path-improving-oral-health-care-veterans) — 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](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) and the [American Institute of Dental Public Health (AIDPH)](https://aidph.org/veteran-oral-health/) that recommends several actions to improve access and quality of care for veterans. **6. “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 ](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained)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. **7. “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. **8. “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. **9. “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](https://www.carequest.org/about/blog-post/connection-between-100-million-mouths-and-oral-health-equity) 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. **10. “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.](https://www.carequest.org/education/webinars/connection-between-healthy-mouth-and-prevention-hospital-acquired-pneumonia) **Categories:** Blog **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [A Decade in the Making: How Hawai‘i Oral Health Advocates Reinstated Adult Dental Coverage](https://carequest.org/blog/a-decade-in-the-making-how-hawaii-oral-health-advocates-reinstated-adult-dental-coverage/) **Published:** January 5, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/01/Nancy-Partika.png)Nancy Partika, RN, MPH In 2009, in the wake of a major national recession, Hawai‘i — like many other states — grappled with the difficult decision on what to cut from its state budget. Unfortunately, non-emergency dental benefits for adults on Medicaid were on the “cut” list, leaving hundreds of thousands of adults in Hawai‘i without access to preventive and restorative dental care. More than a decade later, that reality is about to change. 2022 brought a major victory for Medicaid beneficiaries in Hawai‘i with the passage of a state budget that reinstated these crucial dental benefits. Beginning earlier this week, on January 1, 2023, more than 250,000 adult Medicaid recipients in Hawai‘i became eligible to receive reinstated benefits for comprehensive oral health care, which is vital to overall health and wellness. ![](https://carequest.org/wp-content/uploads/2023/01/Patrick-Donnelly-206x300.jpg)Patrick Donnelly “I’ve heard countless stories of people who have been rejected for jobs, can’t chew food, wait months to be seen by a dentist, can’t live a full life, or are pulling out their own teeth with pliers because they haven’t been able to access dental care,” says Nancy Partika, RN, MPH, the OPEN (Oral Health Progress and Equity Network) grassroots representative for Hawai‘i and a member of the Hawai‘i Oral Health Coalition (HOHC). “Now dental care will be offered freely as a right to care for so many who have struggled for so long to access the dental care they need and deserve.” But how did Hawai‘i get there? What did the years-long fight look like to reinstate these critical benefits? It wasn’t easy, but many advocates on the ground played a major role in this victory. And as we –— CareQuest Institute, advocates, patients, and other key stakeholders — continue to push for all states to include adult dental benefits in their state Medicaid programs, it’s important to learn more about Hawai‘i’s path to success and gather lessons learned. ## The Root of Oral Health Advocacy in Hawai‘i Partika admits that her strong interest in oral health did not emerge until 2015. Like many, she hadn’t fully appreciated the important connection between oral health and overall health. “It wasn’t until 2016 that I got involved in oral health specifically. I was a leader for a local public health organization when our University of Hawai‘i medical school contact suggested that we start looking at opportunities to do more around oral health issues,” says Partika. “At the time, I didn’t really see the connection because, until then, I considered oral health as dentistry and public health as everything else.” Patrick Donnelly, the statewide oral health coalition manager for the Hawai‘i Public Health Institute and the Hawai‘i Oral Health Coalition, started appreciating the importance of oral health when he was a rural-based Head Start health specialist. He realized that oral health seemed to always be at the bottom of the priority list for families and children, especially those on Medicaid. He also realized the importance of access to dental care for whole families. “There was a study of Head Start children that showed that a staggering amount of kids come into preschool with tooth decay already. So we set to work with these children, but then realized that the parents didn’t have access to dental care,” says Donnelly. “This really is a family issue because how can a parent adequately support their child in care when they don’t even have the opportunity themselves?” ## The Path to Reinstating Dental Benefits In 2016, the DentaQuest Foundation (now operating as CareQuest Institute for Oral Health) began to fund Hawai‘i nonprofits to work specifically on the significant disparities in oral health. The work included organizing meetings statewide around oral health and disparities, locating and sharing disparities-related oral health data and information, and mobilizing supporters in affected communities around oral health. As that work progressed, efforts to reinstate dental benefits became better organized in 2018, as advocates, under the newly-established Hawai‘i Oral Health Coalition (HOHC), started building a statewide and diverse constituency around the issue. Effectively, they began working together as a more unified group. CareQuest Institute has continued to fund the Hawai’i Children’s Action Network and the Hawaii Public Health Institute, which operates HOHC, throughout this process. In 2021, Partika and Donnelly, representing HOHC, approached the University of Hawai‘i’s School of Medicine and the Hawai‘i State Department of Health to collaborate on a longitudinal five-year retrospective study to analyze all emergency room (ER) visits) statewide for non-traumatic dental conditions. The study revealed that between 2016 and 2020, those dental-specific ER visits cost more than $38.7 million, with nearly half of those visits coming from adult Medicaid recipients. Between the ER study and significant visible community support, the push to reinstate an adult dental benefit regained momentum in the 2022 legislative session. To prepare for legislative hearings, Partika, Donnelly, and other HOHC and community advocates worked tirelessly to make sure all supporters of the bill had the information and support they needed to effectively advocate for its passage before the legislature. They sent out regular reminders and updates on bill hearings and supplied testimony templates, talking points, and training, so everyone was supported and prepared. The hard work paid off. For every bill hearing on adult dental benefits, 40 to 60 individuals and organizations testified in favor of the dental benefits bill. “We had so many organizations across the state who signed on for support, and so many showed up to testify,” says Donnelly. “Going to these hearings, it was overwhelming to see all the people who were in support. It made the issue hard to ignore when you have testimony after testimony advocating for this. It really spoke to the scope and the severity of the problem.” With the backing and advice of some legislative champions of the bill, the measure reverted from bill form to a state budget line item — a better way to guarantee these funds would be sustained year after year. The long-term [advocacy efforts](https://www.carequest.org/how-we-work/policy-and-advocacy) came to fruition in May of 2022 when the Hawai‘i State Legislature approved the state budget, which included $25.9M for reinstating Medicaid adult dental benefits. ## Next Step: Implementation While advocates took time to celebrate the momentous occasion, they soon got back to work to focus on preparing for the implementation of the program. “Getting the bill passed was the easy part compared to implementation,” says Partika. “Getting the funding is one thing, but doing a good job with it and making sure that we are measuring progress is even more important. Now we need to move implementation along and make it accountable, measurable, and responsive to Medicaid recipients.” Advocates are now working with community dental leaders and other stakeholders to expand the dental workforce statewide, as well as identify ways to encourage dental providers to accept Medicaid in order for Hawai‘i to prepare for more than 250,000 Medicaid adult recipients seeking dental care. “On some islands in Hawai‘i, you might have one office that’s open only one day a week in a town. We need more providers who take Medicaid, and we are exploring how to do that through incentive programs like increasing reimbursement and reducing administrative burdens,” says Donnelly. “And because we have a provider shortage, we want to think about how we can enhance the ability of the current workforce to be able to handle this influx. That could be through expansion of scope of practice for dental hygienists, or the use of dental therapy.” The path forward will have its challenges, but the advocates have a clear vision. “Above all,” Donnelly adds, “we need to work together and break down silos, because we are stronger together.” **Categories:** Blog **Tags:** Dental Coverage --- ### [‘More People Have Access to Oral Health Services’: How West Virginia Is Using the Medicaid Adult Dental Coverage Checker](https://carequest.org/blog/more-people-have-access-to-oral-health-services-how-west-virginia-is-using-the-medicaid-adult-dental-coverage-checker/) **Published:** January 17, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Jason-Roush-205x300.jpg)Jason Roush, DDS Jason Roush, DDS, realized early on in his career the importance of improving the oral health of all West Virginians. He started as a private practice dentist after graduating from the West Virginia University School of Dentistry in 1998, but he quickly started to look beyond the four walls of his office. “I thought I could have a bigger impact working in the state government in the [West Virginia Oral Health Program](https://dhhr.wv.gov/oralhealth/Pages/default.aspx) than what I could in the private sector,” Roush says. Twelve years later, in 2010, he became West Virginia’s first full-time state dental director. He’s been in that position ever since. “I’m blessed to work with passionate individuals that want to improve the health and well-being of the citizens of West Virginia,” he says. During that tenure, one of the biggest challenges he has faced is how to strengthen dental benefits for adults on Medicaid: The state only provided coverage for emergency procedures. That reality was reflected in 2020, when West Virginia appeared on the [Medicaid Adult Dental Coverage Checker,](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) an interactive tool that shows where a state’s Medicaid adult dental benefits package lies compared to other states. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories. “The Coverage Checker allows states to see where their benefits package falls on a continuum from no benefits up to extensive,” says Stacey Auger, MPH, a policy consultant at CareQuest Institute. “In doing so, it allows them to identify areas for improvement and expansion.” ## Moving to the Medicaid Adult Dental Coverage Checker For many years, policymakers and advocates have relied on the classification system of the American Dental Association (ADA) for state Medicaid adult dental benefits. Adopted and adapted by other organizations, this system classifies Medicaid adult dental benefits into four categories: extensive, limited, emergency, and none. Using the ADA’s classification system, a state’s dental benefits package may be considered extensive but can include services that are not among those that the best evidence shows are necessary to maintain oral health. “CareQuest Institute convened a workgroup that quickly decided the oral health community would benefit from a new assessment tool,” Auger says. “We wanted to develop something that moved us beyond simply counting the number of procedures covered.” While this classification system served the oral health community well for many years, four leading oral health organizations decided that states would benefit from a classification system that provides clear guidance on: - the specific covered service categories necessary to constitute an extensive benefit - the specific procedures to be covered within each service category - the specific service frequency to be covered - whether coverage is offered to all adult Medicaid beneficiaries or only to select subset(s) (e.g., individuals who are pregnant, people with disabilities, etc.) The Adult Dental Medicaid Coverage Checker is designed to meet these needs. CareQuest Institute released a new round of surveying earlier this month, and the Coverage Checker will be updated with the new data later this spring. “We are really excited to have launched the new round of surveying and to be able to create a visual representation of the many expansions in coverage that have happened since 2020,” says Michael Monopoli, DMD, MPH, MS, FACD, FICD, vice president of grant strategy at CareQuest Institute. “Starting this year, surveying will be done annually. Having year-over-year data will allow users to track movement in benefit offerings over time and to better understand the coverage landscape at the state and national levels.” ## West Virginia Strengthens Dental Benefits for Adults The Coverage Checker’s results are pulled from a survey state dental directors complete and share with CareQuest Institute. The data represent a snapshot in time and are reflective of coverage offered by each state at the time of completion. Looking at the results of the 2020 survey, which was released in summer 2022, West Virginia scored an 8 out of 32 on the Coverage Checker. “I mean, we’re behind if you look at that first tracker compared to what other states are offering,” Roush says. “I think when you first see it, it’s kind of shock and awe. It confirms where you’re at. But once you get past that, then you start to visualize how you can use the tool to implement change.” Roush says the tool is extremely useful for state leaders to see what bordering states are doing and covering, and it’s helpful for oral health advocates and supporters. The Coverage Checker doesn’t just provide numbers — it tells a story that oral health leaders can tell state lawmakers. “I would use that tool and probably will use that tool in the new cycle in 2023, when it comes out, and make sure it’s disseminated amongst our partners — because those are the people that really educate, advocate, that really help tell the story,” Roush says. The story is already getting better, something that will be reflected in the coming update of the Coverage Checker later this year. In March 2020, West Virginia passed a state law that expanded dental coverage for adults on Medicaid. It provides $1,000 in coverage per year for adult Medicaid beneficiaries for diagnostic, preventive, and restorative dental services with prior authorization. That can help individuals get dentures, implants, bridges, or even corrective procedures, like root canals. That law went into effect on January 1, 2021. Following a global pandemic, it may take some time before the impact of the expansion fully reaches the people of West Virginia. “I don’t think we’ve seen the full potential of the benefit yet. We’ve had dental practices shut down for three months in the state,” Roush says. “We’re trying to roll something new out — I mean, that’s been a challenge in and of itself. You’ve got to educate the providers. You’ve got to educate the community. It’s been a success but also a challenge.” With the positive momentum, Roush believes West Virginia’s number on the Checker will improve drastically — and likely more than double. “I don’t know what it’ll be — I’m hoping in the 20s,” Roush says. “But when you look at that, what’s that mean? To me, it looks like we have a lot more people who have access to oral health services.” **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Dr. Donna Balaski on Strengthening Connecticut Medicaid Adult Dental Benefits](https://carequest.org/blog/voices-from-the-field-dr-donna-balaski-on-strengthening-connecticut-medicaid-adult-dental-benefits/) **Published:** January 26, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Since 2010, Donna Balaski, DMD, has voiced the importance of periodontal coverage for adults on Medicaid in Connecticut. “By failing to treat periodontal disease,” she says, “it is like allowing an infection in a person’s lower limb to progress to gangrene where the ultimate treatment is amputation.” Balaski hopes her analogy — and her research-backed words of advocacy — will soon reach the ears of state leaders and lawmakers, inspiring them to strengthen Medicaid adult dental benefits in Connecticut. She knows the far-reaching effects benefits can have on access, equity, and the health of individuals in every corner of the state. “What you should do in terms of population health and programs that address population health is more important than what code you cover,” she says. ![](https://carequest.org/wp-content/uploads/2025/10/Donna-Balaski-240x300.jpg)Donna Balaski, DMD Balaski, a manager of medical care administration for the Connecticut Department of Social Services (DSS), knew she wanted to be a dentist when she was 5. In fact, she wrote about it in her “what I want to be when I grow up” essay in fifth grade, when most girls wanted to be a nurse or teacher. She achieved that goal and has been in the DSS for nearly 20 years, including a tenure as the executive director of the Board of Education and Services for the Blind. She’s no stranger to advocacy tools and points to the [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), an interactive tool that shows where a state’s Medicaid adult dental benefits package lies compared to other states, as a valuable one. When she first explored it last summer, she noticed Connecticut offers coverage for extractions, fluoride treatments, and more for adult Medicaid members — but not periodontal. Why is that coverage crucial? And what headway have advocates in the state made? **What brought you to the Department of Social Services in Connecticut?** I came to the Department of Social Services in 2004 to help settle a class action lawsuit against the state for the lack of access to dental care. I was charged with designing a program that was less administratively burdensome and improved utilization of dental services. **Can you share more on the history of Connecticut’s Medicaid adult dental benefits?** Connecticut has been covering Medicaid adult dental services since the 90s. In 2018, rather than lose dental benefits entirely for adults, state lawmakers reached a compromise to place a cap on dental benefits with an annual benefit maximum of $1,000. The state reduced cleanings to one time per year for healthy adults in 2019, but for adults with chronic medical conditions it stayed at two per year. **Do state legislators look at dental coverage as an area to cut from the budget?** In the past, dental has always been the sacrificial lamb when it comes to the state budget, especially the adult dental benefits, because it’s an optional program. There are many worthy programs that need funding, but since many people don’t understand or know the importance of having good oral health, optional programs, such as dental, are not valued and often among the first to be cut. Finally, we said, “We have no more bones to give you.” **Why have you been fighting to specifically get periodontal coverage for adults on Medicaid?** In 2008, the Connecticut Dental Health Partnership (CTDHP) formed. One of the CTDHP’s missions is to restore good oral health to adult Medicaid members. The CTDHP receives numerous referrals for people with chronic and often uncontrollable diseases who need care because of their complex medical histories. CTDHP often encounters members who have not had oral health care in years for a variety of reasons, including health equity, social determinants of health, and other significant barriers to accessing care. The Partnership then discovers that some of those members have periodontal disease. Failing to treat that disease is called “supervised neglect” and is reprehensible. **Has the Medicaid Adult Dental Coverage Checker helped you show people the importance of periodontal coverage?** Yes. I was able to tell how many other states had periodontal coverage, and that we were behind, and why. And I was able to give people a source to point to, not something they had to go digging in layers to try to find and understand and look at code fees. **What, if any, headway have you made with policymakers in Connecticut?** I have been doing this since 2010, and this is the first time I ever got anyone interested. Most of the people that I’ve spoken to are community groups we work with. I shared 60 research papers on the negative impact of periodontal disease on people’s health they could read. I’ve presented the issue to my bosses, the new Medicaid director, who has been very interested in dental and oral health services, and he’s very happy with the way our program is running. He’s giving it some attention that we haven’t gotten in many years. We have also been very lucky to have DSS Commissioner Deidre Gifford, who understands the importance of improving oral health, and Governor Ned Lamont, who has been very supportive of improving benefits for adults. **Can you give an example of the information you shared on the benefits of periodontal coverage?** [A study led by the Mayo Clinic](https://www.aegisdentalnetwork.com/cced/2022/03/association-between-preventive-dental-care-and-healthcare-cost-for-enrollees-with-diabetes-or-coronary-artery-disease-5-year-experience?q=) found providing preventive dental care and treatment of periodontal disease results in a cost savings for people who have diabetes and/or cardiovascular disease. A person with one of those conditions would save about $550 with periodontal coverage per year. If they have both conditions, they can save about $866 per year. **What are the next steps in the process?** After a fiscal analysis, my recommendations would go to the Office of Policy and Management for approval. Then it would be included in the governor’s budget, and in the last step, the state legislature would vote on it. **Why do you think state leaders and lawmakers are hesitant to strengthen coverage?** Like most of the population, they don’t understand the value or the importance of good oral health. Many people think of going to the dentist as taking care of their teeth, and they think of dental benefits as being related to cleanings, x-rays, fillings, and dentures. It is much more than that. There is more to your mouth than just teeth, and that is the oral environment that impacts your whole body. They don’t understand how oral health is related to systemic health. It’s not about what codes you cover; it’s about what services you offer, bringing people back to functional health, good oral and functional health. **Do you recommend other states use the Coverage Checker?** Yes, because it is simple and provides information in layman’s language, which is ideal. A legislator who is looking at individual codes has no idea what an all-ceramic restoration versus a high noble metal porcelain fused to metal restoration is. The Coverage Checker makes it easy to understand what types of services a state provides and where and how policymakers might make changes to improve their coverage. It also allows those policymakers to compare their coverage to that offered in other states and to look to other states as examples of where they want to be. **Categories:** Blog **Tags:** Dental Coverage --- ### [Five Ways to Improve the Oral Health of Medicaid-Enrolled Children](https://carequest.org/blog/five-ways-to-improve-the-oral-health-of-medicaid-enrolled-children/) **Published:** February 1, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Dentist-with-child_0-200x300.jpg)Early oral health care is essential for all children. So, it’s good news that Medicaid mandates comprehensive dental coverage for enrolled children until they’re 21 years old. But families with low incomes confront a persistent challenge: having coverage doesn’t guarantee access to care. Data show that children enrolled in Medicaid are less likely to receive the early dental care they need. Thankfully, there are effective solutions that dental and medical professionals, oral health advocates, and others can advance to connect more Medicaid-enrolled children to care. ## Children’s Oral Health Is Important, Especially for Those Enrolled in Medicaid Medicaid requires states to cover health assessments and services for enrolled kids throughout childhood, according to a schedule set by the Early and Periodic Screening, Diagnostic and Treatment benefit. Yet several barriers push services out of reach. The hurdles are higher in some states than others. In Arizona, for example, research finds that only about [one in four young children enrolled in Medicaid are receiving early dental care.](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children) Leading dental and child health experts — including the American Dental Association, American Academy of Pediatrics, and American Academy of Pediatric Dentistry — [agree that kids should have their first dental appointment by their first birthday.](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children) When left untreated, dental disease can have long-term consequences for children. Early exams can help. They help prevent childhood dental disease before it starts or catch it before it worsens. More specifically: - Children can get the care they need to stay healthy when providers can diagnose tooth decay early on. - Early diagnosis leads to more preventive support as children grow up. - Early diagnosis also means there’s less risk that a child will need oral surgery that can cost more than earlier care. Unfortunately, [many Medicaid-enrolled children don’t get a dental exam soon enough](https://www.carequest.org/resource-library/pediatric-primary-care-and-oral-health). National data [show that most children enrolled in Medicaid have their first oral health exam at age 3.](https://www.carequest.org/resource-library/age-first-oral-health-examination-and-dental-treatment-needs-medicaid-enrolled) This delay in care increases the risk that young children will undergo more extensive dental care, like fillings, than preventive treatment. ## Barriers to Oral Health Care for Children Enrolled in Medicaid According to research, [children enrolled in Medicaid have more oral health problems](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children) and see a dental provider less often than their peers with private coverage. Several factors make it challenging for children to access dental care: 1. There is a shortage of dental providers nationwide and many providers won’t see people enrolled in Medicaid. 2. Doctors and other primary care providers who perform well-child visits don’t conduct recommended dental exams often enough. 3. Data suggest nearly [1 million Medicaid-enrolled children rely on school-based oral health programs](https://www.carequest.org/resource-library/school-dental-programs-face-stiff-challenges) for basic dental care. The COVID-19 pandemic interrupted services and continues to cause disruptions for students. 4. Barriers based on structural racism remain a steep challenge. Nationwide studies confirm the depth of these hurdles. Data from 13 states show that, in 2013, [only 6% of children who had a well-child visit received an oral exam](https://www.carequest.org/resource-library/pediatric-primary-care-and-oral-health) during the appointment. Four years later, in 2017, this level only improved by 1%. Regarding school-based oral health programs, a [44-state survey](https://www.carequest.org/resource-library/school-dental-programs-face-stiff-challenges) affirms that the COVID-19 pandemic disrupted children’s dental care in many ways. The crisis forced oral health leaders to shift focus, taking time from school-based programs. Leaders had less capacity to inform school administrators, staff, and families about the program’s safety. Many school-based oral health programs were still not fully operating in 2021. The [research suggests](https://www.carequest.org/resource-library/challenges-implementing-school-based-oral-health-programs-short-and-long-term) that this challenge and others “may persist for years once the pandemic has ended.” State-level data also offers a look at how other barriers to children’s dental health care play out. An analysis of children’s dental health care information from Medicaid-enrolled children in Arizona provides one stark example. Experts find that [less than 1%](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children) of Arizona children enrolled in Medicaid had a dental visit before turning 1 year old. The hurdles they confront align with national trends: - Overall, the state does not have enough dentists to care for people in rural and low-income communities. - The provider shortage is a particular problem for children in Arizona. At least [four Arizona counties do not have a pediatric dentist](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children) to treat Medicaid-enrolled children. - The state also contends with deep racial disparities. Compared to other racial groups, [American Indian or Alaska Native children are the least likely to have a dental visit by age 1](https://www.carequest.org/resource-library/room-grow-analysis-dental-and-health-care-claims-medicaid-enrolled-children). They also travel the farthest to get care. ## How to Increase Children’s Access to Oral Care There are steps that health providers, advocates, and others can take to make progress securing early oral health care for Medicaid-enrolled children. These first three solutions can bolster school-based oral health programs, since so many children in low-income families count on such programs for care: 1. [Preserve programs](https://www.carequest.org/resource-library/school-dental-programs-face-stiff-challenges) by prioritizing what services to offer and where to provide them. School-based oral health program leaders can consider using a mobile dental van or shifting care to a different community building to keep care open to students. 2. Plan to adapt programs in a future public health emergency. Leaders can explore using [telehealth](https://www.carequest.org/resource-library/school-dental-programs-face-stiff-challenges) to give children and their families virtual guidance on developing healthy dental habits at home. 3. Create materials [to inform](https://www.carequest.org/resource-library/challenges-implementing-school-based-oral-health-programs-short-and-long-term) school administrators, school staff, and students’ families about the safety and importance of school-based oral health program services. Engaging educators and the school community about children’s oral health can help it remain a priority. Outside of school, here are two other effective approaches to improve access: 1. Dental education institutions can boost the number of providers who know how to support kids. They can [increase training](https://www.carequest.org/resource-library/age-first-oral-health-examination-and-dental-treatment-needs-medicaid-enrolled) in dental schools to equip general dentists, who normally care for adults, to treat children. 2. Dental and medical providers can expand [interprofessional](https://www.carequest.org/resource-library/pediatric-primary-care-and-oral-health) efforts and integrate children’s oral health into their primary care. This coordination can ensure the right follow through happens. With stronger connections, primary care providers will have a dental network to refer to after conducting a well-child visit with an oral exam. Early oral care is critical to children’s overall health. These solutions can help children enrolled in Medicaid get the early care they need. **Categories:** Blog **Tags:** Dental Coverage --- ### [Applied Learning: Hygienist Puts Brush-On Education to Use](https://carequest.org/blog/applied-learning-hygienist-puts-brush-on-education-to-use/) **Published:** February 6, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Trinity-Cleveland-at-AZMOM-scaled.jpg)Trinity Cleveland, RDH, volunteering at the annual Arizona Dental Mission of Mercy Trinity Cleveland, RDH, was volunteering at the Arizona Dental Mission of Mercy (AZMOM), an annual two-day event that provides dental services to underserved populations. It was her ninth time helping at AZMOM. “In Arizona, very few adults have access to dental benefits in Medicaid,” Cleveland says. “There’s a very small population that has that benefit. So, a lot of people come to these events.” This time, working in the dental hygiene section of the event was different for Cleveland. As in past years, she came with the same spirit of optimism and desire to help. And it certainly wasn’t her first time treating patients with caries — Cleveland has seen countless cases as a dental hygienist. But this was the first time she used silver diamine fluoride (SDF) as a treatment. Cleveland gained knowledge about SDF — and other brush-on therapies — with more than 650 peers during the CareQuest Institute webinar “[SDF and Beyond: Patient-Centered Brush-On Therapies for Caries Management](https://www.carequest.org/education/webinars/sdf-and-beyond-patient-centered-brush-therapies-caries-management)” held just a few days before the AZMOM event. In the webinar, the expert panel talked about SDF, a water-based tinted liquid that can be brushed on teeth every six months to stop them from decaying. SDF is a form of [minimally invasive care (MIC)](https://www.carequest.org/about/blog-post/19-questions-and-answers-about-brush-dental-therapies) — a nonsurgical alternative to help preserve teeth. It’s not as expensive or invasive as drilling and filling the tooth, and it reduces pain and hypersensitivity. “I was able to get enough information from that webinar that I could very comfortably pass along to the patients to help them make an informed decision,” Cleveland says. “It was a great feeling.” During the webinar, the expert panel explored minimally invasive therapies and how to offer them based on patient needs. They also discussed how to empower oral health teams to use them to provide patient-centered care and how to navigate future advancements. “The quality of the content and presenters is phenomenal. It’s just top-notch, and I appreciate that,” she says. ## Applying Practical Knowledge — and Applying Brush-On Therapies One patient from the event sticks out in Cleveland’s mind. “She was probably mid-30s. Rampant class V caries just everywhere,” Cleveland says. “There’s no way we’re going to be able to take care of most of her dental needs.” Cleveland walked the woman through the pros and cons of SDF, explaining the main side effect: SDF will stain any caries on the teeth black. “She goes, ‘My teeth are already black. Why do I care if they’re stained? If this is going to help buy me some time, I’m all in,’” Cleveland says. After Cleveland applied the SDF and finished the cleaning, the patient went on to the dentist for more care. “I felt confident when I went in to use it,” she says. “I wasn’t apprehensive about it at all.” Cleveland ran into the patient later in the day, an interaction that has stayed with her for weeks. “I saw her when she was sitting in line to do the extractions, and she was just so grateful,” Cleveland says. “And as is typical with a lot of people, she was scared, but she was smiling and crying and hugged me and was so grateful that we were able to give these things to her to give her a jump-start to change that trajectory.” ## Improving Outcomes for Medicaid Beneficiaries Cleveland began her career as a dental hygienist for a private practice, but for the last four years she’s been a government healthcare consultant at Mercer, a consulting firm that provides services ranging health and benefits to investments and retirement. “I try to improve the health outcomes of Medicaid beneficiaries, essentially,” she says. “We help the state to come up with innovative ways for care delivery and services and help them set up new programs or revamp their standing ones.” She has volunteered in 9 of the 10 AZMOM annual events, which are run by the [Central Arizona Dental Society](https://www.cadsfoundation.org/). “Everything is by volunteerism and donations,” Cleveland says. “And it is absolutely amazing. I have goosebumps right now talking about it. We provide dental services to anybody who shows up. Everything is free, but we can’t do everything for everybody.” This year, more than 1,100 people received dental care valued at a total of $1.7 million. This wasn’t the first year AZMOM offered SDF to patients — they’ve had it at the event since 2019. But it was the first time Cleveland had used it. That’s because in prior years, she worked in the local anesthesia part of the clinic, not the dental hygiene part. She wasn’t the only one using SDF on her patients that day. “It was frequently off of the table where all the central supplies are, so I’m assuming it was used quite a bit,” she says. Later that day, Cleveland was able to apply even more knowledge gained from the brush-on therapies webinar when a woman in her 40s walked in. “She had some cavities — not a bunch, but she had a few — and so she was going to get a couple of them fixed,” Cleveland says. “And she had told me that she had either been rinsing with or swabbing on povidone iodine onto her cavities because she read somewhere that that might be helpful to stop decay.” The webinar Cleveland attended also covered the benefits of another form of MIC — povidone iodine, a water-based liquid that can prevent tooth decay. “And she definitely had caries there, but they were arrested (stopped). They were in a good spot,” Cleveland says. “And I was like, ‘Wow, this is amazing.’ And I told her, ‘Oh my gosh, I just learned about this a couple days ago on this webinar I took.’ So, I was able to validate that information for her. She was just thrilled that she wasn’t messing something up.” ## The Value of CareQuest Institute Webinars Cleveland says the [CareQuest Institute webinars](https://www.carequest.org/education/webinars) are extremely helpful, and she has attended many on topics ranging from value-based programs to mobile care. The knowledge she gains is helpful to her not only as a dental hygienist but also as a government healthcare consultant. She takes the information from those webinars back to her team of nurses, pharmacists, behavioral specialists, and other colleagues, and shows them how better oral health leads to better overall health — something she couldn’t do as a hygienist at a private practice. “Even though I miss getting my hands wet in the clinical setting,” she says, “I just feel like I’m in a really good position to touch millions of lives instead of the 8 or 10 we might see in a day, and that makes me very happy.” **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [How We Can Advance Oral Health Equity](https://carequest.org/blog/how-we-can-advance-oral-health-equity/) **Published:** February 22, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Man-at-dentist.jpg) The COVID-19 pandemic disproportionately harmed Black, Hispanic, and other people of color, sparking renewed attention on America’s [oral health disparities](https://www.carequest.org/reimagining-oral-health). While some communities face higher hurdles to good oral health than others, promising solutions exist to achieve greater equity. Policy and health care leaders can do more to advance equitable access to services, including in dental care. ## The Importance of Oral Health Equity Dental access and services are inequitably distributed, pushing good dental health out of reach of many. Improving [oral health equity](https://www.carequest.org/topics/health-equity) is vital to communities’ [overall health](https://www.carequest.org/topics/health-equity) and economic well-being. When people can’t support their dental needs, it can hurt other areas of the body. For example, dental disease is associated with [dangerous pregnancy complications](https://www.carequest.org/resource-library/importance-oral-health-during-pregnancy). It is also a [risk factor for dementia](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) and can make it harder to manage chronic conditions, such as diabetes. These inequities also take a financial toll. Without access to affordable care, a preventable problem can become a crisis. In such circumstances, many Americans resort to their hospital’s emergency department for care. [Data suggest](https://www.carequest.org/resource-library/repeated-use-emergency-departments-non-traumatic-dental-conditions-factors) that having inadequate dental coverage, or lacking coverage altogether, makes it more likely that someone will regularly seek dental relief this way. Most hospitals cannot treat the root of a person’s suffering but only provide painkillers or antibiotics. These visits cost our health system billions of dollars each year. In 2019, they cost [$3.4 billion](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) overall. [Advancing oral health equity](https://www.carequest.org/reimagining-oral-health) would ensure a better use of resources and improve community oral health. ## A Snapshot of Oral Health Disparities in America According to a [2021 CareQuest Institute survey](https://www.carequest.org/resource-library/oral-disease-common-access-care-not), roadblocks to care and the resulting burden of dental disease fall hardest on people with low incomes and on communities of color: - People with low incomes are three times more likely than higher-income people to say they could not afford to treat a dental disease symptom they faced in the past year. - Black and Hispanic adults are three times more likely than white peers to have never seen a dentist. - Black adults are [68% more likely](https://www.carequest.org/topics/health-equity#pane-262) than white adults to have a dental problem that has not been addressed. The COVID-19 pandemic deepened these disparities. For instance, [65% of people](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) who lost health insurance in the public health crisis had one or more dental problems but could not get needed care. ## Barriers to Oral Health Equity Several factors shape our oral health and access to care, including where we are born, live, and work. Health leaders note that these circumstances have significant impacts. In a [*Boston Globe* article](https://www.carequest.org/about/news/boston-globe-opinion-solve-health-care-inequity-mass-should-address-social-determinants), Myechia Minter-Jordan, MD, MBA, and president and CEO of CareQuest Institute, and Michael Curry, president and CEO of the Massachusetts League of Community Health Centers, point to the reality that “[social determinants](https://www.carequest.org/topics/expanding-access) — like food access, affordable housing, transportation, child care, public safety, and more — account for 80% of a person’s health status, with access to health care making up only 20%.” Other experts observe how current systems place steeper barriers to good oral health in the path of people with lower incomes and communities of color. Patrick Smith, DMD, MPH, clinical assistant professor at the University of Illinois Chicago, has examined oral health disparities for several years. In a blog post, [he shares](https://www.carequest.org/about/blog-post/voices-field-dr-patrick-smith-oral-health-challenges-black-men) that “the narrative will likely always be that white populations collectively have better oral health, simply because they tend to fall on the better end of the spectrum of how social determinants affect health.” Data [affirm](https://www.carequest.org/topics/health-equity) that racism and economic inequity drive several barriers: - [Nearly half](https://www.carequest.org/SOHEA2022) of Black, Asian, and Hispanic adults experience racial discrimination in dental settings, compared to one in three white peers. - People experiencing poverty who lack dental insurance are more than [two times](https://www.carequest.org/resource-library/nhanes-oral-health-data-reflect-barriers-inequities) likelier than higher income people to have unmet dental needs. - When people living in poverty do seek care, they spend [10 times more](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families#:~:text=Only%2028%25%20of%20individuals%20living,those%20in%20high%2Dincome%20families.) of their annual income family income on services than people with higher incomes. Variation in state Medicaid programs illustrates how policy decisions compound these harms, worsening health for people of color with limited resources. Due to centuries of structural inequality, Medicaid disproportionately covers people of color. Studies show that [4 in 10](https://www.carequest.org/resource-library/nhanes-oral-health-data-reflect-barriers-inequities) Black and Hispanic adults live in a state where Medicaid does not cover any adult dental care, or only covers adults’ emergency benefits. Smith asserts that smart leadership and targeted funding can lift these barriers. “Balancing the scale with interventions to reduce inequities will require more resources, priority, and political will.” ## Changing Policy to Reduce Inequities Policy and health leaders can act to advance oral health equity. Effective solutions include strengthening dental coverage and embracing innovations to place care within reach of more people. One critical step is expanding [adult dental benefits](https://www.carequest.org/topics/adult-dental-benefit) in Medicaid and Medicare. Advocates and policymakers are making progress winning better coverage. Between 2020 and 2022, seven states added, expanded, or restored [Medicaid adult dental benefits](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) in some way. Federal policymakers slightly expanded Medicare’s dental benefits. Moving forward, leaders must protect and build on these gains. Other efforts to advance oral health equity include: - [Adopting dental therapy](https://www.carequest.org/about/blog-post/nine-questions-dive-deeper-dental-therapy) to expand access to care. Dental therapists specialize in commonly needed services, such as filling cavities, and can work outside of clinics. They are often from the historically marginalized communities they serve. These providers can effectively expand access to affordable, culturally competent care. - [Integrating](https://www.carequest.org/topics/medical-dental-integration) oral health into primary care. Doctors can support patients’ dental health by incorporating oral health assessments and similar care into appointments. With help from initiatives like [Medical Oral Expanded Care (MORE Care)](https://www.carequest.org/how-we-work/health-improvement-programs/more-care), medical teams can get necessary technology and strengthen relationships with dental partners to develop strong referral networks. - [Expanding teledentistry](https://www.carequest.org/resource-library/teledentistry-removing-barriers-and-moving-toward-implementation). The COVID-19 pandemic increased awareness of virtual medical and dental care. People value teledentistry, [with 86%](https://www.carequest.org/resource-library/patients-give-high-marks-their-teledentistry-experience) saying they would recommend it to others. This strategy can connect currently underserved communities to care while wisely using finite resources. Investing in these solutions can open the door to care for more people and those most in need — and we can inch ever closer to improving the oral health of all. **Categories:** Blog **Tags:** Health Equity --- ### [Transforming Community Health: Incorporating Social Determinants in a Dental Setting](https://carequest.org/blog/transforming-community-health-incorporating-social-determinants-in-a-dental-setting/) **Published:** March 2, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Dr.-Elly-Steel-225x300.jpg)Elly Steel, DMD, MPH Elly Steel, DMD, MPH, says she and her colleagues at Cabarrus Health Alliance can easily identify the factors in their patients’ lives that affect their health just by observing and listening. “I know which of my patients have difficulty with transportation because they either show up an hour early or an hour late for their appointments,” says Steel, the dental director of the public health authority in Cabarrus County, North Carolina. “Our patients tell us all the time, ‘At school, I can get chocolate milk for the same price as regular milk, so I’m going to get that chocolate milk.’” She says providers at [Cabarrus Health Alliance](https://www.cabarrushealth.org/) have been adding each patient’s social determinants of health (SDOH), like access to transportation and nutritious food, to their patients’ notes. But they were not tracking the patterns of all their patients’ information across the dental clinic. Now they are, and they plan to put that invaluable data to use as part of their ongoing learning within the [Community Oral Health Transformation (COrHT) Initiative](https://www.carequest.org/how-we-work/health-improvement-programs/corht). ## Transforming Oral Health Care Delivery in North Carolina COrHT, an initiative of CareQuest Institute, provides a framework for safety net dental clinics to implement medical-dental integration and value-based oral health care. The initiative also features a learning community that reimagines efficient, equitable oral health care and promotes the imminent shift toward value-based care in dentistry. CareQuest Institute’s [Three Domain Framework](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) — which focuses on 1) tele-prevention (teledentistry), 2) minimally invasive care (non-surgical treatment of disease), and 3) integration of oral health with overall health care — serves as the foundation for the learning. The clinics also provide clinical, financial, and demographic data related to those domains to CareQuest Institute. COrHT Initiative in North Carolina launched last year as a partnership between CareQuest Institute; the Blue Cross and Blue Shield of North Carolina Foundation; and the North Carolina Oral Health Collaborative (NCOHC), which is a program of the Foundation for Health Leadership & Innovation (FHLI). Steve Cline, DDS, MPH, is the vice president for the NCOHC. He says the experience with the COrHT Initiative has been a positive one. “We are so excited to be working with CareQuest Institute on this important learning initiative in North Carolina,” Cline says. “We have 14 progressive dental clinics \[including 11 safety net clinics\] across North Carolina exploring how to incorporate some of the newest dental office practices to improve the dental and overall health of their patients. The lessons we learn will inform the future of dental practice.” Stephanie Clester, RDH, MS, clinical content and support specialist at CareQuest Institute, has been leading educational and community-building efforts in the state. “The clinics who participate in the COrHT Initiative are oral health champions who are poised to help transform the oral health care delivery system,” says Clester. “The Three Domains provides the framework for teams to implement cost-effective, comprehensive, and integrated care while also preventing disease.” Early data are showing improvements in the care the clinics are providing as they work to implement the Three Domain Framework with their patient populations. For example, four clinics completed 531 chronic screenings between October and December 2022. Also, application of silver diamine fluoride (SDF) — a brush-on treatment that can arrest tooth decay — have increased. ## Implementing a Social Determinants of Health Screening Tool In January, Cabarrus Health Alliance started using a SDOH screening tool from the North Carolina Department of Health and Human Services for dental patients. (It was already using the SDOH screening tool for medical patients.) The Cabarrus Health Alliance’s leadership team, which included Steel, believed the questionnaire would be a good way to screen many of the other patients, so they implemented the process agency-wide. “We wanted to have a standardized SDOH screener for different programs, different departments, different clinical services,” Steel says. SDOH screening tools identify the needs of patients and help medical professionals connect them to the resources they need. The tool asks questions such as, “Within the past 12 months, did you worry that your food would run out before you got money to buy more?” and “Within the past 12 months, has a lack of transportation kept you from medical appointments or from doing things needed for daily living?” “There’s a lot of opportunity,” Steel adds, “to reach a lot of different people in the community.” Because the data are so new, it’ll take a few more months before Cabarrus Health Alliance can analyze them. But Steel says she expects the data will tell important stories. “That’s something I’m looking forward to seeing as the data progress,” Steel says. “Like, oh, in 2023, we were able to see that 60% of our patients say they have food insecurities, but now we are down to 40% of our patients. Maybe it’s something we did — an intervention — that might have made a difference.” ## Moving Forward with COrHT The COrHT Initiative has two phases. In this first phase, clinics like Cabarrus Health Alliance are participating in the learning community. It was during a learning community call that Steel shared Cabarrus Health Alliance’s wider adoption of the SDOH screening tool with the 10 other safety net dental clinics that are participating in COrHT. “I really enjoy getting to know other clinics throughout the state, including ones that have different setups than us,” Steel says. “So as a local health department, I talk to other health departments. I don’t talk to a lot of Federally Qualified Health Centers. I don’t talk to a lot of private practices who do a lot of Medicaid or self-pay patients, and so having that community is fantastic. But also just learning from experts from other states.” Steel says community health workers and patient navigators have also been a crucial part of the process. “Having someone who has been trained on having the conversations with the patients and knowing how to get them to the resources has been invaluable,” Steel says. In the second and final phase of the COrHT Initiative, NCOHC and CareQuest Institute will develop a comprehensive impact report, which will help safety net clinics sustain the work and influence long-term reform. “We are now halfway into the COrHT Initiative in North Carolina, and the teams are hitting their strides to implement and reach goals to improve oral health outcomes for the communities they serve,” Clester says. “The work Dr. Steel and the Cabarrus Health Alliance team is doing is both innovative and inspirational!” The COrHT Initiative in North Carolina runs through September, and Steel says she’s looking forward to sharing the outcomes. “Just seeing the results of our changes that we’ve implemented is going to be the best and most exciting part,” Steel says. “I would hope with the outcomes of COrHT in a few months from now, we will be able to say, ‘Hey, this model that has been used in other states, like Oregon or Iowa, worked well for these 11 clinics that did it here in North Carolina. This is what we recommend.’” **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration, Value-Based Care --- ### [Five Oral Health Challenges Facing American Indian/Alaska Native Communities](https://carequest.org/blog/five-oral-health-challenges-facing-american-indian-alaska-native-communities/) **Published:** March 14, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/American-Indian-Family-Resized3.jpg)The oral health disparities American Indian (AI) and Alaska Native (AN) communities face can be traced back to the 15th century — when European settlers arrived in North America. Fast forward several hundred years, and AI/AN communities continue to battle striking inequities. A new [white paper](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral) — a collaboration between CareQuest Institute for Oral Health, the Society of American Indian Dentists, and the National Indian Health Board — details those disparities, highlighting several troubling statistics about access to care and health outcomes. “American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease’: Reversing Inequities Involves Challenges and Opportunities” presents data from the *State of Oral Health Equity in America* survey, the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. When collecting the data, CareQuest Institute researchers purposefully oversampled AI/AN communities to try to shine a light on the oral health challenges they face. Tamanna Tiwari, BDS, MDS, MPH, a coauthor on the paper and assistant professor in the Department of Community Dentistry and Population Health at the University of Colorado School of Dental Medicine, reflected on those challenges. “They’re not just neglected from an access perspective from oral health, but also overall health,” says Tiwari. “If you look at life expectancy, mortality numbers for American Indian populations, you’ll see a difference.” Here are five urgent oral health challenges facing AI/AN communities: **1. Fewer AI/AN adults reported seeing an oral health care provider (69%) than non-AI/AN individuals (79%) in the last year.** Fewer also reported having dental insurance and having a place they go for dental services on a regular basis (dental home). The white paper includes a quote from one dentist who explains, through personal experiences, some of the issues facing AI/AN communities. In part of a quote from the white paper, the dentist says, “I see it daily . . . the history of dental trauma and having no steady provider that you can form a relationship with, or somebody coming in who isn’t culturally safe . . . ” On top of those barriers, AI/AN adults often have more difficulty getting transportation to the dentist, which leads to delayed care and missed appointments. **2. Three and a half times as many people who identified as AI/AN reported going to the emergency department (ED) for dental care or mouth pain in the last year,** compared to non-AI/AN adults. In addition, 39% of AI/AN adults said getting care from a dentist would be difficult based on where they live, compared to 24% of non-AI/AN individuals. What does that data mean? It suggests that when AI/AN adults have dental pain, getting to a dentist is difficult and they are likely to try to endure it or [go to the ED for treatment.](https://www.carequest.org/ED-Use) **3. More than one in four (28%) AI/AN individuals rated their oral health as “fair,”** compared to about 18% of non-AI/AN individuals. On the other hand, **only one in five (20%) of AI/AN individuals rated their oral health as “very good”** (31% for non-AI/AN adults). AI/AN adults were more likely to have at least one oral health symptom in the past year. They were also more likely to feel self-conscious because of their teeth in the past year. **4. More than half of AI/AN individuals say they have been denied health care or oral health care at some point because of discrimination.** A larger proportion of AI/AN individuals identified race/ethnicity, age, physical appearance, sexual orientation, and language as sources of discrimination they have faced, compared to non-AI/AN individuals. **5. The number of AI/AN students applying to dental school nationally has decreased dramatically in the past decade,** according to the [American Dental Education Association](https://www.adea.org/), with a record high of 92 in 2005, record lows of 16 in 2019, and 19 in 2021. A lack of AI/AN students applying to dental school reduces the likelihood that AI/AN people will be able to receive care from AI/AN dentists. There are also many barriers AI/AN communities face that make the process of qualifying for, applying for, and attending dental school difficult for prospective AI/AN dentists. In the white paper, the dentist was asked about the college and dental school journey. The response: “I just didn’t know how to navigate . . . academia. My parents had no idea. They pretty much discouraged me from anything past undergrad just because taking out student loans freaked them out. They couldn’t financially help me in any way.” What can we do about these challenges? The white paper provides strategic recommendations, calls to action, and potential solutions to respond to these issues. One important step, say the authors, is to listen. “Do not assume what they want. Talk to them. Partner with them,” Tiwari says. “That’s how you will actually develop trust with that community and be able to work alongside them and really make a difference.” **Categories:** Blog **Tags:** Health Equity --- ### [Veterans Deserve Access to Affordable, Quality Oral Health Care](https://carequest.org/blog/veterans-deserve-access-to-affordable-quality-oral-health-care/) **Published:** March 20, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Veterans-Access-to-Oral-Health-Care.jpg)A 70-year-old veteran living in Arizona making less than $30,000 a year who was forced to receive dental care in Mexico but was unable to update his dentures due to COVID-19 travel restrictions. A 61-year-old, college-educated veteran living in Rhode Island who has diabetes and PTSD and can’t speak or eat with his dentures can’t afford the tens of thousands of dollars needed for dental implants and struggles to stay employed because of his oral health. A fully disabled 53-year-old veteran living in Arkansas with depression, PTSD, heart disease, and diabetes who couldn’t see a dentist because the dental referrals from the US Department of Veterans Affairs (VA) were backlogged a year. These stories are real and happen too often to those who dedicated their time and service to defending our country. And these veterans are not alone. This is the stark reality for millions of veterans across our country who struggle to access dental care. These men and women have higher rates of oral health problems like gum disease, tooth pain, and tooth abscesses — many of which develop due to a lack of dental coverage. To help bring attention to these troubling trends and to educate policymakers on the benefits of expanding access to dental care for veterans, the American Institute of Dental Public Health (AIDPH) is partnering with CareQuest Institute and with veteran service organizations for Veteran Oral Health Hill Day on March 27 and 28 to educate policymakers on the benefits of strengthening dental benefits for veterans. (To help support the event, AIDPH will host a tweet chat on March 28 at 1 p.m. ET using #Dental4Vets.) ## Troubling Statistics about Veteran Oral Health The need to strengthen those benefits is clear when you look at the numbers: According to the VA , out of the 9.2 million veterans enrolled in VA health care, about 1.4 million are eligible for comprehensive dental care — that’s just 15%. This is because veterans’ dental care is only covered during time of service or for 180 days post-separation from the military. After that, most veterans are on their own. Even those who are eligible for coverage often have difficulty navigating the complex system, with only 33% accessing their benefits. This unfortunate reality exists because our government requires veterans to meet [strict eligibility requirements](https://www.va.gov/health-care/about-va-health-benefits/dental-care/). Essentially, veterans do not qualify for dental care from the VA unless they have a pre-existing dental condition, are 100% disabled, or were a prisoner of war. This is becoming increasingly problematic as [more research](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) is demonstrating that poor oral health has a direct tie to poor overall health, particularly among veterans. This critical gap in health care coverage is having a grave impact on the health of our country’s veterans. A 2022 [white paper](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) issued by [CareQuest Institute](https://www.carequest.org/) and the AIDPH revealed veterans are more likely than non-veterans to experience oral diseases that affect their quality of life. Approximately 42% of veterans report having had gum treatment or bone loss around their teeth, compared to 27% of non-veterans. Roughly two in five, or 8 million veterans, describe their oral health as “fair” or “poor.” Additionally, nearly 24% of veterans live in rural areas, where consistent access to care can be challenging. A [new report](https://www.carequest.org/resource-library/improving-oral-health-rural-veterans) from AIDPH and CareQuest Institute shows that compared to urban veterans, rural veterans are more likely to rate their dental health as “poor,” more likely to have or need dentures, and pay higher out-of-pocket costs for dental care. We need a comprehensive solution to this unmet problem faced by millions of people who so bravely risked their lives to fight for our country. ## A Step Forward in Mental Health, An Urgent Need in Oral Health Even though oral health care does not seem to be top of mind, the VA recently took a big step to address the needs of veterans’ mental health. Starting January 17, [veterans in suicidal crisis can go to any VA or non-VA facility for free emergency health care](https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5852). This strengthening of mental health care for veterans is commendable. Now the VA needs to also see the value of oral health care for veterans — and organizations are taking steps to make that happen. Partnerships like the one between CareQuest Institute and AIDPH have led to the development of data-driven recommendations informed by the veteran community to increase accessibility to oral health care and stimulate rural oral health innovation. Among those recommendations is the expansion of eligibility requirements for VA dental services. Congress and the federal government should act so that more veterans are covered. Veterans also need access to comprehensive care teams that collaborate seamlessly to provide optimal care by addressing medical, dental, and behavioral health needs. That includes deploying diverse, multidisciplinary care teams to facilitate whole-person care. And because nearly a quarter of our nation’s veterans live in rural areas that further create barriers to dental care, the role of Federally Qualified Health Centers (FQHCs) and rural health clinics must be expanded to better reach these areas. All of these solutions are within reach, and there is hope on the legislative front, too. Senator Bernie Sanders (I-Vt.) has long advocated for veterans’ rights and, specifically, their right to oral health care. During the 117th Congress, he introduced the [Veterans Dental Care Eligibility Expansion and Enhancement Act](https://www.congress.gov/bill/117th-congress/senate-bill/3017/text), which would have expanded eligibility for comprehensive dental care to all veterans receiving VA health care. The bill urged the VA to establish and maintain a dental clinic in every state and creates a student debt repayment program for incoming dental professionals who serve VA dental clinics. Unfortunately, legislators did not pass the bill. But stakeholders are hoping that legislators introduce similar bills in the current term. ![](https://carequest.org/wp-content/uploads/2023/03/Chelsea-Chokas-Cropped-275x300.jpg)Chelsea Chokas, MSM After putting their lives on the line to serve our country, access to critical health care services is the last thing that veterans should have to worry about. And while the data show that the barriers to this care are having dire consequences for veterans, we have the ability to make positive advancements to help them. Now, we just need the will to ensure that veterans have access to the health care they need and deserve. *Authored by Chelsea Chokas, MSM, Program Specialist, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Voices from the Field: Julie Seward on Advancing Oral Health in AI/AN Communities](https://carequest.org/blog/voices-from-the-field-julie-seward-on-advancing-oral-health-in-ai-an-communities/) **Published:** March 27, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Indigenous communities face several barriers to accessing oral health care. For American Indian and Alaska Native (AI/AN) families who live on tribal lands, often in rural areas, a shortage of dental providers is a common hurdle. This is among many challenges and varied solutions highlighted in a new white paper, “[American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease’: Reversing Inequities Involves Challenges and Opportunities](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral).” Julie Seward, RDH, MEd, a co-author on the paper, and the oral health programs manager for the Southern Plains Tribal Health Board (SPTHB), knows what it’s like to live in a dental desert. She grew up in a small, rural town in Oklahoma, with a pediatric dentist more than 60 miles away. With her parents working full time, Seward’s grandmother would make the one-hour drive to ensure she and her siblings got dental care. ![](https://carequest.org/wp-content/uploads/2023/03/Julie-Seward-Cropped-264x300.jpg)Julie Seward, RDH, MEd “While it was inconvenient to make a two-hour round trip and miss school, I cherished the time with my grandmother,” she says. “Those trips to the dentist were surrounded by positive reinforcements and joyful experiences that fueled my passion to work in oral health.” Despite the inequity, Seward, a member of the Cherokee Nation, sees silver linings from the experience, including the inspiration to pursue an oral health career. “I particularly connected with the hygienists in the office,” she says, “which is why I chose to be a dental hygienist.” After practicing and teaching dental hygiene, in 2016, Seward joined SPTHB, an organization that improves public health among the 43 federally recognized tribes in Kansas, Oklahoma, and Texas. It is also a liaison to the National Indian Health Board. She brought the experience and knowledge to the research and writing process, and here offers several insights on disparities and potential solutions highlighted in the new paper. **This paper describes how dental disease falls hardest on indigenous communities, while also looking at diverse solutions. Who do you think will benefit from reading it?** It’s for advocacy organizations, as another tool for their tool belt. It’s for the lay person, to understand and support efforts toward oral health equity. And for those working at the state, national, or federal level, it’s further evidence that we must invest in native communities in a sustainable way. But most importantly, it’s for Indian country, to let them know we are all working hard for change. **Change is certainly needed, as AI/AN communities have been historically neglected when it comes to oral health access and care. Can you explain why?** This is a multifaceted question. But I will attempt to come at it from a data integrity angle: When AI/AN populations are consistently “othered” in the data, how does that serve us? How does that provide evidence and awareness of the struggles we face, so that we have the level of resources and support needed? How does that tell our stories? It doesn’t. By not collecting and reporting AI/AN data, and racially misclassifying AI/AN data that is collected, it portrays that we do not exist. We must address significant flaws in the system so we are accurately represented in the data. We must establish standardization in collecting and reporting AI/AN data nationwide, alongside and in consultation with tribes, and I believe there are efforts underway to address this. **![](https://carequest.org/wp-content/uploads/2025/10/AI-AN-White-Paper-Photo.jpg)What are one or two of the steepest barriers to good oral health that AI/AN communities currently face?** To start, racial stereotypes and implicit bias can be a significant barrier. The historical context — and layers of systemic and structural racism — has molded a very complicated health care delivery system for AI/ANs. Those not familiar with this landscape and its historical implications may assume AI/AN people have “universal” or “free” health care \[through the ITU, which is part of the Indian Health Service (IHS), an agency in the US Department of Health and Human Services, Tribal and Urban Indian Healthcare delivery systems\] \[I think this puts our communities in a silo. Secondly, we do not have anywhere near the amount of AI/AN representation in the oral health workforce. The IHS is chronically underfunded, which presents many issues with their ability to provide quality, consistent care. Additionally, the Westernization and colonization of health care delivery generally omit key traditional and cultural practices that are so important in treating the whole person. Oral health is health, and we need to continue to work from that frame of mind. There have been flagrant attacks on tribal sovereignty that impede tribes’ ability to use culturally centric, evidenced-based approaches to improve oral heath in their communities. **Can you share more insight into what is driving some of these barriers and challenges?** Abigail Echo Hawk, citizen of the Pawnee Nation of Oklahoma, executive vice president of the Seattle Indian Health Board, and director of the Urban Indian Health Institute, recently presented “Data Practice through the Lens of American Indian/Alaska Native Communities” on a CDC \[Centers for Disease Control and Prevention\] webinar. During this presentation, she mentions that communities of color are not “problems to solve,” but that these communities are the answers. She says: “Data looks at people of color as problems to solve. And we are not. We are, in fact, every single one of the answers. When consulted; when and how we are able to use our decolonized data practices; when tribal sovereignty is respected; when tribal epidemiology centers and tribal public health authorities are respected; and we receive the resources we have a legal right to, through our treaties, we are not the problem to solve. The systems are the problems to solve.” That is such a powerful statement. **Are there one or two opportunities that surfaced when researching this report that make you hopeful about improving AI/AN communities’ oral health?** Far too often, the AI/AN data that are reported show the deficits and the disparities. But what I would love to see more often are the ways tribes are innovative in addressing the health and well-being of their communities. I think that innovation is apparent when you look at the data \[about\] medical-dental integration. Tribes have been focused on person-centered care since time immemorial. **Do you have a story that illustrates the promise of a solution that you’re excited about?** One of the first trips that I took \[for SPTHB\] was to a conference in Washington, DC, where I attended a session focused on [dental therapy](https://www.carequest.org/about/blog-post/nine-questions-dive-deeper-dental-therapy) advocacy for tribes. \[Dental therapists are oral health professionals brought to the US by Alaska Native communities. Complementing the dental team, and often from the communities they serve, they expand access to routine care in underserved areas.\] I sat beside the executive director of a national tribal organization. She asked me about my particular interest in tribal public health and oral health. I let her know that I was a tribal citizen and described how I ended up in this role. She said wholeheartedly, “Thank you so much for coming back. Thank you for doing this work.” There was true gratitude in her face. I see so many young native people who are passionate about helping their communities and addressing health equity. Native youth are reconnecting with their culture and traditions and rethinking the way we approach issues. I am so excited to see this next generation come into the workforce and shake things up a bit. **Categories:** Blog **Tags:** Health Equity --- ### [Closing the Oral Health Care Gap for Rural Populations](https://carequest.org/blog/closing-the-oral-health-care-gap-for-rural-populations/) **Published:** April 10, 2023 **Author:** Caitlin Locklear **Content:** Rural populations face many barriers when it comes to accessing oral health care, including cost, transportation, distance, and availability of providers. Right now, [70 million people who live in the US](https://data.hrsa.gov/topics/health-workforce/shortage-areas), or one in five people, live in “dental deserts” — areas where no or very few dentists practice. ![](https://carequest.org/wp-content/uploads/2025/10/Mission-of-Mercy-event-in-Virginia.png)Mission of Mercy event in Virginia Marcia Brand, former strategic advisor for CareQuest Institute, knows the struggles that these populations face well, through her own personal and professional experience. Growing up as a child of Appalachia in West Virginia, an area disproportionately impacted by oral health disparities, Brand has seen firsthand the obstacles in accessing care. She was struck by the desperation of people seeking this critical form of care in her volunteer work for the Mission of Mercy project in Virginia, which provides free dental care to those most in need in Appalachia. “Mission of Mercy would be set up at county fairgrounds, and people would sleep in their cars to make sure they were in line first thing in the morning to get dental care because it’d been so long,” says Brand. “In the middle of the fairgrounds, you’d see a couple thousand patients, and we heard so many stories: people who have been in pain every day for six months; people who requested all of their teeth to be pulled so they never had to deal with the pain again.” ## Barriers to Oral Health Care for Rural Populations According to Brand and her experience, the main barrier for rural communities is the lack of oral health providers. [A close second](https://www.ruralhealthinfo.org/topics/oral-health) is the fact that many people in rural communities lack dental insurance and cannot pay for dental services out of pocket. Further compounding these issues is that states with larger rural populations have [historically not included comprehensive adult dental coverage](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) in their state Medicaid programs, such as Alabama and Mississippi. There are also often many older people in rural communities, and Medicare only covers limited oral health services. Rural veterans also [face major barriers](https://www.carequest.org/resource-library/improving-oral-health-rural-veterans) to oral health care. They are less likely to qualify for coverage and pay higher out-of-pocket costs for dental care compared with urban veterans. They are also more likely to rate their dental health as “poor” and to need dentures than their city-dwelling counterparts. In some cases, the barriers that rural populations face are generational and the result of a lack of not just resources but also education. “In a number of these communities, younger people see their grandparents and parents with poor oral health or losing teeth and just accept it as part of the aging process,” says Brand. “My grandparents didn’t have their teeth in their 20s, and even my mother didn’t have anterior teeth very early on in her life, and that was not unusual where she grew up.” ## Finding Solutions to Expand Access As Brand’s career progressed — from teaching dental hygiene to working in the US Senate — she dedicated herself to improving rural oral health. She served in various leadership roles at the Health Resources and Services Administration (HRSA), an agency within the US Department of Health and Human Services that works to improve access to health care services for people who are uninsured, isolated, or medically vulnerable. As director of HRSA’s Federal Office of Rural Health Policy, she was able to directly serve and represent the community she came from. When she joined the DentaQuest Partnership for Oral Health Advancement, which later became part of CareQuest Institute, Brand was able to bring her perspective and experience working on rural oral health to the organization and help drive solutions through oral health philanthropy. Brand worked with CareQuest Institute through its grantmaking efforts to support various organizations that focus on improving rural oral health, including the [National Rural Health Association](https://www.ruralhealth.us/) (NRHA). The NRHA provides leadership on rural health issues through education, communication, and advocacy. NRHA has more than 18,000 members, over 40 state-based affiliates, and funding from CareQuest Institute that has made a major impact. “The investment that CareQuest Institute made in NRHA let them stand up a significant oral health initiative that gave them the capacity to work across their membership and also with states,” says Brand. “NRHA is the strongest advocate we have when it comes to rural health, and the grant from CareQuest Institute was the biggest investment they had ever received for oral health.” With Brand’s guidance, CareQuest Institute has also been one of the most significant supporters of the creation and exploration of new ways to get oral health services to people and connecting them to care — including supporting teledentistry, mobile dentistry, and dental therapy. These new innovations have proved effective for rural populations. For example, teledentistry is [more often used by individuals living in rural areas](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time) (13%) compared to those living in suburban (10%) or urban (6%) locations, and [studies show](https://www.pewtrusts.org/en/research-and-analysis/articles/2018/03/12/dental-therapists-can-provide-cost-efficient-care-in-rural-areas) that dental therapists can provide more cost-efficient care in rural areas. CareQuest Institute has also supported the work of the [National Interprofessional Initiative on Oral Health](https://www.niioh.org/) (NIIOH), whose sole purpose is to integrate oral health into primary care. Brand, who ran the organization at one point, stresses that because many rural populations don’t have access to dental care, it’s even more important that primary care providers assume some responsibility for oral health in those areas, and they can often do this with just a quick check. “Doctors look in your ears, eyes, nose, and even in your mouth at your throat, but they aren’t trained to look at your teeth and gums, which would take an extra 30 seconds to identify problems and make a referral to a dentist,” says Brand. Community health centers like Federally Qualified Health Centers (FQHCs) are a critical model in these areas because dental and primary providers are often colocated at these places, making medical-dental integration easier. While there is certainly more work to do to increase access to dental care for rural populations, investments in work being done on the ground to close this gap and in innovative new solutions are moving the needle. For Brand, she goes back to her days volunteering at Mission of Mercy to explain the progress she’s seen. “What was really remarkable was that over the course of the years, the line for extractions got shorter, and the line for restorative care got longer. So, it was clear that we really began to effectively address some of the most acute needs within those populations.” **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Push for Portability: The Latest on Dentist and Dental Hygiene Compact Privileges](https://carequest.org/blog/push-for-portability-the-latest-on-dentist-and-dental-hygiene-compact-privileges/) **Published:** April 3, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/04/Value-Based-Care-Teeth-Cleaning-1.jpg)Are you one of the dentists or dental hygienists who have a professional license in more than one state? If so, you are aware of the significant challenges and roadblocks of obtaining a professional license in another state — regardless of your education or experience. You, like Stephanie Clester, RDH, MA, may have a frustrating story to tell about wanting to gain additional licensure in another state. “I had to find a patient in Indiana, fly him to Florida, pay for him to stay in a hotel, pay for his food and (incidentals), and pay for the testing and licensure,” says Clester, a clinical content and support specialist at CareQuest Institute. “On Friday I could scale teeth in Indiana, but on Saturday, in Florida, I couldn’t.” Clester is not alone. Although states require [Commission on Dental Accreditation (CODA)](https://coda.ada.org/standards) standards for education and standardized clinical and written board examinations, dentists and dental hygienists have not been allowed to practice across state borders without being licensed in that state. To gain a license in another state, a potential candidate (who already holds a dentist or dental hygiene license) must show proof of license, qualifying dental education, written board exam, clinical exam, and clinical hours worked in practice, *then* retake the clinical examination in the new state. The result is often frustrated dentists and dental hygienists, especially those who live near state borders, are in the military, or are a military spouse. Meeting all the criteria — taking additional examinations, meeting additional continuing education requirements, and paying for another license — can be time-consuming and costly, which is contributing to a [shortage across the industry](https://www.npr.org/2022/09/12/1122482181/a-dental-hygienist-shortage-has-dentist-offices-struggling-to-schedule-patients). That reality can make it challenging to schedule patients, reducing access to preventive care that is critical to an individual’s oral and overall health. At a time when we need to be expanding access for all, rules around license portability are taking us in the other direction. Fortunately, there’s progress on the portability front. ## The Early Days of Licensure . . . and Stephanie’s Adventures Beyond standardized education, there has also been an increase of standardized testing across the United States to obtain dentist or dental hygiene licensure. The Northeast Regional Board of Dental Examiners (NERB) was founded in 1969 to create consistency with testing standards for dental and dental hygiene licensure exams. Initially, NERB consisted of eight states in the northeastern region of the United States. In 1976, as more states began to see the value of standardized testing for clinical exams, the Western Regional Examining Board (WREB) was created. These two regional examining boards are now combined into one entity known as the [Commission on Dental Competency Assessments (CDCA)](https://adextesting.org/about/#id_3). This organization administers the ADEX dental and dental hygiene clinical licensure examinations and ensures standardized testing and proctoring for dental and dental hygiene licensure. Although there is consistency within states on dental and dental hygiene education requirements and licensure examinations, each state has its own dental examining board managing licensing logistics, creating a complicated process to gain licensure from other states. Clester has experienced firsthand the challenges with gaining a dental hygiene license in other states. She began her dental hygiene journey in Indiana and, after completing her CODA-accredited dental hygiene education and passing a state board and clinical examination, became NERB certified. Being NERB certified meant she could gain licensure in one of the other seven NERB states without needing to retake the written or clinical licensure examinations. Unfortunately, Clester was looking to gain licensure in Florida, which was not part of the NERB certification program. This meant she had to retake a clinical board examination in Florida even though she was a licensed and practicing dental hygienist in Indiana. “When I completed the packet of information (to take the clinical examination in Florida) and began to write the check to pay for the clinical board, they wanted it made out to the NERB,” she said. Feeling a sense of hope that she might not need to take the clinical examination, Clester contacted the Florida dental examining board to tell them that she was NERB certified and would like clarification about retaking the clinical examination. Their response was that they were not a NERB state, but NERB did proctor their clinical examination. In other words, Florida did not want to use the NERB testing standards when they were administered in Indiana, but they did want to use the NERB testing standards when they were administered in Florida. In 2017, Clester moved to Nevada to accept a teaching position. Although she would not need to retake the clinical examination — because Nevada has a restricted dental hygiene educator’s license — she still needed to show proof that she had passed a written board examination and clinical examinations (even with current licenses from Indiana and Florida) and proof that she indeed had an instructor position in a dental hygiene school. Clester soon found out that the restricted educator license that did not allow her to practice outside of a school setting was creating barriers to her students’ education and prevented them from experiencing volunteer opportunities off campus. Even though Clester was licensed in two states and had been a dental hygiene educator for more than four years, she would have to take a third clinical exam if she wanted an unrestricted license in Nevada. “And Nevada did not recognize NERB certification,” she says. “I was teaching students on how to become a dental hygienist, but I had to go through this to get a full license. I was shoulder to shoulder with a recent graduate doing my clinical exam.” After the challenges faced with obtaining each license, Clester keeps all three of them active and manages their individual requirements. “They all have different requirements for continuing education, so managing that can be challenging,” she says. “All of these renew on different months but in the same year. I usually end up with 50 CE hours just to make sure I am fulfilling each state’s requirements and my own professional development.” ## Creating a Dentist and Dental Hygienist Compact Since November 2020, the American Dental Association (ADA) and the American Dental Hygienists’ Association (ADHA) have been collaborating with the Council of State Governments through funding from the Department of Defense to create an interstate licensure compact to allow licensed dentists and dental hygienists in good standing to work in states that have adopted the compact. Working groups have dedicated significant time and collaborative effort into creating a compact that spells out the compact’s objectives, goals, and limitations and is strict enough to uphold oral health professionalism and optimal patient care across states yet flexible enough to allow for transformational oral health care delivery over time and individual state nuances. Matt Crespin, MPH, RDH, executive director of Children’s Health Alliance of Wisconsin and a past president of ADHA, was part of the technical advisory group convened by CSG. This group was made up of representatives from ADA and ADHA, state regulators, representatives from testing agencies, and dental/dental hygiene educators. “I don’t see there being a lot of hurdles or opposition in getting this legislation passed,” he says. “However, some states have never passed other health professional licensure compacts, so this may not pass in all 50 states.” For example, legislators have introduced [compacts for nurses](https://www.ncsbn.org/compacts/nurse-licensure-compact.page), physical therapists, occupational therapists, and physician assistants, but not all states have adopted them. “Each state has to pass this legislation and it has to become part of state law,” Crespin says. For that to happen with the dentist and dental hygienist compact, each state needs to have an oral health champion in the form of a legislator who understands the need and who will introduce the bill to lawmakers. Several states have officially introduced the legislation, including Washington, Iowa, Ohio, Texas, and Tennessee. In Wisconsin, Senator Mary Felzkowski, who has been an oral health champion for residents, is expected to introduce the dental and dental hygienist licensure compact during the upcoming spring session. The National Center for Interstate Compacts has published model legislation on the [Dentist and Dental Hygienist Compact](https://ddhcompact.org/) webpage. To keep the integrity of the compact, states cannot make substantive changes to the model language. Crespin added that a minimum of seven states need to approve legislation for the compact commission to become fully operational and compact privileges to be granted. The compact commission is an agency that will include a designee from each participating state’s licensing board. This is the agency that will review licensure credentials and grant compact privileges. ## What Happens Next? What Can I Do? If states pass compact legislation, dentists and dental hygienists will still have to go through a process to obtain a compact privilege in another state. States, of course, want to make sure that their citizens will receive top-notch care. Requirements include: - The state in which the dental professional is looking to gain compact privileges must have adopted legislation accepting the compact using the model language. - Dentists and dental hygienists need to apply to the compact commission for compact privileges in a specific compact state. - Dentists and dental hygienists must be in good standing in their licensed state. - The compact privilege is to practice general dentistry or general dental hygiene. Advanced licensure or certifications will not transfer to another state but may be obtained through traditional means. - Dentists and dental hygienists must consent to a background check. - Dentists and dental hygienists must understand the state statutes and scope of practice limitations for the compact state and pass a jurisprudence exam for that state. - Dentists and dental hygienists must pay compact and state-associated fees for compact privilege. - The compact state will be notified of a dentist or dental hygienist gaining compact privilege in their state. - If a complaint is filed against a compact privilege recipient in a compact state, the license state will be notified. Those who are in the [military](https://ddhcompact.org/wp-content/uploads/sites/31/2023/02/DDH_Compact_1pg_MilitaryFamilyBenefit.pdf) or have a spouse who is in the military may not be required to pay the compact privilege’s associated fees. ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH To find out what is happening in your state, you can contact your state’s professional dental or dental hygiene associations, oral health coalition, or your local representative or senator. If you would like to have a voice in the legislative process, you can contact your legislative representatives directly. When you call or email, simply state your name, your profession, and ask them if they are aware of the Dental and Dental Hygiene licensure compact. If the answer is “yes,” you can ask if they are in support. If the answer is “no,” you can ask if they would like to learn more about it. Either way, you can offer yourself as a resource to learn more about oral health professions and how to improve access to dental care for individuals in your community. *Authored by Kelly Schroeder, MS, RDH, Program Evaluation Specialist, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [Where to Find CareQuest Institute at the National Oral Health Conference](https://carequest.org/blog/where-to-find-carequest-institute-at-the-national-oral-health-conference/) **Published:** April 10, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/04/CareQuest-Institute-NOHC-Booth.jpg)CareQuest Institute’s NOHC booth From roundtable discussions about applying silver diamine fluoride (SDF), to seminars highlighting the importance of expanding state Medicaid adult dental benefits, to connecting with attendees about the latest oral health research, CareQuest Institute will have a prominent presence at the [National Oral Health Conference (NOHC)](https://www.nationaloralhealthconference.com/). The 2023 conference is scheduled from Monday, April 17 to Wednesday, April 19 at the Double Tree by Hilton Universal Studios in Orlando, Florida. “I am excited to attend NOHC for the first time to share CareQuest Institute’s work around value-based care,” says Caroline McLeod, RDH, MS, value-based solutions manager at CareQuest Institute. “And I’m excited to learn from innovative organizations and communities across the nation to collaborate on opportunities for a more accessible, equitable, and integrated oral health system.” John Gabelus, grants and programs associate at CareQuest Institute, shared a similar sentiment. “As someone who doesn’t have a professional background in oral health, I’m excited and grateful for the opportunity to share some community-centered insights on how oral care solutions can be developed and delivered in the future,” he said. McLeod and Gabelus are just two of several representatives from CareQuest Institute and CareQuest Innovation Partners (a for-profit subsidiary of CareQuest Institute) who will attend the conference to share and learn about updates in the oral health industry. Kelly Schroeder, RDH, MS, health science specialist at CareQuest Institute, is looking forward to sharing research and collecting some qualitative data. “Hearing directly from individuals who are delivering transformational dental care is an important part of knowing what works and what doesn’t work for patient care delivery,” she says. Schroeder will provide a poster presentation on transformational dental care. She and the rest of team will connect with partners and attendees in two ways — at the CareQuest Institute and CareQuest Innovation booths and in the education sessions. (Meet representatives from CareQuest Institute at Booth 202 for a few rounds of “Guess the Data” and maybe win a prize!) If you’re missing the conference this year, you can find some of the presentations and educational materials in the [growing resource library](https://www.carequest.org/resource-library). **Categories:** Blog --- ### [The Process of Rebuilding a School-Based Dental Sealant Program](https://carequest.org/blog/the-process-of-rebuilding-a-school-based-dental-sealant-program/) **Published:** April 17, 2023 **Author:** Caitlin Locklear **Content:** Danica Loring says she’s seen her fair share of people in need of oral care at [Penobscot Community Health Care (PCHC)](https://pchc.com/) in Bangor, Maine — and not just adults. “We live in an area where there is a mixed group of community members, and there is a high number of the lower-income community members,” says Loring, CDA, an expanded functions dental assistant and the director of operations at PCHC’s Dental Center and Jackman Community Health Center. “And it saddens me to see when we have a teenager come into the dental center and their teeth are in desperate need of care.”![](https://carequest.org/wp-content/uploads/2023/04/Danica-Loring-Pull-Quote.png) Something as simple as placing dental sealants on that child’s molar teeth, Loring says, could have prevented those cavities. But ensuring children get those sealants has become even more challenging in the past few years. Like in many other health centers across the US, the COVID-19 pandemic made it challenging to provide access to preventive oral care in rural communities. PCHC shut down its school-based dental program in 2020. “We really had to focus on our dental center,” says Loring. “Just because of the limitations and unknown of the situation of COVID when it initiated, we really had to step back from that position.” But now they are rebuilding the program with a small change — something that came to Loring when she attended a CareQuest Institute webinar entitled “[Best Practices and Innovative Approaches to Strengthen School-Based Dental Sealant Programs](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant).” “It was just like a light switch,” she says. “Like, let’s start small. Why not start with sealants?” ## The Benefit of Oral Care in Schools During the webinar, an expert panel — Steve Geiermann, DDS, chair, Association of State & Territorial Dental Directors (ASTDD) Best Practices Committee; Beth Lowe, MPH, BSDH, health education specialist, National Maternal and Child Oral Health Resource Center, Georgetown University; Shailee Gupta, DDS, MPH, director of dental programs, St. David’s Foundation; and Karen Phillips, MPH, RDH, EPP, school oral health programs coordinator at Oregon Health Authority — explained the importance of school-based sealant programs and reviewed the findings and recommendations from ASTDD’s [School-Based Dental Sealant Program Best Practice Approach Report](https://www.astdd.org/bestpractices/school-based-dental-sealant-programs-bpar-2022-final.pdf). The 2022 report highlights key steps for building and improving effective programs, including the use of evidence-based practices, clinical quality measures, and innovative design. “I always feel like I pull at least one or two things out in each webinar,” says Loring, a frequent participant at CareQuest Institute webinars. “While it doesn’t seem like much, it really adds up.” PCHC had run a school-based dental program for several years until 2020 — not only providing sealants, but also fillings, extractions, and other preventive services. Their team of providers, assistants, and hygienists helped improve hundreds of children’s oral health care, many of whom would never go to a dentist outside of school. “Parents are busy,” Loring says. “Most homes, both parents are working. It’s hard to take time out of the day to take a kid out to a dental appointment. And oftentimes, people look at dental care as secondary to medical care, which is truly unfortunate, because it truly is integrated.” ## Starting Small with Sealants State and school leaders had been asking PCHC when they were going to be back in schools. Over the past 4–5 months, PCHC has been trying to rebuild the program, but the path was filled with obstacles. “We were thinking \[of\] the big picture — like, we’ve got to get a dentist in there every Friday,” says Loring. “We’ve got to get a hygienist in there every week. We need to start doing fillings, stainless steel crowns. We need to do all of this.” The biggest hurdle? The shortage of dental assistants and providers. On top of that, Loring says it’s a challenge to ask the providers who are available to work on Fridays, which are normally their days off. But when Loring attended the CareQuest Institute webinar, she got some much-needed inspiration: The speakers highlighted the fact that dental hygienists can place those sealants with approval from a provider and open the door for future care. “When I attended the webinar, I realized, you know what? Maybe instead of doing these elaborate treatment plans, why don’t we start with a sealant program over there, and just start slow, and then slowly rehabilitating us getting back in there to full capacity,” Loring says. Although the school-based program will not be as big as it once was, Loring believes it’s an important step in the right direction. “This also gives us an opportunity to see the kids’ oral health in general,” says Loring. “We can see what they need, and then our plan this fall is to have a true provider in there providing full-on restorative care.” *Editor’s Note: [Watch the recording of the webinar](https://www.carequest.org/education/webinars/best-practices-and-innovative-approaches-strengthen-school-based-dental-sealant) and access the related PowerPoint presentation in the “Past Webinars” section on carequest.org.* **Categories:** Blog **Tags:** Clinical Practice, Minimally Invasive Care --- ### [Oral Cancer: Recent Findings, Risk Factors, and the Role of Providers](https://carequest.org/blog/oral-cancer-recent-findings-risk-factors-and-the-role-of-providers/) **Published:** April 19, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Dental-Procedure.jpg)Tooth decay is often cited as the most common disease that can threaten a person’s oral health and overall health. It’s true, but it’s certainly not the only threat. The most common sexually transmitted infection in the US, human papillomavirus (HPV), also poses a serious risk. HPV causes [a majority](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers) of mouth and throat cancers. These oral cancers are on the rise and can be life-threatening — something worth noting at any dental appointment but especially during Oral Cancer Awareness Month in April. Fortunately, a vaccine exists that prevents [more than 90%](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) of the six types of cancer that HPV triggers, including oral cancer. Both primary care and dental providers can play a crucial role in raising patients’ awareness about the HPV vaccine and its relationship to mouth and throat cancers. Clinicians can also save lives by actively screening for oral cancer, which does not always have obvious symptoms. ## Recent Research: Who Is at Risk for Oral Cancer? A recent study coauthored by CareQuest Institute researchers shows [a connection](https://www.carequest.org/resource-library/oral-cancer-prevalence-mortality-and-costs-medicaid-and-commercial-insurance) between oral cancer rates and certain forms of insurance. It compares cancer cases among adults who hold private coverage to their peers enrolled in Medicaid, an insurance program for people with low incomes. It’s among the few reports to examine what a broad set of health coverage data can tell us about the threat of oral cancer across communities. This research spotlights that economic inequities continue to drive many oral health disparities, including in oral cancer: - People enrolled in Medicaid have higher levels of mouth and throat cancer overall and face more new diagnoses than their privately insured peers. - Compared to those with private coverage, adults enrolled in Medicaid are more likely to be diagnosed with oral cancer at advanced stages and to die from the disease. - Getting regular dental care can help. People who saw a dentist in the past year were less likely to have oral cancer than those who had not visited a provider. Not every state’s Medicaid program includes [dental benefits for adults](https://www.carequest.org/about/blog-post/voices-field-dr-donna-balaski-strengthening-connecticut-medicaid-adult-dental). Lacking coverage can push oral health care out of the reach of many people with low incomes. Researchers note that this limited access may be one reason why adults enrolled in Medicaid shoulder a greater burden of disease. In addition to the harm posed by financial and policy barriers, oral cancer has other risk factors: - Men are more often diagnosed with mouth or throat cancer than women. - The threat of oral cancer increases with age and tobacco use. - Using [e-cigarettes](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health), or vaping, also heightens the risk of developing oral cancer. In 2020, more than nine million adults used vaping products. Evidence is also clear that HPV is a danger. It causes [7 in 10 cases](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers) of mouth and throat cancer, which are largely preventable with the HPV vaccine. ## Health Providers Play a Pivotal Role in Oral Cancer Screenings People with oral cancer may not have noticeable symptoms, as the disease can lurk in hidden areas of the tongue and mouth. Primary care providers can detect early signs of disease by performing regular [oral cancer screenings](https://www.carequest.org/resource-library/primary-care-providers-role-oral-cancer-screenings). According to Mark Deutchman, MD, a family medicine physician and professor at the University of Colorado, taking a [proactive approach](https://www.carequest.org/resource-library/primary-care-providers-role-oral-cancer-screenings) is key. “Unless we actively look,” he explains in a CareQuest Institute video, “we’ll miss it.” Providing an oral cancer screening during a medical appointment is easy and quick. Deutchman says it “takes literally seconds and could go a long way toward finding these things earlier.” Dental providers also have an important role. They can search for physical symptoms during [oral exams](https://www.nidcr.nih.gov/sites/default/files/2020-09/oral-cancer-exam.pdf). In addition, dentists and dental hygienists can raise patients’ awareness about how HPV can cause oral cancer. Research affirms that oral health providers can be a trusted source on this topic. According to a national CareQuest Institute survey, [nearly 6 in 10 adults](https://www.carequest.org/resource-library/perceptions-about-hpv-and-oropharyngeal-cancers) say they are comfortable discussing HPV and its vaccine with their oral health provider. However, many parents and young people [don’t know](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) about the link between HPV and oral cancer. Dental and medical providers can save lives by opening the conversation. ## Helping to Prevent Oral Cancer HPV-related oral cancer can develop decades after someone has contracted the virus. People are [more often](https://www.nidcr.nih.gov/health-info/oral-cancer) diagnosed after 40 years old. The National Institute of Dental and Craniofacial Research emphasizes that oral cancer “[can spread quickly](https://www.nidcr.nih.gov/health-info/oral-cancer#diagnosis),” so prevention and early detection are critical. For the greatest protection across our lives, health experts [recommend](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) that people get the HPV vaccine starting at age 11 or 12. Young people can receive the two-dose vaccine through age 26. However, due to the COVID-19 pandemic, youth immunizations have dropped nationwide. About [half of all teens](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) are behind in getting their HPV vaccine, and now they’re at greater risk of getting oral cancer later in life. Dentists, dental hygienists, and others on the oral health care team can help close the gap. CareQuest Institute data show they have an important opportunity to promote prevention by talking to young people and their caregivers: - Among youth who visited a dentist over the past year, but are not vaccinated against HPV, [12.5%](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers) of them had not seen a medical provider during the same period. - Young people who had a dental appointment in the past year are [more likely](https://www.carequest.org/resource-library/discussing-hpv-and-detecting-oral-cancer-role-oral-health-providers) to have received the HPV vaccine. Receiving both doses of the HPV vaccine can prevent [more than 9 in 10 cases](https://www.carequest.org/resource-library/vaccine-can-prevent-throat-cancer) of all six forms of cancer caused by the virus. By discussing this core preventive measure with their patients, medical and dental providers can take the lead on reducing the harm of oral cancer. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Understanding Eating Disorders — and How Dental Providers Can Help](https://carequest.org/blog/understanding-eating-disorders-and-how-dental-providers-can-help/) **Published:** May 1, 2023 **Author:** Caitlin Locklear **Content:** ## Eating Disorders and Oral Health During [Mental Health Awareness Month in May](https://jdh.adha.org/content/88/3/156), the number of articles, stories, and reports about mental illnesses increases. Organizations work to [raise awareness](https://www.mouthhealthy.org/all-topics-a-z/eating-disorders), reduce stigmas, and [provide myriad resources](https://www.mouthhealthy.org/all-topics-a-z/eating-disorders) to support individuals and families and advocate for better access to care. Few headlines, however, focus on the connection between mental health and oral health. [Research on the relationship](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125596/pdf/1472-6831-14-92.pdf) between the mouth and the mind is limited, but it is growing. For example, in 2022, a survey by CareQuest Institute found that: - Individuals with severe depression are more than twice as likely to report not brushing their teeth at least twice per day compared to those without depression. - Those with minimal levels of depression also had more than twice the odds of reporting at least one oral health problem than those without depression. - Adults who reported poor mental health were three times more likely to rate their oral health as poor. Awareness of these and other issues — such as eating disorders — can help oral health providers provide whole-person care. Eating disorders play a unique and significant role in oral health, as changes to the mouth are often the first warning signs of a larger issue. That means oral health professionals are often in a prime position to identify many eating disorders that could otherwise go unnoticed. Considering eating disorders have among the [highest mortality rates of all mental health disorders](https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Awareness-Month), early detection and intervention can help save someone’s life. ## ![](https://carequest.org/wp-content/uploads/2025/10/Dentist-looks-into-patients-mouth-with-tools.jpg)Oral Health Indicators for Three Eating Disorders Eating disorders are [among the most lethal of the mental illnesses](https://www.mhanational.org/mental-health-month), second only to overdoses associated with opioid addiction. Several forms of eating disorders exist, including anorexia nervosa, bulimia nervosa, and binge-eating disorder — all of which have [negative effects on the mouth](https://www.towncaredental.com/effects-of-eating-disorders-on-oral-health). In fact, changes to the mouth are often the [first physical indication of an eating disorder](https://www.healthline.com/nutrition/how-sugar-destroys-teeth). Individuals with eating disorders have greater than [eight times the risk of experiencing tooth decay](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) than individuals who don’t experience disordered eating. Given approximately 9% of the United States population, or 28.8 million Americans, will [experience an eating disorder in their lifetime](https://jdh.adha.org/content/88/3/156), it is important to increase awareness of eating disorders as an oral health issue. Below, we’ll explore the background and indicators of three common disorders: **1. Anorexia Nervosa** Anorexia nervosa is a type of eating disorder that often involves the [fear of gaining weight](https://www.samhsa.gov/programs/mental-health-awareness-month). Though likely very thin or extremely underweight, individuals with anorexia nervosa still perceive themselves as large or overweight. Many try to achieve the “perfect body” through starvation or excessive exercise. Given the bidirectional relationship between oral health and diet and nutrition, poor nutrition will negatively impact a person’s teeth and gums. Restricting one’s food consumption can lead to a deficiency of calcium, iron, vitamin D, and other important nutrients critical for dental health. Oral health indicators of anorexia nervosa include: - Tooth decay - Mouth sores - Red/swollen gums - Bad breath - Dry mouth - Cracked/dry lips **2. Bulimia Nervosa** Though similar to anorexia in terms of calorie restriction, [bulimia nervosa differs](https://www.nationaleatingdisorders.org/dental-complications-eating-disorders) in that it includes periods of binge eating, or overeating, several times a week or even several times a day that individuals often try to hide from people around them. In these binging periods, the individual often feels out of control of their eating and can consume up to thousands of calories in one sitting. Following this high calorie intake, the individual will force themselves to vomit or misuse laxatives or enemas in effort to expel the calories that were just consumed. Often this cycle is referred to as “binging and purging.” Patients who self-induce vomiting are [5.5 times more likely to experience dental erosion](https://jdh.adha.org/content/88/3/156) compared to patients who do not. The effects of bulimia on the oral cavity allow oral health professionals to identify signs of bulimia, potentially before other health professionals. Oral health indicators of bulimia nervosa include: - Erosion of tooth enamel - Changes in tooth color, shape, and length - Erosive mucosal lesions - Redness, scratches, and cuts inside mouth - Damage to soft palate - Cuts or bruises on the knuckles from inducing vomiting - Thin and brittle teeth - Exposure of tooth pulp - Arthritis in the temporomandibular joint or other temporomandibular joint disorders (TMD) **3. Binge-Eating Disorder** [Binge-eating disorder](https://anad.org/eating-disorders-statistics/) occurs when an individual overeats but does not purge their bodies of the excess food. Rather, feelings of guilt often cause the individual to overeat once again. Repeated binge eating can increase the risk of tooth decay, the [most common sign of binge-eating disorder](https://www.dentalhealth.org/blog/how-eating-disorders-can-affect-your-mouth). Often, individuals who overeat consume large amounts of [foods that are high in sugar and acidic, while low in nutritional value](https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Awareness-Month). Frequent consumption of foods high in sugar increases the amount of time teeth are exposed to the dissolving effects of various acids, which then [induces decay of the teeth](https://www.hmsadental.com/members/dental-health-tips/eating-disorders-and-dental-health/#TOC_TITLE_HDR_4). Therefore, those challenged by binge-eating disorder face higher risk of dental caries than those without this disorder. ## Discussing and Treating Eating Disorders Eating disorders involve [significant disturbance of one’s eating behavior](https://anad.org/eating-disorders-statistics/), whether it be extreme under- or over-eating. Many serious health complications can arise from eating disorders, and it important for patients to understand that these challenges can be addressed through [proper medical and psychological therapy](https://www.mouthhealthy.org/all-topics-a-z/eating-disorders). In a nonconfrontational manner, dental professionals can bring oral signs that are consistent with eating disorders to the patient’s attention. The University of Washington School of Dentistry has developed a helpful oral health fact sheet about eating disorders for dental professionals. When discussing an eating disorder with a patient: - Use nonjudgmental and nonthreatening communication while discussing suspicion of an eating disorder. - Choose an appropriate time and location. Providers should make sure ample time to discuss concerns is allocated, and no other patients are nearby to ensure the patient privacy and comfort. - Begin the conversation by calmly and slowly communicating the oral changes you have observed and the possible causes of these changes that indicate a potential eating disorder. - Communicate with the patient about body image and eating habits if the patient invites and allows the conversation. - Be aware of community resources for referral if patient is open to help. In a supportive and calm manner, encourage and support the patient in seeking professional help. When helping to treat and prevent effects of eating disorders: - Monitor patients’ dental erosion and mucosal lesions in regular checkups. - Minimally utilize abrasive materials in dental treatment. - Advise patients to avoid brushing their teeth within one hour after vomiting. Instead, they should rinse their mouth with water to reduce the amount of acidity and tooth erosion. Brushing their teeth in a weakened state due to the presence of gastric acid can cause more enamel damage. - Educate patients about healthy eating habits and avoiding acidic foods and beverages. - Consider making patients custom-made trays with 1.1% neutral fluoride gel to be used 5 minutes a day to increase remineralization of tooth enamel. - Encourage chewing sugarless gum with xylitol, particularly for individuals with bulimia nervosa, to promote salivary flow. - Encourage the use of palliative measures such as mouthguards to protect teeth from acid or buffering agents like antacids following self-induced vomiting. - Check in with patient at every dental appointment regarding medical and recovery updates, as well as medication updates. - Discuss referral possibilities with patient, such as a physician, therapist, or nutritionist. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Voices from the Field: Dr. Alayna Schoblaske on Improving Access to Care](https://carequest.org/blog/voices-from-the-field-dr-alayna-schoblaske-on-improving-access-to-care/) **Published:** May 8, 2023 **Author:** Caitlin Locklear **Content:** While most kids hated wearing braces in fifth grade, Alayna Schoblaske, DMD, was the exception. That was when she realized she wanted to be a dentist. “I haven’t turned back since,” she says.![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg) Schoblaske came from a family of engineers and teachers, so the idea of working with her hands while educating patients about their oral health felt like a great fit. And she was fascinated by the impact teeth could have on a person — which led her to her ultimate calling of community dentistry to help patients in underserved areas. “I decided I wanted to be part of the community of dentists finding ways to help more people receive great dental care,” she says. Today, Schoblaske works as a general dentist and dental director at [La Clinica](https://laclinicahealth.org/), a Federally Qualified Health Center (FQHC) that serves all people in Jackson County, Oregon. During her time there, she’s seen her fair share of the hurdles and obstacles blocking access to care for patients in underserved populations. Schoblaske talked to CareQuest Institute about what those barriers to access are, how La Clinica limits those barriers, and what she learned while working with people of various backgrounds and socioeconomic statuses. ![](https://carequest.org/wp-content/uploads/2023/05/Alayna-Schoblaske-1.jpg)Alayna Schoblaske, DMD **Can you tell us more about La Clinica and what you do for the FQHC?** I work in the dental clinic, where we provide comprehensive dental care to patients of all ages. Our mission is to “serve the people who need us most through exceptional, affordable, and compassionate care, inspiring all those we touch to lead full and healthy lives.” Specifically, La Clinica helps people by offering dental, medical, behavioral health, educational, and support services to patients who have traditionally faced barriers to care — for example, financial limitations, houselessness, speaking a language other than English, immigration status, gender identity, and more. We provide a full scope of dental care, from child knee-to-knee exams to restoring dental implants. **What are the barriers to access to care that you see patients face?** There are so many! Here are some that come to mind: - Transportation: Many patients share a car with their family or rely on friends for rides. Some also use public transportation, which can be unreliable in our suburban area. - Childcare: This may be a parent finding childcare while they have a procedure done or arranging for childcare if one of their children has an appointment and the others do not. Either way, childcare is very hard to come by in our community, and patients usually must rely on family or friends. - Housing status: Patients who do not have homes may not have access to a phone for scheduling appointments, or they may not have an address at which to receive treatment plans or insurance notifications. Being houseless can also impact a patient’s ability to care for their teeth. Without predictable access to clean water or a reliable place to store their toothbrush, oral hygiene becomes much harder! - Wait times: I have heard from some patients that other clinics have a 3–4-month wait time for appointments. Or, that they may be seen for a limited exam to diagnose the source of tooth pain, but that treatment to address the pain cannot be completed for another 2–3 months. - Language and immigration status: Some offices don’t have robust language support, so this can be a barrier for some patients. Other patients are fearful to seek care or apply for Medicaid because of their immigration status. - Anxiety: So many of our patients have dental anxiety and may avoid the dentist for months or years because of this. **Do you have a story that stands out to you about how a patient faced barriers to access to care before going to your FQHC?** A couple of weeks ago, I saw a patient who was having a toothache. She said that the tooth had been hurting for over a year, but she was too anxious to come into the clinic. Finally, her spouse called and made an appointment for her because the pain was impacting her ability to sleep and eat. We have an embedded behavioral health team member in our dental clinic, so he was able to meet with the patient and put together a plan to manage her anxiety. We were able to build rapport during that first visit, and I removed her tooth four days later without any additional sedation. It felt like such a win for everyone involved! **How else does La Clinica try to limit barriers to care?** A few ways come to mind: - We take Medicaid and most other insurances and offer a sliding fee scale for patients without insurance. - Just over 20% of our patients prefer a language other than English. Many of our staff are bilingual and are trained as Spanish interpreters, so our patients can easily communicate in Spanish, our most common patient language after English. - We have community resource specialists on our staff who can help patients get free bus passes or arrange for medical transport. That helps a lot with the transportation barriers. - Also, our dental clinic only opens our schedule two weeks at a time, so appointment wait time is never too long. **What else can be done across the industry to limit those barriers for underserved populations?** I would encourage clinics that want to care for traditionally underserved populations to prioritize hiring bilingual and bicultural providers and staff. I am white and monolingual, and I have seen that my colleagues who speak Spanish (or another language such as Ukrainian, Tagalog, or Mandarin) and may have grown up in that culture are able to connect with patients on a deeper level and, often, reach a greater level of comprehension and care. It is also important for health care organizations to be advocates in their community for the various issues that impact our patients’ access to care. Build partnerships with your local housing authority or pay attention to legislation that funds childcare programs. We so often hear that we are part of a safety net — FQHCs are just one thread in that net. We need to talk to the other people who care for our patients to make sure that we are working together to “maintain the dignity and value of all people.” **How do tools like integrated electronic health records (EHR) help limit barriers to access to care?** I completed a residency at a Veterans Affairs hospital, where they use an integrated electronic health record, so that prepared me for the integrated EHR software that we use at La Clinica — Epic Wisdom. Integrated EHRs allow me to see patients’ complete medical history and get more comfortable understanding if and how I need to modify my dental treatment to keep them safe. We have not yet utilized our EHR to significantly impact patient access at La Clinica, but we are hoping to explore a system for internal referrals in the year ahead so that a patient seeing a medical provider could be referred directly to a dental provider for oral health concerns. We do have some dentists colocated in the same building as our medical providers, and we are still working toward a truly integrated system. **Why is moving to an integrated care model important?** I think it’s the wave of the future because, of course, our mouths communicate with our bodies (through inflammatory markers, microbiota, and more), and so our health care system will work best when our oral health teams communicate with our medical teams. **Why are dental assistants integral to the integrated care model?** Dental assistants and dental hygienists are some of the greatest advocates for our patients, and often have the time to dig deeper into a patient’s health history or identify social determinants of health that could be addressed to better treat a patient’s overall health. Most of the time, if we make a referral to a medical provider or a community resource specialist, it is because of a conversation that a dental assistant or dental hygienist has first had with the patient. **Anything else you’d like to add?** If anyone wants to follow along what I do as an FQHC dentist and a leader in organized dentistry, they can find me on Instagram @alaynathedentist. **Categories:** Blog **Tags:** Health Equity, Value-Based Care --- ### [The Connection Between 100 Million Mouths and Oral Health Equity](https://carequest.org/blog/the-connection-between-100-million-mouths-and-oral-health-equity/) **Published:** August 31, 2022 **Author:** Caitlin Locklear **Content:** It all began with an audacious aim and an audacious number. “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,” said Shenam Ticku, BDS, MPH, instructor in Oral Health Policy and Epidemiology at Harvard School of Dental Medicine. “Our Champions can train their peers and create more advocates for oral health.” Ticku and Hugh Silk, MD, MPH, professor in the department of family medicine and community health at UMass Chan Medical School, co-lead the 100 Million Mouths: Creating Primary Care Champions for Equitable Oral Health Campaign, which aims to recruit and train health professionals who will develop oral health curricula at primary care training sites in every state. The Campaign, which is based at the Center for Integration of [Primary Care and Oral Health (CIPCOH)](https://resourcelibrary.hsdm.harvard.edu/), aims to create 50 Oral Health Champions (one in each state) in 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. Ticku and Silk are leading the work along with colleagues Judith Savageau, MPH, professor in the department of family medicine and community health at UMass Chan Medical School, and Christine Riedy, PhD, MPH, chair and Delta Dental of Massachusetts associate professor of oral health policy and epidemiology at the Harvard School of Dental Medicine. “The project is to create 50 state champions who will work to implement some oral health curricula in every health school in the country,” said Silk. “We named it 100 Million Mouths because 100-plus million people do not visit a dentist in any given year but are likely to visit their primary care provider. So, if we could have oral health promotion and disease prevention addressed by primary care graduates in their practices, we could improve the health of that many people.” The initiative was originally funded by Health Resources and Service Administration (HRSA) and is now part of CareQuest Institute for Oral Health’s grantmaking efforts. It aligns very closely with the Institute’s efforts to create an oral health system that is more accessible, equitable, and integrated. Parrish Ravelli, manager of grants and programs at CareQuest Institute, has been involved with the project since it began. “The oral health care system wasn’t and isn’t built to meet the needs of everyone,” Ravelli says. “When we think about the opportunities to evolve, we must think about the role that everyone can play, regardless of their area of practice. Our hope is that this investment will be foundational to growing a new health care workforce that is directly contributing to meeting the oral health needs of everyone, especially those who have been left out.” ![](https://carequest.org/wp-content/uploads/2025/11/100-Million-Mouths-Campaign.jpg)100 Million Mouths Campaign ## The Need to Integrate Oral Health into Overall Health Many Americans visit their primary care provider more regularly than they do a dentist. Additionally, disparities in access to oral health exist across income, race, geography, and immigrant status. In fact, more than 56 million Americans live in areas with [a shortage of dental professionals](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis). Giving more primary care providers tools and training to advise patients about their oral health could fill a critical gap and advance oral health equity. Right now, Silk notes, many PCPs are not trained in oral health risk assessment and management despite the availability of evidence-based curriculum. And it’s clear that patients want more and better connections between their oral health care and overall care. [CareQuest Institute’s 2022 State of Oral Health Equity in America survey](https://www.carequest.org/content/state-oral-health-equity-america-2022), the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health, found that 96% of adult Americans know that there is a connection between the health of the mouth and the rest of the body. “When we listen to people in communities, we better understand the problems we are trying to solve and we create opportunities to solve them together,” Ravelli says. “Both our research and our relationships with trusted community partners show us that integrated, whole-person care is where the oral health field is heading.” ## Campaign Progress to Date The Campaign launched in 2021 with [Oral Health Champions](https://www.hsdm.harvard.edu/news/creating-oral-health-champions-reach-one-hundred-million-mouths-and-advance-oral-health) from six different states across the US: Alabama, Delaware, Hawaii, Iowa, Missouri, and Tennessee. Now in its second year, Champions have recently joined from eight additional states: Arizona, Georgia, Kansas, Kentucky, Maine, New Jersey, New Mexico, and Ohio. Champions represent a range of personal demographics and professional backgrounds, including physician assistants, nurse practitioners, pediatricians, family medicine doctors, med-peds physicians, dental hygienists, and a pediatric dentist. The goal, within a decade, is to have at least one Champion in each state. “We’ve started with those states that need the most in terms of a variety of metrics and outcomes such as numbers of dentists and rates of caries,” said Savageau. “We also want to have champions who work with vulnerable populations to address health equity and social justice in every aspect of oral health education. For example, one champion works with a lot of Head Start preschool programs, and one is working with the Navajo Nation, whose rates of cavities are very high.” Once Oral Health Champions are accepted in the program, they receive training that gives them a toolkit to engage with health profession schools and programs in their home states to increase oral health teaching. CIPCOH provides a comprehensive oral health curriculum, evaluation, a small stipend, and ongoing technical support. Champions are taught to use existing national and state resources, and to partner with local and state experts such as the state dental director, department of public health, and local academic and community-based dentists and dental hygienists. Using their small stipends, Champions can help engage patient representatives in the planning and teaching of learners to garner that personal perspective. The time commitment for Champions is around five hours a month after an initial eight-hour training period. Riedy noted the speed of the spread of the project. “In just a relatively short time, we are already seeing how Champions are creating their own communities of practice in their states to integrate oral health into primary care education and training,” Riedy said. “For example, Dr. Michael Metts (Iowa) worked with MercyOne Family Medicine faculty and residents to provide fluoride varnish education as part of a new quality initiative for pediatric application of fluoride varnish at a Federally Qualified Health Center. Champions are excited about the progress, too. “I have always understood the importance of oral health, and I have worked on multiple projects to improve access to oral health,” said Dr. Wanda Gonsalves, a family medicine Champion from Kentucky. “The 100 MMC gives me an opportunity to not only continue the work that I have been doing, but it also provides a national network of like-minded individuals working collectively to fill this major gap in primary care training. Additionally, this Campaign’s focus on integrating oral health into primary care curriculum with an equity lens, and providing us with tools to that, is very valuable.” That equity lens will continue to shape CareQuest Institute’s overall grantmaking efforts. This project is a quintessential example. “We’re already seeing the success of this investment through both the deep commitment of the Champions and the way that educational institutions are rethinking how they approach oral health,” Ravelli said. “Investing in strategies like this — strategies that seek to systemically move the needle in partnership with communities — is essential to the role that the CareQuest Institute will play.” *Editor’s Note: Learn more about the [100 Million Mouths Campaign](https://www.hsdm.harvard.edu/100-million-mouths-campaign) and the [Center for Integration of Primary Care and Oral Health](https://resourcelibrary.hsdm.harvard.edu/). Additionally, quotes and information from this blog post originally appeared in articles on the [UMass Chan Medical School website](https://www.umassmed.edu/news/news-archives/2022/08/100-million-mouths-other-initiatives-putting-oral-health-at-forefront-of-primary-care/) and the [Harvard School of Dental Medicine website](https://hsdm.harvard.edu/news/creating-oral-health-champions-reach-one-hundred-million-mouths-and-advance-oral-health).* **Categories:** Blog **Tags:** Health Equity --- ### [Voices from the Field: Madeline Steward on Oral Health Equity for Medicaid Populations](https://carequest.org/blog/voices-from-the-field-madeline-steward-on-oral-health-equity-for-medicaid-populations/) **Published:** September 12, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)There’s obviously no one solution, no silver bullet, to creating an equitable oral health system. But for Madeline Steward, MPH, a program officer at the Center for Health Care Strategies (CHCS), there’s one element that’s critical to the effort: trust. “A key ingredient raised by community-based organizations to establishing an equitable oral health care system is strengthening trust between patients and the health care system,” says Steward, a co-author of a new brief, “[Advancing Oral Health Equity for Medicaid Populations](https://www.chcs.org/resource/advancing-oral-health-equity-for-medicaid-populations/),” which was released today. “While the information itself isn’t novel, I was surprised how often this was raised by our key informant interviews. And one way to start building this foundation is to create a culturally competent experience for individuals from all backgrounds.” ![](https://carequest.org/wp-content/uploads/2022/09/Madeline-Pucciarello_ForUpload.jpg)Madeline Steward, MPH That’s just one finding from the research and subsequent brief Steward produced with CHCS colleagues Greg Howe, senior fellow, and Shilpa Patel, PhD, associate director of health equity. CareQuest Institute supported the work that focused on understanding how oral health equity does and does not exist in Medicaid populations, as well as what opportunities exist for advancing it. Steward, who started her career advocating for children with special needs, took some time out of her schedule to highlight key findings from the brief, discuss misconceptions many people have about Medicaid, and share a health care podcast recommendation. **How did you first get interested in working on oral health projects?** Early on, I was asked to support our [State Oral Health Leadership Institute (SOHLI)](https://www.chcs.org/project/state-oral-health-leadership-institute/). In most states, Medicaid programs and public health departments share responsibility for addressing the oral health needs of individuals with low incomes, yet each entity typically has its own dental director — often operating in silos. SOHLI, supported by CareQuest Institute (DentaQuest Foundation at the time), was created to bring together state Medicaid dental program directors and state oral health program directors to advance shared goals. Although the SOHLI program has since wrapped, I chose to remain working in the oral health space. Not only is it an area that I find incredibly interesting, but I am humbled every day by the passion of the oral health stakeholders that I’ve met and worked with along the way. **Why did you and your co-authors develop the “Advancing Oral Health Equity for Medicaid Populations” brief? What was the goal?** In 2020, CHCS conducted interviews with oral health stakeholders across the country — representing oral health providers, Medicaid agencies, professional and consumer organizations, and health plans — to learn more about the state of value-based payment (VBP) in oral health care. As we conducted that research, two points pertaining to equity stuck with us: (1) there are long-standing inequities in oral health, particularly in Medicaid; and (2) there are opportunities for partnerships within communities to make a meaningful difference. We know that Medicaid offers critical opportunities to improve systemic oral health inequities, but there’s limited information available about state efforts to improve oral health equity among Medicaid-enrolled populations. Through this publication, we hoped to learn more about: (1) specific barriers that contribute to and perpetuate oral health inequities, such as consumer-level and system-level barriers (e.g., provider enrollment, state resource constraints); (2) emerging opportunities to reduce oral health-related disparities; and (3) resources to improve oral health equity. **In three bullet points, what were the key takeaways from the paper?** - Medicaid — given its size and diversity of enrollees — offers critical opportunities to dismantle systemic inequities related to oral health access, reduce long-standing disparities, and advance oral health equity. There is limited information, however, about state efforts to improve oral health equity among Medicaid-enrolled populations. - There are common barriers for addressing oral health equity, and we highlight recommendations within four key areas: (1) coverage and access; (2) workforce capacity building; (3) partnerships; and (4) payment. - Lastly, the brief highlights specific opportunities to partner with community-based stakeholders (e.g., community-based organizations, individuals with Medicaid) as part of efforts to reduce oral health disparities and advance oral health equity for individuals with Medicaid. **What’s one misconception many people have about Medicaid populations?** There is a misconception that Medicaid discourages individuals from working — and that those on Medicaid do not want to work in order to continue receiving coverage. That is entirely untrue. Nationally, [more than 6 in 10 nonelderly adults in Medicaid ](https://www.kff.org/medicaid/press-release/only-six-percent-of-adult-medicaid-enrollees-targeted-by-states-new-work-requirements-are-not-already-working-and-are-unlikely-to-qualify-for-an-exemption/)who do not receive federal disability or Medicare coverage are already working full- or part-time. Individuals can still qualify for Medicaid coverage, especially in expansion states, because they work low-wage jobs and still meet the eligibility criteria. Low-wage jobs are less likely to offer employer-covered insurance, and for those that do, workers may not be able to afford coverage. [Research also shows that access to affordable health insurance has a positive effect](https://www.kff.org/medicaid/issue-brief/the-relationship-between-work-and-health-findings-from-a-literature-review/) on the ability to secure and maintain employment. Medicaid coverage can facilitate care to keep folks healthy enough to work. Additionally, many states, either through managed care plans or another mechanism, [take steps to connect their members with job services and employment](https://www.macpac.gov/wp-content/uploads/2018/07/The-Role-of-Medicaid-in-Supporting-Employment.pdf). **The importance of engaging community voices came through loud and clear in the brief. Why is that so critical?** I am a firm believer in “nothing about us, without us,” a mantra which signals that no policy should be decided by any representative without the full and direct participation of members of the group(s) affected by that policy. Considerations for advancing oral health equity would not be complete without the perspective of impacted communities to address health priorities and co-develop solutions. Meaningful and trusting partnerships with community members require substantial time, effort, and a genuine commitment for long-term engagement and change. **Of the recommendations you provided in the brief, are there one or two you think would have the biggest impact?** The recommendations in this publication can help states advance toward increased oral health equity for their beneficiaries, whether they are just beginning to develop an oral health equity agenda or if they are further along in pursuing oral health equity. However, foundational to state-level efforts to advance oral health equity is partnering with the individuals and communities most affected by oral health inequities. Without their expertise in identifying oral health inequities and the root causes that drive them, solutions to address identified inequities may have less impact or even potentially exacerbate disparities. **What actions do you hope readers take after exploring the brief?** There is much work to be done to increase equity in oral health for Medicaid populations, but forging authentic stakeholder relationships, particularly those with the community, is a fundamental first step to advancing equity in oral health. Ultimately, states should look to build and maintain partnerships that include regular opportunities for direct and meaningful engagement with consumers. Health care organizations, such as health systems and Medicaid agencies, may consider leveraging the influence of trusted community figures, such as leaders of community-based organizations, religious leaders, community organizers, or community volunteers, to serve as a launching point for understanding community needs. These leaders may be able to broker relationships with the community more broadly. Health care organizations can hire and meaningfully compensate community liaisons to act as go-betweens, translators, or engagement champions to participate in partnership activities. Medicaid agencies could also leverage existing means of engagement (e.g., Medicaid advisory committees) to solicit input on oral health policy and facilitate connections to other state agencies that impact beneficiaries. Additionally, Medicaid could explore program levers to strengthen community-based organizations (CBOs), including direct funding and incentives for providers and plans to actively engage with CBOs. For example, Medicaid programs can encourage, incentivize, or require health plans to contract with CBOs for the purpose of: (1) care coordination; (2) community needs assessments; and (3) addressing health-related social needs, and more. **Lastly, we know you’re a big podcast fan. Any health care-related shows you’d recommend?** I recently started listening to [“Where It Hurts,”](https://www.npr.org/podcasts/915395193/where-it-hurts) a podcast produced in partnership by Kaiser Health News and St. Louis Public Radio. The series examines overlooked parts of the United States where cracks in the health system leave people frustrated and without the care they need. The first season covers the fallout in rural Fort Scott, Kansas, after Mercy Hospital closes. [More than 500 rural hospitals in the U.S. are at immediate risk of closing](https://chqpr.org/downloads/Rural_Hospitals_at_Risk_of_Closing.pdf) because of financial losses and lack of financial reserves to sustain operations. This podcast does a wonderful job painting a picture of how Mercy’s closure impacts its workers, patients, and the overall Fort Scott area. **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [How Distributed Cognition Can Improve Patient Care](https://carequest.org/blog/how-distributed-cognition-can-improve-patient-care/) **Published:** October 3, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dental-professional-shows-patient-an-x-ray.jpg)Who is the true expert when it comes to a patient’s oral health? The answer depends on the situation and the stage of oral disease a person might be experiencing. For example, when a patient presents to a dental clinic with oral pain, they are the expert, at least at first. Patients in pain find ways to communicate what the problem is, where the problem is, what makes the problem better or worse, and when the problem started. By sharing this invaluable knowledge, the patient is contributing to the identification and resolution of their problem. This is distributed cognition in action. What is distributed cognition? It’s a learning concept that describes a person’s knowledge about a specific topic and how they make decisions based on that knowledge. Awareness of distributed cognition — and the ability to use it — can lead to better, more person-centered care. ## Distributed Cognition in Different Health Settings Cognitive scientists argue that we are continuously using past experiences and new information to frame our environment to make decisions. There are three types of [distributed cognition](https://thedecisionlab.com/reference-guide/neuroscience/distributed-cognition) that collectively contribute to oral and systemic health practice and patient care: past experiences, shared knowledge, and environmental factors. All of life’s lessons play a role in distributed cognition and how those experiences shape us into oral health experts. As oral health professionals advance in their careers, various patient experiences, continuing education courses, state policies, and dental practice climate, to name just a few factors, affect their knowledge base and how they react to various circumstances. The same is true for physicians. Both dentists and physicians use multiple sources to help make final decisions surrounding patient care. These sources include assessments, observations, and background information from [support clinicians](https://www.ahrq.gov/patient-safety/reports/issue-briefs/distributed-cognition-er-nurses.html) such as dental hygienists, dental assistants, and nurses. But there also important differences between the two care settings. For example, nurses are generally not present when the physician examines the patient, whereas for dental visits, the dentist and support clinicians are in the same room. The dental hygienist or dental assistant can supply the dentist with additional or clarifying information as needed. The dental assistant and dental hygienists often act as an interpreter between the patient and dentist, emphasizing important points, and translating language from technical to layman’s terms, improving [distributed cognition](https://www.ahrq.gov/patient-safety/reports/issue-briefs/distributed-cognition-er-nurses.html) and communication between clinicians and patients. Jeremy Horst, DDS, PhD, director of clinical innovation at CareQuest Innovation Partners, emphasized that dental hygienists and dental assistants contribute regularly to the patient’s oral health situation or background information. “There is a sense of urgency and a need to be efficient in the clinic. A dentist cannot take in all the patient’s information alone,” says Horst. “I’ll share an example: A young girl with a swollen cheek had been referred to our office from a medical provider. After doing an oral exam, we could not detect an oral health problem. Because the dental assistant had background information about the family, she was able to share this child was not vaccinated. Having this new information changed the appointment from a dental exam back to a medical exam, and we found the patient had mumps.” ## How the Environment Affects Cognition and Patient Care Many different aspects of an oral or systemic health professional’s environment can affect distributed cognition and ultimately patient care. Factors such as state, local, or clinic policy; clinic software systems; community resources; and provider and patient knowledge, awareness, and beliefs all play a role in patient care and health-related outcomes. Take the emerging changes in traditional oral health care delivery, for example. Using synchronous teledentistry to share patient information requires changes in distributed cognition to maintain good communication among clinicians. Katie, an expanded practice dental hygienist in Oregon, illustrated the point: “When working with the same dentist in the dental clinic, you learn the specific information they want and how they want it presented. When working with different teledentists \[dentists who work remotely and only review patient records\], sometimes there is a breakdown in communication because I don’t know their specific process with diagnosis and treatment planning.” Distributed cognition does not always equate to learned experiences if the new information is not received and processed accurately by another person. Miscommunication can result from failing to share the correct information; failing to actively listen to the information; systems failures; or making assumptions or decisions based on inaccurate information or outside influences. It’s important for [providers to adapt](https://www.ahrq.gov/patient-safety/reports/issue-briefs/distributed-cognition-er-nurses.html) to different situations, too. Jane Frieders, RDH, RTT, had been a respiratory therapist for 24 years before going back to school to become a dental hygienist. Working for a dental office where the recently retired doctor never had a dental hygienist, Jane had to be assertive and compassionate with patients who were not familiar with the dental hygiene process of care. Jane explained that although she was new to dental hygiene, having the medical experience in respiratory therapy helped her with updating protocols with the dentists, other clinicians, and patients. “I came from a medical field where we had to do things for patients they didn’t want to do,” she said. “If didn’t, they wouldn’t be able to breathe, so I learned to be compassionate but stern when impressing the importance of treatment for more functional breathing.” ## Tips to Help You Avoid Miscommunication Advances in technology can remove opportunities to communicate directly with co-workers and patients, tempting us to save time and reducing opportunities for distributed cognition among oral health providers. However, it is important to maintain clear communication among oral and systemic health providers and those who are receiving care. The good news is that traditional dentistry uses a communication method in which the dentist and support clinicians generally work together to share information about patient needs and expectations. Here are some things you (and your organization) can do to utilize distributed cognition and avoid miscommunication: ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH - Have clear standard operating procedures (SOP) for all processes, especially if clinicians are working in synchronous environments. [This blog post on writing standard operating procedures for your practice](https://desergo.com/blog/how-to-write-standard-operating-procedures-for-your-dental-practice/) is helpful. - Begin patient intake with the initial phone call to the dental office. Document the patient’s chief complaint and the instructions given to the patient for their visit. - Clearly document results of patient assessments, diagnosis, treatment plan, patient acceptance of treatment plan, and next steps. The [American Dental Hygienists’ Association’s Standards for Clinical Dental Hygiene Practice](https://www.adha.org/resources/standards/) is an important guide to help you get started. - Identify [protocols and documentation for referrals and communications](https://www.ada.org/resources/practice/practice-management/specialty-referrals) with allied health professionals. - [Be an active listener](https://www.ted.com/talks/katherine_hampsten_how_miscommunication_happens_and_how_to_avoid_it?language=en). Hear and process what others are saying. - Use all your data intake resources to gain new information about patients. Listen, look, and learn from your surroundings and from others. - Be aware of [internal and external influences](https://thedecisionlab.com/reference-guide/neuroscience/distributed-cognition) that may cause inaccurate assumptions or inaccurate patient care. *Authored by Kelly Schroeder, MS, RDH, Program Evaluation Specialist, CareQuest Institute* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Seven Questions on Infection Prevention and Control in Dentistry](https://carequest.org/blog/seven-questions-on-infection-prevention-and-control-in-dentistry/) **Published:** October 19, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dental-professional-cleaning-tools-e1764955016804.jpg)As we approach another COVID-19 winter in the United States, the health care industry is bracing itself for the possibility of another wave of infections. In preparation, in late September, the CDC [issued new infection prevention and control updates](https://www.ahcancal.org/News-and-Communications/Blog/Pages/CDC-Releases-Updates-to-COVID-19-Infection-Prevention-and-Control-Guidance-.aspx), providing guidance around topics including testing, exposure, and universal personal protective equipment (PPE). A recent [CareQuest Institute webinar](https://www.carequest.org/education/webinars/update-latest-infection-prevention-and-control-dental-professionals), produced in collaboration with the Organization for Safety, Asepsis and Prevention (OSAP), the only dental membership association for oral health care professionals that focuses exclusively on dental infection prevention and patient and provider safety, explored the updates and offered advice on the topic. Kathy Eklund, RDH, MHP, director of occupational health and safety and Forsyth research subject & patient safety advocate at The Forsyth Institute, spoke on the webinar, discussing the latest guidance and how it pertains to dental professionals. “As we continue to live with COVID-19, it’s important that the standard precautions are supplemented with the current CDC infection control guidance for health care professionals,” Eklund said. “And this includes dental health care professionals.” During the webinar, which drew more than 600 participants from the oral health industry, Eklund walked through the latest information on standard infection control, prevention, and transmission-based precautions. She also shared the importance of designating someone to monitor the latest in guidelines and community transmission levels for your practice. Participants had several questions as the hour-long webinar came to a close, offering a glimpse on what is most pressing on oral health providers’ minds on the topic of infection prevention and control: **1. Who needs to be wearing a mask in the dental office? Can we wear the same mask all day?** Face coverings for source control need to be worn by everyone. That means anyone coming through the door — personnel, patients, visitors, and vendors. Regardless of people’s vaccination status, source control and face coverings should be worn at all times, until there is a change in guidance. If you’re wearing a mask as source control and you’re not delivering care, you can wear it as long as it’s intact. But if you’re delivering patient care, a face mask needs to be changed between each patient. Also, if you’re wearing a respirator for aerosol generating procedures, the respirator also needs to be changed between each patient. **2. What are the recommendations for using the high-volume evacuation?** If you’re doing anything that’s generating any aerosol, high-volume evacuation is important to help reduce the aerosolization. The National Institute of Occupational Safety and Health (NIOSH) conducted a research study last year looking at comparing different high-volume evacuations — intraoral, not extraoral — and found that they were pretty similar in reducing the amount of aerosols. **3. Can you discuss HEPA filter placement? Also, what is classified as an appropriate type of HEPA filter?** There are different types of air filtration, including HEPA filters. Each of these has what is called a clean air delivery rate. When you have a higher clean air delivery rate, that means the filter is going to circulate more of the air through it. So, if you’re purchasing these, you need to ask yourself: Where are you putting it? What size do you need? What clean air delivery rate do you need? Are you putting it in a broad general area, or are you putting it in an isolated closed operatory? **4. What is the best way for someone in an office to garner support from their leadership to implement some of these recommendations that we’re hearing about today?** It’s always all about communication. Everybody wants to deliver safe and quality care, but you want to make sure that patients and personnel are safe in the process. So, it depends upon the size of your setting. If it’s a private practice setting, you want to have someone who’s been given the responsibility and the authority to be on top of all this information, to be able to review the policies and procedure, to do education and training, and be given the time to do it. In larger practices, like DSOs, you may have someone at the higher level who’s in charge, but then you have to have local site people hold the responsibility and do the monitoring. **5. Should we be reporting if we think we might have been exposed to COVID-19? Should we be reporting to our employer if we might have been exposed but we’re not experiencing symptoms? What do we require from patients?** These questions tie into the recommendations to have a protocol. That’s why you need to have somebody who is on top of this. On September 23, some of the guidance changed for health care personnel, so you need to have someone making sure that your policies and procedures are consistent with the guidance. I use the example of exposure. If you’re fully protected, but you live in a household where two family members have COVID-19 and you’ve been in close contact with them, that’s when having specific policies and procedures around testing and monitoring become important. **6. Who in the dental office do you feel is best suited to be the individual who keeps up with the current guidelines?** It can be anyone, but they have to have the time, the education, and the training. Whoever it is, they should have administrative support for that education and training, and for the time it takes to remain current. They should also be able to address things as they’re needed or bring people together to talk about it. **7. If somebody wants to take the lead in their office and be the person that helps bring all of this together, is OSAP a good resource for them to turn to?** Yes, absolutely. These are some other helpful resources: - [Dental Infection Control by OSAP, the Dental Assisting National Board, and the DALE Foundation](https://dentalinfectioncontrol.org/) has two certification programs: [Dental Infection Prevention and Control®](https://www.cdc.gov/dental-infection-control/hcp/index.html) and the [Dental Industry Specialist in Infection Prevention and Control®](https://www.danb.org/exams/exam/disipc-exam). - [OSAP Dental Infection Control Bootcamp](https://www.osapbootcamp.org/) is an intense three-day program for infection prevention and control in dentistry. There are speakers from the CDC, FDA, NIOSH, and others who participate in this. It’ll be held in person in Atlanta in January 2023, but for those of you who can’t or don’t want to travel, you can do the program and stream it online from February 13 through April 14. - [CDC Foundations: Building the Safest Dental Visit](https://www.cdc.gov/dental-infection-control/hcp/training/index.html) is a three-part education and training that was developed about a year ago. It gives ADA CERP credits. **Categories:** Blog **Tags:** Clinical Practice --- ### [Voices from the Field: Health Program Manager Raydiance Swanston on Reimagining Oral Health in Her Community](https://carequest.org/blog/voices-from-the-field-health-program-manager-raydiance-swanston-on-reimagining-oral-health-in-her-community/) **Published:** October 20, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)When Raydiance Swanston heard about the Community Oral Health Transformation (COrHT) program launching in North Carolina, she knew it was something Mecklenburg County Pediatric Clinic had to join. “One of my personal goals is to innovate and offer new opportunities that haven’t been available,” Swanston said. “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.” The Mecklenburg clinic is one of 14 safety-net dental clinics across North Carolina participating in the [Community Oral Health Transformation (COrHT) Initiative](https://oralhealthnc.org/2025/08/29/the-collaborative-effect-transforming-oral-health-in-north-carolina/) and 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](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care), which focuses on 1) tele-prevention (teledentistry), 2) minimally invasive care (non-surgical treatment of disease), and 3) integration of oral health with overall health care. For Swanston and Mecklenburg County Pediatric Dental Clinic, it is also an important opportunity to move the clinic forward — particularly as the challenges brought on by the pandemic continue to evolve. Here, Swanston shares more about the clinic and what the Mecklenburg team hopes to achieve as they kick off with COrHT. ![](https://carequest.org/wp-content/uploads/2024/01/RaydianceHeadShot-300x300.jpg)Raydiance Swanston, MPH, CHES **What type of work do you do at the Mecklenburg County Clinic?** I’m a health program manager overseeing Mecklenburg County’s Pediatric Dental Clinic. Mecklenburg County Public Health’s Children’s Dentistry Program creates smiles by promoting proper brushing and flossing and regular visits to the dentist. Apart from this role, I also serve on several committees — Safety Committee, Wellness and Recognition Committee — as well as the county’s HIPAA monitoring team. **Why are you excited about participating in COrHT?** Our dental division serves pediatric patients ages 0–17. It is our hope that through this learning initiative, we can provide our patients and the community with value-based oral health care. We also hope to utilize this opportunity to conduct a feasibility study in expanding our services to offer adult dental care. **Are there particular elements of the program you think will really enhance your work?** I’m extremely interested in learning about teledentistry. Due to COVID-19, our clinic unfortunately was impacted and closed for 15 months. I’m sure if we had the opportunity to incorporate teledentistry into our services beforehand, we would have had the ability to continue to support our patients. Telehealth is still new, and dental providers still are learning how to navigate this service offering. I’m sure it will take our team a few weeks to get the hang of this, but we are all in agreement over the need for this service in our community, and we are looking forward to taking on this challenge. **Why do you think there is a need for a program like COrHT?** Stakeholders from throughout North Carolina will come together under COrHT because they share the view that healthy communities and healthy individuals are interdependent, and that oral health is an essential component of overall wellness. This mutual belief allows us to begin the thought-provoking conversation about how we can make a difference in our community. Having the conversation and discussing how we can remove oral health disparities in our community will help us improve oral health for all. **How do you see this changing the way your organization operates going forward?** The framework we are hoping to implement would be the first time this service is offered by the county. We are excited to see how these changes continue to drive patient satisfaction and close the gap in accessing oral health care that currently exists. Going forward, we can expect that despite the current events happening around us, we will have tools and services at our disposal to care for our community’s oral health needs. **How do you think your patients and community will benefit from this work?** This COrHT learning initiative provides a collaborative network for us to share ideas and discuss ways that we can expand our program and offer minimally invasive treatment and affordable dental care and ensure satisfaction for our patients. It is also very important that we remove systemic barriers to good oral health and accelerate the implementation of policies that reduce oral health disparities in our community. **Categories:** Blog **Tags:** Health Equity, Value-Based Care --- ### [Nine Resources to Kickstart Your VBC Journey](https://carequest.org/blog/nine-resources-to-kickstart-your-vbc-journey/) **Published:** October 26, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dental-professional-talking-to-patient-e1764954568866.jpg)Any journey, especially one as winding, complex, and meaningful as the journey toward value-based oral health care (VBOHC), starts the same way — with a step. “We are all at different points in reforming and leading value-based health care efforts,” said Kristen Simmons, PhD, MHA, RDH, former chief operating officer at Willamette Dental Group, in a [CareQuest Institute webinar on October 20](https://www.carequest.org/education/webinars/are-you-ready-transition-value-based-care). “At the end of the day, value-based health care is reform based upon concrete structures, processes, and outcomes leading to better quality and bending the cost curve.” Nevertheless, how do we get those structures and processes to achieve those outcomes? As part of the webinar, [“Are You Ready for the Transition to Value-Based Care?,”](https://www.carequest.org/education/webinars/are-you-ready-transition-value-based-care) Simmons presented a three-phase framework — exposure (walk), capacity building (jog), and responsibility (run) — to move from theory to practice. Questions to consider in the “walk phase,” for example, include “Do you need a project manager?” and “Can existing staff launch the project?” “The walk phase is when you contemplate, plan, and advocate for the advancement of VBOHC,” Simmons said. “It creates a clear understanding of current need and where you want to go.” More than 300 oral health professionals started to explore those needs in the webinar, which also featured two CareQuest Institute experts: Rebekah Mathews, MPA, vice president of health improvement, and Danielle Apostolon, program manager. All three have worked with several organizations in the early phases of the transition. “No one size fits all,” Simmons said. “The exploration phase must be sufficient to have a plan, budget, timelines, responsibilities, reporting structures, and most importantly, your commitment to the ownership of the processes.” Together, the three experts highlighted nine resources in three different categories that are especially helpful in the “walk phase” when organizations are trying to assess their readiness to transition to OHVBC. ## The Basics of Value-Based Oral Health Care - [What are the value-based programs?](https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs) A webpage from CMS that highlights the “why” behind VBC, including the five original VBC programs and associated timelines. - [“The wicked problem of the oral health care system.”](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12424) This article appeared in the Journal of Public Health Dentistry in 2020. “This article includes a graphic that helps visualize elements that are considered vital to driving the evolution of VBOHC with equity at its core,” Apostolon said. “The article also explains oral health transformation requires multifaceted solutions involving a multitude of stakeholders.” - [“A Three Domain Framework to Innovating Oral Health Care.”](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) This white paper outlines a framework and a new model in dentistry that envisions a more cost-effective, efficient, and equitable system. Each domain includes a strength-weakness-opportunity-threat (SWOT) analysis that highlights opportunities within each domain of oral health transformation. - [“How do you implement value-based care methodologies in dentistry with existing dental organizational paradigms?”](https://onlinelibrary.wiley.com/doi/pdf/10.1111/jphd.12412?casa_token=-y2HT-scznEAAAAA:rxLw_lJRI78f_7OD1pHmU4VUGcG4lfx7Mzaqp_UWkD1TmtYEcO65LtbV96s8IRkaTErxlJx8gqacHQ) Co-authored by Simmons, this article in the Journal of Public Health Dentistry explores the VBC model and then dives into the accountable care organization (ACO) model and the patient-centered medical home (PCMH) model. ## Project Management and Budgeting Resources - [“What are the core competencies of a successful project manager?”](https://www.pmi.org/learning/library/core-competencies-successful-skill-manager-8426) This article from the Project Management Institute compares the roles and competencies of a project manager across different approaches. This resource provides you with key performance indicators to help a project manager or identified employee oversee the execution of VBOHC. - [“10+ Types of Budget.” ](https://simplicable.com/new/budget)“This resource,” said Simmons, “provides you with very broad basic knowledge of different types of budgeting processes.” ## Community Engagement and Leadership Resources - [“Evolving Roles of Health Care Organizations in Community Development.”](https://journalofethics.ama-assn.org/article/evolving-roles-health-care-organizations-community-development/2019-03) In this article in AMA Journal of Ethics, author Austin J. Hilt “makes an important point about the social determinants of health and the importance of community development,” said Simmons. - *[The Knowing-Doing Gap.](https://www.gsb.stanford.edu/insights/knowing-doing-gap)* “This book highlights the importance of turning knowledge into performance,” Simmons said. “Knowing is not always enough.” - [*The Checklist Manifesto.* ](https://www.slideshare.net/AsthaGupta12/checklist-manifesto-26977576)“This book emphasizes that under conditions of complexity, checklists are of value and can actually improve performance outcomes,” Simmons said. *Editor’s note: To see the recording of “Are You Ready for the Transition to Value-Based Care?” and access the accompanying slides, visit the [CareQuest Institute webinar library](https://www.carequest.org/education/webinars/are-you-ready-transition-value-based-care).* **Categories:** Blog **Tags:** Value-Based Care --- ### [Voices from the Field: Sarah A. Sherman on Improving Rural Veterans’ Oral Health Access](https://carequest.org/blog/voices-from-the-field-sarah-a-sherman-on-improving-rural-veterans-oral-health-access/) **Published:** November 14, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Most Americans may assume that thanks to their sacrifices, veterans have unfettered access to comprehensive health services. But that’s not the case, as Sarah A. Sherman learned when she became Director of Strategic Partnerships at the Maine Bureau of Veterans’ Services (MBVS). The agency advocates for veterans and their families. “Roughly 90% of veterans nationwide don’t receive their dental care from the Veterans Administration (VA),” Sherman explained. “These men and women put their lives on the line and they can’t even get their teeth cleaned — an effective preventative care measure.” Unless they were prisoners of war, or they have a disability or a 100% service-connected pre-existing dental condition, many veterans don’t qualify for dental care from the VA. Medicare only pays for certain dental services provided in a hospital, and Medicaid provides limited or no adult dental benefits in several states. In Maine, access to MaineCare dental services for low-income adults was just expanded on July 1, 2022. ![](https://carequest.org/wp-content/uploads/2025/11/Sarah-Photo-228x300.png)Sarah A. Sherman This hurts veterans’ health. Veterans have [greater rates](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity) of tooth decay and gum disease than their civilian peers. They’re also more likely than non-veterans to have diabetes and hypertension, which dental disease can make harder and more expensive to manage. Since joining MBVS four years ago, Sherman has made progress expanding veterans’ access to care, particularly in rural communities. She conducted a needs assessment in 2020 just as the COVID-19 pandemic hit. Reaching people to interview by phone was one bright spot amid the tragedy. (“Everyone was home that I wanted to interview,” Sherman said.) The assessment culminated in the robust report “[Oral Health Access for Veterans in Maine](https://www.maine.gov/veterans/benefits/healthcare/dental-care)” and led to the formation of a statewide, grant-funded network of dental providers now serving veterans, the Maine Veterans’ Dental Network. **You bring a unique background to your role. Are there lessons from previous work that spurred your interest in oral health?** Prior to joining the Bureau, I worked as a domestic violence legal advocate. Many of my clients had experienced physical violence that caused broken teeth, and they would keep a hand over their mouth as they told me their stories. This experience raised my initial awareness about the lack of access to dental care in our state. **MBVS’s report, Oral Health Access for Veterans in Maine, surfaced veterans’ deep need for better access to dental care. What barriers are confronting veterans today?** Nationally, there are several barriers confronting veterans. Some are due to VA policy, including not being 100% service-connected to the VA (meaning their military service didn’t cause or aggravate a health condition) or not meeting the VA’s Class I-VI qualifications (rules assigning veterans to different priority levels for care). Other national barriers include providers’ dental school debt, the challenge of recruiting dentists to practice in rural areas, and providers’ enrollment in the VA’s Community Care Network. **What about hurdles unique to Maine veterans, including in rural communities?** State barriers to oral health care include cost, transportation, and, relatedly, the distance someone may need to drive to receive care. Veterans may also have challenges getting care if they reside in a Veterans Home or private nursing home. Other barriers include a shortage of dentists in Maine and the financial struggles of nonprofit dental clinics. **You developed the Maine Veterans’ Dental Network, a program in** **partnership with Northeast Delta Dental that’s starting to address some of these challenges. How did it get started?** In 2020, as part of the needs assessment, I interviewed Northeast Delta Dental’s CEO Tom Raffio and Chief Dental Officer and Vice President of Professional Relations Dr. Mitch Couret, DDS. Two months after we published the Oral Health Access report, they offered us a $35,000 grant to start a dental pilot project. **That happened quickly! Did it take long to coordinate the program itself?** Four months later, the Maine Veterans’ Dental Network (MVDN) was formed. Its goal is to provide dental care to veterans who otherwise can’t afford it and don’t have dental insurance. I started it as a one-woman show, but recently welcomed a new colleague, April Bretton. Together, we manage the program for the entire state. **How does MVDN work?** We partner with nonprofit dental clinics, dental teaching schools, and Federally Qualified Health Centers. By May 2021, we had created a network of 15 dental clinics and started connecting veterans to them. In 2021, Northeast Delta Dental’s Board voted to increase our grant to $100,000 and we added seven more dental clinics to the network. **What impact is the program having so far?** In 2021, we received 428 requests for care, and more than half, 281 veterans, qualified for the program. In 2022, we received 870 requests for dental care. The number served will be determined by year’s end. **Have veterans shared that it’s making a difference for them?** Veteran James Barret is one example of our success. In this feedback, he described his MVDN experience, sharing how we helped him overcome the barriers he faced: *“I had x-rays and they took care of my two bad teeth that needed fillings. Then the dentist told me that I had a third, and she would schedule me back in to get it taken care of. I explained that transportation is a problem for me, and she announced, ‘Well, let’s do it right now,’ and she did. Please thank their staff for taking such excellent care of me. I really appreciate it.”* **What are some unresolved challenges you’re seeing to rural veterans’ oral health care access?** The largest unresolved challenges in Maine include finding additional funding sources and the lack of oral health professionals serving Native American dental clinics. First, the MVDN cannot solely depend on one grant funder. Second, Native American members from Maine’s Wabanaki communities (including the Mi’kmaq, Maliseet, Passamaquoddy, Abenaki, and Penobscot Nation) have served in every conflict since the Revolutionary War. When our report was published in 2020, some of their communities could only offer dental services part-time. Others lacked oral health providers to run their clinics. **How about beyond Maine? Could this improve equitable access to quality dental care in other states?** The MVDN model works, and I would like to see it expanded to every state. It received the VA’s 2022 Abraham Lincoln Pillar of Excellence Award. MBVS also recently presented Maine’s model to the National Association of State Directors of Veterans Affairs. It was very well received. Why not use Veterans’ Services to create efficient, cost-effective veterans’ dental programs nationwide? **Do you have suggestions for policymakers at the federal level?** For policymakers, I hope they increase incentives and loan forgiveness programs for dentists and hygienists to practice in rural areas. Until there is cooperation in Congress on this issue, many challenges will not improve. Congress can also improve connection to the VA’s Community Care Network, and help the VA expand dental services, by working to pass S.3017, the Veterans Dental Care Eligibility Expansion and Enhancement Act. **Lastly, what do you plan to share with participants during the AIDPH-CareQuest Institute webinar on November 30?** I will share about the difficulties confronting Maine’s Native American communities. They are having challenges finding dentists and hygienists to keep their dental clinics open in some of the most rural parts of our state. *Editor’s Note: Hear more from Sherman on the AIDPH/CareQuest Rural ECHO webinar, “Supporting the Oral Health and Wellbeing of Rural Veterans,” on November 30.* **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Colleagues and Friends Remember Oral Health Innovator Dr. Mark Doherty](https://carequest.org/blog/colleagues-and-friends-remember-oral-health-innovator-dr-mark-doherty/) **Published:** November 3, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Mark-Doherty.jpg)Dr. Mark Doherty His colleagues, who were really friends, all used the same words when they shared memories of Dr. Mark Doherty: Generous. Compassionate. A champion for oral health. A forceful and unwavering advocate for oral health access for the underserved, Mark died on October 7 at age 75. He is survived by his wife (of 53 years) Deborah, two children, five grandchildren, and three siblings. Many of his colleagues at the CareQuest Institute for Oral Health came to know his family over the years. “Mark’s family — you were his biggest accomplishment and he spoke of you often,” said Carolyn Brown, DDS, MS, senior advisor and consultant at CareQuest Institute. “There are many grieving while equally also celebrating your life and contributions.” Mark earned his Doctor of Dental Medicine degree from the University of Pennsylvania School of Dental Medicine in 1974. In 1979, he founded Commonwealth Mobile Oral Health Services, which brings dental teams to Massachusetts schools for children who may not have access to care. It still operates today. He went on to work at the Dorchester House Multi-Service Center, initially as Director of Oral Health Services and later as Director of Oral Health Policy. “It was a big piece of his heart — making sure kids got access,” said Danielle Apostolon, training specialist, value-based care at CareQuest Institute. Mark served as DentaQuest Institute’s Safety Net Solutions (SNS) executive director from 2005 to 2019. With deep passion and expertise, he and his team gave training and technical assistance to oral health providers nationwide. “Mark was a champion for safety net oral health programs, especially community health centers,” said Scott Wolpin, DMD, chief dental officer, Eastern Shore Rural Health System, Inc. Wolpin continued, “Mark saved many dental programs from closing their doors and instead turned them around so they could expand their reach. . . . I will never forget his mantra, ‘We need to be a higher version of what we are asking our clients to be.’” Caroline Darcy, former SNS project manager, reflected on Mark’s warmth. “Our SNS team was our family with Mark as the patriarch. He never hesitated to take time to talk with me or to take a call from someone in need of advice.” Colleagues remember that he treated everyone with this giving spirit. “He loved life, and he loved helping people,” said Susan Lawson, director of oral health services, Ohio Association of Community Health Centers. “Mark always made me feel so important. He helped me, as a brand-new oral health coordinator at the primary care association, learn what our centers needed to be successful. He was patient and kind to everyone. Mark always said, ‘Anything for you, Susan,’ and he meant it.” In 2019, Mark became cofounder and executive director of D4 Practice Solutions, continuing his focus on improving dental access, outcomes, and quality. “There was nobody like him,” said Danielle Apostolon. “His love for patients, as a provider, first and foremost. And he was always focused on treating underserved communities, thinking about how to do the work in a sustainable way.” Many colleagues remembered Mark’s drive for excellence. “To know Mark was to love him. He was fiercely passionate about the work we did,” said Laura Skaret, BS, RDH, manager, clinical innovation, CareQuest Innovation Partners. “He firmly believed there was no reason our team couldn’t have fun while we worked extremely hard to make the world a little better every day. Mark injected life and fun into every situation and showed me how to live every day to the fullest.” This upbeat energy and sense of humor are another part of his legacy. One past SNS colleague, Da-Nell Pedersen, MPA, reminisced about “how much we laughed.” Pedersen offered a memory of Mark’s joyful approach on the job: “We worked hard and put so much passion into what we did at Safety Net Solutions, but Mark always made it fun.” “I’ll never forget when he told me he wanted to play Irish music during his presentation at one of the value-based care convenings we did,” she said. “I was terrified about how it would be received. But you know what? Everyone loved it. Mark taught me not to take myself so seriously, which I desperately needed. I am a better person for knowing him.” ## Accomplishments of an Oral Health Champion During his long and accomplished career, Mark received many honors, including the College of Holy Cross Sanctae Crucis Award for Contributions to National Healthcare, the 2016 National Network for Oral Health Access President’s Award, and the 2020 Pierre Fauchard Academy’s Distinguished Service Award for the J. Murray Gavel Chapter. Over time, Mark also served on several oral health committees, including as a trustee for the Massachusetts Dental Society. He also authored or coauthored several dental health publications. While dedicated to oral health, Mark’s talents extended beyond dentistry into sports. He was an accomplished boxer, becoming — at age 65 — the first master boxer to capture the title in every major masters tournament in the US. His in-ring accomplishments were profiled this year in a short documentary, “The Legend of Doc.” Sharing his passion as an athlete, he wrote the book Arm Wrestling for Everyone in 1986. His sportsmanship came through in his professional life, too. “I’ve seen him negotiate some tough situations,” said Bob Russell, DDS, MPH, MPA, CPM, FACD, FICD, dental director and bureau chief, Oral and Health Delivery System Bureau, Iowa Department of Public Health. “He could have walked away. Instead, he took the criticism and humbled himself for the greater good. Mark was a fighter in spirit and was certainly known to give a punch or two. However, he knew strategically when to take the punch.” Colleagues will cherish Mark’s memory as a passionate teacher and leader. “Simply put, Mark was my hero,” said William Donigan, DDS, MPH, chief dental officer at Kintegra Health. “I have his Superman bobblehead on my shelf, and when the bureaucracy gets in the way, I remember Mark always saying, ‘Remember why we do it! For the patient!’” Mark set an example that many strove to follow in their work. “He was a mentor to me, even though he may not have known that,” said Nathan Suter, DDS, chief innovation officer at Enable Dental. “That is how I remember Mark. The type of leader that sparked a fire in many young dentists like myself to improve the oral health care delivery system.” Amy Martin, DrPH, MSPH, chair and professor in the Department of Somatology, Division of Population Oral Health, at the James B. Edwards College of Dental Medicine, Medical University of South Carolina, agreed. “Mark was always the encouraging mentor. There are so many favorite memories of Mark… most of all, his personal investments in people.” Many of those people are now continuing the work he did and inspiring others to do the same. “So many of us have him to thank for so many professional achievements,” Martin said. “His mentorship included how to lead impactful change, calculated risk taking… but above all else the courage to challenge ourselves. Mark, along with his team of staff and advisors, has left an indelible ‘mark’ on the nation’s fabric of dental safety net providers.” *Editor’s Note: [Read Mark’s full obituary](https://www.legacy.com/us/obituaries/bostonglobe/name/mark-doherty-obituary?id=36802233), including information on donating to a food bank in his community.* **Categories:** Blog **Tags:** Health Equity --- ### [Maryland’s Successful Path to Securing Dental Coverage for Low-Income Adults](https://carequest.org/blog/marylands-successful-path-to-securing-dental-coverage-for-low-income-adults/) **Published:** November 18, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2022/11/MarylandBillSigning.jpg)It was the tragic story of 12-year-old Deamonte Driver — a boy who died from an untreated tooth infection that spread lethal bacteria to his brain — that first compelled advocates in Maryland to take up the fight to expand dental coverage to low-income children in 2007. As they made meaningful advances in dental coverage for children in Maryland, the organization at the forefront of this work, the [Maryland Dental Action Coalition (MDAC)](https://www.mdac.us/), then turned its attention to expanding dental coverage for adults on Medicaid. They knew they would need to take the time to build their case to Maryland legislators and make incremental progress toward their goal. “We started by educating the state legislature about the issue and brought oral health champions on board to help these policymakers really understand the importance of oral health to overall health and the existing barriers in achieving equitable access to dental care,” says Mary Backley, CEO of MDAC. And now, 15 years after MDAC and the advocate community began its work, on May 12, 2022, Maryland Governor Larry Hogan signed [SB150/HB 6](https://legiscan.com/MD/bill/SB150/2022) into law, creating a dental benefit for all adults on Medicaid. Starting January 1, 2023, 800,000 Maryland Medicaid adult beneficiaries will gain access to comprehensive dental coverage. The journey to that moment provides several lessons for oral health advocates in all 50 states. ## Language Matters As part of their education and advocacy campaign, MDAC and its partners first focused on their messaging. They prioritized terms like “coverage” and “investment.” And “IF we get adult dental” became “WHEN we get adult dental.” “In this instance, it’s one word, it’s two extra letters, but it’s a world of difference when it comes to messaging and momentum,” says Robyn Elliott, who serves as MDAC’s policy and governmental affairs consultant. “The messaging piece is so important; it might actually be the most important thing we did as an advocacy community.” ## Data Are Key After fine-tuning their messaging, MDAC began to collect data to build the case to policymakers that expanding Medicaid adult dental coverage was a smart investment to make. They partnered with [CareQuest Institute for Oral Health](https://www.carequest.org/) on a study related to how much Maryland’s state Medicaid program was paying for emergency room visits for non-traumatic dental conditions. The results of that study revealed that the state was spending $10 million per year for these visits, which are costly, ineffective, and largely avoidable with accessible preventive dental care. The report also included more granular data that proved incredibly useful to MDAC. “As part of its groundbreaking study, which was so important to build a groundswell of support, CareQuest Institute also gave county-level data so that stakeholders could go to their respective representatives and delegates and inform them of the savings,” says Backley. ## A Network of Support The efforts of MDAC and its partners led to a bill that was filed in the 2022 legislative session to create a dental benefit for all adults on Medicaid. MDAC is part of an inclusive and committed advocacy community that goes well beyond the dental sector and includes behavioral health advocates, nurses, physicians, youth advocates, and AARP, among others. Backley credits this large network of stakeholders for helping to gain support for the bill. “MDAC’s network is its greatest asset, and it was instrumental in galvanizing the legislative support and helping people understand the connection between overall and oral health,” says Backley. When the hearing for the bill came up, more than 100 organizations signed on in support of it, and 30 individuals testified in its favor, including stakeholder representatives and patients, who spoke about what a profound impact dental care had on their overall health. ## Victory After a Years-Long Fight And now, 800,000 Maryland Medicaid adult beneficiaries will gain access to comprehensive dental coverage, including diagnostic, preventive, periodontal, and restorative services. No cap or annual maximum is applied to coverage, which will allow all individual patient needs to be met in a timely manner. Backley and Elliott recall the day they were waiting for the final vote on the bill. They were in constant communication throughout the day, and Elliott worked down to the last minute with legislative staff to make sure the bill’s language included everything they wanted. “We ended up getting everything we needed in the bill, which was, and is to this day, amazing,” says Elliott. “Then, it was one of the best phone calls I’ve ever made in my life, to Mary, who was the first person I called to tell the news.” ## Impact and Implementation Although this is a huge victory for MDAC and the people it fights on behalf of each day, MDAC’s work is not over. Now, they’ll shift their focus to implementation, which will include working with their partners and stakeholders on a significant education and outreach campaign to make sure people know that coverage exists and help them gain access. They’ll also work with the Maryland State Dental Association to inform their members that more providers are needed to cover the upswing in people seeking dental care. For Backley, the impact this new legislation will have on low-income adults in Maryland is remarkable, and she looks forward to fielding the many calls MDAC will receive from people looking for help. “I get a lot of calls to our office from people who are desperate and asking where they can get dental care,” says Backley. “Now when I get those calls, I can tell people that they will have dental coverage under the new law, starting January 2023. When I share that news, the joy and elation on the other end of the phone is indescribable. That’s quite extraordinary, and it’s the motivation to keep fighting. You are helping people in terms of changing their lives through their ability to get this critical care.” **Categories:** Blog **Tags:** Dental Coverage --- ### [Speaking Softly and Still Being Heard: Advice on Advocating for Yourself in a Professional Setting](https://carequest.org/blog/speaking-softly-and-still-being-heard-advice-on-advocating-for-yourself-in-a-professional-setting/) **Published:** June 6, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/You-got-this.jpg)Like many of you, becoming a health care professional, specifically a dental hygienist, was a dream job for me. The small-town practice I worked for really cared about their employees, patients, and the community. For many years as a clinical dental hygienist, I felt I had found my purpose. I loved my job and my patients, but like every good love story, there was a dark side. It didn’t take long for me to realize the standard of care I learned in dental hygiene school did not always match with office logistics and business constraints. Have you heard the phrase, “school is ideal not real”? Although, we performed oral health assessments, clinicians (dentists and dental hygienists) often felt pressured by patient expectations, insurance benefits, and office administrators to recommend a minimum care treatment plan — prophylaxis and brushing and flossing instruction — regardless of the oral health diagnosis. There was concern among co-workers that the cost and time commitment of a periodontal treatment plan would scare patients away. However, without the right treatment plan to mitigate oral disease, a patient’s oral health was at risk. It finally dawned on me that we were overlooking the multifactorial components of patient’s whole health. This is when I knew I wanted to do more with oral health care delivery and felt compelled to be part of the process for change. Taking a leap of faith that there would be a place for me, I continued my education, earning a master’s degree in dental hygiene public health with a focus on research. While working on my thesis project, I needed assistance with community oral health outreach and decided to contact my local professional association. Becoming involved with my professional association created a whole new perspective for me on the important role oral health professionals have in advocating for themselves and patients. It also provided networking opportunities and a chance to be involved in legislation. Once I learned the skills on how to advocate for community and professional concerns, it became easier to advocate for patients and myself. I also realized at that point that I wasn’t alone. People get this feeling of dissatisfaction and have a lack of fulfillment in their profession for a lot of different reasons. It’s not always an ethical dilemma about patient care and feeling the need to change industry standards. [Research shows](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8834764/) that long work hours, unfair pay, unrealistic expectations, and negative work culture can all contribute to work dissatisfaction and the desire to leave your job or sadly, your profession. Instead of leaving your profession, what if you were able to advocate for yourself, co-workers, and patients (customers) to improve conditions and create lasting policy change? In a time when burnout is becoming more pervasive in all corners of the health system — [something that can be harmful to both practices and patients](https://www.dentaleconomics.com/practice/article/14214763/the-staffing-shortage-is-limiting-dentistrys-recovery-whats-next) — I wanted to learn more. ## Why Don’t We Advocate for Ourselves? So why don’t we advocate for ourselves? Mostly because it feels uncomfortable and we might fail, not be supported, or worse, lose our jobs. Don’t you hate the feeling of sweaty armpits and a dry throat when you need to speak up in uncomfortable situations? Although the nervous feeling seems like torture, living in a chronic state of frustration isn’t good for you either. It’s never easy but advocating for yourself or others can be less difficult when you feel passionately about something. In his TED Talk, which has been viewed more than 7 million times, social psychologist Adam Galinsky, PhD, says that when feeling strongly about something and especially if you are advocating for others, changes in body language and tone of voice convey passion, increase credibility, and improve your chances of creating lasting change. [Galinsky explains](https://www.ted.com/talks/adam_galinsky_how_to_speak_up_for_yourself) that if we are going to speak up and want others to listen, we need to feel confident in our convictions and we need to be prepared. Drawing on his talk and other research, I’ve identified four advocacy actions to take if you want to create change for yourself and others. 1. **Identify the problem and know what you want.** We are most likely to see change if we clearly define the problem. Be sure to look at the issue through different perspectives to truly understand the scope of the problem and learn how it may affect others. Know what you want to see in place of the current situation. 2. **Develop your case.** Gather credible research on the topic from industry leaders such as the American Dental Association (ADA), the American Dental Hygienists’ Association, the Occupational Safety and Health Administration (OSHA) standards, the Centers for Disease Control and Prevention (CDC), or other reputable sources. This is the time to gain allies who are willing and able to have calm, rational, and positive discussions about the problem and potential solutions. 3. **Propose a solution.** Offer solutions that are flexible and reasonable. Offering more than one solution to a problem and being flexible lowers the defenses of decision makers and makes it more likely for you to get a resolution to the problem. 4. **Know when it is time to let it go or walk away.** One of my current co-workers uses the phrase “it’s not a hill I am willing to die on.” Is the topic at hand an issue you are willing to fight for until the bitter end? If it is, then you may need to cast a wider net to bring in new allies, learn more about the topic, and create novel solutions. Sometimes, it is necessary to let a particular situation rest until there are new policies in place or new information is available. [A recent CareQuest Institute blog post](https://www.carequest.org/about/news/workforce-win-dentist-and-dental-hygiene-license-portability-underway) on license portability is a good example of situation when advocacy efforts take time. ADA and ADHA are expecting a license portability contract between participating states to come into effect in the Spring of 2023. ## Advocacy Advice from Two Dental Hygiene Leaders In discussions with other dental hygienists who are now in leadership roles, common themes emerged that aligned with Galinsky’s advice on advocacy: identifying the problem, knowing what you want, gaining allies, finding solutions, and knowing when to walk away. - Sharity Ludwig, EPDH, MS, director of Alternative Care Models at Advantage Dental Oral Health Center and affiliated practices, shared her perspective on advocacy: “I hadn’t thought of it as personal advocacy, but I do advocate when it is needed for others.” Ludwig explained that she has been very fortunate to work with dentists who have empowered and mentored her and were advocates for improving the oral health of patients. “The office I worked for was providing patient centered risk-based care 20 years ago, moving beyond traditional care,” she said. “I enjoy providing population- based care.” She further explained that the dental hygiene laws in Oregon, where she is licensed, allows dental hygienists to work to their full scope of practice. “In addition, I have had the opportunity to work with dentists that supported team-based care,” she said. “They empowered and mentored the care team, which I was a part of, to work at the top of our license.” Ludwig’s experience could be like yours — you may already have the advocacy tools you need in your environment to be successful, which benefits both patients and employers. But sometimes it can be helpful to look beyond the walls of your practice. - After being a clinical dental hygienist for 19 years, Tameka Lee, MPA, RDH, BSDH, experienced job dissatisfaction in 2019 when additional job requirements were becoming difficult to manage. To help gain new perspective and create allies, she rejoined her professional association to reconnect with “her hygiene bubble.” She realized that she needed to advocate for herself and that she could also help other dental hygienists advocate for themselves. During the COVID-19 safer-at-home order, Lee began Empower RDH, a company that focuses on leadership, productivity, and the patient experience. Lee realized that part of the reason she was no longer enjoying her job was because she “had been stagnant (in her career) for so long” and decided to advance her education with a master’s degree in public administration. She uses her advocacy skills and new degree as a dental contract manager. She recommends four actions for hygienists to advocate for themselves: 1. Knowing your worth and your value. 2. Have a good partnership with the dentist. 3. Find a dentist who will allow you to work to your full scope of practice. 4. When possible, spend time temping or job-shadowing different offices to learn office culture and values. ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH The need to advocate for oneself and for others is going to happen at some point during a professional career if you are to grow. Sometimes we are perfectly happy in our personal and professional lives but overtime, small inequities may start to creep in. When these inequities are affecting your conscience and quality of life, it might be time to get out the advocacy toolbox and develop a plan for change, improvement, and growth. You may be surprised at how many other people, including your employer, will benefit from your willingness to speak up and help create solutions. *Authored by Kelly Schroeder, MS, RDH* **Categories:** Blog **Tags:** Health Equity --- ### [Why CareQuest Institute Grantmaking Focuses on Communities](https://carequest.org/blog/why-carequest-institute-grantmaking-focuses-on-communities/) **Published:** June 9, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Areas-of-Activation.png)CareQuest Institute’s [grantmaking efforts focus on five cross-cutting strategies](https://www.carequest.org/how-we-work/grantmaking): health and racial equity, social determinants of health, community-centered measurement, learning and capacity building, and innovation in oral health. Why those five areas? “We really do believe that working toward systems change is about looking deeper,” said Trenae Simpson, MBA, director of grants and programs at CareQuest Institute, during an April webinar, “[Community-Centered Grantmaking: Why, How, and What Lies Ahead](https://www.carequest.org/education/webinars/community-centered-grantmaking-why-how-and-what-lies-ahead).” Throughout the webinar, Simpson discussed that what initially began as a [grantmaking program](https://www.carequest.org/how-we-work/grantmaking) focused mostly on programmatic work to address specific needs in the community — like the lack of equipment or the development of local clinics — has evolved into a more systems-change approach centered on advocacy around oral health care policy on the local, state and national level. “It’s about challenging our assumptions and really getting to the root cause of issues that we want to address,” Simpson said. “We believe that everyone should have the same opportunity to be healthy, which obviously includes addressing their oral health and \[overall\] health. Equity is really that underlying principle that guides our collective actions as an organization.” To put that principle into action, CareQuest Institute works with grantees directly involved with and invested in their communities to create a more equitable oral health system. Two CareQuest Institute grantees represented their communities during the webinar: Jennifer Goldberg, deputy director at [Justice in Aging](https://justiceinaging.org/), and [Pareesa Charmchi Goodwin](https://www.carequest.org/about/news/behind-scenes-oral-health-advocate), former executive director at [the Connecticut Oral Health Initiative (COHI)](https://www.cthealth.org/grant/connecticut-oral-health-initiative-3/). Together with Simpson, Goodwin and Goldberg answered several participant questions toward the end of the webinar. Four of those questions are below: **1. What advice do you have for health centers that are not able to engage in policy work?** First, think about what partners might be in your area or state that are engaging in policy work and connect with them to understand how your unique voice adds value to what they are doing. This could be your primary care association or a local or state oral health coalition. Second, build a repository of information and data highlighting the specific needs of your patient population. While community health centers may not engage in policy work directly, they often times are in close proximity to low-income communities that are the most at stake in many areas of oral health policy. Collecting their stories and information can be a meaningful tool to drive change. **2. What is the biggest challenge Justice in Aging faces in advocating for Medicare Part B to include dental benefits?** The legislative deadlock in Congress. There’s strong bipartisan support to include dental in Medicare, so it’s a matter of the opportunity in Congress to move the legislation forward. To help create that opportunity and continue the momentum that’s been building over the last few years, we’re continuing to meet with policymakers, highlight the need and disparities in access and outcomes through educational materials and media, and build support at the state and local levels. **3. How does the Connecticut Oral Health Initiative measure success?** We track accessible oral health data and the outcomes and progress of our legislative and administrative policy advocacy campaigns (which is the bulk of our work). This directly aligns with our vision of working toward all Connecticut residents will have equal opportunity to obtain the services needed to maintain good oral health. **4. How do we make sure we (organizations’ workforces) have the cultural humility and appropriate processes to engage communities and avoid perpetuating historical harms?** There is no easy or short-term solution for this. Building deep and meaningful relationships with communities relies on trust, which is something that is fostered over time. Fortunately, we have a network of partners that have been engaging communities meaningfully that love to share their experiences. There are also some tools in the field that can support the operationalizing of intentional community engagement. *For more information about CareQuest Institute’s grantmaking efforts, [visit http://carequest.org/grantmaking.](https://www.carequest.org/grantmaking)* **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Taking Action on Racism: An Inside Look at a Special Issue](https://carequest.org/blog/taking-action-on-racism-an-inside-look-at-a-special-issue/) **Published:** June 21, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Eleanor-Fleming.png)Eleanor Fleming, PhD, DDS, MPH, FICD What is the oral health industry’s role and responsibility in addressing racism in our country? “In contrast to other disciplines (public health and medicine for example), dentistry as a discipline has been relatively quiet in the space of anti-racism,” said Eleanor Fleming, PhD, DDS, MPH, FICD, assistant dean for equity, diversity, and inclusion at the University of Maryland School of Dentistry. “This special issue in many respects fills a void and offers a strategic path forward for dental public health using the lens of anti-racism.” Fleming and Julie Reynolds, DDS, MS, assistant professor in Preventive and Community Dentistry at the University of Iowa, are guest editors on [a special *Journal of Public Health Dentistry* issue on anti-racism that was released this week](https://onlinelibrary.wiley.com/toc/17527325/2022/82/S1). The issue includes 19 articles — a mix of original research, commentaries, editorials, and community action reports — that cover a range of topics related to anti-racism, including the effects of discrimination and anti-racist solutions for research, education, practice, advocacy, and workforce. ![](https://carequest.org/wp-content/uploads/2022/06/Reynolds20221-450.jpg)Julie Reynolds, DDS, MS “We used a combination of personal invitations and open calls for authors to submit their work,” Reynolds said. “There were a number of scholars for whom we were familiar with their work in this area, and we knew we would like to invite to submit. But we also reserved several article slots for open call submissions. This combined approach worked really well to create considerable diversity of authors — ranging from budding dental student scholars to decades-long leaders in the field, and from advocates to practitioners and researchers.” ## Origins of the Issue on Anti-Racism The special issue is one action step from the American Association of Public Health Dentistry’s white paper, [“Anti-Racism in Dental Public Health: A Call to Action,”](https://www.aaphd.org/assets/Webinars/White%20paper%20FINAL%20July%202021.pdf) which was published in July 2021. The white paper outlines, from the perspective of AAPHD’s councils, what work is needed to realize the anti-racist solutions for dental public health. “It is important to note that the white paper was AAPHD’s intentional effort to call out racism as a problem in dental public health and anti-racism as a possible solution,” Fleming says. “A special issue on anti-racism in dental public health became the logical first step.” The work on the issue began the next month and has been a collaborative effort for the last 15 months between Reynolds, Fleming, and the distinguished authors. “Having described the problem in the white paper,” Fleming says, “the special issue offers solutions and best practices where possible and further clarifies the problem in other areas.” ## Five Questions for the Editors Just before the issue was published, we connected with Reynolds and Fleming to ask five questions to better understand the why and how of the project — and what’s next. **Who is the intended audience for the issue?** Anyone who belongs to the space of dental public health, anyone interested in public health, and anyone with an interest in oral health. To be sure, this special issue will hopefully be of interest to anyone interested in health equity. **What do you hope readers do after spending time with the journal? What actions are the editors and authors hoping to see?** We hope that readers won’t treat this special issue as another issue to read through and put on a shelf — if they have a hard copy. We hope that readers will critically engage with the content, taking time for introspection and reflection, and bring to their work a lens of anti-racism. While the journal is not exactly a how-to book, we hope that the reader will finish resourced for action. The issue covers science, education, practice, and policy, so, hopefully, readers can take action in these spaces. **Recent research from CareQuest Institute identified that in the last year, nearly half of Hispanic adults (49%), Asian adults (49%), and Black adults (48%) [reported experiences of discrimination in an oral health care setting](https://www.carequest.org/content/state-oral-health-equity-america-2022), compared to 33% of white adults. What’s your reaction to reading that?** If patients report discrimination while seeking oral health care services, this should concern those of us who practice dentistry, in whatever capacity that we practice. One could argue that the patients are reporting experiences related to racism and their relationship with institutions perpetuating racism. One could also argue that these patients are experiencing interpersonal racism where the biases of providers or oral health care setting staff are impacting the patients. Whether the experience is interpersonal or structural, if the root cause is racism, individuals committed to health (and hopefully health equity) should see this as a call to action. No patient should ever seek oral health care and leave feeling discriminated against. **Why is it critical for the next generation of dental professionals to learn about anti-racism?** If we are not part of the solution, then we are part of the problem. I think most dental students (and much of the general public) don’t understand that racism encompasses so much more than just overt racial discrimination. At an individual level, most racism is unconscious, meaning that most racist behavior occurs without the individual being aware of it. Dismantling it, therefore, requires increased knowledge and awareness about racism and anti-racism to check and reduce our biases. At a structural level, we need to be engaged in critically examining and speaking up about the policies and institutions in which we operate, with the goal of creating policies, systems, and institutions that are more diverse, equitable, inclusive, and just. Without taking these actions, we maintain the status quo of a profession and delivery system that is not representative and not meeting the needs of the communities we serve. **What more can the oral health industry do to become a leader in this area? Do you both think that’s possible?** Yes! Organizations can start by articulating anti-racism and oral health equity as part of their vision, mission, and goals. They can examine equity and belonging within their employees, patients, and/or memberships and act to improve upon it — including tracking progress. They can provide training opportunities to raise awareness about racism and unconscious bias. They can also read our special issue for more ideas. *Editor’s Note: To learn more about the special issue on anti-racism and hear a roundtable discussion with some of the authors, look out for an upcoming CareQuest Institute webinar on July 21.* **Categories:** Blog **Tags:** Health Equity --- ### [How SMILE Health Is Reimagining Oral Health Innovation](https://carequest.org/blog/how-smile-health-is-reimagining-oral-health-innovation/) **Published:** June 16, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/SMILE.png)What adjectives would you use to describe the oral health system? Traditional? Effective? Reliable? One adjective that often gets left out of the conversation: innovative. “There is a lack of innovation in oral health in a couple of ways,” says Kirill Zaydenman, MS, vice president of innovation at our for-profit subsidiary CareQuest Innovation Partners. “One is that dentistry has not kept pace with change in other industries that have been undergoing digital transformation. The other is within public health — it’s a hugely underserved market.” [SMILE Health is trying to change all of that](https://carequestinnovation.com/smile/). The acronym, SMILE, which stands for Simple, Minimally Invasive, Integrated, Low-Barrier, and Equitable Health, serves as the foundation for the accelerator created by CareQuest Innovation Partners and MATTER, the premier health care incubator and innovation hub. Launched in early March, SMILE Health sought novel solutions to make oral health more accessible, equitable, and integrated. So far, the results have been overwhelmingly positive. “The market receptivity metrics were double what we had expected at the top end of our range, given analogous programs in other industries,” Zaydenman said. In six weeks, from March 9 to April 22, SMILE Health received more than 100 applications from start-up companies spanning 11 countries and 28 US states. Of those 101 applications, 80% have female founders and 80% have diverse leadership. During the next 12 weeks, the finalists will participate in an intensive 12-week process culminating with a Demo Day for potential investors and customers during the week of September 12. As the first cohort begins its journey, Zaydenman and Mariya Filipova, MBA, chief innovation officer at CareQuest Innovation Partners, provided some insight into the origins of the program, the goals they are working toward, and the road ahead for the finalists. **Can you share the origins of SMILE Health? What gaps is it trying to fill in the industry?** **Mariya:** First, there was a gap in funding early-stage start-ups. Funding tripled in digital health during the pandemic, but the vast majority, 60%, went to more mature companies, not early-stage companies. The second gap is around innovating for underserved communities and the public health audience, not just commercial markets. And the third piece is really that notion that oral health could be part of overall health, that solutions can purposefully bridge the gap between those two artificially created silos in the way we deliver care and think about health overall. **Are there other programs like this in the oral health space? What makes this one different?** **Mariya:** There are two pieces that are unique to this program. Number one, it’s about the gaps that it serves. CareQuest Innovation Partners, along with CareQuest Institute \[its nonprofit parent organization\], is uniquely positioned to identify those gaps and find solutions that are real, rather than shiny new toys. That’s the first big differentiator. The second one is truly the design of the program. We have evolved the traditional incubator model. What makes SMILE so different is the fact that there is a curated set of what we call impact partners — companies that become accelerators to scale and possible customers for all these solutions. We’re calling them impact partners because, over the course of the program, they validate the potential for that solution to have a meaningful impact and, at the end of the program, have the option to deploy the solution in their own organization with their patients, customers, or employees. **CareQuest Innovation Partners is fortunate to have leaders who have experience with accelerator programs like this. From what you’ve seen, is funding the limiting factor for most of these start-ups?** **Mariya:** What we have found out from our experience in these industries is funding is never the rate-limiting factor to scale. It’s access to customers. And that’s what we have designed SMILE Health around. That’s the one barrier that very few organizations in the industry can remove. And with the very thoughtful, deliberate design of SMILE, we’ve been able to provide access to insights, business case development, and workflow implications that make it easy for customers to adopt the innovative solution and do that sustainably at scale. **Let’s turn to the potential solutions. What has the response from innovators in the field been like so far?** **Kirill:** Qualitatively, what we’re hearing from people are things like, “This is exactly what’s needed to move the industry forward.” In terms of the numbers, we exceeded our expectations. Based on similar programs that MATTER has run across diabetes, women’s care, pulmonary fibrosis, and other similar type programs, they had told us to expect about 30 to 50 applications. We ended up doubling that. **So, you’re clearly seeing a need in the marketplace. What else are you trying to learn in this first year?** **Kirill:** We’re really trying to understand three things: Market receptivity and readiness: - Does the market need this? - Measures of impact: Are these start-ups getting access to capital and customers? - Capability fit: How can we execute a program like this? Can we do it seamlessly? Can we operationalize it? On that first measure of market interest, I think it’s been quite tremendous to date. Those other two things, impact and execution, we continue to track, but market interest seems to be there, so we’re cautiously optimistic. **Which start-ups made it to the final round?** **Kirill:** Here are some of the sample solutions the cohort companies are innovating around: - There is a company that is innovating around at-home saliva screening to diagnose oral cancer a lot earlier. - There’s a company that is democratizing access to sleep apnea diagnosis and treatment through dental offices. - There’s a company that is innovating around how to make hall crowns, which are a noninvasive technique (and a more equitable way) for kids to get crowns. - There’s a company that is leveraging the power of AI and machine learning technology to enable precision and customized patient care. - The last company is using virtual reality during certain types of surgeries to reduce the use of sedation and anesthesia. The most important thing was to make sure that the companies aligned with one of our three tracks of making oral health more accessible, more equitable, and more integrated. We were also assessing the quality, feasibility, and business viability perspectives. And we were looking to see if they were differentiated from other solutions in the market. We were making sure that we thought that the team could ultimately develop and execute the solution. **What is the cohort experience going to be like? What’s on deck for the next 12 weeks?** **Kirill:** The next 12 weeks are about three things: 1. One-on-one time spent with high-profile mentors that have specific expertise to guide the start-ups through the key questions and key needs that they’re working on. 2. Virtual weekly instructional sessions and discussions with experts in topics of interest for these start-ups. This could be around dental reimbursement, workflow, oral health equity, and oral health access. This could be around design thinking. And they’ll be preparing for pitch day. 3. Validation study development, the hands-on work with the matched impact partner to the start-up. This is where they directly work with that partner to validate market readiness of an aspect of their solution. **Lastly, how can interested individuals get involved in SMILE Health?** **Mariya:** We’re always seeking collaborators across the oral health community — and beyond. SMILE Health provides an opportunity to work with oral health visionaries and be a part of systemic change across the industry. To that end, we invite oral health experts, researchers, payors, providers, investors, community leaders, advocacy group members, and representatives from pharma/biotech/device corporations and health systems to [connect with us](https://carequestinnovation.com/smile-health-get-involved/). **Categories:** Blog **Tags:** Health Equity, Minimally Invasive Care --- ### [A New Oral Health Outlook for 2 Million Americans](https://carequest.org/blog/a-new-oral-health-outlook-for-2-million-americans/) **Published:** June 28, 2022 **Author:** Caitlin Locklear **Content:** It’s a troubling reality you’ve likely read about before: Millions of Americans, especially those with lower incomes, people of color, and those living in rural communities, cannot secure the dental care they need due to a variety of factors, including cost, coverage, provider availability, and social determinants of health. As a result, there are wide disparities across [racial, ethnic, and income groups](https://www.carequest.org/state-of-oral-health-equity-america-2021). Those disparities result in poor oral health, which has been associated with higher risk for diabetes, cardiovascular disease and stroke, complications in pregnancy and childbirth, adverse mental health outcomes, and other conditions that are costly to treat. But hope — and significant activity — is on the horizon. During the 2022 legislative sessions, Hawaii, Kansas, Maryland, New Hampshire, and Tennessee enacted legislation and budget measures to create or expand Medicaid adult dental benefits, which [can help reduce those disparities and improve much-needed access to dental care](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2021.01191). That means that nearly 2 million people will soon be gaining access to Medicaid dental benefits. Further, several other states have secured additional legislative and administrative victories for their Medicaid programs that will expand eligibility, coverage, and access to care. ## Securing Medicaid Dental Benefits Although states are required to provide dental benefits for children covered by Medicaid and the federal Children’s Health Insurance Program (CHIP), adult dental coverage is not similarly mandated. States have the option to limit the type or amount of services and populations they will cover. Furthermore, states can exclude adult dental services entirely. Today, while most states provide at least emergency/urgent dental benefits for their adult Medicaid beneficiaries, [nearly one-third of states do not provide dental care beyond emergency procedures](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/whitepaper_0721.pdf). Advocates and policymaker champions work daily to try to change that. In states across the country, those stakeholders have long sought to begin closing the disparities gap by securing Medicaid adult dental benefits in their states. They made great strides in 2020 and 2021, as Delaware, Oklahoma, Virginia, West Virginia each implemented new or significantly expanded benefits for all Medicaid adult beneficiaries in their states. Colorado, Massachusetts, and Minnesota restored certain dental services that had been previously cut, and Texas approved a limited preventive benefit for adults with disabilities. Furthermore, [Maine](https://www.carequest.org/about/news/voices-field-danica-loring-workforce-solutions-maine) approved the creation of an extensive dental benefit for all adult beneficiaries while Louisiana approved the creation of a similar benefit for adults with intellectual and developmental disabilities. These new benefits will take effect in both states on July 1, 2022. These hard-fought legislative wins have been years in the making and have been secured thanks to the persistence of community members, advocates, and legislative champions. The wins have been bolstered by strong economies and a growing understanding of the connection between oral health and overall health and the cost savings associated with providing dental benefits and regular care. ## Momentum Behind Dental Benefit Wins in 2022 Here’s a rundown of the latest developments from the 2022 legislative session: **Hawaii** – The state eliminated all non-emergency dental benefits for adult Medicaid beneficiaries in 2009 during the economic downturn. Governor David Ige included $10.2 M ($3.5 in General funds and $6.7M in Federal funds) in his FY2023 supplemental budget for a prevention-based package of benefits. [HB 1754](https://legiscan.com/HI/bill/HB1754/2022) and [SB 1294](https://legiscan.com/HI/bill/SB1294/2022) outlined a menu of three options for restoring benefits ranging from a basic to extensive package. In May 2022, the Legislature approved the state budget which included $25.9M ($8.8M in General funds and $17.1M in Federal funds) for Medicaid adult dental benefits. The new benefit, which will be designed and implemented by the state’s Department of Human Services Med-QUEST Division, is slated to begin on January 1, 2023. **Kansas** – On April 20, Governor Laura Kelly signed the FY2023 state budget, which included $3.5M in funding to extend dental benefits to all adults enrolled in the state’s Medicaid program. Kansas currently provides only emergency extractions to its adult Medicaid members with some additional dental services offered through the state’s managed care organizations as value-added benefits. While a final package of services will be designed by the Kansas Division of Health Care Finance in consultation with [Oral Health Kansas](https://www.oralhealthkansas.org/MedicaidAdultDentalBenefits.html) and other partners, it is expected that all adult beneficiaries will have access to preventive and restorative care when the new benefit is implemented later this year. **Maryland** – On May 12, Governor Larry Hogan signed [SB150](https://legiscan.com/MD/bill/SB150/2022) which creates a Medicaid dental benefit for all adults. Currently, the majority of adult Medicaid members are covered only for emergency services for dental problems provided in a hospital emergency room. (Maryland currently provides an extensive benefit to pregnant adults, former foster care recipients under age 26, and individuals enrolled in the Rare and Expensive Case Management Program. The state’s Medicaid Adult Dental Waiver Program also currently provides a limited benefit \[$800 per year\] for adults who are dually enrolled in Medicaid and Medicare. All remaining adult beneficiaries are covered only for emergency services for dental problems provided in a hospital emergency department.) Beginning January 1, 2023, all adult beneficiaries will have access to diagnostic, preventive, periodontal, and restorative services. There will be no cap or annual benefit maximum applied to the benefit which will allow all individual patient needs to be met in a timely manner. The Legislature included a fiscal note of $66M for the first six months of the program and an additional $132M for FY 2024. **New Hampshire** – In May, the New Hampshire Legislature passed companion bills in the [House](https://legiscan.com/NH/bill/HB103/2022) and [Senate](https://legiscan.com/NH/bill/SB422/2022) which create a dental benefit for all adults. Set to begin in 2023, the benefit will include diagnostic, preventive, restorative, and oral surgery services. Adults with developmental disabilities, acquired brain disorders, and seniors and adults with chronic illness or disabilities enrolled in the Choices for Independence program will also have coverage for dentures. Currently, New Hampshire offers an emergency-only Medicaid dental benefit to its adult beneficiaries. It is estimated that the new benefit will cost approximately $24M ($6.9M in state funding and $17M in federal funding). As outlined in the bills, the state funding portion would come from the $21 million state settlement with Centene Corporation. At the time of this writing, both bills are being prepared for submission to Governor Sununu who has supported the development of the benefit and is expected to sign. **Tennessee** – Tennessee has been one of a small number of states that has not offered a dental benefit to adult beneficiaries. In January, the state announced it would begin providing extensive dental [coverage to pregnant and postpartum beneficiaries beginning on April 1, 2022](https://www.tn.gov/content/dam/tn/tenncare/documents2/AdditionalMaternalHealthBenefits.pdf). In February, Governor Bill Lee released his budget recommendations, which included $75.5M ($25.5M in general funds and $49.9M in federal funds) to provide dental benefits for the program’s approximately 610,000 adult beneficiaries. In addition to including the Governor’s recommendation in its [approved budget](https://www.tn.gov/content/dam/tn/finance/budget/documents/bgtdocsarchive/2023BudgetDocumentVol1.pdf), the Legislature also included funding for a dental provider rate increase as well as $11.8M (general funds) to support dental schools in effort to ensure an adequate provider network to care for adults with newly acquired dental coverage. Funding will be used to expand the class sizes at the state’s two existing dental schools (Meharry Medical College School of Dentistry and University of Tennessee College of Dentistry), recruit and retain dentists through loan repayment, and expand prosthodontic services. (In addition, Lincoln Memorial University (LMU) will open a dental school in the fall of 2022, and the budget includes $3M to establish a pilot program to serve East Tennessee in partnership with the LMU-College of Dental Medicine.) ## Efforts to Expand Dental Benefits Continue in Other States Advocates and their partners from Arizona and Michigan, to name a few, have drawn on the experience and expertise of their colleagues in different states and are well on their way to successfully expanding their Medicaid adult dental benefit offerings. Through participation in collaborative efforts such as OPEN’s Medicaid Adult Dental Benefit Collaborative (MADBLC), advocates from those states and from across the country serve as supports and resources for one another – sharing strategies, best practices, messaging tips, materials, and encouragement. Since 2017, Arizona has provided an emergency-only adult dental benefit capped at $1,000 per person per state fiscal year. Oral health advocates secured modest expansions in preventive coverage for elderly and disabled adults in 2016. In 2021 (and several preceding legislative sessions), there was significant bipartisan interest in and support to create an extensive benefit for pregnant adults, but the Committee held the bill due to cost concerns — particularly the one-time, initial appropriation to administer the program (estimated at $3.6 million). Concerns were also raised by dentists, who cited a preference for preventive care and pre-conception health to mitigate the risks associated with untreated oral disease during pregnancy. Stakeholders believe that their best course of action is to advocate for an extensive dental benefit for all adults in 2023 and are working to identify legislative champions. ![](https://carequest.org/wp-content/uploads/2025/09/Stacey-Auger-topaz-202x300.jpg)Stacey Auger, MPH In Michigan, Governor Gretchen Whitmer included $243M in the FY2023 state budget to consolidate all Medicaid dental benefits (Healthy Kid’s Dental, Healthy Michigan Plan Dental (Medicaid expansion) and the Adult Fee-for-Service Program) into one managed dental plan. Currently, the Healthy Kids Dental program provides comprehensive benefits to Medicaid-enrolled children under the age of 21 and robust reimbursement rates for participating providers while the Adult Fee-For-Service dental program has limited benefits and reimbursement rates that have not been updated in over 30 years. The House and Senate have proposed to increase rates in the Adult Fee-For-Service program. The Conference Committee is currently negotiating the final budget. Advocates and the dental community have called on the Legislature this session to consolidate all dental benefits into one plan and have focused on expanding the benefit package, increasing utilization, increasing provider reimbursement rates, and improving dentist participation in the Medicaid dental program. *Authored by Stacey Auger, Policy Consultant, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Danica Loring on Dental Workforce Solutions in Maine](https://carequest.org/blog/voices-from-the-field-danica-loring-on-dental-workforce-solutions-in-maine/) **Published:** July 5, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Danica Loring, EFDA, CDA, works as a dental practice manager at Penobscot Community Health Care (PCHC) Dental Center, a nonprofit in Maine. She helps PCHC achieve its mission of providing comprehensive, integrated primary health care services to improve the health and well-being of patients in the Maine community. Danica’s 15-year career as a dental assistant helped hone her passion for direct patient care. In her new role, she oversees PCHC’s Dental Assisting Training Program, which provides on-the-job training to new dental assistants. Danica took some time out of her busy schedule to share her perspective on the recent success of a multiyear effort in Maine to extend dental coverage to low-income adults — and the role dental assistants can play in curbing the workforce shortage. (On July 1, MaineCare, the state’s Medicaid program, will [expand dental coverage for adults and increase reimbursement rates for dental providers](https://www.newscentermaine.com/article/news/health/gov-mills-announces-expansion-of-mainecare-dental-coverage-maine-health-insurance/97-ee4ca24b-b9a1-4f15-96d9-fd03a7231ee8).) Below, Danica explains the details of the training program and other workforce challenges facing the oral health industry. ![](https://carequest.org/wp-content/uploads/2025/10/Danica-Loring-e1766089531178.jpg)Danica Loring, EFDA, CDA **To your knowledge, how long has the dental assistant shortage existed in Maine? How does the shortage affect patient care?** It has been challenging for some time to find an experienced dental assistant in Maine. When the [COVID-19 pandemic arrived](https://www.carequest.org/resource-library/dental-cares-new-normal-survey-reveals-need-adapt), the shortage certainly experienced a new high and directly impacted patient care. The shortage affects the number of patients providers can see within a given day. Without enough assistants, a provider’s daily workflow is interrupted, which means others must take on additional responsibilities that result in overworked and exhausted staffs. **Can you explain how the [PCHC](https://pchc.com/location/penobscot-community-health-center/) Dental Assisting Training Program works to help address the dental workforce shortage?** [The program](https://pchc.com/dental-assistant-training-program-graduates-its-first-class-of-das/) is unique because it’s small and the candidates (no more than six at a time to ensure adequate training) don’t have direct experience in dentistry, but they are patient-centered and are eager to learn. First, PCHC uses an outside consultant to execute the training programs. There are weekly morning training sessions composed of didactic work and hands-on training where candidates learn the fundamentals of infection control, four-handed dental assisting, terminology, and dental software. The candidates are then integrated into our clinical staff, including shadowing dental assistants. By the middle of the program, the trainees are sitting chairside with another assistant available to oversee them assisting in basic restorative procedures. By the end of the program, they assist in extractions, root canals, and other procedures. During the program, candidates also gain the knowledge and education to complete radiation health and safety exams through the Dental Assisting National Board. This ultimately allows them to apply for their Maine Dental Radiographer License. Afterward, the clinical operations supervisors continue to work with candidates as needed. During the program, candidates gain the knowledge and education to complete radiation health and safety exams through the Dental Assisting National Board. This ultimately allows them to apply for their Maine Dental Radiographer License. **How do you think the expanded adult dental benefit will impact your work?** We are excited and preparing as much as possible. On July 1, Maine’s MaineCare system will be expanding their covered services to patients 21 years old and older. The expansion of services has been long overdue. While PCHC accepts MaineCare patients, unfortunately, there is a limited amount of other dental facilities that do, limiting overall accessibility for these patients. There is still a lot to work through for more people to gain accessibility and coverage. **What does gaining comprehensive dental coverage mean for the health of individuals with Medicaid in [the state of Maine](https://www.carequest.org/about/news/new-oral-health-outlook-2-million-americans)?** It creates equity for those that once didn’t have access to the same care as others. It gives adults access to preventive care that, in return, impacts not only their oral health but their entire well-being. It also allows individuals to have good experiences with dental facilities rather than experiencing them only in the case of an emergency and when in pain. Are there other workforce challenges or shortages you are seeing within oral health? Throughout the pandemic, the dental community faced challenges. The entire staff, including the front office assistants, hygienists, assistants, and providers have been on a roller coaster for over two years now. Dental teams are overworked and exhausted yet continue ahead at full speed. It’s important as leaders in the field to find ways to support staffs with resources to feel appreciated. **Categories:** Blog **Tags:** Dental Coverage --- ### [Six Steps to Setting Up a Teledentistry Program](https://carequest.org/blog/six-steps-to-setting-up-a-teledentistry-program/) **Published:** July 11, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Teledentistry.jpg)CareQuest Institute has explored the value and potential of teledentistry and observed that virtual encounters can be a flexible and important care delivery methodology that [improves access to dental care](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time), [increases equity](https://www.carequest.org/resource-library/teledentistry-opportunities-expanding-capacity-and-reach-oral-health-ca-1), and [reduces costs](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money). Although numerous resources exist (three linked in the previous sentence) on teledentistry, we often hear the question, “Where do I start?” A recent webinar, [“Building a Teledentistry Program That Expands Access and Increases Equity,”](https://www.carequest.org/education/webinars/building-teledentistry-program-expands-access-and-increases-equity) proposed some answers. Drawing on that webinar, this post, while not a comprehensive guide, will walk you through six steps to consider when starting a teledentistry program. ## 1. Identify the specific teledentistry need. First, consider the patient populations you already care for and how they could benefit from teledentistry. Also think about new patient populations you’d like to reach using this modality. Is there a specific population or geographic region in your state that lacks access to oral health care services? You may also want to ask your existing patients or community members their opinions on teledentistry and how they may utilize it if offered the opportunity. ## 2. Review state teledentistry policy. States have different policies (or lack thereof) defining teledentistry, who can practice with teledentistry, from where, and which services are permitted and billable using the modality. Medicaid and private insurance, for example, may limit billable services to specific procedure codes, and in some states, teledentistry services may be allowed only in certain areas, such as those deemed Health Professional Shortage Areas (HPSAs). Rules may vary regarding unsupervised (by a dentist) delivery of teledentistry services by auxiliaries (such as dental hygienists), as well as requirements providers must meet before they can deliver care remotely. For example, Ohio requires dentists to obtain a specific permit before providing teledentistry services. If you need help navigating the existing statutes, call or email your state dental board or dental association. ## 3. Identify use case and technology needs. Decide which use case of teledentistry best fits the needs of your patients and community, organization, or office. You can make this determination based on your patients’ needs as well as what’s allowed and reimbursable in your state (i.e., the first two steps above). For example, if you know your community has high rates of emergency department (ED) visits for dental conditions, you may want to start a teledentistry program that focuses on triaging urgent needs — especially if your state Medicaid reimburses for those triaging services. Or, if you want to provide children in your community with better access to preventive care, you could start a community-based teledentistry program in which a hygienist visits schools or Head Start programs, delivers preventive care, conducts assessments, and sends the dentist the assessment data for an asynchronous teledentistry exam. In this case, you’d need to check whether your state allows hygienists to practice with general supervision, and whether asynchronous services are reimbursed through state Medicaid. You should also consider specific equipment requirements or rules requiring informed consent and documentation in your state. You don’t have to limit your practice to one use case, but if you’re starting out, it may be best to pick one and try it. Once you have identified how you want to use teledentistry, you’ll need to identify and potentially purchase the technology needed for the use case you will implement (e.g., laptop, cell phone, teledentistry software, intraoral camera, intraoral scanner). ## 4. Design a workflow. Identify providers and staff who are willing to implement teledentistry and create a workflow(s) that details which staff will perform which services, when, how, using what technology, etc. [Here’s an example workflow for an emergency appointment](https://www.carequest.org/resource-library/teledental-emergency-visit) and [another](https://vahealthcatalyst.org/wp-content/uploads/2020/04/Teledentistry-Workflow-1.pdf). Below is a hypothetical situation that might arise: Let’s say a patient calls your office after hours with an emergency. You, the dentist, request and are granted consent to do a teledentistry visit and ask the patient to capture an image of the area in question. You inform the patient that the visit will be confidential and recorded in their chart for reference. As you would in the office, you should ask SOAP (Subjective, Objective, Assessment, and Plan) questions. After recording the subjective (patient’s initial complaint), record the pain on scale of 1-10. Determine whether there’s any external or internal swelling. (This may require additional pictures — you can coach the patient to use a spoon or two, for example, to retract for intraoral photos.) Then you might ask some questions: Is there any drainage or pus when they push on it? Any difficulty in swallowing? Does swelling feel firm or squishy? You should also ask for the patient’s temperature to assess systemic involvement. Note the duration of the condition and the course — is it getting better or worse? Discuss any comorbidities (diabetes, immune disease, etc.), attempts at home treatments and results, and ask any additional follow-up questions. Then make an assessment and corresponding plan. If care is urgent, send the patient to the ED. Otherwise, offer palliative treatment for pain and schedule an in-person follow-up appointment. Finally, record all the information in the patient’s permanent dental record. ## 5. Train staff. It’s critical to train staff on what teledentistry is, how you will be using the modality, and how to use the indicated technology. This will help ensure that staff can deploy the technology appropriately and integrate it into workflows. Create a time and space where staff can learn how to use the technology (e.g., teledentistry software or intraoral camera or scanner), ask questions, and work together to smoothly complete the workflow in a testing environment. ## 6. Start small. Test teledentistry workflows with one provider and patient, or a small group of providers and patients. Then, iterate on success, and gradually increase the number of patients and providers involved in the program. Track the type and number of teledentistry services provided and types of patients seen via teledentistry over time so you can evaluate the impact and effectiveness of the program. All of this helps to gain provider/staff and patient buy-in and build program sustainability. Teledentistry is an increasingly popular option with both providers and patients. Once you get started, you’ll be on your way to meeting the needs of your patient population in innovative new ways. In the meantime, we invite you to explore the CareQuest Institute [resource library](https://www.carequest.org/resource-library?title=&field_type_target_id=All&field_category_target_id=533), including papers on [dentist perception](https://www.carequest.org/resource-library/dentist-perceptions-about-value-teledentistry) of teledentistry and a [framework](https://www.carequest.org/resource-library/teledentistry-opportunities-expanding-capacity-and-reach-oral-health-ca-1) for states and territories to expand it. *Authored by Caroline McLeod, RDH, MS, and Marybeth Shaffer, DMD* *Editor’s Note: Caroline is the value-based solutions manager at CareQuest Institute, and Marybeth is dental director at Community Action Agency of Columbiana County in Ohio.* **Categories:** Blog **Tags:** Practice Management, Value-Based Care --- ### [A New Look for Medicaid Adult Dental Benefits](https://carequest.org/blog/a-new-look-for-medicaid-adult-dental-benefits/) **Published:** July 22, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2022/07/Snapshot-of-Medicaid-Adult-Dental-Coverage-Checker-2021.png)This week, CareQuest Institute for Oral Health released the [Medicaid Adult Dental Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) in partnership with the American Dental Association (ADA) Health Policy Institute, the Center for Health Care Strategies, Inc., and the National Academy for State Health Policy. The Checker provides a snapshot of a state’s Medicaid adult dental benefits, allowing individuals to better understand the details of their state’s offerings and identify potential areas for improvement. (It’s important to note that the Checker contains information on benefits in the spring of 2020; [several states have expanded](https://www.carequest.org/about/news/new-oral-health-outlook-2-million-americans) in the last two years.) For many years, policymakers and advocates have relied on the ADA classification system to see these benefits. Adopted and adapted by other organizations, this system classifies Medicaid adult dental benefits into four categories: extensive, limited, emergency, and none. While this classification system has served the oral health community well for many years, the four organizations decided that states would benefit from a classification system that provides clear guidance on: - the specific covered service categories necessary to constitute an extensive benefit - the specific procedures to be covered within each service category - the specific service frequency to be covered - whether coverage is offered to all adult Medicaid beneficiaries or only to select subsets Michael Monopoli, DMD, MPH, MS, FACD, FICD, vice president of grant strategy at CareQuest Institute, and Stacey Auger, MPH, a policy consultant at CareQuest Institute, have been at the center of the core team that has worked on this project for the last several years. Below, they share more about the origins and goals of the Coverage Checker. **Let’s start at the beginning. What was the impetus to develop a new way to look at Medicaid adult dental benefits?** **Mike and Stacey:** The idea came to us during the [Oral Health 2020 Campaign](https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/oral-conditions#:~:text=Healthy%20People%202030%20focuses%20on,get%20oral%20health%20care%20services.&text=Regular%20preventive%20dental%20care%20can,re%20usually%20easier%20to%20treat.&text=But%20many%20people%20don%27t,they%20can%27t%20afford%20it.) after a period of very significant expansion and restoration of Medicaid adult dental benefits in several states. CareQuest Institute and the ADA Health Policy Institute collaborated to update the ADA’s classification of states based on these policy wins. After doing so, we shared the new round of state classifications with our grantees and partners, which led to a robust discussion regarding benefit levels and state placement within the classification system. CareQuest Institute convened a workgroup that quickly decided the oral health community would benefit from a new assessment tool. We wanted to develop something that moved us beyond simply counting the number of procedures covered. **Why is it important for oral health stakeholders to understand the details of adult dental benefits?** **Mike and Stacey:** As we learn more about the [connections between oral health and overall health](https://www.carequest.org/resource-library/impacts-beyond-mouth), we need to strengthen state programs and services to ensure they’re improving oral health and meeting patient needs. A dental benefits package that includes coverage for a robust array of services — diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, and extractions — has the best chance of doing that. States need to understand what constitutes an extensive benefit, and the Coverage Checker can help. It not only defines what an extensive benefit is, but it also outlines the specific covered service categories necessary to constitute an extensive benefit, the specific procedures to be covered within each service category, and the specific service frequency to be covered. We’d like to see all states offer an extensive benefit to all their Medicaid adult beneficiaries. But we also know that improving benefit packages can take time and that some states will need to take an incremental approach. **Can you talk about the Rubric that yielded the data for the Medicaid Coverage Checker? How was it created?** **Mike and Stacey:** The Rubric is a survey designed to be completed by state dental directors or their equivalents. It defines an extensive Medicaid adult dental benefit and assesses the extensiveness of existing coverage within each state. This is done by looking at coverage of specific procedures and services, including allowed frequency, in eight service categories. The categories of procedures encompass specific services that are most commonly reimbursed by employer-based dental benefit plans and that are critical to maintaining lifelong oral health. Being part of the development process of the Rubric and Coverage Checker was an incredible experience! Our Core and Advisory Group members drove this process. Together, we worked with a wide range of subject matter experts and leaders at national, state, and local levels throughout every stage. For a few years, we solicited input and guidance from these leaders and experts. We also engaged in multiple rounds of review and revision to the definition and the survey tool, and conducted two full rounds of beta testing. The survey was formally released to all state Medicaid dental directors or their equivalents in the 50 states and DC in the spring of 2020. This was done in partnership with the Medicaid|Medicare|CHIP Services Dental Association (MSDA) and in conjunction with their National Profile of State Medicaid and CHIP Oral Health Programs. We were thrilled to secure responses from all 50 states and DC — no small feat to have accomplished as states were stretched, strained, and in the throes of the pandemic response. (Sidenote: Thanks to all the directors who made time for this!) **State dental directors had to buy into this process. How did you accomplish that?** **Mike and Stacey:** The development of the Rubric and Coverage Checker involved a wide array of stakeholders, including state dental directors. Directors were engaged throughout the entire process and were actively involved in reviewing, revising, and beta testing the Rubric. Specifically: - Our Advisory Group includes a current state dental director (Donna Balaski, DMD) and a former state dental program consultant (Robert Isman, DDS, MPH). - Dental directors (or their equivalents) in more than half the states participated in one or both rounds of beta testing and provided feedback on the content and usability of the Rubric. - Staff and an advisory committee of MSDA provided a full technical review of the Rubric. - Members of the Core Group presented the Rubric at the 2020 MSDA National Symposium. - Members of the Core Group shared the 2020 data with state dental directors at an MSDA “Coffee Hour” in the spring of 2021. As a result of that meeting, we removed two questions from the survey. - Members of the Core Group shared revised results and a preview of the Coverage Checker with a cohort of 10 state dental directors in the spring of 2022. We made several structural changes to the Coverage Checker based on that feedback. **Is there an intended audience for the Medicaid Coverage Checker? Who do you envision using this?** **Mike and Stacey:** The Coverage Checker was designed for a wide range of audiences: - Medicaid agencies: It allows administrators to view the extensiveness of benefits offered in their state and in relation to others, and to determine what improvements are needed to achieve a more extensive benefit. - Advocates: It allows local and state advocates to better understand the coverage landscape in their state and others, and to support efforts to implement/restore benefits. - Legislators and other policymakers: It provides leaders with a definition of an extensive dental benefit and an understanding of the benefits offered in their state on a continuum from no benefits to extensive. **How will the Medicaid Coverage Checker move the needle on improving the oral health of all?** **Mike and Stacey:** We are learning more every day about the critical role oral health plays in overall health. Without regular care, oral health problems can develop and worsen, leading to overall health and social issues that can harm individuals. [Research shows that access to extensive dental benefits](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2021.01191) plays a crucial role in increasing access to — and utilization of — preventive care and reducing disparities in dental care visits, preventive services, and treatment services. We also know that providing dental coverage to adults increases the likelihood that their children will receive timely and appropriate care. Furthermore, adults with dental coverage are more likely to enter and remain in the workforce. The Coverage Checker allows states to see where their benefits package falls on a continuum from no benefits up to extensive. In doing so, it allows them to identify areas for improvement and expansion. Coverage of dentures is a great example of this. Many states cover full dentures, ranging from once every seven years to once per patient’s lifetime. Yet the average denture begins to wear out and should be evaluated for replacement within three to five years. The Rubric acknowledges this need and assesses coverage based on these timeframes. **This has been a long journey to get to the release of this tool. What’s next? Do you have plans to update it?** **Mike and Stacey:** Our first order of business is to make sure everyone knows about this new tool and how to use it. We’ll be doing a formal launch soon, which will include presentations, a webinar, and sharing information on partner websites. We’ll also be soliciting feedback and input on what additional resources stakeholders need and want. We will then turn our attention to the next round of surveying. One of the main goals of the Rubric and Coverage Checker is to track movement in benefit offerings over time. We intend to conduct the Rubric survey on a regular basis and display results in the Coverage Checker. **What should people do if they have questions or feedback about the Medicaid Coverage Checker?** **Mike and Stacey:** We encourage questions and feedback and [would love to hear from you](mailto:info@carequest.org)! **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Dr. Patrick Smith on Oral Health Challenges for Black Men](https://carequest.org/blog/voices-from-the-field-dr-patrick-smith-on-oral-health-challenges-for-black-men/) **Published:** August 3, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Patrick Smith, DMD, MPH, recalls the experience like it was yesterday. “A few years ago, I was part of a team that would drive in a dental van to underserved communities throughout Chicago to perform free tooth extractions,” Smith said. “And many of the patients we’d see were Black men in severe pain. There was one man concerned about a bump in the back of his mouth. He had Medicaid, but his providers didn’t know what the bump was and were unable to perform a biopsy. We were able to refer him to clinics in the area, but a question resonated with me: How many more men didn’t have the wherewithal, trust, comfort, and confidence to approach the dental van? 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?” ![](https://carequest.org/wp-content/uploads/2025/11/Patrick-Smith-DMD-MPH-e1764956655630-279x300.png)Patrick Smith, DMD, MPH Smith has worked for the Division of Prevention and Public Health Sciences and the Department of Pediatric Dentistry at the University of Illinois Chicago since 2017. In his role as clinical assistant professor, he supports the public health dentistry curriculum through several academic activities, including extramural clinical experiences with an emphasis on access to care and the social determinants of health. Dr. 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. Dr. Smith took some time out of his busy schedule to share his perspective on the unique oral health challenges Black men face and how the effects of racism and discrimination create barriers to accessing the care they need. He was also part of a panel of experts who explored this topic and anti-racist solutions for dental public health during a [July 21 CareQuest Institute webinar](https://www.carequest.org/education/webinars/taking-action-advance-anti-racism-dental-public-health). **What initially sparked your passion for dentistry?** The first time I thought about dentistry was in high school. My sister’s college roommate went to dental school, and I thought it sounded cool. I had zero knowledge about the profession and wasn’t interested in going to college beyond wanting to be independent and create opportunities for myself. I attended Morehouse College, an all-male historically Black college, and majored in biology. By my junior year, I started studying for the MCAT, and after two weeks, I walked out on a prep course that I was taking. While doing so, I ran into a classmate, told him what I had just done, and he invited me to a pre-dental meeting. I sat in on a panel of dentists and it just felt right. I still didn’t know if I really wanted to be a dentist, but I liked the sound of having the option to do dentistry from time to time to make money while I pursued other interests and/or learned more about what I really wanted. I made up my mind that night and never looked back. **Since graduating from Harvard School of Dental Medicine in 2006, it seems like improving the oral health of Black men has been a focus for you. Why?** For me, Black man is how I identify and communicate with the world. At that time, there was a lot of dialogue about oral cancer disparities and Black men that resonated deeply with me. I felt a sense of responsibility and didn’t see others raising hell about it. I took that as a sign that there was a need I could fill. From there, exploring how to get involved served as a catalyst for how I got introduced to dental public health. **Once you got involved, what unique oral health challenges did you discover that Black men face?** Not all Black men face the same challenges, but I think a lot of it has to do with the importance of relationships in facilitating the transfer of health information and behavior modification. This applies to not just patient-provider interactions but social networking as well. The challenges are based on several factors. In society, being a Black man can be dangerous and stressful physically, socially, and emotionally. Issues like negative stereotyping, misplaced assumptions of intellect and character, and social isolation can place Black men in harmful situations. How Black men react to those stressors may cause them to lack trust in new relationships or withdraw. Many Black men are taught as young boys to be cautious and guarded as a strategy to survive, stay out of trouble, or succeed in life. This can place Black men in social networks where there is a lack of information, misinformation, or more pressing priorities to discuss beyond oral health. ![Dr. Patrick Smith, DMD, MPH](https://www.carequest.org/sites/default/files/3.png)Patrick Smith, DMD, MPH **What [gaps in care between Black and white adults](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health) surprise you most?** The narrative will likely always be that white populations collectively have better oral health, simply because they tend to fall on the better end of the spectrum of how social determinants affect health. Balancing the scale with interventions to reduce inequities will require more resources, priority, and political will. It would also mean simultaneously maximizing the opportunity for social determinants to improve health for people of color while supporting cultural influences on health that are protective. In our society, there are a host of issues halting efforts to improve access to care, including economic opportunities and neighborhood stability. **How can the oral health community address some of those disparities?** 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. It starts with trying. I like what I’m seeing regarding public insurance reform, workforce expansion, and improving collaboration with our colleagues in other health professions to support oral health as the agenda and have dental care be a part of that. We’re a scientific profession, so we need to develop new models to study and perfect instead of preserving a system that isn’t working for millions of people and will likely get worse. 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. **As an educator, how are you teaching the next generation of providers to pursue oral health equity?** My philosophy is that [students need to know how health care systems work beyond the dental chair](https://pubmed.ncbi.nlm.nih.gov/30962314/) if we’re ever going to accelerate the pace. Simply providing dental care is not enough if we are unwilling or unknowing of how to change payment and practice structures accountable for achieving better access and treatment outcomes. As a profession, we don’t teach how the system works administratively, so we’re missing opportunities. Having conversations with students and getting them to ask questions and think critically rather than just accept the status quo is an important process. **What can today’s providers (and future providers) do to promote anti-racist behaviors?** This is a tough question. On a personal level, I think that there’s a lot that people can do to simply connect and create safe spaces for people to be themselves, with full acceptance of diversity and without judgment. You never know what people may be dealing with that may be race-related, and sometimes allowing people to sit in isolation socially, professionally, and creatively only exacerbates the problems. At the end of the day, I believe that people just want to know that you genuinely care about them. I also think that providers can challenge decisions that are made without the shared input and perspective of racial groups most impacted by those decisions. It’s not enough to ask people what they want or think and then still do what you want to do. Be open to a different way, and trust that a good idea is a good idea — and, if non-concordant leadership doesn’t share perspective with their target populations, that those ideas should be explored as exciting moments for expanding inclusivity, learning, and innovation. **Categories:** Blog **Tags:** Health Equity --- ### [Nine Questions That Dive Deeper into Dental Therapy](https://carequest.org/blog/nine-questions-that-dive-deeper-into-dental-therapy/) **Published:** August 4, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dentist-looks-in-childs-mouth.jpg)Dental therapy is growing. Similar to physician assistants in medicine, dental therapists can work in various settings — from the dental office to the community — and provide various services, including filling cavities, placing temporary crowns, and extracting teeth under some circumstances. Communities throughout the US that struggle with dental workforce shortages or providing access to care outside of the traditional office setting have identified the occupation as an effective way to increase access for patients. The National Institute of Dental and Craniofacial Research highlighted dental therapy as one of the most innovative approaches to improving access to care in its follow-up to the 2000 Surgeon General’s report, [Oral Health in America: Advances and Challenges](https://www.nidcr.nih.gov/research/oralhealthinamerica#:~:text=Oral%20Health%20in%20America%3A%20Advances,over%20the%20last%2020%20years.). And most recently, the Advisory Committee on Training in Primary Care Medicine and Dentistry issued a report calling on Congress and the Health Resources and Services Administration (HRSA) to take action to support the training and deployment of dental therapists across the US. To explore these reports and the topic, the APHA Oral Health Section and CareQuest Institute partnered on a [continuing education webinar](https://www.carequest.org/education) featuring a robust conversation about [expanding dental therapy](https://www.carequest.org/education/webinars/advancing-health-equity-through-dental-therapy). The expert panel — including a dental sociologist, an advocate, and representatives from organized dentistry and dental hygiene — explored the legal, organizational, and educational frameworks for the occupation. They also discussed the impact on quality of care and potential improvements in access and patient outcomes. More than 350 oral health stakeholders joined the webinar, ready with questions and comments about dental therapy. The panel didn’t have enough time to answer all of them, so two members of the panel — Ann Lynch, director of advocacy at the American Dental Hygienists’ Association, and Laura (Hale) Brannon, project manager of dental therapy at Community Catalyst — provided answers, links, and resources to the questions below: **1. What are the training requirements to becoming a dental therapist?** The Commission on Dental Accreditation (CODA) serves the public and dental professions by developing and implementing accreditation standards that promote and monitor the continuous quality and improvement of dental education programs. CODA adopted standards in 2015 to set the minimum educational standards for dental therapy. The foundation of these Standards is a competency-based model of education through which students acquire the level of competence needed to begin the practice of dental therapy. The CODA standards indicate the curriculum must include at least three academic years of full-time instruction. **2. Is there a benefit of a dental therapist first being a dental hygienist?** Some dental therapists are dually licensed as dental hygienists, which provides some additional flexibility for employment. Dually trained providers can be more effective in some settings (like nursing homes) where patients need both restorative and periodontal treatment and it’s not possible or cost-effective to send two providers. Some employers prefer to hire dually trained providers for this reason. **3. Does every state require dental therapy to be under direct dentist supervision?** No, most allow general supervision, as requiring direct supervision would limit the efficacy of the model. The Oral Health Workforce Research Center has a helpful resource that shows the [authorization status of dental therapists by state](https://oralhealthworkforce.org/authorization-status-of-dental-therapists-by-state/). **4. [The chart about authorization status by state](https://oralhealthworkforce.org/authorization-status-of-dental-therapists-by-state/) shows that 14 states have passed dental therapy. Why do only five states have practicing dental therapists and education programs in place?** Currently, 13 states allow dental therapists to practice in at least some setting: Alaska, Arizona, Connecticut, Colorado, Idaho, Maine, Michigan, Minnesota, New Mexico, Nevada, Oregon, Washington, and Vermont. Montana passed legislation authorizing Community Health Aide Program (CHAP) providers, which is the federal program that authorizes dental therapists to work in tribal settings. However, that law removed all the restorative procedures from a dental therapist’s scope, so the provider does not actually meet the minimum scope to be considered a dental therapist. Passing the legislation to allow dental therapists to practice is just the first step in bringing dental therapy to a state. Establishing a CODA-accredited training program takes time, commitment, and resources. A few dental therapy programs are under development and seeking accreditation. And there have been other challenges. Congress created a grant program in 2010 to support states and tribal communities with resources necessary for training and development of dental providers like dental therapists, but each year, the federal appropriations bills has included language prohibiting the funding. That language has been removed in the FY2023 appropriations bills and Congress may pass a final version that allows the Health Resources and Services Administration to provide the grant dollars. Also, the COVID-19 pandemic has had an impact on priorities at some educational institutions. **5. How successful have states been in dental therapists practicing in rural and low-income areas?** Using Minnesota as an example, the state conducts a workforce study, and the distribution of dental therapists closely follows the distribution of the Minnesota population. All respondents to the workforce study reported serving low-income or uninsured patients, and 92% served recipients of Minnesota Health Care programs. This is in keeping with the statutory requirements that dental therapists focus services on underserved populations and areas. **6. Are there restrictions in some states that require dental therapists to only practice in rural, low-income areas that are not competing with existing dental practices?** Yes. Dr. Mertz’s research indicates there are several states limiting dental therapists to certain populations. The article she coauthored, “Dental Therapists in the United States,” appeared in Medical Care and is [free to access online](https://journals.lww.com/lww-medicalcare/Fulltext/2021/10001/Dental_Therapists_in_the_United_States__Health.8.aspx). **7. With the growing number of dental therapist programs across the country, are there any meetings or conferences designed for the educators/program directors of these programs?** The American Dental Hygienists’ Association regularly hosts sessions on dental therapy at its annual conference, the National Oral Health Conference usually has a session or two on dental therapy, and the American Dental Education Association invites educators from all CODA-accredited programs to join. Additionally, Community Catalyst coordinates the Dental Therapy Educator Learning Collaborative (DENTAL THERAPYELC), a space for dental therapy educators and administrators to connect with each other. Contact [Laura Brannon](mailto:lbrannon@commuitycatalyst.org) for more information. **8. Do you have a list of colleges in different states that offers dental therapy or advanced dental therapy? I am very interested in becoming a dental therapist and possibly an advanced dental therapist.** There are currently four dental therapy education programs in the US, with a fifth expected to open next month. Here is a summary of the programs: SchoolStateAccreditation StatusPrerequisitesDegree(s) AwardedIḷisaġvik CollegeAKCODA-accreditedAS in dental therapyUniversity of MinnesotaMNApproved by MN Dental Board and applying for CODA accreditationBS in dental hygiene and MS in dental therapyMetropolitan State UniversityMNApproved by MN Dental Board and applying for CODA accreditationBS in dental hygiene degreeMS in dental therapyMinnesota State University at MankatoMNApproved by MN Dental Board and applying for CODA accreditationBS in dental hygiene degreeMS in dental therapySkagit Valley CollegeWAApplying for CODA accreditation (program scheduled to open in September pending accreditation)AS in dental therapyNote that advanced dental therapy is specific to Minnesota. Here is a resource from ADHA that provides [more information on dental therapy education programs](https://www.adha.org/wp-content/uploads/2023/03/Dental_Therapy_Education-Programs_2022-08.pdf). **9. How are dental therapists getting paid? Medicaid and state payments? Any private insurances?** How dental therapists’ services are reimbursed varies by state (in some, they bill under their own provider number, while in others, they bill under their supervising dentists’ provider number). Where they work, their services are reimbursed by all the same payors that would reimburse for a dentist’s services. This report/toolkit contains a [wealth of information](https://www.health.state.mn.us/facilities/ruralhealth/emerging/docs/dtreg2016.pdf), including information on dental therapy reimbursement. *Editor’s Note: You can [watch a recording of the webinar](https://www.carequest.org/education/webinars/advancing-health-equity-through-dental-therapy), “Advancing Health Equity Through Dental Therapy,” on the CareQuest Institute website.* **Categories:** Blog **Tags:** Clinical Practice --- ### [Actions You Can Take to Advance Anti-Racism in Dentistry](https://carequest.org/blog/actions-you-can-take-to-advance-anti-racism-in-dentistry/) **Published:** August 9, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/04/Value-Based-Care-Teeth-Cleaning-1.jpg)Racism is a [public health epidemic](https://www.carequest.org/about/news/carequest-institute-commends-cdc-declaring-racism-public-health-epidemic). Across the US, there are barriers to care that have blocked people of color from receiving adequate health care for years. Lack of economic opportunity, lack of access to insurance, lack of affordable care, lack of representation in the medical field, implicit bias, and stereotyping are only a few examples of barriers that we have to work to break down. So, what can we do? How can we move forward? A roundtable of oral health leaders came together to discuss those questions at a recent CareQuest Institute webinar, “[Taking Action to Advance Anti-Racism in Dental Public Health](https://www.carequest.org/education/webinars/taking-action-advance-anti-racism-dental-public-health).” The webinar focused on a [special issue in the *Journal of Public Health Dentistry* on the topic](https://onlinelibrary.wiley.com/toc/17527325/2022/82/S1). “We must work broadly toward eliminating the existing structures and policies that perpetuate systemic racism and white supremacy. However, we cannot operate in isolation,” said Eleanor Fleming, PhD, DDS, MPH, FICD, assistant dean for equity, diversity, and inclusion at University of Maryland School of Dentistry on the webinar. “We, as a collective dental public health community, must promote the best scientific information; support efforts to improve equity, diversity, inclusion, and belonging within dental education; advocate for anti-racist policies; and encourage practices that advance health equity.” Dr. Fleming moderated the panel that included Pamela Alston, DDS, MPP, FACD, immediate past president, National Dental Association, and founding director, Diverse Dental Society; Patrick Smith, DMD, MPH, assistant professor, University of Illinois, Chicago College of Dentistry; and Jill Boylston Herndon, PhD, managing member and principal consultant, Key Analytics and Consulting, LLC. Each participant began the webinar with an overview of their article that appeared in the publication. “One of the things that we have to acknowledge in conversations about racism is that for Black men racism is gendered . . . \[so what\] we really wanted to do with our piece in the special issue of the Journal was to highlight exactly how those experiences are gendered,” said Dr. Smith, when introducing the topic of his article. “What steps are we taking in order to get to a point where we can realistically start to address the issues of race and racism for Black men and to continue to promote oral health?” Dr. Boylston discussed her work researching disparities in health care quality for children enrolled in Medicaid and CHIP and the importance of data collection. “Right off the bat, we found that two-thirds of state Medicaid programs are missing at least 10% of race and ethnicity data, and half are missing recent ethnicity data on more than 20% of their beneficiaries,” she said. “Documenting disparities is really only a first step, and it’s a critical step. Lack of data means lack of ability to identify which populations have the biggest care gaps, disparities, and inequities that otherwise remain hidden.” From there, the experts engaged in a roundtable discussion that brought in several questions from the more than 300 oral health stakeholders who joined the webinar. Making progress and taking actions to advance anti-racism were top of mind for everyone. ## Seven Actions to Advance Anti-Racism In a post-webinar survey, we asked participants what actions they planned to take after the discussion. We summarized some of the responses below — and invite any readers to take these actions, too: - **Increase education.** Organizing classes that deal with racism and inclusion. Encourage more people to participate in Diversity, Equity, and Inclusion CE courses[.](https://www.carequest.org/education) - **Have open-minded discussion.** Advance understanding of racial equity among staff and share anti-racism concepts. Open the discussion about the health disparities that racism can foster. - **Share resources.** Share resources like this webinar recording, the Journal of Public Health Dentistry, and the [anti-racism in public health white paper](https://www.aaphd.org/assets/Webinars/White%20paper%20FINAL%20July%202021.pdf) with my team members. - **Participate in trainings.** Do staff-wide training about unconscious biases and managing their own racist behaviors. Recognizing institutional bias in our hiring and doing training to combat it. - **Collect more (and better) data.** Support efforts to collect demographic information as a first step in measuring whether inclusivity efforts are succeeding. Not using “normal” standards, which are typically geared toward a traditional white population, as the comparison for marginalized groups. - **Partner.** Partner with colleagues who are focusing on health equity to ensure that dental needs of the marginalized community members are included in their work. - **Invest with purpose.** Support BIPOC communities by funding grants that express the dire need to address racial disparities in oral health. ‘ *Editor’s Note: You can watch the full recording of the webinar and roundtable discussion in the [CareQuest Institute webinar library](https://www.carequest.org/education/webinars).* **Categories:** Blog **Tags:** Health Equity --- ### [Voices that Helped Shape Oral Health in 2021](https://carequest.org/blog/voices-that-helped-shape-oral-health-in-2021/) **Published:** December 28, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/VoicesLogo_0-300x300.jpg)In 2021, we created a series of blog posts that highlights individuals who are working to improve the oral health system. From providers and policymakers to advocates and patients, our goal is to provide a snapshot of the backgrounds, ideas, successes, challenges, and daily lives of people who are making oral health care more accessible, equitable, and integrated. Here are short snippets from interviews with some of the people who helped shape oral health care in 2021. (Click the links to read the full interviews.) ## [Dr. Matthew Horan on Distributing Vaccines and Medical-Dental Integration](https://www.carequest.org/about/news/voices-field-dr-matthew-horan-distributing-vaccines-and-medical-dental-integration) Dr. Matthew Horan is executive director of dental services at Harbor Health Services, a federally qualified health center (FQHC) in Massachusetts. We spoke with Dr. Horan about his experience vaccinating patients. **The practice of providing vaccinations as part of a routine oral health visit is an example of medical-dental integration. Do you see this as a catalyst toward more integrated care going forward?** The pandemic has led to rapid regulatory changes that allowed for an environment of crazy care innovation — telehealth and vaccine delivery are just a couple of examples. I do think that in the near future, vaccines, more generally, will become an established part of comprehensive dental care in the same way that monitoring blood pressure is now. Diabetes screening, rapid HIV testing, and depression screening are just a few examples. There are lots of ways we can help out on the dental side. Vaccines are just the tip of the iceberg of where we can collaborate as health systems. ## [Dr. Eleanor Fleming on Tackling Inequity and the Future of Oral Health](https://www.carequest.org/about/news/voices-field-dr-eleanor-fleming-tackling-inequity-and-future-oral-health) Eleanor Fleming, PhD, DDS, MPH, was an associate professor in the department of Dental Public Health at Meharry Medical College in Nashville, Tennessee, at the time of her interview. Dr. Fleming, who is now assistant dean for diversity and inclusion at the University of Maryland School of Dentistry, shared her thoughts on living through the COVID-19 pandemic as an epidemiologist. ****What have the last 18 months been like through the eyes of an epidemiologist?**** **The politicization of public health has been shocking to me. I realize that I am a political scientist, so I should not be shocked . . . and yet here I am. It is heartbreaking to see wearing a mask as a political act. As an epidemiologist, I have been pleased to see more people paying attention to data and public health practice. I hope that the last 18 months have made clear just how important public health is and how underfunded public health systems are. As an equity issue, this becomes an opportunity to advocate.** ## [Derek M. Griffith on the Connection Between Structural Racism and Health Outcomes](https://www.carequest.org/about/news/voices-field-derek-m-griffith-connection-between-structural-racism-and-health-outcomes) Derek M. Griffith is a founding codirector of the Racial Justice Institute and founder and director of the Center for Men’s Health Equity. He shared his thoughts on the connection between structural racism and health outcomes. Why should oral health professionals care about racism? **With any kind of health care provider, when your patients come in and have poor health, you want to be able to help them fix and prevent problems. Racism helps to identify ways some patients may not have the same opportunities as others to engage in preventive care or to fix problems once they occur. It’s certainly not the only reason, but it helps to explain why when we zoom out from individuals to populations, we see remarkably similar patterns over time and across locations.** **We need to see patients who have different identities and try to give a fuller, richer, and accurate understanding of their obstacles to health. Some are certainly within their control, but many behaviors are shaped by the environments where they live.** ## [Alex Sheff on Advocating for Oral Health](https://www.carequest.org/about/news/voices-field-alex-sheff-advocating-oral-health) Alex Sheff is codirector of policy and government relations at Health Care for All (HCFA), a consumer health advocacy organization that supports health justice in Massachusetts. Alex discussed how HCFA advocates for improvements within oral health. What’s unique about this work to improve oral health? What drives you and your team? I’ll give you an anecdote. I have a friend who runs a community partner program that helps people with complex needs navigate care in the state. She asked me to speak at their advisory board meeting, and I started to talk about HCFA’s work, including getting the adult dental benefit fully restored in MassHealth last year. (That was a 10-year battle — getting coverage tooth by tooth, as we sometimes say.) I started to mention how we just got this adult dental benefit fully restored, how it now covers root canals and crowns. This person on the board call was like, “Really?x That happened? That’s amazing! I had to go get this procedure, and they instead ended up having to pull the tooth. It was terrible!” I almost never get that kind of response to policy changes. I just think it’s something so tangible, and it really hits home. Oral health is just such a huge deal for people, and I think that impact gets lost sometimes. ## [Dr. Scott Howell on Why Teledentistry Isn’t a Fad](https://www.carequest.org/about/news/voices-field-dr-scott-howell-why-teledentistry-isnt-fad) Scott Howell, DMD, MPH, is an associate professor and director of public health dentistry and teledentistry at A. T. Still University-Arizona School of Dentistry and Oral Health (ATSU-ASDOH). Dr. Howell explained common teledentistry misconceptions. What are one or two misconceptions providers have about teledentistry? One of the misconceptions is that teledentistry is a fad, and another is that it is only for low-income communities. Teledentistry has been around since the mid-1990s, and telemedicine has been around since the early 1900s. I think it’s also important to recognize that any provider in any clinic can use it for any patient. The numerous ways we can use technology isn’t limited to just those living in poverty or to just those with smartphones. A thorough assessment of the clinic’s needs and the patient population’s needs will provide answers to how teledentistry could benefit a particular community. The patients I work with don’t benefit from teledentistry because they are low-income or high-income; they benefit from teledentistry because we recognized an important need for the patients in our clinic and in our communities. **Categories:** Blog **Tags:** Health Equity, Practice Management --- ### [Three Reasons Why Adults on Medicaid Need Dental Coverage](https://carequest.org/blog/three-reasons-why-adults-on-medicaid-need-dental-coverage/) **Published:** January 11, 2022 **Author:** Caitlin Locklear **Content:** Medicaid — the health care program jointly funded by states and the federal government to provide comprehensive health care services to 75 million people nationwide — guarantees comprehensive dental benefits for children. The same is not true for adults, though. Adults who rely on the program are often forced to make difficult decisions about seeing a dentist, going to an emergency department (ED), or wondering how much pain they can endure. Recently, there has been an important national conversation about the need to include dental benefits in Medicare, and rightfully so. Seniors and people with disabilities served by Medicare have gone without necessary oral health care for far too long. But we want to shine a light on the need to advocate for an adult dental benefit in Medicaid too, especially as 2022 state legislative sessions start to ramp up. ## The Current Dental Coverage Landscape for Medicaid-Eligible Adults [Today, more than 76 million Americans](https://www.carequest.org/education/resource-library/snapshot-765-million-americans-without-dental-insurance) lack access to dental coverage — three times the number of people without medical insurance. This lack of coverage disproportionately impacts Black and Latino people, tribal communities, people with disabilities, and those in rural America, among others. The lack of dental benefits available to Medicaid-eligible adults contributes to this gap in coverage. Today, it is optional for state Medicaid programs to provide dental coverage to adult enrollees. Through the incredible work of community advocates and policymakers, some states have acted to strengthen their Medicaid programs by adding adult dental coverage. However, many state Medicaid programs continue to offer only limited benefits or no coverage at all. As of 2022, 10 states cover dental care only for emergencies and three do not provide any coverage at all (a group at CareQuest Institute has been studying specific procedures and services covered by Medicaid in each state). This leaves millions of people without the accessible, equitable, and integrated health care they need. ## The Case for Strengthening Medicaid Dental Coverage Here are three reasons why the time is now to strengthen Medicaid dental coverage for adults: **![](https://carequest.org/wp-content/uploads/2025/11/female-advocate.png)1. Healthy mouths are an equity issue.** Historically marginalized communities are hit with a double whammy when it comes to oral health. Not only do adults with low incomes, those living in rural communities, and Black, Indigenous, and other people of color experience higher rates of poor oral health, but they are also disproportionately represented in Medicaid. Medicaid-eligible adults also experience significantly [higher rates of diseases linked to poor oral health](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125002/), like cardiovascular diseases, oral cancers, and substance use disorders, according to a [study in *The Journal of The American Dental Association*](https://jada.ada.org/article/S0002-8177(21)00486-4/fulltext). This only compounds the impact on peoples’ health that can result from a lack of access to [necessary preventive oral health care](https://jada.ada.org/article/S0002-8177(21)00486-4/fulltext). To address these overarching challenges experienced by Medicaid-eligible adults, we need to include comprehensive dental benefits as part of their health care. And recent [CareQuest Institute research](https://www.carequest.org/education/resource-library/expanding-dental-benefits-good-states) shows that strengthening a Medicaid program by adding adult dental coverage has positive impacts on the oral health outcomes of patients. **2. Dental coverage creates cost savings for all.** Adults with low incomes or otherwise living in poverty spend a significantly higher portion of their annual income on dental care than those with higher incomes — and still face significant unmet needs — according to [CareQuest Institute research](https://www.carequest.org/resource-library/poor-families-spend-10-times-more-their-income-dental-care-wealthier-families). This often leaves Medicaid-eligible adults with a last resort to seek dental care at [hospital EDs](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt). [Nationally](https://www.carequest.org/resource-library/spotlight-arizona-adult-use-emergency-departments-non-traumatic-dental-conditions), Medicaid enrollees ages 21–64 make up 39.5% of all ED visits for nontraumatic dental conditions and account for 33.9% of all costs. The average charge per ED visit for patients with Medicaid is $1,400, and research indicates that nearly 79% of these visits could have been addressed in a dental office. Making dental coverage a required benefit for adult Medicaid enrollees can help divert care from hospital settings to dental offices and community health centers, which could translate into [potential savings](https://www.communitycatalyst.org/blog/new-data-medicaid-adult-dental-coverage-is-wise-investment-for-economic-recovery-health#.YZvK1k7MKUm) of nearly $2 billion per year. **3. Our economy depends on it.** With many industries still pinched for workers because of the pandemic, it is high time we give those looking for a job a leg up. Interviewing for a job can be nerve-racking under the best circumstances. Now imagine you have missing teeth, or it hurts to talk during an interview. [CareQuest Institute research](https://www.carequest.org/resource-library/cutting-medicaid-adult-dental-benefits-would-hurt) conducted prior to the pandemic found ensuring all working adults on Medicaid have access to routine dental care would increase the employability of 9,972 currently unemployed adults — creating $14.2 million in federal tax revenue and saving $7.9 million in unemployment benefits. ## What You Can Do Today Oral health advocates have been working tirelessly to include adult dental benefits in Medicaid — and they’ve made real progress. With state legislatures gearing up for their legislative sessions, health leaders and other advocates from across the health care space can join in and engage with policymakers today. CareQuest Institute, in collaboration with partners, created a [Medicaid Adult Dental Benefit Coverage Checker](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), created [a tool kit with information](https://www.carequest.org/education/resource-library/medicaid-adult-dental-benefit-toolkit-advocates) that makes it easy for anyone to advocate for comprehensive dental coverage. To aid advocates and providers pursuing state-based strategies, CareQuest Institute also built a Medicaid adult dental benefit [forecasting tool](https://www.carequest.org/education/resource-library/medicaid-adult-dental-benefit-forecasting-tool) in collaboration with Virginia Health Catalyst. Simultaneously, it’s up to all of us to push for a federal solution. According to [CareQuest Institute research](https://www.carequest.org/resource-library/dental-insurance-out-reach-many), 65% of American adults strongly agree that comprehensive oral health care for adults should be covered by Medicaid. In Congress, both the House and the Senate have introduced bills to make this a reality. This summer, Congresswoman Nanette Barragan (D-California) filed the Medicaid Dental Benefit Act (H.R. 4439), and Senator Debbie Stabenow (D-Michigan) and Senator Ben Cardin (D-Maryland) introduced a similar bill. These bills would permanently remove a major barrier to care and ensure that low-income Americans in every corner of our country have stable and consistent access to the health care they need and deserve. (You can see Congresswoman Barragan talk about oral health disparities during CareQuest Institute’s recent event with [*The Hill*](https://www.carequest.org/future-medicare-and-oral-health).) Medicare and Medicaid are a lifeline for low-income and elderly communities. While there has been a major push to include dental coverage in Medicare, we must also address the needs of those on Medicaid. That way, we can provide comprehensive dental coverage for all. **Categories:** Blog **Tags:** Dental Coverage --- ### [Looking to the Future of Black History Month](https://carequest.org/blog/looking-to-the-future-of-black-history-month/) **Published:** January 31, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Health-Equity-Mother-And-Baby.jpg)Black History Month, first recognized during the celebration of the United States Bicentennial in 1976, gives us the chance to look back on the countless accomplishments of Black Americans. It’s a time to reflect on the individuals who, through innovation, invention, and courage, helped shape our country. Many Black Americans helped shape oral health history, too. Dr. Robert Tanner Freeman was the first Black person to earn a dental degree when he graduated from the Harvard School of Dental Medicine in 1869. He died four years later, but he was a mentor to many other aspiring dentists. Two decades later, in 1890, Dr. Ida Gray Nelson Rollins became the first Black woman to earn a dental degree when she graduated from the University of Michigan. She opened practices in Cincinnati and Chicago and served those communities for more than 30 years, inspiring generations of providers. Black History Month is also a good time to pause and reflect on what future generations will experience and what they will remember. What will we remember in a decade? Or in 50 years? What changes that we make in society today will get us closer to equity for all in the future? In oral health, we know there is room for improvement. During the past year, CareQuest Institute for Oral Health, with its mission firmly set on creating an accessible, equitable, and integrated oral health system, published several reports and created education that shine a light on the gaps in equity. In the process, we’ve uncovered several statistics that show the work that lies ahead. For example: - Black adults are [68% more likely than white adults to have an unmet dental need](https://www.carequest.org/resource-library/nhanes-oral-health-data-reflect-barriers-inequities). - Black adults were [22% less likely than white adults to have had a routine dental visit](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) in 2020. - [57% of Black adults have lost one or more permanent teeth](https://www.carequest.org/resource-library/inequities-remain-pervasive-oral-health) due to decay or gum disease, compared to 46% of all adults. - Due to the COVID-19 pandemic, compared to white adults, [Black adults were two times more likely to lose dental insurance](https://www.carequest.org/resource-library/coming-surge-oral-health-treatment-needs). - [71% of providers of color reported significant reductions in patient volumes](https://www.carequest.org/resource-library/oral-health-providers-color-face-hardship-covid-19) during the COVID-19 pandemic, compared to 57% of white providers. - [Black adults are almost three times more likely to visit an emergency department](https://www.carequest.org/resource-library/oral-disease-common-access-care-not) for dental care for pain/discomfort than other groups. Taken together, the statistics paint a picture of an inequitable system that needs care, attention, and advocacy to change. That’s exactly what CareQuest Institute is aiming to do. Through efforts like our [Advancing Equity Through Oral Health Fund](https://www.carequest.org/how-we-work/grantmaking/advancing-equity-through-oral-health-fund), we are driving oral health transformation that support efforts to dismantle unjust structures and systems that drive disparities across oral health. Similarly, in our [advocacy work](https://www.carequest.org/how-we-work/policy-and-advocacy), we are providing resources, educational materials, and grants to support efforts to expand adult dental benefits — something that is critical to achieving health equity. What else can we do? How can we start today, the first day of the month in which we celebrate so many meaningful achievements from the past? On the individual level, there are plenty of places to get started. During last September’s webinar “Building Antiracist Policies and Practices into Health Care Settings,” speaker Monica Wang, ScD, MS, associate director of Narrative at the BU Center for Antiracist Research, [shared her perspective](https://www.carequest.org/about/news/actions-anyone-can-take-start-addressing-structural-racism-health-care) on what individuals can do: - Use terms (racism, racist) accurately and talk about them. - Be curious about your own biases. - Learn about different forms of racism. - Pay attention to the language used to describe people. - Familiarize yourself with the literature on racial/ethnic health inequities in your field. Will we be sharing these same actions when we celebrate Black History Month in 2052? Will we be pointing to the same troubling statistics? It’s up to all of us to answer those questions. *Editor’s Note: Learn more about CareQuest Institute’s work to create [an equitable oral health system.](https://www.carequest.org/topics/health-equity)* **Categories:** Blog **Tags:** Health Equity --- ### [Voices from the Field: LaVette C. Henderson on the Path Ahead for the Diverse Dental Society](https://carequest.org/blog/voices-from-the-field-lavette-c-henderson-on-the-path-ahead-for-the-diverse-dental-society/) **Published:** February 4, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0.jpg)Last month, the Diverse Dental Society (DDS) [announced](https://www.nadp.org/diverse-dental-society-dds-presents-lavette-c-henderson-cmp-hmcc-facd-as-the-2022-president/ "Diverse Dental Society press release") LaVette C. Henderson, CMP, HMCC, FACD, as its new president for 2022. The former executive director and current director of finance of the [National Dental Association](https://ndaonline.org/ "National Dental Association ") (NDA), Henderson brings more than 30 years of experience to the role and has a clear vision for what’s next. The DDS was established in April 2020, bringing together the [Hispanic Dental Association](https://www.hdassoc.org/), the [Society of American Indian Dentists](http://www.thesaidonline.org/), and the NDA under the shared mission of addressing the unmet oral health needs of marginalized communities. Henderson joined the NDA in 1998 and began advocating for underserved populations, promoting oral health access and equity because, as she puts it, “Helping others who cannot speak for themselves to improve quality of life should be everyone’s goal.” In 2019, she became a fellow of the American College of Dentists for her leadership and achievements in dentistry as a non-dentist. We caught up with Henderson as she settled into her new role to ask her about DDS’s priorities and what drives her to do this mission-driven work. ![](https://carequest.org/wp-content/uploads/2025/11/LaVette-C.-Henderson.jpg)LaVette C. Henderson, CMP, HMCC, FACD **Congratulations on the announcement! What are your top two or three priorities in the new role?** I’ll share four: - Amplify the need of diversity and inclusion in the dental professions starting at the college level. - Raise practitioner and public awareness of the organization and its goals. - Enhance the growth, influence, and impact of each individual organization. - Eliminate oral health inequalities in our populations. **For those who may not know about the Diverse Dental Society DDS, what are the organization’s primary goals?** In addition to enhancing the growth, influence, and impact of the three organizations under the Diverse Dental Society, we aim to create a safe space to discuss and develop mechanisms to improve access and equity. We do this by collaborating in areas of service, education, and advocacy. **On a personal level, why is advocating for marginalized communities so important to you?** Helping others who cannot speak for themselves to improve quality of life should be everyone’s goal. Knowing how dental visits are vital to a healthy person’s life has inspired me to take a stand and be a voice. This can be achieved if everyone is given the right tools and education. Children are happier, adults become more confident, and seniors continue to socialize and engage when they have a healthy smile. **How did you get involved with the NDA back in 1998?** I was the NDA’s accountant in 1998 and started traveling with them to their annual meetings to assist the executive director, Robert Johns, with daily financial reporting to the board. When my daily duties were complete, instead of going to my room or enjoying the cities, I started volunteering to help with different aspects of the meeting — with the registration desk, room monitoring and sets, crowd control. When a manager role within meetings and conferences became available, Mr. Johns approached me. After numerous discussions, I accepted the full-time position in 2000, moved through the ranks, and here I am today, president of a dental organization representing the voices of marginalized communities. **You’ve spent more than two decades with the NDA. How have you seen the dental industry change in that time?** We have seen improvements in the industry like technology, better dental school recruitment, and increased oral health awareness. But some of these improvements have placed more constraints on marginalized communities. For example, with the new digital dental equipment to improve dental techniques, procedures, and patient comfort, the office visit cost has increased to help cover the practitioner cost of the new technology, but the consumer economic situation has not improved. Therefore, the consumer is still not able to afford routine visits and pay for much-needed dental treatments. Regarding dental schools, the number of minority faculty positions has increased some, but dental schools are not providing equal study support and resources for all students. Minority students are not treated equally to their white counterparts. **Do you believe the dental industry is making strides toward achieving health equity? Where is it still falling short?** Health equity is still falling short in marginalized communities, with our veterans, the underserved, the disabled, minority faculty positions in dental schools, practitioners with unconscious biases and lack of cultural awareness, I could go on . . . We are not sure how to solve the overall issues. However, coming up with an insurance system that makes preventive care more accessible and affordable for people of all ages is needed. Private care insurance fees need to be more affordable and maybe based on family household income. We also need more interprofessional training and collaborations to increase health equity. And we need more minority dentists at the table, especially at the decision-making tables. **What can providers and practices do to create environments that promote equity? What can policymakers do?** All oral health professionals should be required to take cultural competencies courses and implement the skills learned. All providers and their staff should consciously listen to their patients and not just emote an opinion. Policymakers should engage minority dentists who are champions of equity in decisions and discussions about policies and procedures. Minority health professionals should be included in all aspects of these health discussions. And we all should be educating each other and the public of the importance of oral health as it relates to overall health. There cannot be good health in the absence of good oral health! **Categories:** Blog **Tags:** Health Equity --- ### [Exploring Oral Health Care Spending over a Life Span](https://carequest.org/blog/exploring-oral-health-care-spending-over-a-life-span/) **Published:** February 11, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/JADA-Article.jpg)CareQuest Institute for Oral Health researchers recently [published an article](https://www.carequest.org/resource-library/cross-sectional-analysis-oral-health-care-spending-over-life-span) in the *Journal of the American Dental Association* that offers one of the most in-depth explorations of lifetime spending on oral health care. The article appeared on the cover of the February 2022 issue, a signal of its importance to understanding how different populations access and receive care during their lives. “Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the life span,” the authors wrote in the conclusion, “as opposed to policy development that is precipitated by short-term political and financial dynamics.” How did the authors arrive at that conclusion? To dive deeper into this topic, researchers hosted a [webinar](https://www.carequest.org/education/webinars/lessons-study-oral-health-care-spending-over-life-span) in January to explain the article’s key takeaway: that understanding and addressing the factors that impact oral health status and spending at every stage of life must ultimately influence how our oral health care environments are structured. Nearly 300 participants joined the webinar to learn more and ask questions about the research. Understanding health outcomes over time goes beyond keeping track of how a childhood injury may still affect the body or how exposure to a disease could have long-term effects, the researchers explained. When considering oral health, the advantage of analyzing health over a lifetime is that you’re able to better understand how diseases, like caries, don’t just happen in a vacuum. Instead, health and disease patterns are in fact cumulative. “If we keep focusing on the short term,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute, “we’ll continue to see the problems we face today: inequities and disparities in access outcomes.” ## The Spending Gap Between Public and Private Insurance Eric Tranby, PhD, director of analytics and data insights at CareQuest Institute, presented research data — from more than 31 million Medicaid claims and over 45 million commercial or Medicare supplemental claims — revealing the complexities of the current dental service environment and lack of equitable access to oral health care. When looking at the people enrolled in Medicaid over a lifetime, data show three peaks in spending: two in childhood and one later in life. The first childhood peak is likely due to treatment for early childhood caries, Tranby explained. The second peak in early adolescence stems from orthodontics and oral surgeries. Then, people with dental coverage through Medicaid stop accessing care, usually around early adulthood. As they grow older, spending shifts away from the dental system and onto the medical system. “Where we’re spending money, we’re spending money to treat oral health conditions in one place or the other, with Medicaid shifting some of that burden onto the medical system,” Tranby explained. “We see a very different pattern of spending over the life span of commercial insurance.” By contrast, those with commercial insurance experience a very different spending pattern, in which the scale of spending is significantly higher — peaking at $600 per person per year versus Medicaid’s $300. This group still experiences a peak in childhood from orthodontic and oral surgery costs, but peaks related to caries are less likely later in the life span due to easier access to preventive care. “Utilization is a function of both access and coverage, so it really is the way Medicaid is designed and commercial insurance is designed in this country that leads to patterns in spending and some of the outcomes that we’re seeing,” said Tranby. “There is really a missed opportunity in both insurance types, but particularly in Medicaid, to find ways to offset some of the costs of comprehensive dental coverage by knowing that we see cost savings on the medical side.” ## How Changing Oral Health Care Delivery Transforms Patient Outcomes Learning more about cost and structure of care delivery over a life span provides a better understanding of our health systems at large, and how oral health care impacts overall quality of life. It also points toward a solution that will ultimately allow for more equitable care and better outcomes for all. “It’s like a kaleidoscope,” said Carolyn Brown, DDS, MEd, senior advisor on person-centered care at CareQuest Institute. “There are so many national and international programs focused on getting children the care they need so they’re not falling into that spending gap for preventive care.” Focusing dental practices on preventive care means providers are looking first and foremost at patient outcomes, and not on costs. This puts patients on an equal playing field when receiving care, regardless of the type of insurance they have. CareQuest Institute’s Three Domain Framework is a great example of this, utilizing a [value-based care approach](https://www.carequest.org/topics/value-based-care) that emphasizes person-centered care. “Ultimately we need health policies that center people and optimize care delivery, whether you are 4 years old or 85 years old,” Dr. Minter-Jordan said. “If there’s one thing that I hope you take away from \[this research\], it is that we all have a responsibility to come together to create an accessible and equitable oral health system for all.” **Categories:** Blog **Tags:** Dental Coverage, Value-Based Care --- ### [A Snapshot of the Oral Health in America Report ](https://carequest.org/blog/a-snapshot-of-the-oral-health-in-america-report/) **Published:** February 22, 2022 **Author:** Caitlin Locklear **Content:** *![](https://carequest.org/wp-content/uploads/2025/11/1dentalexamfebruary2022_3.jpg)Oral Health in America: Advances and Challenges*, a follow-up to the Surgeon General’s Report on Oral Health in America in 2000, was released in January. The [nearly 800-page report](https://www.nidcr.nih.gov/oralhealthinamerica), which includes writing and research from more than 400 contributors, explores the nation’s oral health during the past two decades. Why is the report significant? What might it mean for the oral health industry? Michael Monopoli, DMD, MPH, MS, FICD, the vice president for grant strategy at CareQuest Institute, shares his reactions below. Dr. Monopoli leads the Institute’s philanthropic grantmaking activities, leveraging his expertise to collaborate with grantees and partners to strengthen communities and promote health equity. He is a past President of the American Association of Public Health Dentistry, a Fellow of the American College of Dentists, and was inducted into the International College of Dentists in 2021. **Can you give us a snapshot of the report? What’s in it?** This report is an extensive review of the status of oral health in America, the effectiveness of the current delivery system, and most importantly, forms a basis for strategies for improvement. It is the work of hundreds of authors and reviewers with community input. **It’s hard to boil down a 790-page report, but what do you see as the main takeaways?** I would call attention to the three calls to action, which summarize the takeaways nicely. They are: - To significantly improve the nation’s oral health, policy changes are needed to reduce or eliminate social, economic, and other systemic inequities that affect oral health behaviors and access to care. - To improve oral health for more people, dental and other health care professionals must work together to provide integrated oral, medical, and behavioral health care in schools, community health centers, nursing homes, and medical care settings, as well as dental clinics. - To strengthen the oral health workforce, we need to diversify the composition of the nation’s oral health professionals, address the costs of educating and training the next generation, and ensure a strong research enterprise dedicated to improving oral health. **What policy changes do you think are probable or likely given what’s in the report?** The report provides compelling evidence of the need and effectiveness of interprofessional care, so continued support and work toward interoperability of electronic records and referral systems seems likely. The report also provides evidence of cost barriers to care, so hopefully policy around strengthening existing public dental benefits and creating new ones will occur. It’s likely that the focus and actions around addressing inequities will be strengthened by this report. **Do you think the report would have been different if the social spending bill that included adding dental benefits to Medicare had passed last year?** I am sure there would have been a specific section on Medicare if it had, but these reports are years in the making. The report was in its final form a year before the opportunity for a Medicare benefit was there. **Did anything in the report surprise you?** It’s focus on future opportunities for innovation was strong and it waded into some of the controversial issues like workforce changes. The focus on technology and future possibilities is a hopeful sign that we can move forward and rethink the way we manage oral disease and support equitable access and outcomes. It’s always a good sign when there is courage to productively discuss controversial topics, but we still have a way to go. **What was CareQuest Institute’s role in the report?** Many of our team members, grantees, and partners contributed to the report and we advocated strongly with then Surgeon General Adams to sponsor the report. **Several CareQuest Institute grantees are noted in the report.** Yes, for example, the National Interprofessional Initiative on Oral Health (NIIOH) and its Smiles for Life curriculum was recognized in several places throughout the report. And the North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Health Leadership and Innovation to increase access and equity in oral health care for North Carolina’s most vulnerable populations, was called out. In 2021, NCOHC and its key stakeholders drafted and introduced legislation in the North Carolina General Assembly to codify teledentistry in the state’s Dental Practice Act. **How might this report shape CareQuest Institute’s priorities and work in the coming years?** Since we advocated strongly to advance the report, we were gratified that it was very much aligned with our priorities. It will help us to advocate for our priorities and I hope we can use it as a baseline to show the progress of our work. **Why does a report like this come so infrequently?** It started as a Surgeon General Report. Surgeons general generally have focus areas and it takes a great deal of advocacy to get a Surgeon General to make the significant investment in a subject area that it takes for one of these reports. Our advocacy was strengthened by being able to say it has been 20 years, that it was a perfect time to reassess. *Editor’s Note: View the [full report, related fact sheets, and videos](https://www.nidcr.nih.gov/oralhealthinamerica) on the National Institute of Dental and Craniofacial Research website.* **Categories:** Blog **Tags:** Health Equity --- ### [Centering Veteran Voices: Takeaways from the Transforming Veteran Oral Health Colloquium](https://carequest.org/blog/centering-veteran-voices-takeaways-from-the-transforming-veteran-oral-health-colloquium/) **Published:** February 28, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Chelsea-Chokas-Quote.gif)It was one of those questions, one of those statements, that echoes long after an event concludes. “Go back to the simple question,” said Chelsea Chokas, MSM, a US Navy veteran and a project coordinator at CareQuest Institute for Oral Health. “‘Have you ever served?’ That’s a simple thing a doctor could ask in order to assess and give the best care.” The powerful call to action came at the conclusion of a virtual colloquium on Transforming Veteran Oral Health held by the [American Institute of Dental Public Health](https://aidph.org/) (AIDPH) in partnership with CareQuest Institute for Oral Health on February 15 and 16. Spanning two days and nine sessions, more than 120 industry stakeholders heard from nationally renowned speakers — health care providers, advocates, policymakers, educators, and veterans — on ways to transform the oral health care system for veterans. The event was part of a recently formed partnership between CareQuest Institute and AIDPH to explore solutions to veteran oral health care. As a part of that partnership, they released a white paper — “[Veteran Oral Health: Expanding Access and Equity](https://www.carequest.org/resource-library/veteran-oral-health-expanding-access-and-equity)” — in December. “We began our veteran oral health initiative near the beginning of 2021, focused on three key areas: access, research, and advocacy,” said Annaliese Cothron, AIDPH executive director. “Near the end of 2021, we co-authored a white paper with CareQuest Institute, defining eight strategic recommendations for improving access to and quality of oral health care for veterans.” The colloquium sessions built off the strategic recommendations made in the white paper, which were informed by the veteran community. “Together, our work with AIDPH is shining a light on the social, structural and individual drivers that impact veteran oral health,” said Chokas. “Our recent report includes strategic recommendations to increase accessibility to care for our veterans and stimulate rural oral health innovation — and all are informed by actual veterans and their experiences.” The two organizations are collaborating on a second white paper that will be published in the first half of 2022 and additional education to continue to highlight continued obstacles and promising solutions around veteran oral health. ## Opportunities to Improve Veteran Oral Health The event keynote was delivered by Dr. Rena D’Souza and Dr. Renée Joskow from the National Institute of Dental and Craniofacial Research, who discussed the [organization’s recent report](https://www.nidcr.nih.gov/oralhealthinamerica) that explores the nation’s oral health over the last 20 years and includes opportunities to advance innovative oral health for veterans. During other sessions: - Rear Admiral Timothy L. Ricks, DMD, MPH, FICD, who currently serves as the chief dental officer of the U.S. Public Health Service as well as assistant Surgeon General, participated in a discussion about the need to advance medical-dental integration for veterans. - Rebekah Fiehn, MSPA, manager of care coordination and interoperability at CareQuest Institute, discussed the latest developments, projects, and initiatives underway to help strengthen and build a coordinated oral health infrastructure for veterans. - Alan Morgan, chief executive officer for the National Rural Health Association, highlighted the importance of expanding the role of rural health clinics in veteran oral health care delivery. - Aniela Brown and Aimee Rachel from the Texas Association of Community Health Centers presented on prioritizing trauma-informed approaches to clinical care for veterans. In the final session to close out the colloquium — Veteran Voices: Dental Care from a Patient Perspective — a panel of veterans shared how their lived experiences have shaped their perception and access to dental care. Their perspectives gave some stark insights into the barriers to care, but also helped highlight pathways forward to achieve a more equitable and accessible dental care system for veterans. ## The Connection Between Oral Health and Overall Health The veteran panelists highlighted a lack of education for veterans about the connection between oral health and overall health. For Ashley Carothers, operations director at Minority Veterans of America and a veteran of the US Air Force, this began during active duty and is still a factor for her as a veteran today. “When they would talk about the whole person and taking care of yourself and your health, it left out dental,” said Carothers. “We were talking about mental and physical health and how those are connected, but dental health was never part of that equation. Even now, when I show up for an annual exam, we don’t even talk about dental.” Coupled with the lack of medical-dental integration, this has resulted in many active-duty service members and veterans not being armed with important information about how their oral health is connected to their overall medical health. ## Barriers to Care and Low Utilization Rates Many veterans do not qualify for dental care through the US Department of Veterans Affairs. Those who do often have difficulty navigating the complex system. [According to the VA](https://department.va.gov/wp-content/uploads/2025/06/2026-Budget-in-Brief.pdf), out of the 9.2 million veterans enrolled in VA health care, only about 1.4 million are eligible for comprehensive dental care, and, of those, only 33% access their benefits. The veteran panelists shed light on why this might be: long wait times to schedule appointments, limited dental services offered, lack of accommodation for service-related injuries, transportation hardships, and trauma. Tammy Barlet, MPH, the deputy director of Nation Legislative Services at Veterans of Foreign Wars who served in the US Coast Guard, stressed the importance of oral health clinicians incorporating trauma-informed approaches into oral health care for veterans and being sensitive to their life experiences. “Just having a slight grasp of whether that patient of yours sitting right there had served in the military or not can help,” said Barlet. Carothers highlighted transportation as a major barrier for veterans to access dental care, even if they’re eligible. VA dental clinics are often located in cities, while many veterans live in rural areas, often making transportation difficult and costly. “A lot of folks will take a look and say, ‘Do I go to my VA appointment two hours away, or do I go buy groceries?’” said Carothers. ## Solutions and Calls to Action To close out the session, the veteran panelists were asked about solutions and calls to action to improve the oral health care delivery system for veterans. For Carothers, it’s about building relationships and recognizing oral health as a part of overall health. She stressed the importance of “relationships, building partnerships with folks, and allowing folks to tell their story.” She also urged attendees to “bring whole health back into the picture for folks, starting with dental.” Barlet stressed oral care as preventive care. “Many oral diseases and conditions are preventable with early treatment, so if there’s awareness it’s going on before it gets too far along, it’s so beneficial,” she said. For Chokas, her main takeaway for the audience was that simple, yet powerful, question that she hopes providers will ask their patients more often: “Have you ever served?” **Categories:** Blog **Tags:** Dental Coverage --- ### [More on MDRAN: Answers to 11 Questions about a Successful Care Coordination System](https://carequest.org/blog/more-on-mdran-answers-to-11-questions-about-a-successful-care-coordination-system/) **Published:** March 16, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/2care-coordination-and-interoperability_2000x1335.jpg)Care coordination involves ensuring that all providers caring for a patient have access to the same information and can communicate seamlessly with one another. That coordination is critical to providing the right care, in the right place, at the right time. That coordination is also difficult to achieve — especially in the oral health system. One promising solution, the Medical Dental Referral and Navigation (MDRAN) system, was featured in the March 10 CareQuest Institute for Oral Health webinar, “Taking a Community-Based Approach to Care Coordination.” More than 300 dental and medical professionals joined the live call to learn more about the value of care coordination in oral health and the success of MDRAN, part of a pilot organized by [Children Now](https://www.childrennow.org/), in improving dental care for children in California. The presenter and panelists — Katie Andrew, EdM, associate director, Health, Children Now; Matthew Crandall, vice president of technology, MDRAN, Oral Health Solutions; Roberto Garces, MPH, program director, MDRAN, Oral Health Solutions; Robyn Alongi, health program planner, Sacramento County Public Health; and Rebekah Fiehn, manager of [care coordination and interoperability](https://www.carequest.org/topics/care-coordination-and-interoperability) at CareQuest Institute — responded to several questions during the program, but participants wanted to learn more about the success of the system. The panelists collaborated after the call to answer 11 questions about MDRAN and oral health care coordination efforts in Sacramento County. **1. What is MDRAN?** The MDRAN system was originally created to allow physicians to easily refer their Medicaid patients aged 0 – 20 years to a dentist. MDRAN is a HIPAA compliant, user-friendly, web-based system that uses claims/encounter data to make referral and tracking easy. In 2021, the system was expanded to include all Medicaid members in Sacramento County regardless of age. (In Sacramento County, care coordination is provided by the three managed care dental plans.) MDRAN also expanded the type of users from strictly physicians to include any organization/program that interacts with the Medicaid population to create a “no wrong door” approach to connecting people to dental care. This includes school-based screening programs, school nurses, WIC, Nurse Family Partnership home visiting program, and more. MDRAN tracks the referral to completion and notifies the referring user when a dental visit associated with one of their referrals has occurred. **2. Can MDRAN be used in other states?** Yes. For MDRAN to operate in other locations, it is necessary to obtain dental Medicaid data from the state directly or the contracted managed care dental plans. Because care coordination is a key component to ensure that a referral is “successful,” stakeholders would need to lay out a potential care coordination strategy based on the resources available. In the case where dental services are provided through a dental managed care structure, for example, the team would need agreement from the managed care dental plans to provide care coordination supports. **3. Do the providers (both medical and dental) need to log in to this system? Has there been resistance to “another” log in?** No. Only the referring user needs to log into the system. Once a referral is generated in the system, it is routed to the care coordination team embedded within the dental plan assigned to the Medicaid member so that they can initiate care coordination supports, such as assistance in scheduling a dental appointment, arranging for language services, and/or transportation assistance. The system then monitors new data uploads from the dental plans for a dental claim associated with that referral and alerts the referring user that a dental appointment happened, when it occurred, and what services were provided. The dentist who provided services does not have to log in to MDRAN or enter any information about the visit. **4. When MDRAN started, who engaged all the various organizations to participate?** Through the [Medi-Cal Dental Advisory Committee](https://dhs.saccounty.gov/PUB/Pages/Medi-Cal%20Dental%20Advisory%20Committee/GI-Medi-Cal-Dental-Advisory-Committee.aspx), Sacramento County has had a robust group of oral health stakeholders who have been meeting for many years to provide oversight and guidance to improve Medi-Cal dental utilization rates and the delivery of dental care services in the county. During the [Dental Transformation Initiative](https://www.dhcs.ca.gov/provgovpart/Pages/dti.aspx), this group was the basis for connections. Robyn Alongi (Sacramento County coordinator for the DTI) and Katie Andrew (Children Now, lead for the Medical-Dental Partnership pilot) were responsible for mapping out programs/organizations that provide services to the Medi-Cal community and then conducting outreach and recruitment. They connected with community clinics, OB/GYN providers, county programs, school nurses, the local dental society, the school-based screening program, and other stakeholders. **5. Was it necessary to incentivize medical providers to join MDRAN?** No incentives were provided to users. We have heard for many years that there was a huge unmet need and physicians did not have a reliable method to refer their patients to a dentist, nor were they informed of the outcomes of the referral if one was made. It took time and effort to recruit providers. Once we had data to support efficacy and primary care physicians understood how quick and easy the referral was, more providers began using the system. **6. Does MDRAN interact or connect data to health information exchanges?** Not at this time. MDRAN engaged with two of the largest health information exchanges in California and explored the possibility but discovered HIE currently does not have a robust enough dental dataset for MDRAN to work. We will continue to monitor the progress of HIE and its inclusion of dental data. **7. Is MDRAN still dependent on grant funding?** While our work in San Joaquin Valley is currently grant funded (Children Now is a grantee of CareQuest Institute), the three managed care dental plans currently support MDRAN in Sacramento County. We are discussing future support and expansion into other counties with local oral health programs and the managed care health plans that deliver Medi-Cal benefits within each of those counties. **8. Are there hopes to integrate Medicare and a system of referrals for oral care?** Dental referrals and referral management for the Medicaid population is the focus of MDRAN for the time being, as we work to expand the userbase in Sacramento and into other counties. There is still a lot of work to be done in the Medicaid space, but we are always open to exploring how MDRAN can facilitate referrals for other populations as well. **9. What system-level changes are still needed to ensure sustainability and spread of the MDRAN program?** Due to policy changes at the state-level through a managed care procurement process and a reimagining of California’s Medicaid program (referred to as CalAIM), Medicaid managed care plans in California are becoming increasingly responsible for the oral health of their members and are exploring strategies for care integration and coordination. The implementation of CalAIM will require a significant lift by both the managed care health plans and the state. As integration and oral health becomes more of a focus of the managed care plans, they will need to ensure that their provider networks are considering both the physical and oral health of their patients. It will be critical for referrals from medical providers to be tracked and managed as these integration efforts are rolled out. **10. We see MDRAN as a system well-positioned to assist Medi-Cal managed care plans in helping to connect their members to dental care, monitor care coordination efforts, and track and manage referrals. Care coordination takes more than just a referral. Often, there are other barriers to care which must be considered when building a network. Can you describe how your community is addressing social determinants of health and other barriers?** The care coordination teams that receive and coordinate MDRAN referrals have workflows that integrate some social determinants of health screens to determine if patients need assistance (e.g., transportation to get to their appointment, translation/language assistance, etc.). We are exploring the possibility of embedding additional SDOH screenings into MDRAN to be used at time of referral or at care coordination. **11. If a community wanted to get started with organizing around care coordination, what advice would you offer?** We have five pieces of advice: - Determine a source of funding. Talk to the local health plan, search for grant funding, ask the county. - Create a list of providers (who are accepting new patients) and the attributes of each office: what languages are spoken, what accommodations they make for patients with special needs (including wheelchair access to the exam rooms), their comfort with treating pregnant women, their office hours, etc. Keep this list up to date. - Think about how to organize the care coordinators by using a central hub or a place within key organizations such as Federally Qualified Health Centers, hospitals, and community-based organizations. - List organizations in the community that could refer people with dental needs to your care coordination team, including physicians, food banks, county programs, shelters, special needs programs, schools, and the local dental society. Who in your network has a connection to an organization that could facilitate an introduction? - Start reaching out to those organizations. *Editor’s note: For more information about MDRAN, contact Katie Andrew at [kandrew@ChildrenNow.org](mailto:kandrew@childrennow.org) or Roberto Garces at .* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Voices from the Field: Dr. Deborah George on Dentistry’s Lessons from the Pandemic](https://carequest.org/blog/voices-from-the-field-dr-deborah-george-on-dentistrys-lessons-from-the-pandemic/) **Published:** March 24, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Dr. Deborah George has worked at the [Jessie Trice Community Health System, a Federally Qualified Health Center in Florida](https://www.jtchs.org/), for more than 25 years. In her roles as the executive president of community affairs and chief dental officer, she oversees the system’s oral health program while cultivating collaborative relationships with community stakeholders. Dr. George’s career has focused on public health and university-based clinical and dental health care, rooted in her commitment to helping ensure that individuals have access to high quality health care and education. Dr. George took some time out of her busy schedule to share her perspective on the many changes the COVID-19 pandemic brought to the oral health industry. She’ll be part of a panel of experts who will explore the topic during the[ April 7 CareQuest Institute webinar](https://www.carequest.org/education/webinars/lasting-lessons-pandemic-responses-safety-net-dentistry). ![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Deborah-George-214x300.jpg)Dr. Deborah George **How did you first get into dentistry? Was there a moment in your life that pulled you toward that career path?** There is no greater honor than human service. My brief career working as a nurse in public and university-based hospitals reinforced my desire to serve and help people live healthier lives. I wanted to play a greater role in health care delivery. My firsthand awareness of the oral health disparities and inequities existing among low-income racial and ethnic minority groups and the underrepresentation of Black women in the dental profession influenced my decision to become a dentist. **Is there a woman in your life who influenced you on your path to becoming a leader?** First and foremost, I owe this honor to my grandmother and mother. And I have been surrounded by inspirational mentors, courageous leaders, nationally recognized CEOs, and grateful patients throughout my dental career. It is my personal connection to purpose and my duty to represent and be a vessel for those who sacrificed their lives to pave the way, not only for me, but for many women and colleagues to provide quality health care to those who need it most. **Why is it so important that we focus more attention on providing preventive care, especially to underserved populations?** Preventive care saves and improves lives. It has been reported that the four essential [risk factors](https://www.carequest.org/resource-library/covid-19-pandemic-deepens-oral-health-inequities) for severe COVID-19 include diabetes, high blood pressure, heart disease, and obesity. [These factors place people at-risk](https://www.carequest.org/resource-library/inequities-remain-pervasive-oral-health) for severe complications from COVID-19 and have known associations with poor hygiene. **Can you describe what delivering care throughout the COVID-19 pandemic has been like?** It became very personal to me. I lost a young, bright, and promising family member. At the same time, I felt fortunate to be a health care provider at Jessie Trice Community Health System. We provided teledentistry, emergency care, access to food, masks, COVID-19 tests, and vaccines to thousands of individuals. The benefits of offering COVID-19 testing in practices, which was quick and easy for patients, provided staff members with some reassurance about the health status of the patients who needed to be treated. We also had dedicated outreach oral health staff charged with providing cultural messaging and education on prevention and COVID-19, information on how to access COVID-19 testing and vaccines, and information on how to set up teledentistry visits. **Do you think the pandemic revealed any unique opportunities?** Dentists’ ability to administer vaccines and point-of-care health screenings. Oral health professionals play a role in helping patients achieve better overall health and may prevent the onset of chronic disease. There’s a need to strengthen medical-dental integrative care. **What pandemic-related changes to dentistry have you seen?** I’d highlight four: - I’ve seen increased access to point-of-care screenings in the dental setting, including COVID-19, HbA1c, and pulse oximetry tests. - We have dental equipment designed to decrease the generation of aerosol during dental procedures. - More dentists are receptive to the latest dental technology that will increase access to care and reduce the time patients spend in the dental chair—things like 3D imaging and 3D dental impression scanners. - We’ve seen an increase in the application of [silver diamine fluoride](https://www.carequest.org/resource-library/provider-and-public-perceptions-silver-diamine-fluoride). **Which of those changes do you think are likely to stick?** First, I see [telehealth](https://www.carequest.org/topics/teledentistry) as an opportunity to provide team-based care during a single visit (medical, dental, and behavioral health) as promising and long-lasting. I’d add the standardization of dental visits to include blood pressure checks, BMI, and glucose reading when required. Lastly, a positive change for patients: There’s been an increase in community literacy on oral manifestation of systemic diseases. **If you had a magic wand, how would you make dental care more accessible and equitable?** I would retire the professional title, “Dentist” and replace it with, “Oral health physician.” In addition to that, I’d promote dentistry as a specialty of medicine. This may influence the public perception and mindset on the value of a holistic approach to health care and how [oral health is integral to overall health](https://www.carequest.org/resource-library/impacts-beyond-mouth). Dental care can also become more accessible through health policy changes, including required well-child visits. School health physicals should not be deemed complete unless the individuals receive age-appropriate dental visits. *Editor’s note: Voices from the Field is a series of blog posts that highlight individuals who are working to improve the oral health system. From providers and policymakers to advocates and patients, we provide a snapshot of the backgrounds, ideas, successes, challenges, and daily lives of people who are making oral health care more accessible, equitable, and integrated. If you know someone we should feature, please write to us at .* **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration --- ### [Busting Four Myths about Investing in Health Equity ](https://carequest.org/blog/busting-four-myths-about-investing-in-health-equity/) **Published:** March 29, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2022/03/Dr.-Myechia-Minter-Jordan-presenting-at-a-recent-SXSW-session.jpg)Earlier this month, CareQuest Institute for Oral Health CEO and president Myechia Minter-Jordan, MD, MBA, presented an hour-long session at South by Southwest (SXSW) about [the business case for investing in health equity](https://www.fiercehealthcare.com/finance/sxsw-2022-business-case-investing-innovating-health-equity) — a topic that has increasingly become a priority across all industries, including health care. The COVID-19 pandemic drove home the reality that our health care system was built on [generations of systemic racism](https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01466). But it also created opportunities. Attitudes are changing rapidly, government regulations and priorities are changing almost as fast, and we are seeing rapid advances in technology and innovation in health care. So why aren’t more companies pursuing these opportunities? The reality is that the business case for investment is rooted in this historic underinvestment in communities of color for generations. This has led to myths and stereotypes about working in underserved communities that only perpetuate the inequities we — as nonprofit leaders, health care leaders, or tech investors — all seek to address. At SXSW, Myechia set out to bust four common myths about investing in health equity impact — lessons that extend far beyond the business world. ## Myth #1: Any investment in BIPOC communities is a good health equity investment. However well-intentioned, this is a common misconception. When working to lift up BIPOC communities, the first and most important thing to do is to check and double-check your biases. We all have them. To understand how your biases may impact your approach, do your research. Talk to the people most impacted. And do it before you start down the path. The quote “nothing about me without me,” coined in 1998 and often used to discuss the importance of shared decision-making in health care, fits well here. It’s used when patients and doctors are making medical decisions. Simply put, patients — or employees or communities — should be involved in decisions that directly affect them. It’s a lesson that CareQuest Institute brings to our work in oral health every day. ## Myth #2: The Medicaid population isn’t a viable market. One barrier to investments, particularly in Medicaid populations, is the notion that underserved communities are too challenging and complex. Any investment, the thinking goes, is philanthropic and provides little true business value. But that is absolutely not the case. Take the expansion of services covered within Medicaid. Particularly during the pandemic, states have begun to understand that expanding covered services is another way to reduce disparities in health care. For example: - Since the American Rescue Plan passed in March, [19 states have expanded pregnancy coverage](https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/) under Medicaid to help address the Black maternal health crisis. - And [seven states have expanded to include preventive dental coverage](https://familiesusa.org/wp-content/uploads/2021/10/OH-2021-224_Medicaid-Adult-Dental.pdf) in order to reduce health costs and better address chronic illnesses. The expansion of dental care under Medicaid to increase access to care will offer opportunities for nonprofit and for-profit organizations across the health care spectrum. ## Myth #3: Health Equity “investments” aren’t sustainable or scalable. Many people worry that developing solutions specifically focused on underserved communities isn’t sustainable or scalable from a business perspective. But the reality is that communities that are chronically underserved by our current models are often the best place to start, especially in health care. [Cityblock Health](https://www.cityblock.com/), a company dedicated to improving care for Medicaid populations, is proving this point. Cityblock Health now has a [valuation of over $5.7 billion](https://www.fiercehealthcare.com/practices/cityblock-health-raises-another-mega-round-cash-banking-a-reported-400m) — and continues to grow. ## Myth #4: Government and regulations kill opportunity. Understandably, the idea of working with a population that is entirely dependent on government programs that are heavily regulated can give people a headache. Anyone who works in the nonprofit space knows this reality. However, we’ve also seen that regulations in health care right now are changing at a relatively rapid pace, especially as government has been forced to adjust to the new reality of the pandemic. Teledentistry is a perfect example. In many states, at the start of the pandemic, it wasn’t even legal. But that is quickly changing. In June 2021, the [Texas legislature passed a law allowing teledentistry](https://www.dentistryiq.com/dental-hygiene/technology/article/14207643/texas-passes-timely-teledentistry-legislation), and many more states are following suit. Organizations like CareQuest Institute are also helping make it happen through funding and capacity-building activities within community organizations and advocacy. We’re working with the Texas Health Institute, which, since the law passed, has used grant funds to ensure that the community and consumer voice is involved in the design and early-stage implementation of the new law. Telehealth, and teledentistry in particular, is an area that is ripe for innovation and opportunity. And direct involvement of community-based organizations will ensure those advancements successfully help those who need it the most. **Categories:** Blog **Tags:** Health Equity --- ### [Six Things We Learned in Our First Year as CareQuest Institute](https://carequest.org/blog/six-things-we-learned-in-our-first-year-as-carequest-institute/) **Published:** March 29, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Areas-of-Activation.jpg)One year ago today — March 29 — we officially launched CareQuest Institute for Oral Health. Building on the strengths of past organizations, including the DentaQuest Partnership for Oral Health Advancement, we are accelerating oral health care transformation and moving faster, together, toward a health system designed for everyone. What’s our “why?” What drives us? Our health care system is not built to work for everyone: people of color, those living in rural communities, people with disabilities, older adults, and other historically marginalized groups have been left behind. The result is that millions of Americans suffer from unnecessary oral diseases every year. Our oral health system is ready for — and urgently needs — change. Every day, that’s what we try to do — create positive change. We elevate ideas and solutions to create a more accessible, equitable, and integrated health system for everyone through our five Areas of Activation: grantmaking, research, health improvement programs, policy and advocacy, and education. Within those areas, the last 12 months were filled with activity: - In collaboration with dozens of industry leaders and researchers, we published more than [130 publications and peer-reviewed articles](https://www.carequest.org/resource-library). - We worked with [101 grantees across 33 states](https://www.carequest.org/how-we-work/grantmaking), investing more than $14 million to improve local communities and systems. - We partnered with several organizations to produce more than 20 educational programs, [including 16 webinars](https://www.carequest.org/education/webinars) that provided skills and knowledge to oral health stakeholders. - We partnered with The Hill on a program about the [future of oral health](https://thehill.com/event/571965-future-of-medicare-and-oral-health) that drew interest from nearly 1,000 leaders across the health care spectrum. - We educated more than 10,000 oral health professionals, many of whom are striving to make change in our [health improvement programs](https://www.carequest.org/how-we-work/health-improvement-programs). Inside those numbers — inside those surveys, presentations, programs, publications, and investments — there are several lessons about the oral health industry that we learned alongside you in the last 12 months. As we reflect on our first year as CareQuest Institute, these six lessons stand above the rest: ## 1. Equity and access gaps are still widening. We launched the first-of-its-kind annual consumer oral health survey in 2021 focused on better understanding oral health inequity in the US. The findings were stark but not unexpected: People of color and lower-income populations consistently [experience obstacles to preventive oral health care](https://www.carequest.org/state-oral-health-equity-america-2021). Our research team is analyzing the results from this year’s survey, and we will be sharing several new publications in the next few months. Early results show that, despite some progress, barriers remain. ## 2. Communities of like-minded learners are transforming oral health. Building on past successes, the COrHT (Community Oral Health Transformation) Community Oral Health Transformation (COrHT) and MORE Care™ (Medical Oral Expanded Care) initiatives are positioned to enable more states, dental practices, and partners to work toward [redesigning our oral health system](https://www.carequest.org/how-we-work/health-improvement-programs). Better coordination, more integration, and the continued transition to value-based care will be the focus as work accelerates with new partners in states like Ohio and North Carolina in the coming months. ## 3. Strengthening adult dental benefits will be a journey. For the first time, Medicare dental coverage was a topic of national discussion last year. While the fight to include dental coverage for ALL Medicare beneficiaries continues, the support for ensuring that seniors and people with disabilities have access to the oral health care they need has never been stronger. [The fight, undoubtedly, will continue](https://www.carequest.org/education/resource-library/why-we-still-need-add-dental-medicare). We also saw more research that [strengthening Medicaid benefits helps states](https://www.carequest.org/resource-library/expanding-dental-benefits-good-states), adding energy and evidence to our continued [advocacy efforts in 2022](https://www.carequest.org/how-we-work/policy-and-advocacy). ## 4. Our veterans deserve better. In 2021, CareQuest Institute and the American Institute of Dental Public Health (AIDPH) partnered to begin exploring ways to improve veteran oral health care. A joint white paper, created in collaboration with veterans’ organizations and stakeholders across oral health, shined a light on the [gaps in oral health access and care for veterans](https://www.carequest.org/education/resource-library/veteran-oral-health-expanding-access-and-equity). The ongoing partnership will continue its focus on studying the current state of veteran oral health and access to care and then developing data-driven recommendations informed by the veteran community. ## 5. There’s a thirst for knowledge about minimally invasive care. Our most popular webinar from 2021 — [Providing Minimally Invasive Care with Silver Diamine Fluoride](https://www.carequest.org/education/webinars/providing-minimally-invasive-care-silver-diamine-fluoride-sdf) — came in August, grabbing the attention of nearly 1,000 industry leaders. Minimally invasive dentistry —preventive and noninvasive treatments to equitably reduce suffering from caries and periodontal disease — has the potential to improve the care experience for patients and providers. Our experts answered [17 additional questions](https://www.carequest.org/about/news/answers-17-your-silver-diamine-fluoride-questions) after the program, predictably, ran short on time. ## 6. Holistic, person-centered care is the future. Our oral health system developed over time in patchwork form, producing a system that isn’t well-designed to achieve the best outcomes for patients. The existing fee-for-service model leads to misaligned financial incentives. And dental providers are siloed from the rest of health care, despite clear evidence of the connection between [oral health and overall health](https://www.carequest.org/learn/online-learning-center/resource-library/mouths-matter-more-you-may-know) and the [benefits of integration](https://www.carequest.org/resource-library/more-care-evaluation-interprofessional-oral-health-quality-improvement-initiative). We will continue to build upon the [Three Domain Framework](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) as we envision a new oral health system of the future. For all those lessons and more, all of us at CareQuest Institute would like to thank you. Thank you for working with us, learning with us, and improving with us. Together, and only together, we will improve the oral health of all. We can’t wait to see what the next year will bring. **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Voices from the Field: Dr. Kelly Tanner on Elevating Dental Hygienists](https://carequest.org/blog/voices-from-the-field-dr-kelly-tanner-on-elevating-dental-hygienists/) **Published:** April 15, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)Dr. Kelly Tanner knew from a young age she wanted to be a dental hygienist. Today, as the CEO of Next Level Dental Hygiene and Ascend Health Partners, she provides dental organizations and hygienists with support and educational tools to develop leadership skills and accelerate careers in oral health care. In honor of National Dental Hygienists Week (thanks to all the hygienists for the great work they do every day!), we asked Dr. Tanner to answer some questions about her experience as a dental hygienist, industry educator, and frequent speaker. Below, she shares the unique lens in which she views the role dental hygienists play in creating a more accessible and equitable oral health system — and one leadership skill all hygienists need to be successful. ![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Kelly-Tanner-e1764966211369.jpg)Dr. Kelly Tanner **Why did you choose to pursue a career as a dental hygienist?** Dental hygiene is the best profession in the world because of the impact we can make in people’s lives. As the owner of Next Level Dental Hygiene and Ascend Health Partners and part owner of The Team Equation, I’m able to help millions of people through what I’ve learned in my three decades of experience in dentistry and earning coaching certifications, and a PhD in organizational leadership. **Was there an experience or moment when you knew it would be a career for you?** My career in dentistry began at 17, when I was a dental assistant. When observing my hygienist, I could see the difference she was making in people’s lives and knew that’s what I wanted to do. I knew from a young age that dental hygiene was a profession that had no limits on the impact I could make in the world. **You’ve had many roles throughout your career — educator, case manager, small business owner. Which did you find most rewarding?** The most rewarding role wasn’t in a position for me — it is in the way I see the possibility to help people reach their highest potential. Finding my “why?” and purpose has served as a beacon for how I perform in any role. **You’ve also delivered many presentations in your career. (Your LinkedIn page says more than 1,500!) Can you share a couple tips on how to deliver a compelling presentation?** Always make it about the audience, focusing on their emotions, wants, and desires. **What one innovation do you see as really transformative for dentistry in the next year or two?** [Shared systems for patient health records](https://www.carequest.org/topics/care-coordination-and-interoperability) across all medical professions. I believe that medical-dental technology solutions that connect patient records can deliver the best health outcomes. There’s an enormous opportunity to streamline the care hygienists provide and communicate the information across a global system of health. **What one leadership skill do you think hygienists need to be successful in their field?** Communicating with empathy. It’s important to meet people where they are to connect in a meaningful way and understand their perspectives. Then you can decide the best way to respond. **What one change would you make to elevate the dental hygiene profession?** A shift in mindset and openness from the industry on how hygienists can utilize technology to serve their true purpose of educating and caring for patients. **How can hygienists help create a more equitable, accessible oral health system?** First, it’s critical for hygienists to understand the importance of how the information they gather every day is informing a larger opportunity for patients. The assessments and digital health scans all inform other health care systems of causal effects of possible disease and health. Comprehending this information empowers hygienists to understand their role and create systems with their team and other health care providers to improve outcomes of patients across health care systems. Second, hygienists are organically elevated because of the vital role they play in [value-based care](https://www.carequest.org/topics/value-based-care). Hygienists can take this information and apply it to educational systems, nonprofits, and even their own offices. *Editor’s note: Voices from the Field is a series of blog posts that highlight individuals who are working to improve the oral health system. From providers and policymakers to advocates and patients, we provide a snapshot of the backgrounds, ideas, successes, challenges, and daily lives of people who are making oral health care more accessible, equitable, and integrated. If you know someone we should feature, please write to us at marketing@carequest.org.* **Categories:** Blog **Tags:** Health Equity --- ### [How One FQHC in Florida Is Approaching the Future of Oral Health Care](https://carequest.org/blog/how-one-fqhc-in-florida-is-approaching-the-future-of-oral-health-care/) **Published:** April 18, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Quote-from-Dr.-Deborah-George-e1764966024703.gif)Over the course of the pandemic, health care providers have adapted to a new kind of workplace reality. For oral health care providers, that meant learning how to deliver dental care in the safest way possible, for both patients and staff. To discuss how the pandemic has led to some lasting changes in oral health, Dr. Deborah George, the chief dental officer and executive vice president at the [Jessie Trice Community Health System, a Federally Qualified Health Center (FQHC) in Florida](https://www.jtchs.org/), shared her organization’s experience during the March 7 CareQuest Institute webinar “[Lasting Lessons from Pandemic Responses in Safety Net Dentistry](https://www.carequest.org/education/webinars/lasting-lessons-pandemic-responses-safety-net-dentistry).” Sarah E. Raskin, PhD, MPH, an assistant professor and researcher at Virginia Commonwealth University, and Lisa E. Simon, MD, DMD, fellow in Oral Health and Medicine Integration at Harvard School of Dental Medicine, also joined the expert panel and shared their perspectives on the ongoing changes in the industry. ![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Deborah-George-214x300.jpg)Dr. Deborah George ## Medical-Dental Integration and Social Determinants of Health Throughout Dr. George’s presentation, there was one key theme that emerged: the importance of proper [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration). As an FQHC, the Jessie Trice Community Health System has a variety of health care providers on staff, and patients can meet with all their providers in one visit. This kind of care system prioritizes treating a patient’s overall health — a desired outcome of medical-dental integration — versus siloed treatment. When discussing some of the top lessons learned during the pandemic, Dr. George homed in on several ideas around how to improve the medical-dental experience for patients. “For one, we know that teledentistry and team-based telehealth visits really work, and they increase access to care,” Dr. George said. “There’s an opportunity to strengthen oral health and primary care integration, and we were able to do that through team-based care and having one visit. With teledentistry and telehealth, \[patients\] had different doctors on board, and each one of them provided care to the patient for 15 minutes each. Patients were appreciative, and it was a good alternative to coming in on a regular basis, and they can see all their health care providers in just over an hour.” Dr. George also discussed the increased need to address social determinants of health and the importance of culturally competent care, including understanding a patients’ lived experiences outside the health center. “During the pandemic, we learned a few things,” said Dr. George. “For example, when we asked people to wait in their car because we couldn’t accommodate more than 10–15 patients in our lobby, some patients would tell us, ‘I don’t have a car to wait in.’” ## The Future of Oral Health Incorporating those lessons learned, Dr. George went on to explain the center’s vision for the future of dentistry, one that focuses on three main areas: - Promoting prevention and optimizing dental care visits, including: - oral cancer screenings - education around vaccine hesitancy - a focus on minimally invasive dentistry - Strengthening a dental-medical integrative care model, including: - team-based telehealth care visits (dental, medical, nutritional, pharmacy, and behavioral health) - increased use of intraoral camera in school-based programs - hiring a patient-centered health care navigator to help improve access to preventive dental health care; work closely with the primary care medical team; and coordinate oral health visits for prenatal patients, children, adolescents, adults, and seniors with chronic medical and dental diseases - Increasing patient access and workflow efficiency, including: - an enhanced AEGD Residency Program - increased access to dental procedures and decreased patient time spent in the dental chair - a robot assistant that can provide age-specific oral health education and post-operation instructions *Editor’s Note: To learn more, [watch a recording of the webinar.](https://www.carequest.org/education/webinars/lasting-lessons-pandemic-responses-safety-net-dentistry)* **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration --- ### [Behind the Scenes with an Oral Health Advocate](https://carequest.org/blog/behind-the-scenes-with-an-oral-health-advocate/) **Published:** April 19, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Pareesa-e1764965594667.jpg)Pareesa Charmchi Goodwin For Pareesa Charmchi Goodwin, hearing people’s stories, hearing how she can help, is a gift. “I am fortunate to have built relationships with community leaders and people we advocate for,” she says. “I am honored and humbled when people trust us with their stories and ask for advice on navigating the system. And unfortunately, there is no shortage of these stories.” Goodwin is the executive director at the Connecticut Oral Health Initiative (COHI), a 501(c)(3) nonprofit that [advocates for oral health access, equity, and quality though policy change.](https://www.carequest.org/how-we-work/policy-and-advocacy) COHI prioritizes the perspectives of directly impacted communities — i.e., minoritized and underserved communities — and works in close partnership with provider associations and oral health stakeholders. “But we are not a traditional oral health coalition,” Goodwin says. “We are clear that we advocate for the public and prioritize the concerns of communities that experience disproportionate levels of adverse oral health outcomes and do not have consistent access to quality oral health services.” Goodwin and hundreds of oral health advocates like her around the country are continually working behind the scenes to improve the oral health system. She will share some of the lessons learned during the April 21 CareQuest Institute webinar, [“Community-Centered Grantmaking: Why, How, and What Lies Ahead.](https://www.carequest.org/education/webinars/community-centered-grantmaking-why-how-and-what-lies-ahead)” Leaders from the CareQuest Institute grantmaking team and Jennifer Goldberg, JD, a deputy director at Justice in Aging will also discuss the historical power imbalances in oral health and the urgent need for systems-change solutions. A glimpse into Goodwin’s work provides a snapshot of the challenges and successes many advocates see every day. ## Goals and Recent Accomplishments “I am proud of the community engagement practices we have built and continue to hone,” Goodwin says. “We are building on our long-standing relationships with community leaders to reach adults on Medicaid, gather their perspectives, and shape our policy agendas and priorities based on community feedback.” In 2022, those priorities for COHI include: - Increase the dental reimbursement rates for adults to expand provider participation in the HUSKY program and the acceptance of adults on HUSKY as patients. - Increase access to care by developing a dental therapy workforce. - Close gaps in Medicaid dental coverage, including covering periodontal services, two cleanings per year, and the use of silver diamine fluoride. - Determine the impact of the annual maximum benefit policy on adult dental Medicaid. - Build support for — and advocate for — the state to capture dental claims in the all-payors claims database. Promote the inclusion of oral health inclusion in the newly forming Health Information Exchange (HIE). “We are also engaging interested individuals and groups in advocacy to address the problems they identify,” Goodwin says. “We help people identify and contact their legislators, testify at public hearings, and track legislative proposals, for example.” In the past three years, Goodwin points to some important policy gains: - a 25% increase in the Medicaid adult dental reimbursement rates and an additional increase for adult dental endodontic services (pending Connecticut state budget approval in May) - a second cleaning for adults on Medicaid who have chronic conditions or are pregnant - Adults on Medicaid in Connecticut are otherwise limited to one cleaning a year - a public act that allows dependents up to age 26 to keep their family dental coverage — just as they can health/medical insurance - authorization of dental therapy “We have much to do to implement dental therapy,” adds Goodwin, “including making changes to the statute to establish a license and removing unnecessary barriers to developing the workforce.” ## A Day in the Life of an Oral Health Advocate There’s no “average day” for an advocate. Instead, it’s a mix of activities depending on the time of the year. “There are always lots of phone and video calls (since the pandemic) with oral health stakeholders throughout the state, including provider associations, state agencies, as well as health/poverty alleviation/social justice advocates, and direct service providers,” says Goodwin. “We work hard to reach community leaders and families in rural areas and cities, faith groups, people who are experiencing economic insecurity.” In the spring, during the legislative session, the calendar is filled with testifying at public hearings, getting others to testify at hearings, speaking with legislators and state agency staff, and speaking at press events with partners. There’s also frequent and ongoing coordination with other health and social justice advocates, such as the HUSKY 4 Immigrants Coalition and Medicaid Strategy Group, to move the needle on issues through coordinated advocacy campaigns and contribute unique and invaluable oral health perspectives and knowledge. Throughout the year, Goodwin meets with researchers and partners on projects like the Medicaid Gap Analysis. She also sits on multiple state advisory bodies where she aims to (1) advance oral health access, equity, and quality and (2) elevate community voice. And always, the team is fielding calls from people who are having difficulty finding a provider or navigating the dental care system. “Mostly we hear from people on Medicaid, people with special health care needs (or parents of children with special health care needs, people who are undocumented and not eligible for public insurance,” Goodwin says. Like everyone, the work has looked different during the pandemic — but it led to some positive changes, too. “We had to shift our community and stakeholder engagement, partner and team meetings, and advocacy from in-person to virtual engagement,” Goodwin says. “This was a difficult shift in some ways (e.g., some communities lack good broadband access), but we were able to continue a lot of the work that we do and even develop a deeper community engagement strategy during the past year.” The shift toward virtual communication and engagement also alleviated transportation and childcare coordination barriers to participation. ## Hope for the Future What’s next for Goodwin and COHI? Along with the coming legislative sessions, the focus on their six key priorities will keep them busy in 2022. And if Goodwin could wave a magic wand? “Comprehensive oral health services would be an essential component of health coverage for all ages,” she says. “This would do wonders for access, as coverage and affordability are key components of access, and it would do wonders culturally. Oral health is treated as an ‘optional benefit.’ This undermines the importance of oral health and makes it difficult to secure additional funds for oral health or fend off budget cuts.” In the meantime, she and the team will be answering calls and sharing resources, including information on the state’s Medicaid program, and guiding people toward community health centers and other safety net options in local communities. “I stay grounded by staying close to community and anchoring myself in their experiences,” Goodwin says. “There is a lot of work to do in the way of oral health access and equity in Connecticut.” *Editor’s Note: To hear more from Goodwin, check out the April 21 CareQuest Institute webinar, [“Community-Centered Grantmaking: Why, How, and What Lies Ahead.”](https://www.carequest.org/education/webinars/community-centered-grantmaking-why-how-and-what-lies-ahead)* **Categories:** Blog **Tags:** Health Equity --- ### [Why We Created the Oral Health Equity in America Survey — and What We Found](https://carequest.org/blog/why-we-created-the-oral-health-equity-in-america-survey-and-what-we-found/) **Published:** April 22, 2022 **Author:** Caitlin Locklear **Content:** How is America’s oral health? It’s a challenging question, especially when you consider all the potential sources of information. Is the best answer based on behaviors and experiences in dental offices and communities across the country? Or is it better to look at knowledge, like how much a person understands about the connection between their oral health and overall health? Or perhaps perception would provide the best insight — the value of oral health in one’s life or confidence in a particular smile. The best answer is probably all of the above, which is exactly why CareQuest Institute for Oral Health created a nationally representative survey of 5,682 adults earlier this year. The survey — what we call the State of Oral Health Equity in America survey — is a [follow-up to a similar survey we created in 2021](https://www.carequest.org/state-of-oral-health-equity-america-2021). (NORC at the University of Chicago collects the responses.) This year’s survey yielded dozens of novel and compelling insights on the landscape of oral health, many of which the CareQuest Institute research team is examining and comparing as you read this. As a companion to the many reports, articles, and educational programs the Institute will release in the coming weeks and months, here are some additional insights from our research team on why we conduct the survey, some early findings, and areas within oral health that are ripe for change. **What is the State of Oral Health Equity in America survey?** The State of Oral Health Equity in America survey is the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. In addition to gathering information on individuals’ oral health experiences, this survey also collected information on how insurance coverage, oral health literacy, and how access to a trusted provider can improve oral health opportunities and affect outcomes. **Who completed the survey?** NORC at the University of Chicago collected survey results in January–February 2022 (and in 2021) on adults 18 and older on the AmeriSpeak panel. The data obtained from more than 5,000 adults from across the United States can be stratified in a variety of ways to gain a better understanding of oral health behaviors, literacy, and other neighborhood, social, and psychosocial factors associated with oral health inequities. Barriers to oral health care have been well recognized in the past, but these data provide new perspectives on inequities related to factors such as food insecurity, housing instability, discrimination experiences, and the social determinants of health. **What were some noteworthy findings from the 2022 survey?** There are far too many to list here, so here are six that stood out: - 96% of adult Americans know that there is a connection between the health of the mouth and the rest of the body. - Cost (27%) was the primary reason adults did not go to the dentist in the last two years. COVID-19 (18%) was the second-most-common reason. - More than two-thirds of adults strongly agree that dental care should be covered by Medicaid (67%) and Medicare (70%). - Nearly 6 in 10 (59%) of Black adults have lost one or more permanent teeth to decay or gum disease compared to 45% for all adults. - Nearly a third of adults (29.9%) used a patient portal to access oral health information in 2022, compared to only 16.2% in 2021. - Approximately 1 in 4 adults (25.2%) rate oral health as more important than physical health. **What one finding was most surprising?** That we have seen substantial increases in American’s knowledge of the interconnection between overall and oral health in just the last year. The time is right to create more [medical/dental integration](https://www.carequest.org/topics/medical-dental-integration). Americans are asking for it. **Why do we dedicate so much time and effort to this? Why do we believe it’s important?** To our knowledge, there is not another nationally representative survey of this size and high quality completely devoted to oral health. Other major surveillance tracking surveys, generally funded by the federal government, have some oral health questions, but it’s challenging to add new questions to those surveys or to use the information in them to respond to immediate changes in the environment, as the data can be 2–4 years old by the time it’s released. Our survey provides timely and actionable insights into the state of adult attitudes, knowledge, and beliefs — as well as the state of oral health equity — and allows for a deeper understanding among key market segments and historically underserved communities. **What do we hope oral health stakeholders do with this knowledge?** We hope that they use the knowledge we generate with this data to inform advocacy, policy, technology advancement, and clinical endeavors to serve those who can most benefit from increased access to oral health care as we continue our work to transform the oral health care system into one that is more accessible, equitable, and integrated. CareQuest Institute uses the findings to inform our programmatic initiatives and grantmaking efforts, and we think it can be used by others in the industry to react to market trends in a timely way. **What other topics do we plan to explore in dedicated reports and articles?** We’re still examining the data and aligning areas with our strategy — and [we’d love to hear any ideas from the field](mailto:info@carequest.org?subject=Ideas%20for%20State%20of%20Health%20Equity%20Survey%20Research) — but we can definitely share a few topics we will be exploring: - Dental anxiety - Oral hygiene habits - Attitudes toward value-based care - The oral health of specific populations, including veterans, LGBTQIA+ individuals, and members of American Indian and Alaska Native communities - Emergency department use for dental conditions **How can you call the survey “nationally representative”?** AmeriSpeak is a probability-based panel designed to be representative of the United States’ household population. Randomly selected US households were sampled using area probability and address-based sampling, with a known, non-zero probability of selection from NORC National Sample Frame. Sampled households were contacted by mail, telephone, and field interviewers. A sampling unit of 17,603 was used, with a final sample size of 5,682 and a final weighted cumulative response rate of 4.0%. All data presented account for appropriate sample weights. The margin of error for the survey is 1.75%. **Will we be doing this every year for the foreseeable future?** Yes. We will continue to track trends in existing variables while also expanding and revising to adapt to the changing needs of the oral health care landscape. **Categories:** Blog **Tags:** Health Equity --- ### [A Workforce Win: Dentist and Dental Hygiene License Portability Is Underway](https://carequest.org/blog/a-workforce-win-dentist-and-dental-hygiene-license-portability-is-underway/) **Published:** May 2, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Hygienist-200x300.jpeg)When you pull out your wallet, you’re likely to see a driver’s license. Perhaps you earned that license in Maine, Minnesota, or Montana. Or maybe it was in West Virginia or Wisconsin. Although your education and licensure took place in one of those states, you can legally operate a vehicle in all 50 states. As the driver, it is your responsibility to know and follow the traffic laws of the state in which you are driving, even when crossing state lines. This is how dental and [dental hygiene licenses](https://www.carequest.org/education) would work within states that agree to an interstate licensure compact. As a dental hygienist for many years, I can write with confidence that this would benefit the industry and the providers within it. Fortunately, the American Dental Hygienists’ Association (ADHA), along with the American Dental Association (ADA), has been working with the National Center for Interstate Compacts to allow dentists and dental hygienists to work seamlessly within states that choose to join the compact. The session on the topic was one of the most popular ones I attended during the [National Oral Health Conference (NOHC)](https://www.nationaloralhealthconference.com/) last month in Fort Worth, Texas. The work on the compact began in November 2020, with completion anticipated during the spring of 2023. This development will help increase access to care for patients and expand the ability for many licensed providers to practice in the oral health profession. “ADHA is excited to be a part of the development of an interstate licensure compact for dental hygienists and dentists,” said Ann Lynch, director of advocacy at ADHA. “We are grateful to the US Department of Defense for funding this critical project and to The Council of State Governments for its expertise in crafting interstate licensure compacts. This is a transformative moment for the professions of dental hygiene and dentistry.” ## The Complexity of Dental and Dental Hygiene License Portability Dentists and dental hygienists must be licensed by the state in which they are practicing. If a person chooses to move to a different state, or lives near state borders, they may need to become licensed in more than one state. Applying for licensure in different states can be complicated and expensive, as each state has different requirements for continuing education. “Professional licensure mobility can be an obstacle for all practitioners with additional fees, paperwork, and producing records to meet a new state’s licensure requirements,” said Lynch. “Dental hygienists and dentists who work in multiple states, who are moving, or are military spouses know the challenges of seeking licensure in a new state. Interstate licensure compacts improve license portability and are a solution to the many hurdles practitioners face in seeking a license in a new state.” [Costs for dental hygiene licenses vary by state](https://www.adha.org/education-resources/maintain-your-licensure/ce-requirements-by-state/). For example, the most expensive states include Louisiana ($270 for two years), Texas ($222 for two years), and Maine ($175 for two years). On the other end of the spectrum, Washington ($50 for one year), Utah ($37 for two years), and South Dakota ($95 for five years) are among the least expensive. There are also a variety of continuing education (CE) requirements for [dental hygiene license](https://www.carequest.org/education) renewal. For example, Wisconsin requires 12 CE credits every two years, Utah requires 30 credits every two years, and Arkansas requires 40 credits every two years. Further, some states spell out specific licensure CE criteria needed such as CPR certification, human trafficking awareness, infection control, chemical dependency awareness, tobacco cessation, and/or jurisprudence. Some states put specific limits on how many CE credits can be earned in a specific area such as insurance, governmental relations, patient management skills, and methods of health care delivery. ## Voices for Change in the Oral Health Industry It’s no secret that the COVID-19 pandemic has disrupted the oral health industry in countless ways. Infection control, access to care, teledentistry, and [growing inequities](https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need) are just a few of the topics that have reshaped dentistry in the past two years. [Staffing shortages](https://jdh.adha.org/content/96/1/27) among dental hygienists is on the list, too. And those shortages can lead to a [gap between patient supply and demand](https://www.dentaleconomics.com/practice/article/14214763/the-staffing-shortage-is-limiting-dentistrys-recovery-whats-next). Making it easier for dental hygienists to move from state to state can only help. A few minutes on the Wisconsin Dental Hygienists’ Association Facebook page reveals a compelling need among dental hygienists faced with state licensure challenges: - “I am a travel hygienist based in Illinois. As I travel every 4–6 months, getting a new license in every state is challenging.” -M. Hussen - “I live in MN, 1 mile from Iowa where I work, and 45 miles from WI and pay to have all 3 licenses current . . . It is a major pain to keep up with all the different licensure requirements and different renewal dates.” -M. Hirsch Coyle - “I feel stuck in Wisconsin. The knowledge of how to do our job is the same in each state. There are nuances in each state, which could easily be learned.” -H. Jenness - “I am a military spouse. We move on average every 2–3 years. I currently have 3 active state licenses and one additional state license that I didn’t renew, that require different amounts of continuing education (CE) to keep up, different renewal times, and costs. We currently live in a state that if I would try to get a [dental hygiene license](https://www.carequest.org/education), I would have to start over like a new graduate. It’s a headache.” -K. Gall ## The Path to Dental and Dental Hygiene License Portability After her presentation at NOHC, Lynch provided additional details on the status of the interstate compact project: “It has formed a technical assistance group and is now forming a document team to draft a compact based on the recommendations of the technical assistance group,” she said. “Later this year, a draft will be available for all stakeholders to review and comment on.” “Creating the case for an interstate licensure compact and writing the actual contract takes time, patience, and collaboration with key stakeholders,” Lynch said. For example, the US Department of Defense has been a [key player in initiating and supporting the compact ](https://dimensionsofdentalhygiene.com/article/adha-ada-join-forces-advocate-license-portability-mobility-across-state-lines/#:~:text=The%20ADHA%20and%20ADA%20are,lines%20and%20continue%20to%20practice.)because of the high number of military spouses who were unable to work in their licensed dental profession when their military spouse was relocated to another state. There are three phases to the process, including development, education and enactment, and transition and operation. Ultimately, the proposed compact will based on professional requirements that are already similar from state to state: education requirements from accredited programs, a written examination, a clinical examination, a jurisprudence exam, a background check, and CPR Certification. ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH “Once final compact language is developed, state legislatures will need to consider and enact the new legislation to implement the interstate licensure compact for dental hygienists and dentists,” Lynch said. “States that become members of the compact will improve licensure portability opportunities for their practitioners.” *Authored by Kelly Schroeder, MS, RDH, Health Science Specialist, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [Seven Common Questions on Dental Fear and Anxiety](https://carequest.org/blog/seven-common-questions-on-dental-fear-and-anxiety/) **Published:** May 11, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Sad-person.jpg)Dental fear and anxiety can pose significant barriers to receiving dental treatment and affect people across socioeconomic and demographic groups. “Estimates of dental anxiety range widely from about 30–80% in the US and worldwide,” said Lisa Heaton, PhD, science writer for Analytics and Evaluation at CareQuest Institute for Oral Health. “Different studies define and measure dental anxiety differently and measure it within different populations. For example, estimates of dental anxiety are likely to be lower in a survey in an undergraduate classroom setting than from a survey from patients in an emergency dental clinic waiting room.” Wherever it’s measured, dental fear and anxiety can be challenging for patients to cope with and for providers to treat. It can create a “cycle of avoidance,” leading to missed care, deteriorating oral health, and costly procedures that impact the overall oral health system. Cameron Randall, PhD, assistant professor at the Department of Oral Health Sciences at the University of Washington School of Dentistry, and Dennis Nutter, DDS, DABPD, FACD, diplomate from the American Board of Pediatric Dentistry, joined Heaton in a [CareQuest Institute webinar on the topic on May 5](https://www.carequest.org/education/webinars/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help). The trio shared their expertise on dental fear and anxiety across the life span and discussed how childhood experiences can influence oral and overall health in adulthood. “The first conceptual issue that I think is critical for understanding and managing a patient’s anxiety is that the causes and the impact of dental fear and anxiety are highly individualized,” Randall explained. Heaton began by exploring public perceptions of dental fear and anxiety, including [some results from the CareQuest Institute’s State of Oral Health Equity survey](https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need). Randall, a clinical psychologist, explored the science behind the negative feelings many individuals have about receiving dental care. And Nutter, who has practiced pediatric dentistry for more than 30 years, discussed potential solutions for preventing or addressing dental fear and anxiety. “We have kids who are orchids, and we have kids who are dandelions,” Nutter said. “We need to provide all of our child patients with the environment in which they can thrive. And, really, the way to do that with kids with high levels of fear is to not do procedures that you can defer until the child ages to procedural tolerance or until the baby tooth falls out.” Webinar participants shared several thoughtful questions on the topic before and during the program. We’ve compiled a list of the questions and answers below — and tapped our expert panelists to address a few additional ones. **1. Is it appropriate to use nondental terms to lower children’s dental fears — for example, telling a child you are putting a star on their tooth instead of a filling?** We need to communicate with the child on the level at which they process their environment. You need to adjust your terminology to what the child can understand. For example, a slow-speed dental handpiece becomes “Mr. Bumpy.” We are trying to change the way they think about an apparatus or parts of a procedure so that they don’t fear it. We have to be careful about that because we can’t trick children into painful experiences, but we need to communicate with kids at their level. **2. What’s the connection between dental anxiety/fear and depression?** There is a [recent systematic review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142663/pdf/CPEMH-14-207.pdf) on the association between higher levels of dental fear and anxiety and other psychiatric comorbidities. In the case of depression specifically, there have not been any studies that have tried to tease apart cause and effect, which comes first, or how they are related. But what we know, from the health psychology literature more broadly, is that sometimes a mood disorder like depression can lead people to become less engaged with hygiene activities, including oral hygiene. That can lead people to have more negative experiences when they finally do visit the dentist, or it can result in more symptom-driven, treatment-seeking behavior. **3. Do you have any tips for reducing sensory stimuli like the sound of the drill?** Sensory distress that comes with any part of the procedure may be there because the patient had pain associated with it in the past, a common cause of dental fear and anxiety. So, if they are having distress with the sound of a drill, they’re likely having it because it’s invoking fear. Deconditioning is necessary to curb this fear, which is done by making sure that they don’t have pain associated with the sounds and other aspects of dental treatment — and that takes time. We also want to seize opportunities to prevent dental fear in the first place. One strategy is to distract the patient from the dental stimuli, for instance, to help minimize the “scariness” of the sounds of the drill in the future. People have a finite amount of attention to give to things, so if we can divert attention away from the dental stimuli through distraction, that is an excellent approach. The real trick to doing this most effectively is to use the most immersive, distracting stimuli, like virtual reality, television, or music. **4. How can we address anxiety that prevents patients from initially scheduling an appointment or before a patient has their first appointment?** A major source of dental fear and anxiety for people looking for a new dentist is the unknown. Will this new dentist understand my fear? Will they be able to treat me and make me comfortable? A dentist’s practice website is a great place to share information with potential new patients about how the dentist helps fearful, anxious, and phobic patients feel more comfortable before, during, and after treatment. If possible, testimonials from current patients who have overcome (or at least learned to manage) their fear and anxiety with the help of the dentist can go a long way to helping new potential patients decide to make that first call. When working at the Dental Fears Research Clinic at the University of Washington, we sometimes had patients who were seeking a new dentist due to relocating to a new state, for example. I would always suggest that they schedule a “meet and greet” session with a new dentist to discuss their concerns, what has been helpful for them in managing their fears before, and how the new dentist can help them. Over the last two years, we’ve all become much more familiar with videoconferencing (e.g., Zoom), and it’s easy to have a short video call with a new patient so they can get to know you and vice versa. This will help alleviate at least some of the fear of the unknown before the new patient arrives in your office for the first time. **5. What tools would you recommend for assessing dental anxiety? Are there one or two you would highlight?** There are several validated self-report questionnaires that can be used to measure the severity of a patient’s dental anxiety. The [Dental Fear Survey](https://pubmed.ncbi.nlm.nih.gov/4511174/) and the [Index of Dental Anxiety and Fear](https://pubmed.ncbi.nlm.nih.gov/20528055/) are two good choices; they each have a strong evidence base and have been used widely in clinical and research settings. Their length — they are 20 and 24 questions long, respectively — is both a potential limitation and strength. On the one hand, a longer questionnaire takes more time to complete, and time with patients can sometimes feel scarce. On the other hand, a longer questionnaire can give providers a much more comprehensive and nuanced understanding of a patient’s individual anxiety experience and presentation, which is critical for tailored, effective management. Some clinicians (and researchers) balance these pros and cons by using the [Modified Dental Anxiety Scale](https://pubmed.ncbi.nlm.nih.gov/7584581/), which is another good choice given its strong evidence base and wide use, its length (only 5 questions!), its availability in almost 30 languages, and the [accompanying support website](https://www.st-andrews.ac.uk/dentalanxiety/#:~:text=The%20Modified%20Dental%20Anxiety%20Scale,question%20measure%20of%20dental%20anxiety.), which can be a helpful resource for clinicians. Any of these tools can be used with adolescents and adults. For children, the [Children’s Fear Survey Schedule — Dental Subscale](https://pubmed.ncbi.nlm.nih.gov/6960031/) (completed via parental report for younger children) or the [Modified Child Dental Anxiety Scale](https://pubmed.ncbi.nlm.nih.gov/10079713/) (for children 8 years and older) are good evidence-based choices. An efficient approach to dental fear assessment involves screening all patients with a brief measure and following up with longer measures for patients with elevated screening scores so a comprehensive conceptualization and tailored management plan can be developed. It is recommended that a question about dental fear and anxiety be included on all new patient intake forms or as part of the health history taking. The last question of the Dental Fear Survey, which asks about fears generally, has been validated as a single-item assessment tool and makes a great screener. Providers also can simply ask whether a patient ever experiences anxiety or apprehension about dental treatment — so long as they routinely and systematically do it for all patients and follow up with a more detailed assessment should a patient endorse fear and anxiety. **6. Can the more widespread use of silver diamine fluoride as first-line treatment for dental caries (instead of drill/fill) help reduce dental fear?** Silver diamine fluoride is a good first-line treatment for dental caries and it does help reduce dental fear, as well as associated pain experience. It does this by delaying exposure to fear and pain-evoking stimuli associated with procedures. Silver diamine fluoride can often be used to delay caries progression until the child ages to procedural tolerance — that milestone is age 7. At that age, they can assess threat better and they have better voluntary control of attention. **7. Is it researched “best practice” to cover instruments in the operatory so they are out of patients’ sight?** There haven’t been any “best practice” studies that have looked at differences in patients’ fear and anxiety based on whether the instruments are covered or not when a patient enters the operatory. During the program, we discussed that fear and anxiety are highly individualized, so some patients likely take comfort in not being able to see the instruments as they walk in, while others may find it stressful, as though the dentist is trying to hide something. As part of the initial meeting, dentists or assistants can ask patients which they prefer. While most patients haven’t given it a second thought and won’t have a strong preference, patients who prefer to see the tray of instruments at the start will appreciate being asked. The dentist or staff can then make a note in the patient’s record to uncover the tray at that patient’s future appointments. That kind of attention to detail will go a long way in making your patients much more comfortable in your practice. *Editor’s Note: View a [full recording of the webinar](https://www.carequest.org/education/webinars/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help) in the CareQuest Institute webinar library.* **Categories:** Blog **Tags:** Clinical Practice --- ### [Three Resources That Explore the Connection Between Oral Health and Mental Health](https://carequest.org/blog/three-resources-that-explore-the-connection-between-oral-health-and-mental-health/) **Published:** May 17, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Depression-stat.jpg)A quick Google search, especially during Mental Health Awareness Month this May, will yield thousands of results about the connection between physical health and mental health. Healthy behaviors — healthy eating, regular exercise, a good night’s rest — result in better mental health for people across their lifespan. But what about oral health? Does a healthy mouth lead to a healthy mind and vice versa? The answer is yes — and the research is growing. In each of the last two years, CareQuest Institute conducted the State of Oral Health Equity in America survey, a nationally representative survey to examine attitudes, experiences, and behaviors related to oral health. Respondents self-rated their mental health and oral health status and answered questions about oral health care utilization. The survey relied on self-report of the individual’s mental and emotional health, which is impacted by myriad factors and personal circumstances. Findings from the studies showed consistent oral health disparities among those with self-identified poor mental health. For example, some new research from the 2022 survey found that: - Individuals with severe depression are more than twice as likely to report not brushing their teeth at least twice per day compared to those with no depression. - Even individuals with minimal depression have significantly higher odds of not brushing twice per day compared to those without depression. - Those with minimal depression also had more than twice the odds of reporting at least one oral health problem than those without depression. Unfortunately, some of this research might not be surprising. The pandemic has intensified the mental health crisis in the United States. [A CVS Health/Morning Consult survey](https://healthexec.com/topics/patient-care/care-delivery/cvs-mental-health-concerns-are-rising) released earlier this month found that nearly 6 in 10 Americans (59%) have experienced concerns about either their own mental health or that of family and friends. That’s a 9% increase from April 2020. Even before the COVID-19 pandemic, poor mental health was linked to exacerbated oral health issues. Research has shown that those with poor mental health also tend to have poor oral health and are more likely to have decayed teeth, periodontal disease, and dry mouth. During the last two years, there has been an increased incidence of cracked teeth, which media reporting has linked to the stress caused by the pandemic. Access to care was also hindered by closure of dental offices and fear of catching COVID-19, which worsened oral health problems. As we continue to navigate an uncertain return to a new normal, learning more about the connections between oral health and mental health will be important. Here are three CareQuest Institute resources that explore that connection: **1. Association Between Mental Health and Oral Health Status and Care Utilization.** This study, [which appeared in *Frontiers in Oral Health*](https://www.carequest.org/resource-library/association-between-mental-health-and-oral-health-status-and-care-utilization), is the first to evaluate the relationship between oral health and mental health during the pandemic. Based on a nationally representative survey of adults in the US, the study found that “poor oral health status among the respondents were associated with poor mental health, age, socioeconomic status, and not visiting the dentist at regular intervals.” More specifically, the study found that adults who reported poor mental health were: - more likely to be facing financial and emotional hardships - three times more likely to rate their oral health as poor - more likely to have one or more unmet oral health needs The survey also uncovered that there is a lack of research on the association between poor mental health and poor oral health status. “Further research is necessary,” the authors write, “to understand the mechanisms underlying these associations and develop models of care that will promote oral health utilization by individuals with mental health problems.” **2. The Connection Between Oral Health and Mental Health.** In this visual report from 2021, the [CareQuest Institute State of Oral Health Equity in America survey](https://www.carequest.org/state-of-oral-health-equity-america-2021) found: - Almost one out of five respondents rated their current mental health status as fair or poor. - Americans who had poor mental health were prescribed opioids for a problem with their teeth or mouth after surgery at a higher rate than those with good mental health. - Those who had poor mental health were nearly four times more likely to report they were self-conscious or embarrassed because of their teeth, mouth, or dentures than those respondents with good mental health. In the coming months, CareQuest Institute will release more findings and analysis from the 2022 State of Oral Health Equity in America survey. **3. Dental Fear Is Real. Providers Can Help.** This CareQuest Institute visual report explores the impacts of dental fear, how it varies by demographic and poses a significant barrier to receiving dental treatment. Some key findings: - Hispanic adults were more than two times more likely to report dental fear compared with white adults. Black and Asian adults were also more likely to report dental fear than white adults. - Nearly 3% of adults reported that at their last dental appointment, they were “so frightened and nervous” that it either made the dental treatment difficult or the treatment didn’t succeed. During a [May 5 CareQuest Institute webinar](https://www.carequest.org/education/webinars/dental-fear-and-anxiety-why-it-exists-and-what-providers-can-do-help) on the topic, an expert panel explored the science behind the negative feelings many individuals have about receiving dental care and potential solutions for dental fear and anxiety. The panel also [answered seven common questions](https://www.carequest.org/about/news/seven-common-questions-dental-fear-and-anxiety) about dental fear and anxiety, including the connections to depression. As Mental Health Awareness Month continues, CareQuest Institute will share more content and resources on the connection between oral health and mental health. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Researchers on Stage at the 2022 National Oral Health Conference](https://carequest.org/blog/researchers-on-stage-at-the-2022-national-oral-health-conference/) **Published:** May 20, 2022 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Members-of-CareQuest-at-NOHC-2022.gif)Members of the CareQuest Institute team at NOHC 2022 Medical-dental integration. Dental anxiety. Value-based care. Periodontal therapy. These are just a few of the topics researchers at the CareQuest Institute for Oral Health presented at the [National Oral Health Conference (NOHC)](https://www.nationaloralhealthconference.com/) last month in Fort Worth, Texas. The annual multi-day conference offers educational sessions and presentations by leaders in dental public health for anyone interested in improving the overall oral health system. Here are a few highlights and key takeaways from four CareQuest Institute presentations: ## [1. Oral Health Integration: Attitudes on Medical-Dental Collaboration](https://www.carequest.org/resource-library/2022-oral-health-integration-attitudes-medical-dental-collaboration) Medical-dental integration encourages providers to create comprehensive care plans for the whole person. [CareQuest Institute Research](https://www.carequest.org/how-we-work/research) Analyst Adrianna Sonnek further explained [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) through the lens of our [State of Oral Health Equity in America survey](https://www.carequest.org/about/news/why-we-created-oral-health-equity-america-survey-and-what-we-found). The nationally representative, probability-based survey of adult consumer attitudes, experiences, and behaviors on oral health sheds light on the inextricable link between oral health and overall health. Sonnek shared several results about the connections between oral health and overall health: - 96% of consumers acknowledged the connection between the health of the mouth and that of the rest of the body. - 45% of responding oral health providers reported “rarely” integrating care with clinicians outside of dentistry. - More than 90% of oral health providers surveyed agree that dietary habits should be assessed in all patients. ## [2. Diabetes Treatment Costs Decrease after Periodontal Therapy: Medicaid and Commercial Claims Data](https://www.carequest.org/resource-library/2022-diabetes-treatment-costs-decrease-after-periodontal-therapy-medicaid-and) A healthy mouth is vital to a diabetes management program. During this poster presentation, CareQuest Institute Research and Analytics Manager Madhuli Thakkar-Samtani shared data from a recent study examining the relationship between periodontal treatment and diabetic medical costs in both commercial and Medicaid claims data. Principal findings included the following: - Receiving periodontal therapy reduced overall health care costs for patients with diabetes in both Medicaid and commercial claims data. - Expanding programs that provide health care coverage to those with lower socioeconomic status, such as Medicaid and Medicare, to include comprehensive periodontal treatment has the potential to reduce overall health care costs for individuals with diabetes. ## [3. Interpretation of Ambiguous Dental Scenarios by Severity of Dental Anxiety](https://www.carequest.org/resource-library/2022-interpretation-ambiguous-dental-scenarios-severity-dental-anxiety) Dental anxiety poses a significant barrier to adequate oral health care for 5–15% of adults, explained CareQuest Institute Science Writer Lisa Heaton in a presentation on dental anxiety. Heaton provided results from a recent study analyzing how dentally anxious individuals compare to those with lower [dental anxiety](https://www.carequest.org/resource-library/dental-fear-real-providers-can-help) when interpreting ambiguous dental scenarios. The study concluded: - Dentally anxious respondents used words related to anxiety as a greater proportion of their overall words. - Less anxious individuals more often describe concerns about the cost of treatment. - While dentally anxious individuals were more likely to use terms like “worried” and “scared,” less anxious individuals were more likely to use words like “cost” and “money.” ## [4. Exploring Connections to Value-Based Care in Dental Education](https://www.carequest.org/resource-library/2022-exploring-connections-value-based-care-dental-education) Although [value-based care](https://www.carequest.org/topics/value-based-care) remains a new topic area for schools of dentistry, the opportunity to shift the mindset of new clinicians toward new approaches and embrace them is promising. During a poster presentation, CareQuest Institute Value-Based Care Director Rebekah Mathews shared results from a study examining the results of a survey disseminated to clinical deans at dental schools evaluating current value-based care approaches and designs. The study found - 65% of respondents acknowledged value-based care was not currently included in didactic curriculum. - Almost 25% of schools are considering value-based care within their dental clinics. - While VBC is not yet broadly adopted within dental schools, many acknowledge the opportunity to align with VBC concepts when considering patient care and student experience. **Categories:** Blog **Tags:** Medical-Dental Integration, Value-Based Care --- ### [How Providers Are Using Teledentistry Today](https://carequest.org/blog/how-providers-are-using-teledentistry-today/) **Published:** May 27, 2022 **Author:** Caitlin Locklear **Content:** ## ![](https://carequest.org/wp-content/uploads/2022/05/Nathan_Suter.gif) As we continue to recover from the COVID-19 pandemic, the benefits of telehealth to connect patients with health care providers have become clear. Whether it’s telemedicine, teletherapy, or teledermatology, [telehealth is here to stay](https://hbr.org/2022/05/the-telehealth-era-is-just-beginning). And that includes teledentistry, which can increase access to oral health care and decrease costs — now and beyond the pandemic. In a [recent CareQuest Institute webinar](https://www.carequest.org/education/webinars/building-teledentistry-program-expands-access-and-increases-equity), Marybeth Shaffer, DMD, dental director of [Community Action Agency of Columbiana County](https://caaofcc.org/) in Ohio, and Nathan Suter, DDS, chief innovation officer at [Enable Dental](https://enabledental.com/), discussed how teledentistry has improved their care delivery in public and private practices and how they’ll continue to use the valuable technology in their practices. Caroline McLeod, RDH, MS, value-based solutions manager at CareQuest Institute, kicked off the webinar by sharing some of the latest research on [provider perceptions on the value of teledentistry](https://www.carequest.org/resource-library/dentist-perceptions-about-value-teledentistry). “Teledentistry is a tool that providers and programs can leverage to improve the care that they’re already offering and to extend that care as well,” said McLeod. “It’s valuable to providers as well as patients.” ## Reaching New Populations in Ohio with Teledentistry At the Community Action Agency of Columbiana County, Shaffer and her team use teledentistry to accomplish three main objectives: to triage emergency patients, to facilitate referrals, and to facilitate remote periodic examinations. Using teledentistry technology to triage emergency patients [saves states money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money), providing an alternative to costly care in emergency departments. Using it for referrals also helps support [care coordination and interoperability](https://www.carequest.org/topics/care-coordination-and-interoperability) between providers at community health centers. In all of these cases, teledentistry serves as an important method of eliminating barriers to care — especially for [rural patients ](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time)who may not have a dental provider nearby and for student-based oral health care programs that allow children without a dental home to receive the care they need. “What was our value proposition?” said Shaffer when discussing teledentistry as a tool for school-based care. “We felt if we brought preventive care to children rather than waiting for parents to bring children to care, we might have some impact. We also have a problem with health literacy in our rural Appalachian county, and we were hoping to improve the health care knowledge of our county. Now, all patients that we see have a dental home — and many times they have siblings that we are trying to encourage to come in, as well as the parents.” ## Expanding Business — and Access to Care “If you want to know whether the business case \[for teledentistry\] makes sense, you can see that there is a cost-benefit that makes sense to do this,” said Suter, as he explained the value to private practices. According to a recent CareQuest Institute study, [teledentistry visits were on average less expensive ($99 per visit) than in-person visits ($114 per visit)](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time), making care more accessible to a wider range of people. And based on his own experiences, Suter agrees that using teledentistry increases access and availability of care. “Before the pandemic, we would use teledentistry to supplement the schedule if I wasn’t in the office,” he said. “After lockdown, we started using teledentistry to catch up on hygiene-only days and would use it as a tool to expand access to care.” Using teledentistry technology, Suter and his team have continued to refine their workflow. They’re able to do radiographs, extra-oral photos, intra-oral photos, tooth charting, and take logic-based clinical notes — all through their teledentistry software. It allows them to work better as a team and to increase capacity without adding operational costs to the practice. “The successful adoption of teledentistry depends on our industry moving to more modern, cloud-based software,” Suter said. “Without these tools, the IT limitations will limit both the ease of adoption for the team and the user experience for the patient.” Teledentistry is becoming a [permanent feature](https://www.carequest.org/about/news/voices-field-dr-scott-howell-why-teledentistry-isnt-fad) in our oral health care system, with both patients and providers recognizing the benefits of teledentistry appointments. In fact, [almost 85% of oral health professionals said dentistry was ready to accept teledentistry as a care delivery method](https://www.carequest.org/resource-library/oral-health-professionals-are-ready-accept-teledentistry) and, in a 2020 study, [86% of patients said they would recommend teledentistry to another person.](https://www.carequest.org/resource-library/patients-give-high-marks-their-teledentistry-experience) As we move past the difficulties of a COVID world, telehealth — and teledentistry specifically — will continue to be an important care delivery tool that provides a flexible, convenient way to connect patients and providers in different physical locations. *Editor’s Note: [View the recording and slides](https://www.carequest.org/education/webinars/building-teledentistry-program-expands-access-and-increases-equity) from “Building a Teledentistry Program That Expands Access and Increases Equity” and [explore upcoming CareQuest Institute webinars](https://www.carequest.org/education/webinars).* **Categories:** Blog **Tags:** Practice Management --- ### [CareQuest Institute Applauds Federal Recognition of Juneteenth, Calls for Continued Action](https://carequest.org/blog/carequest-institute-applauds-federal-recognition-of-juneteenth-calls-for-continued-action/) **Published:** June 18, 2021 **Author:** Caitlin Locklear **Content:** At CareQuest Institute for Oral Health, equity is at the core of everything we do. Whether it’s through our grantmaking, advocacy, health improvement work, education or research we prioritize the underserved and amplify their voices.![](https://carequest.org/wp-content/uploads/2025/11/juneteenth-300x184.jpg) Today, we stand together and applaud the passage of the *Juneteenth National Independence Day Ac*t. Dr. Myechia Minter-Jordan, CareQuest Institute president and CEO, shared her perspective on this historic moment: “Today we join in celebrating the actions of Congress and the Biden Administration making Juneteenth a federal holiday,” said Dr. Minter-Jordan. “This is an important step in recognizing our shared history, but we must continue to take concrete action to address racial equity and systemic racism. We have the tools and understanding to address racial injustice head on — from health disparities to police brutality to economic inequity. To truly be a society founded on “freedom and justice for all,” we need to work together to fight for the future.” Juneteenth is an annual holiday commemorating the end of slavery in the United States and has been celebrated by African Americans since the late 1800s. It commemorates the day (June 19) in 1865 when Union troops arrived in Galveston, Texas, to inform enslaved African Americans of their freedom, more than two years after the Emancipation Proclamation was signed and two months after the Civil War had ended. President Joe Biden [signed the *Juneteenth National Independence Day Act*](https://bidenwhitehouse.archives.gov/briefing-room/speeches-remarks/2021/06/17/remarks-by-president-biden-at-signing-of-the-juneteenth-national-independence-day-act/) into law on June 17, 2021. **Categories:** Blog **Tags:** Health Equity --- ### [Voices from the Field: Dr. Matthew Horan on Distributing Vaccines and Medical-Dental Integration](https://carequest.org/blog/voices-from-the-field-dr-matthew-horan-on-distributing-vaccines-and-medical-dental-integration/) **Published:** June 29, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/VoicesLogo_0-300x300.jpg)Dr. Matthew Horan is executive director of dental services at [Harbor Health Services](https://www.hhsi.us/), a federally-qualified health center (FQHC) in Massachusetts. He also works part-time as a state dental director — dual roles that give him a unique perspective on how the COVID-19 pandemic has changed dentistry during the last 16 months. What’s next for the industry? Dr. Horan has some ideas about that, too. We spoke with Dr. Horan about his experience vaccinating patients and how this has helped accelerate the movement toward medical-dental integration. **How has the pandemic affected your patients and the dental clinic at Harbor Health Services?![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Matthew-Horan-239x300.png)** At Harbor Health Services, we see an excess need all the time — our dental clinic sees about 40% of the health center’s medical patients, which is a lot. Most dental clinics at other health centers see 10-15%. While the demand has always been there, now, we’re also seeing a 20-30% increase in patients coming in with cavities due to delayed preventive care. We know we need to be focusing on prevention rather than endless treatment and the pandemic has exacerbated that. **Harbor Health Services has played a big role in Massachusetts’ vaccination distribution, including standing up three large community-based sites. What has your experience been like as a dentist distributing vaccines?** I’ve personally been giving vaccines since mid-February. At that point, we were vaccinating health care workers and the most vulnerable populations. People were clapping and smiling . . . they were so thrilled to get the vaccine. And when they realized I was a dentist, they were even more excited to tell their friends. At one site, we had a patient who was more than100 years old that came in with both sleeves torn off her shirt because she was so happy to be getting the vaccine. As the state closes the mass distribution sites and transitions to a more community-based approach, we’re now piloting a new program that offers patients a vaccine right at the dental clinic when they come in for their dental appointment. **Has vaccine hesitancy been a factor in your experience, and do you think dentists can play a unique role in mitigating that?** [Dentists are an important access point](https://www.carequest.org/topics/medical-dental-integration) because many of our patients might not have a medical home at all, but we typically see dental patients 2-3 times a year, so we can review their vaccination status and provide guidance. There is a lot of misinformation out there and as dentists we can, and should, be a trusted source for our patients. Whether helping them understand where to get reliable information or addressing concerns about how it might impact other health conditions, being able to answer questions as a trusted source opens the door to more people getting vaccinated. **The practice of providing vaccinations as part of a routine oral health visit is an example of medical-dental integration. Do you see this as a catalyst toward more integrated care going forward?** The pandemic has led to rapid regulatory changes that allowed for an environment of crazy care innovation — telehealth and vaccine delivery are just a couple of examples.I do think that in the near future, vaccines, more generally, will become an established part of comprehensive dental care in the same way that monitoring blood pressure is now. Diabetes screening, rapid HIV testing, and depression screening are just a few examples. There are lots of ways we can help out on the dental side. Vaccines are just the tip of the iceberg of where we can collaborate as health systems. *Editor’s note: read more about Dr. Horan and the vaccine pilot at Harbor Health Services in the post* [*Why Vaccines Could Signal a Future of Integrated Care*](https://www.carequest.org/about/news/why-vaccines-could-signal-future-integrated-care)*.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Four Steps to Future-Proof Our Oral Health System](https://carequest.org/blog/four-steps-to-future-proof-our-oral-health-system/) **Published:** July 11, 2021 **Author:** Caitlin Locklear **Content:** *This is an excerpt from the July 8 webinar “Consumer Perspectives on Oral Health Access, Outcomes, and Quality of Care.” Carolyn Brown, DDS, M.Ed, senior advisor, consultant, person-centered care at CareQuest Institute for Oral Health, shared her perspective on future-proofing — designing or changing a system so it will continue to be useful and successful in the future if the situation changes — the oral health system.* As for future-proofing . . . how can we take strategies and make sure we aren’t making the same mistakes in the system that we’ve already built? How can we learn from what we’ve heard from the [State of Oral Health Equity in America 2021](https://www.carequest.org/state-oral-health-equity-america-2021)? 1. We need to build an equitable and inclusive system for all. Part of that is listening to your community voice and really taking the time as you’re either changing things, adding benefits, redesigning systems . . . take the time to pull in all sorts of stakeholders so that you are building a system that is going to work for everyone. 2. We need to pay for prevention and outcomes and align with the type of system that we’d like to build and sustain. We can see from Consumer Perspectives in the State of Oral Health Equity that there is overwhelming support for alignment dental payment with various components of value-based care. 3. We need to investigate and dismantle structural racism in the oral health and overall health system. 4. Lastly, as you can see here: Part of the future-proofing is really expanding and [protecting all our dental programs](https://www.carequest.org/how-we-work/advocacy), including Medicare, Medicaid, and people living with disabilities. Just yesterday, Dr. Myechia Minter-Jordan, President and CEO of CareQuest Institute, [released a statement about dental care being essential health care](https://www.carequest.org/about/news/carequest-institute-commends-congressional-legislation-provide-oral-health-care-benefit). This was in response to a policy and a bill that was put forward around expanding Medicare to include dental, vision, and hearing benefits. Hear more from Carolyn and the other two experts on the panel — Madhuli Thakkar-Samtani, BDS, MPH, biostatistician, analytics and evaluation at CareQuest Institute and Eleanor Fleming, PhD, DDS, MPH, associate professor, Department of Dental Public Health, Meharry Medical College — in the [full recording of the webinar. ](https://www.carequest.org/education/webinars/consumer-perspectives-oral-health-access-outcomes-and-quality-care) **Categories:** Blog **Tags:** Health Equity --- ### [Voices from the Field: Dr. Eleanor Fleming on Tackling Inequity and the Future of Oral Health](https://carequest.org/blog/voices-from-the-field-dr-eleanor-fleming-on-tackling-inequity-and-the-future-of-oral-health/) **Published:** July 19, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/VoicesLogo_0-300x300.jpg)Eleanor Fleming, PhD, DDS, MPH, is an associate professor in the department of Dental Public Health at Meharry Medical College in Nashville, TN. She’s also a Diplomate of the American Board of Dental Public Health and has worked for nine years as a dental epidemiologist. On top of that, she served as an officer in the Epidemic Intelligence Service at the U.S. Centers for Disease Control and Prevention, where she investigated disease outbreaks and was principal investigator on several studies. Simply put, she’s someone who has a unique perspective on the challenges and opportunities facing the oral health industry. Dr. Fleming took a few minutes out of her busy schedule to share her thoughts on living through the last 18 months as an epidemiologist, what she would like to see taught in dental curricula, and one step anyone can take today to start tackling inequity. **How did you get into dentistry? What pulled you toward that career path?![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Eleanor-Fleming-285x300.png)** I found my way to dentistry through Dr. David Satcher and the first [Surgeon General’s Report on Oral Health](https://www.nidcr.nih.gov/research/data-statistics/surgeon-general). I heard Dr. Satcher speak about oral health disparities, and that information left me dumbfounded. I did not understand then and don’t understand now how it is that people do not have access to dental care. I grew up going to the dentist and saw dental offices everywhere in my hometown so that idea that people do not have access to care makes no sense to me. At the time, I was in graduate school pursuing my PhD in political science, but I changed course and found myself writing my dissertation by day and taking my pre-dental science courses by night at a local community college. I saw myself working in a community health center tackling the disparities. But then came the death of [Deamonte Driver in 2007](https://www.theguardian.com/inequality/2017/jun/13/healthcare-gap-how-can-a-child-die-of-toothache-in-the-us) and everything changed for me. I could not see myself being that provider; I had to be systems change agent. Deamonte Driver did not die for want of a dentist, as Mary Otto wrote. His death was a system failure. Because I understand policy and was entering dental school to learn the practice of dentistry, I envisioned a career in this thing called “public health.” At the time, I did not know what that meant, but I knew that I could not provide care at the individual level when change was needed to improve population-level health. And so, I became a dental epidemiologist. **What would you like to see taught to future dentists that isn’t part of the current curriculum?** As a new full-time faculty member in dental school, it is striking to me to see dental public health curricula that does not fully reflect the practice of dental public health. Pre-doctoral dental students are trained to provide clinical care to individuals, and yet dental public health focuses on prevention at the population level. While I realize those two ends seem to be in conflict, I believe that a prevention focus, especially at the system and institutional level, is important. I would love to see dental curricula that engages racism and social determinants of health in a very real way. **Can you share an example of a recent public health initiative that you’d like to see spread?** I would like to see how organizations are not only acknowledging that racism is a public health problem, but also identifying steps that are actionable to take. While public statements are important, I would like to see more action, more collaboration, more asking of tough questions, and more of a willingness to reimagine the systems and processes that reinforce racism and prevent equity. **There’s obviously no easy solution to systemic oral health inequity. But what’s one positive step anyone can take today?** Organize, organize, organize! I applied to Meharry Medical College envisioning a career where I would be the provider tackling community disparities. While that is possible for some people to accomplish, systemic oral health equity is a team sport and those of us who believe in oral health equity must be organized and working in collaboration with other groups at local, state, national, and global levels. One positive step that everyone can take is to join a group that is doing the work and lend support such as resources, time, and expertise. **What have the last 18 months been like through the eyes of an epidemiologist?** The politicization of public health has been shocking to me. I realize that I am a political scientist, so I should not be shocked . . . and yet here I am. It is heartbreaking to see wearing a mask as a political act. As an epidemiologist, I have been pleased to see more people paying attention to data and public health practice. I hope that the last 18 months have made clear just how important public health is and how underfunded public health systems are. As an equity issue, this becomes an opportunity to advocate. **When you look to the future of oral health, what concerns you?** When I look to the future of oral health, I am most concerned about workforce. [Recent ADA data](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471137/) show that very little progress has been made to increase the number of Black, Hispanic, and American Indian dentists. This is a persistent disparity over the course of the last decade, and it is striking to me that more progress has not been made. I realize that this is big issue that cuts across CODA (Commission on Dental Accreditation), ADEA (American Dental Education Association), professional organizations, higher education, K-12 education, etc. This is an area where I hope progress will be made to support the recruitment and retention of Black, Hispanic, and American Indian students with sustainable pathways, mentoring support, and scholarships. **When you look to the future of oral health, what gives you hope?** I am hopeful about the future of oral health when I see advocates, researchers, and organizations that are not the usual suspects (not dental organizations or dentists) elevating oral health. I am hopeful to see states approving dental therapy programs which certainly requires more than dentists working as advocates. I am hopeful to see states including dental benefits in adult Medicaid programs. I am also hopeful to see value-based care becoming a reality and the shift happening to include and pay for prevention. *Editor’s Note: To hear more from Dr. Fleming, listen to a recording of the July 8 webinar,* [*“Consumer Perspectives on Oral Health Access, Outcomes, and Quality of Care”*](https://www.carequest.org/education/webinars/consumer-perspectives-oral-health-access-outcomes-and-quality-care?destination=learn/online-learning-center/instructional-webinars) *or* [*follow her on Twitter.*](https://twitter.com/DrEFleming7) **Categories:** Blog **Tags:** Health Equity --- ### [What’s Next for Oral Health in Medicare? A Former Congressman Explains.](https://carequest.org/blog/whats-next-for-oral-health-in-medicare-a-former-congressman-explains/) **Published:** July 29, 2021 **Author:** Caitlin Locklear **Content:** Congress is working on significant legislation — including adding dental coverage to Medicare — that [could improve the lives of millions of Americans](https://www.carequest.org/how-we-work/policy-and-advocacy/medicare-dental). So, what happens next? And how did we end up in this situation where we’re trying to expand dental coverage for people who need it most? Chet Atkins served![Chet Caption](https://www.carequest.org/sites/default/files/ChetCaption.png) as Congressman for the 5th District of Massachusetts from 1985 – 1993 and was a member of the House Appropriations Committee and the House Ethics Committee. Before that, he served in the Massachusetts House of Representatives and the State Senate for more than 10 years. He knows his way around legislation and budgeting, and he’s passionate about improving our oral health and overall health systems. We asked Chet a few questions about this moment, something he calls, “literally, a once-in-a-lifetime opportunity.” **Let’s start at the beginning. Why isn’t oral health covered under Medicare?** Health coverage has been a central issue in American politics going back to 1912 when Teddy Roosevelt first proposed coverage. Harry Truman proposed it after that, but it wasn’t until 1965 that Medicare was signed into law by Lyndon B. Johnson. In 1965, that legislation was a terrible fight — one of the great political fights of the 20th century. While dentists were qualified as health care providers, the legislation and subsequent regulations covered only an extremely limited set of dental procedures. When we look at those covered procedures today, they seem irrationally limited in the context of today’s health care delivery. **And that’s part of the historical separation between medicine and dentistry?** Yes, it isn’t based in science or clinical evidence. It’s based in politics and in the historical circumstances surrounding medical and dental education and training. Over time, study after study has shown the [importance of integrating oral health care with all other health care coverage](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know). Oral health is a central driver of overall health outcomes. And oral health coverage, particularly oral health prevention, leads to significant savings in the health care system. More than $1 billion is spent every year on ED visits that are related to a lack of oral health care. There is now widespread recognition of two things: One, our health care system is flawed because of this lack of integration; two, we understand that lack of oral health coverage has a disproportionate impact on underserved populations. Health disparities are far greater in oral health because of this lack of coverage. **Can you pinpoint a few of those disparities?** There have been a number of studies from groups like the [Kaiser Family Foundation](https://www.kff.org/medicare/issue-brief/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/) that show 1 in 5 seniors have untreated tooth decay, 70% of seniors have gum disease, and 27% of Black seniors have experienced complete tooth loss. The potential savings and improvements in health outcomes are increasingly clear and compelling. **When did the momentum for our current moment begin?** After the Affordable Care Act passed in 2010, members of Congress started to look at Medicare to include coverage of hearing, vision, and dental. Senator Bernie Sanders (I-Vermont) offered legislation in 2015 to include a dental benefit in Part B. In 2019, the House passed legislation that expanded Medicare Part B to include a dental and vision benefit. Senators Sanders and Senator Ben Cardin (D-Maryland) have made this a top priority for the Budget Committee. In the current Congress, there’s overwhelming support among House Democrats and we’ve seen a growing number of senators (including Majority Leader Senator Chuck Schumer (D-NY)) sign on. **Let’s jump to now. What’s next for this legislation?![](https://carequest.org/wp-content/uploads/2025/11/Family-300x200.jpg)** The current situation is that the Senate had divided infrastructure into two bills: hard infrastructure (things like bridges, roads, and dams) and human infrastructure (things like health care (including dental benefits in Medicare), daycare, early childhood education). [A bipartisan group of Senators, on Wednesday, voted to begin work on hard infrastructure](https://apnews.com/article/joe-biden-government-and-politics-business-c5e6ce9620ad98687cabb678121042a3). Once the Senate passes that bill, the Senate plans to address human infrastructure. For almost all matters, the Senate requires 60 votes to pass legislation. The one exception to this is a process called [reconciliation](https://www.brookings.edu/blog/up-front/2021/02/05/what-is-reconciliation-in-congress/), which requires only 51 votes. The reconciliation process begins in the Senate Budget Committee, which Senator Sanders chairs. And the Senate Budget Committee has now agreed on a $3.5 trillion human infrastructure bill with non-binding instructions, which encourages the Senate Finance Committee to pass legislation to cover Medicare Part B to include a dental, vision, and hearing benefit. The Budget Committee allocates a sum of money to Senate Finance, which will have the last say on how they spend that money, so the key players right now for Medicare Dental expansion are the Democratic members of the Senate Finance Committee who will make the ultimate decision about which priorities get funded. While these instructions are not binding, it is highly likely that the Senate Finance Committee will accept the Senate Budget Committee instructions and pass the expanded Medicare coverage through the Senate Finance Committee for inclusion in a budget reconciliation package. That package would be considered by the full Senate. **What, specifically, would be covered if this legislation passes?** While the language has not been drafted in the Senate, it appears from previous House action that the language will be something like the following, “services that are necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.” In general terms, it means Medicare Part B would cover regular preventive care (cleanings, x-rays), minor work (fillings), and major work (crowns, root canals, dentures). It would cost $238 billion over 10 years. It would cover 2 out of 3 Medicare recipients who don’t have supplemental coverage for dental right now, 1 in 2 seniors who haven’t seen a dentist in last year, and 1 in 7 seniors who have lost all their teeth. **What can oral health advocates and stakeholders do to show their support for this?** The challenge for oral health advocates will be to make sure that dental coverage is included in the final negotiation. There are far more funding demands for reconciliation than there is financing available. This is reflecting the adage that the legislative process is akin to trying to fit 10 pounds of sausage into a 2-pound sausage skin. Something is going to be left on the butcher shop floor and we need to make sure dental care isn’t what’s left there. **That’s memorable imagery! So, contacting legislators is the best next step?** Yes! Personal contact — personal emails and letters — are the most effective advocacy. The important message is a thank you for your support and an emphasis on how important expanded coverage will be, particularly with stories about individual experiences with people lacking coverage. The legislative process is sometimes driven by numbers but mostly driven by narrative. [We need to tell stories about what happens when seniors do not have access to coverage. ](https://familiesusa.org/share-your-story/)Every Senator has a dentist and a dental hygienist. The Senators understand the importance of oral health in their own lives. The key is to engage them, to let them know this is important and that this needs to happen now. This is literally a once-in-a-lifetime opportunity. We are right on the 2-yard line of making this a reality and we need to use every ounce of persuasion we have. **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Why Teledentistry Will Help Shape the Future of Oral Health](https://carequest.org/blog/why-teledentistry-will-help-shape-the-future-of-oral-health/) **Published:** August 10, 2021 **Author:** Caitlin Locklear **Content:** Dental care in the United States has been changing, gradually, in the last decade. New treatments, new payment models, and new technologies have been shifting providers away from the surgical management of oral disease to a greater focus on prevention and health promotion. Then the COVID-19 pandemic hit the country, and, by necessity, the industry stepped on the gas pedal. Questions became realities. Promising ideas became protocols. The shift accelerated. And, now, the industry is faced with a question: What will the new future of care look like in—and beyond—the dental chair in a still uncertain future? Teledentistry will be part of that answer. What’s next for teledentistry? Three new CareQuest Institute visual reports lay out a potential future that positions it as a tool to improve access to care and health outcomes even after the pandemic ends. ## [Teledentistry: What to Know & How It Works](https://www.carequest.org/resource-library/teledentistry-what-know-how-it-works) This report aggregates highlights from several surveys and reports to show how teledentistry is growing across different US states, the services teledentistry supports, and both provider and patient perspectives on the technology. Of note:![](https://carequest.org/wp-content/uploads/2025/11/TeledentistryBlog-300x171.jpg) - In a survey from August 2020, nearly a quarter of dental providers were seeing patients via telehealth platforms. - In that same survey, public health dental providers were twice as likely as all other practice types to use telehealth. - In a survey from June 2020, 86% of patients said they were satisfied with their overall teledentistry experience and would recommend teledentistry to another person. The infographic also highlights several examples of community-based programs, health centers, health systems, and private practices that are making use of teledentistry to help reduce barriers to care. ## [Teledentistry: Removing Barriers and Moving Toward Implementation](https://www.carequest.org/resource-library/teledentistry-removing-barriers-and-moving-toward-implementation) This report explores variety of state-level barriers stand in the way of teledentistry’s continued expansion. It reviews an overview of the current landscape, barriers, potential solutions, and action steps related to teledentistry. Recommendations include: - Create State Practice Acts that permit each dental provider to practice to the full extent of their credentials and to provide care in community settings. - Update reimbursement policies to allow coverage for teledentistry beyond the current pandemic and to stipulate parity regardless of whether the procedure or service is provided via teledentistry or in person. - Address and clarify legal issues regarding liability and data security. ## [Teledentistry Use Beyond the Pandemic](https://www.carequest.org/resource-library/teledentistry-use-beyond-pandemic) The COVID-19 pandemic has highlighted inequities in the United States and, at the same time, increased awareness of technologies that can help address those inequities. Even after the pandemic, teledentistry can be useful in a variety of settings and situations. For instance, providers can use teledentistry when patients cannot be present, for various reasons, in a traditional office setting. Providers can also use teledentistry in the traditional office setting to connect a patient’s caregiver to the dental team in the operatory to review findings and discuss treatment plans. This report explores four reasons why teledentistry is here to stay. Teledentistry: - Helps states be better prepared to weather a crisis - Can increase convenience and reduce costs for consumers and states - Helps expand the reach of care - Is being embraced by patients Together, the three reports highlight the value and potential of teledentistry at this unique moment. Teledentistry could significantly expand oral care access for underserved populations, help prioritize dental chair time for the highest-risk patients, and keep low-risk patients healthy and safe. **Categories:** Blog **Tags:** Practice Management --- ### [Answers to 17 of Your Silver Diamine Fluoride Questions](https://carequest.org/blog/answers-to-17-of-your-silver-diamine-fluoride-questions/) **Published:** August 18, 2021 **Author:** Caitlin Locklear **Content:** **![](https://carequest.org/wp-content/uploads/2025/11/CareQuest_90-Percent-of-377-providers_1080x1080-300x300.jpg)**Silver diamine fluoride (SDF) has been widely recognized as an effective noninvasive tool for the prevention and management of dental caries. And it has proven to be an invaluable treatment during the COVID-19 pandemic. As noninvasive dentistry continues to rise in popularity, CareQuest Institute of Oral Health dedicated [its latest webinar to an exploration of SDF](https://www.carequest.org/education/webinars/providing-minimally-invasive-care-silver-diamine-fluoride-sdf). Our expert panel explored the science behind SDF, best practices for use today and in the future, and the challenges of incorporating it into practice. And we received lots (and lots) of questions — both before and during the show. Because the show was only 60 minutes, our clinical experts — Jeremy Horst Keeper, DDS, PhD, director of clinical innovation at CareQuest Innovation Partners and Sharity Ludwig, EPDH, MS, director of alternative care models at Advantage Dental Oral Health Center and Affiliated Practices — didn’t have time to answer all, or even most, of the questions. As a bonus for webinar participants and a resource for anyone interested in SDF, here, Jeremy and Sharity answer 17 questions on SDF: **1. What are the risks related to Silver Diamine Fluoride (SDF)?** The short-term taste and smell can be off-putting. They go away with a little water on the tongue or, preemptively, you can add a smear of toothpaste on the tongue or gauze that is used to keep the area dry. The main side effect is that any porous tooth structure (caries or hypomineralization), will stain black. If SDF comes into contact with skin, it will cause a small dark spot that will go away on its own in 1-2 weeks. If it comes into contact with existing white fillings, it might stain the margins if they are open. And if a filling is placed the same day, it will probably stain. Lastly, note that the most severely sensitive patients might not want to be treated a second or third time. **2. Is SDF recommended once a year or twice a year? And how would one in private practice code this?** Based on my practice, for frequency, I align this with caries. If moderate risk, I’d suggest two times per year. If high risk, at least two times per year, but I will see them four times per year and use either SDF or alternate with PVP-Iodine in conjunction with fluoride varnish. For coding, it is dependent on the intended use of the SDF. If it’s for prevention, D1355 or D1208, as the lesion isn’t yet cavitated. If there is breakdown in the tooth structure, then I would use D1354. **3. Are most insurances reimbursing for SDF now?** Most insurance plans reimburse dental teams for treatment using D1354. The CDT code for prevention in healthy surfaces by tooth, D1355, just launched in 2021. D1208, for full mouth prevention should be, is almost always, reimbursed. **4. At my Indian Health clinic, SDF is not a covered procedure according to MediCal. This makes it difficult to provide the service to our community, as SDF is quite costly to buy. My clinic doesn’t want to do procedures that are not covered by insurance. Most of our patients cannot or will not afford payment for SDF. Any thoughts?** Many tribes have chosen to pay for SDF for many reasons. In IHS clinics dependent on Medicaid, the best step is to reach out to the Medicaid state dental director directly and let them know the need. To address patients that cannot and will not pay for non-covered services: As a provider, it is our responsibility to inform the patient of their options, considering their wants, needs, and desires. Can the organization come up with a cost-effective plan that may be more accepted by patients? For example, I have heard of offices charging a one-time set fee for SDF treatments up to four visits. Also, can you have your business office figure out what cost per visit is and have the fee be a break-even dollar amount to just cover costs? Not all patients will accept, but if at least one or a few do, you’re helping them to make a difference in their oral health. **5. What is the evidence for the use of SDF as a preventative for older adults? Would you recommend it as part of a prevention protocol for adults with dry mouth?** The evidence is strong, at 60%. ([See more in CareQuest Institute’s newest infographic on SDF](https://www.carequest.org/resource-library/provider-and-public-perceptions-silver-diamine-fluoride)). I always find it interesting when providers ask me about use on adults. From my perspective, we know it is more effective then fluoride varnish, so why not use it? In my experience, it comes down to the esthetic aspect of SDF, so I approach it with patients regardless of age. I start by asking what is important to the patient for their oral health and present options that align. **6. What are the supervision restrictions for placement of SDF in Florida (or any state)? Can a hygienist place in a mobile dental setting without a dentist present?** You can find state-specific and supervision information in this [helpful resource from the American Dental Hygienist Association](https://www.adha.org/wp-content/uploads/2022/12/Silver_Diamine_Fluoride_State_by_State_Information.pdf). There’s also a very helpful infographic, [“Application of Silver Diamine Fluoride (SDF) by Dental Hygienists,”](https://oralhealthworkforce.org/silver-diamine-fluoride-sdf/) about scope of practice from the Oral Health Workforce Research Center. **7. Does application of SDF have any effect on bondability of the remineralized tooth structure to composite if a filling is placed later in the future?** No, not from my experience. If you rinse before bonding, you can do so to maximum strength immediately (but wait at least one minute to allow soaking in). A same-day composite will stain, though. After a week, there won’t be a problem. **8. Can you consider the stain to be a good thing for posteriors, for example, to show that the SDF is working?** Absolutely! That is what I share with my patients to put a positive spin on it. **9. When looking at bitewings, when would SDF be recommended for an interproximal lesion as compared to fluoride varnish?** **Should the lesion be into the dentin? Halfway through the enamel? Or some other indicator?** SDF can be considered for the treatment of a caries lesion at any stage before irreversible pulpitis. Although SDF clinical trials have focused on prevention of new lesions and treatment of cavitated lesions, I think it is fair to assume that the greater efficiency and effectiveness of SDF over fluoride varnish for prevention could also translate to treatment of non-cavitated lesions (for example, enamel lesions). Of course, the side effects are long-term stain, short-term taste, and smell. If there’s no visible cavity, there won’t be stain. **10. Should we use SDF instead of sealants for prevention?** You should make the determination with your patients, but it is about 20 times more cost effective to use SDF than sealants. Per tooth, [SDF is about 60%](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500430/) preventive fraction while sealants are about 70%. Considering material and time, SDF is the more cost-effective preventive treatment. **11. How can you tell if the caries risk has been lowered vs. the lesion being arrested?** Speaking to caries risk, I mentioned the risk assessment used for the clinical algorithms was focused on the clinical presentation of the teeth. As changes in the teeth occurred, you would see a change in risk level. In my experience in working with dentists, arrest varies to some degree, but dark, hard, glassy appearance are common terms shared by dentists. **12. How do you use SDF preventively? Do you place it on all teeth?** Focus on high-risk surfaces for patients — exposed roots, occlusal surfaces of newly erupted molars, proximals in teens, etc. You can learn more on the topic — see Prevention of Caries by Silver Diamine Fluoride 38% — [at this link](https://www.youtube.com/watch?v=EwA5vhA5UGI&t=1s). **13. When SDF is applied for prophylaxis to surfaces with no caries — for example to an erupting molar — does the tooth turn black?** SDF will discolor teeth if there is a breakdown in tooth structure. **14. Why would you cover with fluoride if SDF, by definition, already has fluoride? Is it overkill?** To cover the flavor and protect the decay-SDF reaction from dilution by saliva. The fluoride from varnish is not necessary. Providers have also used Vaseline in place of varnish to prevent the saliva washout. **15. Is SDF recommended for extensive decay, such as lesions that are close to the pulp? Or are there negative effects if SDF is placed too closely to the pulp chamber?** SDF is somehow incredibly well-tolerated by the pulp. We do not put it directly on the pulp, ever, but with at least a band of dentin over the pulp, it seems to desensitize and prevent sensitivity. **16. Can you say more about interproximal caries/superfloss technique sensitive or as long as it gets “close”?** It is water based, so the drier you get the tooth/decay, the more it will wick in via capillary action. The superfloss is an option but there is no evidence that it is helpful, and there have been a few semi-formal comparisons. The floss may soak the SDF or help it in. I just dry and apply at the embrasures. **17. How is SDF detected radiographically?** Sometimes a radiolucent line appears in the outer layer of the cavity, but usually, there is no radiographically visible change. The goal is to see no change in the size of the lesion over time. *Editor’s Note: To view the full recording of the webinar, Providing Minimally Invasive Care with Silver Diamine Fluoride (SDF),* [*visit the CareQuest Institute webinar library.*](https://www.carequest.org/education/webinars/providing-minimally-invasive-care-silver-diamine-fluoride-sdf) **Categories:** Blog **Tags:** Minimally Invasive Care --- ### [Voices from the Field: Derek M. Griffith on the Connection Between Structural Racism and Health Outcomes](https://carequest.org/blog/voices-from-the-field-derek-m-griffith-on-the-connection-between-structural-racism-and-health-outcomes/) **Published:** September 28, 2021 **Author:** Caitlin Locklear **Content:** Derek M. Griffith is a founding co-director of the Racial Justice Institute, founder and director of the Center for Men’s Health Equity, and professor of Health Systems Administration and Oncology at Georgetown University. He also is a contributor to and editor of *Men’s Health Equity: A Handbook* and *Racism: Science and Tools for the Public Health Professional.![](https://carequest.org/wp-content/uploads/2025/11/VoicesLogo_0-300x300.jpg)* Trained in psychology and public health, Griffith has published more than 140 articles on pursuing racial, ethnic, and gender equity in health, and addressing racism as a determinant of health. He received the Tom Bruce Award from the Community-Based Public Health Caucus of the American Public Health Association, and he was named by the Community of Scholars one of Cell Mentor’s 1,000 Inspiring Black Scientists in America. Griffith, who is a speaker on the CareQuest Institute webinar [“Building Antiracist Policies and Practices into Health Care Settings,”](https://www.carequest.org/education/webinars/building-antiracist-policies-and-practices-health-care-settings) took time to share his thoughts on the connection between structural racism and health outcomes. He explains how witnessing racism as a child helped shaped his career path, what he’s learned about the connection between race and health outcomes, and how individual health care providers and practices can work toward achieving greater health equity. **![](https://carequest.org/wp-content/uploads/2025/11/Derek-Griffith-e1766076997238.png)Tell us a bit about your background. Was there a particular experience or moment that led you down this career path?** I grew up in Atlanta, Georgia, and I had several experiences that, when I look back, were incidents of racism. Some were overt and others were more subtle experiences with classmates and teachers. I didn’t understand why someone had such strong feelings about me, someone they had never met. Experiences like that led me to major in psychology and African American studies, which provided me the language and historical context to make more sense of these and other events. I didn’t really know what I wanted to do with my career, but I’ve been fortunate and blessed to be able to pull this together. But it certainly was not something I set out to do. **When did you decide racial justice and health equity would be focal points of your work?** My formal training is in clinical-community psychology with a master’s and PhD. One of the things I found difficult about dealing with issues of race and racial justice is that in psychology, the unit of change is one person at a time and the pace of change is small and incremental. I also noticed trying to measure things that are difficult to measure like self-esteem and attitudes made it difficult to define success. When I discovered health, I realized who lives, who dies, how long somebody lives, and when somebody dies were very hard outcomes. Looking at this issue and understanding why this differs by race, when there is no biological reason for differences in health outcomes, fascinated me. **And now you’re founding co-director of the Racial Justice Institute at Georgetown. What is that? Why does it exist?** It is the fulfillment of a promise the president of [Georgetown made a few years ago](https://www.georgetown.edu/news/georgetown-shares-slavery-memory-and-reconciliation-report-racial-justice-steps/). Georgetown had started to reckon with their history of having sold slaves to keep financially solvent and wanted to create a research institute that would basically help prevent the norms, practices, and policies that made slavery possible from ever happening again. We’re looking at the scholarly ways we need to bring together the different disciplines to create justice, a true and fair opportunity for all to be healthy and well. We know the solutions will not come from any one disciplinary or scholarly area. We need the complementary perspectives that different disciplines provide to address the combination of patterns and processes we call structural racism. We’re developing a concrete vision, an identity, and are creating a three to five-year plan we can adjust, adapt, and re-evaluate going forward. **Homing in on your area of expertise, how does racism influence health outcomes?** Racism basically creates a structure and context that disadvantages some groups and advantages others by race, and it drains the resources we have as a nation for all to achieve health and well-being. It triggers processes in the body that lead to biological aging by creating different obstacles to being able to take care of your health across education, housing, criminal justice, health care, and other sectors of society. Racism creates things like redlining and food deserts. In some cases, they are characterized [as food swamps](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708005/) when you have an overabundance of unhealthy food that would lead to oral health issues. It is an effort to explain why all of these aspects of life seem to advantage and disadvantage the same people despite the differences in communities and sectors. Racism basically affects every aspect of life that can influence health. **Why should oral health professionals care about racism?** With any kind of health care provider, when your patients come in and have poor health, you want to be able to help them fix and prevent problems. Racism helps to identify ways some patients may not have the same opportunities as others to engage in preventive care or to fix problems once they occur. It’s certainly not the only reason, but it helps to explain why when we zoom out from individuals to populations, we see remarkably similar patterns over time and across locations. We need to see patients who have different identities and try to give a fuller, richer, and accurate understanding of their obstacles to health. Some are certainly within their control, but many behaviors are shaped by the environments where they live. Oral health providers are typically not some of the first people thought of in conversations about how to achieve optimal health for all Americans. Yet I think they have a unique perspective and can play an important role in local and national conversations and efforts. **What can an individual provider (oral health or otherwise) do if they are interested in combating structural racism in our health system?** There are what providers can do personally, and what they can do professionally. Personally, it is being open to learning and understanding, and being comfortable with the concept of racism. Unfortunately, race is a very useful proxy for those who are likely to have better or worse outcomes in our society despite individual gifts, motivation, and character. Personally, providers can try to open themselves up to opportunities to learn more. From a professional standpoint, within a practice, it’s about recognizing every patient is not going to have the same opportunities and resources. While you should not assume their life circumstances or resources based on their race or other factors, it is helpful to create a common set of questions to ask all about the barriers and resources they have to adhere to your recommendations and guidance. Providers should avoid not giving certain patients options because they assume they may not have the economic or other resources to follow them. Even if they cannot, try to work with patients to come up with creative and effective solutions to overcome the barriers they have to do what you know they need to do to have good oral health. Simply make it a practice to treat all your patients the same. As basic as that sounds, try not to lean on proxies like race. Providers need to make a practice of asking questions, so it doesn’t limit patients’ options to be able to achieve their best health. **Categories:** Blog **Tags:** Health Equity --- ### [Medical-Dental Integration Just Got a Boost](https://carequest.org/blog/medical-dental-integration-just-got-a-boost/) **Published:** September 16, 2021 **Author:** Caitlin Locklear **Content:** As part of the Dental Data Exchange Project, CareQuest Institute for Oral Health helped develop the first implementation guides to help bridge the communication gap between primary care and oral health care. National partners and thought leaders collaborated on the guides, which include critical information for electronic dental health information (EHI) coordination. These new publications, formally known as the [HL7® CDA® R2 Implementation Guide: Dental Data Exchange, Release 1, STU 1 – US Realm](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=579) and the [HL7 FHIR® Implementation Guide: Dental Data Exchange, Release 1 – US Realm](http://hl7.org/fhir/us/dental-data-exchange/STU1/), are designed to facilitate care coordination and create best practices for the electronic exchange of patient data between dental and medical professionals — something that has been clunky, at best, and nonexistent, at worst, up to this point. What does all of this mean for the way oral health is delivered? How will this help providers in their daily work? And, most importantly, how will it benefit patients? Rebekah Fiehn, care coordination and interoperability manager at CareQuest Institute for Oral Health, helps explain why all of this is a big step forward for medical-dental integration and the oral health industry. **In a nutshell, what are these publications?![woman typing on laptop](https://carequest.org/wp-content/uploads/2025/11/Interop2Sized-1024x583.jpg)** These standards provide a framework for the sharing of electronic health information between software applications. The overarching goal is to make sure that the right people get the right information at the right time to provide the best care possible. The Dental Exchange standards were created to address how health information should be exchanged between dental providers and others when a referral is needed. CareQuest Institute participated in a consensus-based process where industry leaders and stakeholders worked together to provide guidance and best practices for referrals and consults, which were then developed into technical standards and corresponding implementation guides. **Why are these standards important?** Health care is essentially an environment of independent, complex, and distributed systems. In terms of health information technology, each individual point of care can be a complex web of independent technologies. That means communication and coordination of care between oral health and other health care disciplines are disrupted by the inability of health information systems to meaningfully collect, interpret, and share data — something that becomes evident when a transition of care or coordination of care is needed. In many clinics, for example, providers must rely on antiquated information technology systems and manual processes for extracting and sending patient information to other providers or clinic systems. Through the implementation of the Dental Exchange standard, we will be able to improve the overall coordination and delivery of health care because providers will be able to share data regardless of systems or applications. **How will they change daily life for providers?** While the change won’t be immediate, when implemented, these standards will ensure that providers are able to find, send, receive, and integrate the essential information they need to provide the best care possible. Providers will have near-immediate access to health information they need to deliver care. This type of robust information access can: - Reduce patient risk - Increase the relevance and the accuracy of information that providers receive from external sources or that they send to external sources - Help build better relationships between health care providers and health care organizations - Lead to a reduction in duplicated referrals and referral processing time - Make closed-loop referrals possible for dental providers **What can happen when these standards are implemented that can’t happen now?** Implementation of these standards will open up opportunities for improvement and can ease the burden of care coordination, which is important as we consider the transition from traditional dentistry to a model of care that focuses on the individual, promotes care coordination, and disease management. In other words, a model that is based in value. These standards can help facilitate care coordination, making sure that providers have a clear picture of a patient’s health and can make the right clinical decisions in collaboration with the patient in the chair. **How will patients benefit from medical-dental integration guides?** These standards will help ensure that every provider has the same accurate and updated information about a patient. Timely access to patient information is vital during patient care, especially for patients who see multiple specialists, those who might be receiving treatment in emergency settings, and those making transitions between care settings. Patients already experience the benefit of standardized electronic health information exchange in most medical settings, where, for example, primary care provider may make a referral for lab work, imaging, or to a specialist. Those orders and referrals are largely sent electronically to the receiving practice. In dentistry, many referrals are handed to the patients to manage themselves or information is sent by email or fax to a specialty provider. These types of referrals are often missing vital health information, including previous imaging, and other relevant clinical data. And that can lead to errors and unnecessary procedures or tests. And often a referral to or from a dentist has limited ability to be tracked, which means providers don’t know the outcome of treatments or if the patient ever received care. **Why hasn’t dentistry had standards like these until now?** It’s complicated and there are many factors, but one of the major limitations for information exchange standards in dentistry is the limited use and slow adoption of electronic health records by the industry in general. It wasn’t until about 2017 that a majority of dentists even had electronic health records that were utilized in practice. In medicine, a lot of innovation and progress came from initiatives like the [meaningful use incentives](https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms) that encourage providers to adopt certified health information technology software and to participate in programs at the state and regional levels. Dentistry is now in a position where we are playing catch up and trying to integrate ourselves into the medical system. **What role did CareQuest Institute play in all of this?** During our work on the [MORE Care Initiative](https://www.carequest.org/how-we-work/health-improvement-programs/MORE-care), we identified a need for improved communication and coordination of care between oral health providers and other health care disciplines. However, limitations in health information systems to meaningfully share data limited our ability to create successful interprofessional oral health networks. In early 2019, we joined the [Dental Data Exchange Project](https://confluence.hl7.org/display/ATT/Dental+Summary+Exchange+Project), which was convened under the auspices of the HL7® Payer/Provider Workgroup. This Project included representatives from the Department of Defense, the American Dental Association (ADA), Federal Electronic Health Record Modernization (FEHRM) Program Office, and other stakeholders who also recognized the need for standardized information exchange. CareQuest Institute participated as subject-matter experts in medical-dental integration and care coordination. **What happens next? What’s the timeline for implementation/change?** Now that the standard and implementation guides are published, we are moving into a testing and implementation phase. We are seeking out clinical partners who are interested in being early adopters to help them implement the standard within their systems. During this implementation phase, we plan to work with clinics to establish processes for exchanging electronic referrals and consult notes. Our goal is to ensure that the information included within these standards are what providers need, and that changes to referral systems lead to improved outcomes. And our work on electronic health information exchange will continue under the MORE Care and [COrHT Initiatives](https://www.carequest.org/how-we-work/health-improvement-programs/corht), as well as in partnerships with state organizations and partners who wish to explore additional opportunities for health data exchange to improve population health and quality measurement. The goal of this care coordination and interoperability work is to develop strategies and evidence to improve the clinical application of oral health care coordination. Right now, providers can get involved by reaching out to their software vendors and asking about their plans to adopt and implement the standards. The more these vendors and developers hear from their customers that this type of information exchange is needed, the more likely they are to begin to offer it in their product packages. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Four Reasons More Providers Should Consider Using SDF](https://carequest.org/blog/four-reasons-more-providers-should-consider-using-sdf/) **Published:** September 17, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/SDF1Sized.jpg)Silver diamine fluoride (SDF) — a liquid medication used to treat and prevent caries — has proven to be an especially valuable tool during the COVID-19 pandemic, when [minimally invasive care](https://www.carequest.org/about/blog-post/answers-17-your-silver-diamine-fluoride-questions) became more widespread. Despite the black stain it leaves on the damaged cavity portion of the tooth, nearly [80% of adults in a recent survey](https://www.carequest.org/resource-library/provider-and-public-perceptions-silver-diamine-fluoride) think that the application of SDF on posterior teeth is acceptable. Acceptance for children can be even higher — another study found that [80% of parents accepted SDF anywhere in the mouth](https://bmcoralhealth.biomedcentral.com/track/pdf/10.1186/s12903-019-0915-1.pdf). And among parents whose children were actually treated with SDF, [only 3% were uncomfortable with the stain](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12241). But still, there are providers who doubt its value. As we shared in a recent [CareQuest Institute webinar on the topic](https://www.carequest.org/education/webinars/providing-minimally-invasive-care-silver-diamine-fluoride-sdf?destination=learn/online-learning-center/instructional-webinars), SDF can be a useful treatment in a variety of settings with a variety of patients. Yes, the short-term taste and smell can be off-putting. And there’s the main side effect that any porous tooth structure (caries or hypomineralization) will stain black. But, in our experience, for many patients, it’s the right and best option. Here are four reasons we believe more providers should be using SDF: **1. Silver diamine fluoride is effective and has the ADA’s strongest seal of support.** There is no question about the effectiveness of SDF for controlling dental caries. The [ADA Council on Scientific Affairs concluded](https://journals.sagepub.com/doi/10.1177/0022034518800014) that “38% silver diamine fluoride solution applied biannually \[is\] effective for arresting advanced cavitated carious lesions on any coronal surface (moderate to high certainty).” And assured “clinicians are encouraged to prioritize use of \[nonrestorative treatments\] based on effectiveness, safety, and feasibility.” This level of certainty that a dental procedure actually works is unprecedented. **2. Silver diamine fluoride can make money for providers and save money for patients.** The cost of SDF itself and the speed of application result in a dramatically lowered cost for cavity treatment compared to fillings — a win for patients! And the profit margin and efficiency make it profitable for dental teams. Of course, the payment model in which you practice is part of the equation. In a value-based contract, the focus is on oral health outcomes and not outputs. SDF, with the antimicrobial component, influences the disease that leads to cavities and improves oral health. In addition, a provider can easily use SDF at an exam appointment after diagnosis of lesions to start repairing the tooth structure. **3. Choosing silver diamine fluoride offers an opportunity to build patient trust.** Some providers don’t think patients want SDFs, but we’ve found that’s often not the case. This is an opportunity for providers to put aside their assumptions and truly listen to patients and hear their needs. When SDF was first introduced to the US, there were dentists standing on tables demanding that their colleagues who used it should lose their licenses. Now, those same dentists are the leading advocates for SDF, writing legislation to support it and running clinical trials to advance its use. They learned that it works and that patients want it. It turns out that most patients are not as focused on cosmetics as dentists are, but they do trust dentists to guide them. When disease control is the first step, and then esthetics are considered, you can build long-term trust. **4. Silver diamine fluoride is the best chance we have to control the most common disease.** No one wants to turn cavities black. No one likes the taste of SDF. But SDF controls the disease dental caries more effectively than anything we have ever seen: [1 or 2 applications of SDF per year stops 4 in 5 cavities](https://journals.sagepub.com/doi/10.1177/2380084416661474) and [60% less new cavities occur with SDF treatment just once per year](https://www.aegisdentalnetwork.com/cced/ebooks/prevention-of-dental-caries-by-silver-diamine-fluoride). All providers have patients who keep getting new and recurrent cavities, despite everyone’s best attempts. This is the place where dental teams can start — it allows providers to first control the disease and then make the teeth more beautiful when resources allow. In fact, it works so well that it usually ends up being offered throughout a practice. Further, SDF can be done anywhere, by [essentially all members of the dental team](https://oralhealthworkforce.org/silver-diamine-fluoride-sdf/). It is hard to imagine a better solution for cavities. Change is hard, especially when it means working in a new and different way. But adding SDF to a provider’s toolbox can attract new patients to a practice. And for existing patients, it can be an important step toward delivering truly patient-centered care — a worthy goal for all of us. *Authored by Jeremy Horst Keeper, DDS, PhD, director, Clinical Innovation, CareQuest Innovation Partners and Sharity Ludwig, EPDH, MS, director, Alternative Care Models, Advantage Dental Oral Health Center and Affiliated Practices* **Categories:** Blog **Tags:** Minimally Invasive Care --- ### ['How Do You Not Include Dental Care in Overall Health?'](https://carequest.org/blog/how-do-you-not-include-dental-care-in-overall-health/) **Published:** October 4, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Dr.-Nathan-Fletcher-224x300.png)![](https://youtu.be/9Nb-a0HwiqY)Nathan Fletcher, DDS, is the dental director at AmeriHealth Caritas District of Columbia, a Medicaid insurance company. He is chairman of the Board of Trustees and past president of the National Dental Association (NDA) and former NDA executive director. Dr. Fletcher is also former co-owner of Fletcher & Fletcher Dental Baltimore, MD, a role he held from 1996 – 2020. He graduated from Howard University College of Dentistry in 1987. In addition to making decisions for dental policies for 130,000 Medicaid recipients, he now spends a lot of his time mentoring younger people inside and outside of the profession. His work with the NDA provides a unique look into the underserved communities Dr. Fletcher aims to help. Drawing from those experiences and through that lens, Dr. Fletcher shared his thoughts on Congress’s ongoing work that could add dental coverage to Medicare. **What’s your view on adding dental coverage to Medicare?** I support adding dental coverage to Medicare to provide oral health care to individuals who have paid into a system to provide for their overall health care. Oral healthcare is part of overall health care, as we see with diabetes, heart disease, lung conditions, and gastrointestinal conditions. Gum disease is the most common cause for the most inflammation in the body in adults, which affects heart disease and other conditions. And it’s preventable. The senior population is the hidden underserved when it comes to dental care. Those on fixed income are often not able to afford even basic preventive services without assistance. And that doesn’t include dentures to get proper nutrition and avoid GI problems. Unfortunately, [some of the larger dental organizations oppose](https://www.wsj.com/articles/dentists-group-fights-plan-to-cover-dental-benefits-under-medicare-11632735002) the addition of a dental benefit for all Medicare beneficiaries. It is unfortunate, but I do believe that we will make the health of US citizens our top priority. **From what you’ve seen, do other providers across the country support the legislation?** The NDA has surveyed its members and found close to 2/3 take Medicaid. The communities they serve are those that are often underserved when it comes to health care services many take for granted. That includes seniors. It is my belief that these same providers will accept Medicare for the same reasons they take Medicaid. The NDA, along with several other clinical organizations, signed a joint letter in support of Part B on September 29, 2021. The letter states, “This will ensure that ALL Medicare beneficiaries have equitable access to an oral health benefit that is integrated into our current Medicare system.” It is astounding to me that it has been purported that the administration of Medicare dental services would pose some difficulties in managing dental coverage under Part B. The Centers for Medicare and Medicaid Services (CMS) manages dental services for Medicaid right now. This same government agency could easily add management of dental services for Medicare with its goals to address health equity in the health disparities that underlie the health system and to increase access to health care as part of its mission. The proposition by some that would be a burden seems disingenuous to me. **Are there patients you’ve seen that crystallize the need for this change?** You can pick a senior anywhere who could tell a story of neglect due to cost. There are any number of stories of patients who cannot afford routine dental care to include preventive services due to retirement or disabilities. When we consider that many have paid into the Medicare program every day, it’s hard to say that they don’t deserve dental care. **Let’s imagine legislation passes. What looks different in the oral health industry?** In a few years, you’ll be able to quantify the reduction in health care costs for a diabetic population, for example. There may be a quantifiable reduction in heart conditions of those who see their dentist regularly. And the industries’ profile would reflect a better image than it does now, with the negative perceptions of dentists. Overall health care would improve for the citizens who are paying every day for health care services right now. **How could this legislation change individual practices?** I took Medicaid patients when I was in private practice. I participated in a loan repayment program, as well, although I took Medicaid patients prior to participation. It fulfilled the dual purpose of service and business. If the reimbursement rates are reasonable, I believe that more dentists will participate than do currently. There will always be the segment of the dental profession who will not take anything except fee-for-service, depending on the region and surrounding environment. In areas where insurance is prevalent and underserved populations exist in high numbers, there will be those who will provide the services. **Why are some in the dental industry against this legislation?** I believe that those against this proposition feel it is an infringement on their “right” to do business outside of government intervention. There are those in the profession who provide service to the community and the priorities of others that are different. My opinion is that the face of the profession does not relate to those of underserved groups. [The NDA has advocated for](https://files.constantcontact.com/26b50534101/010585a1-b939-4fa0-a3a9-333856ee48d8.pdf) undeserved groups since its inception 108 years ago. Meanwhile, African American dentists weren’t allowed to join professional organizations for more than a hundred years. When they did, the impediments of true members still made it hard to join. The interests of the NDA are different in that respect. But I do have to add that reimbursement should allow a reasonable business to be profitable and thrive. Maybe not to have that vacation home but to allow for student loan repayment and a comfortable life. **Why is this a needed change for our country?![](https://www.carequest.org/sites/default/files/Fletcher2_1.mp4)** The change this would bring is in line with changing health care policies, such as the Affordable Care Act, to truly address the health care of the nation. How do you not include dental care in overall health? Research has shown a diabetic patient who visits the dentist twice a year saves at least $2,000 in physical health costs annually. Those savings could be spent on dental care. For the average patient, the cost of preventive services would help reduce the overall health care costs in the nation. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Actions Anyone Can Take to Start Addressing Structural Racism in Health Care](https://carequest.org/blog/actions-anyone-can-take-to-start-addressing-structural-racism-in-health-care/) **Published:** October 7, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Antiracismpost.jpg)Racism. Antiracism. Health care. At first blush, it may not seem like those three terms fit together, but, more and more, we are starting to understand how racism and antiracism influence our health care systems and the care patients receive. In our latest CareQuest Institute for Oral Health webinar, our expert panel from oral health and primary care [explored the foundations of structural racism](https://www.carequest.org/education/webinars/building-antiracist-policies-and-practices-health-care-settings?destination=learn/online-learning-center/instructional-webinars) and how those foundations ultimately shape our care environments. Four speakers from diverse perspectives — Eleanor Fleming, PhD, DDS, MPH, associate professor at Meharry Medical College; Derek M. Griffith, PhD, founding co-director of the Racial Justice Institute at Georgetown University; Sarah E. Raskin, PhD, MPH, assistant professor at Virginia Commonwealth University; and Monica Wang, ScD, MS, associate director of Narrative at the BU Center for Antiracist Research — presented research and insights into how antiracist policies and practices influence our systems. You can [watch the full recording of the program here](https://www.carequest.org/education/webinars/building-antiracist-policies-and-practices-health-care-settings?destination=learn/online-learning-center/instructional-webinars). One key theme that emerged during the webinar was that many participants (and their organizations) are at much different places on their journey. After the show, our panelists homed in on one question: **What approach do you recommend for an organization that is just beginning its journey into diversity, equity, and inclusion?** Their answer: *Start with asking yourself why you care? How does having a more diverse, fair, and inclusive organization help to improve your organizational culture and bottom line? How does the status quo waste resources, hinder innovation, and limit opportunities for advancement, retention, and satisfaction of your best employees?* *Also, look at your data and the ways it is collected and aggregated. See if there are differences in key factors by race, ethnicity, and other factors that matter in your context. Ask yourself why and talk to staff at all levels about why those may exist and consult the literature. Likely, you will have different explanations. See which explanations seem to fit the way your organization operates, and which explanations have received less consideration (but may in fact be more accurate) in your organization.* Toward the close of the program, Professor Wang offered several other practical ways individuals and organizations can get started on their journey to build antiracist policies and practices into their local settings: **On the individual level:** - Use terms (racism, racist) accurately and talk about them. - Be curious about your own biases. - Learn about different forms of racism. - Pay attention to the language used to describe people. - Familiarize yourself with the literature on racial/ethnic health inequities in your field. **On the interpersonal level:** - Be an active bystander/ally. - Focus on calling out the specific behavior - Diffuse the situation. - Discuss the situation with a group leader. - Mentor and be a sponsor. - Treat patients with a health equity lens. - Recognize the need to build trust. - Spend quality time (ask more or different questions, encourage dialogue, ask for feedback). - Avoid coming across as in a rush or impatient. - Meet patients where they are. - Learn more about different sub-groups and ask; don’t assume. **On the organizational level:** - Revisit and establish guidelines around work culture. - Establish protocols to address discrimination in the work setting and accountability structures. - Value and encourage research on health equity. - Integrate health equity into training programs and CME. - Establish or enhance partnerships with community organizations. - Examine for inequities in the data. Editor’s Note: To view the full recording of the webinar, [“Building Antiracist Policies and Practices into Health Care Settings,”](https://www.carequest.org/education/webinars/building-antiracist-policies-and-practices-health-care-settings) visit the CareQuest Institute webinar library. **Categories:** Blog **Tags:** Health Equity --- ### [An Introduction to Value-Based Care — in Five Minutes](https://carequest.org/blog/an-introduction-to-value-based-care-in-five-minutes/) **Published:** October 18, 2021 **Author:** Caitlin Locklear **Content:** The future of oral health is coming — and value-based care holds many of the keys to success. For more than two centuries, dentists (and much of health care) have practiced in a fee-for-service model. The way dentists work and the system that surrounds them — workflows, care delivery, reimbursement, staffing, documentation, technology, and measurement — have all been designed to emphasize volume over value. Now, though, government regulations and a growing desire from all stakeholders to provide better, more personalized care for patients are driving change toward a new system. In the next [CareQuest Institute webinar](https://www.carequest.org/education/webinars/how-value-based-care-will-change-dentistrys-future), we’ll explore some of these dental processes and procedures that are ripe for change. We’ll also explore [CareQuest Institute’s Three Domain Framework](https://www.carequest.org/education/resource-library/three-domain-framework/resource-library/three-domain-framework-innovating-oral-health-care), which proposes a new model for dentistry and a case study of what a patient journey can look like when we prioritize value over volume. ## What Is Value-Based Care? Value-based care has many definitions. At its core, value-based care is a care delivery model in which providers are rewarded for quality health outcomes rather than the quantity of care delivered. And in this system, quality and outcomes should improve while costs remain the same (or fall). The reason? The healthier a person is, the fewer expensive (and often restorative and complicated) services they need. Think of this simple equation: (Outcomes + Quality) / Cost How do you measure quality? In 2001, now 20 years ago, the Institute of Medicine put forward [a framework that is still in use today](https://www.ahrq.gov/talkingquality/measures/six-domains.html). The framework includes six aims for patient care: 1. patient-centered 2. equitable 3. timely 4. safe 5. efficient 6. effective Measuring outcomes requires us to look longer and further into the future. This is particularly challenging for dentists and dental systems as providers are paid for the procedure they perform. Looking at outcomes requires a different perspective and longer buy-in — something that will require a shift in the system. ## Improving the Care Experience The goal, of course, is better patient care. When it comes to improving the overall care experience, value-based care revolves around providers who are paid to care for a population, with incentives for demonstrating value through preventing dental disease and keeping patients healthy. This graphic helps highlight the differences between traditional dental care and a value-based care model: ![](https://carequest.org/wp-content/uploads/2025/11/Traditional-vs-OHVBC-e1762371612154.png) Value-based care prioritizes: - prevention-focused oral health care including minimally invasive techniques and teledentistry - medical-dental integration and referrals - electronic health records focused on linking quality to care - patients receiving personalized care for their specific needs [Value-based care models](https://www.carequest.org/topics/value-based-care) are designed to align the system of care, the person, the provider, and the community to achieve better health outcomes at lower costs. Successful designs are prevention-focused, minimally invasive, person-centered, and risk-based to ensure an equitable distribution of resources. In value-based systems, medical care does not exist in silos. Instead, primary, specialty, and acute care are integrated. This team-oriented approach to patient care and sharing of patient data helps to coordinate care and makes it easier to measure outcomes. Communication and coordination of care between oral health and other health care disciplines has long been an obstacle. This disconnect — the inability of health information systems to meaningfully collect, interpret, and share data — limits the system’s ability to address whole-person care across the lifespan. Dismantling silos is vitally important in the move toward value-based care — and, fortunately, something that recently received a boost with the [publication of the first implementat](https://www.carequest.org/about/news/medical-dental-integration-just-got-boost)[ion guides to help bridge the communication gap](https://www.carequest.org/about/news/medical-dental-integration-just-got-boost) between primary care and oral health care. Access to electronic health data can help isolate specific geographic or population-based areas where individuals can benefit from enhanced care and social coordination efforts to provide more timely and effective interventions. Further, dental and medical providers have increased use of oral health risk assessments and are beginning to use targeted outreach and population health analytics in their practices. ## Payment Transformation through Value-Based Care As highlighted in the equation above, the “value” in value-based care is derived from measuring health outcomes against the cost of delivering care. And there’s a growing chorus in the industry who believe that fee-for-service is no longer the best method for revenue generation. The COVID-19 pandemic helped to underscore the reality that payments based upon value rather than the units and types of services delivered is [more predictable and stable](https://www.carequest.org/resource-library/public-health-dental-providers-embrace-covid-19-related-changes). Therefore, payment design is an enabler for value-based care. But it’s a challenging transition to make, as the systems to truly measure cost of the care for a patient population are still incomplete. It’s also still a new concept for many in the oral health industry. According to a [2020 CareQuest Institute report](https://www.carequest.org/resource-library/alternative-payment-models-dentistry), more than half (51%) of responding providers had never heard of [alternative payment models](https://www.carequest.org/topics/value-based-care) (value-based care is an example) in dentistry. But in the same report, research highlighted that alternative payment models are increasingly being used both in Medicaid and Medicare and are even entering private insurance. Nearly 70% of Medicaid beneficiaries are enrolled in managed care plans today. And[ ongoing work in states like Michigan and New Hampshire](https://www.cms.gov/priorities/innovation/innovation-models/miap) is paving the way to make the transition to a value-based payment model. Editor’s note: To learn more register for the October 21 webinar, [“How Value-Based Care Will Change Dentistry’s Future.”](https://www.carequest.org/education/webinars/how-value-based-care-will-change-dentistrys-future) **Categories:** Blog **Tags:** Value-Based Care --- ### [Voices from the Field: Alex Sheff on Advocating Oral Health Care for All](https://carequest.org/blog/voices-from-the-field-alex-sheff-on-advocating-oral-health-care-for-all/) **Published:** November 5, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/VoicesLogo_0-300x300.jpg)Alex Sheff is co-director of policy and government relations at [Health Care For All](https://hcfama.org/) (HCFA), a consumer health advocacy organization that supports health justice in Massachusetts by working to promote health equity and ensure coverage and access for all. Since 2004, CareQuest Institute for Oral Health has helped fund HCFA’s critical work around oral health in the Commonwealth. With that support, in 2021 HCFA has been focusing on improving oral health integration, licensing dental therapists to increase access to care, establishing a commission to improve data collection and management, and continuing to defend the Medicaid adult dental benefit in the state. We caught up with Alex to learn more about these initiatives and the daily work at HCFA as it helps consumers navigate the health care system and advocate for improvements within oral health. **![](https://carequest.org/wp-content/uploads/2025/11/Alex-Sheff.png)Can you tell us more about Health Care For All’s work?** I would say our work really starts with our HelpLine, which takes about 20,000 calls a year from people who are trying either to get enrolled in health insurance or navigate their coverage. Some have transitioned to a new job, some have complicated immigration statuses, and others have coverage but aren’t sure how to utilize it or find a provider. Our HelpLine takes calls all day, every day with more than half of the calls in Spanish and Portuguese. We’ve been trying very hard to expand to some other languages, like Haitian Creole, but we haven’t gotten there yet. We had to expand the HelpLine’s capacity in the pandemic and added two new bilingual counselors. HCFA’s policy and advocacy work are guided by the themes we hear from callers on the HelpLine. We understand individuals’ problems and then try to translate what \[counselors\] are hearing into policy solutions. **Can you give an example of oral health policy and advocacy work Health Care for All is focused on in 2021?** We’re working right now on a bill to establish an oral health special commission and needs assessment. It’s been more than 20 years since we’ve had one in Massachusetts. We think this is really a moment where we need to take a deeper look at the oral health needs in the state. We know there are challenges in access and care. And we know there’s a disproportionate impact on communities of color and low-income communities. We just don’t have a full picture of that impact by age, by geography, by disease burden, and that’s what this bill would do. Within oral health, we’ve also been working on the 1115 Medicaid waiver proposal. **Can you talk about that Medicaid waiver?** Every five years, the state negotiates with the federal government to determine how the state’s whole Medicaid program is going to operate. [In the last waive](https://www.mass.gov/doc/ma-1115-waiver-summary-1/download)r, we fought really hard, thanks to CareQuest Institute’s support, to include an oral health quality measure that all of the Accountable Care Organizations (ACOs) that participate in the state’s program in the state had to adhere to. That was our big oral health win, which moves us toward more integration. This year, we are advocating for a couple of different things. One is to require all primary care practices that participate in the ACO program to have a two-question oral health screener. They’re going to be required to assess how recently a patient has seen a dental provider or if a patient is experiencing mouth pain. Then the provider would have to do some follow-up to provide a pathway toward care. **How does having a partner like CareQuest Institute help you do this work?** Having a partner like CareQuest and having stable funding enable us to dedicate staff resources consistently, which makes a big difference. I’ll start there. The second thing is that CareQuest Institute is full of experts that help us do our work, sharing their knowledge, data information, presentations . . . it’s really a two-way street. I think it’s both of those things. **What’s unique about this work to improve oral health? What drives you and your team?** I’ll give you an anecdote. I have a friend who runs a community partner program that helps people with complex needs navigate care in the state. She asked me to speak at their advisory board meeting, and I started to talk about HCFA’s work, including getting the adult dental benefit fully restored in MassHealth last year. (That was a 10-year battle — getting coverage tooth by tooth, as we sometimes say.) I started to mention how we just got this adult dental benefit fully restored, how it now covers root canals and crowns. This person on the board call was like, “Really? That happened? That’s amazing! I had to go get this procedure, and they instead ended up having to pull the tooth. It was terrible!” I almost never get that kind of response to policy changes. I just think it’s something so tangible, and it really hits home. Oral health is just such a huge deal for people, and I think that impact gets lost sometimes. **Can you say a little more about getting the adult dental benefit restored?** In the last recession in 2009, the state did not have the revenue and so they cut several programs, including MassHealth. One of the results was that the state eliminated most of the adult oral health benefit. So, over a 10-year period, HCFA and others worked to get different pieces of that adult oral health benefit restored. We helped restore periodontal services a couple years ago. Then finally, the last step was adding back in coverage for root canals and crowns last January. **Lastly, has the COVID-19 pandemic changed the work and the focus on oral health?** Oral health is connected to overall health — that is the bottom line. We talk a lot now in the context of COVID-19 about underlying chronic conditions and what it means. It means something different than it did a year and a half ago — it was bad then, and now it’s terrifying with the links conditions can have due to COVID-19 complications. People may be able to understand the connection between oral health and management of other chronic conditions in a different way now. Editor’s note: [Explore our application process](https://www.carequest.org/how-we-work/grantmaking/apply) to learn more about how to apply for a grant at CareQuest Institute. **Categories:** Blog **Tags:** Dental Coverage, Practice Management --- ### [Four Common Questions (and Answers) about Value-Based Care](https://carequest.org/blog/four-common-questions-and-answers-about-value-based-care/) **Published:** November 30, 2021 **Author:** Caitlin Locklear **Content:** One thing is clear about the dental industry’s transition to [value-based care](https://www.carequest.org/about/news/introduction-value-based-care-five-minutes): There are a lot of questions: What is value-based care? Are providers familiar with [alternative payment models](https://www.carequest.org/resource-library/alternative-payment-models-dentistry)? What are the benefits of value-based care? During CareQuest Institute for Oral Health’s recent Value-Based Care Office Hour — a bonus session after the [webinar on the topic last month](https://www.carequest.org/education/webinars/how-value-based-care-will-change-dentistrys-future) — a panel of experts fielded several questions about the how and why of transitioning dentistry to value-based care. The panel included Randal Christensen, Chief Clinical Information Officer, Chiricahua Community Health Centers, Inc.; Brianna Hillier, DMD, Director of Dental Services, Chiricahua Community Health Centers, Inc.; Lisa Simon, MD, DMD, Fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine; Bob Russell, DDS, MPH, MPA, CPM, FACD, FICD, Consultant, CareQuest Institute for Oral Health; Rebekah Mathews, Director of Value-Based Care, CareQuest Institute for Oral Health; and Danielle Apostolon, Training Specialist, Value-Based Care, CareQuest Institute for Oral Health. The questions from participants ranged from payment and care transformation to data and measurement models. Here, we share four memorable questions as a quick recap for participants who joined and anyone who wants to learn more about the topic: **How can we get dentists to embrace the value-based care methodology?![](https://carequest.org/wp-content/uploads/2025/11/value-based-care-exam_960x600_0-300x188.png)** Incentives that motivate, changes in dental curriculum, continuing education opportunities in VBC, and closer integration of EHR and protocols with medical care. The shift to [value-based care is als](https://pubmed.ncbi.nlm.nih.gov/33058156/)[o](https://pubmed.ncbi.nlm.nih.gov/33058156/)[ coming from external pressures](https://pubmed.ncbi.nlm.nih.gov/33058156/) to engage in the development and evaluation of quality metrics and play a role in developing the model. It is important dental has a voice in value-based care design, therefore any opportunities to participate as an early adopter through testing care and payment models that optimize patient health outcomes are important since the future of payment and care delivery will change. **What would you say motivates providers to embrace value-based care, especially since most view value-based care as generating less revenue?** Value-based care payment models are not one-size-fits-all and can provide opportunities to earn incentives based upon achieving certain quality metrics. Rather than being paid per procedure, providers are reimbursed for the total care provided, which goes beyond treatment to a person-centered approach. Value-based care emphasizes providers and patients seeking minimally invasive and prevention-focused care that is not typically reimbursed under a fee-for-service model. Dental providers are already spending time interviewing and educating patients, providing preventive care, and tailoring recall intervals to patient needs. Yet in the current system, remuneration is limited to specifically defined services and benefit structures. **What positive outcomes of value-based care weren’t anticipated by early adopters?** In states that have adopted value-based care, models in primary care are reporting an improvement in no-show rates and chronic disease management and a reduction in costs. [Value-based care models also include](https://www.carequest.org/system/files/CareQuest%20Institute-A%20Learning%20Community%20Aims%20to%20Change%20Oral%20Health.pdf)[ collaboration with a broader team](https://www.carequest.org/resource-library/learning-community-aims-change-oral-health) and acknowledgement of important clinical work previously unremunerated in the fee-for-service system such as inter-visit care and coordination with other providers. Also, it is important to note increased staff rapport and interdisciplinary communication. **How can the industry shift to a mindset of prevention instead of restoration?** Re-educating the dental profession to see risk-based diagnosis, early intervention, and minimally invasive care as the primary paradigm for dental intervention is the primary pathway. Primary care models like the [patient-centered medical home](https://pcmh.ahrq.gov/page/defining-pcmh) and behavioral health integration demonstrate myriad options for empowering providers to deliver team-based preventive care rather than reactive restorative care. For example, quality metrics can incentivize primary care teams to screen, refer, or provide preventive care and enable other members of the care team to provide continuous care. Successful value-based care innovations within medicine do not punish providers and systems for providing invasive care when needed; instead, they allow the development of systems that make it easier and more rewarding to provide the care providers already like: spending time on education, targeting at-risk patients with more intensive preventive services, and building meaningful relationships with patients and colleagues. To learn more on the topic, watch the recording of the webinar, [“How Value-Based Care Will Change Dentistry’s Future.”](https://www.carequest.org/education/webinars/how-value-based-care-will-change-dentistrys-future?destination=learn/online-learning-center/instructional-webinars) **Categories:** Blog **Tags:** Value-Based Care --- ### [Why These Two Providers Believe Teledentistry Is Here to Stay](https://carequest.org/blog/why-these-two-providers-believe-teledentistry-is-here-to-stay/) **Published:** December 10, 2021 **Author:** Caitlin Locklear **Content:** For Dr. Mina Paul and Dr. Brianna Hillier, teledentistry has been an invaluable addition to their daily work. “Teledentistry is here to stay, and I am absolutely an advocate,” said Paul. “There’s a lot more we can do.” In the past two years, the COVID-19 pandemic required many providers like Dr. Paul and Dr. Hillier to rethink how to treat patients outside of a traditional office setting safely and effectively. Teledentistry — using telehealth systems and methodologies within oral care — quickly [gained momentum](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19). The [emergence of teledentistry](https://www.carequest.org/education/resource-library/teledentistry-what-know-how-it-works) led to learning curves and challenges during the pandemic while spotlighting the power of providing equitable access to oral health care. Whether it was within a dental office, in a community setting, or, often during the pandemic, from a patient’s home, the array of virtual tools allowed for [convenient and urgent care.](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money) “Providers can assess patients’ needs and comfort level, and then manipulate schedules so the patient can get an appropriate appointment time,” Dr. Paul said. ## ![](https://carequest.org/wp-content/uploads/2025/11/Teledentistry-Provider-And-Patient_500x333.png)A Quick Pivot in March 2020 As the dental director for East Boston Neighborhood Health Center’s various dental clinics in usetts, Dr. Paul first launched a teledentistry program in March 2020 to provide urgent care at the beginning of the pandemic. “Teledentistry was a learning moment in terms of doing nonvisual work,” Dr. Paul explained. “My skill set expanded during virtual exams and fortified the patient bonding experience. I found I could spend more time with patients than I normally would pre-pandemic. Patients felt like someone was really listening and taking time to ask more questions.” Dr. Hillier, the director of dental services, Chiricahua Community Health Centers, Inc., in Cochise County, Arizona, was also quick to see the benefits of a virtual connection. “I can take good intra-oral photos and radiographs virtually during teledentistry appointments,” she said. “The patient doesn’t need to physically come in, and they are very thankful for that. For rural communities like the one I work in, teledentistry is an asset at this point. [It’s a barrier to care if you can’t do it.”](https://www.carequest.org/education/resource-library/teledentistry-removing-barriers-and-moving-toward-implementation) As the pandemic has continued, the value of teledentistry has remained.“We \[still\] have telehealth calls every day,” Dr. Paul said. “It’s very common to get three or four call requests a day and for my [providers to make those calls to triage patients](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money). What we’re doing is a win-win in the sense that people can get the care they need a lot faster by phone.” Triaging patients, in particular, was a huge benefit in emergency situations. Dr. Paul also points out how teledentistry is beneficial not just in terms of administrative work but also in providing patients immediate treatment. “The other piece to teledentistry is sometimes patients will have emergencies your health center is not equipped to handle, and they don’t know where to go,” Dr. Paul added. “This makes teledentistry advantageous in triaging and directing patients to the right place sooner than later.” ## Connecting Through COrHT Dr. Paul and Dr. Hillier both participated in CareQuest Institute for Oral Health’s [Commu](https://www.carequest.org/health-improvement-programs/corht)[nity Oral Health Transformation Initiative](https://www.carequest.org/how-we-work/health-improvement-programs/corht), gaining more knowledge and insights about teledentistry. The COrHT initiative, which began during the pandemic, serves as a learning community for the implementation of [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) and [value-based oral health care](https://www.carequest.org/about/news/introduction-value-based-care-five-minutes). **“**We participated in the CoHRT program, and I found some of the tips very useful to help flesh out questions and customize care according to what we need to do to serve our population,” Dr. Paul said. “Every population is different and made up with different demographics. Some of the COrHT presentations helped spark ideas for how to address this in the future.” Dr. Hillier found the medical-dental integration discussions within COrHT particularly useful. “I use the COrHT system’s [Three Domain Framework](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) to take a step back and learn how I could further help my medical team from within my dental clinic,” she said. “For example, I am now thinking about more integration opportunities so I can go into the nooks and crannies of the rural communities I serve and help.” ## The Potential of Teledentistry That focus on the unique needs of rural communities is top of mind for both Dr. Hiller and Dr. Paul. “There are patients who can’t come see us as easily,” Dr. Paul explained. “So, a lot of times these community members are not patients of the dental clinic and literally have nowhere to go. That’s where we step in and provide access to care and serve as a beacon for patients to get some sort of solace and treatment. Teledentistry helps open avenues and options for patients in need.” The advantages of teledentistry — improving access in rural settings, person-centered care, ability to triage — point to its staying power. “I’ve talked to colleagues across the country, and they are looking at different ways of handling follow-up and consult appointments and oral hygiene,” Dr. Paul said. “As a community health center that’s not where we’re currently at with teledentistry, but five years down the line with the support of infrastructure, insurance companies, and guidelines, we can go a lot further.” **Categories:** Blog **Tags:** Practice Management --- ### [Voices from the Field: Dr. Scott Howell on Why Teledentistry Isn’t a Fad](https://carequest.org/blog/voices-from-the-field-dr-scott-howell-on-why-teledentistry-isnt-a-fad/) **Published:** December 13, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/VoicesLogo_0-300x300.jpg)Scott Howell, DMD, MPH, is an associate professor and director of public health dentistry and teledentistry at [A.T. Still University-Arizona School of Dentistry & Oral Health (ATSU-ASDOH).](https://www.atsu.edu/arizona-school-of-dentistry-and-oral-health/teledentistry) He is a fellow in George Washington University’s Atlantic Fellows for Health Equity program, which he will complete in 2022. Prior to dental school, Dr. Howell worked in portable dentistry as a dental assistant in Michigan, going to long-term care facilities, detention centers, and inner-city schools. After residency, including one year at the Swedish Medical Center GPR in Seattle treating patients with complex medical conditions and special needs, he returned to ATSU-ASDOH to develop a teledentistry program. He has spoken on teledentistry at state, national, and international levels, written extensively on the subject, and has advocated for changes in teledentistry policy and laws in his home state of Arizona. He’s presenting on the topic in a CareQuest Institute-Association of State and Territorial Dental Directors webinar — “[Best Practices for Teledentistry Today and in the Future](https://www.carequest.org/education/webinars/best-practices-teledentistry-today-and-future)” — on December 16. In short, Dr. Howell knows teledentistry. And as he prepared for the webinar, he shared some insights on why teledentistry isn’t a fad, offered advice for organizations just getting started on a program, and discussed potential innovations the industry could see in the coming years. **How did you first get interested in telehealth? What about it appealed to you?** When I was hired at A.T. Still University in October of 2015 — as an HRSA-funded position — I was asked to expand our interprofessional education curriculum and develop a new teledentistry curriculum with a hygienist. I had no clue what teledentistry meant. The night before my interview, I was looking up articles related to the topic. A lot of what I saw was coming from Dr. Paul Glassman, who I endearingly refer to as the godfather of teledentistry. [Dr. Glassman has paved tremendous pathways](https://www.mouthwatch.com/innovators-recognized-at-the-2019-teledentistry-innovation-awards/) for all of us to be able to use teledentistry within our communities. What was so intriguing to me about it was that it was closely connected to my roots in mobile dentistry, but it brought a new technological aspect that I hadn’t seen before. **Can you tell us a little about working in portable dentistry in Michigan? How did the experience of going to long-term care facilities, detention centers, and inner-city schools shape your future?** My father started a portable dentistry company in Michigan when I was in middle school, but it wasn’t until my second year of college that I even explored the idea of becoming a dentist. I worked for his company for a summer in the office doing billing and paperwork, and then went into the field to see dentists working in a nursing home and in a school a couple of times. I was hooked from the moment I saw what they were doing and how they were able to help people. After graduating from college, I came back to the company in 2008 and spent the next two years driving up to 2.5 hours one way to get to some of the most rural communities in Michigan and working with some of the most amazing dentists and dental assistants. The entire experience taught me that we don’t have to do dentistry the way we’ve always been doing it. And to this day, as an educator, it is so important to me that I teach my students to challenge the status quo, which is exactly what I learned to do working in mobile dentistry. **How has the COVID-19 pandemic changed teledentistry?** It brought a lot of awareness to teledentistry, but I think it also created a lot of misconceptions. When clinics and offices closed and still wanted to be able to help their patients, a lot of people turned to teledentistry. From community health centers to private practices to academic institutions, everyone was looking for a way to connect with their patients. For a lot of providers who didn’t know anything about teledentistry up to this point, many only knew about the direct-to-patient videoconferencing that was becoming more prevalent during the pandemic. What they didn’t realize is that there had been several decades of teledentistry use cases that didn’t utilize this type of approach. About a year into the pandemic, I started seeing articles come out about teledentistry being a fad and that it won’t be necessary after the pandemic. I think this is a huge misconception and one we continue to work to correct. But the good news is that a lot more people are talking about teledentistry and exploring how they can use it within their own clinics. **What are one or two misconceptions providers have about teledentistry?** As I mentioned above, one of the misconceptions is that teledentistry is a fad, and another is that it is only for low-income communities. [Teledentistry has been around since the mid-1990s,](https://medium.com/oraleye-network-news/how-did-we-get-here-a-brief-history-of-teledentistry-f985b8e0b7b3) and telemedicine has been around since the early 1900s. The fact that it wasn’t until the pandemic that a lot of oral health providers even heard of teledentistry doesn’t make it a fad. I think it’s also important to recognize that any provider in any clinic can use it for any patient. The numerous ways we can use technology isn’t limited to just those living in poverty or to just those with smartphones. A thorough assessment of the clinic’s needs and the patient population’s needs will provide answers to how teledentistry could benefit a particular community. I’ve used it to connect with a hygienist working in a detention center, and I’ve used it to save patients four-hour, one-way trips to the clinic for a quick post-op visit or treatment plan presentation. These patients I work with don’t benefit from teledentistry because they are low-income or high-income; they benefit from teledentistry because we recognized an important need for the patients in our clinic and in our communities. **What advice would you give to an organization that is trying to set up a teledentistry program today?** It is so important to assess why you think you want to use teledentistry. There is a particular document from the American Medical Association called [Telehealth Implementation Playbook](https://www.ama-assn.org/system/files/2020-04/ama-telehealth-implementation-playbook.pdf) that might be helpful for those considering using teledentistry. The very first section is all about the “pre-game,” and the first step is identifying a need. If there is no true need to use technology to connect with patients, then a lot of time will be wasted setting up a teledentistry plan. **What role do you think teledentistry will play in the future of oral health?** I graduated from dental school in 2014 and, like most dentists at the time, didn’t know anything about teledentistry. But here it is in 2021, and I’m seeing dental school applicants write about it in their applications. In just a few years, we have seen an explosion of interest in the role of technology in making health care more accessible. Personally, I’ve had half a dozen telemedicine appointments since the start of 2020. I don’t think the general concepts will change, but the sheer number of people who use teledentistry — both patients and providers — is going to continue to grow. As the technology we use becomes more advanced, how we use that technology will change, too. I wouldn’t be surprised to see AI-assisted diagnosis be more prevalent (there are already some companies working on this), and I also think image quality is going to improve, which will aid in our assessments of patients and conditions they present with. I think we will also see more opportunities for patients to collect their own clinical records (under the guidance of an oral health professional) and submit those records for review. We definitely need more research in this area—it’s probably one of the biggest gaps in the teledentistry literature right now—but there are already some promising outcomes from studies that have explored patient-collected data and the accuracy of those data as it relates to the oral health provider’s findings. *Editor’s Note: To hear more from Scott, register for the upcoming webinar, [Best Practices for Teledentistry Today and in the Future](https://www.carequest.org/education/webinars/best-practices-teledentistry-today-and-future)* **Categories:** Blog **Tags:** Practice Management --- ### [The Five Most Popular Publications of 2021](https://carequest.org/blog/the-five-most-popular-publications-of-2021/) **Published:** December 14, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Top-Publications-Blog.png)Research is one of [five Areas of Activation](https://www.carequest.org/how-we-work) at CareQuest Institute for Oral Health. It’s an integral part of our strategy to improve the oral health system and build a future where every person can reach their full potential through excellent health. Research is also one of our most prolific areas. In 2021, CareQuest researchers created and published more than 100 items, including white papers, journal articles, research reports, and infographics. (You can find all the items and more in our [Resource Library.](https://www.carequest.org/resource-library)) The goal of that research is simple yet powerful: to conduct innovative research and actively seek out and analyze data to reveal opportunities to transform oral health care and improve patient outcomes. And in 2021, there was no shortage of items that fit that description. Based on the collective interest from our audience of providers, policymakers, advocates, and oral health stakeholders across the industry, here are the five most popular CareQuest Institute publications from the last year. ## [5. More Than Meets the Eye: Oral Health, Eye Health, and Overall Health](https://www.carequest.org/resource-library/more-meets-eye-oral-health-eye-health-and-overall-health) This report highlights the links between oral health, eye health, and overall health. For example, systemic causes of visual impairment, such as diabetes and heart disease, are also associated with poor oral health outcomes in addition to compromising overall health. Knowledge of these links is key for clinicians to diagnose, educate, and treat high-risk individuals. Key points from the report: - Periodontal disease is associated with increased risk of developing glaucoma. - Patients with diabetes have a significantly increased risk of developing glaucoma. - Disabled and aging populations are more predisposed to oral issues and ocular diseases. ## [4. Provider and Public Perceptions of Silver Diamine Fluoride](https://www.carequest.org/resource-library/provider-and-public-perceptions-silver-diamine-fluoride) Silver diamine fluoride (SDF) is highly effective in arresting the progression of active caries as well as preventing new lesions. But is has downsides, too: it leaves a black stain on these lesions and may burn or stain the soft tissue surrounding them. How do dental providers and patients view SDF? This report offered details on their attitudes, including the following: - Of nearly 400 surveyed providers, 90% agreed that SDF is an effective treatment. - Of the surveyed adults, 78% thought that the application of SDF on posterior teeth was acceptable versus only 20% who thought it was acceptable on anterior teeth. - Females were more likely than males to accept SDF as the treatment of choice for both posterior and anterior teeth. ## [3. A Learning Community That Aims to Change Oral Health ](https://www.carequest.org/resource-library/learning-community-aims-change-oral-health) The COVID-19 Oral Health Recovery and Transformation (COHRT) Learning Community brought together Federally Qualified Health Centers in Massachusetts to make systemic changes to their delivery of oral health care. The goal was to not just respond to the pandemic but also begin the process of long-term transformation in oral health. This report describes that learning community and its outcomes, including the following: - There was a steady increase in caries risk assessments (CRAs) at the FQHCs over the course of the learning community, from a total of 275 in June 2020 to 1365 in November 2020. - By the end of the learning community, 75% of participants agreed or strongly agreed that the traditional dentistry model will need to significantly transform in the next five years. - Seven of the eight participating FQHCs reported that they were confident or extremely confident in their ability to use primary and secondary interventions. ## [2. New Survey Suggests Optimism about Teledentistry Experience and Access ](https://www.carequest.org/resource-library/new-survey-suggests-optimism-about-teledentistry-experience-and-access) This report from June, based on the State of Oral Health Equity in America 2021 survey of 5,320 adults, found that many patients have not experienced a virtual visit with a dental provider: only 2% of survey respondents had received dental care remotely in the last year. This is, at least in part, because of limited awareness and availability: 63% of respondents were unaware of whether their dentist offered teledentistry, and 33% said they knew their dentist did not. But patients who had experiences with teledentistry had positive feedback, and many who had never had a virtual visit were willing to try it, given the opportunity. ## [1. Inequities Remain Pervasive in Oral Health ](https://www.carequest.org/resource-library/inequities-remain-pervasive-oral-health) This report from July, the most popular publication of the year, explores the pervasive inequities in oral health. Based on a survey of 5,320 adults, it found the following: - Fifty-seven percent of Black adults have lost one or more permanent teeth due to decay or gum disease, compared to forty-six percent of all American adults. - Black respondents (40%) were two times more likely to respond that oral health is more important than physical health, compared to white respondents (20%). - Eighty-seven percent of respondents supported the alignment of payment with prevention and management of disease—key elements in value-based care. The report also highlighted disparities between different groups in terms of the prevalence of different oral health problems and attitudes toward value-based payment within different income levels. **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration, Minimally Invasive Care, Practice Management --- ### [Promising Opportunities to Support Veteran Oral Health](https://carequest.org/blog/promising-opportunities-to-support-veteran-oral-health/) **Published:** December 16, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2021/12/Veteran-Dental-Care.png)Roughly 19 million veterans live in the US, comprising about 6% of the total population. Those veterans are more likely to experience worse oral health outcomes — higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care — compared to nonveterans. [A new white paper](https://www.carequest.org/veteran) from CareQuest Institute and the American Institute of Dental Public Health (AIDPH) aims to shine a light on the social, structural, and individual drivers of these outcomes. Here is a short excerpt from the paper: Most veterans place [a significant value on oral health](https://pubmed.ncbi.nlm.nih.gov/31409719/), recognizing the benefits of improved dental insurance coverage and access to care currently not offered through VA guidelines. Organizations, including FQHCs and local providers, are stepping in to meet veterans’ oral health care needs, but many veterans still experience poor oral health and unmet dental needs. Advocates like the Veterans of Foreign Wars (VFW) have urged Congress to pass policy measures that expand access to oral health care for veterans. Recently, [the VFW asserted](https://docs.house.gov/Committee/Calendar/ByEvent.aspx?EventID=110920), “Providing essential dental care services as a preventative health measure enhances veterans’ overall well-being by reducing the risk of oral and periodontal diseases, which then reduces or prevents the cost of treating veterans with these illnesses. Good oral hygiene increases a veteran’s self-esteem, which is a factor that can affect everything from mental health to employment.” Veterans, like all Americans, experience a siloed system of care that does not effectively consider oral health in the context of overall health or socioeconomic and environmental factors. Recognizing opportunities to improve veteran health, the VA announced a partnership with the National Academies of Sciences, Engineering, and Medicine to stimulate integration and person-centered care for the veteran community. The resulting committee is charged with identifying promising new research-driven health care delivery models for veterans. While oral health is not currently represented in the focus areas, the opportunity remains to integrate it into this initiative. VETSmile is a new pilot program from the VA Center for Care and Payment Innovation (CCPI). VETSmile aims to improve access to dental care for veterans by establishing a network of community dental care providers (DCPs) that provide a dental home for veterans pro bono or at a discounted rate. The program launched July 2021 with partners from the New York University College of Dentistry in New York, NY, Zufall Health Center, Rutgers School of Dental Medicine, and CompleteCare Health Network in New Jersey. VETSmile expects to serve 3,900 veterans through 9,000 patient visits in the first year of implementation. After the initial launch, the number of veterans served overall is expected to increase as CCPI builds partnerships with additional dental care providers across the nation. CCPI’s strategic partnerships with the American Dental Association, the National Association of Community Health Centers, and VA Dentistry support the development and success of this pilot. While longitudinal outcomes of the program are still pending, this promising approach to public-private partnerships can be potentially scaled to address the structural oral health care needs of veterans throughout the US. *Editor’s Note: [Explore the full white paper](https://www.carequest.org/veteran) that seeks to catalyze oral health professionals and policymakers toward advancing health equity for veterans.* **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [The Path to Improving Oral Health Care for Veterans](https://carequest.org/blog/the-path-to-improving-oral-health-care-for-veterans/) **Published:** December 21, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/Bosco-Jerez-e1766077978637.png)Bosco Jerez When Bosco Jerez returned from Iraq, he was diagnosed with post-traumatic stress disorder (PTSD) and dental care wasn’t his top priority. “During that time, I didn’t take care of my teeth like I should have been because I had other things on my mind,” says Jerez, a veteran from Virginia. “And of course, I didn’t have dental insurance to take care of it.” In the 10 years it took him to seek care for his teeth, Jerez’s oral health was up and down. Although he didn’t have any major oral health issues during that time, he also couldn’t afford preventive care. Luckily, he was able to connect with Dr. Kathleen Mullaney, DDS, who runs a clinic where she provides free dental care to veterans in the Alexandria, Virginia, and D.C. areas. “I am a veteran, I served for six years,” says Dr. Mullaney. “I feel so grateful to be able to give a little bit back and honor people who’ve given so much.” Jerez knows he’s lucky to have “just one cavity so far,” but the same isn’t true for many veterans. Thousands of men and women who fought to defend our country have oral health problems like gum disease, tooth pain, tooth abscess, and other dental issues — many of which develop due to a lack of dental coverage. While many providers like Dr. Mullaney and other organizations have stepped up to help fill this unmet need, there needs to be a more comprehensive solution. To help, CareQuest Institute and the American Institute of Dental Public Health (AIDPH) recently entered into a [new partnership](https://www.carequest.org/about/news/carequest-institute-and-american-institute-dental-public-health-partner-advance-veteran "Partnership with AIDPH") to explore solutions to veteran oral health care, increase accessibility to care, and stimulate rural oral health innovation. The partnership will focus on studying the current state of veteran oral health and access to care and then developing data-driven recommendations informed by the veteran community. The partnership’s first output is a new white paper — [“Veteran Oral Health: Expanding Access and Equity”](https://www.carequest.org/veteran "Veteran Oral Health: Expanding Access and Equity") — focused on the need to better understand the significant deficits surrounding veteran oral health. The goal of the paper, which includes several strategic recommendations to improve access and quality of care, is to catalyze oral health professionals and policymakers toward advancing health equity for veterans. ## The Reality Veterans Face Ongoing research provides a glimpse into the reality veterans are facing. [According to the VA](https://department.va.gov/wp-content/uploads/2025/06/2026-Budget-in-Brief.pdf), out of the 9.2 million veterans enrolled in VA health care, only about 1.4 million are eligible for comprehensive dental care. The VA reports that 33% of eligible veterans (463,000) received a total of more than 3.6 million dental procedures during 1.3 million visits in 2020. The VA notes “significant potential for growth” among dental utilization rates for veterans. [In the National Survey of Veterans](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12095), close to half of veterans (41%) described their oral health as “fair” or “poor,” and these veterans were more likely to report having a self-identified disability than veterans with better self-reported oral health. More than half (56%) of veterans had seen a dentist in the past 12 months, with the majority of those individuals paying out of pocket or through other payment sources, such as employer-based dental insurance. [A survey of nearly 200 veterans in Michigan](https://onlinelibrary.wiley.com/doi/10.1111/jphd.12095) found that while most (80%) were not eligible for dental benefits through the VA, over half of the respondents who were ineligible had been seen by a dentist in the previous six months. Survey respondents who were not eligible for dental benefits through the VA reported that cost was a significant barrier to seeking out dental care. This reality exists because our government requires veterans to meet [specific eligibility requirements](https://www.va.gov/health-care/about-va-health-benefits/dental-care/). Essentially, veterans do not qualify for dental care from the VA unless they have a preexisting dental condition, a disability, or were a prisoner of war. This lack of coverage for our veterans is compounded by the fact that Medicare only pays for certain dental services patients receive in the hospital and Medicaid provides limited or no adult dental benefits in many states. Meanwhile, [more research](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) is demonstrating that poor oral health has a direct tie to poor overall health, particularly among veterans. ## The Connection Between Oral Health and Overall Health Roughly 19 million veterans live in the United States, comprising about 6% of the total population. Those veterans are more likely to experience worse oral health outcomes — higher rates of tooth decay, higher rates of gum disease, and an increased need for restorative dental care — compared to nonveterans. Lack of coverage and care for those veterans has led to significant health problems for them. Veterans are at greater risk of oral health issues than most populations and, overall, [41% of veterans report a negative oral health perception](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664889/). Veterans are exposed to physical injuries that frequently lead to jaw fractures and tooth loss, and many confront PTSD — like Jerez — and other mental illnesses that affect their teeth as well. According to [one study](https://pubmed.ncbi.nlm.nih.gov/17436978/), 61% of veterans with serious mental illness (SMI) self-reported fair to poor dental health, and 34.1% reported that oral health problems made it difficult for them to eat. ## Hope for the Future The partnership between CareQuest Institute and AIDPH aims to uncover more of these issues. “Now more than ever, veterans need innovative, whole-person approaches to care in an integrated system that they have a voice in designing,” says Annaliese Cothron, AIDPH executive director. “We have been listening to the veteran community, stakeholders, and veteran-run organizations to set the priorities for our joint work.” There’s hope on the policy front, too. One recent piece of legislation, the Veterans Dental Care Eligibility Expansion and Enhancement Act of 2021, proposed by Senator Bernie Sanders, would specifically expand and improve comprehensive health care for veterans by expanding eligibility to all veterans receiving VA health care. Editor’s note: To learn more about veteran oral health, [read the white paper](https://www.carequest.org/veteran). **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Reducing Preventable Dental-Related Hospital Emergency Visits is More Important than Ever](https://carequest.org/blog/reducing-preventable-dental-related-hospital-emergency-visits-is-more-important-than-ever/) **Published:** April 13, 2020 **Author:** Caitlin Locklear **Content:** **As overtaxed hospitals struggle to meet the demands of a pandemic, emergency department utilization for non-traumatic dental care contributes to an overburdened system.** Hospitals across the country are facing an unprecedented public health crisis as the novel coronavirus sweeps through our communities. It has completely overwhelmed a health care system that was already overtaxed, forcing hospitals and medical providers to take drastic action to preserve resources and care for patients. Emergency departments (EDs) were already operating near capacity before the crisis. And one significant reason people visit an ED is for non-traumatic dental care. The reasons why are complex. But the need to address it is more urgent than ever. ## Inconsistent Access to Oral Health Benefits Poor oral health remains a national concern impacting overall health. There is widespread agreement that the current oral health system is failing, with several barriers to access and care including lack of transportation and cost. The differing levels of health benefits nationwide, particularly in states that lack any public oral health coverage, is a major obstacle that drives up ED use. Specifically, people who face barriers to care often turn to EDs for relief when their pain becomes too much to bear. But dental services provided in EDs generally cost more and focus on managing pain or infections rather than addressing the oral health condition. What’s more, EDs often lack systems for oral health provider referrals, so many patients return to the ED again. ## Medicaid Expansion Prompts Surge in Emergency Visits As states have worked to increase access to oral health care, many have expanded adult Medicaid benefits to include oral health coverage. While this is a positive step forward, it has resulted in ED surges of people with significant but not emergency dental needs, most of which could have been prevented or addressed in a dental visit and with easier access to ongoing preventive care. Evidence shows this surge can happen for up to two years after Medicaid expansion before seeing a decline, as patients catch up on oral health care needs that were previously neglected due to lack of coverage. A recent research report from the DentaQuest Partnership for Oral Health Advancement studied this phenomenon, evaluating both ED and inpatient hospital utilization for non-traumatic dental conditions in Oregon from 2013 to 2015. It found that both ED and inpatient visits more than doubled between 2013 and 2015, as a direct result of Medicaid expansion enrollment, with declines beginning in 2015. This finding mirrors trends seen when adults gain public insurance benefits and increase use of all services, not just oral health. Additional studies have shown that Medicaid expansion, when combined with adult dental coverage in Medicaid, resulted in an overall decline of ED visits. ## Cost to the Health System and Communities The current system and ED use trends also reflect major social and geographic disparities in accessing health care. According to the report, Black and American Indian or Alaskan Native patients had the highest ED utilization rate in Oregon for non-traumatic dental conditions. Residents of rural counties were also more likely to seek care at an ED, given rural areas have provider shortages and a higher rate of untreated dental needs, the authors note. This is all a significant cost to the health system and to individuals and families. In fact, dental-related ED visits nationwide cost an estimated $2.1 billion per year, but nearly 79% of those visits could’ve been addressed in a dental office, saving up to $1.7 billion per year, according to the American Dental Association’s Health Policy Institute. “These cost savings could be used to fund Medicaid premiums, preventive dental office visits, oral health literacy efforts, or other more cost-effective interventions.” ## Moving Toward A Multi-Level Approach Though a significant challenge, the Oregon Hospital Utilization Report outlines evidence that a focus on multi-level solutions can make a difference. Oregon, for example, began implementing a unique system to offer health insurance coverage through regional coordinated care organization (CCOs), which link providers from across disciplines including behavioral and oral health. This type of proven and effective coordinated approach includes referral programs, medical-dental integration, and tools to increase access to dental care, such as teledentistry. Multi-level solutions are especially important right now, as EDs and health care workers face the biggest public health threat in generations. The strain on these resources will be an ongoing challenge, likely for years to come. As oral health leaders, we can prioritize these issues and drive changes to better serve our patients, providers, and communities — through this crisis, and beyond it. **Categories:** Blog **Tags:** Dental Coverage --- ### [Charting a New Path for Oral Health Care](https://carequest.org/blog/charting-a-new-path-for-oral-health-care/) **Published:** March 29, 2021 **Author:** Caitlin Locklear **Content:** The CareQuest Institute for Oral Health recently conducted a large national survey to understand how the COVID-19 pandemic has influenced the health of communities across our country. The goal was to understand how the pandemic has shaped perceptions, behaviors, and outcomes in the past year. The results were clear: serious challenges in health care lie ahead as the pandemic recedes. Our health care system doesn’t work for everyone because it wasn’t built for everyone. CareQuest Institute is going to help change that and address the deep disparities that have existed for generations — the same disparities that the survey mentioned above revealed. ## The Future of Oral Health In the next several months, according to the survey, our health system could face a tsunami of patients with severe health issues that have gone untreated over the last year. Roughly 6 million adult Americans lost their dental insurance due to the pandemic and nearly two-thirds of them have a symptom that is frequently linked to oral diseases, such as tooth decay and periodontal disease. Many others have canceled or put off important preventive care in the last year — in fact, nearly 4 in 10 adults (38%) have delayed care because of concerns ranging from cost and lacking insurance to risk of exposure to the virus. Given the direct link between oral health and a variety of chronic health conditions, the anticipated rise in oral diseases has serious implications for the broader health care system. The data also reinforces what became very clear early in the pandemic: low-income and minority communities have been disproportionately impacted by this virus. In fact, according to the survey, 60% of Black respondents said they knew someone personally who has died from COVID-19. The higher a respondent’s income level, the less likely they were to know someone who has died from COVID-19. ## Moving Forward to Address Oral Health Inequities Addressing those inequities — through research, grantmaking, education, advocacy and improvement programs — will be the focus at CareQuest Institute. It will work to address the longstanding barriers to dental care and affordable health coverage that have created significant unmet oral health needs, disproportionately felt by underserved communities. The federal government’s decision to reopen the health care marketplace for three months and extend open enrollment will help a lot of people this year. But the fact remains, most state Medicaid programs do not cover comprehensive dental services, even though low-income Americans are at greater risk for oral disease. And Medicare has never covered routine oral health care. There’s work to do. Our health system must be better connected, embracing holistic, integrated care. And we must continue to advance and embrace technology, innovations, and approaches that allow us to deliver care to those who need it. The explosion of telehealth in the last year brings tremendous opportunity to make oral health care more accessible, affordable, and integrated, while innovations like artificial intelligence have the potential to transform health care and make it more efficient and equitable. All of this brings us to an inflection point right now that demands action. And CareQuest Institute will be putting everything it has into solving these issues and driving progress toward a health system that works for everyone. **Categories:** Blog **Tags:** Health Equity --- ### [Why Vaccines Could Signal a Future of Integrated Care](https://carequest.org/blog/why-vaccines-could-signal-a-future-of-integrated-care/) **Published:** June 10, 2021 **Author:** Caitlin Locklear **Content:** *Do you have any symptoms of COVID-19? Have you been in contact with anyone who tested positive for COVID-19? Have you had a positive COVID-19 test in the last 14 days?* These familiar questions won’t go away anytime soon when visiting a dental or medical office. However, patients of the dental clinic at [Harbor Health Services](https://www.hhsi.us/), where Dr. Matthew Horan is executive director of dental services, are now being greeted with an additional question that may surprise them: *Can we offer you a COVID-19 vaccine at your appointment today?![](https://carequest.org/wp-content/uploads/2025/11/Covid-Vaccine-Rollout-Fin-300x188.jpg)* The effort is part of a new pilot project at Harbor Health Services, a Federally Qualified Health Center (FQHC) in Massachusetts. As the [state’s major vaccination sites are now shutting down](https://www.wbur.org/news/2021/06/03/massachusetts-vaccination-sites-closing) and community-based settings are being prioritized, it’s part of a broader movement for dentists to be involved in vaccinations. “These community partnerships couldn’t be more important to developing trust with patients as we go forward,” Horan says. “It helps with vaccine hesitancy but, even more, it helps provide access to those who otherwise could not or would not get a vaccine for any number of reasons.” ## The Value of Community-Based Care “Since the start of the pandemic, Harbor Health Services’ relationships with community partners has been critical to maintaining operations and to delivering over 30,000 vaccines,” Horan says. The health center worked with the contact tracing team at [Partners in Health](https://www.pih.org/coronavirus-response) to provide outreach to local businesses, directing them to the vaccine clinic. Community organizations and individuals such as the Cape Cod Council on Churches and elected officials also helped spread the word about vaccine availability. In establishing and operating three large vaccination clinics in Boston, the South Shore, and Cape Cod, the health center also partnered with a local college, firefighters, town administrative officials, local health departments, and the National Guard. While large-scale vaccination sites were an important community asset to establish early in the pandemic, this new unique pilot approach, Horan says, takes community-based vaccination to the next level. Now, when patients arrive for a dental appointment at the Harbor Health Services location in Hyannis, they are screened and offered a vaccine right in the dental center — no additional appointment necessary. They have an opportunity to talk about any concerns with a trusted provider and get their shot in the convenience of the dental chair, with the post-vaccination wait time built-in as they get their cleaning or other planned dental care. The pilot bolsters the state’s push toward equity in vaccine distribution, helping to ensure that all communities have access. Data from the CDC show that COVID-19 has disproportionately affected groups that have been historically marginalized, a trend that continued with vaccination distribution. A recent [research report](https://www.carequest.org/resource-library/dentists-are-untapped-resource-delivering-covid-19-vaccines) from CareQuest Institute for Oral Health showed that vulnerable and underserved populations, such as those with lower income and education and those living in rural areas, report lower rates of vaccine willingness. (CareQuest Institute was also an [early advocate](https://www.carequest.org/about/news/states-urged-allow-dentists-administer-coronavirus-vaccines) for the involvement of dentists in the vaccination process.) “Stepping back to the state-wide level, community health centers have played a critical role in the vaccination rollout’s success in Massachusetts,” says Horan, who also serves part-time as a state dental director. “Health centers are part of the recipe for vaccine equity which remains at the front of our minds. A variety of methods are being used by the state, including community-specific vaccination data and targeted additional support, focused grassroots outreach, support for municipalities and local boards of health, mobile vaccination services, and communication materials.” ## Building Patient Trust Horan says the key to combating vaccine hesitancy is trust and being in the right place at the right time. “Dentists often have a unique doctor-patient relationship,” he says. “Many of our patients might not have a medical home at all, but we typically see dental patients 2-3 times a year, so we can review their vaccination status and provide guidance.” That could be especially important in the coming weeks and months when the health system is trying to reach people who have delayed access or are experiencing some vaccine hesitancy. Getting the vaccine in a trusted and convenient clinical setting, Horan says, can help make the patient feel comfortable. “There is a lot of misinformation out there,” he says. “As dentists, we can and should be a trusted resource for our patients — whether helping them understand where to get reliable information or addressing concerns about how it might impact other health conditions. Being able to also do this in an extremely convenient way opens the door to more people getting vaccinated.” While the pilot is still in its early stages, Horan says the reception from patients has been positive. “Many are surprised by the offer,” he says. “I think for those who were on the edge of deciding, the convenience helps them to say they might as well do it.” ## Modeling Integrated Care The program is also an example of medical-dental integration — an approach to care that integrates and coordinates dental medicine into primary care and behavioral health — working in daily practice. Horan is quick to point out that FQHCs have been leading the way on this front. They often work closely with primary care associations and meet, as a larger provider group, to share best practices and problem solve together. Horan loves that spirit of innovation and collaboration. “In a fast-paced, challenging environment with limited resources, you feel like you’re not going at it alone. It makes you more willing to get creative and try new things,” Horan says. “The pandemic has led to rapid changes that allowed for an environment of crazy care innovation including telehealth, vaccinations, and working closer with clinical pharmacists, nursing, and primary care teams.” Horan says that if we want these changes to stick post-pandemic, however, the industry will need to continue to demonstrate that [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) can help achieve the goals of better care, lower costs, improved health outcomes, and satisfied providers and patients. “In my experience, all those things are true,” Horan says. “Dental and medical working together is logical.” What does that mean for the future? Horan says vaccines, more generally, will become an established part of comprehensive dental care in the same way that monitoring blood pressure is now. He can imagine working with medical providers in managing diabetes screening, rapid HIV testing, and depression screening, to start. “There are lots of ways we can help out on the dental side,” he says. “Vaccines are just the tip of the iceberg of where we can collaborate as health systems.” *Editor’s Note: Read more about the role dental providers can play in* [*administering COVID-19 vaccines and booster shots.*](https://www.carequest.org/resource-library/dental-providers-offer-key-access-point-covid-19-booster-shots) **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [A Conversation on Oral Health Integration with Dr. Myechia Minter-Jordan](https://carequest.org/blog/a-conversation-on-oral-health-integration-with-dr-myechia-minter-jordan/) **Published:** June 14, 2021 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/hcbizinterview_1.png)It’s no secret that oral health affects a person’s overall health and quality of life. A simple toothache can turn a good day into a painful one pretty quickly. And, for many, pain is just the beginning. [Growing research tells us](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know-0) that poor oral health can lead directly to a higher risk of chronic diseases like diabetes and heart disease. It can also contribute to depression, poor maternal health outcomes, and sometimes death. [Pandemic-related research](https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13435) even shows that it can increase the risk associated with COVID-19. Despite these adverse effects, our oral health system is often siloed from the rest of our health care system. The notion of dentistry as a field separate from medicine is a historical phenomenon that has been reinforced through legislation, education, and care delivery. Consider more than 65 million Americans lack dental coverage, and Medicare and some Medicaid programs don’t provide oral health benefits to adults and seniors. This division places an undue burden on underserved populations who face barriers to accessing basic care. [Recent data from CareQuest Institute for Oral Health](http://www.carequest.org/policy-advocacy/medicaid/) found that Black adults are nearly seven times more likely to have an unmet dental need than white adults, and nearly 4 in 10 Black and Latino adults reside in the 14 states where Medicaid’s adult dental benefits cover no services or emergency-only care. But where there are problems there are also opportunities. CareQuest Institute President and CEO Dr. Myechia Minter-Jordan recently sat down with [The #HCBiz Show](https://thehcbiz.com/165-the-moral-and-business-case-for-oral-health-integration-with-dr-myechia-minter-jordan/) to discuss these opportunities, including the [areas of activation that inform CareQuest Institute’s mission](https://www.carequest.org/how-we-work). From research and care delivery to impact investing and innovation advancement, Dr. Minter-Jordan does a deep dive into why oral health matters. Listen to the [full podcast](https://thehcbiz.com/165-the-moral-and-business-case-for-oral-health-integration-with-dr-myechia-minter-jordan/). *Editor’s note: You can also listen to the #HCBiz Show on your favorite podcast platform.* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Three Domain Framework White Paper Executive Summary](https://carequest.org/resource/three-domain-framework-white-paper-executive-summary/) **Published:** January 5, 2021 **Author:** Darren Edwards **Content:** **Attachment:** [CareQuest-Institute-Three-Domain-Framework-Executive-Summary.pdf](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Three-Domain-Framework-Executive-Summary_0.pdf) (1.83 MB) **Categories:** Publication, Resource **Tags:** Practice Management, Value-Based Care --- ### [Sample Billing Flow Chart](https://carequest.org/resource/sample-billing-flow-chart/) **Published:** January 11, 2021 **Author:** Darren Edwards **Content:** [![View chart](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Sample-Billing-Flow-Chart_Page_1-300x232.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Sample-Billing-Flow-Chart.pdf)View chart View a sample dental billing flow chart. **Categories:** Resource, Tool **Tags:** Practice Management --- ### [Common Scripting for the Community Health Dental Practice](https://carequest.org/resource/common-scripting-for-the-community-health-dental-practice/) **Published:** January 11, 2021 **Author:** Darren Edwards **Content:** **Attachment:** [CareQuest-Institute-Common-Scripting-Community-Health-Dental-Practice.pdf](https://carequest.org/wp-content/uploads/2025/11/CareQuest-Institute-Common-Scripting-Community-Health-Dental-Practice.pdf) (110.3 KB) **Categories:** Resource, Tool **Tags:** Practice Management --- ### [Answering that Dental Emergency Call Remotely](https://carequest.org/resource/answering-that-dental-emergency-call-remotely/) **Published:** June 2, 2020 **Author:** Darren Edwards **Content:** Welcome to Teledentistry: Bringing Patient-Centered Care into the Synchronous Teledental Emergency Visit Using a New Approach, the SHARE Framework. **Categories:** Resource, Video **Tags:** Practice Management --- ### [Expanding Oral Health: Teledentistry](https://carequest.org/resource/expanding-oral-health-teledentistry/) **Published:** June 2, 2020 **Author:** Darren Edwards **Content:** [![Read white paper](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Expanding-Oral-Health-Teledentistry-White-Paper-Cover.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Expanding-Oral-Health-Teledentistry-White-Paper.pdf)Read white paper Telehealth offers exciting new opportunities for dentistry, particularly in terms of reaching underserved populations. A report from CareQuest Institute reviews the regulatory environment needed to support telehealth-connected teams, as well as considerations for incorporating telehealth into dental practices and community-based oral health care systems. It explores various telehealth modalities, coding updates and the nuts and bolts of implementation. Finally, it outlines the role that telehealth is projected to play in dentistry in the coming decades. Highlights from the report include: - States can support advances in oral health care by creating favorable policy environments, with an initial focus on public payment programs. - Business models that can incorporate teledentistry include: outreach to existing patients of a dental practice; integration of oral health into general health care environments; and mobile and portable care delivery. - The Virtual Dental Home System of Care (VDH) is a promising approach that uses telehealth technologies to facilitate a comprehensive community-based system of care. Telehealth technologies can be described as an emerging “disruptive innovation” in the oral health industry. With appropriate regulatory environments in place, and with strategic changes by dental practices, these new models of care have the potential to significantly improve the reach and impact of oral health care. **You may also be interested in:** [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. [Teledentistry is an Effective Tool to Triage Patients and Save Money](https://www.carequest.org/resource-library/teledentistry-effective-tool-triage-patients-save-money) explores dental service utilization patterns and rate of return following teledentistry visits. [Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis) explores how providers can use telehealth to consult with patients, triage their needs and offer limited urgent services, deterring those with nontraumatic dental conditions from seeking care in emergency departments. **Categories:** Publication, Resource **Tags:** Dental Coverage, Practice Management --- ### [Fast-Track to Teledentistry: Removing Barriers While Maximizing Overall Health](https://carequest.org/resource/fast-track-to-teledentistry-removing-barriers-while-maximizing-overall-health/) **Published:** June 2, 2020 **Author:** Darren Edwards **Content:** [![Read white paper](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Fast-Track-to-Teledentistry-White-Paper-Cover.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest-Institute-Fast-Track-to-Teledentistry-White-Paper.pdf)Read white paper A white paper from CareQuest Institute for Oral Health explains how [teledentistry can improve the health of Americans](https://www.carequest.org/topics/teledentistry) while saving money by delivering care and education more quickly and efficiently. Millions of Americans, particularly in rural areas, have inadequate access to dental care. And when people have inadequate dental care, numerous studies show, their overall health declines. Further, people who lack access to dental care are more likely to eventually experience a severe dental problem that brings them to a hospital emergency department (ED), where treatment is expensive and usually fails to address the underlying cause. Telehealth, especially during the COVID-19 pandemic, can play a large role in closing the gaps in access to dental care. And with more than 56 million Americans residing in areas with a shortage of dental professionals, it’s time to fully tap the potential that teledentistry offers to improve access to care. The paper explores several topics, including the impact of not receiving care, trends and positive developments in teledentistry, and the opportunities and potential cost savings states can seize by embracing the technology. It offers several summary points: - Many Americans aren’t getting the dental care they need, and crises such as the COVID-19 pandemic exacerbate these access gaps. - Teledentistry helps close the gap in access to dental services and can save money for states and consumers. - Teledentistry and other telehealth initiatives can create and preserve jobs, especially in rural areas. - States should take steps now to address barriers to teledentistry. By helping teledentistry grow, states can improve their residents’ oral health and overall health, reaching people earlier in the disease cycle — managing or treating conditions before they deteriorate into serious infections that require expensive care, cause school or workplace absences and potentially threaten lives. **You may also be interested in:** [Teledentistry Use Gains Traction During COVID-19](https://www.carequest.org/resource-library/provider-teledentistry-use-gains-traction-during-covid-19) highlights the continued value of telehealth and its opportunity to provide additional revenue while enhancing dental care access for current and new patients. [Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://www.carequest.org/resource-library/teledentistry-providing-access-care-during-covid-19-crisis) explores how providers can use telehealth to consult with patients, triage their needs and offer limited urgent services, deterring those with nontraumatic dental conditions from seeking care in emergency departments. [Patients Give High Marks to Their Teledentistry Experience](https://www.carequest.org/resource-library/patients-give-high-marks-their-teledentistry-experience) highlights findings from a survey that shows of patients valued the option of teledentistry and that a clear majority who received it were pleased with their experience. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Different Levels of Associations Between Medical Co-morbidities and Preterm Birth Outcomes Among Racial/Ethnic Women Enrolled in Medicaid 2014-2015](https://carequest.org/resource/different-levels-of-associations-between-medical-co-morbidities-and-preterm-birth-outcomes-among-racial-ethnic-women-enrolled-in-medicaid-2014-2015/) **Published:** June 15, 2020 **Author:** Darren Edwards **Content:** Different levels of associations between medical co-morbidities and preterm birth outcomes among racial/ethnic women enrolled in Medicaid 2014–2015: retrospective analysis **Attachment:** [Different Levels of Associations Between Medical Co-Morbidities and Preterm Birth Outcomes Among Racial/Ethnic Women ](https://carequest.org/wp-content/uploads/2025/12/s12884-020-2722-8.pdf "s12884-020-2722-8.pdf")(1017.74 KB) **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey](https://carequest.org/resource/trends-in-non-traumatic-dental-emergency-department-use-in-new-york-and-new-jersey/) **Published:** June 15, 2020 **Author:** Darren Edwards **Content:** **Attachment:** [Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey](https://carequest.org/wp-content/uploads/2025/12/jphd.12343.pdf "jphd.12343.pdf") (814.3 KB) **Categories:** Journal Article, Resource **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Dental Anxiety and Oral Health in American Indian and Alaska Natives](https://carequest.org/resource/dental-anxiety-and-oral-health-in-american-indian-and-alaska-natives/) **Published:** August 29, 2024 **Author:** Darren Edwards **Content:** This peer-reviewed article in the *Journal of Public Health Dentistry*, co-authored by researchers from CareQuest Institute and the University of Colorado and Marquette University Schools of Dentistry, explores associations between dental distrust, dental fear and anxiety, and oral health outcomes in American Indian and Alaska Native (AI/AN) adults. #### Key Findings - About one in five AI/AN adults reported dental distrust and high levels of dental anxiety. - Fewer AI/AN adults with increased dental distrust and anxiety had visited a dentist in the past year compared with adults with lower levels of distrust and anxiety. - More AI/AN adults with increased dental distrust and anxiety reported poor health outcomes — including poor oral health, overall health, and mental/emotional health — compared to adults with less distrust and anxiety. According to the National Institutes of Health, AI/AN populations have the highest burden of oral diseases among all racial and ethnic minority populations in the US. This study demonstrates that dental distrust and dental anxiety are important intervention targets to improve oral health in AI/AN communities. > Future work to understand dental provider trust and dental anxiety’s association with dental care utilization should include the concept of provider cultural humility as a potential mechanism. [Read the article](https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.12633) in the *Journal of Public Health Dentistry* (open access) **You may also be interested in:** - [American Indian and Alaska Native Communities Face a Disproportionate Burden of Oral Disease](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral), a white paper ― a collaboration between CareQuest Institute and native-led organizations ― that explores oral health disparities in AI/AN communities, their causes, and possible solutions. - [American Indian and Alaska Native Oral Health: Challenges and Opportunities](https://www.carequest.org/education/webinars/american-indian-and-alaska-native-oral-health-challenges-and-opportunities), a recorded webinar that features a panel of experts from native-led organizations sharing culturally and community-driven strategies to improve AI/AN oral health. - [Voices from the Field: Julie Seward on Advancing Oral Health in AI/AN Communities](https://www.carequest.org/about/blog-post/voices-field-julie-seward-advancing-oral-health-aian-communities), a blog post in which the oral health programs manager for the Southern Plains Tribal Health Board discusses opportunities and solutions to improve AI/AN oral health. **Categories:** Journal Article, Resource **Tags:** Health Equity, Medical-Dental Integration --- ### [The Need for Medicare Dental Coverage](https://carequest.org/resource/the-need-for-medicare-dental-coverage/) **Published:** September 29, 2025 **Author:** Darren Edwards **Content:** [![Click to view resource](https://carequest.org/wp-content/uploads/2025/09/Thumbnail_medicare-oral-health-fact-sheet_250x324-232x300.png)](https://carequest.org/wp-content/uploads/2025/09/medicare-oral-health-fact-sheet_FINAL.pdf)Click to view resource Despite the essential role of oral health in overall well-being, Medicare does not provide comprehensive dental coverage, leaving one in three older adults without dental coverage and forcing them to pay out-of-pocket or go without necessary care. This oral health fact sheet from CareQuest Institute highlights the health risks and economic consequences of Medicare’s limited dental coverage. For example, strengthening Medicare to include periodontal treatment for patients with diabetes and heart disease could save up to $42 billion annually. **You may also be interested in:** - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a report analyzing the billions of dollars that could be saved in treating chronic diseases by including periodontal treatment in Medicare. - [Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage), a report finding that one in three US adults over age 60 do not have dental insurance. - [Dental Coverage National Voter Polling Results](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results), a nationwide poll showing that 9 in 10 US voters support adding a dental benefit to Medicare. **Categories:** Resource, Visual Report **Tags:** Dental Coverage, Medical-Dental Integration --- ### [From Silos to Synergy: Integrating Oral Health into Whole-Person Care Through Interprofessional Practice](https://carequest.org/resource/from-silos-to-synergy-integrating-oral-health-into-whole-person-care-through-interprofessional-practice/) **Published:** October 2, 2025 **Author:** Darren Edwards **Content:** [![View white paper](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_From-Silos-to-Synergy-White-Paper_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_From-Silos-to-Synergy-White-Paper_10.7.25.pdf)View white paper *Correction: A revised version of the white paper was uploaded on October 7, 2025, in order to correct the in-text numbering of references #225–272.* Helping patients achieve optimal health and a high quality of life requires the full integration of oral health into health care systems. Such integration requires robust collaboration across disciplines, known as interprofessional practice (IPP). This comprehensive white paper and accompanying use cases, a collaboration between CareQuest Institute and more than 15 authors, explores IPP as a strategy to enhance patient outcomes, strengthen chronic disease management, and advance public health. > By embracing interprofessional oral health practice as a foundation of whole-person care, we can redefine what it means to provide comprehensive, collaborative, and equitable health care for all across the lifespan.” [![View use cases](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_From-Silos-to-Synergy-Use-Cases_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_From-Silos-to-Synergy-Use-Cases_FINAL.pdf)View use cases Key takeaways include: - Sustaining effective IPP models requires rigorous program evaluation, interprofessional education, and supportive policy. - IPP thrives in diverse care environments such as integrated care clinics, school-based health centers, long-term care facilities, and mobile clinics — settings that prioritize accessibility and person-centered care for underserved populations. - Innovative payment models such as Medicaid pay-for-quality programs, accountable care organizations (ACOs), and targeted grants demonstrate that integrated care can yield better health outcomes and lower costs. - The future of IPP lies in expanding integration beyond primary care, incorporating nursing, pharmacy, and behavioral health. As this white paper shows, successful IPP will depend on policy coherence, sustainable payment models, stakeholder engagement, and a cultural shift toward collaborative, whole-person care. [![View executive summary](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_From-Silos-to-Synergy_Executive-Summary_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_From-Silos-to-Synergy_Executive-Summary_9.29.25.pdf)View executive summary **You may also be interested in:** - [Transforming Oral Health Care Through Interprofessional Education](https://www.carequest.org/resource-library/transforming-oral-health-care-through-interprofessional-education), a white paper and use cases investigating the critical role of interprofessional education to foster collaborative, patient-centered health care. - [Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://www.carequest.org/resource-library/oral-systemic-interactions-and-medical-dental-integration-life-course-approach), a report and infographic providing an overview of the connection between oral health and overall health across the lifespan. - [Partners in Progress: Pursuing Medical-Dental Integration in Ohio](https://www.carequest.org/resource-library/partners-progress-pursuing-medical-dental-integration-ohio), an impact report and case study exploring results from a pilot program to integrate oral health into pediatric primary care. **Categories:** Publication, Resource **Tags:** Clinical Practice, Medical-Dental Integration, Person-Centered Care --- ### [Framing for Oral Health Equity Now: A Communications Toolkit for Advancing Oral Health Reform](https://carequest.org/resource/framing-for-oral-health-equity-now-a-communications-toolkit-for-advancing-oral-health-reform/) **Published:** October 8, 2025 **Author:** Darren Edwards **Content:** [![View toolkit](https://carequest.org/wp-content/uploads/2025/12/Frameworks-Toolkit-Cover-Thumbnail-233x300.png)](https://carequest.org/wp-content/uploads/2025/12/OPEN-Frameworks-Toolkit_10.10.25_Final.pdf)View toolkit This toolkit, a collaboration between the [FrameWorks Institute](https://www.frameworksinstitute.org/) and CareQuest Institute’s [Oral Health Progress and Equity Network (OPEN)](https://www.carequest.org/content/open), provides strategies and examples to help oral health advocates communicate effectively about community-led, collaborative approaches to eliminate oral health disparities. The tools and recommendations have been updated to be relevant in the current political climate but still draw on original studies of culture and communication conducted by the FrameWorks Institute. > With consistent, coordinated framing, we can build the public and political will to drive meaningful change, address inequities, and ensure that every community has access to the oral health care they need.” [![View reframe guides](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_reframe-guides_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/OPEN-Frameworks-Toolkit_reframe-guides_FINAL.pdf)View reframe guides **You may also be interested in:** - [OPEN](https://www.carequest.org/content/open), a web page with more information about the work of the Oral Health Progress and Equity Network and how to get involved. - [The Oral-Systemic Connection Across the Lifespan](https://www.carequest.org/resource-library/oral-systemic-connection-across-lifespan), an infographic summarizing the connection between oral health and overall health from pregnancy through older adulthood. - [The Need for Medicaid Adult Dental Coverage Across All States](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states), a fact sheet explaining why comprehensive oral health coverage for all would benefit both individuals and the overall health system. **Categories:** Resource, Tool **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration --- ### [Implicit Racial Bias in Oral Health](https://carequest.org/resource/implicit-racial-bias-in-oral-health/) **Published:** October 27, 2025 **Author:** Darren Edwards **Content:** ## A Scoping Review of Students’ and Providers’ Perceptions In this article published in *JDR Clinical & Translational Research*, authors from CareQuest Institute and the Center for Justice in Public Health examined the available scientific literature about implicit bias held by dental/dental hygiene students, faculty, and dental professionals. Their objective was to determine how such bias may affect patient outcomes. The authors write, “the examined studies suggest negative bias to be more prominent for individuals from racial and ethnic identities different from one’s own.” However, they caution that the available number of studies specific to implicit bias in oral health was limited and more studies are needed. Additional Key Findings - One study found a bias among dentists toward recommending tooth extraction for a Black patient and tooth-saving root canal treatment for a white patient, despite the level of tooth decay being identical for both patients. - Another found that following a diagnosis for oral cancer, Black patients were significantly less likely to be recommended for surgery than white patients, regardless of cancer stage and socioeconomic status. Implicit bias is defined as “a form of unintentional and automatic bias that affects judgment, decisions, and behaviors that is often driven by subconscious thoughts.” Implicit bias in the health care setting can contribute to disparities in health. Therefore, the authors note, workforce diversity and training to increase awareness of and reduce implicit bias are critical for students and providers of oral health care. [Read the article](https://journals.sagepub.com/doi/10.1177/23800844251338167) in *JDR Clinical & Translational Research* (open access). **You may also be interested in:** - [Does Our Oral Health Care System Welcome Everyone?](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone), a research report that examines factors that persist in creating barriers to equitable access to oral health care for all. - [Antiracism in Dental Public Health](https://onlinelibrary.wiley.com/toc/17527325/2022/82/S1), a special issue of the *Journal of Public Health Dentistry* that explores antiracism through the lenses of science, education, policy, and practice. - [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2023), a resource highlighting key findings and reports from previous annual surveys on the oral health of adults in the US. **Categories:** Journal Article, Resource **Tags:** Health Equity --- ### [Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions](https://carequest.org/resource/dental-care-in-crisis-tracking-the-cost-and-prevalence-of-emergency-department-visits-for-non-traumatic-dental-conditions/) **Published:** November 3, 2025 **Author:** Darren Edwards **Content:** [![View visual report](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Dental-Care-in-Crisis_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Dental-Care-in-Crisis_10.31.25-1.pdf)View visual report While emergency department (ED) visits for non-traumatic dental conditions (NTDCs) have declined since 2019, costs have risen significantly — $500 million — to a total of $3.9 billion, according to a new analysis of ED trends by CareQuest Institute. In 2019, there were 1.8 million ED visits for NTDCs at a cost of $3.4 billion; in 2022, there were 1.6 million ED visits at a cost of $3.9 billion. The higher costs were driven by a 29% increase in the mean cost of an ED visit for NTDCs, from $1,887 in 2019 to $2,437 in 2022 — **much higher than the average cost of a dental visit.** Additional key findings include: - Among children aged 14 and under, there was a significant increase in ED visits for NTDCs, from 27.3 to 43.1 visits per 10,000 people between 2019 and 2022. - Among children aged 14 and under overall from 2020-2022, the rate of ED visits for NTDCs per 10,000 visits was higher than that of ED visits for other types of injuries, including those involving firearms, motor vehicles or other types of transportation, drowning, or poisoning. - Among children aged 14 and under who visited an ED for NTDCs, nearly 75% had Medicaid dental insurance. - Two-thirds (66.6%) of all ED visits for NTDCs were made by individuals with Medicaid dental insurance (48.1%) or were uninsured (18.5%). Hospital ED visits for non-traumatic dental conditions can strain vital resources and increase the workload for ED staff. The authors write: > ED visits for dental care increase when Medicaid adult dental benefits are eliminated.” Several sources have estimated that [as many as 12 million people will lose their Medicaid health insurance](https://www.kff.org/affordable-care-act/issue-brief/how-will-the-2025-reconciliation-bill-affect-the-uninsured-rate-in-each-state-allocating-cbos-estimates-of-coverage-loss/) due to the 2025 federal budget reconciliation law. **You may also be interested in:** - [The Need for Medicaid Adult Dental Coverage Across All States](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states), a fact sheet outlining the health risks and economic consequences of Medicaid’s varying adult dental benefits across states. - [Federal Medicaid Cuts Threaten State Dental Benefits](https://www.carequest.org/resource-library/federal-medicaid-cuts-threaten-state-dental-benefits), a report examining the lessons learned in six states that eliminated Medicaid adult dental benefits in the past. - [It’s Time, Right Now, for Policy Leaders to Address America’s Oral Health Crisis](https://www.carequest.org/about/blog-post/its-time-right-now-policy-leaders-address-americas-oral-health-crisis), a blog post from our Senior Director of Policy & Advocacy outlining the policy solutions that are needed to improve oral health in the US. **Categories:** Resource, Visual Report **Tags:** Access to Care, Dental Coverage, Health Equity --- ### [Community Oral Health Needs Assessment Tool](https://carequest.org/resource/community-oral-health-needs-assessment-tool/) **Published:** November 3, 2025 **Author:** Darren Edwards **Content:** [![Download tool](https://carequest.org/wp-content/uploads/2025/11/cover_Community-Oral-Health-Needs-Assessment-Tool-_0-238x300.png)](https://carequest.org/wp-content/uploads/2025/11/Community-Health-Needs-Assessment-Guide.pdf)Download tool This tool provides practical tips and guidance for an oral health provider and/or stakeholder undertaking a community oral health needs assessment. It includes information and instruction on the stages of a needs assessment, letting the oral health provider/stakeholder efficiently complete the process as part of their work. What’s inside: - An overview of the type of information an oral health provider/stakeholder needs to consider when creating a profile of the community. - A list of resources to help guide the information gathering process. - A checklist to perform an analysis of how to use the information, prioritize efforts, and create an action plan. **Categories:** Resource, Tool **Tags:** Health Equity --- ### [Oral Health in America: Who Gets Left Behind?](https://carequest.org/resource/oral-health-in-america-who-gets-left-behind/) **Published:** November 7, 2025 **Author:** Darren Edwards **Content:** [![View report](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_SOHEA_2025_250x324-1-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute-State-of-Oral-Health-Equity-in-America_2025_11.6.25-1.pdf)View report CareQuest Institute’s latest State of Oral Health Equity in America survey reveals both progress and ongoing gaps that demand attention. While 70% of US adults report having a dental visit in the past year, millions of adults still seek dental care in the emergency department (ED), put off care because they exceed their annual deductible, or travel outside the US to receive more affordable dental care. Key insights for policymakers, providers, and advocates: - Adults with at least one disability are less likely to have a dental home or a usual source of dental care (72%) compared to those without a disability (82%). - 5% of adults without dental insurance say they sought dental care in an ED, compared to 3% of adults with any kind of dental insurance. - 4% of adults (10.7 million) traveled outside the US to receive dental care. - 89% of adults (237.6 million) want their dentist to be able to speak to them in their preferred language. [![View key survey findings](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_SOHEA-2025-Key-Survey-Findings_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/11/CareQuest_Institute_SOHEA-2025-Key-Survey-Findings_11.10.25.pdf)View key survey findings The authors conclude: > Enhancing dental insurance coverage, improving the affordability of care, growing the oral health care workforce, and fostering inclusive oral health care settings are essential steps toward a more equitable oral health system.” **You may also be interested in:** - [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america-2023), a web page highlighting key findings and reports from previous annual surveys on the oral health of adults in the US. - [Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions](https://www.carequest.org/resource-library/dental-care-crisis), a visual report finding an alarming increase in ED visits by children for dental conditions. - [The Need for Medicaid Adult Dental Coverage Across All States](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states), a fact sheet outlining the health risks and economic consequences of Medicaid’s varying adult dental benefits across states. **Categories:** Publication, Resource **Tags:** Dental Coverage, Health Equity --- ### [Community Water Fluoridation: Proven, Safe, and Essential for Oral Health](https://carequest.org/resource/community-water-fluoridation-proven-safe-and-essential-for-oral-health/) **Published:** November 11, 2025 **Author:** Darren Edwards **Content:** [![View fact sheet](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_fluoridation-fact-sheet_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/fluoridation-fact-sheet_FINAL.pdf)View fact sheet This fact sheet from CareQuest Institute highlights the overwhelming benefits of community water fluoridation (CWF) to prevent tooth decay and reduce health care costs. More than 75 years of research and over 7,000 studies demonstrate that, at appropriate levels, fluoride is safe and essential in preventing tooth decay — especially for tens of millions without dental insurance, who can’t afford care, or live far from a dental provider. Leading health organizations support CWF, including the American Dental Association and the American Academy of Pediatrics. A national survey of US adults shows 81% either support CWF or are not opposed to it (29%). The authors write: > By improving access to community water fluoridation, policymakers can improve overall health, reduce dental disease, and save billions in health care costs.” **You may also be interested in:** - [Study Shows Costly Consequences for States Banning Fluoride](https://www.carequest.org/about/blog-post/new-study-shows-costly-consequences-states-banning-fluoride), a blog post with authors of a study in [*JAMA Health Forum*](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2834515) summarizing their findings — ending water fluoridation could result in 25 million additional decayed teeth and nearly $10 billion in health care costs. - [Fluoride: Top 10 Questions Parents Ask](https://www.carequest.org/content/fluoride-top-10-questions-parents-ask), answers from health care providers to frequently asked questions about fluoride and community water fluoridation. - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. **Categories:** Resource, Tool **Tags:** Health Equity --- ### [Oral Health’s Role in Identifying Undiagnosed Diabetes](https://carequest.org/resource/oral-healths-role-in-identifying-undiagnosed-diabetes/) **Published:** November 17, 2025 **Author:** Darren Edwards **Content:** [![View resource](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Oral-Health-Role-in-Identifying-Undiagnosed_Diabetes_250x324-231x300.png)](https://carequest.org/wp-content/uploads/2025/12/CareQuest_Institute_Oral-Health-Role-in-Identifying-Undiagnosed_Diabetes_FINAL.pdf)View resource Incorporating HbA1c screening into dental practices offers a valuable opportunity to identify patients with undiagnosed diabetes and prediabetes, especially among those who may not regularly seek medical care. This resource from CareQuest Institute outlines the benefits, roles, and considerations for oral health providers in screening for diabetes. Key Insights - Periodontal disease and diabetes have a bidirectional relationship driven by systemic inflammation. - Approximately 80% of individuals with prediabetes and 22% of those with diabetes are unaware they have it. - An estimated 9% of individuals who visit a dentist annually do not also visit a medical provider, emphasizing the important role for oral health providers in educating patients about diabetes. The author’s write: > By leveraging their unique position, oral health providers can help bridge gaps in health care, promote early intervention, and support better overall health outcomes.” **You may also be interested in:** - [Periodontal Treatment Associated with Decreased Diabetes-Related Costs](https://www.carequest.org/resource-library/periodontal-treatment-associated-decreased-diabetes-related-treatment-costs), an article in *The Journal of the American Dental Association* demonstrating cost savings up to 14% for patients with diabetes who received periodontal treatment. - [A Simple Alternative Payment Model to Incentivize Periodontal Care for Diabetes Patients in Community Health Centers](https://www.carequest.org/resource-library/simple-alternative-payment-model-incentivize-periodontal-care-diabetes-mellitus), an interactive tool simulating potential costs savings from covering periodontal treatment for diabetes patients. - [Another Billion Reasons for a Medicare Dental Benefit](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), a research report finding that including periodontal treatment in Medicare has the potential to save up to $14.5 billion annually for patients with diabetes. **Categories:** Publication, Resource **Tags:** Clinical Practice, Medical-Dental Integration, Person-Centered Care --- ### [2026 Community Water Fluoridation Policy Map: State Legislative Activity](https://carequest.org/resource/2026-community-water-fluoridation-policy-state-legislative-activity/) **Published:** February 18, 2026 **Author:** Darren Edwards **Content:** Despite overwhelming scientific evidence that community water fluoridation (CWF) is a safe and effective way to prevent cavities, many states introduced legislation in 2025 to restrict or ban CWF, laying the groundwork for continued action in 2026. In 2025, Florida and Utah enacted statewide bans, and similar proposals are under consideration in states across the country in 2026. This map shows the policy landscape as of **May 26, 2026**. For questions, please contact [**Matt Steele**](mailto:msteele@carequest.org), Director, State and Local Advocacy. ![](https://carequest.org/wp-content/uploads/2026/05/Fluoride-Map-52626-1024x609.png) [Download the map](https://carequest.org/wp-content/uploads/2026/05/Fluoride-Map-52626-header-scaled.png) **You may also be interested in:** - [Community Water Fluoridation: Proven, Safe, and Essential for Oral Health, ](https://carequest.org/community-water-fluoridation-proven-safe-and-essential-for-oral-health/)a fact sheet highlighting the overwhelming benefits of community water fluoridation to prevent tooth decay and reduce health care costs. - [Fluoride: Top Questions Parents Ask](https://carequest.org/fluoride-questions-parents-ask/), answers from health care providers to frequently asked questions about fluoride and community water fluoridation. - [Community Water Fluoridation](https://www.carequest.org/community-water-fluoridation), a collection of statistics and science-based resources on the topic. **Categories:** Publication, Resource **Tags:** Access to Care, Health Equity --- ### [It’s Time to Give All Veterans a Good Reason to Smile](https://carequest.org/resource/its-time-to-give-all-veterans-a-good-reason-to-smile/) **Published:** May 12, 2026 **Author:** Lisa Sall **Content:** ## Veterans Are More Likely to Lose Teeth, Suffer Pain, and Struggle to Access Regular Dental Care The men and women who have served our country deserve to live the rest of their lives with dignity and pride. But when it comes to oral health, America is not living up to its obligations to its veterans: Of more than 9 million veterans who are eligible for medical care through the Veterans Health Administration (VHA), only 26% are eligible for dental care. [![Veteran man in a blue shirt smiling outdoors beside a CareQuest Institute poster about giving veterans a reason to smile.](https://carequest.org/wp-content/uploads/2026/05/Thumbnail_Time-to-Give-All-Veterans_612x792-232x300.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Institute_Time-to-Give-All-Veterans_Visual-Report_5.7.26.pdf)View visual report A visual report from CareQuest Institute, based on the State of Oral Health Equity in America survey, shows that veterans are struggling with unmet oral health needs. Key findings include: - Older US veterans are much more likely to have had at least six teeth removed (31%) than older nonveterans (20%). - Veterans are more than twice as likely (7.7%) as nonveterans (3.0%) to seek care at a hospital emergency department (ED) for an oral health condition. - Older veterans are more likely to have other chronic health conditions (53%) compared to older nonveterans (47%). Conditions like diabetes and heart disease can be worsened by poor oral health. - Younger veterans (ages 18-59) are less likely to have seen a dental provider (65%) in the past year than older veterans (72%). This report shows the importance of ensuring veterans have access to the care they need and deserve. **You may also be interested in:** - [Veterans Need Affordable Dental Care](https://carequest.org/veterans-need-affordable-dental-care/), a fact sheet highlighting the health risks and financial burdens veterans face in accessing dental care, and policy solutions to strengthen dental access for veterans. - [Oral Health Is Essential to Veteran Productivity and Well-Being](https://carequest.org/oral-health-is-essential-to-veteran-productivity-and-well-being/), a report exploring the lost productivity due to oral health problems experienced by 600,000 veterans in a single year. - [Veteran Oral Health Data Dashboard](https://vetdentaldata.org/), a website with local, state, and national veteran oral health data for use in advocacy and policy change efforts. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [Oral Health in People with Intellectual and Developmental Disabilities](https://carequest.org/resource/oral-health-in-people-with-intellectual-and-developmental-disabilities/) **Published:** May 18, 2026 **Author:** Lisa Sall **Content:** ## What National Data Shows — and Why Action Matters In this data analysis, CareQuest Institute researchers found that people with intellectual and developmental disabilities (IDD) face greater barriers to dental care and have worse oral health outcomes than those without disabilities. [![](https://carequest.org/wp-content/uploads/2026/05/Thumbnail_Oral-Health-IDD_Visual-Report_May2026-232x300.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Institute_Oral-Health-IDD_Visual-Report_5.9.26.pdf)View visual report Key Findings - Three times as many individuals with IDD said they could not afford dental care (15%) compared to those without IDD (5%). - Adults with cognitive disabilities were more likely to have an oral health problem in the prior year (82%) than adults without IDD (51%). - Nearly twice as many adults with cognitive disabilities rate their oral health as fair or poor (41%) compared to adults without IDD (22%). - Individuals with cognitive disabilities were significantly more likely to have visited an emergency department for a non-traumatic dental condition than those without IDD. The authors write: > These inequities contribute to preventable pain, emergency department use, and higher health care costs, underscoring the need for a multifaceted approach to improve oral health for this population.” **You may also be interested in:** - [Special Patient Care](https://carequest.org/education/self-paced-courses/special-patient-care/), a collection of free self-paced courses that help dental teams tailor care to individuals with complex care needs — such as physical, developmental and cognitive disabilities. Each course is eligible for one free CE credit. - [Teaching Dental Students to Confidently Care for Patients with Disabilities,](https://carequest.org/teaching-dental-students-to-confidently-care-for-patients-with-disabilities/) a blog post about a pilot program at the University of Florida College of Dentistry that trains the next generation of dentists to confidently care for patients with special needs. - [Exploring Oral Health and Care Access among Adults with Disabilities,](https://carequest.org/exploring-oral-health-and-care-access-among-adults-with-disabilities/) a report about the challenges adults with disabilities face in accessing oral health care and policy recommendations to improve access to care. **Categories:** Resource, Visual Report **Tags:** Health Equity, Person-Centered Care --- ### [Crossing Borders for Care: Dental Tourism among US Adults](https://carequest.org/resource/crossing-borders-for-care-dental-tourism-among-us-adults/) **Published:** June 2, 2026 **Author:** Lisa Sall **Content:** Approximately 4% of US adults — or 9.6 million people — say they have traveled outside the US for dental care, according to findings from the annual State of Oral Health Equity in America survey by CareQuest Institute [![](https://carequest.org/wp-content/uploads/2026/06/Thumbnail_Crossing-Borders-232x300.png)](https://carequest.org/wp-content/uploads/2026/06/CareQuest_Institute_Crossing-Borders.pdf)View visual report Dental tourism is the most prevalent form of medical tourism among US residents. Common reasons for seeking dental care abroad include lack of dental insurance and lower cost of dental services than in the US. Additional findings include: - When asked to identify the primary reason they sought dental care outside the US, more than half (58%) of respondents cite costs. - Adults identifying their race/ethnicity as Asian/Pacific Islander (9.4%) or Hispanic (8.5%) report traveling for dental care in greater percentages than adults identifying as white (2.2%). - Adults who reached their maximum dental benefit in the past year report traveling for dental care at a higher rate (7.6%) than adults who did not reach their maximum dental benefit in the past year (2.7%). While dental tourism may offer financial benefits, it also carries potential risks such as differences in safety standards and challenges in follow-up care. Improving the accessibility and affordability of dental care within the US is vital to reduce the need for individuals to leave the country to address their dental needs. **You may also be interested in:** - [Oral Health in America: Who Gets Left Behind?](https://carequest.org/oral-health-in-america-who-gets-left-behind/), findings from the State of Oral Health Equity in America survey reveal both progress and gaps in access to dental care. - [Maxed Out: The Reality of Reaching Dental Insurance Limits](https://carequest.org/maxed-out-the-reality-of-reaching-dental-insurance-limits/), a report finding that 32 million US adults’ dental care needs will exceed their dental plan’s maximum benefit. - [The Dental Home Is Where Good Oral Health Starts](https://carequest.org/the-dental-home-is-where-good-oral-health-starts/), a report analyzing who is more likely to have a dental home and what are the benefits to oral health outcomes. **Categories:** Resource, Visual Report **Tags:** Dental Coverage --- ### [OPEN Hill Day 2026 Policy Priorities](https://carequest.org/resource/open-hill-day-2026-policy-priorities/) **Published:** June 2, 2026 **Author:** Lisa Sall **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/OPEN-300x78.png) OPEN is a network of thousands of individuals and organizations across the nation who are taking on America’s oral health challenges. We look forward to working with members of Congress to make good oral health a reality for everyone. Learn more about our policy priorities for 2026 in these fact sheets. ###### Oral Health Policy Actions: What Can Congress Do? [![](https://carequest.org/wp-content/uploads/2026/05/Thumbnail_Policy-Actions_May2026-232x300.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Policy-Actions_May2026_FINAL.pdf)View publication ###### Veterans Need Affordable Dental Care [![](https://carequest.org/wp-content/uploads/2026/05/Thumbnail_Veterans-Need-Affordable-Dental-Care_May2026-232x300.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Veterans-Need-Affordable-Dental-Care_May2026_FINAL.pdf)View publication ###### The Need to Protect Medicaid Adult Dental Coverage Across States [![](https://carequest.org/wp-content/uploads/2026/05/Thumbnail_Protect-Medicaid_May2026-232x300.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Protect-Medicaid_May2026_FINAL.pdf)View publication ###### The Need for Federal Oral Health Programs [![Infographic titled “The Need for Federal Oral Health Programs” showing a dentist with a patient on the right, and two columns of text outlining risks, policy goals, and the importance of federal funding, plus a blue banner and CareQuest/Open logos.](https://carequest.org/wp-content/uploads/2026/05/Thumbnail_InfrastructureMay2026-232x300.png)](https://carequest.org/wp-content/uploads/2026/05/CareQuest_Need_Federal_Oral_Health_Programs_FINAL.pdf)View publication **You may also be interested in:** - [Oral Health in People with Intellectual and Developmental Disabilities](https://carequest.org/oral-health-in-people-with-intellectual-and-developmental-disabilities/), a report finding that people with disabilities face greater barriers to dental care and have worse oral health outcomes than those without disabilities. - [It’s Time to Give All Veterans a Good Reason to Smile](https://carequest.org/its-time-to-give-all-veterans-a-good-reason-to-smile/), a report exploring the challenges millions of veterans face because they are ineligible for dental care through the VA. - [State Oral Health Dashboard](https://carequest.org/state-oral-health-dashboard/), a dashboard that breaks down oral health data for 16 measures by state to help policymakers understand access, costs, and outcomes. - [Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions](https://carequest.org/dental-care-in-crisis-tracking-the-cost-and-prevalence-of-emergency-department-visits-for-non-traumatic-dental-conditions/), a report finding that 1.6 million ED visits for preventable dental conditions cost $3.9 billion annually. **Categories:** Publication, Resource **Tags:** Dental Coverage --- ### [From Pregnancy to First Tooth: 11 Questions on Early Oral Health](https://carequest.org/blog/from-pregnancy-to-first-tooth-11-questions-on-early-oral-health/) **Published:** June 8, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/06/KatyBattani_Headshot.jpg)Katy Battani, RDH, MS Oral health begins before birth. It’s widely known that a pregnant person’s oral health shapes their child’s oral health. And after birth, bacteria that cause dental caries can find their way into an infant’s mouth via shared spoons and pacifiers cleaned with parent saliva, increasing a child’s risk for developing tooth decay. “This is why it’s especially important to address and treat active oral disease of the mother during pregnancy before the baby is born,” says Katy Battani, RDH, MS, during the recent CareQuest Institute’s webinar — in collaboration with the National Maternal and Child Oral Health Resource Center — “[Oral Health from Pregnancy to Early Childhood: Improving Access, Safety, and Continuity of Care](https://learning.carequest.org/#/online-courses/aea9d575-7a97-4c56-b993-7ad427a09ca5).” ![](https://carequest.org/wp-content/uploads/2026/06/PatriciaBraun_Headshot.png)Patricia Braun, MD, MPH, FAAP “It’s important to educate \[parents\] about getting oral health care during pregnancy, practicing good oral hygiene behaviors, eating healthy foods, drinking water, and understanding caries prevention for the baby after they are born,” Battani says. ![](https://carequest.org/wp-content/uploads/2026/06/Valerie-Cuzella.jpg)Valerie Cuzella, RDH, BAS During the webinar, experts discussed how oral health teams can improve access, safety, and continuity of care for mothers and their children. Valerie Cuzella, RDH, BAS, Patricia Braun, MD, MPH, FAAP, and Battani answered numerous questions, but there were some they couldn’t get to in the 60-minute program. As a bonus, here are 11 more questions about the connection between oral health and maternal and pediatric health, what is safe and unsafe for pregnant patients and infants, and how to get medical providers’ buy-in on the importance of oral health: ### **1. How can a pregnant person’s periodontal disease contribute to preterm birth?** Periodontal disease can contribute to preterm birth in both direct and indirect ways: - Through the [direct pathway (bacterial translocation)](https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1070917/full), the mouth acts as a space for disease-causing bacteria. Because periodontal disease increases vascular permeability and gum inflammation, activities like chewing or brushing your teeth can cause frequent, low-grade bacteria to enter the bloodstream. That [bacteria can then travel through the bloodstream and take root in the placenta](https://pubmed.ncbi.nlm.nih.gov/32385886/), amniotic fluid, and fetal membranes and cause inflammation that impacts the placenta and the support of the growing fetus. - The [indirect pathway (systemic inflammation)](https://www.mdpi.com/2227-9032/11/10/1372) does not require the physical presence of oral bacteria in the uterus. Instead, it is driven by the body’s systemic response to the chronic inflammatory site in the mouth. Inflammatory markers from the chronic inflammation then circulate through the pregnant person’s body and can trigger early labor. ### **2. During pregnancy, can pregnant people get fluoride varnish?** Yes, [pregnant people can get fluoride varnish](https://www.drugs.com/pregnancy/fluoride-topical.html). ![](https://carequest.org/wp-content/uploads/2026/06/Pregnant-Woman-1.jpg) ### **3. Is it okay to numb pregnant patients who need scaling and root planing?** Yes, certain local anesthetics with epinephrine are safe to use during pregnancy (see [this pharmacology table](https://mchoralhealth.org/PDFs/OralHealthPregnancyConsensus.pdf)). However, articaine-epinephrine should only be given during pregnancy when benefits outweigh risks. The anesthetic has been [assigned to pregnancy category C by the FDA](https://www.drugs.com/pregnancy/articaine-epinephrine.html#:~:text=Articaine%2Depinephrine%20has%20been%20assigned,pregnancy%20when%20benefits%20outweigh%20risks). ### **4. How do you handle reluctance from patients/parents or health providers for use of silver diamine fluoride (SDF)?** Some parents say no, or say not to apply SDF to their child’s front teeth. Other parents accept it right away and are especially grateful to have an option that doesn’t involve general anesthesia. No matter what, it is always a shared decision-making process with parents and patients. Do not assume they will say no, and always have a discussion about all the options. ### **5. How do you answer the parent question, “Can I start cleaning a baby’s mouth at an early age with silicone or a towel for residue?”** Yes! As soon as day one, I recommend nightly cleaning of the child’s mouth with a damp cloth or silicone finger brush to reduce bacterial and fungal populations and to get the child accustomed to this before their teeth come in. ### **6. Is it okay to use benzocaine products on infants?** I discourage the use of benzocaine products for teething pain in infants because there is a small risk of them developing methemoglobinemia. Instead, focus on using cold-based teethers, like frozen fruit, to relieve infant teething pain. ### **7. Do you recommend xylitol to prevent caries?** Xylitol is a great adjunct that can help reduce bacterial and viral adherence. I use it myself as a preventive nasal spray. Xylitol does not replace fluoride as the gold standard for dental caries prevention. If patients are not open to fluoride, it is good to have some options to recommend, like xylitol. ### **8. If kids are sharing food, is that also another cause of spreading caries to other kids?** Yes, horizontal transmission of dental caries is the spread of cavity-causing bacteria (mainly Streptococcus mutans) between people in the same age group or environment, rather than from parent to child. It typically happens among siblings, classmates, or playmates through saliva-sharing activities such as using utensils, cups, or toothbrushes. ### **9. Why does the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit in some states exclude dental?** States are required to develop or adopt a dental periodicity schedule. In September 2024, the Centers for Medicare & Medicaid Services (CMS) issued a [letter](https://www.medicaid.gov/federal-policy-guidance/downloads/sho24005.pdf) to state health officials reminding them that EPSDT requires states to develop or adopt a dental periodicity schedule in consultation with recognized dental organizations in child health. A dental periodicity schedule outlines recommended oral health services for children on Medicaid by age. As of May 2026, 21 states have adopted the [AAPD dental periodicity schedule](https://www.aapd.org/globalassets/media/policies_guidelines/bp_chart.pdf), 21 states have developed their own, and [8 states do not have a schedule](https://www.aapd.org/research/policy-center/state-dental-periodicity-schedules/). ### **10. What do I do if an obstetrician-gynecologist (ob-gyn) doesn’t want a pregnant patient to have routine radiographs, which are needed for full new-patient exams?** Consider sharing the [National Consensus Statement (NCS)](https://www.mchoralhealth.org/materials/consensus_statement.php) with your prenatal colleagues. The NCS states, “Take radiographs to evaluate and definitively diagnose oral diseases and conditions when clinically indicated.” Also note that in 2024, the [American Dental Association (ADA) released guidance](https://jada.ada.org/article/S0002-8177(23)00734-1/fulltext?_gl=1*1nx13o8*_ga*MjA4MTE3MTc5MC4xNzc0OTY4MjA1*_ga_NVSBFQCBYE*czE3Nzk5MDc1MjEkbzUkZzEkdDE3Nzk5MDc1NjUkajE2JGwwJGgw*_ga_JDE0LTHGWL*czE3Nzk5MDc1MjEkbzUkZzEkdDE3Nzk5MDc1NjUkajE2JGwwJGgw*_gcl_au*MTY5Nzc1OTQ4Ni4xNzc0OTY4MjA1*_ga_X8X57NRJ4D*czE3Nzk5MDc1MjEkbzUkZzEkdDE3Nzk5MDc1NjUkajE2JGwwJGgw) in the Journal of the American Dental Association (JADA) on safety and regulatory aspects of radiography. In 2026, [updated recommendations](https://www.ada.org/about/press-releases/new-recommendations-confirm-dental-x-rays-most-effectively-used-in-moderation) for planar (2-D) and cone-beam computed tomography (CBCT; 3-D) dental radiography patient selection were copublished by the ADA and the American Academy of Maxillofacial Radiology. ### **11. How can we get ob-gyns to discuss the importance of oral health with pregnant patients and/or refer them to dentists?** Consider sharing the [NCS](https://www.mchoralhealth.org/materials/consensus_statement.php) and [American College of Obstetricians and Gynecologists (ACOG)](https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan) committee opinion with your prenatal colleagues, perhaps via a one-on-one discussion, study club, or [CE course](https://learning.carequest.org/#/online-courses/f249a2a2-2bc6-4420-9b90-688a76b78071). **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Advancing Public Health Through Collaboration at APHA](https://carequest.org/blog/advancing-public-health-through-collaboration-at-apha/) **Published:** November 19, 2025 **Author:** Caitlin Locklear **Content:** All disciplines across public health under one roof collaborating to “champion optimal, equitable health and well-being for all.” A clear and urgent call to action to “make the public’s health a national priority.” And more than 12,000 attendees. ![](https://carequest.org/wp-content/uploads/2025/11/Hannah-and-Lisa-at-APHA.jpg)Dr. Priyanka Gudsoorkar, Dr. Khairunisa Hashmani, Hannah Cheung, and Dr. Lisa Heaton This November’s American Public Health Association (APHA) annual meeting and exposition in Washington, DC, had all of that and more. As a biostatistician in my first year at CareQuest Institute (I started in March), I was excited to see how we contributed to these critically important conversations. In particular, these four presentations — three from my colleagues at the Institute — stuck with me long after the conference ended. - Keynote speakers emphasized the need for making actionable plans to strengthen and reinforce public health infrastructure and policies right now. In “Mission Possible — Rebuilding the US Health System and Reestablishing Health Leadership to Become the Healthiest Nation,” speakers highlighted the opportunity to envision a future that integrates public health entities and increases collaboration across fields to achieve optimal outcomes. - CareQuest Institute Science Writer Lisa Heaton, PhD, and Health Sciences Specialist Hannah Cheung, MPH, MS, RDH, presented in the oral session “Collaborative Community-Based Oral Health Strategies,” highlighting strategies for integrating oral health into interprofessional and public health education. Hannah spoke about the [development of an interprofessional education model at the University of North Carolina at Chapel Hill](https://www.carequest.org/resource-library/transforming-oral-health-care-through-interprofessional-education), while Lisa presented research from the [State of Oral Health Equity in America](https://www.carequest.org/content/state-oral-health-equity-america) (SOHEA) survey that examined how many US adults receive oral health information from their medical providers. Both presentations speak to the need for continued [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) in the professional educational setting and in clinical practice. (And both links are worth a click if you have a minute!) - In another oral session, “Smiles for Life: Aging and Oral Health,” CareQuest Institute Biostatistician Morgan Santoro, MPH, presented on oral health, care, and access among adults living with cognitive disabilities compared to adults living with other types of disabilities. Using data from the 2024 and 2025 SOHEA surveys, Morgan’s presentation highlighted the finding that [adults with cognitive disabilities were more likely to report fair or poor oral health compared to adults with other disabilities](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities). This research emphasizes the need to understand how different disabilities affect oral health outcomes and access. - Building on CareQuest Institute’s body of work on [emergency department (ED) utilization](https://www.carequest.org/resource-library/dental-care-crisis), Senior Director of Analytics & Data Insights Eric Tranby, PhD, presented “Who Seeks Dental Care in the ED and Why?” during the “Oral Health Systems: Beyond the Dental Chair” session. This research focused on “super-utilizers” of EDs (those who seek care through hospital EDs four or more times per year) and found that they are disproportionately more likely to visit for a non-traumatic dental condition than those who utilize the ED less frequently. With such a large conference (more than 12,000 attendees!), I found many opportunities for learning and connecting across disciplines. As a biostatistician, I was very interested in presentations on machine learning techniques. These complex statistical models can provide deeper insights into big data and will be highly valuable to fully utilize in CareQuest Institute’s future work. ![](https://carequest.org/wp-content/uploads/2025/11/Eric-at-APHA.jpg)Eric Tranby presenting at APHA annual meeting APHA fosters a highly collaborative environment full of people and organizations looking for initiatives and solutions to public health’s greatest challenges. I’m already looking forward to next year! *Authored by Emily Haanschoten, MSPH, Biostatistician, CareQuest Institute* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [How Hygienists Are Providing Critical Oral Care to ICU Patients](https://carequest.org/blog/how-hygienists-are-providing-critical-oral-care-to-icu-patients/) **Published:** October 14, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Sheba-Jones-RDH-and-dental-hygiene-student-providing-oral-care-1.png)Sheba Jones, RDH, and dental hygiene student providing oral care The scene, sadly, is a familiar one: A patient on a ventilator in a hospital bed is surrounded by beeping monitors and the steady hum of machinery. Medical staff quietly observe and adjust settings to ensure stability and comfort. “The patient is unable to provide any type of care for themselves,” says Janell Ragains, RDH, a critical care dental hygienist in the ICU Oral Care program that is supported by the [Dignity Health Foundation East Valley](https://www.supportdignityhealtheastvalley.org/) in Arizona. “They’re totally 100% dependent on us to provide that care for them.” One type of care that often gets overlooked while the patient is intubated: oral health care. And that can be a serious problem. ![](https://carequest.org/wp-content/uploads/2025/10/Janell-Ragains_Cropped-277x300.png)Janell Ragains, RDH “The intubation tube creates a direct pathway where bacteria in the oral cavity can spread from the mouth to the lungs,” Ragains says. “Then [that bacteria can cause pneumonia](https://www.carequest.org/resource-library/link-between-ventilator-associated-pneumonia-and-mouth) if it goes to the lungs. For patients that are in critical condition, if they get pneumonia, their chance of survival is greatly decreased.” In 2019, Dignity Health launched a grant-funded pilot program, the [ICU Oral Care program](https://www.supportdignityhealtheastvalley.org/what-we-support/community-oral-health-programs), to address oral care for patients in the intensive care unit (ICU) at Dignity Health Chandler Regional Medical Center. Through the program, the organization embedded five critical care dental hygienists into the Medical and Trauma ICUs. ![](https://carequest.org/wp-content/uploads/2025/10/MGross-Panico-Cropped.png)Michelle Gross-Panico Going strong five years later, the organization received a grant from CareQuest Institute to work toward bringing their ICU Oral Care model to the larger health care system state and nationwide. The funding allows the organization to conduct a study to evaluate changes in patient oral conditions, assess the interprofessional care model, and complete a cost analysis. Michelle Gross-Panico, the Clinical Program Research and Development Manager and ICU Project Director at Dignity Health, is encouraged by the early results. “Thus far, we have received positive feedback from families, hospital staff, and physicians,” she says. “I see it as an opportunity to improve integrated care and make a positive impact in the health outcomes for patients in critical condition.” ## Moving to a More Integrated Model of Care A patient on a ventilator can get a dry mouth quickly because their mouth stays open while they are intubated. “It just creates an environment where bacteria flourishes,” Ragains says. Nurses can provide some oral health care by keeping the patient’s mouth moist, but dental hygienists are able to assess and identify infections and abnormalities that a nurse typically can’t. The hygienists use the [Bedside Oral Exam (BOE) and the Barrow Oral Care Protocol (BOCP)](https://pubmed.ncbi.nlm.nih.gov/23702324/) as a guide to provide oral care for those patients. “Part of our armamentarium is we wear magnification loupes, and they have a light on them,” Ragains says. “So, we can see a lot more than the nurses can with just the naked eye.” ![](https://carequest.org/wp-content/uploads/2025/10/Critical-Care-Hygienist-Kit.jpg)Critical care dental hygienist oral health care kit To prevent bacteria buildup, the critical care dental hygienists use lip balm and moisturizing gel to keep the patient’s mouth moist, a small electric toothbrush to clean the teeth, and a tongue scraper to keep the tongue clean. They make sure that patients who need care get it every 12 hours, and they communicate with the patient and the nurses about the patient’s needs. “A lot of our intubated patients are sedated, but we still talk to them because our understanding is that even though they can’t respond, they can still hear us,” Ragains says. “Once we provide the care, we let the family know why we’re there and our purpose. We educate them on why oral care is essential for these intubated patients.” Through the ICU Oral Care program, the dental hygienists also share information with nurses and hospital leaders about the link between oral and overall health. “It’s just helping educate them on what’s going on in the mouth and how it affects the other systems of the body: the heart, the lungs,” Ragains says. “[Periodontal disease is also linked to diabetes](https://www.carequest.org/about/blog-post/connections-between-periodontal-disease-and-overall-health), which is a disease that our patients are often managing. There are so many factors and reasons why the bacteria in the mouth can cause negative effects to other parts of the body.” Having a hygienist as part of the care team helps in ways that some might not have foreseen. After a patient is extubated, for example, the hygienists often work with nurses and speech therapists. Ragains recalls a time when a speech therapist told her a patient was having difficulty communicating. A wall of secretions built up in the back of the patient’s throat was blocking the patient’s airway. “I was able to let the speech therapist know what I found and reinforce to the therapist and the nurses the importance of keeping the oral cavity moist so that this doesn’t reoccur,” Ragains says. “It took a couple days to remove what was there, and then the patient was able to communicate and breathe a little bit better because we opened up the airway.” ## Education, Electronic Health Records, and Exploring Payment ![](https://carequest.org/wp-content/uploads/2025/10/Dental-hygiene-student-providing-oral-assessment.png)Critical care dental hygienist oral health care kit Gross-Panico and Ragains say the program has helped patients, hospital leaders, and medical professionals understand the value of having critical care dental hygienists in the hospital. There’s more to learn, though. The organization started patient care and data collection funded by CareQuest Institute in March 2025 and will continue until June 2026. “We have experienced demand for more training from respiratory therapists,” Gross-Panico says. “And we completed a one-hour continuing education class on the basics of oral health, the link between oral health and overall health, and expanded oral care protocol used by the dental hygienists in the intensive care unit.” Dignity Health is also exploring opportunities for partnerships with the University of Arizona College of Nursing and the National Network of Healthcare Hygienists to develop curriculum and training opportunities for both student and licensed nurses and dental hygienists. In the meantime, Gross-Panico says the next step of the ICU Oral Care project is to serve patients in other departments of Chandler Regional Medical Center. “This will be done by integrating the dental hygienist as a provider type in the electronic medical record, so a consult request can be made for any patient to receive an oral exam and expanded oral care,” she says. The grant from CareQuest Institute has also allowed Dignity Health to explore a payment model through medical insurance reimbursement. “I’m deeply grateful for the support from CareQuest Institute to help us blaze new trails,” she adds. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [A New Perspective: Eight Questions with CareQuest Institute CEO Wade Rakes](https://carequest.org/blog/a-new-perspective-eight-questions-with-carequest-institute-ceo-wade-rakes/) **Published:** October 16, 2025 **Author:** Caitlin Locklear **Content:** Wade Rakes understands that oral health care impacts overall health outcomes. And he’s clear on the obstacles standing in the way of those outcomes. ![](https://carequest.org/wp-content/uploads/2025/10/Wade-at-SMILE-Reveal-Day-scaled.jpg)Wade Rakes speaks at SMILE Health Reveal Day “Access, access, access,” he says. “Expanding affordable and available access to oral health care is the game changer.” Rakes has been focused on improving health care for nearly 20 years — first as a senior advisor to Ohio’s governor and later by helping build Centene from a small regional Medicaid-focused company into a national, multiline health organization serving more than 20 million members. Now, as the CEO of CareQuest Institute, he’ll lead an organization dedicated to transforming oral health access and outcomes for underserved populations across the US. “Together, we will expand access, drive innovation, shape policy, and ensure that oral health is recognized as essential to overall health,” says Rakes. What led Rakes to CareQuest Institute? What are his goals for his new organization? Whose words does he turn to for inspiration? The new CareQuest Institute CEO took some time out of his full fall travel schedule to answer eight questions about himself and his vision for the future. **What drew you to the mission of improving oral health?** Whether it was being the kid with braces and mouthguards well into my teen years, helping family members navigate tough choices like dentures and implants, or seeing the surge in emergency department dental visits as a health plan CEO, oral health has always been front and center in my life. It’s clear that access and quality in oral health are in crisis across America. Tackling that challenge is no small feat, but the potential to make a lasting, positive impact on people’s lives makes it a mission worth pursuing. **What’s one thing you’ve learned from past leadership roles that you’ll bring to this one?** Time is the one resource we can’t re-create. I’ve learned that when you’re addressing a real need, you have to move with urgency and purpose. That mindset will guide me here because the need is great, and the time is now. **What do you see as the biggest opportunity in oral health today? What one change would impact most people?** Access, access, access. Whether it’s advocating for coverage, investing in innovative care delivery models, or supporting our health professionals on the front lines, expanding affordable and available access to oral health care is the game changer. It’s the key to unlocking better outcomes for millions. **In which areas do you see CareQuest Institute making the largest impact in the next two years?** Medical-dental integration is a huge opportunity. More people see a doctor than a dentist each year. Imagine the possibilities if oral health were seamlessly woven into those visits. We’re uniquely positioned to lead that charge and make it a reality. **How will you define success for the organization — and for yourself — in the next two years?** Success will be measured by clear, measurable goals that we’ll set together for 2026 and 2027. And we won’t just set them: We’ll track them, talk about them, and celebrate progress together in our monthly all-hands meetings. Impact is the goal, and we’ll know we’re succeeding when we see it in the communities we serve. **What is one thing you’re passionate about outside of work?** Travel! I love exploring new places, cultures, and perspectives. It’s a great way to recharge and stay curious. **Are you willing to share something most people don’t know about you?** At 14, I became an Eagle Scout. One of the most meaningful parts of that journey was having my late father as my Assistant Scoutmaster. He didn’t have any scouting experience, but he saw a need and stepped up to help guide dozens of young men — including me. That spirit of service and showing up for others has stuck with me ever since. **Can you share one piece of advice or a famous quote that you turn to often for inspiration?** “A life is not important except in the impact it has on other lives.” — Jackie Robinson. This quote reminds me why we do what we do. It’s about making a difference, one life at a time. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [The New Fault Lines on Fluoride in Four States — and What They Mean for Medicaid](https://carequest.org/blog/the-new-fault-lines-on-fluoride-in-four-states-and-what-they-mean-for-medicaid/) **Published:** October 23, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Oral-Health-Policy-Perspective.png)Across the country, there’s a new wave of proposals targeting community water fluoridation (CWF) as many states are tightening Medicaid budgets. That combination is uniquely dangerous for low-income families: End fluoridation -> see cavities rise -> watch public insurance spending swell. Recent modeling published in *JAMA Health Forum* [projects that eliminating fluoridation nationally](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2834515) would increase tooth decay in children by 7.5 percentage points over five years, adding roughly 25.4 million cavities and $9.8 billion in additional dental treatment costs. Those expenses land hardest on kids covered by Medicaid, which finances about half of all pediatric dental care in the United States. Below are four states to watch — and why the stakes are financial and clinical. ## Colorado: Oral Health Funding Meets Budget Headwinds ![](https://carequest.org/wp-content/uploads/2025/10/Matt-Steele-Headshot.jpeg)Matthew Steele Colorado is already trimming Medicaid dental spending. In September 2025, [the state moved to cut adult dental funding by rolling back a recent rate increase](https://cdaonline.org/news/latest-news/medicaid-rates-lowered-in-budget-shortfall-but-not-all-news-is-bad/) as part of broader spending reductions tied to a significant budget shortfall. The state’s Department of Health Care Policy and Financing [confirmed these changes in a bulletin outlining rate reductions](https://hcpf.colorado.gov/sites/hcpf/files/Special%20Provider%20Bulletin%20-%20Rate%20Reductions%20092025_B2500528_0.pdf) effective October 1, 2025. These cuts will make it harder for providers to participate in Medicaid and could reduce access to preventive and restorative dental care across the state. With more than 1 million Coloradans relying on Medicaid for coverage, even modest rate reductions risk widening care gaps, especially for seniors and rural residents who already face barriers to accessing dental care. ## Kentucky: A Live Fight over Local Opt-Outs In Kentucky, CWF will be front and center this upcoming week as the Interim State Government Committee is scheduled to hold an informational hearing on fluoride restriction measures that gained momentum last session. While this interim hearing carries no legislative authority, it signals that the issue remains a priority among lawmakers heading into the 2026 legislative session. Policy insiders in Frankfort expect that legislation will be introduced next session that will allow local water systems to opt out of fluoridation or even ban fluoride statewide. Such measures would dismantle Kentucky’s long-standing public health standard and place Kentucky among a small but growing number of states considering fluoride bans. ## Louisiana: A Near Miss and Likely Return This spring, Senate Bill 2 advanced in Baton Rouge to ban fluoridation statewide, [a sweeping proposal that ultimately failed](https://www.ladental.org/news-details/2025/04/28/sb-2--fluoride-ban-bill-makes-headlines) in the House Health & Welfare Committee. The bill’s text made the intent explicit: to prohibit fluoridation of any public water system. While the measure was stopped during the session, it is widely expected to return in 2026. The debate around Senate Bill 2 revealed strong pockets of anti-fluoride sentiment in both chambers, even garnering bipartisan support in committee and floor votes. If the legislation is revived and passes in 2026, it will likely increase Medicaid and public health costs tied to preventable dental disease. ## Oklahoma: Fluoride, Medicaid, and a Fresh Budget Alarm Oklahoma has emerged as another Medicaid and fluoride defense flash point. In June 2025, [state leaders withdrew Oklahoma’s public health recommendation for water fluoridation](https://apnews.com/article/stitt-kennedy-snap-waiver-food-stamps-healthy-df0424a088ef5ce0ef327508456e8b80) under a “Make Oklahoma Healthy Again” executive order. During the issuance of the order, the Governor even garnered federal attention by inviting US Secretary of Health and Human Services Robert Kennedy Jr. to celebrate its release. At the same time, legislators have been studying the state budget consequences of federal Medicaid reductions. Given the passion from the Governor’s office over the summer to recommend against CWF and the apparent planning from lawmakers to find budget savings in the state Medicaid program, we’ll be watching Oklahoma closely on the policy front in 2026. ## The Bottom Line [The science is settled](https://ebooks.ada.org/24ltpik/?_gl=1*7zxxjl*_gcl_aw*R0NMLjE3NTUxODgwMTIuQ2p3S0NBandrdmJFQmhBcEVpd0FLVXo2LTBVTE1nNTJLLS1yUzBKa2xySmhFNmo5OVlYTFR3YVY4TUU5Mk9TbkdaZktUMkwzSjVkamRSb0NtNWNRQXZEX0J3RQ..*_gcl_au*NTIxODA1ODUwLjE3NTgzMDI4NTc.*_ga*ODEzNDQyMzYwLjE3NDA4MTk2MDI.*_ga_X8X57NRJ4D*czE3NjEwNzA2MTgkbzM0JGcxJHQxNzYxMDcwNjM1JGo2MCRsMCRoMA..*_ga_NVSBFQCBYE*czE3NjEwNzA2MTgkbzM0JGcxJHQxNzYxMDcwNjM1JGo2MCRsMCRoMA..*_ga_JDE0LTHGWL*czE3NjEwNzA2MTgkbzM0JGcxJHQxNzYxMDcwNjM1JGo2MCRsMCRoMA..), and the budget math is sobering. Whether your state is confronting explicit bans (Louisiana), local opt-outs (Kentucky), executive orders (Oklahoma), or Medicaid belt-tightening (Colorado), ending CWF and rolling back funding for dental Medicaid benefits are in focus for state legislatures. For lawmakers and governors, the fiscally conservative move is also the public health move: Protect fluoridation. Protect Medicaid. For advocates, the time is now to contact your legislators and encourage them to protect these resources critical to oral health care. *Authored by Matthew Steele, State and Local Advocacy Director, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Learning to Lead: Teens Connect Community to Oral Health Care](https://carequest.org/blog/learning-to-lead-teens-connect-community-to-oral-health-care/) **Published:** October 24, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/CHWs-walking-into-building-1.jpg)Junior CHWs with NMPHI walk into building Two programs, two states, and one goal: engaging a younger generation to help people in their communities get access to oral health care. With the help of a CareQuest Institute grant, [New Mainers Public Health Initiative (NMPHI)](https://nmphi.org/) in Maine and [Kids In Need of Dentistry (KIND)](https://kindsmiles.org/) in Colorado engaged junior community health workers (CHW) and promotoras to help individuals in their communities access and learn about oral health. “I was telling people what our community did — helping kids get insurance about their teeth and stuff like that,” explains Victoria, a KIND junior promotora. “And I also handed out flyers, so people can call us or text us if they wanted to get insurance because my mom also helps with that.” “I feel like it was easier when someone’s my age because they’re more likely to listen to me,” says Iqra, a junior CHW with NMPHI. In Maine, several dental practices and clinics have shut down — leaving many without a dental home. And across the US, approximately 72 million adults (27%) do not have dental insurance, according to CareQuest Institute’s latest State of Oral Health Equity in America survey. ![](https://carequest.org/wp-content/uploads/2025/10/KIND-Promotoras-at-booth.jpg)KIND junior promotoras at a booth talk to other kids in their community “It was really crazy that some kids don’t brush their teeth, or some kids just can’t afford to go to the dentist,” says Josefa, a KIND junior promotora. “And that was really shocking for me.” As the kids are educating the community, they’re learning a lot, too. “Victoria and I really enjoyed being promotoras because we get to connect with the community a lot, and it gave us some skills that we didn’t have before becoming promotoras,” Josefa says. See the work and impact these teenagers have on their communities in this video: **Categories:** Blog **Tags:** Dental Coverage --- ### [How New Interactive Licensure Maps Are Helping Dental Hygiene Careers](https://carequest.org/blog/how-new-interactive-licensure-maps-are-helping-dental-hygiene-careers/) **Published:** November 3, 2025 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/11/BronwynBarrera_2024-08-scaled.jpg)Bronwyn Barrera, MBA For years, dental hygienists have been frustrated with having to hunt through multiple websites and sources to piece together information about continuing education requirements and scope of practice variations. This is even more challenging for dental hygienists who are licensed in — or want to practice in — more than one state. ![](https://carequest.org/wp-content/uploads/2025/11/Kelly-Schroeder-topaz-enhance-4x-faceai-241x300.png)Kelly Schroeder, MS, RDH As more states sign onto the [interstate licensure compact](https://ddhcompact.org/), making it easier to work in multiple states, the issue of knowing legislative requirements for each state continues to escalate. The solution to this growing problem seemed straightforward: Consolidate as much available information into one centralized, visual platform. That’s why the American Dental Hygienists’ Association (ADHA), with grant funding from CareQuest Institute, created two interactive maps — one focused on initial licensure requirements, and the other covering licensure renewal requirements. - The [Initial Licensure Map](https://www.adha.org/resources/licensure-maps/#:~:text=RDH%20License%20Renewal%20Map.%20Every%20state%20has,requirements%20and%20fees%20are%20tied%20to%20the) has information about each state’s accepted clinical exams, scope of practice overview, and state rules and regulations. - The [RDH License Renewal Map](https://www.adha.org/resources/licensure-maps/#:~:text=RDH%20License%20Renewal%20Map.%20Every%20state%20has,requirements%20and%20fees%20are%20tied%20to%20the) has information about each state’s renewal cycle, CE hours required per cycle, renewal fees, special requirements, and scope of practice overview. Individual states in both maps are color coded for their dentist and dental hygienist legislative compact status. (A state with no active legislation to sign onto the licensure compact is gray, pending legislation is purple, and enacted legislation is indigo.) Since launching in late July 2025, the interactive licensure maps have attracted more than 5,000 visitors. While these numbers show interest, we wanted to know: Would dental hygienists actually use this resource? And would it make their professional lives easier? ## How Dental Hygienists Are Using the Maps![](https://carequest.org/wp-content/uploads/2025/11/RDH-Renewal-Map.png) To find out if the maps were serving their intended purposes, the ADHA did a pulse check survey of dental hygienists and educators across the country. The survey showed that dental hygienists are: - **Understanding scope of practice differences:** Survey respondents use the maps to compare how the dental hygiene scope of practice allowances varies from state to state. This is important for anyone thinking about relocating or working across state lines. - **Managing license renewals:** Some of the survey respondents said they use the maps to keep track of their continuing education requirements and renewal cycles, especially those juggling licenses in multiple states. - **Career planning:** Dental hygienists are using the maps to make career decisions such as where to get their initial license and what other states they want to work in. Here are some other highlights from the survey: - Lauren Bouras, BSDH, RDH, in California, who is licensed in both California and Wisconsin, described the maps as having an “easy-to-navigate, centralized location” for critical information. - Robin Marino, RDH, in Arizona encapsulated the ADHA maps in a single phrase — “ease of use and accuracy of information.” - Another dental hygienist, who preferred to remain anonymous, shared how the maps helped with career strategy: “Knowing which states have signed legislation or have a bill introduced (around a specific scope of practice issue), and thinking about where \[my\] family is located if the need arises to relocate, or know\[ing\] where the potential to work part-time in retirement is when that day comes.” ## A Help for Dental Hygiene Educators, Too The majority of dental hygiene educators who participated in the survey were already aware of the maps and use them as a career building tool with their students. Educators are incorporating the maps into their teaching in different ways: - **Classroom instruction:** Dental hygiene educators are using the maps during lectures, particularly when discussing scope of practice and public health. - **Career counseling:** The maps help students make decisions about which clinical board exams to take based on where they plan to practice. - **Advocacy education:** Some instructors use the maps to help students connect policy to clinical practice, engage in advocacy work, and understand how legislative differences affect access to care. This is what dental hygiene instructors had to say: “It is an easy and concise resource for students to use,” one dental hygiene educator noted. “A one-stop shop, and they are exploring their options.” Another educator said, “The maps are very useful in Dental Public Health \[curriculum\] when scope of practice is discussed.” ADHA plans to update the maps semi-annually and will make changes sooner if needed. Future additions are being considered based on feedback from users, such as the number of dental hygiene programs per state. The success of these maps shows how important it is to invest in tools that support the oral health workforce. Making licensure requirements easy to understand helps dental hygienists to manage their license and navigate their career options. *Authored by Bronwyn Barrera, MBA, Director of Marketing & Communications, ADHA* *and Kelly Schroeder, MS, RDH, Program Evaluation Specialist, CareQuest Institute* *Editor’s Note: If you haven’t explored ADHA’s interactive licensure maps yet, visit* [*adha.org/licensuremaps*](https://www.adha.org/licensuremaps)*.* **Categories:** Blog **Tags:** Dental Coverage --- ### [Better Together: How Interprofessional Learning and Practice Benefits Patients](https://carequest.org/blog/better-together-how-interprofessional-learning-and-practice-benefits-patients/) **Published:** October 1, 2025 **Author:** Caitlin Locklear **Content:** In medical school, Anthony Marchlewski, MD, didn’t learn much about oral health. But as a resident at [ProHealth Care](https://www.prohealthcare.org/), a community-based health care system in Waukesha County, Wisconsin, he had the chance to dive into the world of dentistry. He participated in a two-week rotation with [Community Smiles Dental](https://www.communitysmiles.org/), a nonprofit safety-net organization located in the same building as a ProHealth Care clinic. During the rotation, residents shadow the dental providers, participate in dental exams, and learn how to ask basic dental triage questions. “Probably the biggest advantage is being able to pull back that curtain and getting a better idea of exactly what the colleagues you’re referring people to are actually doing,” Dr. Marchlewski says of the invaluable experience.![](https://carequest.org/wp-content/uploads/2025/10/Lab-Research-1.jpg) He vividly recalls the “hands-on experiences, seeing dental abscesses, and seeing tooth removal.” And since completing the rotation, Dr. Marchlewski has consistently applied what he learned in his day-to-day practice. “I’m better able to understand what \[dentists\] are capable of doing and what questions to ask,” he says. “And I can counsel patients better on what to expect and make them better prepared or less nervous about it.” This partnership is just one example of what’s known as interprofessional practice (IPP). According to the World Health Organization ([WHO](https://iris.who.int/server/api/core/bitstreams/d743ea4e-8c14-493c-b3a5-1a0022e6ce54/content)), IPP refers to clinical care in which “multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, carers, and communities to deliver the highest quality of care across settings.” Interprofessional education (IPE), in which students from various health care disciplines learn to deliver collaborative care, provides an essential foundation for IPP. Both have gained traction in recent years — as showcased in CareQuest Institute’s latest white papers — which is critical to providing whole-person, integrated care. ## Connecting Oral Health and Systemic Health Oral health and systemic health are [deeply interconnected](https://www.carequest.org/resource-library/impacts-beyond-mouth) across the [lifespan](https://www.carequest.org/resource-library/oral-systemic-connection-across-lifespan). For example: - Periodontal disease in pregnant people is associated with preterm births and low birth weights. - Frequent consumption of sugar-sweetened drinks raises the risk of both obesity and tooth decay among children and adults. - Improving oral hygiene among medically fragile seniors can reduce rates of hospital-acquired pneumonia. When health care providers from multiple professions collaborate, they can bridge the gap between the mouth and the body, offering care that improves patient outcomes, strengthens chronic disease management, and advances public health. IPP is one aspect of a broader [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) that aims to treat the whole person. The [two CareQuest Institute white papers capture examples and perspectives from providers](https://www.carequest.org/resource-library/silos-synergy-integrating-oral-health-whole-person-care-through-interprofessional) who are focused on providing that whole person care every day. “Efforts to break down professional silos and increase interprofessional practice have enabled us to remove barriers to care, meet our patients where they are, and provide a higher quality of care and patient experience,” says Christopher Brendemuhl, DMD, CDIPC, at Valleywise Health in Maricopa County, Arizona. ## Moving Dental Care Out of Its Silo Historically, dental care has been separate from other health disciplines, with dentists’ offices siloed from the broader health care system. This isolation was reinforced by structural factors such as separate medical and dental insurance, electronic health records (EHRs) that did not communicate across professions, and a dearth of interprofessional training. In the mid-20th century, however, understanding of the links between oral health and systemic health deepened. The American Dental Association ([ADA](https://www.ada.org/)) and other dental organizations began to promote the idea that oral health was essential to overall health. The natural next step was to integrate medical and dental care. Today, interprofessional collaboration links oral health care with multiple different types of other health care professions. (You can read about several examples below and in the newest CareQuest Institute white paper.) Even more promising, virtually all oral health education programs engage in IPE activities. In fact, the Commission on Dental Accreditation ([CODA](https://coda.ada.org/)) requires dental and dental hygiene programs to integrate IPE into their curricula to ensure that students graduate with the ability to collaborate effectively within health care teams. ## Implementing Interprofessional Care Care teams are already providing interdisciplinary, collaborative care in a wide variety of settings. Here are some examples from the white papers of how IPP is already benefiting patients: - At federally qualified health centers (FQHCs), primary care physicians and other non-dental health professionals provide oral health screenings, fluoride varnish, and referrals to dental providers. - Integrated school-based health centers deliver preventive dental services such as oral health screenings and referrals, application of fluoride varnish and sealants, as well as primary care services, behavioral health services, and nutrition counseling. - At long-term care facilities, oral health care providers work alongside facility staff to deliver care to older adults and/or adults with disabilities. - Mobile integrated care clinics deliver comprehensive care, including oral health care, primary care, vaccinations, and other screenings, to rural communities using mobile health equipment. Although all patients can benefit from IPP, it can be particularly critical for individuals with intellectual and developmental disabilities and those who experience dental anxiety. For these patients, behavioral and oral health providers can collaborate on strategies to dramatically improve access to care and patient comfort. ## Obstacles and Opportunities in Practice Despite remarkable progress, barriers remain to expanding IPP to its full potential. These barriers include: - Fragmented financing structures, especially the separation of dental and medical insurance - Incompatible billing systems - Non-integrated EHRs - Limited interprofessional training However, there is strong momentum for change. There has been a move toward shared EHRs and co-located, aligned workflows, which are facilitating integration. For example, the Mayo Clinic Health System (MCHS) represents a pioneering model of integrated health care. Established in 2019 through a collaboration with Minnesota State University (MSU), Mankato, MCHS brings together dental professionals, primary care physicians, and pediatric health specialists under one roof. At the center of the MCHS model is a multidisciplinary team of dental, medical, and pediatric professionals working collaboratively to provide seamless, patient-centered care. A shared EHR system ensures that all providers can access the most current patient information, including clinical notes, labs, and treatment plans. Innovative models such as Medicaid pay-for-quality programs, accountable care organizations (ACOs), and targeted grants have shown that integrated care can improve outcomes and lower costs. All of this incentivizes further progress in IPP. “The integration of oral health into IPP is not just a logistical step,” Fábio Renato Manzolli Leite, DDS, MS, PhD, notes in the paper. “It is a change in thinking that redefines how we view and deliver holistic care.” With a continued focus on IPP and IPE, health care organizations, educational institutions, and policymakers can bring us closer to a system that works for everyone — a system that serves the whole person. “All the different specialties are all connected to the same person, and they definitely play off each other,” says Dr. Marchlewski. “Interprofessional practice has given me a better idea of how each system works, which will help us address problems promptly and appropriately.” **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Insight at Your Fingertips: Introducing the Health Data Exchange](https://carequest.org/blog/insight-at-your-fingertips-introducing-the-health-data-exchange/) **Published:** May 28, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/05/HDX_screen-scaled.jpg) What does Medicaid adult dental coverage look like across states? Where do shortages of medical and dental providers exist? How many people in a specific county have dental insurance? Now, you can find all those answers — and much, much more — in one place. This spring, CareQuest Institute launched its most ambitious data offering to date, a platform that connects medical, oral health, and social data. The [Health Data Exchange](https://dataexchange.carequest.org/), which includes an AI Research Explorer, provides oral health stakeholders — from advocates to policymakers and everyone in between — with tools and knowledge to improve decision-making and strengthen care in communities across the country. “CareQuest Institute’s Health Data Exchange empowers users to access oral health data in the way they need it most,” says Rebecca Preston, CareQuest Institute Senior Manager of Analytics & Data Insights. “The combination of the medallion architecture \[a trusted way to organize data so it’s ready to use\], AI, and data products delivers insights faster and accurately to support our partners in advancing our mission of improving oral health for all.” After months of development from the Analytics & Data Insights (ADI) team, John Bowyer, Data Engineer Manager, and Adrianna Sonnek, Data Products Manager, share more about why the Health Data Exchange was created, how it will help advocates, researchers, and oral health stakeholders, and what success looks like. **Q: Why did the ADI team build the Health Data Exchange?** **Bowyer:** Before the Health Data Exchange, analysts spent weeks manually pulling together state‑level data from multiple disconnected sources. That approach did not scale with our goal of advancing health equity nationwide. We built the Health Data Exchange to move from fragmented data silos to a unified platform. **Q: Who is the Health Data Exchange designed for, and how do you envision people using it?** **Sonnek:** The Health Data Exchange is designed for anyone who is interested in oral health data — no matter their level of experience. Data products, like our [AI Research Explorer](https://dataexchange.carequest.org/data/10), allow people without technical expertise to easily gather insights in seconds. At the same time, our analytic workbench tools give advanced researchers the space and capabilities to conduct more complex analyses on one centralized platform. **Q: How did the ADI team build the Health Data Exchange?** **Sonnek:** To start this endeavor, we first had to create a data strategy that kept us centered around CareQuest Institute’s mission and values. We interviewed valuable colleagues and partners across our network and collectively recognized that there needed to be a solution to group all the data together into an easy-to-use platform to extend our reach. We then started planning and building the technical infrastructure needed to support this. Months of work went into shaping our data and platform to make the Health Data Exchange what it is today. We are excited to show off the brand-new data products developed to coincide with the launch of the Health Data Exchange. For example: - AI Research Explorer - AI Data Explorer - Medicaid 360 - Workbench options for advanced analysis **Q: How is artificial intelligence (AI) integrated into the Health Data Exchange?** **Sonnek:** AI is integrated into the development process for data products, optimizing our processes so that we can develop as many helpful resources as possible. Beyond that, it is also available to users of the Health Data Exchange so that they can take our extensive data resources and quickly gain the insights they are looking for — without the steep learning curve that often comes with analyzing new data sources. **Q: How is the Health Data Exchange maintained?** **Sonnek:** The Data Products team supports users by answering questions, assisting with data requests, and [providing technical help.](https://dataexchange.carequest.org/help) They also gather feedback from the research community and use it to improve existing tools and develop new ones. Our Data Engineering team supports data ingestion and maintains data infrastructure, which enables our team to improve and update our tools. They also gather feedback from the research community and use it to improve existing tools and develop new ones. **Q: What part of launching the Health Data Exchange are you most excited about?** **Sonnek:** I am most excited about seeing how people use the tools we’ve built to solve real-world problems. It’s rewarding to see new users jump into the Health Data Exchange, find answers quickly, and apply those insights in their everyday work to advance oral health equity for all. **Q: Can you give us an example of the Health Data Exchange in action?** **Sonnek:** Recently, we provided a [Hill Day](https://carequest.org/the-power-of-collective-action-a-look-at-open-hill-day-2026/) training session for [OPEN](https://carequest.org/policy-advocacy/open/) members. During Hill Day, OPEN members and advocates meet with legislators in Washington, DC, about prioritizing oral health in their communities. In preparation for the training session, we met with a member to discuss what specific questions they have about their state and how long they have to discuss these data points with their legislators (which is not very long!). We helped training attendees answer the following questions, which helped with Hill Day preparation: - What does oral health status look like for veterans compared to nonveterans? - What has CareQuest Institute published on veterans’ oral health? - What does Medicaid coverage look like in my state? - Which dental procedures are covered by Medicaid? - Is preventive coverage included in Medicaid? - How do Medicaid enrollment numbers compare to the state’s general population? - Which areas are considered Dental Health Professional Shortage areas? **Q: What does success look like in the first few years after the launch?** **Bowyer:** In the first year, success is building adoption and trust. Teams can find and analyze data on their own without relying on the Data Engineering team as an intermediary. The time from question to answer decreases because the data is already integrated and governed, and users rely less on manual extracts and one-off requests. **Sonnek:** We want the Health Data Exchange to become a trusted source for oral health data and insights — one that people turn to and cite regularly. As we expand our data resources and tools, we aim to show that oral health *is* health and make it easier include oral health topics in the overall health conversation. Learn more about the [Health Data Exchange](https://dataexchange.carequest.org/) and its data products. **Categories:** Blog **Tags:** Dental Coverage, Medical-Dental Integration --- ### [Speaking Up: A Fresh Perspective on Maternal Oral Health Education](https://carequest.org/blog/speaking-up-a-fresh-perspective-on-maternal-oral-health-education/) **Published:** May 6, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/05/SADE-museum-tour-1.jpg)Sade Jones Sade Jones knows what it’s like to feel helpless in a dental chair — especially at eight months pregnant. “I was getting work done, and my teeth were hurting really badly,” she says. “I didn’t say anything at first, but after a while, it started hurting more, and I spoke up.” The dental provider continued the procedure anyway. To this day, Jones is living with the consequences of not being heard. “The problem was still there,” she says. “It actually caused my teeth to come out after a while.” That experience would later shape her decision to speak up — not just for herself but for others in her position. Jones decided to join the [Prenatal and Postpartum Advisory Board](https://www.dental.umaryland.edu/about/news/may-2022/making-access-to-dental-care-a-reality-for-maryland-mothers-.php) (PPAB) of the [University of Maryland School of Dentistry](https://www.dental.umaryland.edu/) (UMSOD). The PPAB is a diverse group including moms with lived experiences, committed to expanding dental care access for underserved pregnant and postpartum people. “That was something that I really wanted to be a part of because I had my own experience, and they actually wanted to hear from me,” she says. Jones’s experience is not unique, and it’s exactly why the UMSOD created the PPAB. Originally, the PPAB helped strengthen Medicaid dental coverage for prenatal and postpartum people in the state. Over the years, the PPAB grew into a broader program that integrates maternal oral health education into dental hygiene programs. The [University of Maryland Baltimore Institute for Clinical and Translational Science](https://www.umaryland.edu/ictr/) and the [ADEAGies Foundation](https://www.adea.org/adeagies-foundation) initially supported the work. The program later expanded, through support from CareQuest Institute, to include community health worker (CHW) trainings and address the state’s ongoing workforce shortage. Since 2021, the Institute has provided more than $600,000 in grant funding to support PPAB’s work. “We’re very happy to see this evolution and impact of this work over the years,” says CareQuest Institute Senior Grants Officer John Gabelus. “What began as an effort to listen to community voices has grown into something far more powerful, with those voices now shaping solutions and filling key gaps in our oral health system.” ## **Bringing Pregnant Patient Voices to the Table** For many pregnant and postpartum people, dental care comes with a lot of uncertainty. What’s safe during pregnancy? What questions should you ask your providers? And will anyone listen if something doesn’t feel right? That uncertainty keeps many people from getting care at all — even though [poor oral health during pregnancy has been linked](https://carequest.org/the-role-of-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum/) to preeclampsia, preterm birth, and low-birth-weight infants. A [CareQuest Institute study](https://carequest.org/the-role-of-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum/) found that fewer than half of pregnant people received dental care during their pregnancy. Further, only one third (35%) of obstetricians and nurse midwives said they discussed oral health with their pregnant patients. Even more concerning, 77% of obstetricians reported that some of their patients had been turned away by dentists — despite dental care being safe during pregnancy. (Learn more about how oral health teams can collaborate effectively with prenatal and pediatric care providers to improve access, safety, and continuity of care in our webinar, “[Oral Health from Pregnancy to Early Childhood](https://learning.carequest.org/#/instructor-led-courses/e8c50396-cf79-449c-bbcf-930790e3199e).”) In the Baltimore area and surrounding counties, pregnant and postpartum people face additional barriers to accessing care. ![](https://carequest.org/wp-content/uploads/2026/05/89496f33-d3d3-4094-915d-bbc6ff04c7bb.jpg)The PPAB conducts a panel discussion moderated by CareQuest Institute Senior Director of Philanthropy Trenae Simpson at the 2025 State of Black Health Conference. “This community is a Dental Health Professional Shortage Area,” says Lisa Bress, RDH, MS, Clinical Associate Professor at UMSOD. “And most of the prenatal and postpartum patients, at least at this clinic, rely on Medicaid, and it’s not always easy to get a provider who accepts it.” The PPAB is made up of 10–12 individuals: prenatal providers, oral health providers, public health professionals, and prenatal and postpartum mothers who have personally faced oral health inequities. They meet a few times virtually and, occasionally, in person every year. Together, they examine the barriers to care and examine opportunities for better integration of care and improved access. “The relationships among advisory board members developed in the first year,” Bress says. “Then, in the second year, we went out into the community.” ## **From Board Member to Educator** For Jones, being heard on the advisory board was only the beginning. Through her involvement with the board, she found a path to turn her lived experience into action — first as a certified CHW, educating prenatal and postpartum people about oral health and linking them to a dental home. “I share my own experience with them, and a lot of them are scared to talk because they experience the same thing,” she says. As a CHW, Jones educates prenatal and postpartum patients at two University of Maryland Women’s Health Center clinics and is integrated into dental hygiene oral health literacy courses to help dental hygiene students learn effective communication techniques with their patients. “I talk about what it feels like to be in the chair and why patients don’t always say something — even when it hurts,” Jones says. Those words often spur action. Just a few weeks ago, Jones called Bress advocating for a pregnant patient who was in urgent need of oral health care. “Sade would not let up until we got this poor girl in the chair,” Bress says. “I saw the patient at the clinic — she had her pajamas on, was 23 weeks pregnant, covering her mouth with her hood up because she was in so much pain. I read the chart afterward, and the dental student had started a root canal, which addressed the pain and saved the tooth.” By hearing directly from someone who has been on the other side of care, dental hygiene students and dental providers get the opportunity to think differently about trust, communication, and their role in supporting pregnant and postpartum patients — particularly those who face barriers to care. “So this is a win-win situation,” Bress says. “You have a student being educated and a patient getting the care she needs, care that could make a life‑changing difference.” Both Jones and Bress are continuing to raise awareness about the importance of oral health care among dental hygiene students at other universities, CHWs, and expecting mothers. Most recently, they went to the Howard University Pediatric Dentistry Department in Washington, DC, to talk about how students can emphasize the importance of oral health to patients to improve health outcomes. Moving forward, the PPAB will continue integrating oral health education into CHW training — helping ensure pregnant and postpartum people have the information, support, and confidence they need to access care and speak up for themselves. “I want to expand our impact,” Jones says. “And continue advocating for patients so their voices are heard.” **Categories:** Blog **Tags:** Health Equity, Medical-Dental Integration --- ### [The Power of Collective Action: A Look at OPEN Hill Day 2026](https://carequest.org/blog/the-power-of-collective-action-a-look-at-open-hill-day-2026/) **Published:** May 12, 2026 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2026/05/OPEN-Hill-Day-Appointments_120-scaled.jpg)OPEN Hill Day 2025 As we look ahead to [OPEN Hill Day](https://eventmobi.com/website/openhillday) this June, I’ve been reflecting on what makes moments like this so important — not just as events but as expressions of something bigger. At CareQuest Institute, we often talk about the importance of systems change. But systems don’t change on their own. They shift because people — advocates, community leaders, providers, and partners — come together with a shared purpose and a willingness to act. Hill Day is one of the clearest examples of that purpose in action, when OPEN members meet with legislators in Washington, DC, about prioritizing oral health in their communities. Across the country, the organizations we partner with are advancing oral health equity every day — often in ways that are not visible at the national level. They are building coalitions, responding to policy threats, and working alongside communities to improve access to care. Hill Day brings those efforts together and makes them visible on the national stage, connecting local experience to national policy conversations, and aligning voices around a shared set of priorities. This year, that alignment is especially important. ## **Three Priorities for OPEN Hill Day 2026** [OPEN Hill Day](https://eventmobi.com/website/openhillday) is focused on a set of clear, coordinated federal priorities: 1. Improving access to dental care for veterans 2. Protecting Medicaid as a critical pathway to care 3. Ensuring sustained federal investment in oral health infrastructure and prevention ![](https://carequest.org/wp-content/uploads/2026/05/OPEN-Hill-Day-Appointments_85-scaled.jpg)\#image\_title These are not abstract policy issues — they reflect what our partners see every day in their communities and where federal action can make a meaningful difference. When we collectively elevate these issues, we help build champions and raise awareness. More specifically, we shift how policymakers understand the role of oral health in overall health and well-being. We see this connection in the work of grantees and partners across the country. Organizations like [Asian Resources Inc.](https://asianresources.org/) in California are expanding access through culturally responsive outreach and enrollment efforts that connect underserved communities to coverage and oral health services, while groups like [Maine Equal Justice](https://maineequaljustice.org/) have led campaigns to expand Medicaid dental coverage — improving access to preventive and restorative care for adults. Meanwhile, partners such as the [Colorado Consumer Health Initiative](https://cohealthinitiative.org/) are mobilizing consumer voices to advance more equitable coverage and affordability, while organizations like [Alabama Arise](https://alarise.org/), [Health Care for All](https://hcfama.org/) in Massachusetts, and [Smiles Across Montana](https://www.smilesacrossmontana.com/) are leading efforts to protect community water fluoridation, an evidence-based intervention that improves oral health at scale. Many of these organizations are doing this while navigating limited resources and increasing demand. What makes this work effective is not just individual leadership but coordination across organizations, states, and strategies in pursuit of a shared mission. That’s what OPEN is designed to support. ## **The Lasting Impact of OPEN Hill Day** Through OPEN, partners have opportunities to connect, share learning, and align their efforts over time. Hill Day builds on that foundation by creating space for coordinated advocacy — equipping participants with the policy context, data, and messaging they need to engage effectively with policymakers. They are creating opportunities to translate community priorities into federal action, ensuring that the people closest to the challenges are also shaping the solutions — and that their perspectives are heard by those making decisions that affect access to care. Hill Day is not a stand-alone moment. It is part of a sustained, ongoing effort by OPEN and its members to strengthen advocacy, deepen relationships, and build collective power over time. One day in Washington, DC, does not create change on its own, but it plays a critical role in reinforcing and accelerating the work happening year-round across the field. At CareQuest Institute, our role is not just to fund this work but to help connect it — to support the relationships, shared learning, and infrastructure that allow it to grow and sustain over time. That means investing in networks like OPEN, supporting advocacy and policy efforts, and continuing to learn alongside our partners about what it takes to drive meaningful change. ![](https://carequest.org/wp-content/uploads/2026/02/Trenae-Simpson-Web-250x300.gif)The challenges in front of us are real and, in many cases, intensifying. But so is the strength of the field. As we gather for Hill Day, I’m reminded that our greatest asset is not any single strategy or initiative. It’s the collective commitment of partners across the country who are working — together — to protect access, advance equity, and build a better oral health system. For more information on OPEN, go to [carequest.org/policy-advocacy/open/](https://carequest.org/policy-advocacy/open/). *Authored by Trenae Simpson, Senior Director of Philanthropy, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [A Team Effort: The Push for Better Oral Health Care for Individuals with Disabilities](https://carequest.org/blog/a-team-effort-the-push-for-better-oral-health-care-for-individuals-with-disabilities/) **Published:** October 31, 2023 **Author:** Caitlin Locklear **Content:** Early on in his 23-year tenure with the [Coalition of Texans with Disabilities](https://www.txdisabilities.org/) (CTD), Executive Director Dennis Borel noticed that some of his colleagues and people he socialized with who had disabilities had problems with their oral health. “I used to see a lot of my folks with missing teeth, sometimes no teeth, broken teeth, stained, bad shape,” Borel said. He used to think those oral health problems were the result of self-care deficits. For instance, if a person has compromised hands or arms, if they’re paralyzed, or if they don’t see well, they may not be able to take care of their teeth as well as others. But Borel says he had a wake-up call when he discovered the main reason for those oral health issues: [More than 400,000 Texan adults](https://www.txdisabilities.org/our-priorities#:~:text=More%20than%20400%2C000%20adult%20Texans,better%20use%20of%20public%20funds.) who are enrolled in Medicaid receive little to no dental services — and that number includes thousands of people with disabilities. “The majority — that’s something like 85% — for their entire adult lifetime, had no dental services in their care plan,” he said. “That was a huge barrier.” Through grants from CareQuest Institute, CTD has led the charge to change that reality for individuals with disabilities and eliminate other barriers to access health care, including oral health care. Now the organization is working to help implement a preventive dental benefit for Texans enrolled in Medicaid that was passed in 2021. “Frankly, we couldn’t have done it without CareQuest Institute,” he said. ## Working to Improve Oral Health Care Borel says the push to support people with disabilities is a group effort. He and his team of 10 colleagues work to ensure that Texans with disabilities can work, live, learn, play, and participate fully in the community of their choice. But they don’t do it alone. CTD has had to build partnerships with other organizations and get funding for the work their team does. ![](https://carequest.org/wp-content/uploads/2023/10/advocacy-team-Capitol-stairs-2-scaled.jpg)The CTD team on the steps inside the Texas Capitol building “We’re primarily an advocacy organization. We represent a very low-income population. Keeping this organization running is a challenge, and very few places give out grants for advocacy work,” Borel said. CTD was first awarded a grant from CareQuest Institute in 2017, the same year that CTD made a push for a Medicaid adult dental benefit. At that time, the CTD team began developing relationships with other organizations in Texas to get the topic in front of state legislators. Research they gathered found that money spent on oral health care would be more than offset by savings in acute care, emergency room visits, and hospitalizations. “We had to start by getting \[legislators\] to agree to even study the issues,” Borel said. “Then what it came down to was proving to them that oral health care is not a cost; it’s actually a key to a sustainable public health system.” CTD also encouraged people with disabilities to share their stories directly with state legislators. “These men and women in the Capitol, they’re pretty far away from your typical public health beneficiary,” he said. “They might say, ‘Oh yes, I know some people with disabilities.’ Yes, they might know a few. But I am one step away from them, and I bring them with me. That’s the story \[CareQuest Institute\] helped us tell.” This work led to Texas legislators passing a bill in 2021, which added a preventive dental benefit for Texans enrolled in Medicaid. CTD and other organizations in the state are now working to help implement those benefits. CareQuest Institute continues to support CTD’s work through grant funding, with the most recent grant, “Expanding Dental Services for Adults with Disabilities, Year 5,” in the amount of $73,858. ## The Drive to Help People with Disabilities Borel has a history of working with disadvantaged populations. When he was serving in the Peace Corps, he spent two years in a third-world country teaching children skills to become self-reliant and self-sufficient. He has worked for small volunteer fire departments and an alternative school for dropouts to give them a second chance. “I’ve worked with all these at-risk populations, these disadvantaged groups,” says Borel. “And when I came to \[CTD\] I realized I found a group that was even more disadvantaged than low-income minority dropout youth, and that’s individuals with disabilities. That has resonated with me.” He said that people with disabilities generally have a [lower income](https://www.nolo.com/legal-updates/social-security-and-ssi-disability-and-benefit-amounts-for-2022.html), have a [higher unemployment rate](https://www.bls.gov/news.release/pdf/disabl.pdf#:~:text=In%202022%2C%2021.3%20percent%20of%20persons%20with%20a,up%20from%2063.7%20percent%20in%20the%20prior%20year.), and are less likely to own their own [vehicle](https://www.bts.gov/sites/bts.dot.gov/files/2022-01/travel-patterns-american-adults-disabilities-updated-01-03-22.pdf) or [home](https://thearc.org/policy-advocacy/housing/), compared to people who don’t have disabilities. “They’re more likely to die prematurely, not from their disability, but from substandard health care,” he said. “Their very civil right to exist free from discrimination based on their disability wasn’t even acknowledged until 1990 with the passage of the Americans with Disabilities Act. And that discrimination still lingers to this day. That’s why this is important work.” Along with adding a preventive dental benefit for Texans enrolled in Medicaid, CTD has also supported [legislation to authorize teledentistry in Texas](https://www2.aaoinfo.org/texas-dental-board-enacts-strong-new-teledentistry-regulations%EF%BF%BC/#:~:text=Among%20other%20requirements%20on%20teledentistry,the%20same%20or%20similar%20circumstances.). That bill passed in 2021, which was another big win for people with disabilities. “What if that dentist had never met this patient and was just told, ‘Okay, this is a patient who has a disability’?” Borel said. “How valuable is it to have had a teledentistry meeting ahead of time so that dentists can actually visually assess what kind of accommodations would be needed in the dental clinic?” Borel said CTD’s goal is to continue to make more progress to improve access to care for people with disabilities in the state, from education to transportation to medicine to voting rights. “Just think of access, and the whole idea is to have a self-directed life so people can choose the community they live in and have enough support to do that,” Borel said. “So, basically, equality.” **Categories:** Blog **Tags:** Health Equity, Special Patient Care --- ### [Advocacy in Action: How OPEN’s Virtual Hill Day Is Catalyzing Congressional Change](https://carequest.org/blog/advocacy-in-action-how-opens-virtual-hill-day-is-catalyzing-congressional-change/) **Published:** November 7, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/11/OPEN-Virtual-Hill-Day-Photo.jpg)Screenshot from OPEN Virtual Hill Day By the numbers, OPEN’s Virtual Hill Day was a great success. There were more than 100 oral health advocates and Oral Health Progress and Equity Network (OPEN) members representing 37 states. Congressional staff from 59 Senate offices and 43 House offices also attended. They had one goal, together, of creating an oral health care system that is equitable, accessible, and affordable. But the real success, the change, came after the event in mid-September, with action from two senators just a month later. On the heels of Hill Day, Senators Ben Cardin (D-MD) and Cory Booker (D-NJ) sent a letter to the Health Resources & Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC), requesting a plan to expand their oral health grant programs. That plan would expand the agencies’ programs evenly to all states, including an expansion of existing grant programs that would improve access to oral health care for people in need across the US. Senators Chris Van Hollen (D-MD), Debbie Stabenow (D-MI), Richard Blumenthal (D-CT), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), and Jeffrey Merkley (D-OR) also signed the letter and met with OPEN members from their state as part of Hill Day. ## Bringing Advocates Together Through OPEN OPEN is made up of people and organizations from across the US whose goal is to integrate oral health into overall health and make health care equitable, accessible, and affordable for everyone. CareQuest Institute supports the network. “Our aim was to bring unique and varied stakeholders together to really effect change,” said Bianca Rogers, MBA, a project manager for CareQuest Institute. “Events like this help energize advocates and light the fires we need to continue this challenging and meaningful work.” Senator Cardin, who referenced the tragic story of Deamonte Driver, a 12-year-old boy from Maryland who tragically died after a tooth infection, received the Oral Health Advocate of the Year Award as part of OPEN’s Hill Day. Senator Cardin talked about Driver’s legacy and the fight to expand children’s dental benefits in Maryland. Senator Cardin also thanked OPEN for its work in expanding the Children’s Health Insurance Program (CHIP), under Medicaid, to include a pediatric dental benefit as an essential health service under the Affordable Care Act. OPEN advocates responded by highlighting three policy changes to senators and representatives that they’d like to see: 1\. The first was a call to action to support the Healthcare Extension and Accessibility for Developmentally Disabled and Underserved Population (HEADs Up) Act (H.R. 3380). Individuals with intellectual and developmental disabilities face significant disparities in health outcomes and accessing health care, including oral health. The act recognizes individuals with intellectual and developmental disabilities as a medically underserved population, expanding their access to vital health programs. 2\. The second request to legislators was aimed at broadening dental care services for veterans with chronic conditions, like heart conditions and diabetes. Advocates presented data showing the strong connection between oral health and chronic conditions to explain the need for preventive dental care. They showed how this approach could lead to substantial savings for the Veterans Health Administration and emphasized that investing in dental care could result in healthier lives and reduced medical costs for veterans. 3\. The third request focused on the need for legislators to appropriate funds to support [HRSA Oral Health Workforce](https://www.hrsa.gov/grants/find-funding/HRSA-22-050) and [CDC Oral Health Cooperative Agreements](https://www.cdc.gov/oral-health-funded-programs/funding/index.html?CDC_AAref_Val=https://www.cdc.gov/oralhealth/funded_programs/cooperative_agreements/index.htm) in every US state and territory. The people in states that already receive this funding have easier access to oral health services, but the grants are only available to a handful of states, leaving many people in many regions without essential oral health services because of inadequate support. ## The Critical Work of Advocating for Oral Health The success of OPEN’s Virtual Hill Day and the letter from Senators Cardin and Booker is a clear example of how the power of advocacy and speaking directly with congressional representatives can lead to change. ![](https://carequest.org/wp-content/uploads/2023/11/Hill-Day.png)Screenshot from OPEN Virtual Hill Day Kerri Dittrich, a public health dental hygienist at Elkhorn Logan Valley Public Health Department in Nebraska, shared her experience and explained the importance of the planned meetings. “This was my first opportunity to participate in OPEN Hill Day, and it was such a great experience,” she said. “I was thankful that they allowed me to speak specifically about my areas of oral health advocacy and expertise.” Not only did personal advocacy efforts empower OPEN members like Dittrich to speak directly to policies impacting their communities, but it also allowed them to bring their views and research to the forefront of legislators’ attention. “I will definitely be participating in this event in the future,” Dittrich added. **Categories:** Blog **Tags:** Dental Coverage --- ### [Unique Oral Health Needs Among Elderly Individuals](https://carequest.org/blog/unique-oral-health-needs-among-elderly-individuals/) **Published:** November 20, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2023/11/Dental-Appointment.jpg)More than [65 million people](https://www.carequest.org/resource-library/uninsured-and-need) nationwide count on Medicare for their health care, including senior citizens once they turn 65 and many adults with disabilities. However, this health program doesn’t include comprehensive dental care, a gap that pushes oral health care out of reach. This gap is especially harmful for seniors who live on limited incomes, in rural communities, or who face systemic racial inequities. Simply put, it worsens their overall health and well-being. Advocates and lawmakers can help. They can alleviate some of the challenges elderly individuals and others face in accessing oral health care by advancing legislative change. How? Enhancing Medicare with dental coverage is one important policy solution. Another is adding adult dental benefits to Medicaid, which is also a lifeline for millions of adults with low incomes. Let’s start, though, by highlighting the importance of oral health for older adults. ## The Importance of Oral Health for Seniors America’s elderly are predisposed to more health challenges than younger people. [More than half](https://www.carequest.org/resource-library/beyond-nice-smile) of older adults live with at least two chronic conditions. Lacking equitable access to dental care compounds the harm of systemic disease and can increase seniors’ risk of life-altering diagnoses: - Untreated gum disease can [make it harder](https://www.carequest.org/resource-library/beyond-nice-smile) to manage chronic illnesses like diabetes and high blood pressure. - Adults with poor oral health, including tooth loss, are more likely to develop [Alzheimer’s disease](https://www.carequest.org/resource-library/beyond-nice-smile) and face memory problems. - Dental disease can also place seniors at greater risk of [developing cancer](https://www.carequest.org/resource-library/beyond-nice-smile), including in the mouth, breast, and prostate. Untreated dental disease and tooth loss is also tied to respiratory illness, [raising the dangers](https://www.carequest.org/about/press-release/carequest-institute-applauds-congressional-leaders-urging-expansion-dental) of COVID-19. Better access to oral health care could reduce these threats, benefiting elderly individuals’ overall health and quality of life. ## Dental Problems Facing the Elderly In the 2023 State of Oral Health Equity in America survey, CareQuest Institute for Oral Health researchers found that [68.5 million adults](https://www.carequest.org/resource-library/uninsured-and-need) lack access to dental insurance today. This study also revealed the extent of the gaps in dental insurance for senior citizens: - People [age 60 and older](https://www.carequest.org/resource-library/uninsured-and-need) are most likely to lack dental coverage among all other adults without this insurance. - [One in three](https://www.carequest.org/resource-library/uninsured-and-need) adults enrolled in Medicare go without dental coverage. Within the elderly population, challenges accessing dental care and the resulting burden of disease can be uneven. Additional CareQuest Institute research shows that the consequences fall hardest on adults confronting structural obstacles, such as geographic isolation, limited transportation, and systemic racism: - Overall, [7 in 10](https://www.carequest.org/about/blog-post/whats-next-oral-health-medicare-former-congressman-explains) seniors have gum disease while [one in five](https://www.carequest.org/about/blog-post/whats-next-oral-health-medicare-former-congressman-explains) has untreated tooth decay. - [One in five seniors](https://www.carequest.org/about/press-release/carequest-institute-applauds-congressional-leaders-urging-expansion-dental) who live in a rural area has not visited a dentist in the last five years. - [More than one in four](https://www.carequest.org/about/blog-post/whats-next-oral-health-medicare-former-congressman-explains) seniors who are Black have lost all of their teeth. - Hispanic adults are [twice as likely](https://www.carequest.org/resource-library/uninsured-and-need) to have lost dental coverage in the past year than their white, non-Hispanic peers, making it more difficult to access care. ## How Legislative Change Can Improve Elderly Oral Health Current Medicare policy [limits access](https://www.carequest.org/about/press-release/carequest-institute-applauds-congressional-leaders-urging-expansion-dental) to necessary dental coverage for the elderly and people with disabilities. It leaves them without the ability to get needed care as they age, contributing to poor oral and overall health. Policymakers can [strengthen Medicare](https://www.carequest.org/about/press-release/national-oral-health-organization-praises-senate-inclusion-dental-medicare) by adding dental coverage to the program. In Congress, in 2021, Rep. Lloyd Doggett (TX-37) introduced the Medicare Dental, Vision, and Hearing Benefit Act. In March of this year, Senators Bob Casey (D-PA) and Ben Cardin (D-MD) elevated the legislation, which would enable more Medicaid and Medicare beneficiaries to [access comprehensive dental, vision, and hearing coverage](https://www.aging.senate.gov/press-releases/casey-cardin-bill-would-expand-medicaid-and-medicare-dental-vision-hearing-coverage). “Because of a patchwork of limited health care coverage options for Medicare and Medicaid beneficiaries, many older adults, people with disabilities, and low-income families have inconsistent access to basic dental, vision, and hearing services,” said Casey. “Cost should not be a barrier to care, and all Americans deserve access to comprehensive dental, vision, and hearing coverage, no matter what state they live in or how much money they make.” ## ![](https://carequest.org/wp-content/uploads/2023/11/Depressed-Elderly-Man-Web.jpg) Myechia Minter-Jordan, MD, MBA, and CEO and president of CareQuest Institute, [applauded this policy development](https://www.carequest.org/about/press-release/carequest-institute-commends-congressional-legislation-provide-oral-health-care), reiterating the integral link between oral and overall health. “Dental care is essential health care with direct connections to systemic health, chronic illness, and mental health diseases,” she said. Oral health care leaders and advocates for older adults can take action for continued progress. Talk with elected officials about the myriad benefits of strengthening Medicare with dental coverage. Some key points to raise include: - Tooth decay can [worsen chronic illness](https://www.carequest.org/resource-library/beyond-nice-smile) and raise the risk of other disease, but improving dental coverage would lead to better health for seniors and people with disabilities. - Black and Hispanic seniors, as well as rural adults enrolled in Medicare, [disproportionately go without](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) dental care. Strengthening Medicare with dental coverage would advance health equity. - This policy change would also [bring down health care costs](https://www.carequest.org/about/blog-post/whats-next-oral-health-medicare-former-congressman-explains). Among other evidence, one study estimates that providing dental care through Medicare could save [$63.5 billion](https://www.carequest.org/about/press-release/carequest-institute-applauds-congressional-leaders-urging-expansion-dental) in medical costs over a decade. Plus, this solution is widely supported. Polling shows that [8 in 10 voters](https://www.carequest.org/about/press-release/national-oral-health-organization-praises-senate-inclusion-dental-medicare) favor adding dental coverage to Medicare. ## Additional Solutions to Improve Access to Care In addition to Medicare, [the Medicaid program](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage) is a lifeline to millions of seniors and people with disabilities. More than 75 million people across the US count on this health care program, which is jointly funded by states and the federal government. While Medicaid guarantees dental coverage for children, these benefits end when young people turn 21. It is optional for state Medicaid programs to cover dental services for adults, and benefits [vary greatly across states](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). CareQuest Institute research from 2023 finds that: - [One in three adults](https://www.carequest.org/resource-library/uninsured-and-need) enrolled in Medicaid lacks dental coverage. - Another [14 million adults](https://www.carequest.org/resource-library/uninsured-and-need) may lose Medicaid dental coverage this year due to policy changes stemming from the end of the national COVID-19 Public Health Emergency in April 2023. - People with low incomes who don’t have dental coverage are [less likely](https://www.carequest.org/resource-library/uninsured-and-need) to have seen a dentist in the past year, increasing the risks of untreated dental disease. As the movement to strengthen Medicare coverage advances, advocates and policymakers must continue working to achieve comprehensive adult dental care in Medicaid. This aspiration would not be fulfilled overnight. Change can happen incrementally, and many policies and other structural factors shape adults’ access to care. Despite advocacy-driven victories [enhancing Medicaid](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) in several states, too many people are being left behind waiting for states to do the right thing. Congress [can act](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage) to ensure adults enrolled in Medicaid have comprehensive dental coverage. Polling shows that [65% of Americans](https://www.carequest.org/about/blog-post/three-reasons-why-adults-medicaid-need-dental-coverage) support this kind of legislation. Over time — and thanks to the work of tireless advocates and legislative champions — the US could ultimately become a place where we provide good dental coverage for all. ## The Urgent Need for Policy Change These two legislative solutions would significantly advance health equity and improve well-being for seniors and others who count on Medicare and Medicaid. In the wake of the COVID 19 pandemic, the need for change is urgent. Prior to the pandemic, dental care was already inaccessible for millions of seniors, people with disabilities, and adults with low incomes. Data from 2021 show that [one in four seniors](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) had not received dental care in over two years, well before the pandemic began. In addition to lacking coverage, seniors have cited the high hurdles of cost and inadequate transportation among their primary obstacles to getting needed care. Many of these challenges remain, as senior citizens still bear the ill effects of delaying dental care in the pandemic: - Medicare-enrolled adults put off [oral health care the most](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic) of any other health service due to COVID-19. - [Black seniors](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic) enrolled in Medicare delayed dental care amid the pandemic for a longer period than their peers in other racial groups, while they and their families were among the hardest hit by COVID-19. - [Fifteen million seniors](https://www.carequest.org/resource-library/many-older-adults-delayed-dental-care-during-pandemic) are economically insecure, a factor keeping care out of reach due to barriers of cost. [Experts are clear](https://www.carequest.org/resource-library/solutions-oral-health-inequities) that policy solutions like adding dental coverage to Medicare and Medicaid “could have a profound impact on reducing oral health inequities” that the COVID-19 pandemic deepened. Coverage opens the door to more affordable, regular dental care. It can help prevent oral disease and treat problems before they become emergencies. By moving these legislative priorities forward, we can expand access to dental care, reducing costs and supporting healthier lives for people with disabilities, adults with low incomes, and seniors. **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Amanpreet Kaur on Elevating Health Literacy](https://carequest.org/blog/voices-from-the-field-amanpreet-kaur-on-elevating-health-literacy/) **Published:** November 13, 2023 **Author:** Caitlin Locklear **Content:** Amanpreet Kaur first encountered the concept of health literacy — defined as the ability to find, understand, and use information and services to inform health-related decisions and actions — as a young college graduate. Although she had never heard the term before, it instantly made sense to her.![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg) “As a child of immigrant parents, I have been helping the adults in my life navigate life for as long as I can remember,” she says. “Through my childhood experiences as an interpreter and cultural broker, I was exposed to a variety of health topics, which helped me reduce personal stigma around topics that would also come up in health education coursework at school.” Now, health literacy is at the heart of her work. After earning her Master of Library and Information Science degree from Rutgers University, she joined the Leon Levy Dental Medicine Library at the University of Pennsylvania as its inaugural health literacy librarian in 2022. In February 2023, Kaur and a colleague launched the Health Literacy Study Club, a virtual discussion series facilitated by dental students. ![](https://carequest.org/wp-content/uploads/2023/11/Kaur-261x300.jpg)Amanpreet Kaur The club reads and discusses texts related to health literacy and patient education, with a particular focus on oral health and dental medicine. Participation is open to anyone who is interested; some dentists who practice overseas attend. The group also includes individuals outside of the oral health field, leading to fruitful conversations. A key theme of the club is engaging with patients outside the health care setting, a focus of a recent CareQuest Institute webinar, [Connecting to the Community: A Provider’s Work Beyond the Dental Chair](https://www.carequest.org/education/webinars/connecting-community-providers-work-beyond-dental-chair). Kaur attended the webinar and pointed to it as a source of ideas for future Health Literacy Study Club discussions. Below, Kaur shares more about the club and what she hopes it can accomplish. **When did you start the Health Literacy Study Club? What was the impetus?** In July 2022, Laurel Graham, the head of the Leon Levy Dental Medicine Library, introduced me to faculty and staff in the Community Health Oral Division. During this meeting, Dr. Joan Gluch, the division chief, brainstormed the idea of forming a journal club to further engage dental students with health literacy content outside of class. The idea intrigued me because I had previously led health literacy–related article discussions. While there are book, journal, and discussion clubs and groups at the University of Pennsylvania for a wide assortment of personal and academic interests, I did not know of a health literacy–focused one. In addition, when I shared information with the Institute of Healthcare Advancement’s (IHA) Health Literacy Solutions Center, I learned that this was a novel concept, which led to a poster presentation at the IHA Virtual Health Literacy Conference earlier this year. **How do you choose which texts to discuss? Can you share a few?** Dr. Gluch and I wanted to discuss both foundational and emerging research and best practices about health literacy and patient education, so we launched the club in February 2023 with a foundational article and a newer article to start the discussion. From March through May 2023, participants suggested articles and topics to discuss. Starting in September 2023, we have invited Penn Dental students to facilitate discussions using topics and articles of their choice. Articles that we have discussed thus far include: - [“Oral Health Literacy Levels Among a Low-Income WIC Population”](https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1752-7325.2011.00244.x) - [“Is the Information About Orthodontics on YouTube and TikTok Reliable for the Oral Health of the Public? A Cross Sectional Comparative Study”](https://doi.org/10.1016/j.jormas.2022.04.009) - [“The Evaluation of Chatbot as a Tool for Health Literacy Education Among Undergraduate Students”](https://pubmed.ncbi.nlm.nih.gov/34054328/) In November, we will be discussing an article titled, [“Barriers and Facilitators to Dental Care Access Among Asylum Seekers and Refugees in Highly Developed Countries: A Systematic Review.”](https://doi.org/10.1186/s12903-020-01321-1) **Can you describe the mix of people who participate and what draws them in?** In the registration list, there is usually a mix of Penn Dental faculty, staff, and students; students and staff from other parts of the university or adjacent health care system; and people from outside of Penn. We regularly have public health professionals from across the country along with dentists practicing overseas. We promote the Health Literacy Study Club via social media and via the Health Literacy Solutions Center. We are always looking for more participants and perspectives. As of September 2023, the Penn Dental Medicine’s Continuing Education Office is offering continuing education (CE) credits for participants and facilitators of the Health Literacy Study Club. **Will the club stay virtual?** We originally planned to start virtually and move to in-person or hybrid as the weather got warmer. However, we stayed virtual to accommodate participation from multiple time zones. **What is the ultimate goal — how do you hope the club will eventually benefit patients?** The original idea of the Health Literacy Study Club was to further engage dental students with health literacy content outside of class, and it turns out that there are many groups of people around the world who want to discuss oral health literacy issues and learn from each other. I hope that the participants of the Health Literacy Study Club will go on to improve their interactions with the patients and loved ones. For me, it’s given me some thought about what I can ask my hygienist, dentist, and orthodontist during my next appointment. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [The Five Most Popular CareQuest Institute Publications of 2023](https://carequest.org/blog/the-five-most-popular-carequest-institute-publications-of-2023/) **Published:** December 11, 2023 **Author:** Caitlin Locklear **Content:** - The prevalence of early childhood caries in American Indian/Alaska Native (AI/AN) communities is three times higher than for white children. - Black and AI/AN women are 2.9 and 2.5 times more likely, respectively, to die from pregnancy-related causes than non-Hispanic white women. - There is growing evidence that individuals who use electronic cigarettes (e-cigarettes) are at a higher risk for dental caries. These are just a few key findings from three of the most popular CareQuest Institute research reports published in 2023. ![](https://carequest.org/wp-content/uploads/2025/10/American-Indian-Family-Resized3.jpg) Throughout the year, CareQuest Institute produced more than 100 publications, from peer-reviewed journal articles to comprehensive white papers. These publications were all powered by state- and national-level representative data sources, including health care claims data, integrated medical-dental databases, and surveys of health care experiences. The research uncovered provocative trends in the oral health care system that spur and support the development of evidence-based, person-centered strategies for care and new value-based financing models. In 2023, our research garnered about 175,000 page views — more than doubling the total from 2022. Based on popularity, these are the five top publications of the year: 1\. [Clearing the Air: The Relationship Between Electronic Cigarette Use, Vaping, and Oral Health](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health) (January) Although presented as a safer alternative to tobacco, e-cigarette use is associated with a variety of health risks, according to [this visual report](https://www.carequest.org/resource-library/clearing-air-relationship-between-electronic-cigarette-use-vaping-and-oral-health). The report explains how individuals who use e-cigarettes are significantly more likely to report having periodontal (gum) disease compared to those who do not smoke or use other nicotine products. E-cigarette use is linked with signs of periodontal disease such as increased plaque, deeper periodontal pockets around the teeth, and bone loss. **Spotlight statistic:** Individuals who use e-cigarettes are significantly more likely to report having periodontal (gum) disease compared to those who do not smoke or use other nicotine products. 2\. [Addressing the Oral Health Needs of Hispanics in the US](https://www.carequest.org/resource-library/addressing-oral-health-needs-hispanics-us) (May)![](https://carequest.org/wp-content/uploads/2023/12/Girl-Smiling.jpg) Disparities in oral health particularly impact communities of Latinos, who now represent nearly 19% of the US population. In [this comprehensive two-part white paper](https://www.carequest.org/resource-library/addressing-oral-health-needs-hispanics-us), the Hispanic Dental Association, in partnership with CareQuest Institute, identifies several key policies that can improve oral health and reduce inequalities among Hispanics in the US. The report also analyzes the use of dental services and evaluates Hispanic representation within the dental workforce. **Spotlight statistic:** On average, less than half of Hispanic children from 12 to 19 years of age had one or more dental sealants, with few racial/ethnic differences. 3\. [Dental Danger: Home Remedies to Avoid When Awaiting Care](https://www.carequest.org/resource-library/dental-danger-home-remedies-avoid-when-awaiting-care) (May) [This visual report](https://www.carequest.org/resource-library/dental-danger-home-remedies-avoid-when-awaiting-care) finds that half of adults who experienced an oral health problem in the last 12 months used a home remedy for the problem — a decision that isn’t always safe. Some of the dangerous home remedies included pain medication prescribed for another purpose, illegal narcotics, a needle to lance a gum abscess, and alcohol. The report emphasizes the importance of having a regular dentist for ongoing prevention and treatment, so patients don’t turn to these potentially harmful solutions to treat tooth pain. **Spotlight statistic:** Individuals who identified as Black (62.4%) or as two or more races/ethnicities (60.0%) reported that they used a home remedy for oral health symptoms more often than individuals identifying as white (49.5%), Hispanic (45.5%), Asian (42.9%), or “other” (47.6%). ![](https://carequest.org/wp-content/uploads/2023/12/Pregnant-Woman-Exam.jpg)4. [Addressing the Role of Oral Health in Maternal Mortality and Pregnancy Outcomes](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes) (April) Both maternal mortality and preterm birth rates have increased in the United States during the last three years. Even more alarming, those rates are especially high for people of color. In [this visual report](https://www.carequest.org/resource-library/addressing-role-oral-health-maternal-mortality-and-pregnancy-outcomes), CareQuest Institute examines the worsening state of maternal and infant health in the US, highlighting the importance of communication between dentists and patients regarding oral health risks during pregnancy. **Spotlight statistic:** Black women with a completed college education or higher have maternal mortality rates 1.6 times that of white women with a high school degree or less experience. 5\. [American Indian and Alaska Native Communities Face a “Disproportionate Burden of Oral Disease” ](https://www.carequest.org/resource-library/american-indian-and-alaska-native-communities-face-disproportionate-burden-oral)(March) The prevalence of early childhood caries in AI/AN communities is three times higher than for white children — just one stark finding from this white paper. The white paper, a collaboration between CareQuest Institute and native-led organizations based on data from the State of Oral Health Equity in America survey, explores ongoing disparities, their causes, and possible solutions. Those solutions, the authors write, must be grounded in diversity, equity, inclusion, and justice. **Spotlight statistic:** Three and a half times as many people who identify as AI/AN report going to the emergency department for dental care or mouth pain in the last year (13.5%) compared with those who do not identify as AI/AN (3.9%). To explore other reports, white papers, poster presentations, and infographics on topics ranging from medical-dental integration to minimally invasive care, visit our [Resource Library](https://www.carequest.org/resource-library). **Categories:** Blog **Tags:** Health Equity --- ### [The Relationship Between Oral Health and Heart Disease](https://carequest.org/blog/the-relationship-between-oral-health-and-heart-disease/) **Published:** December 18, 2023 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/10/Senior-Man2-.jpeg)Oral health is often viewed in isolation, yet its impact extends far beyond the mouth. Oral health can hurt the heart. [Emerging research](https://www.carequest.org/resource-library/heart-matter) has established a concerning link between oral health and heart issues. Gum disease, for example, can trigger cardiovascular problems and increase the risk of having a heart attack. Tooth decay and other oral infections in childhood can contribute to atherosclerosis (clogged arteries) in adulthood. These risks can especially hurt older adults. [A majority of seniors](https://www.carequest.org/resource-library/beyond-nice-smile) have a chronic illness, such as heart disease, which can worsen with poor oral health. However, millions of older adults can’t get needed dental care because Medicare doesn’t include oral health coverage. Health industry leaders and policymakers can reduce the harms of dental and heart disease in many ways. How? First, let’s explore why oral health and hearth disease are connected. ## Understanding the Link Between Oral Health and Heart Disease Poor oral health, including gum disease, causes bacteria to grow in our mouths. These germs can enter our bloodstream and travel to other parts of our body, risking our systemic health in the process. When bacteria from our mouth reaches our heart, [they can cause inflammation](https://penndentalmedicine.org/blog/gum-disease-and-heart-disease/). Oral bacteria has been linked to dangerous conditions affecting cardiovascular and brain health. - Inflammation from dental bacteria can lead to infections of the heart lining, called endocarditis. - Oral bacteria can lead to clogged arteries and heart attacks. - Dental disease can also increase an adult’s risk of having a stroke. While poor oral health may not be the [sole cause](https://www.health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease) of these threats, research shows other strong connections between our oral hygiene and heart health: - People with gum disease are [28% more likely](https://www.colgate.com/en-us/oral-health/heart-disease/how-oral-health-and-heart-disease-are-connected) to suffer a heart attack than those without dental problems. - Poor oral health is a [risk factor](https://www.carequest.org/resource-library/getting-heart-it) for human papillomavirus (HPV) infection, which can make us more susceptible to having a [heart attack](https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.313779). Maintaining good oral health — and ensuring everyone has access to good oral health — can reduce these risks, protecting our heart and overall health. ## Oral Health and Heart Disease in Older Adults The influence of our oral health on our heart takes shape early in life. Researchers of a 2019 study [concluded](https://www.carequest.org/resource-library/getting-heart-it) that “childhood oral infections may be a modifiable risk factor for adult cardiovascular disease.” That is, having dental disease as a child may be tied to [having clogged arteries](https://www.carequest.org/resource-library/getting-heart-it) as an adult. The risks and complications of poor oral health get worse as we get older: - People who can’t access dental care as teens or young adults are [more likely](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit) to have high blood pressure later in life. - Compared to those with better oral health, people with gum disease have a [greater risk of heart attack](https://www.carequest.org/resource-library/getting-heart-it). - People with gum disease are [three times more likely](https://www.carequest.org/resource-library/heart-matter) to have a stroke that could impair their vision and other bodily functions. Greater access to dental coverage to help people afford care could improve adults’ gum health, lowering their risk of heart disease and stroke. ## Adding Dental Coverage to Medicare Would Improve the System and Save Money Even though the risk of having a heart condition increases as we age and the threats of untreated dental disease are well known, many seniors nationwide do not receive the necessary dental care: - Access to dental care [dramatically decreases](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker) for older adults because Medicare does not include dental benefits. - Dental coverage also varies within [Medicare Advantage](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit) plans. In 2021, advocates and legislative champions came [closer than ever](https://www.health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease) to strengthening Medicare by adding dental benefits. At that time, federal lawmakers were striving to advance this change as part of an infrastructure spending bill. While dental benefits were ultimately excluded from the final legislation, and today’s political climate has stalled progress, research shows this solution provides [clear gains.](https://www.carequest.org/resource-library/heart-matter) A recent CareQuest Institute analysis of Medicare data revealed that adding dental benefits to Medicare would improve the health system and strengthen care for patients. - More than [42% of adults](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit) enrolled in Medicare have at least one heart condition. - If Medicare included comprehensive dental benefits, it could save the health care system up to [$27.8 billion each year](https://www.carequest.org/topics/medical-dental-integration) for adults with heart disease. - Health system [savings would grow](https://www.carequest.org/resource-library/mouths-matter-more-you-may-know) as more Medicare-enrolled adults received gum disease treatment. As CareQuest Institute researchers [summarized](https://www.carequest.org/resource-library/another-billion-reasons-medicare-dental-benefit), adding dental benefits to Medicare holds incredible promise to create “a ‘win-win’ result,” reducing costs while improving patient health. ## Other Ongoing Solutions to Promote Better Health for All As health industry leaders, advocates, and lawmakers continue pressing for progress in Medicare, [other approaches](https://www.carequest.org/about/blog-post/barriers-care-are-driving-oral-health-disparities-these-four-solutions-can-help) can also expand access to dental care. Here are three systemic solutions: **1. Strengthening Medicaid adult dental coverage.** Medicaid is a lifeline to many seniors with low incomes. While the program covers dental care for children, it is [optional for states](https://www.colgate.com/en-us/oral-health/heart-disease/how-oral-health-and-heart-disease-are-connected) to offer dental benefits to adults. Among the states that offer adult coverage, [it varies widely](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). Like strengthening Medicare, making dental services more accessible to older adults with low incomes would improve their oral health and [generate cost savings](https://www.carequest.org/about/blog-post/barriers-care-are-driving-oral-health-disparities-these-four-solutions-can-help). **2. Expanding teledentistry.** Today, virtual technology is connecting people to oral health care. One success story comes from North Carolina, where a Federally Qualified Health Center (FQHC) used teledentistry to deliver care to [1,200 students](https://penndentalmedicine.org/blog/gum-disease-and-heart-disease/) in one year. It helped overcome [access barriers](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina) confronting local families, including being uninsured, having low incomes, or lacking transportation. Leveraging teledentistry in more communities could further expand access to care for. **3. Increasing medical-dental integration (MDI).** For adults who don’t regularly see a dental provider, but visit a doctor, MDI is a proven strategy to support oral health. MDI incorporates oral health into primary and behavioral health care, empowering providers in those fields to conduct oral health assessments and talk with patients about dental hygiene. Dental and medical professionals can also build relationships to develop a [referral network](https://www.carequest.org/how-we-work/health-improvement-programs/more-care) for patients needing greater levels of care. By adopting these diverse strategies to increase access to dental care, we’d see cost savings across the health system — and, more importantly, older adults would see improvements in oral, heart, and overall health. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Up to the Challenge: Finding New Ways to Expand Access to Care in Oregon](https://carequest.org/blog/up-to-the-challenge-finding-new-ways-to-expand-access-to-care-in-oregon/) **Published:** January 2, 2024 **Author:** Caitlin Locklear **Content:** As Operations and Policy Analyst I at the Oregon Health Authority (OHA), Vesna Hopkins has the goal of helping Oregonians get better access to oral health care. “As a dental analyst, my boss says, ‘Challenge me. Give me ideas. Tell me how do you want to improve dental health for Oregonians, and let’s talk about it,’” Hopkins says. “So, I’m in a position to have the freedom to simply say, ‘It’s my educated opinion that Oregonians need help in dental here or here.’” The OHA is a government agency that oversees most of Oregon’s health-related programs, including the state’s Medicaid program, which provides coverage for 1.5 million Oregonians. Hopkins is on the team that handles the dental part of the program — even though she’s not trained as a clinician. “I’m not a dentist,” Hopkins says. “I’ve never been in a dental or dental hygienist role.” But Hopkins does have a strong dedication to serving Oregonians. She worked for the Oregon Department of Human Services for 15 years before her job at OHA, and she loves to learn. She takes it upon herself to learn as much about oral health care as she can, including investing her time in CareQuest Institute education. “Being in a position now to handle a dental program, I feel that CareQuest Institute’s webinars are very valuable to me so I can learn as much as I can about dentistry,” Hopkins says. “So then when I’m supposed to make decisions regarding our dental program, I am more informed and knowledgeable.” ## Diving into Oral Health Care Education Hopkins attended the CareQuest Institute webinar “[Managing Dental Caries: Evolving Strategies and Proven Techniques](https://www.carequest.org/education/webinars/managing-dental-caries-evolving-strategies-and-proven-techniques)” back in August. (The education from the webinar is the foundation of a [new self-paced course](https://www.carequest.org/education/course/managing-dental-caries-evolving-strategies-and-proven-techniques-0/overview).) In the webinar, experts explored the importance of avoiding a “one-size-fits-all” approach to caries management and shared guidance on nonsurgical and nonrestorative protocols and implementation. ![](https://carequest.org/wp-content/uploads/2025/10/Dental-Office.jpg) Hopkins says she learned a lot of valuable information about preventive care. “In my mind, any prevention is much better than fixing a problem once it appears,” Hopkins says. “So, I think we should work on approving all the possible preventive procedures that exist and are out there, versus waiting for a problem to happen.” She also found value in the research articles experts shared during the webinar and put them to immediate use at OHA, helping to emphasize the importance of preventive care. For example, right now, teeth cleanings are only covered once a year for adults enrolled in Medicaid. “I can say, ‘That’s not enough,’” Hopkins says. “My argument would be: Based on my classes I’ve taken through CareQuest Institute on prevention, based on my continuing education, based on my research articles that I’ve read, I think it \[preventive care\] should be done \[more frequently\] at any time.” ## Increasing Access to Oral Health Care at OHA During Oregon’s legislative sessions, Hopkins will analyze five bills involving oral health care, exploring how they will affect Oregonians. If they pass, she will update the codes accordingly. Hopkins also has a hand in helping create policy changes for people enrolled in Medicaid. One of the policy changes that Hopkins helped make was OHA providing coverage for [people under 21 years old who are enrolled in Medicaid and have handicapping malocclusions](https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1711) (crooked, crowded, or protruding teeth that affect appearance, speech, and/or the ability to eat) to get braces. That change became effective at the beginning of 2023. “Braces are not something that most states cover,” Hopkins says. “So I was happy that I was involved in a bill that we’re going to implement that is going to cover some braces for people who are really struggling. It affects their whole body, not just their mouth. It trickles down to other issues.” During the nonlegislative session, in January and October, Hopkins researches Oregon’s dental codes and reimbursements to see if they are comparable to those of other states. She also talks to local dentists and orthodontists to see what private insurance companies are paying. If the reimbursements are not comparable, Hopkins and the rest of the OHA team determine what a comparable rate or change would be and what Oregon can afford to pay, then they make an effort to readjust the dental codes. That includes explaining to the legislature how this change would affect Oregonians and getting feedback from the public. One dental code she is currently working to change involves dentures. Oregon’s current Medicaid coverage allows a person to get new dentures every 10 years. But Hopkins discovered that many people needed new dentures long before that. “In my research, speaking to denturists, I found out that a lot of dentures are being stolen. . . . Dentures are so expensive, and new ones are only made once every 10 years, and people don’t have access to them,” Hopkins says. “Not to mention, physiologically, people’s mouths and bites and faces change within 10 years, especially in adult years.” With that information, Hopkins suggested to her boss that Oregonians who need dentures should be able to get new ones every 5 years, instead of 10. “That’s how I get challenged. That’s how I make oral health better,” Hopkins says. “Based on my knowledge, and my information, and based on the research I did, and based on my awesome boss who allows me to challenge him on stuff like that, now all the Oregonians who need dentures would have them in 5 years instead of 10 years.” Examples like that, examples of fighting for the best oral health care interests of Oregonians, are challenges she fully accepts. “Because, in the end, it’ll be much cheaper for anybody to provide preventive care versus dealing with a cavity,” she says. “Filling a cavity is $1,200, versus a preventive topical application of fluoride is $3 or $5. So, in my mind, I have an excellent argument.” **Categories:** Blog **Tags:** Dental Coverage --- ### [Voices from the Field: Raydiance Swanston After a Year of Transforming Oral Health](https://carequest.org/blog/voices-from-the-field-raydiance-swanston-after-a-year-of-transforming-oral-health/) **Published:** January 29, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2025/09/VoicesLogo_0-300x300.jpg)In late 2022, Raydiance Swanston, MPH, CHES, was eager to bring the [Community Oral Health Transformation (COrHT) program](https://www.carequest.org/how-we-work/health-improvement-programs/corht) to the Mecklenburg County Pediatric Clinic in North Carolina. CareQuest Institute [talked to Swanston](https://www.carequest.org/about/blog-post/voices-field-health-program-manager-raydiance-swanston-reimagining-oral-health-her) at that time to discuss her expectations and why she felt the program — which provides a framework for safety net dental clinics to help transform oral health care delivery — was an ideal fit for her clinic. One year later, how are things going? We followed up with Swanston to hear more about her experience and how the program has helped the clinic to break down barriers and expand access to even more people in the community. The Mecklenburg clinic is one of 14 safety net dental clinics across North Carolina that have participated in COrHT, forming a learning community that has worked to redefine what efficient, equitable oral health care looks like. COrHT focuses on prevention, minimally invasive care, and integrating medical care into oral health care, with the goal of making it more accessible for everyone. Below, Swanston shares her learnings: ![](https://carequest.org/wp-content/uploads/2024/01/RaydianceHeadShot-300x300.jpg)Raydiance Swanston, MPH, CHES, Mecklenburg County Pediatric Clinic **How has your experience with COrHT benefited the clinic overall?** The clinic is really undergoing a transformation, moving toward more value-based care and integrated care. We’re already seeing how this is benefiting patients. We’re implementing caries risk assessments, are now checking patient vitals to determine if they need primary care, and screening and providing referrals for social determinants of health and food insecurity. Through COrHT, we’ve also been able to secure additional community partners to refer patients who may need more specialized care. For example, we don’t have nitrous oxide (laughing gas for sedation) at the clinic, so we would have to refer that out to another pediatric provider. **Have you seen any unexpected benefits from participating in the learning community?** Yes, it was somewhat of a surprise how much it has impacted our ability to recruit new providers. We found that even in the midst of a [workforce crisis](https://www.dentistryiq.com/practice-management/staffing/article/14299082/dental-practice-staffing-shortage-where-practices-are-struggling-the-most), our participation in COrHT was a big draw for dentists and dental hygienists interested in a more integrated, minimally invasive care approach. We even had providers from across the country hear about this and reach out. We now have four dentists, up from one-and-a-half a year ago. **You mentioned last year that one of your biggest goals was to expand the clinic’s dental care to include adults. Have you made progress toward that goal?** We’re very excited about this. Over the last year, we completed a feasibility study and determined what it would take to best help the county scale to offer adult dental care. And in the coming year, we’ll be launching a mobile program to service the entire community, including adults and kids. This is huge progress and wouldn’t have been possible without COrHT. Through COrHT, and with CareQuest Institute’s support, we were able to gather data and provide metrics to demonstrate to county leaders and decision makers that our goals made sense. It allowed us to have a stronger voice in the community and build consensus among people not as familiar with dental \[care\] disparities. **What were some of the challenges you faced when trying to make large organizational changes?** Naturally, it was a little bumpy in the beginning. It’s hard to change a program that has been running exactly the same for 25 years, including the same technology. So, there was a learning curve, but everyone got there and now it has become more routine and our providers are very excited about it. This was my first experience working with COrHT and funders, and I knew bandwidth would be a challenge. But I have a lot of gratitude for CareQuest Institute for the support provided throughout the year. **What is your reaction when you see your clinic expanding access to care in so many ways?** I’m so excited to see the mobile clinic coming to fruition and to have an opportunity to bring something significant to a community that wouldn’t typically have accessible and affordable dental care. We’ll be starting in schools and, when schools aren’t in session, going to community resource centers, community engagement events, and health and wellness events. It’s going to be everywhere, and we’ll also be serving adults. We’ll also be tackling teledentistry this year. Now that we have the mobile unit, we know we need to utilize opportunities to connect with people who can’t drop what they are doing and come to the clinic for emergencies. So, we’ll be working with our IT department to make sure our technology supports it. **Do you have any advice for future participants in oral health learning communities?** I would say to really participate and engage with the learning community, which has been a great support and resource. I always tried to engage in the community calls, to help others learn from what we did, and share the wins and challenges. I would also say to anyone starting out that it’s okay to not solve everything right away. **Categories:** Blog **Tags:** Health Equity, Value-Based Care --- ### [Providing Equitable Care to Special Populations in North Carolina](https://carequest.org/blog/providing-equitable-care-to-special-populations-in-north-carolina/) **Published:** February 13, 2024 **Author:** Caitlin Locklear **Content:** Early in his career, Bill Milner, DDS, MPH, realized that special populations — especially people with intellectual and developmental disabilities and the elderly — are often left behind when it comes to accessing oral health care. “There has been a gap in services in dentistry that we knew back in the 1980s had to be filled,” says Milner. “Dentistry had no answer for folks that we now serve. We thought, ‘Why not provide the same quality care to those with intellectual and developmental disabilities or the elderly, who may not be able to afford it?’” ![](https://carequest.org/wp-content/uploads/2024/02/007_access_dental_unload_sam_3574-scaled.jpg)Three dental team members examine patient’s mouth So, with the help of his chief operating officer, Betsy White, RDH, Milner started [Access Dental Care](https://www.accessdentalcare.org/) in North Carolina in 2000. The nonprofit organization provides oral health care services for residents in retirement communities, those with intellectual and developmental disabilities in nursing home facilities and group homes, participants in Programs for All-Inclusive Care for the Elderly (PACE), those in the Central North Carolina Health Network HIV/AIDS program, and other people in the community. “You can’t treat these patients in volume,” White says. “You can’t treat these patients based on diagnosis because they’re all different. You can’t put these folks in a box and shepherd them through a dental procedure or dental care.” CareQuest Institute for Oral Health is one of more than a dozen organizations that provides grant funding to support Access Dental Care’s efforts to offer oral health care to special populations. CareQuest Institute also supported the organization in the [Community Oral Health Transformation (COrHT)](https://www.carequest.org/how-we-work/health-improvement-programs/corht) Initiative in 2023, a learning community that focused on the implementation of [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) and [value-based care in oral health](https://www.carequest.org/topics/value-based-care). ![](https://carequest.org/wp-content/uploads/2024/02/Bill-Milner-Professional-Email-200x300.jpg)Bill Milner, DDS, MPH, Access Dental Care Founder “It was a great year of being able to network with other like-minded professionals or dental professionals within North Carolina,” White says. Through collaboration and networking, COrHT enabled teams to share insights and experiences to support each other. White and Milner were peer mentors to other clinics, since Access Dental Care had been providing care for special populations and using teledentistry for years prior to joining the initiative. Work with the Institute also helped the organization record value-based services that Access Dental Care hasn’t always had a way to track. “We were able, as a unique population, to be able to gather that data with the care coordination, with caries risk assessments,” White says. “And now we’re going to carry that forward and use that data to be able to say, ‘Okay, here’s the work it takes. Here’s the man hours that it takes to do this work. And here’s what we need to be reimbursed for that.’” It was a great year for other reasons, too, as Access Dental Care won multiple awards for its work. More specifically, Milner won the [ADA’s 2023 Humanitarian Award ](https://adanews.ada.org/ada-news/2022/december/2023-humanitarian-award/)and Access Dental Care was given the [2023 Helen C. “Holly” Riddle Award](https://nccdd.org/news-media/in-the-news/1426-advocacy-and-leadership-awards-recipients-2023.html) from the North Carolina Council for Developmental Disabilities. “There is such a pride in being able to do something that nobody else can do in dentistry,” Milner says. “We really feel responsible to dentistry at large to make sure that things are done correctly because we know we’re in the spotlight.” ## Mobilizing Oral Health Care ![](https://carequest.org/wp-content/uploads/2024/02/001_access_dental_unload_sam_3394-scaled.jpg)Dental team members carry out mobile equipment Access Dental Care has five teams comprising a dentist, a dental hygienist, and two dental assistants, and the organization brings in portable equipment. “We have all the bells and whistles that any dental office would have, and we move two operatories’ worth of dental equipment in,” Milner says. “We see 15 to 18 patients a day. We do all the good work, and then we load it up at the end of the day and come back to home base.” Their patients don’t fit into the routine of traditional dentistry: Some patients can’t drive themselves to their dental appointment, so they need a family member or friend to take them. Some are in wheelchairs and can’t transfer themselves into a dental chair, which can challenge some practitioners. “Or on the behavioral side of it, somebody with dementia or somebody with autism that doesn’t immediately respond when you say, ‘Hey, open your mouth,’” White says. And typically, the medical histories of these populations are complex. “Our average older adult is on about 14 different medications, and that can be a little nerve-wracking to a private practitioner,” White says. For Milner and White, they say their work relieves stress from caretakers. “They’ve been to dentists, and they come into our program, and we just say, ‘OK, get in the chair. No big deal,’” Milner says. “And they burst out in tears. These families are under stress that we have no concept of.” ## ‘Serving the Needs of North Carolinians’ White says one way Access Dental Care has been successful in their practice is by using teledentistry. [CareQuest Institute awarded a grant to Access Dental Care in 2022](https://www.carequest.org/content/g-2109-17201) to test the effectiveness of teledentistry compared to having a dentist onsite. ![](https://carequest.org/wp-content/uploads/2024/02/Betsy-Professional-Headshot-2-2023-scaled.jpg)Betsy White, RDH, Access Dental Care Chief Operating Officer “It did work,” White says. “We were able to determine that \[teledentistry\] was an effective mode of treatment.” The results were [published in *The Journal of the American Dental Association*](https://www.sciencedirect.com/science/article/abs/pii/S0002817724002666?dgcid=author) in June. Now, Access Dental Care is getting ready to present a $10.3 million plan to its board to add six special care clinics in North Carolina. Milner says they also want to train dental students to be a part of their team. “We still need about five to six more teams in North Carolina that will travel out as far as an hour and a half a day,” Milner says. “But we are going to continue to simply just serve North Carolina to be able to provide everything to this population.” Milner and White’s team have also started up a new division called Access Dental Solutions, which would help other teams across the country start their own programs to help special populations. They will continue to serve as a mentor, as they did throughout their time in COrHT. But to keep successfully doing their work, they need the funding. “We’re dealing with [Medicaid rates](https://www.carequest.org/resource-library/medicaid-adult-dental-benefits-offered-specific-beneficiary-groups) right now that are about $0.34 on the dollar,” Milner says. “And we’ve just got a fabulous group in Raleigh that is being an advocate for dental Medicaid, but it’s at the same rate that we used to be reimbursed in 2008.” Despite these growing challenges, Milner says his Access Dental Care team is ready to continue to help as many people as they can. “We’ve been around 24 years, and I think we’ll be around a little bit longer,” he says. “And part of that is we need the money to be able to do the good work, but also we’re very conscious of how to run a business, how to run a larger organization, and how to be able to serve the needs of North Carolinians.” **Categories:** Blog **Tags:** Health Equity, Special Patient Care --- ### [Overcoming Barriers to Oral Health Care Access in Tanzania](https://carequest.org/blog/overcoming-barriers-to-oral-health-care-access-in-tanzania/) **Published:** February 20, 2024 **Author:** Caitlin Locklear **Content:** Katanta Simwanza, DDS, knows what it’s like to not have access to oral health care. “Growing up, I was surrounded by a high prevalence of dental diseases within my community where oral health services were scarce,” Simwanza says. “I, and many other children and elders alike, personally experienced the pain of dental abscesses and oral health diseases.” These experiences growing up in Tanzania pointed him toward pursuing a career in health — specifically oral health. ![](https://carequest.org/wp-content/uploads/2024/02/WEKEZA16Days4-19-scaled.jpg)Katanta Simwanza, DDS, speaks into microphone “I was also greatly influenced by my uncle who was a doctor himself and had used his profession to make people’s lives better,” Simwanza says. “I wanted to emulate that.” Simwanza has now made it his mission to help people in his country access oral health care — as a development and public health specialist with more than 15 years of experience in dentistry. He has added the position of MC-Tanzania country manager for [MCW Global](https://mcwglobal.org/) (Miracle Corners of the World) to his list of accomplishments and is the first dentist to have this title in MCW’s history. Serving in that role, he met CareQuest Institute President and CEO Myechia Minter-Jordan, MD, MBA, in November 2023 at a conference aimed at creating and implementing oral health strategies in the [World Health Organization (WHO) Africa Region](https://www.afro.who.int/). The two discussed how Simwanza makes use of global resources to help improve oral health in his country. “CareQuest Institute, I would say, is a great resource,” [he said to Minter-Jordan at the conference](https://www.youtube.com/watch?v=duAOMqYT-pE). Simwanza highlighted [CareQuest Institute’s webinars](https://www.carequest.org/education/webinars), [reports, and white papers](https://www.carequest.org/resource-library) “as a source of information if I want to learn something around oral health. In particular, I’m so interested with medical-dental integration, as well as integrated care.” The primary goal of the conference — “Exploring Global Strategies To Promote Oral Health in the WHO African Region” — was to accelerate oral health policies using evidence-informed strategies and propose actionable recommendations. More than 70 delegates from 24 countries of the WHO African Region attended. Simwanza is working to strengthen MCW’s relationship with government officials and work with leaders from many of those countries to provide oral health care services for people in Tanzania. He also plans to collaborate with other organizations to form a group that will help implement [medical-dental integration](https://www.carequest.org/topics/medical-dental-integration) in the country. “The country’s policies need to be more supportive of oral health services,” he says. “For example, Tanzania currently has no updated country oral health strategic plan.” ## A Shortage of Providers, a Need for Knowledge About Integration Simwanza says people in Tanzania face many barriers to accessing care. One is the shortage of dentists. The current ratio of dentists to people in Tanzania is 1 dentist for every 125,000 people, while the WHO recommends 1 dentist for every 75,000 people. He says another barrier is that oral health is a low priority to stakeholders in the system, so there are no school-based health programs or outreach programs. Additionally, many people in Tanzania don’t know a lot about oral health and the importance of it, especially its link to overall health. MC-Tanzania is currently working on two projects: the Community Health Fellowship Program and the Dental Therapist Outreach Training Program. Both programs aim to empower communities with education and information on oral health care and train dental therapists to provide preventive services for their community. Dental therapists provide preventive and restorative dental care, including exams, filling cavities, educating patients about oral health, cleaning teeth, placing temporary crowns, and performing extractions. In the future, Simwanza says he hopes to see more investments made into training oral health care providers, since there is such a shortage in the area. He also wants to strengthen MC-Tanzania’s relationship with the government to help them develop and review policies, guidelines, and a strategic plan for oral health care. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [A Collaborative Conversation: How to Elevate Black Voices in Oral Health Care](https://carequest.org/blog/a-collaborative-conversation-how-to-elevate-black-voices-in-oral-health-care/) **Published:** February 28, 2024 **Author:** Caitlin Locklear **Content:** From 2005 to 2020, the [percentage of US dentists who identify as Black has stayed around 3.8%](https://adanews.ada.org/ada-news/2023/january/february-jada-highlights-experiences-of-black-dentists/). “The stagnant nature of this percentage should give us all pause,” said Eleanor Fleming, PhD, DDS, MPH. “This disparity is why having conversations like this around Black dentists, Black workforce, and issues related to the Black community are important for those of us who work in oral health.” Fleming started that conversation as the moderator the recent CareQuest Institute of Oral Health webinar, “[Examining History, Shaping the Future: Elevating Black Voices in Oral Health Care](https://www.carequest.org/education/webinars/examining-history-shaping-future-elevating-black-voices-oral-health-care).” Fleming is the assistant dean of equity, diversity, and inclusion at the University of Maryland School of Dentistry. She and the following speakers discussed the pressing need to increase representation and equity in dental education and practice: Caswell A. Evans Jr., DDS, MPH, emeritus professor and former associate dean for prevention and public health at the University of Illinois Chicago College of Dentistry; Nicole Cheek, DDS, the 100th president of the National Dental Association; and Jeanne Sinkford, DDS, PhD, DSc, professor and dean emeritus of Howard University College of Dentistry. The webinar was created in partnership with the National Dental Association to recognize Black History Month and spotlight the crucial contributions Black dental professionals make within their communities. Below are just a few of the questions and shortened answers that came up during [this important discussion](https://www.carequest.org/education/webinars/examining-history-shaping-future-elevating-black-voices-oral-health-care): **![](https://carequest.org/wp-content/uploads/2025/10/Senior-Dental-Exam-1.jpg)What are some of the challenges Black oral health providers face when it comes to achieving oral health equity?** **Evans:** So much of our education for the profession is focused on teeth, and too little of it is focused on oral health. We really don’t have, in the profession, broadly defined, overt, and explicit commitment to addressing oral health inequities, achieving social justice, and ensuring that all people have adequate access to oral health services. We’re still stuck in this private practice domain, and the idea of public service suffers substantially. Social justice for oral health just does not get the attention and commitment that it should. **Sinkford:** We have the haves and the have-nots. There are states that have laws that don’t allow the new models of practice for dental therapists, community health coordinators, and hygienists that have different roles depending upon how they deliver services. So, we do have inequity in our ability to provide access and licensure for individuals that could expand the pool \[of oral health providers\] who are providing care in those communities where they don’t have access to quality oral health care. **Can you help us understand how reports like the Gies Report affected Black communities and Black people in the oral health industry? And, how is the Gies Report still affecting Black people today?** **Evans:** The [Gies Report](https://www.acd.org/wp-content/uploads/JACD-79-1-2012-2.pdf) was issued in the 1920s, and in the report it has a section that is entitled “The Deficiency of Dental Services for the Negro Group.” And the narrative in that chapter states rather frankly that white dentists would not be going into the segregated health system that served the Black population — to use the Gies Report language, the Negro population. Because of that segregation and that Jim Crow structure in society at the time, the report then argued that there had to be an education system to train Black dentists — again using their language Negro — or there would be no services for the Black population. Much of that sentiment still seems to be prevalent today — that Black dentists are there to serve the Black population — because for whatever variety of reasons, dentists of other ethnicities are providing less services \[to the Black population\]. **What can we do to ensure that dentists who do not share the same cultural experiences of patients can build trust and serve effectively in those communities?** **Evans:** A lot of that goes back to our education system. And we need to question, “Are we training dentists effectively in these regards?” And I think that answer is probably no. There are some dental schools that do a great job, and there are dental schools that just produce dentists. **Where are opportunities to ensure that communities can access preventive services such as sealants?** **Evans:** There needs to be bold change in terms of the clinical reimbursement structure and reimbursement of organizations that are prepared to remunerate for preventive services equivalent to and perhaps viewed as more valuable than destructive intervention services. **Sinkford:** I think we can do better with our academic partnerships, our community outreach programs. I think we can begin using our churches and our community leaders to help us get those concepts across to people earlier and to help us with funding for the programs. You need some funding for sustained community activities, and you need to have health educators at the schools at the early levels. **What can allies and partners do to address systemic barriers to accessing oral health care?** **Sinkford:** Something we could do nationally and locally is institute the preventive programs in our public schools. That’s where many of our needy students are, and we could do health education and preventive treatment in our outreach programs. **Evans:** Dentists and oral health people spend too much time talking among themselves and too little time talking to others. We need to be much more effective in working collaboratively with other health professional groups and less focused upon talking to ourselves and singing to the choir. We need to have a broader commitment to interprofessional collaboration leading to other health professionals recognizing their role in oral health — not their role in dentistry — and the contribution that they can make to oral health. Check out the [full conversation and the recording of the webinar](https://www.carequest.org/education/webinars/examining-history-shaping-future-elevating-black-voices-oral-health-care) in our [growing library of learning opportunities](https://www.carequest.org/education/webinars). **Categories:** Blog **Tags:** Health Equity --- ### [Two Funding Opportunities to Advance Oral Health for Children and Veterans](https://carequest.org/blog/two-funding-opportunities-to-advance-oral-health-for-children-and-veterans/) **Published:** March 5, 2024 **Author:** Caitlin Locklear **Content:** CareQuest Institute is always seeking new voices representing historically marginalized communities to advance oral health. Through its philanthropic work, it partners with grassroots and community-based organizations that represent and engage those who are most directly impacted by oral health inequities. On March 13, the Institute is opening two new requests for proposals, looking to fund projects and partner with organizations that are: - [Engaging schools to address systemic barriers to oral health](https://www.carequest.org/content/school-based-and-school-linked-initiatives-improve-oral-health-rfp), inclusive of access, for children and their families - [Working to address system-level barriers to oral health for veterans ](https://www.carequest.org/content/veterans-rfp) The deadline to apply is May 1. “These two areas of need came up in conversations with our community partners as both areas of need and opportunities to make change,” says Melodie Griffin, manager, grants and programs at CareQuest Institute. “The Institute has provided funding in these areas before, but is excited to take an intentional and concerted effort to bring grantees working in these areas together to learn from one another and advance access to oral health care.” ## Improving Oral Health Through School-Based and School-Linked Programs According to the National Institutes of Health’s [*Oral Health in America: Advances and Challenges*](https://www.nidcr.nih.gov/research/oralhealthinamerica) report, approximately half of all children in the United States are not receiving needed oral health care due to social, economic, and geographic barriers. ## ![](https://carequest.org/wp-content/uploads/2024/03/iStock-517491102.jpg) Schools present an underused opportunity to open doors to children’s oral health. According to the [National Center for Education Statistics](https://nces.ed.gov/fastfacts/display.asp?id=372#PK12-enrollment), about 60 million children in the US attend public or private school. Schools provide an excellent opportunity to expand access to care and well-being through oral health education, screening, assisted referrals, and preventive services. Schools can become the center for multiple opportunities to improve the oral health and overall health of students, reducing racial, ethnic, and economic disparities, and increasing students’ chances to stay in school and achieve in life. [The School-Based and School-Linked Initiatives to Improve Oral Health RFP](https://www.carequest.org/content/school-based-and-school-linked-initiatives-improve-oral-health-rfp) seeks to fund creative, innovative projects that drive systemic change in oral health and that promote school-based or school-linked oral health programs. Successful school-based and school-linked oral health programs benefit from thorough planning, community collaboration, and partnerships between schools and health providers to ensure the program meets the needs of students and their families. “Oral health care in the school-based setting took a hit after the COVID-19 pandemic,” Griffin says. “We aim to use this opportunity to reinvigorate and innovate within the oral health field to advance access to oral health care for school-aged children.” Services may be provided in school buildings through school nurses or school-based health centers. Drop-in services, such as mobile vans operating on school grounds, may also provide oral health services. School-linked programs may also provide services through community outreach opportunities. CareQuest Institute is prioritizing proposals that reflect the applicant’s authentic commitment to engage members of the community meaningfully and consistently throughout their proposed project. For more information on those priorities, eligibility, selection criteria, or to [apply to this RFP, click here](https://www.carequest.org/content/school-based-and-school-linked-initiatives-improve-oral-health-rfp). ## Expanding Oral Health Equity and Access for Veterans According to research from both [CareQuest Institute and the American Institute for Dental Public Health](https://www.carequest.org/veteran-oral-health), veterans have consistently high rates of periodontitis, missing teeth, and filled teeth, even when controlling for other factors like chronic medical conditions and smoking status. Also, [a new report released by CareQuest Institute](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being) shows that veterans are 60% more likely than nonveterans to experience tooth decay, impacting their daily functioning and productivity in the workplace. Veterans are also more likely than nonveterans to have health conditions such as diabetes and hypertension, which are associated with poor oral health and often lead to higher out-of-pocket costs for patients. Other key data points: ![](https://carequest.org/wp-content/uploads/2024/03/Group-of-Veterans.jpg) - 42% of veterans reported having had gum treatment or bone loss around their teeth — a significantly higher proportion than reported by nonveterans (27%). - Roughly two in five veterans described their oral health as fair or poor. - Nearly 24% of veterans live in rural areas, where consistent access to care can be challenging. “By gathering grantees across the US working to improve the oral health of veterans, we can advance access and quality of oral health care for this important population, leading to improved health overall,” says Bree Bess, grants and programs associate with CareQuest Institute. [The Veteran Oral Health RFP](https://www.carequest.org/content/veterans-rfp) seeks to fund projects that drive system-level change in oral health to promote access to care for the veteran population. The criteria for selection of proposals are intentionally broad, recognizing that innovative work aligned with this strategy may employ a variety of tactics and partnerships, and that system-level barriers may vary depending on geographic region of focus. For more information on those priorities, eligibility, selection criteria, or to [apply to this RFP, click here](https://www.carequest.org/content/veterans-rfp). **Categories:** Blog **Tags:** Health Equity --- ### [Making Connections: How a Community Clinic Is Integrating Dental and Overall Care](https://carequest.org/blog/making-connections-how-a-community-clinic-is-integrating-dental-and-overall-care/) **Published:** March 13, 2024 **Author:** Caitlin Locklear **Content:** ![](https://carequest.org/wp-content/uploads/2024/03/VCC-3.jpg)A dental hygienist at Vista Community Clinic cleans child’s teeth A Federally Qualified Health Center (FQHC) in southern California noticed an alarming statistic last year: Only about 22% of their pediatric medical patients were also going to their dental department. “We really wanted to promote the one-stop-shop, under-one-roof, collaborative care with the medical providers and really dig into why they weren’t seeking dental care at all or . . . were going elsewhere,” says Rebecca Cornille, DDS, the chief dental officer at [Vista Community Clinic (VCC](https://www.vistacommunityclinic.org/)). The FQHC had hired an integration coordinator for patients with diabetes in 2021, and Cornille, along with project manager Rajni Lopez, says that inspired the idea of hiring an integration coordinator for their pediatric patients. “What we were looking for is someone acting somewhat behind the scenes of the actual direct care team to make the connections between these parts of the body — from the medical care to the dental care,” Cornille says. The organization didn’t have the budget for the position, so VCC applied for — and received — a $125,000 CareQuest Institute of Oral Health grant as part of the Institute’s Community and Care Transformation initiative. “I think it’s a great partnership,” says Rajni Lopez, the project manager of VCC. “It’s great to have an organization like CareQuest Institute who is willing to fund programs like this that are innovative.” ## The Benefits of an Integration Coordinator The pediatric integration coordinator started in December and benefited from the integration structure — built around diabetes — that was already in place at the organization. Cornille says when it comes to treating patients who have diabetes, medical physicians are often busy managing the condition, and they may give an optometry referral to rule out diabetic retinopathy. ![](https://carequest.org/wp-content/uploads/2024/03/VCC-2-scaled.jpg)A child gets teeth examined by dental hygienist at Vista Community Clinic “But dental — that piece was just missing,” she says. [Diabetes can increase a person’s risk of developing periodontal (gum) disease by 86%](https://www.carequest.org/resource-library/beyond-nice-smile), and it is more severe than for people without diabetes. So VCC members were challenged to figure out how to make sure patients who were diagnosed with diabetes were also getting the oral health care they needed. “What I’ve learned in health centers is that everybody’s working at their maximum capacity, and if you add another thing to their list, you can get a lot of pushback and folks can border the line of burnout,” Cornille says. “The \[integration coordinator\] can act as the facilitator to get those appointments scheduled and reach out to those patients as another layer of the care team.” Patients have already experienced the benefits from that extra layer of care, as evidenced by several testimonials the organization has received. “I have been going to VCC for regular checkups,” reads one testimonial. “I have prediabetes, and thanks to my VCC provider, \[I’ve\] been able to keep my blood sugar levels low. Today when I came in, I met Maria, diabetes patient navigator, and she educated me on the importance of dental checkups for diabetic patients. I was hesitant at first because I have had bad experiences with another dentist. With Maria’s encouragement, I agreed to be seen by a VCC dentist at VCC, and I’m glad I did, because I had a great experience.” ## Helping the Community Through Care At VCC, most of the patients are on Medicaid. “I think more than 60% of our patients are female. A lot of our patients are Hispanic or Latino — some only speak Spanish,” Lopez says. “We also have a large group, about 15% or so, that are either migrant farm workers or homeless. And about a third of our patients are children.” ![](https://carequest.org/wp-content/uploads/2024/03/VCC-1.jpg)Dental hygienist gives gift to patient Both Cornille and Lopez say that even though it has only been a few months, the new pediatric integration coordinator, Juan C. Lopez, is already making connections between patients’ oral and overall health. “I am happy to be a part of a team that is willing to help out families that aren’t aware there are services to assist them and help get the coverage they need,” he says. “Now we’re able to target those pediatric patients with \[Juan\], who physically is embedded in the pediatric department and can talk with the parents, provide education, and facilitate warm handoffs,” Cornille says. “I think last week or the week before, we had about 45 kids that he was able to coordinate right into dental, which is amazing. And that’s probably 45 kids that wouldn’t have made it otherwise.” As for the long-term plan for the integration coordinator, Cornille says she’s hopeful it proves to be a financially sustainable and recognized position within the care team. In the meantime, she says she’s appreciative of CareQuest Institute providing that sustainability with their grant. “This is the first time that that we’ve been funded through CareQuest Institute, and it has been amazing because our work was great, but it was struggling without the financial backing,” Cornille says. “It has really been able to help us move the needle forward on our objectives.” **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Biden Administration Keeps Door Open for Oral Health Advocacy in 2024](https://carequest.org/blog/biden-administration-keeps-door-open-for-oral-health-advocacy-in-2024/) **Published:** March 19, 2024 **Author:** Caitlin Locklear **Content:** Earlier this month, President Joe Biden’s State of the Union Address reiterated the administration’s focus on improving the health of people across the country and lowering health costs for our nation’s families. Biden expressed his commitment to protecting health care access, making health insurance and prescription drugs more affordable, defending reproductive health care, and investing in the behavioral health workforce — promises also reflected in his FY 2025 budget proposal released March 12. These priorities keep the door open for continued progress on oral health into 2024 — even if it wasn’t explicitly mentioned in the president’s address. Thanks to the tireless efforts of the oral health community, we’ve seen oral health directly tied into policy discussions around lowering health care costs, improving health, and advancing equity more than ever before. In fact, over the last three years, we’ve experienced some of the most productive and effective policy discussions in decades. ## A Commitment to Improving Oral Health Coverage Thanks to decades of advocacy and engagement by so many dedicated oral health professionals, advocates, educators, and policymakers, we have been closer to major oral health coverage reform in the past several years than ever before. Our collective action ensured that the Biden administration’s transition plan was the first to ever make a commitment to improving oral health coverage for older adults and people with disabilities. As a result, the administration and numerous members of Congress worked to advance a Medicare dental benefit within the Build Back Better Act, which was nearly passed in 2020 and 2021. This was the first time since the creation of the Medicare program that Congress gave serious consideration to Medicare dental coverage policy. While Congress ultimately passed a slimmed down legislative package that did not include Medicare dental, among other important policies, it remained the most popular policy to be dropped from the package. In 2022, the Biden administration clarified that Medicare covers “medically necessary” dental coverage, which ensures that Medicare will cover dental services that improve the outcomes of certain covered medical services — a real victory for oral health access. This coverage was strengthened to include additional conditions in 2023. The momentum continued to build last year when the Senate Finance Committee [held a hearing on oral health](https://www.congress.gov/event/118th-congress/senate-event/333928?s=1&r=95), the first committee hearing ever on the issue. And for good reason. Recent voter polling shows that support for Medicare dental benefits continues to be incredibly strong: [92% of voters support strengthening Medicare](https://www.dataforprogress.org/blog/2024/1/12/voters-strongly-support-expanding-medicare-coverage-and-lowering-the-eligibility-age) to include dental, vision, and hearing benefits. ![](https://carequest.org/wp-content/uploads/2024/03/US-Congress-scaled.jpg) In addition to the considerable progress on Medicare dental coverage, in 2021 we also saw the first federal legislation on Medicaid adult dental coverage introduced. This legislation — which aims to establish a federal requirement for state Medicaid programs to provide dental coverage to adults enrolled in the program — has since been reintroduced in the current Congress and included in major equity bills like the Health Equity and Accountability Act. Beyond Medicare and Medicaid, the administration recently released a proposed regulation that would further increase access to oral health by allowing states to include adult dental benefits in their Essential Health Benefits benchmark plan. This rule has the potential to increase access to oral health benefits for those who get their insurance coverage through the individual and small-group insurance markets, as well as certain other state-based programs. Each of these legislative and regulatory opportunities have cast a spotlight on the important role oral health can and must play in health policy change. Heading into this election year, it is more important than ever to keep up the momentum. ## Three Key Steps to Improving Coverage This year, we need to work with policymakers to capitalize on immediate opportunities while also laying groundwork for additional policy change in 2025 and beyond. While current dynamics in Congress will make it hard to pass any major legislation, the administration has several important pathways to continue to improve oral health coverage: 1\. Make Medicare “medically necessary” dental coverage as robust as possible by continuing to identify additional covered services and ensuring strong implementation of the benefit. 2\. Finalize regulations that would allow states to make dental coverage more available and affordable through the private marketplace. 3\. Identify additional opportunities to address and invest in oral health through research and broader health policies. These solutions are made more urgent by the fact that millions of people have lost their Medicaid medical and dental coverage through the redetermination process that continues to unfold following the end of the COVID-19 Public Health Emergency. Our analysis shows that roughly [14 million people](https://www.carequest.org/content/medicaid-redetermination-2024) across the country lost Medicaid dental coverage in 2023 as a result of this process. ![](https://carequest.org/wp-content/uploads/2025/07/Melissa-Boroughs-Web-250x300.gif)Melissa Burroughs Looking to 2025 and beyond, we need to keep up our momentum and build more oral health champions in Congress, in the presidency, and in the states to make our goals a reality. The past three years are clear evidence that advocacy efforts can pay off. As we get deeper into this election year, we need to make sure that candidates at all levels and from all parties understand the importance of oral health so that we can keep making progress together. *Authored by Melissa Burroughs, Senior Director of Public Policy, CareQuest Institute* **Categories:** Blog **Tags:** Dental Coverage --- ### [Finding the Pathway to Interoperability at HIMSS 2024](https://carequest.org/blog/finding-the-pathway-to-interoperability-at-himss-2024/) **Published:** March 22, 2024 **Author:** Caitlin Locklear **Content:** The health care system in the United States is unique in many often-cited ways. It does not provide universal coverage, mixes publicly and privately funded insurances, and spends more on [care per person than any other wealthy country](https://www.pgpf.org/blog/2023/07/how-does-the-us-healthcare-system-compare-to-other-countries). But the US system is similar to that of other countries in one way that was on display at last week’s [Healthcare Information and Management Systems Society (HIMSS) Global Health Conference & Exhibition](https://www.himssconference.com/) in Orlando: The challenges of health care information systems, management, and interoperability are worldwide. But there is good news! Our experience at HIMSS shows that the opportunities for new technology, collaboration, and innovation are limitless, and engaging with partners across the broad health care ecosystem is critical to CareQuest Institute’s mission to improve the oral health of all. Below, we share some insights we had from the event. ## The Importance of Interoperability HIMSS is a massive event, drawing more than 30,000 attendees and hundreds of presentations. As it does every year, it brought together health care professionals — including oral health care professionals — from across the health ecosystem for expert education, innovation, and collaboration. Attendees built relationships, learned from experts, and discovered innovative health technology solutions to meet their greatest challenges. The conference was also an eye-opening experience, and opportunity to discuss information sharing, data security, and artificial intelligence (AI) across continents and cultures and hear about challenges and solutions in other countries. One of our focus areas was interoperability. CareQuest Institute sponsored the Interoperability and HIE Pre-Conference Forum, where Andrea had the opportunity to share information about the Institute’s work in [advancing oral health equity](https://www.carequest.org/topics/health-equity) and access, and the critical nexus between [making oral health care integrated](https://www.carequest.org/topics/medical-dental-integration), person-centered, value-based, and interoperable. Interoperability is necessary for true whole-person care. [What is interoperability?](https://www.carequest.org/topics/care-coordination-and-interoperability) Interoperability is the ability for systems from different vendors to share data securely and efficiently. One area of focus for CareQuest Institute is [integration between medical and dental providers](https://www.carequest.org/about/blog-post/medical-dental-integration-just-got-boost). With the availability of data, providers can make better informed decisions and improve patient care regardless of their location. In the US, we’re seeing progress. The [Trusted Exchange Framework and Common Agreement](https://www.healthit.gov/topic/interoperability/policy/trusted-exchange-framework-and-common-agreement-tefca) became operational in December 2023, with the US Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology announcing the first seven Qualified Health Information Networks (QHINs). This launch is a quantum leap for nationwide health care data interoperability in the US, as embodied in the [Health Interoperability Outcomes 2030](https://www.healthit.gov/topic/interoperability/health-interoperability-outcomes-2030) statements. Below are some of the “aspirational, achievable, and measurable” outcomes identified: - Individuals will be able to seek and receive care . . . without needing to gather and provide their health information themselves. - Individuals and health professionals will be able to discover and compare online the cost of a health care service, procedure, or drug. - All referral and transition of care data will be electronic. - Individuals will no longer fill out paper forms for any health care encounter or process. - The health system will enable evidence-based, precision care that accounts for the social and health conditions of each patient, including links between health and human services. When a patient’s health information is available electronically to their provider, access to accurate and up-to-date clinical data will result in an improved outcome and patient experience. The provider can readily identify high risk conditions, provide evidence-based care, and reduce the duplication of tests and procedures. ![](https://carequest.org/wp-content/uploads/2024/03/Andrea-Clark-Cropped-220x300.png)Andrea Clark, MS ## Engaging Market Stakeholders to Improve Health IT The private sector in the US drives change, and the customer is always right. This highlights the critical importance of engaging market stakeholders to demand improved functionality and investments in health IT. We at CareQuest Institute leverage our trusted advisor role with oral health partners to help dental providers assess their readiness for value-based care, advocate for advances in health IT, and [ensure that common standards are being applied](https://www.carequest.org/resource-library/dental-data-exchange-hl7-implementation-guides) to maintain interoperability after it has been established. Moreover, as new technologies like AI revolutionize the health care market, oral health must be part of these conversations. ![](https://carequest.org/wp-content/uploads/2025/06/Renee-Clark-2025-200x300.jpg)Renee Clark Attending HIMSS was a great way to represent oral health in an industry dominated by inpatient and outpatient organizations. And it is always rewarding to share our work with others in the industry. Their excitement and feedback when learning about CareQuest Institute and oral health drives our passion for the many opportunities that lie ahead. *Authored by Andrea Clark, MS, Director, Health Care Economics, and Renee Clark, Care Coordination & Interoperability Manager* **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Finding a New Way to Provide Dental Care to Children](https://carequest.org/blog/finding-a-new-way-to-provide-dental-care-to-children/) **Published:** March 27, 2024 **Author:** Caitlin Locklear **Content:** Carolina Family Health Centers, Inc. has provided medical and dental care for patients in three North Carolina counties for years. But during that time, the Federally Qualified Health Center (FQHC) was having trouble accessing a specific part of the population that needed oral health care — children. “Since I’ve been here, within these nine years, we’ve had a very low pediatric population that we treat here for dental,” says Jessica Ezzell, RDH, a dental hygienist at Carolina Family, which provides care in the northeast corner of the state. “So, it has been a big goal of ours to reach out to that pediatric population and bring them in.” ![](https://carequest.org/wp-content/uploads/2024/03/Carolina-Family-Edited-Photo-Web.jpg)Jessica Ezzell, RDH, shows child how to properly brush teeth at school [Carolina Family](https://www.cfhcnc.org/) has been participating in CareQuest Institute for Oral Health’s [Community Oral Health Transformation (COrHT) Initiative](https://www.carequest.org/how-we-work/health-improvement-programs/corht) for the past two years. Ezzell says the initiative helped the clinic reach out to a local elementary school to provide oral health care for its students. “We worked with the onsite school nurse and principal to set up dates and times that we could come to the school that worked best with the students’ schedules,” Ezzell said. “And we took our dental unit — our bus — out there to their parking lot and set up. We walk the students from their class in small groups to the dental bus to have their screenings and get some dental education before returning them back to class.” Improving access to care for children was just one track of the work Carolina Family Health Centers did as part of COrHT. They also focused on the transition to value-based care and increasing the use of minimally invasive care for patients. “We were able to incorporate caries risk assessments, periodontal risk assessments, and oral cancer screenings and assessments for patients,” says Hilary Patterson, DMD, the chief dental officer at Carolina Family. “And we documented those accurately with the help and guidance of our coaches and team members with COrHT.” ## Incorporating Value-Based and Minimally Invasive Care Patterson says the clinic took CareQuest Institute’s [Value-Based Care (VBC) Readiness Assessment](https://www.carequest.org/content/value-based-care-readiness-screener) as a starting point of COrHT to evaluate organizational readiness to transition to a value-based care and payment model in dentistry. “On our medical side, we have been slowly transitioning to value-based care with insurance and with patients,” Patterson says. “We have seen growth of a department focused on population health with care coordinators who work with patients directly to improve those quality measures. And I think overall it has been a transition from sick care to a goal of health care.” Carolina Family also focused on using [minimally invasive care](https://www.carequest.org/topics/minimally-invasive-care) as an option for patients. Through COrHT, the clinic discovered a significant increase in primary and secondary prevention procedures, from fluoride varnish applications to nutritional counseling. “We added [silver diamine fluoride](https://www.carequest.org/about/blog-post/answers-17-your-silver-diamine-fluoride-questions) to our armamentarium,” Patterson says. “We also saw a decrease in surgical intervention over the past year and a half, which shows that we’re improving the oral health of our patients.” ## The Need for a School-Based Oral Health Program Through COrHT, Carolina Family was also able to meet with [other dental offices](https://www.carequest.org/about/blog-post/teledentistry-and-community-learning-help-kids-get-care-north-carolina) to gain some knowledge and guidance about starting their school-based oral health program. “Our monthly coaching calls gave us a lot of information and kept us motivated even when it was taking such a long time to get approved to get into the school systems,” Ezzell says. “And then also the funding. Without the funding, we wouldn’t have been able to get the supplies and everything we needed to get the bus up and running for the screening event at the school.” Ezzell says dental education is low or lacking in the pediatric population in the counties Carolina Family services, and getting oral health care for their children is challenging for parents. “For parents, it’s a big issue with transportation or taking time off of work to bring their children into the dentist,” Ezzell says. “For us to be able to take our dental bus to them to offer these services, or even offer transportation for them to bring their children to us, has been a big help in getting these children seen and treated.” And the FQHC hopes to help even more than the 400 students they’ve seen at the local elementary school. “With our future plans, if we’re able to grow our team, we can hopefully grow into more schools nearby and see more of the pediatric population,” Ezzell says. To learn more about Carolina Family’s participation in COrHT and their school-based program, watch [this video](https://www.youtube.com/watch?v=VrvAlPCjHDg). **Categories:** Blog **Tags:** Medical-Dental Integration, Minimally Invasive Care --- ### [CareQuest Institute Joins 90 Organizations Urging Congress to Lift Funding Ban on Dental Workforce Programs](https://carequest.org/press-release/carequest-institute-joins-90-organizations-urging-congress-to-lift-funding-ban-on-dental-workforce-programs/) **Published:** April 11, 2022 **Author:** Jasmin Fernandes **Content:** ## *Group seeks to ensure states have access to federal grants for dental therapy programs in FY2023.* [CareQuest Institute for Oral Health](http://carequest.org), a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system, joined a nonpartisan group of organizations urging Congress to lift a federal funding ban that prohibits states and Tribal communities from accessing health workforce grants for dental therapy programs. The group, which includes more than 90 organizations, sent a letter to the House and Senate appropriations subcommittees asking for the elimination of this funding ban in the FY2023 appropriations bills. Dental therapists are licensed providers who work under the supervision of a dentist to provide routine dental care like exams and fillings and can help expand access to oral health care, especially in rural communities. Their employment cost is lower than dentists, so hiring dental therapists can be a cost-effective way for safety-net clinics to stretch their budget to treat more patients. Congress recognized the opportunity to improve access to care through the expanded use of dental therapists when it created a federal grant program in 2010 to support training and development of dental providers like dental therapists. Unfortunately, this grant program has never been funded because Congress continues to pass appropriations language that prohibits the Health Resources and Services Administration from doing so. “Congress recognized the opportunity to expand access to dental care through dental therapists more than 10 years ago. Lifting the funding ban on dental therapy programs would allow states and Tribes to pilot and scale these programs to increase access to oral health for communities that face the highest barriers to it,” said Dr. Myechia Minter-Jordan, president and CEO of CareQuest Institute for Oral Health. “Amid ongoing health care workforce shortages, we are joining the call to Congress to authorize this funding so communities can access the critical resources they need to expand their dental workforce.” Oral health is one of the most visible causes of health disparities in America, and good oral health remains out of reach for many low-income families, communities of color, Tribal communities, and rural communities. [Research from Minnesota published](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2790249) in March in the *Journal of the American Medical Association* indicates that expanding the dental workforce to include dental therapists shows associated improvements in access to dental care among disadvantaged populations. Across the country, more and more states are authorizing the licensure of dental therapists to ensure that every community has access to dental care. Support for expanding the dental workforce to include dental therapists is diverse and bipartisan. Dental therapists are working or authorized in at least some settings in 12 states and have had a positive impact on the communities they serve. Seven more states have had legislation introduced in the last year to authorize them. However, many of these states lack the federal support they need to further expand their oral health workforce through dental therapy. The coalition is also asking Congress to fully fund the alternative dental health care provider demonstration grant program, which supports dental therapy. Specifically, they are asking for at least $5 million in funding to be allocated to the grant program to allow states to take advantage of this critical resource. **Categories:** Press Release **Tags:** Dental Coverage, Health Equity, Medical-Dental Integration, Person-Centered Care, Special Patient Care, Value-Based Care --- ### [A Voice for the Unheard: Improving Oral Health in Connecticut](https://carequest.org/blog/a-voice-for-the-unheard-improving-oral-health-in-connecticut/) **Published:** January 17, 2024 **Author:** Caitlin Locklear **Content:** On a warm Saturday in November, dozens of vendors lined Dunkin’ Park in Hartford, Connecticut, for the Get Out the Vote Health Fair, where visitors could find information on health care resources and connect with community partners. One of those booths belonged to the [Connecticut Oral Health Initiative (COHI)](https://www.ctoralhealth.org/) — an organization that advocates for oral health access, quality, and equity in the state. That day, the COHI team was doing one of its favorite activities: educating the community about the importance of dental care. “COHI exists to be a voice for those who are currently unheard,” says Gary Turco, community engagement specialist at COHI. “We’re connecting with people who need care the most.” COHI is the only nonprofit in Connecticut that focuses solely on advocating and pursuing policy changes for oral health for Connecticut residents. COHI does not provide direct patient services. Instead, they work with like-minded organizations to collaborate for equitable oral health policies. COHI is a small organization made up of three employees: Turco, Executive Director T. J. Clarke II, and Operations Assistant Najla Mack. But the nonprofit gets help from its active board of directors and organizations like CareQuest Institute, which has awarded grants to COHI. “With the funding that CareQuest Institute provided, we are surveying Connecticut residents on their oral health . . . to actually uncover what the greater need is,” Clarke says, citing one recent project. “And then we can turn those results into policy recommendations.” Those recommendations have helped the small team make big changes. One example is COHI’s report, “[A Medicaid Gap Analysis of Oral Health Care for Adults in Connecticut](https://www.ctoralhealth.org/medicaid-gap-analysis-report-2022)“, which collected and analyzed Medicaid service utilization data, geographical information on the state’s provider network, and the experiences of Medicaid beneficiaries and providers. Using this report, advocates showed that the lack of periodontal coverage within Medicaid was one of the most severe issues negatively affecting the oral health of adults in the state. Starting in 2024, the new state budget includes [funding for periodontal coverage](https://www.carequest.org/about/blog-post/medicaid-adult-dental-benefits-progress-report-and-look-future) for people enrolled in Medicaid in Connecticut who have certain medical conditions, like diabetes. It’s the latest victory of many that the organization has helped spearhead since [it was founded in 2001](https://www.ctoralhealth.org/our-story-timeline). In 2019, COHI also led the effort to get a dental therapy bill passed in Connecticut. This bill allows dental therapists, who are also licensed dental hygienists with at least 18 months of additional training, to work within public health settings. COHI is still working to improve the law and ensure implementation. “If it wasn’t for COHI, there wouldn’t be anyone that would have the same focus like we do with oral health,” says Turco. To learn about COHI’s work and partnerships in communities across Connecticut, check out [this video:](https://www.youtube.com/watch?v=Fgd4S0CxkNk) **Categories:** Blog **Tags:** Dental Coverage, Health Equity --- ### [Voices from the Field: Dr. Lisa Bozzetti on Creative Ways to Improve Community Health](https://carequest.org/blog/voices-from-the-field-dr-lisa-bozzetti-on-creative-ways-to-improve-community-health/) **Published:** January 23, 2024 **Author:** Caitlin Locklear **Content:** As part of his role to advance the integration of oral health and overall health, CareQuest Institute Chief Health Equity Officer Kaz Rafia, DDS, MBA, MPH, is always trying to find exemplars. He seeks models and individuals that are focused on the community and on finding innovative ways to improve the system. ![Voices from the Field](https://www.carequest.org/sites/default/files/2022-12/200VoicesLogo_1_0_1_0.jpg) He’s looking for stories like Lisa Bozzetti, DDS, and Virginia Garcia Memorial Health Center. “What I love about their work is how innovative and resourceful they are in providing not only integrated care, but care that is truly person-centered and community-driven,” Rafia says. “It’s an excellent example of what an equitable, accessible health care model should look like.” [Virginia Garcia Memorial Health Center](https://virginiagarcia.org/) (Virginia Garcia) is a Federally Qualified Health Center (FQHC) that provides comprehensive, culturally appropriate primary health care to the communities of Washington and Yamhill Counties. Their mission is caring for migrant and seasonal farmworkers and others with barriers to receiving health care. Rafia recently interviewed Bozzetti, dental director at Virginia Garcia, to learn more about their work. **How does Virginia Garcia work to ensure that care is rooted in the local community?** ![Dr. Lisa Bozzetti head shot](https://www.carequest.org/sites/default/files/2024-01/Lisa%20Bozzetti%20Blog%20Photo_0.jpg)Lisa Bozzetti, DDS I’ll share a couple of examples: First, we support and operate patient councils facilitated by a patient engagement specialist. These groups of patients meet to share their experiences and are asked questions related to services. It ensures that we’re hearing their concerns and adapting our practices to reflect the needs of the community. Second, recent workforce shortages also led us to invest heavily in the community, by supporting opportunities for staff, high school students, and community members to become dental assistants, medical assistants, and pharmacy technicians. From offering workforce development training to providing resources during the pandemic, the health center continually works to break down systemic barriers and find innovative and creative ways to improve the community’s health. That includes looking at oral health as part of overall health. **Medical-dental integration can encompass a lot of different things. Can you describe the level of integration between physical, behavioral, and oral health at Virginia Garcia?** The entire health center operates within the same electronic health record, allowing information to be shared across departments. Here are some specific examples of why this is so important, and how it’s put into practice: - An appointment can be made for a primary care visit in the dental clinic. - When a patient is seen in the dental clinic, overdue vaccines and overdue A1Cs (a blood test that measures a patient’s average blood sugar levels over the past three months) are noted and shared with the patient. - Upon learning that 70% of patients with oropharyngeal cancers also test positive for the human papillomavirus (HPV), the dental team made it a priority to inform parents and patients about the HPV vaccine and began a pilot to administer the vaccine in the dental clinics. - Since 2018, Virginia Garcia has embedded a dental hygienist in primary care, in the reproductive care clinic, incorporating oral health care into prenatal care. **It can be difficult to access the resources required to care for patients in an integrated way, especially as a FQHC. How has your organization been resourceful?** We are resourceful and creative because we have to be. But it shows that you can put these practices into place even with limited resources. For example, just prior to the pandemic, a staff member discovered a deal on A1C blood testing equipment. They could be purchased for pennies as part of a promotion. The dental program had planned to start doing A1C tests but had not gone through the training yet. Thanks to some quick thinking, we purchased the A1C equipment and stored it for later use. Unfortunately, the pandemic got in the way of implementation, and we are now planning to implement A1C testing early next year. **That sounds like a creative solution. Any other examples you can share?** Just prior to the pandemic, we had to cut back on some of our services. We pulled our dental hygienists from our SBHC (school-based health center) clinics. To compensate for this, we relocated the dental chairs in several of the SBHC clinics, moving them to our dental clinics, and we salvaged one that could not be used in the existing dental clinics to save for a potential dental training lab. That chair was mounted on wheels and put into storage until three years later, when we hired a dental assistant trainer and were able to implement a dental training lab along with this trainer position. **What do you think has been a key to the success at Virginia Garcia?** I think a key to our success is how everyone is constantly looking for new ways that we can work better together across departments to better care for our patients. The reproductive health clinic is a great example. The dental hygienist in that clinic has worked to become a part of the primary care team, learning new tasks to support the team and, in turn, help promote oral health care. For example, the dental hygienist noted that phlebotomy is greatly needed, and we are now exploring how the dental hygienist can learn this skill to further support the team onsite, in addition to being an integral liaison to the dental department. This clinic now has the highest percentage of patients who receive both dental and physical health care at Virginia Garcia, a testament to the effectiveness of this model. **Categories:** Blog **Tags:** Medical-Dental Integration --- ### [Making Connections to Improve Oral Health Care in Alabama](https://carequest.org/blog/making-connections-to-improve-oral-health-care-in-alabama/) **Published:** December 5, 2023 **Author:** Caitlin Locklear **Content:** Jennifer Harris, the senior health policy advocate at Alabama Arise, says no day is the same at her job. “You may have someone that’s working over here to reduce tooth decay in school-age children, and then you may have someone in another part of the state that is looking at the accessibility for someone who’s disabled to be seen by a provider,” Harris says. “What I’m doing is creating a network where we can bring all our work together to really make strides in access when it comes to oral health.” [Alabama Arise](https://www.alarise.org/) is a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. It has been doing that grassroots work for more than 35 years. “Part of my role as the health policy advocate at Alabama Arise is being in the community, hearing from people and their lived experiences, seeing what the day-to-day is like, and hearing what their needs are,” says Harris. “Then I work to connect those things to real policy changes and improvements.” Alabama is a state that [does not offer dental coverage to people enrolled in Medicaid](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), creating a barrier to access oral health care — something that Harris is advocating to change with the help of CareQuest Institute. CareQuest Institute provided a grant to Alabama Arise in 2023 to help the organization advocate for better oral health benefits. “Some of the unique issues and barriers when it comes to health care in Alabama is you kind of have this divided system,” Harris explains. “We have some world-class health centers in Alabama — at UAB Hospital, at University of South Alabama in Mobile, and the Huntsville Hospital. But between those cities and locations, there’s a lot of state. And in this state, there are people that have to travel two to three hours multiple times a week just to receive the care they need.” Watch [this video](https://www.youtube.com/watch?v=Ks7ZwvTA_Jk) to learn more about Alabama Arise and the efforts Harris is helping to lead to create better oral health in the state. **Categories:** Blog **Tags:** Dental Coverage --- ### [KMOX Radio: Hundreds of Thousands of Missourians Lost Dental Coverage in Medicaid Rollback in 2023](https://carequest.org/in-the-news/kmox-radio-hundreds-of-thousands-of-missourians-lost-dental-coverage-in-medicaid-rollback-in-2023/) **Published:** May 16, 2024 **Author:** Jasmin Fernandes **Content:** Gary Harbison, Executive Director of the Missouri Oral Health Coalition, talks with KMOX Radio about the 224,063 people who lost dental coverage due to the Medicaid unwinding in 2023 in Missouri. **Categories:** In The News --- ### [WOAY NewsWatch: Biden Administration Finalizes Rule Allowing States to Add Dental Insurance Coverage to Affordable Care Act Plans](https://carequest.org/in-the-news/woay-newswatch-biden-administration-finalizes-rule-allowing-states-to-add-dental-insurance-coverage-to-affordable-care-act-plans/) **Published:** May 21, 2024 **Author:** Jasmin Fernandes **Content:** According to the Carequest Institute for Oral Health, nearly 69 million adults did not have dental insurance or access to routine oral health care last year. [Read the full story here.](https://woay.com/biden-administration-finalizes-rule-allowing-states-to-add-dental-insurance-coverage-to-affordable-care-act-plans/) **Categories:** In The News --- ### [Becker's Dental Review: What's Needed to Advance Medical-Dental Integration: CareQuest CEO](https://carequest.org/in-the-news/beckers-dental-review-whats-needed-to-advance-medical-dental-integration-carequest-ceo/) **Published:** June 11, 2024 **Author:** Jasmin Fernandes **Content:** Dr. Minter-Jordan recently spoke with Becker’s about what medical-dental integration efforts can learn from the behavioral health field and the factors that will support medical-dental integration in the future. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/43873-whats-needed-to-advance-medical-dental-integration-carequest-ceo.html) **Categories:** In The News --- ### [Oral Health Next Gen: Teledentistry: Bridging The Kilometres Between You And Your Patients](https://carequest.org/in-the-news/oralhygiene-teledentistry-bridging-the-kilometres-between-you-and-your-patients/) **Published:** September 4, 2024 **Author:** Jasmin Fernandes **Content:** In a 2022 study of nearly 2,800 dental providers conducted by CareQuest Institute for Oral Health, the scope of survey respondents’ teledentistry practices was vast. [Read the full story here.](https://www.oralhealthgroup.com/nextgen/teledentistry-bridging-the-kilometres-between-you-and-your-patients/) **Categories:** In The News --- ### [Beckers Dental Review: What Dental Leaders Told Us In September](https://carequest.org/in-the-news/beckers-dental-review-what-dental-leaders-told-us-in-september/) **Published:** October 2, 2024 **Author:** Jasmin Fernandes **Content:** Several dental industry leaders spoke with Becker’s about their strategies for growth, the presidential election and the biggest challenges facing DSOs. [Read the full story here.](https://www.beckersdental.com/featured-perspectives/44630-what-dental-leaders-told-us-in-september-2.html) **Categories:** In The News --- ### [Insight Into Diversity: Rooted in Care RIDE Program Boosts Rural Dental Health](https://carequest.org/in-the-news/insight-into-diversity-rooted-in-care-ride-program-boosts-rural-dental-health/) **Published:** April 17, 2024 **Author:** Jasmin Fernandes **Content:** “Individuals in rural communities face a number of barriers in accessing oral care, including financial concerns, lack of insurance coverage, shortage of providers, and difficulty accessing transportation services, according to the 2023 report “Still Searching: Meeting Oral Health Needs in Rural Settings” by CareQuest Institute for Oral Health, a nonprofit organization.” [Read the full story here.](https://www.insightintodiversity.com/rooted-in-care-ride-program-boosts-rural-dental-health/) **Categories:** In The News --- ### [Innocence Project: How Poor Oral Health Care in Prison Continues to Burden Wrongfully Convicted People](https://carequest.org/in-the-news/innocence-project-how-poor-oral-health-care-in-prison-continues-to-burden-wrongfully-convicted-people/) **Published:** March 20, 2024 **Author:** Jasmin Fernandes **Content:** “An estimated 68.5 million adults in the United States lack dental insurance. For those who have experienced incarceration, this financial burden can be insurmountable.” [Read the full story here.](https://innocenceproject.org/effects-of-poor-oral-health-on-the-wrongfully-convicted/) **Categories:** In The News --- ### [Spectrum News 13: Oral Health Disparities Impact Latinos at Larger Rates](https://carequest.org/in-the-news/spectrum-news-13-oral-health-disparities-impact-latinos-at-larger-rates/) **Published:** October 12, 2023 **Author:** Jasmin Fernandes **Content:** “In a study analyzing oral health disparities among Latino residents in the United States, the CareQuest Institute for Oral Health found Latino communities to be more vulnerable when obtaining proper dental services. The study’s findings have raised major concerns among Latino doctors who argue the gaps in accessing oral health care for Hispanics can be diminished by diversifying the medical field.” [Read the full story here.](https://mynews13.com/fl/orlando/news/2023/10/12/oral-health-disparities-impact-latino-communities) **Categories:** In The News --- ### [A Change That Can Help Address the Black Maternal Health Crisis](https://carequest.org/blog/a-change-that-can-help-address-the-black-maternal-health-crisis/) **Published:** April 8, 2022 **Author:** Caitlin Locklear **Content:** *By Myechia Minter-Jordan, MD, MBA, Senior Advisor and former President and CEO of CareQuest Institute for Oral Health* Uncertainty. Anticipation. Fear. These are just a few of the emotions that run through the minds of almost every expecting parent. And for many expecting Black parents, those feelings are more acute. This [Black Maternal Health Week](https://blackmamasmatter.org/bmhw/), we are reminded that Black women in the US are [three times more likely to die](https://www.ajmc.com/view/racial-disparities-persist-in-maternal-morbidity-mortality-and-infant-health) from a pregnancy-related complication than their white counterparts and [twice as likely](https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=23) to lose an infant to premature death. This is the result of generations of structural racism and inequitable access to high-quality, comprehensive care. ## Facing Discrimination and Health Disparities![black-woman-baby](https://www.carequest.org/sites/default/files/80iStock-1044543794.jpg) Health systems rooted in decades of discriminatory policies and narrow, culturally incompetent views of health and wellness are not equipped to address these disparities or adequately support Black parents. In fact, existing systems simultaneously devalue and exacerbate the pain experienced by Black mothers. (Editor’s note: Black Mamas Matter Alliance, the founder of Maternal Health Week, uses the term “Black Mamas” to represent birthing persons (cis women, trans folks, and gender-expansive individuals) that are of African descent across the diaspora (Afro-Latinx, African-American, AfroCaribbean, Black and African immigrant). Wherever possible, we strive to use inclusive language in our communications at CareQuest Institute.) From [higher rates of chronic conditions](https://www.nationalpartnership.org/our-work/health/reports/black-womens-maternal-health.html) — like heart disease and diabetes — and [oral health issues](https://www.carequest.org/education/resource-library/new-nhanes-oral-health-data-reflect-barriers) to [lack of access to care](https://www.mhtf.org/topics/maternal-health-in-the-united-states/) and [explicit bias within health settings](https://www.statnews.com/2020/09/18/how-the-cdc-and-others-are-failing-black-women-during-childbirth/), Black women, in particular, too often find themselves in challenging circumstances when it comes to maintaining their health and the health of their children. Oral health, too, is often overlooked but has a critical impact on maternal and early childhood health. ## Breaking Black Maternal Health Barriers As we recognize Black Maternal Health Week, this is an opportune time for all of us to recognize this crisis and engage in the national conversation about dismantling the systemic barriers to care for pregnant people of color. It’s also time to recognize the importance of providing comprehensive care — including oral care — to all. Fortunately, our nation’s policymakers signed into law a mechanism to expand maternal health coverage that went into effect on April 1, 2022. The change, a provision in the American Rescue Plan, allows states to [extend postpartum Medicaid benefits from the current 60 days to 12 months](https://www.kff.org/policy-watch/postpartum-coverage-extension-in-the-american-rescue-plan-act-of-2021/). Expanding the breadth and duration of maternal health care covered by Medicaid — especially preventive care, including oral health care — is a critical part of the fight to improve health outcomes for parents and children. While [states need to take action](https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/) to extend this coverage, this new provision creates a new pathway to help address health equity among pregnant people and their babies. And while coverage alone will not address all the ways in which systemic racism in health care results in worse outcomes, including higher Black maternal mortality rates, access to affordable health coverage is essential. The American Rescue Plan’s postpartum provision recognizes that oral health plays an essential, but underappreciated, role in protecting the health of babies and their mothers. [Approximately 4 in 10 of all pregnant women](https://www.cdhp.org/resources/320-oral-health-pregnant-women-resource-center) — and the percentage is even higher for expecting Black women — experience oral health issues that raise the likelihood of poor birth outcomes and exacerbate underlying conditions that can lead to major complications and even death. Poor oral health raises a pregnant person’s [risk of high blood pressure](https://familiesusa.org/wp-content/uploads/2020/03/OH_Pregnancy-Related-Oral-Health_FactSheet.pdf), a precursor to preeclampsia, which can lead to major complications and even death. And children are [three times more likely](https://www.cdc.gov/oralhealth/publications/features/pregnancy-and-oral-health.html) to have dental disease if their parent was not able to receive dental care during pregnancy. These kinds of preventable complications and poor health outcomes place additional financial stress on individuals, the health care system, and state budgets. A safe and healthy pregnancy should be a fundamental human right, not a privilege, but far too many people still find themselves without the care they need for themselves and their babies. As we work toward a more equitable recovery from the COVID-19 pandemic, we must transform our health care systems to ensure that comprehensive pre- and postpartum care is universally available. Continuing to expand access to oral and overall health care before, during, and after pregnancy will change lives and bring us closer to real health equity. **Categories:** Blog **Tags:** Health Equity --- ### [Decisions in Dentistry: Grant Funds Address the Oral Health of Patients With Disabilities](https://carequest.org/in-the-news/decisions-in-dentistry-grant-funds-address-the-oral-health-of-patients-with-disabilities/) **Published:** February 29, 2024 **Author:** Jasmin Fernandes **Content:** “CareQuest Institute for Oral Health has allocated $1.25 million in funding to 10 organizations to address systemic barriers to oral health for people with disabilities.” [Read the full story here.](https://decisionsindentistry.com/2024/02/grant-funds-address-the-oral-health-of-patients-with-disabilities/) **Categories:** In The News --- ### [Your Official ADHA Podcast: Staggering Loss of Productivity Due to Dental Issues](https://carequest.org/in-the-news/your-official-adha-podcast-staggering-loss-of-productivity-due-to-dental-issues/) **Published:** June 20, 2024 **Author:** Jasmin Fernandes **Content:** On this episode of the ADHA Podcast host Matt Crespin sits down with Lisa Heaton, PhD, author of a recently published report from the CareQuest Institute for Oral Health on the tremendous amount of lost productivity as a result of dental issues. Dr. Heaton shares some of the eye-opening findings from this study as well as mitigation opportunities for reducing the devastating economic burden of neglected oral health. [Listen to the full episode here.](https://wavve.link/d9oq8WY71) **Categories:** In The News --- ### [Fierce Healthcare: Comprehensive Dental Coverage Gaining Traction In Congress](https://carequest.org/in-the-news/fierce-healthcare-comprehensive-dental-coverage-gaining-traction-in-congress/) **Published:** October 3, 2024 **Author:** Jasmin Fernandes **Content:** CareQuest has worked with and supported Sanders on these issues, but Dingell’s bill is the first time in years that a companion bill has been introduced in the House. [Read the full story here.](https://www.fiercehealthcare.com/payers/comprehensive-dental-coverage-gaining-traction-congress) **Categories:** In The News --- ### [The Journey Toward Oral Health Equity in Virginia](https://carequest.org/blog/the-journey-toward-oral-health-equity-in-virginia/) **Published:** February 5, 2024 **Author:** Caitlin Locklear **Content:** A particular moment stands out to Sarah Bedard Holland, the CEO of Virginia Health Catalyst, as when she realized she wanted to work in health care: “When I was in high school, someone who was very close to me was diagnosed with AIDS, and I had the opportunity to see firsthand how my community reacted to that,” Bedard Holland says. “I saw how the health care system responded to him, his diagnosis, and ultimate death. . . . I think it was that general injustice and inequity that really cemented for me that there was an opportunity to change things.” Then, while working in the health care industry, she experienced another wake-up call: She heard the story of Deamonte Driver, a 12-year-old boy in Maryland who died in 2007 from an infection in his tooth that spread to his brain. Bedard Holland realized that many people faced significant barriers to accessing oral health care — barriers that she helps communities overcome in her work at [Virginia Health Catalyst](https://vahealthcatalyst.org/). Bedard Holland has been with the organization for about 14 years. The statewide nonprofit’s mission is to ensure all Virginians have equitable access to comprehensive health care that includes oral health. Their work includes provider education, public awareness, and advocacy, with a helping hand from CareQuest Institute, which has awarded grants to the organization since 2010. “It has always felt like a relatively strong partnership that doesn’t have the same power dynamics that you sometimes see with other large organizations when there’s kind of a grantee/grantor situation,” Bedard Holland says. In [this video](https://www.youtube.com/watch?v=hQSOh2M-m3Q), Bedard Holland dives deeper into how Virginia Health Catalyst is improving the oral health care system in Virginia and their ongoing partnership with CareQuest Institute. **Categories:** Blog **Tags:** Health Equity --- ## Pages ### [Home - CareQuest Institute for Oral Health](https://carequest.org/) **Published:** August 5, 2025 **Author:** Darren Edwards **Content:** # Improving the Oral Health of All ## Join us in creating a system that is accessible, equitable, and integrated. [Support Veteran Smiles](https://supportveteransmiles.org/) [Medical-Dental Integration](https://carequest.org/about/medical-dental-integration/mdi-in-action/) ![Carequest Institute Overview Graphic](https://carequest.org/wp-content/uploads/2025/09/CQI-Homepage-hero_9.8_1.png "CareQuest Institute Overview Graphic") ## We Champion Oral Health Transformation Our health care system is not built to work for everyone — people of color, those living in rural communities, people with disabilities, older adults, and other historically marginalized groups have been left behind. CareQuest Institute for Oral Health is a nonprofit championing a more equitable future where every person can reach their full potential through excellent health. [About us](https://carequest.org/about/) ## The Latest [![Promotional Banner for a Webinar: Navigating Reimbursement Systems to Support Person-centered Care, by Carequest Institute for Oral Health and Nncha. Date: Thursday July 16, 2026, 7–8 P.m. Et, 1 Ce Credit. Moderator Candace Hsu Owen; Presenters Melinda Diggan and Caroline Mcleod, with Their Credentials, Shown As Circular Headshots on the Right.](https://carequest.org/wp-content/uploads/2026/07/Webinar-Graphics_7-30-26_960-x-540-speaker-graphic-copy-01-e1784559391822.png "Webinar Graphics_7-30-26_960 x 540 - speaker graphic copy-01")](https://carequest.org/education/live-webinars/) Webinar # Evidence and Solutions to Overcome Oral Health Disparities [View webinar](https://carequest.org/education/live-webinars/) [![](https://carequest.org/wp-content/uploads/2025/12/9-Quotes-960X540-scaled.png "9 Quotes 960X540")](https://carequest.org/blog/successes-and-setbacks-9-quotes-about-oral-health-in-2025/) Blog Post ### Successes and Setbacks: 9 Quotes About Oral Health in 2025 [View blog post](https://carequest.org/blog/successes-and-setbacks-9-quotes-about-oral-health-in-2025/) [![](https://carequest.org/wp-content/uploads/2025/11/Who-gets-left-behind.png "Who gets left behind")](https://carequest.org/resource/oral-health-in-america-who-gets-left-behind/) Publication ### Research Report: Oral Health in America: Who Gets Left Behind? [View publication](https://carequest.org/resource/oral-health-in-america-who-gets-left-behind/) ## Stories of Impact This growing collection of stories — featuring our work with communities, patients, providers, policymakers, educators, and advocates — are the building blocks of a more accessible, equitable, and integrated health system. [Read stories](https://carequest.org/about/impact/) ## A Suite of Oral Health Continuing Education CareQuest Institute is an ADA CERP Recognized Provider of oral health care education, offering a growing collection of programs in partnership with leading experts, researchers, and organizations from across the oral health care field. ![](https://carequest.org/wp-content/uploads/2025/08/SPC-1.png "SPC (1)") $ #### Self-paced courses ![](https://carequest.org/wp-content/uploads/2025/08/Live-Webinars-7.png "Live Webinars 7") $ #### Live webinars ## Philanthropy & Grants We address complex and upstream drivers of oral health disparities by investing strategically and providing collaborative, capacity-building support that leads to healthier communities. [Learn more](https://carequest.org/grants-overview/) ## Policy & Advocacy We mobilize diverse coalitions, champion policies, and create pathways that lead us to a more accessible, equitable, and integrated oral health system. [Learn more](https://carequest.org/policy-advocacy/) ![](https://carequest.org/wp-content/uploads/2025/11/Home-Page-PA.jpg "Shot of a group of businesspeople networking at a conference") ![](https://carequest.org/wp-content/uploads/2025/11/Home_ADI.jpg "Laptop statistics, diversity partnership and people review media analytics, feedback data or research project insight. Teamwork, media analyst and business team working on customer experience info") ## Analytics & Data Insights We disseminate research, analytics, and evaluations that providers, policymakers, and advocates can use to improve the oral health system and inform policy and financing decisions. [Learn more](https://carequest.org/publications-tools/) --- ### [Faculty Resources](https://carequest.org/education/faculty-resources/) **Published:** March 27, 2026 **Author:** Chernise Harris **Content:** # Faculty Resources ## Explore evidence-based teaching resources to strengthen oral health curricula. ![](https://carequest.org/wp-content/uploads/2026/04/faculty-resources-hero-1.png "faculty resources hero 1") **Below, find PowerPoint slides, instructor notes, assessments, learning activities, and courses for you to integrate into your curricula.** ### Caries Management and Prevention: A Risk-Based Approach #### Session 1: Foundations of Dental Caries: Disease Process and Epidemiology **Description:** This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations, and host factors such as saliva, diet, fluoride exposure, and oral hygiene behaviors influence cycles of demineralization and remineralization over time. The session will also provide a high-level overview of caries epidemiology to contextualize its impact across populations. **Learning Objectives:** - Explain dental caries as a chronic, dynamic, biofilm-mediated disease process driven by repeated pH changes and influenced by host and environmental factors. - Describe how microbial activity within dental biofilms leads to cycles of demineralization and remineralization over time. - Describe how caries progression varies by individual risk and contextual factors. - Interpret high-level population data on dental caries to explain why early detection and prevention are central to oral health practice. Download the [Session 1 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S1_Proofed.pdf) and the [Sesson 1 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S1_Proofed.pptx) #### Session 2: Understanding the Caries Process: Demineralization, Remineralization, and Biofilm Management **Description:** This session will investigate the pivotal role of fermentable carbohydrates and biofilm bacteria in the development of dental caries, emphasizing how fluoride, calcium, and phosphate contribute to enamel stability and support remineralization through saliva. It also explores plaque formation, ecological shifts within the oral microbiome, and the effects of repeated acidic challenges on enamel demineralization. Students will analyze the role of mutans streptococci as key acidogenic and aciduric organisms associated with lesion initiation and understand how low pH environments favor their persistence and activity. By the end of the session, they will understand the dynamic balance between demineralization and remineralization and how microscopic changes in enamel translate to clinical lesion development. **Learning Objectives:** - Explain how biofilm metabolism of fermentable carbohydrates leads to acid production and repeated pH fluctuations. - Describe how diffusion and critical pH contribute to subsurface enamel demineralization. - Differentiate between demineralization and remineralization at the crystal level, including the role of fluoride in reducing enamel solubility. - Relate microscopic changes in enamel to clinical presentation, including white spot lesions and D1–D4 classification. - Describe how shifts in biofilm composition contribute to lesion initiation and progression. Download the [Session 2 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S2_Proofed.pdf) and the [Sesson 2 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S2_Proofed.pptx) #### Session 3: Caries as a Disease: Etiology, Risk Factors, and Protective Factors **Description:** This session will help students understand if caries is a transmissive or infectious disease and how disease can be transmitted between humans. They will also understand how to coach humans on how to decrease the transmission of pathogenic bacteria that can lead to decay. **Learning Objectives:** - Discuss the evidence on vertical and horizontal transmission of cariogenic bacteria associated with dental caries. - Interpret a case review of saliva data from two families with similar saliva and disease presentations. - Select strategies for families to reduce their risk for dental caries. Download the [Session 3 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S3_Proofed.pdf) and the [Sesson 3 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S3_Proofed.pptx) #### Session 4: Caries Risk Assessment: Identifying and Interpreting Patient Risk **Description:** Dental caries is a multifactorial disease process influenced by the balance between pathological and protective factors. Understanding how disease indicators, risk factors, and protective factors interact helps clinicians identify patients at risk and guide preventive care. Using concepts from Featherstone’s caries balance model, learners examine how biological, behavioral, and environmental factors contribute to the development and progression of dental caries. Frameworks such as Caries Management by Risk Assessment (CAMBRA) and tools such as the ADA Caries Risk Assessment Form (CRA) are introduced as approaches for applying this understanding in practice. Through case-based activities and discussion, learners practice identifying caries risk and applying this information to support prevention and patient-centered care. **Learning Objectives:** - Compare approaches used to assess caries risk. - Identify disease indicators, risk factors, and protective factors associated with dental caries. - Explain how caries risk assessment informs patient conversations and prevention planning. Download the [Session 4 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S4_Proofed.pdf) and the [Sesson 4 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S4_Proofed.pptx) #### Session 5: Personalized Caries Prevention: Applying Risk-Based Strategies **Description:** Applying concepts of caries risk and balance is a core competency for oral health professionals. Through patient scenarios and peer discussion, students practice identifying disease indicators, risk factors, and protective factors and assigning an overall caries risk level. The activity emphasizes clinical reasoning and the role of caries risk assessment in guiding prevention planning and patient conversations. By engaging in a simulated provider-patient interaction, learners begin to connect risk assessment with individualized, preventive approaches to caries management. **Learning Objectives:** - Apply a caries risk assessment tool in a provider-patient scenario. - Differentiate disease indicators, risk factors, and protective factors. - Assign a caries risk level based on patient findings. - Discuss how risk assessment guides prevention planning. Download the [Session 5 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S5_Proofed.pdf) and the [Sesson 5 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S5_Proofed.pptx) #### Session 6: Levels of Prevention in Dental Caries: From Primordial to Tertiary Care **Description:** Learners will explore prevention levels in this session, covering public health strategies and individual/community clinical interventions. The aim is to provide learners with insights into preventive dentistry, emphasizing the pivotal role of early intervention and a comprehensive understanding of risk factors. **Learning Objectives:** - Define primary, secondary, and tertiary prevention. - Discuss the CAMBRA protocol and the evidence for CAMBRA. - Examine the evidence for the protocols listed within the CAMBRA framework. - Explain how prevention aligns with disease progression. - Apply prevention strategies based on timing. - Describe how CAMBRA guides clinical decision-making. Download the [Session 6 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S6_Proofed.pdf) and the [Sesson 6 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S6_Proofed.pptx) #### Session 7: Clinical Decision-Making: Applying Caries Risk Assessment to Patient-Centered Care **Description:** Learners will apply caries risk assessment to two clinical case studies. Participants will identify disease indicators, risk factors, and protective factors, and use this information to determine caries risk level. Emphasis is placed on clinical reasoning and justification of decisions. **Learning Objectives:** - Identify disease indicators, risk factors, and protective factors. - Determine caries risk level using clinical evidence. - Justify their risk assessment using findings from the case. Download the [Session 7 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S7_Proofed.pdf) and the [Sesson 7 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S7_Proofed.pptx) #### Session 8: The Oral Microbiome and Caries: From Dysbiosis to Prevention **Description:** In this session, learners will explore how the quantity and quality of saliva influence oral health. This presentation will examine key factors such as acidity, pH levels, and buffering capacity, and how they shape the oral environment and microbiome. Learners will also consider patient-specific factors affect salivary function and contribute to caries risk. **Learning Objectives:** - Explain the functions of saliva in oral health. - Differentiate how the quality and quantity of saliva affect patients’ disease status. - Describe how saliva influences caries risk. - Identify factors that alter salivary flow and composition. Download the [Session 8 Instructor Guide](https://carequest.org/wp-content/uploads/2026/04/CQ-S8_Proofed.pdf) and the [Sesson 8 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/04/CQ-S8_Proofed.pptx) #### Session 10: Saliva in Disease: Cardiovascular Conditions and Caries Risk **Description:** In this session, learners will explore how saliva, overall health, and disease risk are connected to systemic health. The goal is to help learners understand how the bacteria in saliva can be linked to stroke and heart disease. This presentation will discuss facts about strokes and heart disease, gaining insights, and discussing how dental diseases might be connected to inflammation in the body. **Learning Objectives:** - Discuss the connection of bacteria in saliva to stroke and heart disease. - Examine the relationship between caries and stroke and heart disease. - Evaluate the saliva and clinical case of a patient with congestive heart failure and assess how their oral findings correlate. Download the [Session 10 Instructor Guide](https://carequest.org/wp-content/uploads/2026/07/CQ-S10_Proofed.pdf) and the [Sesson 10 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/07/CQ-S10_Proofed.pptx) #### Session 11: Saliva in Disease: Asthma, Allergic Rhinitis, and Caries Risk **Description:** In this session, learners will explore how asthma and allergic rhinitis can impact saliva and increase the risk of dental caries. This presentation will explore the medications used by patients and guide the creation of a collaborative preventive treatment plan. It will address the impact of asthma and allergic rhinitis medications on the oral microbiome. **Learning Objectives:** - Discuss how the bacteria in saliva connect to asthma and allergic rhinitis. - Examine the relationship between caries and asthma and allergic rhinitis. - Evaluate the saliva and clinical case of a patient with asthma. Download the [Session 11 Instructor Guide](https://carequest.org/wp-content/uploads/2026/07/CQ-S11_Proofed.pdf) and the [Sesson 11 Slides with Faculty Notes.](https://carequest.org/wp-content/uploads/2026/07/CQ-S11_Proofed.pptx) *Note: All course materials [align with CODA Accreditation Standards.](https://carequest.org/wp-content/uploads/2026/04/CODAStandards_March2026.pdf)* [Access answer keys](#request) ## Student Courses Guide your students through short lessons on critical topics, including cariology, prevention, and health equity. $ #### Explore student courses ![Professor Standing at the Front of a Classroom, Reading a Document to Students Seated with Notebooks and a Laptop.](https://carequest.org/wp-content/uploads/2026/07/faculty-pic1.png "faculty pic1") ### Instructor Verification: Access to Answer Keys Please fill out this short form to help us verify that you are the instructor of record for the course listed below and should have access to the assessment answer keys connected to the Session Instructor Guides. \*We will review requests within two (2) business days. After verification, you will receive an email with an access code and directions to access the answer keys. ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) **Instructor Verification Request: Assessment Answer Key Access** Please fill out this short form to help us verify that you are the instructor of record for the course listed below and should have access to the assessment answer keys connected to the Session Instructor Guides. \*We will review requests within two (2) business days. After verification, you will receive an email with an access code and directions to access the answer keys. --- ### [Live Webinars](https://carequest.org/education/live-webinars/) **Published:** January 7, 2026 **Author:** Darren Edwards **Content:** # Live Webinars ## Join leading experts and researchers as they explore some of the most pressing topics facing oral and overall health today. CareQuest Institute webinars are free and available as recordings for your convenience. ![](https://carequest.org/wp-content/uploads/2026/01/Webinar-Hero.png "Webinar Hero") ## Upcoming Webinars ![](https://carequest.org/wp-content/uploads/2026/07/Webinar-Graphics_7-30-26_960-x-540-speaker-graphic-copy-01.png "Webinar Graphics_7-30-26_960 x 540 - speaker graphic copy-01") ### Evidence and Solutions to Overcome Oral Health Disparities ### (1 Free CE Credit) #### Register for webinar “Go see the dentist” is not as straightforward as it sounds. For many patients, finding a provider, scheduling appointments, understanding insurance coverage, and completing referrals can be significant challenges that disproportionately affect individuals with the greatest health and social needs. What can oral health professionals do to help close these gaps? Join CareQuest Institute for a webinar that will explore the current landscape of oral health equity, including policy challenges, insurance barriers, and disparities across populations. The expert speakers will share findings from the latest research — including emergency department (ED) use for non-traumatic dental needs — that reveal both systemic barriers and surprisingly simple, fixable gaps in scheduling communication and care coordination. Speakers will also highlight practical workflow strategies and community-based approaches, such as partnering with community health workers, to improve access to care. ![Carequest Webinar Banner: Safety and Risk Management, Aug 13, 2026, 7–8 P.m. Et; Includes a '1 Ce Credit' Button and 'register Now' Panel.](https://carequest.org/wp-content/uploads/2026/06/813-coming-soon.png "813 coming soon") ### Topic: Safety and Risk Management ### (1 Free CE Credit) #### Register for webinar Webinar details coming soon. ![](https://carequest.org/wp-content/uploads/2026/07/82726-Coming-Soon.png "82726 Coming Soon") ### Topic: Veteran Oral Health ### (1 Free CE Credit) #### Register for webinar Webinar details coming soon. ![](https://carequest.org/wp-content/uploads/2026/07/91026-coming-soon.png "91026 coming soon") ### Medicaid Changes: Guidance for Oral Health Teams ### (1 Free CE Credit) #### Register for webinar Webinar details coming soon. ## Recorded Webinars Missed the live webinar? Watch the recordings when it’s convenient for you. Note: Recorded webinars are not eligible for continuing education. $ #### View recorded webinars ![](https://carequest.org/wp-content/uploads/2025/08/Recorded-Webinars-7.png "Recorded Webinars 7") ## Continuing Education CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [Transforming Oral Health](https://carequest.org/about/transforming-oral-health/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Transforming Oral Health ## We work with public and private partners to build person-centered, integrated care systems that improve health outcomes. ![](https://carequest.org/wp-content/uploads/2025/11/Transforming-OH-header.jpg "Smiling guy in dentist chair looking with trust at doctor") Our health care system is fragmented — medical, dental, and other areas of health are siloed — and when the system is fragmented, so is the quality and continuity of care that a patient receives. Oftentimes, patients slip through the gaps of the system and are burdened with the responsibility of seeking, managing, and integrating their care. Instead, equipped with the right tools and incentives, providers and other health care professionals can be stewards for patients by coordinating and providing comprehensive, holistic care. How are we transforming oral health? Explore the areas below to find related research, publications, thought leadership, educational materials, grant opportunities, and more. ## Medical-Dental Integration The links between oral health and overall health — between the mouth and the body — are increasingly clear. And to treat the whole person, our health system needs to recognize these connections and bridge the silos between medical care and dental care. [Medical-dental integration](https://carequest.org/about/medical-dental-integration/) can help build that critical bridge between oral health and overall health. This approach to care integrates dental medicine into primary care and behavioral health, while also integrating services such as screenings for chronic diseases into dental care. It includes coordinated care that ensures all providers caring for a given patient have access to the same information and can communicate seamlessly with one another through connected systems. ![](https://carequest.org/wp-content/uploads/2025/11/Transforming-OH-mdi.jpg "Female dentist writing information about senior patient") That coordinated system — between dentistry and other health disciplines — is essential but getting that coordination right is complex and challenging. [Promising work is underway](https://carequest.org/about/medical-dental-integration/mdi-in-action/), as providers realize the value of coming up with comprehensive care plans for the whole person. [Learn more](https://carequest.org/about/medical-dental-integration/) ## Minimally Invasive Care [Minimally invasive care (MIC)](https://carequest.org/about/minimally-invasive-care/) in dentistry is an option for patients that is often more desirable and accessible than expensive and painful needles, drills, and extractions. MIC aims to prevent and heal tooth decay without removing any tooth structures. MIC can also help patients (and providers) avoid the cycle of repairs that are often needed with other restorative work, detecting and treating small cavities early. It can reduce anxiety, save money, and result in better long-term outcomes. MIC makes care more accessible and convenient, too. It can be delivered by different members of the care team, including dental hygienists, dental therapists, dental assistants, and medical providers, which can expand access for patients — especially in rural areas. [Learn more](https://carequest.org/about/minimally-invasive-care/) ![](https://carequest.org/wp-content/uploads/2025/11/Transforming-OH-MIC.jpg "Child Boy Receiving Fluoride Treatment from Dentist") ## Value-Based Care In recent years, both medicine and dentistry have experienced a push to begin rewarding not the quantity of services but the quality of outcomes — a model known as [value-based health care](https://carequest.org/about/value-based-care/). This approach incentivizes prevention and personalization, and typically involves alternative payment models (APMs). APMs can use different frameworks to: - Link financial incentives to improvements in care quality and health outcomes - Focus on disease management and prevention to lower spending - Pay for comprehensive and coordinated services The advantages of a value-based care model are clear: less waste, lower costs, and, most importantly, better oral health for patients. Getting to that reality will take innovation, persistence, and a redesigned oral health care system. [Learn more](https://carequest.org/about/value-based-care/) ![](https://carequest.org/wp-content/uploads/2025/11/VBC-Header.jpg "VBC - Header") --- ### [Policy & Advocacy](https://carequest.org/policy-advocacy/) **Published:** September 19, 2025 **Author:** Darren Edwards **Content:** # Policy & Advocacy ## We drive federal and state oral health policy change through in-depth analysis, strategic policymaker engagement, supporting coalitions, and mobilizing advocacy networks. ![](https://carequest.org/wp-content/uploads/2025/11/PA-Hero.png "P&A Hero") ## Advancing Oral Health Policy Issues Changing our health system isn’t easy, but it is essential. We are committed to challenging and transforming traditional models of care to ensure that every person can reach their full potential. CareQuest Institute is actively advocating for the following key oral health policy issues: ### **Protecting Community Water Fluoridation** More than 75 years of research and over 7,000 studies demonstrate that, at appropriate levels, community water fluoridation (CWF) is safe and essential in preventing tooth decay — especially for millions of Americans without dental insurance, who can’t afford care or live far from a dental provider. Leading health organizations support CWF, including the American Dental Association and the American Academy of Pediatrics. Preventing cavities with CWF saves billions of dollars in treating cavities. [Learn more about community water fluoridation](https://carequest.org/policy-advocacy/community-water-fluoridation/) [![](https://carequest.org/wp-content/uploads/2025/11/fluoridation_PA_600x550.png "fluoridation_P&A_600x550")](https://carequest.org/community-water-fluoridation-proven-safe-and-essential-for-oral-health/) ### **Advocating for Veteran Oral Health** More than 80% of US veterans are not eligible for dental benefits through the US Department of Veterans Affairs (VA) despite that veterans have consistently higher rates of tooth decay, gum disease, and missing teeth compared to nonveterans. Lack of dental care among veterans leads to increased risk of chronic disease and financial strain from out-of-pocket expenses. By broadening eligibility for dental care through the VA, policymakers can improve health and quality of life for those who have served our country. [Learn more about veteran oral health](https://carequest.org/policy-advocacy/veteran-oral-health/) [![](https://carequest.org/wp-content/uploads/2025/11/veterans_PA-thumbnail_600x550.png "veterans_P&A thumbnail_600x550")](https://carequest.org/veterans-need-affordable-dental-care/) ### **Strengthening Adult Dental Benefits in Medicaid** Medicaid is a key source of health care coverage for nearly 80 million people in the US. Because adult dental benefits are optional in state Medicaid plans, millions cannot get the dental care they need, or they resort to more costly care in a hospital emergency department — ED visits for non-traumatic dental conditions cost nearly $4 billion annually. Comprehensive dental benefits for all adults enrolled in Medicaid can improve health outcomes, reduce health care spending, and increase employment opportunities. Explore the [Medicaid Adult Dental Coverage Checker](https://carequest.org/medicaid-adult-dental-coverage-checker/) to find out what coverage is available in your state. [Learn more about Medicaid adult dental benefits](https://carequest.org/policy-advocacy/medicaid/) [![](https://carequest.org/wp-content/uploads/2025/11/medicaid_PA_600x550.png "medicaid_P&A_600x550")](https://carequest.org/the-need-for-medicaid-adult-dental-coverage-across-all-states/) ### **Adding a Dental Benefit to Medicare** Maintaining oral health is especially important as we age — poor oral health is linked to diabetes, heart disease, and Alzheimer’s disease. Yet standard Medicare, the insurance program that millions of older people in the US rely on, does not provide dental coverage, leaving approximately one third (31%) of participants paying out-of-pocket or without care. Including dental coverage for all Medicare enrollees has the potential to save the health care system an estimated $42 billion per year treating chronic diseases and improve the overall health of older adults. [Learn more about Medicare dental benefits](https://carequest.org/policy-advocacy/medicare/) [![](https://carequest.org/wp-content/uploads/2025/11/medicare_PA_600x550.png "medicare_P&A_600x550")](https://carequest.org/the-need-for-medicare-dental-coverage/) ## Stats $9.8B Removing fluoride from drinking water would lead to an estimated $9.8 billion in added health care costs. $ #### Learn more 31% Approximately one third (31%) of Medicare recipients do not have dental insurance. $ #### Learn more 80M 80 million people rely on Medicaid for their health care. $ #### Learn more 8M Nearly 8 million veterans report having fair or poor oral health. $ #### Learn more ## Media Looking for expert comment or key data on key policy issues, visit our media page to connect with a spokesperson. [Visit our Media page](https://carequest.org/news/media/) ## Join OPEN Many grantees are also a part of [OPEN](https://carequest.org/policy-advocacy/open/), an initiative of CareQuest Institute, a diverse network of individuals and entities taking on America’s oral health challenges to provide everyone with an equitable chance to thrive. OPEN members use their unique experiences, knowledge, and skills to lead network activities every year, creating collective energy that is driving large-scale change. [Learn more about OPEN](https://carequest.org/open/) ![](https://carequest.org/wp-content/uploads/2025/09/OPEN-Hill-Day-Logo-pos-rgb-500_wbackground-e1758734322431.png "OPEN Hill Day Logo-pos-rgb 500_wbackground") --- ### [Support Veteran Oral Health Partner Toolkit](https://carequest.org/support-veteran-oral-health-partner-toolkit/) **Published:** June 11, 2026 **Author:** Lisa Sall **Content:** # Support Veteran Smiles # Partner Toolkit Thank you for supporting veteran oral health and amplifying veterans’ voices about the lack of dental coverage through the Veterans Health Administration (VA). Nearly 7 million veterans are currently ineligible for dental coverage through the VA, which is harming their physical and mental health. The Support Veteran Smiles campaign aims to raise awareness of this important health issue. CareQuest Institute will begin **organic social promotion from June 30–August 9, 2026, followed by a paid digital campaign running across social and television through November**. Throughout the campaign, we will actively pitch stories to the media. ## Essential Links [Campaign Landing Page](https://supportveteransmiles.org/) [Videos](https://youtube.com/playlist?list=PLaywq-44CQNDJz9pA8mkETGesFaz-UG-l&si=KljpChbUUBxxOpAI) [Sample Press Release](https://carequest.org/press-release/carequest-institute-launches-national-campaign-to-improve-veterans-oral-health/) [Toolkit PDF](https://carequest.org/wp-content/uploads/2026/06/Support-Veteran-Smiles-Partner-Toolkit_FINAL.pdf) ## Phase 1: Campaign Schedule & Sample Posts We’ve drafted a calendar of weekly social copy and creative. We invite you to share our posts and/or create your own social posts using the creative assets available in the toolkit. Please tag CareQuest channels so we can continue to measure the impact and reach of the campaign! - Facebook: @CareQuestInstitute - Instagram: @CareQuestInstitute - LinkedIn: CareQuest-Institute - X: @CareQuestInst **Dates** **Suggested Video** **Suggested Social Posts****Week 1** June 29–July 5 [*60 second video*](https://youtu.be/OjePFo2zbeA?si=sr_1nate5ioNtt-l) [*30 second video*](https://youtu.be/YwMYywQz08s?si=VYSepe2ZQIPr8vRV) On the 250th anniversary of America’s freedom, let’s take care of those who took care of us. Our veterans need — and deserve — dental coverage through the VA for their physical and mental health. Learn more at [SupportVeteranSmiles.org](http://www.SupportVeteranSmiles.org) #SupportVeteranSmiles #America250 On America’s 250th anniversary, let’s take care of those who sacrificed for us. Our veterans need — and deserve — dental coverage through the VA for their physical and mental health. Learn more at [SupportVeteranSmiles.org](https://www.SupportVeteranSmiles.org) #SupportVeteranSmiles #America250 **Week 2 & Week 3** July 6–July 19 [*They Fought for Us longform video*](https://youtu.be/W7Cwj76EWHQ%20)Veterans sacrificed for our country, and they deserve to get the care they need. Today, nearly 7 million veterans are ineligible for dental care through the Veterans Health Administration. Poor oral health takes a toll on them — physically, mentally, and financially. Learn more at [SupportVeteranSmiles.org ](https://www.SupportVeteranSmiles.org)\#SupportVeteranSmiles #America250​ For their service and sacrifice, our veterans deserve dental care. Yet nearly 7 million veterans are ineligible for dental care through the Veterans Health Administration. Fight for our veterans’ oral health. Learn more about what you can do at [SupportVeteranSmiles.org](https://www.SupportVeteranSmiles.org) #SupportVeteranSmiles #America250 **Week 4** July 20–July 26 [*Fight for Them longform video*](https://youtu.be/yqB0OhPaqVo%20)Veterans sacrificed for our country, and they deserve to get the care they need. Today, nearly 7 million veterans are ineligible for dental care through the Veterans Health Administration. And poor oral health takes a toll on them — physically, mentally, and financially. Learn more at [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/) #SupportVeteranSmiles #America250​ For their service and sacrifice, our veterans deserve dental care. Yet nearly 7 million veterans are ineligible for dental care through the Veterans Health Administration. Fight for our veterans’ oral health. Learn more about what simple actions you can take to help at [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/) #SupportVeteranSmiles #America250 **Week 5** July 27–August 2 [*Hiding Smiles longform video*](https://youtu.be/c3BNSubJik0%20)Basic dental coverage isn’t a lot to ask for putting your life on the line for your country . . . is it? Nearly 3 million veterans say they feel self-conscious or embarrassed because of their oral health, which affects them physically, mentally, and financially. Learn more at [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/) #SupportVeteranSmiles ​ Nearly 7 million veterans are ineligible for dental care through the Veterans Health Administration. Being embarrassed about their teeth and mouth impacts a veteran’s ability to get a job and interact confidently with other people. All veterans deserve dental coverage through the VA. Learn more at [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/) #SupportVeteranSmiles **Week 6** August 3–August 9 [*Taya’s Story longform video*](https://youtu.be/uc3CCm0eNL4%20) Oral health is essential to overall health. Yet, today, 75% of veterans are ineligible for dental coverage through the VA. Let’s fight for their health and for their smiles. Learn more at [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/) #SupportVeteranSmiles ## Newsletter Sample Post \[Insert organization name\] has joined CareQuest Institute and a coalition of 19 organizations on a national campaign to highlight the urgent need to improve dental care coverage for millions of veterans nationwide. Nearly 7 million veterans are ineligible for dental coverage through the Veterans Health Administration, which is harming veterans’ physical and mental health. Learn more at [SupportVeteranSmiles.org](https://www.supportveteransmiles.org/). ## Phase 2: CareQuest National Paid Campaign **Timing** **Channels** **Estimated Impressions** August 10–November 20 **Cable TV** (Discovery, CNN, Comedy Central, FoxNews, History Channel, TBS, USA, FX) 112K+ August 10–November 20 **Streaming Services** (ESPN+, Hulu, Amazon Prime) 13M+ August 10–November 20 **Social** (Meta – Facebook, Instagram) 1.25M+ September 1–November 20 **Digital Streaming** (Paramount+) 3.3M+ **17.6M+ Total Estimated Impressions** --- ### [Partner With Us](https://carequest.org/about/partner-with-us/) **Published:** November 7, 2025 **Author:** Darren Edwards **Content:** # Partnering for Impact ## Collaboration and partnership are key to achieving our mission – to improve the oral health of all. [Connect with us](#connect) ![](https://carequest.org/wp-content/uploads/2025/11/Home-Page-PA.jpg "Shot of a group of businesspeople networking at a conference") ## Ways to Partner with Us ##### Medical-Dental Integration We collaborate with public and private stakeholders, working to design health systems that provide person-centered, integrated care that create better outcomes. Partnerships may range from learning communities to pilot programs, all with the aim of advancing [medical-dental integration](https://carequest.org/about/medical-dental-integration/mdi-in-action/). ##### Research & Analytics Our Analytics and Data Insights team collaborates with partners to explore, publish, and disseminate actionable research, analytics, and evaluations. Those [publications and tools](https://carequest.org/publications-tools/) help providers, policymakers, and advocates inform care and policy decision that focus on improving the oral health care system. The Health Data Exchange is actively seeking data partners. ##### Advocacy Our [OPEN](https://carequest.org/policy-advocacy/open/)[ ](https://carequest.org/policy-advocacy/open/)[Initiative](https://carequest.org/policy-advocacy/open/) invites its members to champion policy changes that advance equity and incorporate oral health as a core component of our health system. ##### Grants Our [philanthropy](https://carequest.org/grants2/) team partners with organizations that serve and represent historically marginalized communities to advance oral health policy and systems change through community-driven solutions. ##### Education Our education team collaborates with industry partners within and outside of oral health to disseminate key knowledge and skills via [webinars and self-paced courses](https://carequest.org/education/). ##### Innovation Our for-profit subsidiary, CareQuest Innovation Partners, works closely with industry partners, investors, innovators, and entrepreneurs who are transforming oral health. [Learn more about how to partner with our Innovation team](https://carequestinnovation.com/partner-with-us/). (This link will lead you to a separate website) ## Are You Interested in Partnering with CareQuest Institute? If you’re interested in partnering with CareQuest Institute, please email and a member of our Partnerships team will reach out to learn more. ## Featured Partnerships ![Square Logo Featuring a Red Upper-left Section, a Blue Lower-right Section, and a White Curved Wave Separating Them](https://carequest.org/wp-content/uploads/2026/07/partnerships_henryschein-scaled-1.png "partnerships_henryschein-scaled – CareQuest Institute") #### Henry Schein: BRIDGE Health Network Established by Henry Schein and CareQuest, BRIDGE is a curated network of health care professionals committed to advancing systemic models of care and strengthening disease prevention through medical-dental integration. The initiative’s inaugural pilots focus on incorporating diabetes screenings into routine dental hygiene visits. Participating care teams provide point-of-care testing, share educational resources, and coordinate follow-up care—helping identify risks earlier and connect patients to the support they need. ![Innovaccer Logo with Pink Diamond Icon and Black Brand Name](https://carequest.org/wp-content/uploads/2026/07/Innovaccer-Logo-color.png "Innovaccer-Logo-color – CareQuest Institute") #### Innovaccer: Integrated Medical and Dental Data Through this partnership, CareQuest Institute and Innovaccer link medical and dental claims and clinical data through Innovaccer’s Humbi platform, drawing on Innovaccer’s expertise in unifying complex health data at scale. By creating a more complete, longitudinal view of patient health, the collaboration supports deeper insights into how oral health influences overall patient outcomes and total cost of care. The collaboration explores how these insights can inform interventions that improve care coordination and support more effective, person-centered health care delivery. ![Nxtcare Logo: Circular Blue Gradient with Cyan Rim and White 'nxtcare' Text.](https://carequest.org/wp-content/uploads/2026/07/NxtCare-Orb-Transparent-Bkgrd.png "NxtCare Orb Transparent Bkgrd – CareQuest Institute") #### NxtCare: Integrating Oral Health Insights into Home-Based Care Settings This partnership focuses on home health patients, a high-risk population that is traditionally underrepresented in oral health evaluation across the broader health care continuum. By systematically analyzing oral health assessments within post-acute settings, NxtCare and CareQuest generate clinical intelligence that connects oral health status to broader health outcomes. These insights equip providers, payers, and ACOs with the data needed to improve care quality, reduce costs driven by unaddressed oral health conditions, and accelerate access to treatment before conditions escalate. ![Pds Health Logo: Gray Flower Icon with a Blue Petal, then 'pds Health' Text.](https://carequest.org/wp-content/uploads/2026/07/partnerships_pdshealth-1.png "partnerships_pdshealth 1 – CareQuest Institute") #### PDS Health: Integrated Blood Pressure Screenings As strong evidence exists on the connection between oral and cardiovascular health, CareQuest and [PDS Health](https://www.pdshealth.com/) are working together to standardize and scale workflows for blood pressure screenings and patient consultation across its dental and integrated care practices. This initiative generates insights on the prevalence of undiagnosed hypertension detectable through dental settings, estimate medical cost savings associated with earlier detection and referral into medical care, and strengthen the business case for scale. [Learn more about partnership opportunities](https://carequest.org/about/partner-with-us/) --- ### [Education & CEs](https://carequest.org/education/) **Published:** August 5, 2025 **Author:** Darren Edwards **Content:** # Education & CEs ## Gain the knowledge and skills to transform our oral health system. [Explore courses](https://carequest.org/education/self-paced-courses/) [View webinars](https://carequest.org/education/live-webinars/) ![](https://carequest.org/wp-content/uploads/2025/11/Education-Hero.png "Education Hero") ## A Suite of Oral Health Continuing Education CareQuest Institute is an ADA CERP Recognized Provider of oral health care education, offering a growing collection of programs in partnership with leading experts, researchers, and organizations from across the oral health care field. ![](https://carequest.org/wp-content/uploads/2025/08/SPC-1.png "SPC (1)") $ #### Self-paced courses ![](https://carequest.org/wp-content/uploads/2025/08/Live-Webinars-7.png "Live Webinars 7") $ #### Live webinars ## Looking for CE Certificates? Visit My Learning for a transcript of your education activity and download your CE certificates. If you are looking for a certificate for a webinar or self-paced course completed before December 2025, please [contact us](https://carequest.org/contact-us/) directly for access to our legacy education site. $ #### Visit My Learning ![](https://carequest.org/wp-content/uploads/2025/01/Education-1-1.png "Education 1") ## Explore Faculty Resources Explore customizable curricular modules and instructor-ready materials to integrate prevention, equity, and systems-level thinking into your work to educate the oral health providers of the future. $ #### Faculty resources [![](https://carequest.org/wp-content/uploads/2026/03/faculty-resources.png "faculty resources")](https://carequest.org/education/faculty-resources/) ## What Learners Are Saying . . .  I appreciate all the ideas that the variety of presenters that I have seen and appreciate the online accessibility, especially living in a rural area where in the past I had to pack/drive/hotel for 3 days to take classes, so the low cost and convenience is amazing. Thank you! Anne P. Geriatric Fellow  This was the best CareQuest course I have taken so far. The moderator and speakers were excellent and very engaging. This could have been a 2–3-hour course–great info. Thank you! Barbara H. Dental Hygienist  CareQuest Institute webinars are always excellent, providing current oral health training and evidence-based practices. Tamara T. Dentist, Associate Professor  I truly appreciate the high quality and practical focus of the CareQuest Institute webinars. The sessions are well-organized, evidence-based, and relevant to everyday clinical practice. Karem Q.  Thank you for each unique presenter and their knowledge. I have practiced for over 35 years and learn from each webinar. CareQuest presents unique topics, not found elsewhere. Julie D. DDS  These webinars have been so informative. I really do appreciate the panel you have lined up on so far and how much knowledge they have. I am excited for the next one no matter what the subject is. Stephanie T.  I am very pleased to be able to have the opportunity to keep learning through these webinars, and very grateful to all the presenters and the people involved at CareQuest for making it happen. Mercela G.  This webinar was highly informative and engaging. The practical examples and patient interaction strategies made motivational interviewing concepts easy to understand and applicable in real-world settings. I appreciate CareQuest’s commitment to advancing oral health through education and look forward to future sessions. Maheshwari C. International Dentist  I would like to express my gratitude to the CareQuest Institute for organizing such informative webinars. The content was not only relevant but also presented in a clear and engaging way. I appreciate the opportunity to enhance my knowledge and look forward to future webinars. Congratulations to the team! Raisa S. PhD Candidate in Oral Pathology  Thank you for all the great educational opportunities available to all professionals working in oral health. Kellie S. Dental Hygienist  I love this platform because it always helps me refine my skills and upgrade my knowledge regularly. Parminder S.  I do like the format you have for the webinars. Your webinars run very efficiently. I have told multiple hygienists about CareQuest Institute. Cindy Q.  Great work. Keep up these webinars to keep the oral health community informed on topical issues. Linda N.  The speakers were both fantastic! Best webinar I have attended in a long time. I really liked the examples the first speaker used to emphasize his points. Tiffany B.  All the CareQuest webinars have been extremely informative and non-bias which I super appreciate. Lindsay T.  Being able to go back and watch the webinars over is a bonus! It has helped me to understand better since it takes a few times of reading or listening to the latest information. Thank you so much! Tiffany I. RDA/CDA  Working alongside DT and ADT’s for a couple of years and now as a CMA holder, I can emphatically state that this is the best idea that dentistry has come up with to help face the crisis of the unmet oral health needs and access to care in our society. Gary W. Dentist  I like that we are moving to more MIC, especially for people in underserved communities. I hope that this movement gains more momentum allowing people to live with more comfort and confidence when it comes to them teeth rather than pain embarrassment or fear of going to get treatment. Kelli L. Registered Dental Assistant  I learned that individuals with disabilities need support and special facilities not only in our dental office but also with respect to transportation and knowledge. In my practice, I would like to design a model that offers support with the structural challenges they may face. Divyanka P. Epidemiologist  Thank you so much for this course! I enjoyed it and will use the information to help me in my new position as a public health dental hygienist in the school-based setting, not only with autistic patients. The information provided is useful with all school-aged children to help them have a positive dental experience. Gina H. Dental Hygienist  All webinars are informative and interesting, the lectures are wonderful! Alice R.  This was one of my favorite webinars I’ve attended. So much applicable information. David S. Dental Hygienist  Thank you for providing critical, constructive, and updated information regarding the rapid changes in dental policy Gloria G. Pediatric Dentist CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [OPEN Initiative](https://carequest.org/open/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # OPEN Initiative ## We are a network taking on America’s oral health challenges. Individually, we can make progress. Together, we can transform community health. [Join OPEN today!](https://carequest.org/open/membership-form/) ## What Is OPEN? The Oral Health Progress & Equity Network (OPEN) is a diverse network of people and organizations taking on America’s oral health challenges. OPEN members use their unique experiences, knowledge, and skills to make oral health care more affordable and accessible — especially for underserved populations. Members connect in person and virtually throughout the year to share resources, learn from one another, and align on policy priorities. OPEN is an initiative of CareQuest Institute for Oral Health. ![](https://carequest.org/wp-content/uploads/2025/10/OPEN.png "OPEN") ## The Benefits of Joining OPEN ![](https://carequest.org/wp-content/uploads/2025/10/open-hill-day-group-capitol_2-1.jpg "open hill day group capitol_2 1") OPEN hosts in-person and virtual meetings for members to share resources, learn from one another, and align on opportunities for collective action. [Members have access to free trainings, tools for skill building, and online communities for collaboration.](https://communities.openoralhealth.org/s/) Through shared learning spaces, OPEN members leverage their expertise and resources to advance their own community’s health and equity goals, while also contributing to nationwide momentum for change. OPEN seeks out diversity in membership and representation from community, state, and national levels — also known as grassroots, grassmiddles, and grasstops. [Visit OPEN Communities](https://communities.openoralhealth.org/s/) ## The Importance of Collective Impact During the last decade, OPEN has fueled a national conversation among policymakers, providers, public health activists, and grassroots organizers who are working to build a new health system that works for everyone. OPEN members have organized across the country to spread the message that oral health is essential to overall health and well-being. The diversity of experiences, knowledge, and skills of OPEN members, coupled with a shared vision, create the opportunity for greater collective impact. During OPEN Hill Day, OPEN members meet with legislators about prioritizing oral health in their communities. The [most recent Hill Day](https://carequest.org/blog/open-hill-day-2026-oral-health-advocacy-in-action/), in June 2026, brought more than 120 members from across the US to Capitol Hill. They briefed lawmakers on the importance of [improving access to veterans’ oral health, protecting Medicaid, and elevating oral health in federal decision-making.](https://carequest.org/resource/open-hill-day-2026-policy-priorities/) ## Upcoming Events This network is growing, becoming stronger, and creating the will for change. OPEN is committed to continuing the important work of coming together to create an oral health system that works for everyone. Join an upcoming event to learn more. **Events** OPEN House: Hill Day Momentum & Advocacy Messaging **Date & Time (ET)** June 25, 3-4 p.m. **Location** Online **Registration Link** [](https://us06web.zoom.us/meeting/register/k0NfbXjKSNqcjrtKPtn9zA)[Register](https://us06web.zoom.us/meeting/register/hkhV5yTGSFCmQUYCtnXbWQ#/registration) [View recordings of past OPEN events](https://carequest.org/open/past-events/) ## Join Our Community A strong network is made up of strong communities. [Join OPEN today!](https://carequest.org/open/membership-form/) --- ### [Medicare](https://carequest.org/policy-advocacy/medicare/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Medicare ## Including dental coverage in Medicare can save the health care system billions of dollars per year and improve the overall health of individuals with chronic systemic diseases. ![](https://carequest.org/wp-content/uploads/2025/11/medicare-header.jpg "Grandfather Carries Grandson On Shoulders During Walk In Park") ## The Issue At every stage of our lives, oral health is connected to overall health. For older adults, oral health and dental care are especially important because the risk of dental concerns increases with age. Yet standard Medicare, the insurance program that millions of older people in the US rely on, does not provide dental coverage, leaving approximately [one third (31%)](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage) of participants without it. This inadequate coverage can lead to preventable health problems for people enrolled in Medicare, as well as higher long-term costs ## Why It Matters There are several reasons why older adults need regular dental care — reflecting the interconnections between age, oral health, and systemic health. For instance, the risk of periodontal disease rises with age, and people with periodontal disease have a [28% higher risk of suffering a first-time heart attack](https://www.carequest.org/about/blog-post/relationship-between-oral-health-and-heart-disease) than those without dental problems. Another example: Most older adults take medications that can cause xerostomia (dry mouth), and a reduced flow of saliva raises the risk of tooth decay. ![](https://carequest.org/wp-content/uploads/2025/11/medicare-2.jpg "Serious caucasian old elderly senior couple grandparents family counting funds on calculator, doing paperwork, savings, paying domestic bills, mortgage loan, pension at home using laptop.") ![](https://carequest.org/wp-content/uploads/2025/11/medicare-1.jpg "Black man at routine dental appointment") When they retire, many older adults are surprised to discover that standard Medicare does not cover routine dental coverage. To obtain coverage, they need to buy a Medicare Advantage plan or pay out of pocket. The lack of access to regular dental care for older adults is also an equity issue — [it disproportionately affects older adults of color and those living in rural areas.](https://www.carequest.org/resource-library/why-we-still-need-add-dental-medicare) ## The Path Forward Expanding Medicare’s coverage of dental care is urgent, as the US population ages and the cost of living rises. Improving Medicare’s dental benefits is also a political winner: [More than 9 in 10 voters nationwide (92%) support adding a dental benefit to Medicare](https://www.carequest.org/resource-library/dental-coverage-national-voter-polling-results), according to results from a 2024 national poll commissioned by CareQuest Institute and OPEN. ([OPEN](https://carequest.org/policy-advocacy/open/) is a network of people and organizations taking on America’s oral health challenges.) Leaders can effectively [address the shortcomings in access to care](https://www.carequest.org/about/blog-post/oral-health-and-aging-improving-access-care-older-adults) for people enrolled in Medicare. Many solutions are within reach, including policy and systems-level change: - Federal policymakers can advance measures to add a dental benefit to Medicare knowing the public strongly support it. - Health industry leaders can look to care models such as medical-dental integration (MDI) to benefit adults’ health and lower costs. - Advocates and providers can continue to educate the public and patients about gaps in the system, encouraging them to speak out for stronger Medicare coverage. ![](https://carequest.org/wp-content/uploads/2025/11/medicare-3.jpg "Senior woman with oral pain talking with dentist") ## Stats 31% Approximately one third (31%) of Medicare recipients do not have dental insurance. $ #### Learn more 52% Among older adults who had not seen a dentist in more than two years, 52% said they had experienced at least one symptom — such as a toothache, bleeding gums, or pain when chewing — that is frequently linked to oral disease. $ #### Learn more 1 in 5 Almost 1 in 5 older adults (18%) cited the cost of care as a reason why they did not seek services to address oral health symptoms. $ #### Learn more 75% At least 75% of total dental costs among Medicare or Medicare Advantage participants were paid for out of pocket. $ #### Learn more --- ### [News](https://carequest.org/news/) **Published:** June 3, 2025 **Author:** Darren Edwards **Content:** # News & Blog ## While you’re here, sign up for our newsletter and get timely oral health stories, resources, and education delivered straight to your inbox. Check out a [sample newsletter](https://email.carequest.org/fluoride-policy-updates-ces-and-highlights-from-2025 "sample newsletter"). [Subscribe to our newsletter](https://carequest.org/newsletter/) [Share your story](https://carequest.org/story-submission-form/) ## Blog [![](https://carequest.org/wp-content/uploads/2025/11/News-and-Blogs__Blog.png "News and Blogs__Blog")](https://carequest.org/news/blog/) [Read the blog](https://carequest.org/news/blog/) Want to hear from experts in oral health, primary care, and public health who are working to increase access, equity, and integration in oral health? Curious about the new innovations and emerging best practices that are shaping the future of care? Explore our blog to find the stories, perspectives, and ideas that are driving positive change in oral health. ## In the News [![](https://carequest.org/wp-content/uploads/2025/11/News-and-Blogs__In-the-News.png "News and Blogs__In the News")](https://carequest.org/news/in-the-news/) [Explore media highlights](https://carequest.org/news/in-the-news/) Our “In the News” section shares oral health highlights from the world of media, including online news sites, magazines, and TV. Here, you’ll find coverage on a variety of topics, including medical-dental integration, oral health research, policy changes, and health equity. Come back often to see how CareQuest Institute’s work is influencing the world of oral health. ## Press Releases [![](https://carequest.org/wp-content/uploads/2025/11/News-and-Blogs__Press-Release.png "News and Blogs__Press Release")](https://carequest.org/news/press-releases/) [Read press releases](https://carequest.org/news/press-releases/) Our press releases keep you up to date on CareQuest Institute news, issues, and research. Here, you can also access our official statements from organization leaders on a myriad of issues, ranging from progress toward health equity and improved access to care, to ongoing policy changes and oral health legislation in our nation’s capital and in states across the US. ## Media [![](https://carequest.org/wp-content/uploads/2025/11/News-and-Blogs__Media.png "News and Blogs__Media")](https://carequest.org/news/media/) [Media contact](https://carequest.org/news/media/) Interested in expert comment, interviews, or speaking opportunities? ## **About CareQuest Institute for Oral Health®** CareQuest Institute for Oral Health® is a national nonprofit championing a more equitable future where every person can reach their full potential through excellent health. We do this through our work in philanthropy, analytics and data insights, health transformation, policy and advocacy, and education as well as our leadership in dental benefits and innovation advancements. We collaborate with thought leaders, health care providers, patients, and local, state, and federal stakeholders, to accelerate oral health care transformation and create a system designed for everyone. Follow us on [Twitter](https://twitter.com/CareQuestInst), [LinkedIn](https://www.linkedin.com/company/carequest-institute/about), [Facebook](https://www.facebook.com/CareQuestInstitute), and [Instagram](https://www.instagram.com/carequestinstitute). [Learn more](https://carequest.org/about/) ![](https://carequest.org/wp-content/uploads/2025/04/All-Staff-edit-crop-scaled.jpg "All Staff-edit crop") --- ### [Impact](https://carequest.org/about/impact/) **Published:** September 24, 2025 **Author:** Darren Edwards **Content:** # Stories of Impact ## This growing collection of stories — featuring our work with communities, patients, providers, policymakers, educators, and advocates — are the building blocks of a more accessible, equitable, and integrated oral health system. [Share your story](https://carequest.org/story-submission-form/) ![](https://carequest.org/wp-content/uploads/2025/09/Stories-of-Impact-Illustration-6.12-01.png "Stories of Impact Illustration-6.12-01") ## Featured Stories [![](https://carequest.org/wp-content/uploads/2025/11/CHWs-walking-into-building.jpg "CHWs walking into building")](https://carequest.org/helping-older-adults-with-their-oral-health-from-miles-away/) ### Learning to Lead: Teens Connect Community to Oral Health Care Learning to Lead story should be moved to top with this blurb: Two CareQuest Institute grantees in two states, New Mainers Public Health Institute (NMPHI) in Maine and Kids In Need of Dentistry (KIND) in Colorado, are empowering children to help individuals in their communities access and learn about oral health. Check out the impact those kids are making in this blog post and video. [Read more](https://carequest.org/learning-to-lead-teens-connect-community-to-oral-health-care/) [![](https://carequest.org/wp-content/uploads/2025/11/Sheba-Jones-RDH-and-dental-hygiene-student-providing-oral-care_0.png "Sheba Jones, RDH and dental hygiene student providing oral care_0")](https://carequest.org/how-hygienists-are-providing-critical-oral-care-to-icu-patients/) ### How Hygienists Are Providing Critical Oral Care to ICU Patients [Read more](https://carequest.org/how-hygienists-are-providing-critical-oral-care-to-icu-patients/) [![](https://carequest.org/wp-content/uploads/2025/11/older-adults.png "older adults")](https://carequest.org/learning-to-lead-teens-connect-community-to-oral-health-care/) ### Helping Older Adults with Their Oral Health . . . from Miles Away [Read more](https://carequest.org/helping-older-adults-with-their-oral-health-from-miles-away/) [![](https://carequest.org/wp-content/uploads/2025/09/Fluoride_Cropped-1.jpg "Fluoride_Cropped (1)")](https://carequest.org/winning-on-water-fluoridation-lessons-from-louisiana-and-connecticut/) ### **Winning on Water Fluoridation:** Lessons from Louisiana and Connecticut [Read more](https://carequest.org/winning-on-water-fluoridation-lessons-from-louisiana-and-connecticut/) [![](https://carequest.org/wp-content/uploads/2025/09/Joshua-Neely.jpg "Joshua Neely")](https://carequest.org/aging-out-a-story-of-an-adult-with-disabilities-trying-to-find-oral-care/) ### **Aging Out:** A Story of an Adult with Disabilities Trying to Find Oral Care [Read more](https://carequest.org/aging-out-a-story-of-an-adult-with-disabilities-trying-to-find-oral-care/) [![](https://carequest.org/wp-content/uploads/2025/09/More-Smiles-Wisconsin.png "More Smiles Wisconsin")](https://carequest.org/connecting-the-dots-two-innovative-approaches-that-help-kids-access-care/) ### **Connecting the Dots:** Two Innovative Approaches that Help Kids Access Care [Read more](https://carequest.org/connecting-the-dots-two-innovative-approaches-that-help-kids-access-care/) [![](https://carequest.org/wp-content/uploads/2025/09/India-Washington.jpg "India Washington")](https://carequest.org/voices-from-the-field-a-student-perspective-on-open-hill-day/) ### **Voices from the Field:** A Student Perspective on OPEN Hill Day [Read more](https://carequest.org/voices-from-the-field-a-student-perspective-on-open-hill-day/) [![](https://carequest.org/wp-content/uploads/2025/09/Veteran-in-chair-looking-in-mirror-D4V_0.jpg "Veteran in chair looking in mirror D4V_0")](https://carequest.org/theyve-done-so-much-for-us-why-arent-we-taking-care-of-them/) ### **Veteran Oral Health:** ‘They’ve done so much for us. Why aren’t we taking care of them?’ [Read more](https://carequest.org/theyve-done-so-much-for-us-why-arent-we-taking-care-of-them/) [![](https://carequest.org/wp-content/uploads/2025/09/Jessica-Robertson.jpg "Jessica Robertson")](https://carequest.org/voices-from-the-field-dr-jessica-robertson-on-providing-care-in-rural-areas/) ### **Voices from the Field:** Dr. Jessica Robertson on Providing Care in Rural Areas [Read more](https://carequest.org/voices-from-the-field-dr-jessica-robertson-on-providing-care-in-rural-areas/) [![](https://carequest.org/wp-content/uploads/2025/09/TIC.png "TIC")](https://carequest.org/trauma-informed-care-creating-a-safe-space-for-dental-patients/) ### **Trauma-Informed Care:** Creating a Safe Space for Dental Patients [Read more](https://carequest.org/trauma-informed-care-creating-a-safe-space-for-dental-patients/) [![](https://carequest.org/wp-content/uploads/2025/09/ECU-Smiles-for-Vets-1.jpg "ECU Smiles for Vets (1)")](https://carequest.org/the-urgent-case-for-improving-veteran-oral-health/) ### **Veteran Oral Health:** The Urgent Case for Improving Veteran Oral Health [Read more](https://carequest.org/the-urgent-case-for-improving-veteran-oral-health/) [![](https://carequest.org/wp-content/uploads/2025/09/KC-Uber.jpg "KC Uber")](https://carequest.org/oral-health-in-incarcerated-persons/) ### **Care for the Incarcerated:** Barriers to Better Oral Health [Read more](https://carequest.org/oral-health-in-incarcerated-persons/) [![](https://carequest.org/wp-content/uploads/2025/09/zavras-1.jpg "zavras (1)")](https://carequest.org/voices-from-the-field-dr-thanos-zavras-on-improving-oral-health-care-for-patients-with-disabilities/) ### **Voices from the Field:** Dr. Thanos Zavras on Oral Health Care for Patients with Disabilities [Read more](https://carequest.org/voices-from-the-field-dr-thanos-zavras-on-improving-oral-health-care-for-patients-with-disabilities/) ## Impact Report Together, with our partners — providers, patients, policymakers, and stakeholders across oral health — we are creating a more accessible, equitable, and integrated health system for everyone. Explore the [CareQuest Institute Impact Report 2025](https://carequest.org/impact-report/) to find videos, stories, and statistics about how we’re improving the oral health system through our collaborative work in philanthropy, analytics and data insights, health transformation, policy and advocacy, innovation, and education. [Explore the report](https://carequest.org/impact-report/) [![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft-1-e1767640194591.png "2025-Impact-Report-Draft-1")](https://carequest.org/impact-report/) --- ### [Blog](https://carequest.org/news/blog/) **Published:** June 3, 2025 **Author:** Darren Edwards **Content:** # Blog ## Explore our blog to find the stories, perspectives, and ideas that paint a picture of progress and change in oral health. [Subscribe to our Newsletter](#subscribe) [Share your story](https://carequest.org/story-submission-form/) [![Medical Professional Hands a Bottle of Pills to a Patient in a Clinical Setting.](https://carequest.org/wp-content/uploads/2026/07/Pill-Bottle.jpg "Man and woman wearing doctor uniform having medical consultation prescribe pills at clinic – CareQuest Institute")](https://carequest.org/blog/navigating-the-gray-areas-of-premedication-decisions-in-dentistry/) [Navigating the Gray Areas of Premedication Decisions in Dentistry](https://carequest.org/blog/navigating-the-gray-areas-of-premedication-decisions-in-dentistry/)## [Navigating the Gray Areas of Premedication Decisions in Dentistry](https://carequest.org/blog/navigating-the-gray-areas-of-premedication-decisions-in-dentistry/) Patient premedication can be one of the biggest areas of uncertainty in dentistry when patients have complex medical histories or receive... Jul 6, 2026 | 3 min read --- ### [MDI in Action](https://carequest.org/about/medical-dental-integration/mdi-in-action/) **Published:** November 11, 2025 **Author:** Darren Edwards **Content:** # Medical–Dental Integration in Action ## Oral health *is* health ![](https://carequest.org/wp-content/uploads/2025/11/mdi-mdiinaction_header.jpg "asian senior woman interested in a female nurse using digital tablet,giving advice self health care at home") Many common, chronic diseases are connected to poor oral health. But, too often, our system isn’t set up to treat the body and the mouth together. Technology, communication, and payment structures are often separate, making it challenging to provide whole-person care for patients. Everyone working in health care — from providers to payers — has a role to play in improving this system. CareQuest Institute is focused on leading this change. We know that oral health is health. And through research, advocacy, strategic partnerships, philanthropy, and education, we’re working to help create a more integrated system that leads to lower costs, better patient experiences, and better health care outcomes. ## Stats 2-3x People with gum disease have 2 to 3 times the risk of having a heart attack, stroke, or severe cardiovascular event. $ #### Learn more 40% 40% of pregnant women have some form of periodontal disease, which may contribute to preeclampsia and miscarriage. $ #### Learn more 86% Diabetes raises the risk of developing gum disease (periodontitis) by 86%. $ #### Learn more 27M 27 million people see a dentist but not a physician each year. $ #### Learn more ## Diabetes and Oral Health There is a well-established and bi-directional [link between diabetes and periodontal (gum) disease](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.carequest.org%2Fresource-library%2Fconnection-between-oral-health-and-diabetes&data=05%7C02%7Ccstrang%40carequest.org%7C8632d580aaba494dc53a08ddf7a39d2d%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638939004289407702%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=2swszQ0RBHNP6sx%2B4tPJQAjBW2PzzhxyDNQrMgoHPS4%3D&reserved=0). Diabetes raises the risk of developing gum disease by 86%, and untreated gum disease makes it harder to manage blood glucose levels. And many people with diabetes living in the US may not know they have it. Screening for diabetes in the dental office can help. A large-scale systematic review found that dental chairside HbA1c screening identified more than 11% of previously undiagnosed dental patients as having type 2 diabetes and an additional 47% as having prediabetes. [Learn more](https://www.carequest.org/resource-library/oral-healths-role-identifying-undiagnosed-diabetes) ## Cardiovascular Health and Oral Health ![](https://carequest.org/wp-content/uploads/2025/11/mdiinaction_heart.jpg "Doctor on a house call performing a medical exam") [Emerging research](https://www.carequest.org/resource-library/heart-matter) has established links between oral health and heart issues, too. Poor oral health, including gum disease, causes bacteria to grow in the mouth. These germs can enter our bloodstream and travel to our heart, [which can then cause inflammation](https://penndentalmedicine.org/blog/gum-disease-and-heart-disease/). People with gum disease have 2 to 3 times the risk of having a heart attack, stroke, or severe cardiovascular event. While poor oral health is not the [sole cause](https://www.health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease) of these threats, research shows other strong connections between our oral hygiene and heart health. [Learn more](https://www.carequest.org/resource-library/heart-matter) ## Pregnancy and Oral Health During pregnancy, oral health care is essential, yet often underutilized. In fact, 40% of pregnant women have some form of periodontal disease, which may contribute to preeclampsia and miscarriage. Adequate prenatal and postnatal care, better interprofessional communication between oral health and maternal health providers, and policies to strengthen Medicaid coverage can significantly improve these poor outcomes, especially for Black women. [Learn more](https://www.carequest.org/content/pregnancy-and-oral-health) [Explore more oral systemic health conditions](https://www.carequest.org/resource-library/impacts-beyond-mouth) ![](https://carequest.org/wp-content/uploads/2025/11/mdiinaction_pregnancy.jpg "Happy Pregnant Woman Having Ultrasound Scan") ## Financial Impacts $42B Including periodontal treatment in Medicare could save more than $42 billion annually for patients with diabetes and patients with heart disease. $ #### Learn more $5.9K Providing individuals who have diabetes and periodontitis with periodontal treatment was predicted to save each individual an average of $5,904 in health care costs. $ #### Learn more $3.9B More than 1.6 million emergency department visits for non-traumatic dental conditions cost the health care system $3.9 billion annually. $ #### Learn more ## Featured Partnerships ![Square Logo Featuring a Red Upper-left Section, a Blue Lower-right Section, and a White Curved Wave Separating Them](https://carequest.org/wp-content/uploads/2026/07/partnerships_henryschein-scaled-1.png "partnerships_henryschein-scaled – CareQuest Institute") #### Henry Schein: BRIDGE Health Network Established by Henry Schein and CareQuest, BRIDGE is a curated network of health care professionals committed to advancing systemic models of care and strengthening disease prevention through medical-dental integration. The initiative’s inaugural pilots focus on incorporating diabetes screenings into routine dental hygiene visits. Participating care teams provide point-of-care testing, share educational resources, and coordinate follow-up care—helping identify risks earlier and connect patients to the support they need. ![Innovaccer Logo with Pink Diamond Icon and Black Brand Name](https://carequest.org/wp-content/uploads/2026/07/Innovaccer-Logo-color.png "Innovaccer-Logo-color – CareQuest Institute") #### Innovaccer: Integrated Medical and Dental Data Through this partnership, CareQuest Institute and Innovaccer link medical and dental claims and clinical data through Innovaccer’s Humbi platform, drawing on Innovaccer’s expertise in unifying complex health data at scale. By creating a more complete, longitudinal view of patient health, the collaboration supports deeper insights into how oral health influences overall patient outcomes and total cost of care. The collaboration explores how these insights can inform interventions that improve care coordination and support more effective, person-centered health care delivery. ![Nxtcare Logo: Circular Blue Gradient with Cyan Rim and White 'nxtcare' Text.](https://carequest.org/wp-content/uploads/2026/07/NxtCare-Orb-Transparent-Bkgrd.png "NxtCare Orb Transparent Bkgrd – CareQuest Institute") #### NxtCare: Integrating Oral Health Insights into Home-Based Care Settings This partnership focuses on home health patients, a high-risk population that is traditionally underrepresented in oral health evaluation across the broader health care continuum. By systematically analyzing oral health assessments within post-acute settings, NxtCare and CareQuest generate clinical intelligence that connects oral health status to broader health outcomes. These insights equip providers, payers, and ACOs with the data needed to improve care quality, reduce costs driven by unaddressed oral health conditions, and accelerate access to treatment before conditions escalate. ![Pds Health Logo: Gray Flower Icon with a Blue Petal, then 'pds Health' Text.](https://carequest.org/wp-content/uploads/2026/07/partnerships_pdshealth-1.png "partnerships_pdshealth 1 – CareQuest Institute") #### PDS Health: Integrated Blood Pressure Screenings As strong evidence exists on the connection between oral and cardiovascular health, CareQuest and [PDS Health](https://www.pdshealth.com/) are working together to standardize and scale workflows for blood pressure screenings and patient consultation across its dental and integrated care practices. This initiative generates insights on the prevalence of undiagnosed hypertension detectable through dental settings, estimate medical cost savings associated with earlier detection and referral into medical care, and strengthen the business case for scale. [Learn more about partnership opportunities](https://carequest.org/about/partner-with-us/) --- ### [Leadership Team](https://carequest.org/about/leadership-team/) **Published:** July 22, 2025 **Author:** Darren Edwards **Content:** # CareQuest Institute Leadership ## Executive Leadership [![](https://carequest.org/wp-content/uploads/2025/09/Bonnie1.png "Bonnie1")](#bonnie) ### Bonnie Bystrek, MSHRM Chief People Officer $ #### Read bio [![](https://carequest.org/wp-content/uploads/2025/04/Leaslie-PNG.png "Leaslie PNG")](#leslie) ### Leslie Carver, MHA Chief Operating Officer, Executive Vice President $ #### Read bio [![](https://carequest.org/wp-content/uploads/2025/04/Grandy-PNG.png "Grandy PNG")](#grandy) ### Grandy Cody, MBA Vice President, Strategy $ #### Read bio [![](https://carequest.org/wp-content/uploads/2026/04/NGuyen.png "NGuyen")](#nguyen) ### An Nguyen, DDS, MPH Chief Clinical Officer $ #### Read bio [![](https://carequest.org/wp-content/uploads/2025/04/Patty-PNG.png "Patty PNG")](#patty) ### Patricia Ma, Esq. Chief Legal & Compliance Officer, Executive Vice President $ #### Read bio [![](https://carequest.org/wp-content/uploads/2025/04/Denise-PNG.png "Denise PNG")](#denise) ### Denise W. Marks, MBA, CPA Chief Financial Officer, Executive Vice President $ #### Read bio [![](https://carequest.org/wp-content/uploads/2025/09/Wade2.png "Wade2")](#wade) ### Wade Rakes, MBA Chief Executive Officer $ #### Read bio ## Leadership ![](https://carequest.org/wp-content/uploads/2025/04/Mike-PNG.png "Mike PNG") ### Michael Briddon, MA Senior Director, Education and Content ![](https://carequest.org/wp-content/uploads/2025/04/Shannyn-PNG.png "Shannyn PNG") ### Shannyn Burch Director, Talent Management & Organizational Culture ![](https://carequest.org/wp-content/uploads/2025/04/Melissa-PNG.png "Melissa PNG") ### Melissa Burroughs Senior Director, Policy & Advocacy ![](https://carequest.org/wp-content/uploads/2025/04/Andrea-PNG.png "Andrea PNG") ### Andrea Clark, MS Director, Health Care Economics ![](https://carequest.org/wp-content/uploads/2025/04/Edward-PNG.png "Edward PNG") ### Edward Gray Director, Financial Planning & Analysis ![](https://carequest.org/wp-content/uploads/2025/09/Steven1.png "Steven1") ### Steven Lee Director, Total Rewards ![](https://carequest.org/wp-content/uploads/2025/09/Alisa.png "Alisa") ### Alisa Lewis, CHC, CRISC Senior Director, Governance, Risk, and Compliance ![](https://carequest.org/wp-content/uploads/2025/09/Kate.png "Kate") ### Kate Lewis Vice President, Marketing & Communications ![](https://carequest.org/wp-content/uploads/2025/09/Brian.png "Brian") ### Brian Linden, MS Vice President, Information Technology ![](https://carequest.org/wp-content/uploads/2025/09/Azeem.png "Azeem") ### Azeem Mallick, MBA Vice President, Enterprise Strategic Partners ![](https://carequest.org/wp-content/uploads/2025/09/Meredith.png "Meredith") ### Meredith Moore Director, People & Culture ![](https://carequest.org/wp-content/uploads/2026/03/Osborne2.png "Osborne2") ### Nate Osborne Vice President, Controller ![](https://carequest.org/wp-content/uploads/2025/10/Patrick2.png "Patrick2") ### Patrick Ouellette Associate General Counsel ![](https://carequest.org/wp-content/uploads/2025/09/Nupa.png "Nupa") ### Nupa Patel, Esq. Associate General Counsel II ![Professional Headshot of a Bearded Man in a Gray Suit Jacket and Light Shirt, Smiling at the Camera. (informative Portrait)](https://carequest.org/wp-content/uploads/2026/05/Mike-P.png "Mike P") ### Michael Petrellese Director, Financial Planning & Analysis ![](https://carequest.org/wp-content/uploads/2025/09/Brian-S.png "Brian-S") ### Brian Schweitzer Vice President, Data & Analytics ![](https://carequest.org/wp-content/uploads/2025/09/Trenae.png "Trenae") ### Trenae Simpson, MBA Senior Director, Philanthropy ![](https://carequest.org/wp-content/uploads/2025/09/Matthew.png "Matthew") ### Matthew Steele Director, State and Local Advocacy ![](https://carequest.org/wp-content/uploads/2025/09/Carly.png "Carly") ### Carly Strang, MBA Senior Director, Enterprise Marketing ![](https://carequest.org/wp-content/uploads/2025/09/Eric.png "Eric") ### Eric P. Tranby, PhD Senior Director, Analytics and Data Insights ![](https://carequest.org/wp-content/uploads/2025/09/Gregory.png "Gregory") ### Gregory P. Winn, MBA Vice President, Treasury ![](https://carequest.org/wp-content/uploads/2025/09/Paul.png "Paul") ### Paul Wynne, MBA Vice President, Financial Planning and Analysis ![Professional Headshot: Smiling Woman with Long Blonde Hair, White Shirt, Dark Blazer, Outdoors in Natural Light.](https://carequest.org/wp-content/uploads/2026/05/Janeva-Zabala.png "Janeva Zabala") ### Janeva Zabala, CCGP Director, Corporate Governance ## Learn More [![](https://carequest.org/wp-content/uploads/2025/11/About__what-we-do.jpg "About__what we do")](https://carequest.org/about/) $ #### What we do [![](https://carequest.org/wp-content/uploads/2025/11/About__BOD.png "About__BOD")](https://carequest.org/about/board-of-directors/) $ #### Board of Directors [![](https://carequest.org/wp-content/uploads/2025/11/About__careers.png "About__careers")](https://carequest.org/careers/) $ #### Careers ![](https://carequest.org/wp-content/uploads/2025/09/Bonnie1.png "Bonnie1") # Bonnie Bystrek, MSHRM ## Chief People Officer Bonnie Bystrek serves as chief people officer of CareQuest Institute for Oral Health. As a member of the executive leadership team, Bonnie leads CareQuest Institute in fostering an inclusive, engaging, and high-performing culture that aligns with the mission and values. She also drives initiatives to attract, develop, and retain top talent while championing employee well-being, diversity, equity, belonging, inclusion, and innovation. Bonnie has more than 25 years of experience leading human resources strategy across diverse industries, including financial services, technology, health care, and professional services. Before joining CareQuest Institute, Bonnie served as interim chief human resources officer at WellSense Health Plan, where she led the People and Culture function for 1,100 employees during a period of significant growth. Bonnie earned her bachelor’s degree in business from the University of Connecticut and her master’s degree in human resources from Northeastern University. ![](https://carequest.org/wp-content/uploads/2025/04/Leaslie-PNG.png "Leaslie PNG") # Leslie Carver, MHA ## Chief Operating Officer, Executive Vice President Leslie Carver serves as chief operating officer and executive vice president of CareQuest Institute for Oral Health. As a member of the executive leadership team, Leslie leads the organizational strategy, integration, and operational efforts across the organization. She also oversees CareQuest Institute’s data and information strategy, project management, marketing, and operations teams. Leslie is focused on building the right organizational infrastructure to support the organization’s intended impact and support the next chapters of growth at CareQuest Institute, CareQuest Innovation Partners, and Delta Dental of Massachusetts. Leslie has more than 30 years of experience in the health care industry. Before joining CareQuest Institute, Leslie served as executive director of Boston HealthNet, where she led an integrated network of 11 Federally Qualified Health Centers affiliated with Boston Medical Center (BMC). As ACO operations director at BMC, Leslie managed the implementation of MassHealth’s Accountable Care Organization program for more than 115,000 members. She also brings extensive experience with health plans, including leading value-based contracting strategy at Blue Cross Blue Shield of Rhode Island as well as contract management and operations at Tufts Health Plan. Leslie earned her bachelor’s degree in health management and policy from the University of New Hampshire and her master’s degree in health administration from the University of North Carolina at Chapel Hill. ![](https://carequest.org/wp-content/uploads/2025/04/Grandy-PNG.png "Grandy PNG") # Grandy Cody, MBA ## Vice President, Strategy Grandy Cody serves as vice president of strategy for CareQuest Institute for Oral Health. In this role, Grandy supports the executive team by driving organizational strategy and process improvement to better enable CareQuest Institute’s core nonprofit areas of activation. Prior to joining CareQuest Institute, Grandy held program and operations roles with leading nonprofits, including the DentaQuest Partnership and United Way organizations in Massachusetts Bay and Greater Cincinnati. Prior to United Way, Grandy served as a United States Peace Corps business consultant in Oradea, Romania, helping local NGO’s develop business plans and secure grant funding. Grandy serves as an officer of the board of directors for Jeff’s Place, a nonprofit that offers hope and healing in a supportive community for grieving children, teens, families, and individuals in Massachusetts. Grandy earned bachelor’s and master’s degrees in business administration from the University of Cincinnati. ![](https://carequest.org/wp-content/uploads/2025/04/Patty-PNG.png "Patty PNG") # Patricia Ma, Esq. ## Chief Legal Officer, Executive Vice President Patricia (Patty) Ma, Esq., serves as chief legal officer, executive vice president for CareQuest Institute for Oral Health. As a member of the executive leadership team, Patty provides legal and executive leadership and strategic counsel to advance the work of CareQuest Institute in support of its mission and vision. Patty has more than 25 years of experience in navigating health care legal, regulatory and compliance matters. She has served in executive leadership roles and as general counsel for both private and publicly traded health care companies. Patty’s areas of expertise include corporate governance, compliance programs and regulatory oversight, contract management and processes, litigation, and negotiating and executing complex transactions, such as joint ventures, partnerships, licensing agreements, and mergers and acquisitions. Before joining CareQuest Institute, Patty was general counsel and chief compliance officer for Active Day, the country’s largest operator of adult day health centers. Prior to that, Patty held leadership roles at Zelis Healthcare, DentaQuest, an affiliate of CareQuest Institute, and Gentiva Health Services. She has also served as outside deal counsel to DaVita, Inc., one of the country’s largest dialysis providers. Patty earned a bachelor’s degree in political science from Johns Hopkins University and a juris doctor from Boston University School of Law. ![](https://carequest.org/wp-content/uploads/2026/04/NGuyen2.png "NGuyen2") # An Nguyen, DDS, MPH ## Chief Clinical Officer An Nguyen, DDS, MPH, is the Chief Clinical Officer of CareQuest Institute for Oral Health. As a member of the executive leadership team, An drives clinical strategy to advance the organization’s mission and vision. She leads efforts to integrate oral health with overall health, guide enterprise-wide clinical initiatives, and position CareQuest Institute as a national leader in oral health transformation. An has dedicated her career to the care of underserved communities. She brings nearly two decades of clinical and leadership experience focused on advancing equitable oral health care, expanding access, and improving outcomes for patients and communities. Before joining CareQuest Institute, An was the Chief Dental Officer at Clinica Family Health and Wellness, a large, innovative community health center and a nationally recognized leader in health equity, quality, and interdisciplinary integration. An has been appointed to and served on multiple policy, philanthropic, and academic boards, contributing to efforts in health integration, public health, and policy and advocacy. She is immediate past President of the National Network for Oral Health Access and is Chair-Elect of the Dental Quality Alliance. Her work has been recognized with honors for clinical excellence and leadership from the Colorado Dental Association, Oral Health Colorado, and Colorado Health Service Corps, and she was appointed by the governor of Colorado to the state’s Department of Health Care Policy and Financing Medical Services Board. An is also active in several national organizations, including the American Association of Public Health Dentistry, the American Dental Association, and the National Association of Community Health Centers. She is a fellow of both the American College of Dentists and International College of Dentists. An holds a Master of Public Health in community health and behavioral science from Saint Louis University and a Doctor of Dental Surgery degree from the University of Tennessee. ![](https://carequest.org/wp-content/uploads/2025/04/Denise-PNG.png "Denise PNG") # Denise W. Marks, MBA, CPA ## Chief Financial Officer, Executive Vice President Denise W. Marks serves as chief financial officer, executive vice president of CareQuest Institute for Oral Health. As a member of CareQuest Institute’s executive leadership team, Denise is involved in strategic decision making across all aspects of CareQuest Institute operations and its full portfolio of organizations, including CareQuest Innovation Partners, a for-profit innovation and impact investing subsidiary. Her leadership has resulted in establishing effective partnerships with leading organizations in the oral health and health care space to advance CareQuest Institute’s intended impact. Denise has more than 25 years of experience in senior finance and operations roles. Before joining CareQuest Institute, Denise was chief administrative partner and chief compliance officer at SV Health Investors, a global investment firm focused on the health care sector. Prior to that, Denise held finance, operations, and compliance positions at CMGI, @Ventures, and PriceWaterhouseCoopers. Denise serves on a variety of boards of directors, including Incisive Technologies, Enable Dental, Grin, and MouthWatch, and is a board observer at Wesper. She earned a bachelor’s degree in finance from The Pennsylvania State University and joint master’s degrees in accounting and business administration from Northeastern University Graduate School of Professional Accounting. She is a licensed Certified Public Accountant in Massachusetts. ![](https://carequest.org/wp-content/uploads/2025/09/Wade2.png "Wade2") # Wade Rakes, MBA ## Chief Executive Officer Wade Rakes is the Chief Executive Officer of CareQuest Institute for Oral Health. He joined the organization in 2025, bringing deep expertise in health care, government, and community leadership. Prior to joining CareQuest, Wade held various leadership positions at Centene Corporation, a leading health care enterprise delivering high-quality, cost-effective services to government and commercial programs. During his 15 years at Centene, Rakes rose to Chief Growth Officer and helped propel the company’s transformation from a 6-state Medicaid care management organization into a 30-state, multi-product health care entity deeply connected to local communities. As President and CEO of Peach State Health Plan, he guided one of Centene’s largest subsidiaries, delivering care to more than 1 million state residents. Earlier in his career, Wade served as a cabinet-level official in the State of Ohio and has remained a committed civic leader. He is Vice Chair of the Board of the High Museum, a Trustee of the Woodruff Arts Center, and a member of the Board of Advisors of the James A. Baker III Institute at Rice University. Wade earned a Bachelor of Arts degree from Princeton University and a Master of Business Administration degree from the University of Michigan. --- ### [OPEN Past Events](https://carequest.org/open/past-events/) **Published:** October 3, 2025 **Author:** Darren Edwards **Content:** # OPEN Past Events ## Missed an Oral Health Progress & Equity Network meeting? No problem! Stay up-to-date and access recorded OPEN meetings and slides here. ![](https://carequest.org/wp-content/uploads/2025/10/240_F_407170440_e8jczDoNceFZmU3J0tLMeYh1ePMakefF.jpg "240_F_407170440_e8jczDoNceFZmU3J0tLMeYh1ePMakefF") ## 2026 Events June 25, 2026 [![](https://carequest.org/wp-content/uploads/2026/06/OPEN-June-25-cover-e1782845934293.png "OPEN June 25 cover")](https://carequest.org/wp-content/uploads/2026/06/6.25.26_OPEN-House_Slides.pdf) [View recording](https://youtu.be/r8luE346zqI) [Download slides](https://carequest.org/6-25-26_open-house_slides/) ## 2025 Events February 19, 2026 [![](https://carequest.org/wp-content/uploads/2026/02/Thumbnail_OPEN-House_2.19.26.png "Thumbnail_OPEN House_2.19.26")](https://carequest.org/wp-content/uploads/2026/02/OPEN-House_Slides_2.19.26.pdf) [View recording](https://www.youtube.com/watch?v=k8js3JovuMg) [Download slides](https://carequest.org/open-house_slides_2-19-26/) December 4, 2025 [![](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_-OPEN-House-12.4.25_960x540.png "Thumbnail_ OPEN House 12.4.25_960x540")](https://carequest.org/wp-content/uploads/2025/10/Medicaid-Adult-Dental-Benefits-Not-Optional_Slides-09.30.25_FINAL.pdf) [View recording](https://www.youtube.com/watch?v=PkuB551y8hA) [Download slides](https://carequest.org/open-house-special-edition-ppt/) ### OPEN House: Network Health Insights and 2026 Plans OPEN members gathered to reflect on 2025 engagement efforts, explore what “value” means to members, and share ideas for 2026 strategies and goals. September 30, 2025 [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Medicaid-Adult-Dental-Benefits-Not-Optional.png "Thumbnail_Medicaid-Adult-Dental-Benefits-Not-Optional")](https://carequest.org/wp-content/uploads/2025/10/Medicaid-Adult-Dental-Benefits-Not-Optional_Slides-09.30.25_FINAL.pdf) [View recording](https://youtu.be/LJpWbNxjklA) [Download slides](https://carequest.org/medicaid-adult-dental-benefits-not-optional_slides-09-30-25_final/) ### Take 60: Medicaid Adult Dental Benefits are Not Optional Panelists discuss the growth of Medicaid adult dental benefits, current threats to coverage, and how a unique collaboration in Utah has led to comprehensive dental benefits for all adults enrolled in Medicaid. September 18, 2025 [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_OPEN-House_9.18.25_.png "Thumbnail_OPEN House_9.18.25_")](https://carequest.org/wp-content/uploads/2025/10/OPEN-House_9.18.25_Slides.pdf) [View recording](https://youtu.be/5ezBdL-PhoA) [Download slides](https://carequest.org/open-house_9-18-25_slides/) ### OPEN House — Quarterly Network Orientation In this quarterly meeting, we welcomed new members, gave an overview of the network, heard updates from each committee, and had small group discussions by interest area. July 8, 2025 [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Framed-Messaging.png "Thumbnail_Framed Messaging")](https://carequest.org/wp-content/uploads/2025/10/Take-30-Framing-101-Slides-07.08.25.pdf) [View recording](http://youtube.com/watch?v=16WAZo1c3oI) [Download slides](https://carequest.org/take-30-framing-101-slides-07-08-25/) ### Take 30: Framed Messaging 101 Communications experts from FrameWorks Institute introduce key framing concepts and highlight a new opportunity for OPEN members to receive messaging support. June 5, 2025 [![](https://carequest.org/wp-content/uploads/2025/10/thumbnail_OPEN-House-Cover-Slide.png "thumbnail_OPEN House Cover Slide")](https://carequest.org/wp-content/uploads/2025/10/Slides_OPEN-House_6.5.25.pdf) [View recording](https://youtu.be/VO3s3hzs-PM) [Download slides](https://carequest.org/slides_open-house_6-5-25/) ### OPEN House — Quarterly Network Orientation Attendees shared knowledge and resources on key topics including storytelling, bipartisan messaging, and coalition sustainability. May 7, 2025 [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Virtual-Day-of-Action-1280x720-1.png "Thumbnail_Virtual Day of Action-1280x720")](https://carequest.org/wp-content/uploads/2025/10/OPEN-Take-30-Get-Ready-for-Our-Virtual-Day-of-Action-.pdf) [View recording](https://youtu.be/-yXlLCXUVvk) [Download slides](https://carequest.org/open-take-30-get-ready-for-our-virtual-day-of-action/) ### Take 30: Get Ready for Our Virtual Day of Action This Take 30 prep session will equip you with the knowledge and tools to effectively engage with your legislators in a virtual setting. April 17, 2025 [![](https://carequest.org/wp-content/uploads/2025/10/thumbnail-take-30_1.png "thumbnail take 30_1")](https://carequest.org/wp-content/uploads/2025/10/4_17_25-Take-30.pdf) [View recording](https://youtu.be/cvsAGzyVkSs) [Download slides](https://carequest.org/4_17_25-take-30/) ### Take 30: Community Water Fluoridation: Facts & Myths Experts provide clarity on myths and misinformation to help policymakers understand the health benefits and risks to make informed decisions. --- ### [Community Water Fluoridation](https://carequest.org/policy-advocacy/community-water-fluoridation/) **Published:** September 11, 2025 **Author:** Darren Edwards **Content:** # Community Water Fluoridation ## Fluoride is safe and plays a critical role in preventing tooth decay and promoting good oral health. ![](https://carequest.org/wp-content/uploads/2025/11/fluoride-header.jpg "Parent and child drinking cup of water") ## The Issue What if one simple step could improve the oral health of an entire population, while saving money at the same time? That’s exactly what community water fluoridation (CWF) has been doing for 80 years. More than 7,000 studies show that community water fluoridation (CWF), the process of adjusting the amount of fluoride in drinking water to an optimal level to prevent tooth decay, is a safe and effective way to [improve health and reduce health care costs](https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/). It is a critical benefit for millions who can’t afford preventive dental care or live far from a dental provider. And it’s popular: A national survey [shows 81% of adults in the US](https://www.carequest.org/resource-library/community-water-fluoridation-national-opinion-poll-results) either support CWF (52%) or they are not opposed to it (29%). And major US health organizations, such as the [American Academy of Pediatrics](https://www.aap.org/en/patient-care/oral-health/fluoridation), the [Mayo Clinic](https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/keeping-childrens-teeth-healthy), and the [American Dental Association](https://www.ada.org/resources/community-initiatives/fluoride-in-water/fluoridation-faqs), also support CWF. Despite the support of CWF and the research showing its benefits, some states, including Utah and Florida, have recently passed legislation to restrict or remove fluoride from drinking water. ## Why It Matters The process of adding fluoride to public water systems in the US began in 1945 in Grand Rapids, Michigan. Soon after, rates of cavities declined dramatically. That’s why the Centers for Disease Control (CDC) named fluoridation of drinking water one of [10 great public health interventions of the 20th century](https://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm). CWF also saves money for both families and the health care system by decreasing the need for expensive dental treatment. Evidence from places like Anchorage, Alaska; Calgary, Canada; and Israel, prove that removing fluoride from drinking water leads to higher dental treatment costs. Removing fluoride from water can also lead to [increased oral health disparities, higher treatment costs, and reduced access to preventive care](https://www.carequest.org/about/blog-post/new-study-shows-costly-consequences-states-banning-fluoride), especially in underserved populations. ![](https://carequest.org/wp-content/uploads/2025/11/fluoride-path-forward2.jpg "Cropped hands of man filling water in glass at sink") ## Community Water Fluoridation Policy in the State Legislatures in 2026 Despite overwhelming scientific evidence that community water fluoridation (CWF) is a safe and effective way to prevent cavities, many states introduced legislation in 2025 to restrict or ban CWF, laying the groundwork for continued action in 2026. In 2025, Florida and Utah enacted statewide bans, and similar proposals are under consideration in states across the country in 2026. [![Click to Enlarge Map](https://carequest.org/wp-content/uploads/2026/05/Fluoride-Map-52626-scaled.png "Fluoride Map-52626")](https://carequest.org/wp-content/uploads/2026/05/Fluoride-Map-52626-scaled.png "Click to enlarge map") This map shows the policy landscape as of May 26, 2026. For questions, please contact [Matt Steele](mailto:msteele@carequest.org), Director, State and Local Advocacy. ## The Path Forward ![](https://carequest.org/wp-content/uploads/2025/11/fluoride-3.jpg "Two multiracial girls sit in kitchen feels thirsty drink water") Dental professionals play a crucial role in supporting person-centered care and advocating for community health by engaging in clear, evidence-based conversations about fluoridation. While the data supporting CWF is strong, [patients will ask questions](https://carequest.org/fluoride-questions-parents-ask/) about misconceptions they’ve heard, and it’s important for dental professionals to help explain that fluoridation is safe and effective. Efforts outside of dental clinics are critical, too. Recent [events in Louisiana and Connecticut](https://www.carequest.org/about/blog-post/winning-water-fluoridation-lessons-louisiana-and-connecticut) provide timely and informative case studies. These wins for public health show that coordinated stakeholder efforts, evidence-based data, and local engagement can protect access to fluoride, even in challenging political climates. ## Stats 25M Ending water fluoridation could result in more than 25 million additional decayed teeth among children in the next five years, with the greatest impact on low-income and uninsured families. $ #### Learn more $9.8B Removing fluoride from drinking water would lead to an estimated $9.8 billion in added health care costs. $ #### Learn more 25% Drinking fluoridated water keeps teeth strong and reduces cavities by about 25% in children and adults. $ #### Learn more 6% Only 6% of respondents of a national survey think all communities should ban putting fluoride in water. $ #### Learn more --- ### [Veteran Oral Health](https://carequest.org/policy-advocacy/veteran-oral-health/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Veteran Oral Health ## These national heroes who have sacrificed for their country deserve better access to care. ![](https://carequest.org/wp-content/uploads/2025/11/veteran-3.jpg "Hugging Dad") ## The Issue Veterans in the US have consistently higher rates of gum disease, missing teeth, and filled teeth, compared to nonveterans. Yet, of the more than 9 million veterans who are eligible for medical care through the US Department of Veterans Affairs (VA), only 20% are eligible for dental coverage. For a veteran to get dental benefits through the VA, they need to have been a former prisoner of war, be 100% disabled, or have a service-related injury. Even when veterans are eligible to receive benefits, multiple barriers often stand in the way, including red tape, geographic barriers, and lack of awareness that they have a right to these services. ## Why It Matters ![](https://carequest.org/wp-content/uploads/2025/11/Veteran-2.jpg "Portrait of female soldier carrying gear") Inadequate access to dental care for veterans has impacts far beyond the mouth. Oral health is linked to overall health, and veterans are more likely to have health conditions such as diabetes and hypertension. Poor oral health can worsen these conditions — and vice versa. Without dental coverage, veterans are left to pay for care on their own. On average, veterans pay [65%](https://aidph.org/wp-content/uploads/2024/04/Inadequate-Dental-Care-for-Veterans.pdf) more in out-of-pocket dental costs compared to nonveterans — with veterans living in rural areas paying even more. In some cases, [veterans need to choose](https://www.carequest.org/about/blog-post/urgent-case-improving-veteran-oral-health) between feeding their families and getting needed care. These issues have even larger economic implications. Self-consciousness and pain related to dental problems can also affect employment prospects and undermine productivity at work. Veterans who experienced oral pain at least occasionally within the past year were [13.5 times](https://www.carequest.org/resource-library/oral-health-essential-veteran-productivity-and-well-being) more likely to report oral health-related productivity loss. ## What We Can Do Policy solutions can help address this problem. The most effective one is expanding dental eligibility criteria for veterans who are already receiving medical care through the VA. Other recommendations include: - Strengthening the [Community Care Network (CCN)](https://www.va.gov/COMMUNITYCARE/providers/Community-Care-Network.asp) by improving provider availability, streamlining referrals, and enhancing transportation assistance. The CCN is a private network of VA-affiliated providers available to eligible veterans who cannot get care in a VA facility due to long wait times or geographic distance. - Supporting Federally Qualified Health Centers (FQHCs) that can offer affordable and integrated care for veterans, especially ones who live in rural communities. ![](https://carequest.org/wp-content/uploads/2025/11/Veteran-header.jpg "Group of new military recruits in classroom training") By providing veterans with the coverage they need, policymakers can improve access to necessary care for veterans, reduce costs for veterans and society, and have a positive impact on the economy. ## Stats 8M Nearly 8 million veterans report having fair or poor oral health. $ #### Learn more $2,000 Approximately 1.1 million veterans spend at least $2,000 out of pocket annually on dental care, totaling more than $2.2 billion per year. $ #### Learn more 39.8% Rural veterans are more likely to need or have dentures (39.8%) compared to urban veterans (23%) and report higher out-of-pocket dental costs. $ #### Learn more 45% A national survey conducted in 2021 reported that nearly half (45%) of veterans had permanent teeth removed because of pain and infection. $ #### Learn more --- ### [Medicaid](https://carequest.org/policy-advocacy/medicaid/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Medicaid ## Adding oral health coverage for adults enrolled in Medicaid — which is optional for states — can save states money, reduce costly visits to emergency departments, improve job prospects, and improve overall health outcomes. ![](https://carequest.org/wp-content/uploads/2025/11/medicaid-header2.jpg "African male dentist explaining x-ray to the patient") ## The Issue Medicaid is a key source of health care coverage for nearly 80 million people in the United States. While Medicaid provides comprehensive dental coverage for children, adult dental benefits are optional for states. As a result, [coverage varies widely across the country](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker), with many states offering limited or emergency-only care. This fragmented system leaves adults without the dental services they need. Impending cuts to Medicaid are expected to exacerbate the problem. ## Why It Matters Access to oral health care remains out of reach for many low-income families, with cost being one of the biggest barriers. Without stable, comprehensive dental benefits, people enrolled in Medicaid — particularly people with disabilities and residents of rural communities — are more vulnerable to preventable health issues. Lack of access to dental care can contribute to worse overall health outcomes and drive higher health care costs. ![](https://carequest.org/wp-content/uploads/2025/11/medicaid-waiting-room-dentist.jpg "Crowded stomatology waiting area with people filling form") ![](https://carequest.org/wp-content/uploads/2025/11/Medicaid-5.jpg "Portrait of a mature woman carrying her son waiting in line at a community center") Dental coverage provides significant benefits for low-income adults. Regular oral health care can prevent dental issues from worsening and can contribute to improved overall health. It can even improve employment prospects: In a recent survey, [nearly 18% of all adults reported](https://www.carequest.org/resource-library/need-medicaid-adult-dental-coverage-across-all-states) that the appearance of their mouth and teeth affected their ability to interview for a job, with this figure rising to 29% among those with lower incomes. Insurance makes regular care possible and affordable. Routine dental care can also reduce overall health care costs. Those without dental coverage often delay treatment until issues become severe or painful. This leads to visits to the emergency department (ED), which are significantly more expensive, costing an estimated $2.1 billion per year. [Research from the American Dental Association (ADA) shows that nearly 79% of these visits](https://www.ada.org/resources/community-initiatives/action-for-dental-health/emergency-department-referrals) could have been addressed in a dental office, which translates into potential savings of up to $1.7 billion per year. ![](https://carequest.org/wp-content/uploads/2025/11/medicaid-er.jpg "hospital waiting room with people with medical appointment") ## The Impact of Medicaid Cuts With recent federal legislation cutting Medicaid benefits, adult dental benefits are in danger. Experience, unfortunately, shows that these cuts will have devastating consequences. In recent years,[ several states, including Oregon, Massachusetts, Maryland and Pennsylvania, cut Medicaid adult dental benefits (MADBs)](https://www.carequest.org/resource-library/federal-medicaid-cuts-threaten-state-dental-benefits). As a result, low-income adults lost access to needed dental services, and their dental health suffered. While these cuts are intended to reduce spending, experiences from those states show that eliminating or reducing MADBs often simply shifts costs from one part of the health care system to others. In many cases, when MADBs are cut, limited access to dental care leads more people to seek treatment in EDs, which are ill-equipped to meet oral health needs. In both Oregon and California, initial “savings” derived from cuts to MADBs were quickly offset by increased ED costs and MADBs were ultimately restored in both states. The experiences of these states show that reducing or eliminating MADBs is a short-sighted decision that harms patients, burdens health systems, and ultimately costs more in the long run. ![](https://carequest.org/wp-content/uploads/2025/11/Medicaid-4.jpg "Smiling patient shaking hands with doctor in clinic") ![](https://carequest.org/wp-content/uploads/2025/01/Care-Coordination-And-Interoperability_Provider-And-Couple_960x600.png "Care-Coordination-And-Interoperability_Provider-And-Couple_960x600+") ## The Path Forward All adults enrolled in Medicaid should enjoy comprehensive oral health coverage, ensuring that low-income families can access timely and appropriate dental services. By ensuring that states provide comprehensive dental benefits for adults who rely on Medicaid for their health coverage, policymakers can improve oral health outcomes, increase employment opportunities, and reduce long-term health care spending on chronic disease management and emergency department use. ## Stats 80M Nearly 80 million people rely on Medicaid for their health care. $ #### Learn more $2,918 Patients with diabetes would save approximately $2,918 annually if Medicaid covered periodontal care for adults. $ #### Learn more $2,437 The average dental ED visit costs on average $2,437, much higher than the average cost of a dental visit. $ #### Learn more 21% In Maryland, the elimination of Medicaid reimbursement for adult dental services led to a 21% increase in dental-related ED visits. $ #### Learn more 60% In Pennsylvania, spending on ED dental care has increased by more than 60% since the state cut MADBs in 2011. $ #### Learn more 74% More than 7 in 10 (74%) voters support adding adult dental benefits to Medicaid at the state or federal level. $ #### Learn more --- ### [Student Resources](https://carequest.org/education/faculty-resources/student-resources/) **Published:** May 15, 2026 **Author:** Darren Edwards **Content:** # Student Resources ## Placeholder – Explore customizable modules, instructor-ready materials, and self-paced courses on topics from prevention to health equity. ![](https://carequest.org/wp-content/uploads/2026/04/faculty-resources-hero-1.png "faculty resources hero 1") ### Risk-Based Oral Health Care and Prevention Risk-Based Oral Health Care and Prevention is a 12-module microlearning series designed to build foundational knowledge and clinical decision-making skills in caries management. Through short, case-based modules, learners develop an understanding of caries as a disease process, caries risk assessment, and risk-based prevention and care planning. ### Track 1: Foundations #### Caries as a Disease Process What is dental caries? This module introduces dental caries as a dynamic disease process rather than a single clinical event. Learners explore the balance between demineralization and remineralization and how caries develops over time. [View course](https://learning.carequest.org/#/online-courses/e48e9219-7fda-4983-8300-5858585fb85b) #### Caries Risk Assessment What influences caries risk? This module introduces the key factors used in caries risk assessment, including disease indicators, risk factors, and protective factors. Learners examine how biological, behavioral, and environmental factors influence future disease risk. [View course](https://learning.carequest.org/#/online-courses/0398b4c1-e464-4637-bb0d-67822e1fb8f0) #### Risk Categories and Meaning How is caries risk categorized? This module explores how assessment findings are synthesized into low-, moderate-, and high-caries-risk categories. Learners develop an understanding of how risk categories guide clinical communication and support risk-based care decisions. [View course](#) ### Track 2: Clinical Decision-Making #### Using Risk to Guide Treatment Decisions Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Non-Operative vs Operative Care Decisions Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Remineralization Strategies in Practice Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Fluoride Decision-Making by Risk Level Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Targeted Preventive Strategies Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) ### Track 3: Patient Management and Application #### Applying Levels of Prevention Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Behavioral and Social Risk Factors Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Monitoring and Recall Decisions Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) #### Case-Based Clinical Decision Making Placeholder – This session introduces dental caries as a chronic, dynamic, biofilm-mediated disease rather than a static lesion. Learners will examine how microbial metabolism, repeated pH fluctuations. [View course](#) ## Faculty Materials Placeholder – Guide your students through short lessons on critical topics, including cariology, prevention, and health equity. $ #### Explore faculty materials ![](https://carequest.org/wp-content/uploads/2025/01/Education-1-1.png "Education 1") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [Research and Analytics](https://carequest.org/research-and-analytics/) **Published:** March 23, 2026 **Author:** Darren Edwards **Content:** # Research & Analytics ## We advance oral health access, equity, and integration through rigorous, actionable research that informs policy, practice, and systems change. ![](https://carequest.org/wp-content/uploads/2026/03/ADI-Hero.png "ADI Hero") ## Transforming Health with Integrated Data and Actionable Insights Our vision for the future is an integrated data ecosystem that accelerates learning, enables collaboration, and drives actionable change across the health system. To get there, we are bringing together dental, medical, and social data to help move evidence into policy and practice. ### Where We Change the Health System - Whole-person health - Medicaid innovation and equity - Quality measurement and value-based care - Rural and underserved community needs - Workforce and delivery system transformation ### How We Change the Health System - Advanced health analytics - Mixed methods research and evaluation - Equity-focused insights and measurement - Data ecosystem development and governance - Policy-and action-oriented storytelling ## Research Priorities ![Caregiver or Clinician Sits Beside an Elderly Woman in a Bright Clinic, Writing on a Clipboard and Taking Notes.](https://carequest.org/wp-content/uploads/2026/06/MDI.png "MDI") ### Advancing Medical-Dental Integration (MDI) **Key focus areas include:** - Relationships between oral health and chronic conditions - Health outcomes and costs in integrated versus non‑integrated systems - Patient and provider perspectives on integrated care - Evaluation of innovative care and payment models **Intended impact:** Equip health systems, payers, and policymakers with evidence that helps them to design and scale effective medical-dental integration. ### Centering Health Equity Through Metrics and Data Collection **Key focus areas include:** - Oral health equity data collection at state and national levels - Impacts of policy, social drivers of health, and cost on access to care - Development and testing of quality and equity metrics - Patient‑reported outcomes and experiences, including discrimination and trust **Intended impact:** Strengthen the evidence base needed to advance equitable oral health policy, accountability, and system improvement. ![Professional Reviews Colorful Stock Charts on Two Monitor Displays, Analyzing Market Data with a Stylus in Hand.](https://carequest.org/wp-content/uploads/2026/06/metrics-and-data-collection.png "metrics and data collection") ![Three Healthcare Professionals—two in Blue Scrubs and One in a White Coat—discussing a Document on a Blue Folder at a Conference Table.](https://carequest.org/wp-content/uploads/2026/06/Interprofessional-Audiences.png "Interprofessional Audiences") ### Expanding Reach to Interprofessional Audiences **Key focus areas include:** - Research on interprofessional education and practice - Collaboration with health systems, industry, and policy partners - Dissemination through non‑dental journals, conferences, and media - Implementation‑focused products that translate research into action **Intended impact:** Empower a broad network of health leaders to advance sustainable systems change that includes oral health. ## Making Data More Integrated and Accessible to Improve Whole Health The [**CareQuest Institute Health Data Exchange**](https://dataexchange.carequest.org/) brings together dental, medical, and social data in a single, cloud-based environment. It enables researchers, policymakers, payers, and providers to quickly find, access, and use high-quality datasets and tools to drive whole-person health insights. Within the Exchange, you can: - **Find:** Search curated datasets and data products with clear documentation. - **Access:** Request data directly in the platform and track approvals with secure, role-based permissions. - **Use:** Analyze data in the built-in Analytics Workbench, explore dashboards, and accelerate insights with AI-powered tools. Data sources include: claims (Medicaid, Medicare, commercial); clinical data (electronic medical/dental records; social and community datasets; CareQuest pilots and programs. ### Featured Data Products ![](https://carequest.org/wp-content/uploads/2026/03/hde-features_AI-Research.png "hde features_AI Research") Search for key findings, explore trends, and analyze outcomes, all in one place. ![](https://carequest.org/wp-content/uploads/2026/03/hde-features_Medicaid-dental-360.png "hde features_Medicaid dental 360") A clear, consolidated view of US dental coverage data across states. Explore adult coverage levels, population demographics, provider density, and cost and utilization metrics, all in one place. ![](https://carequest.org/wp-content/uploads/2026/03/hde-features_AI-Data.png "hde features_AI Data") Transform how you interact with dental and medical data through a secure, intuitive, AI-powered interface. Uncover trends, generate insights, and explore patient outcomes. [Explore the Health Data Exchange](https://dataexchange.carequest.org/) ## Featured Research [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Out-of-Pocket_SOHEA2024_612x792.png "Thumbnail_Out-of-Pocket_SOHEA2024_612x792")](https://carequest.org/out-of-pocket-a-snapshot-of-adults-dental-and-medical-care-coverage/) **Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage** [![](https://carequest.org/wp-content/uploads/2025/12/Thumbnail_Dental-Care-in-Crisis_250x324.png "Thumbnail_Dental-Care-in-Crisis_250x324")](https://carequest.org/dental-care-in-crisis-tracking-the-cost-and-prevalence-of-emergency-department-visits-for-non-traumatic-dental-conditions/) **Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions** [![](https://carequest.org/wp-content/uploads/2025/11/Thumbnail_SOHEA_2025_250x324-1.png "Thumbnail_SOHEA_2025_250x324 (1)")](https://carequest.org/oral-health-in-america-who-gets-left-behind/) **Oral Health in America: Who Gets Left Behind?** [View more publication & tools](https://carequest.org/publications-tools/) ## Partner with Us We prioritize high-impact research, strategic partnerships, and accessible dissemination to support policy-relevant change and health system transformation. We are interested in collaborating with partners to explore, publish, and disseminate actionable research, analytics, and evaluations to create a health care system that is accessible, equitable, and integrated. [Explore partnership opportunities](https://carequest.org/about/partner-with-us/) --- ### [Story Submission Form](https://carequest.org/story-submission-form/) **Published:** June 9, 2026 **Author:** Darren Edwards **Content:** # Tell Us Your Story ## Share your story and help improve our oral health system. ![Older Couple with Arms Around Each Other, Smiling Outdoors in a Park-like Setting with Trees in the Background.](https://carequest.org/wp-content/uploads/2026/06/Share-Story.png "Share-Story") ![Smiling Man in a Blue Plaid Shirt Stands Outdoors in a Sunlit Park.](https://carequest.org/wp-content/uploads/2026/06/young-man.png "young man") ### Why? At CareQuest Institute for Oral Health, we are working to improve oral health of all. Why? Because our oral health system wasn’t built for everyone. People of color, those living in rural communities, people with disabilities, older adults, and other historically marginalized groups have been left behind. We need to work together to create a system that is accessible, equitable, and integrated. ### That’s where we hope you come in Your story can highlight where our system is falling short. Your story can inform policymakers and providers, inspire other patients, and help drive change in your local communities. Your story can make a difference. ![Close-up of an Older Man with Gray Hair and a White Goatee, Wearing a Blue Shirt, Looking at the Camera.](https://carequest.org/wp-content/uploads/2026/06/grandfather-and-child.png "grandfather and child") ![Woman with Brown Hair in a White Turtleneck Sweater Leaning Against an Orange Wall Outdoors, Looking at the Camera.](https://carequest.org/wp-content/uploads/2026/06/woman-with-arms-crossed.png "woman with arms crossed") ### How? With your permission and collaboration, there are many ways we could share your story — in an article or publication, on our website, on social media, or in a presentation. After you fill out the form below, someone from our team will contact you to learn more about your story. ## Share Your Story --- ### [Search](https://carequest.org/posts-search/) **Published:** June 3, 2025 **Author:** carequestordev **Content:** Search Search --- ### [Publications & Tools](https://carequest.org/publications-tools/) **Published:** April 10, 2025 **Author:** Darren Edwards **Content:** # Publications & Tools ## We publish white papers, research reports, briefs, articles, posters, infographics, and tools on topics ranging from adult dental benefits to teledentistry. ![](https://carequest.org/wp-content/uploads/2025/11/ADI.png "ADI") Use the filters below to find resources by type or topic. TitleTopicTypePublishedhf:tagshf:categories[Dental Distrust and Discrimination: A Nationally Representative Perspective on LGBTQ+ Adults’ Experiences with Oral Health Care](https://carequest.org/resource/dental-distrust-and-discrimination-a-nationally-representative-perspective-on-lgbtq-adults-experiences-with-oral-health-care/)Health Equity, Person-Centered CareJournal Article, ResourceJuly 21, 2026health-equity person-centered-carejournal-article resource[Examining Associations Between Medicaid Policy and Silver Diamine Fluoride Utilization](https://carequest.org/resource/examining-associations-between-medicaid-policy-and-silver-diamine-fluoride-utilization/)Clinical PracticeJournal Article, ResourceJuly 10, 2026clinical-practicejournal-article resource[It’s All Connected: How Unmet Dental Needs Can Delay Medical Treatment](https://carequest.org/resource/its-all-connected-how-unmet-dental-needs-can-delay-medical-treatment/)Medical-Dental IntegrationResource, Visual ReportJune 11, 2026medical-dental-integrationresource visual-report[OPEN Hill Day 2026 Policy Priorities](https://carequest.org/resource/open-hill-day-2026-policy-priorities/)Dental CoveragePublication, ResourceJune 2, 2026dental-coveragepublication resource[Crossing Borders for Care: Dental Tourism among US Adults](https://carequest.org/resource/crossing-borders-for-care-dental-tourism-among-us-adults/)Dental CoverageResource, Visual ReportJune 2, 2026dental-coverageresource visual-report[Oral Health in People with Intellectual and Developmental Disabilities](https://carequest.org/resource/oral-health-in-people-with-intellectual-and-developmental-disabilities/)Health Equity, Person-Centered CareResource, Visual ReportMay 18, 2026health-equity person-centered-careresource visual-report[It’s Time to Give All Veterans a Good Reason to Smile](https://carequest.org/resource/its-time-to-give-all-veterans-a-good-reason-to-smile/)Dental CoverageResource, Visual ReportMay 12, 2026dental-coverageresource visual-report[Forward Together: Advancing Health Equity in Uncertain Times](https://carequest.org/resource/forward-together-advancing-health-equity-in-uncertain-times/)Health EquityJournal Article, ResourceApril 28, 2026health-equityjournal-article resource[Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a Superutilizer](https://carequest.org/resource/repeated-use-of-emergency-departments-for-nontraumatic-dental-conditions-factors-associated-with-being-a-superutilizer/)Dental CoverageJournal Article, ResourceApril 16, 2026dental-coveragejournal-article resource[Periodontal Therapy Among Patients with Cardiovascular Disease: Exploring Its Association with Lower Medical Spending](https://carequest.org/resource/periodontal-therapy-among-patients-with-cardiovascular-disease-exploring-its-association-with-lower-medical-spending/)Clinical Practice, Medical-Dental IntegrationJournal Article, ResourceMarch 23, 2026clinical-practice medical-dental-integrationjournal-article resource[Scaling Medical-Dental Integration Nationally: Outcomes from the MORE Care Initiative](https://carequest.org/resource/scaling-medical-dental-integration-nationally-outcomes-from-the-more-care-initiative/)Health EquityJournal Article, ResourceMarch 8, 2026health-equityjournal-article resource[Maxed Out: The Reality of Reaching Dental Insurance Limits](https://carequest.org/resource/maxed-out-the-reality-of-reaching-dental-insurance-limits/)Dental Coverage, Health EquityResource, Visual ReportFebruary 19, 2026dental-coverage health-equityresource visual-report[2026 Community Water Fluoridation Policy Map: State Legislative Activity](https://carequest.org/resource/2026-community-water-fluoridation-policy-state-legislative-activity/)Access to Care, Health EquityPublication, ResourceFebruary 18, 2026access-to-care health-equitypublication resource[Water Fluoridation: Protecting Health and Saving Money for Kentuckians](https://carequest.org/resource/water-fluoridation-protecting-health-and-saving-money-for-kentuckians/)Access to Care, Health EquityPublication, ResourceFebruary 6, 2026access-to-care health-equitypublication resource[How Ending Water Fluoridation Would Affect Children and State Medicaid Costs](https://carequest.org/resource/how-ending-water-fluoridation-would-affect-children-and-state-medicaid-costs/)Health EquityResource, Visual ReportJanuary 29, 2026health-equityresource visual-report[Mapping the Health Divide: LGBTQIA+ Oral Health and the Role of Policy Inclusion](https://carequest.org/resource/mapping-the-health-divide-lgbtqia-oral-health-and-the-role-of-policy-inclusion/)Access to Care, Health Equity, Person-Centered CarePublication, ResourceJanuary 29, 2026access-to-care health-equity person-centered-carepublication resource[Water Fluoridation: Protecting Health and Saving Money for Louisianians](https://carequest.org/resource/water-fluoridation-protecting-health-and-saving-money-for-louisianians/)Access to Care, Health EquityPublication, ResourceJanuary 21, 2026access-to-care health-equitypublication resource[Water Fluoridation: Protecting Health and Saving Money for Nebraskans](https://carequest.org/resource/water-fluoridation-protecting-health-and-saving-money-for-nebraskans/)Access to Care, Health EquityPublication, ResourceJanuary 21, 2026access-to-care health-equitypublication resource[Dental Therapy: Expanding Access to Dental Care in Florida](https://carequest.org/resource/dental-therapy-expanding-access-to-dental-care-in-florida/)Access to Care, Dental CoveragePublication, ResourceJanuary 21, 2026access-to-care dental-coveragepublication resource[Discrimination and (In)dignity in the Oral Health Care Setting and Oral Health Outcomes: A Latent Class Analysis](https://carequest.org/resource/discrimination-and-indignity-in-the-oral-health-care-setting-and-oral-health-outcomes-a-latent-class-analysis/)Health EquityJournal Article, ResourceDecember 4, 2025health-equityjournal-article resource[Strengthening State Medicaid Adult Dental Benefits: Five Success Stories](https://carequest.org/resource/strengthening-state-medicaid-adult-dental-benefits-five-success-stories/)Dental CoverageResource, ToolDecember 3, 2025dental-coverageresource tool[Oral Health’s Role in Identifying Undiagnosed Diabetes](https://carequest.org/resource/oral-healths-role-in-identifying-undiagnosed-diabetes/)Clinical Practice, Medical-Dental Integration, Person-Centered CarePublication, ResourceNovember 17, 2025clinical-practice medical-dental-integration person-centered-carepublication resource[Community Water Fluoridation: Proven, Safe, and Essential for Oral Health](https://carequest.org/resource/community-water-fluoridation-proven-safe-and-essential-for-oral-health/)Health EquityResource, ToolNovember 11, 2025health-equityresource tool[Oral Health in America: Who Gets Left Behind?](https://carequest.org/resource/oral-health-in-america-who-gets-left-behind/)Dental Coverage, Health EquityPublication, ResourceNovember 7, 2025dental-coverage health-equitypublication resource[Community Oral Health Needs Assessment Tool](https://carequest.org/resource/community-oral-health-needs-assessment-tool/)Health EquityResource, ToolNovember 3, 2025health-equityresource tool[Dental Care in Crisis: Tracking the Cost and Prevalence of Emergency Department Visits for Non-Traumatic Dental Conditions](https://carequest.org/resource/dental-care-in-crisis-tracking-the-cost-and-prevalence-of-emergency-department-visits-for-non-traumatic-dental-conditions/)Access to Care, Dental Coverage, Health EquityResource, Visual ReportNovember 3, 2025access-to-care dental-coverage health-equityresource visual-report[Implicit Racial Bias in Oral Health](https://carequest.org/resource/implicit-racial-bias-in-oral-health/)Health EquityJournal Article, ResourceOctober 27, 2025health-equityjournal-article resource[Framing for Oral Health Equity Now: A Communications Toolkit for Advancing Oral Health Reform](https://carequest.org/resource/framing-for-oral-health-equity-now-a-communications-toolkit-for-advancing-oral-health-reform/)Dental Coverage, Health Equity, Medical-Dental IntegrationResource, ToolOctober 8, 2025dental-coverage health-equity medical-dental-integrationresource tool[From Silos to Synergy: Integrating Oral Health into Whole-Person Care Through Interprofessional Practice](https://carequest.org/resource/from-silos-to-synergy-integrating-oral-health-into-whole-person-care-through-interprofessional-practice/)Clinical Practice, Medical-Dental Integration, Person-Centered CarePublication, ResourceOctober 2, 2025clinical-practice medical-dental-integration person-centered-carepublication resource[The Need for Medicare Dental Coverage](https://carequest.org/resource/the-need-for-medicare-dental-coverage/)Dental Coverage, Medical-Dental IntegrationResource, Visual ReportSeptember 29, 2025dental-coverage medical-dental-integrationresource visual-report[Partners in Progress: Pursuing Medical-Dental Integration in Ohio](https://carequest.org/resource/partners-in-progress-pursuing-medical-dental-integration-in-ohio/)Medical-Dental IntegrationResource, Visual ReportSeptember 12, 2025medical-dental-integrationresource visual-report[Fluoride: Questions Parents Ask](https://carequest.org/resource/fluoride-questions-parents-ask/)Health EquityResource, Visual ReportSeptember 5, 2025health-equityresource visual-report[Unseen Needs: The Frequency of Dental Care Received by People Living with HIV](https://carequest.org/resource/unseen-needs-the-frequency-of-dental-care-received-by-people-living-with-hiv/)Special Patient CareResource, Visual ReportAugust 26, 2025special-patient-careresource visual-report[Lifelong Oral Health: How Insurance Type Shapes Dental Care Spending](https://carequest.org/resource/lifelong-oral-health-how-insurance-type-shapes-dental-care-spending/)Dental CoverageResource, Visual ReportAugust 25, 2025dental-coverageresource visual-report[The Need for Medicaid Adult Dental Coverage Across All States](https://carequest.org/resource/the-need-for-medicaid-adult-dental-coverage-across-all-states/)Dental CoveragePublication, ResourceAugust 7, 2025dental-coveragepublication resource[Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://carequest.org/resource/medicaid-adult-dental-benefits-offered-to-specific-beneficiary-groups/)Dental CoverageResource, Visual ReportAugust 6, 2025dental-coverageresource visual-report[Medicaid Adult Dental Coverage Checker](https://carequest.org/resource/medicaid-adult-dental-coverage-checker/)Dental Coverage, Health EquityDashboard, ResourceAugust 1, 2025dental-coverage health-equitydashboard resource[Oral Health Literacy from a Person-Centered Focus in the US](https://carequest.org/resource/oral-health-literacy-from-a-person-centered-focus-in-the-us/)Health Equity, Person-Centered CareJournal Article, ResourceJuly 23, 2025health-equity person-centered-carejournal-article resource[Perspectives and Experiences with Equitable Data Collection in Oral Health](https://carequest.org/resource/perspectives-and-experiences-with-equitable-data-collection-in-oral-health/)Health EquityJournal Article, ResourceJuly 21, 2025health-equityjournal-article resource[Community Water Fluoridation National Opinion Poll Results](https://carequest.org/resource/community-water-fluoridation-national-opinion-poll-results/)Health EquityResource, Visual ReportJuly 16, 2025health-equityresource visual-report[Inequities Among LGBTQIA+ People of Color](https://carequest.org/resource/inequities-among-lgbtqia-people-of-color/)Health Equity, Person-Centered CareResource, Visual ReportJuly 11, 2025health-equity person-centered-careresource visual-report[Veterans Need Affordable Dental Care](https://carequest.org/resource/veterans-need-affordable-dental-care/)Dental CoveragePublication, ResourceJuly 8, 2025dental-coveragepublication resource[The Dental Home Is Where Good Oral Health Starts](https://carequest.org/resource/the-dental-home-is-where-good-oral-health-starts/)Dental Coverage, Health EquityResource, Visual ReportJuly 1, 2025dental-coverage health-equityresource visual-report[Federal Medicaid Cuts Threaten State Dental Benefits](https://carequest.org/resource/federal-medicaid-cuts-threaten-state-dental-benefits/)Dental CoveragePublication, ResourceJune 26, 2025dental-coveragepublication resource[The Collaborative Effect: Transforming Oral Health in North Carolina](https://carequest.org/resource/the-collaborative-effect-transforming-oral-health-in-north-carolina/)Dental Coverage, Medical-Dental Integration, Minimally Invasive Care, Person-Centered Care, Value-Based CarePublication, ResourceJune 4, 2025dental-coverage medical-dental-integration minimally-invasive-care person-centered-care value-based-carepublication resource[State Oral Health Dashboard](https://carequest.org/resource/state-oral-health-dashboard/)Dental Coverage, Health EquityDashboard, ResourceMay 12, 2025dental-coverage health-equitydashboard resource[Out of Pocket: A Snapshot of Adults’ Dental and Medical Care Coverage](https://carequest.org/resource/out-of-pocket-a-snapshot-of-adults-dental-and-medical-care-coverage/)Dental CoverageResource, Visual ReportMay 9, 2025dental-coverageresource visual-report[Exploring Oral Health and Care Access among Adults with Disabilities](https://carequest.org/resource/exploring-oral-health-and-care-access-among-adults-with-disabilities/)Special Patient CarePublication, ResourceMay 4, 2025special-patient-carepublication resource[Transforming Oral Health Care Through Interprofessional Education](https://carequest.org/resource/transforming-oral-health-care-through-interprofessional-education/)Dental Coverage, Medical-Dental Integration, Person-Centered CarePublication, ResourceApril 2, 2025dental-coverage medical-dental-integration person-centered-carepublication resource[Links Between Sugar and Dental Decay in US Children from Low-Income Families](https://carequest.org/resource/links-between-sugar-and-dental-decay-in-us-children-from-low-income-families/)Clinical Practice, Health Equity, Person-Centered CarePublication, ResourceMarch 17, 2025clinical-practice health-equity person-centered-carepublication resource[Artificial Intelligence-Produced Radiographic Enhancements in Dental Clinical Care](https://carequest.org/resource/artificial-intelligence-produced-radiographic-enhancements-in-dental-clinical-care/)Clinical PracticeJournal Article, ResourceMarch 17, 2025clinical-practicejournal-article resource[National Oral Health Data Portal](https://carequest.org/resource/national-oral-health-data-portal/)Dental Coverage, Health EquityDashboard, ResourceMarch 1, 2025dental-coverage health-equitydashboard resource[Does Our Oral Health Care System Welcome Everyone?](https://carequest.org/resource/does-our-oral-health-care-system-welcome-everyone/)Health EquityPublication, ResourceJanuary 14, 2025health-equitypublication resource[Social Determinants of Health Linked with Oral Health](https://carequest.org/resource/social-determinants-of-health-linked-with-oral-health/)Dental Coverage, Health EquityJournal Article, ResourceJanuary 7, 2025dental-coverage health-equityjournal-article resource[Oral Health in Incarcerated Persons](https://carequest.org/resource/oral-health-in-incarcerated-persons/)Health EquityResource, Visual ReportDecember 5, 2024health-equityresource visual-report[Teledentistry as a Tool for Health Care Transformation](https://carequest.org/resource/teledentistry-as-a-tool-for-health-care-transformation/)Practice Management, Value-Based CareJournal Article, ResourceNovember 27, 2024practice-management value-based-carejournal-article resource[A Simple Alternative Payment Model to Incentivize Periodontal Care for Diabetes Mellitus Patients in Community Health Centers](https://carequest.org/resource/a-simple-alternative-payment-model-to-incentivize-periodontal-care-for-diabetes-mellitus-patients-in-community-health-centers/)Medical-Dental Integration, Value-Based CareResource, ToolNovember 27, 2024medical-dental-integration value-based-careresource tool[Medical-Dental-Behavioral Integration](https://carequest.org/resource/medical-dental-behavioral-integration/)Medical-Dental IntegrationJournal Article, ResourceNovember 21, 2024medical-dental-integrationjournal-article resource[Mental Health, Socioeconomic Position, and Oral Health: A Path Analysis](https://carequest.org/resource/mental-health-socioeconomic-position-and-oral-health-a-path-analysis/)Health Equity, Medical-Dental IntegrationJournal Article, ResourceNovember 18, 2024health-equity medical-dental-integrationjournal-article resource[The Role of Oral Health Providers in Screening and Referrals for Mpox](https://carequest.org/resource/the-role-of-oral-health-providers-in-screening-and-referrals-for-mpox/)Clinical Practice, Medical-Dental IntegrationResource, Visual ReportNovember 8, 2024clinical-practice medical-dental-integrationresource visual-report[Oral and Mental Health During and After Pregnancy](https://carequest.org/resource/oral-and-mental-health-during-and-after-pregnancy/)Medical-Dental IntegrationResource, Visual ReportOctober 28, 2024medical-dental-integrationresource visual-report[Teledentistry Utilization by Oral Health Professionals and Policy Considerations](https://carequest.org/resource/teledentistry-utilization-by-oral-health-professionals-and-policy-considerations/)Practice Management, Value-Based CareJournal Article, ResourceOctober 24, 2024practice-management value-based-carejournal-article resource[Dental Insurance Coverage and Oral Health in Battleground States](https://carequest.org/resource/dental-insurance-coverage-and-oral-health-in-battleground-states/)Dental CoveragePublication, ResourceOctober 22, 2024dental-coveragepublication resource[Attention to Detail: ADHD and Oral Health](https://carequest.org/resource/attention-to-detail-adhd-and-oral-health/)Medical-Dental IntegrationResource, Visual ReportOctober 7, 2024medical-dental-integrationresource visual-report[Medicaid Adult Dental Benefits Offered to Specific Beneficiary Groups](https://carequest.org/resource/medicaid-adult-dental-benefits-offered-to-specific-beneficiary-groups-2/)Dental CoverageResource, Visual ReportOctober 1, 2024dental-coverageresource visual-report[State of Oral Health Equity in America 2024](https://carequest.org/resource/state-of-oral-health-equity-in-america-2024/)Health EquityResource, Visual ReportSeptember 3, 2024health-equityresource visual-report[Dental Anxiety and Oral Health in American Indian and Alaska Natives](https://carequest.org/resource/dental-anxiety-and-oral-health-in-american-indian-and-alaska-natives/)Health Equity, Medical-Dental IntegrationJournal Article, ResourceAugust 29, 2024health-equity medical-dental-integrationjournal-article resource[Unlocking Value in Alternative Payment Models](https://carequest.org/resource/unlocking-value-in-alternative-payment-models/)Medical-Dental Integration, Practice Management, Value-Based CarePublication, ResourceAugust 26, 2024medical-dental-integration practice-management value-based-carepublication resource[Trauma-Informed Care in Oral Health Care](https://carequest.org/resource/trauma-informed-care-in-oral-health-care/)Clinical PracticeJournal Article, ResourceAugust 20, 2024clinical-practicejournal-article resource[Dental Coverage National Voter Polling Results](https://carequest.org/resource/dental-coverage-national-voter-polling-results/)Dental CoveragePresentation, ResourceJuly 15, 2024dental-coveragepresentation resource[Lower-Income Families Still Spend More on Dental Care](https://carequest.org/resource/lower-income-families-still-spend-more-on-dental-care/)Dental Coverage, Health EquityResource, Visual ReportJune 25, 2024dental-coverage health-equityresource visual-report[The Heart of the Matter](https://carequest.org/resource/the-heart-of-the-matter/)Medical-Dental IntegrationResource, Visual ReportJune 6, 2024medical-dental-integrationresource visual-report[Periodontal Treatment Associated with Decreased Diabetes-Related Treatment Costs](https://carequest.org/resource/periodontal-treatment-associated-with-decreased-diabetes-related-treatment-costs/)Clinical Practice, Dental Coverage, Medical-Dental IntegrationJournal Article, ResourceJune 6, 2024clinical-practice dental-coverage medical-dental-integrationjournal-article resource[Poor Oral Health May Contribute to the Risk of Dementia](https://carequest.org/resource/poor-oral-health-may-contribute-to-the-risk-of-dementia/)Medical-Dental IntegrationResource, Visual ReportApril 24, 2024medical-dental-integrationresource visual-report[An Estimated 12 Million Children and Adults Lost Medicaid Dental Insurance after the COVID-19 Public Health Emergency Expired](https://carequest.org/resource/an-estimated-12-million-children-and-adults-lost-medicaid-dental-insurance-after-the-covid-19-public-health-emergency-expired/)Dental CoveragePublication, ResourceApril 1, 2024dental-coveragepublication resource[Implicit Bias Among Dental Professionals: A Scoping Review](https://carequest.org/resource/implicit-bias-among-dental-professionals-a-scoping-review/)Health EquityPresentation, ResourceMarch 27, 2024health-equitypresentation resource[Oral Health Is Essential to Veteran Productivity and Well-Being](https://carequest.org/resource/oral-health-is-essential-to-veteran-productivity-and-well-being/)Dental CoverageResource, Visual ReportMarch 19, 2024dental-coverageresource visual-report[Minor Restorations Decreased after Implementation of Sugar-Sweetened Beverage Tax](https://carequest.org/resource/minor-restorations-decreased-after-implementation-of-sugar-sweetened-beverage-tax/)Health EquityPresentation, ResourceMarch 19, 2024health-equitypresentation resource[Experiences with and Outcomes of Oral Health Care](https://carequest.org/resource/experiences-with-and-outcomes-of-oral-health-care/)Dental Coverage, Health Equity, Medical-Dental Integration, Minimally Invasive Care, Value-Based CareResource, Visual ReportMarch 15, 2024dental-coverage health-equity medical-dental-integration minimally-invasive-care value-based-careresource visual-report[Value-Based Care Readiness Assessment](https://carequest.org/resource/value-based-care-readiness-assessment/)Value-Based CareResource, ToolFebruary 29, 2024value-based-careresource tool[Medical Oral Expanded Care in Ohio](https://carequest.org/resource/medical-oral-expanded-care-in-ohio/)Value-Based CareResource, ToolFebruary 7, 2024value-based-careresource tool[The Hour of Need: Productivity Time Lost Due to Urgent Oral Health Needs](https://carequest.org/resource/the-hour-of-need-productivity-time-lost-due-to-urgent-oral-health-needs/)Dental Coverage, Health EquityResource, Visual ReportFebruary 2, 2024dental-coverage health-equityresource visual-report[Oral-Systemic Interactions and Medical-Dental Integration: A Life Course Approach](https://carequest.org/resource/oral-systemic-interactions-and-medical-dental-integration-a-life-course-approach/)Clinical Practice, Medical-Dental IntegrationPublication, ResourceNovember 28, 2023clinical-practice medical-dental-integrationpublication resource[2023: Oral Health Among Individuals Requiring Support of a Caregiver](https://carequest.org/resource/2023-oral-health-among-individuals-requiring-support-of-a-caregiver/)Dental CoveragePresentation, ResourceNovember 21, 2023dental-coveragepresentation resource[2023: Safe and Dangerous Home Remedies Used for Oral Pain and Discomfort](https://carequest.org/resource/2023-safe-and-dangerous-home-remedies-used-for-oral-pain-and-discomfort/)Dental CoveragePresentation, ResourceNovember 21, 2023dental-coveragepresentation resource[2023: Beyond the Screen: How Dental Providers are Using Teledentistry to Meet Patient Needs](https://carequest.org/resource/2023-beyond-the-screen-how-dental-providers-are-using-teledentistry-to-meet-patient-needs/)Practice ManagementPresentation, ResourceNovember 21, 2023practice-managementpresentation resource[Still Searching: Meeting Oral Health Needs in Rural Settings](https://carequest.org/resource/still-searching-meeting-oral-health-needs-in-rural-settings/)Dental Coverage, Health EquityPublication, ResourceNovember 14, 2023dental-coverage health-equitypublication resource[Framework for Fiscal Impact Analysis of Managing Initial Caries Lesions with Noninvasive Therapies](https://carequest.org/resource/framework-for-fiscal-impact-analysis-of-managing-initial-caries-lesions-with-noninvasive-therapies/)Clinical Practice, Minimally Invasive CareJournal Article, ResourceNovember 14, 2023clinical-practice minimally-invasive-carejournal-article resource[Teledentistry Regulation and Policy Guidance](https://carequest.org/resource/teledentistry-regulation-and-policy-guidance/)Practice ManagementResource, ToolNovember 13, 2023practice-managementresource tool[Discrimination and Dignity Experiences in Prior Oral Care Visits Predict Racialized Oral Health Inequities Among Nationally Representative US Adults](https://carequest.org/resource/discrimination-and-dignity-experiences-in-prior-oral-care-visits-predict-racialized-oral-health-inequities-among-nationally-representative-us-adults/)Health Equity, Medical-Dental IntegrationJournal Article, ResourceOctober 27, 2023health-equity medical-dental-integrationjournal-article resource[Hunger Pains: How Food Insecurity Affects Oral Health](https://carequest.org/resource/hunger-pains-how-food-insecurity-affects-oral-health/)Health Equity, Medical-Dental IntegrationPublication, ResourceOctober 10, 2023health-equity medical-dental-integrationpublication resource[Opioids for Acute and Chronic Pain When Receiving Psychiatric Medications](https://carequest.org/resource/opioids-for-acute-and-chronic-pain-when-receiving-psychiatric-medications/)Clinical PracticeJournal Article, ResourceSeptember 28, 2023clinical-practicejournal-article resource[Uninsured and in Need](https://carequest.org/resource/uninsured-and-in-need/)Dental Coverage, Health EquityPublication, ResourceAugust 28, 2023dental-coverage health-equitypublication resource[Medical and Dental Integration: A Need for Improved Electronic Health Records](https://carequest.org/resource/medical-and-dental-integration-a-need-for-improved-electronic-health-records/)Medical-Dental IntegrationResource, Visual ReportAugust 17, 2023medical-dental-integrationresource visual-report[The Oral-Systemic Connection Across the Lifespan](https://carequest.org/resource/the-oral-systemic-connection-across-the-lifespan/)Medical-Dental IntegrationResource, Visual ReportJuly 20, 2023medical-dental-integrationresource visual-report[Cost, Race, and the Persistent Challenges in Our Oral Health System](https://carequest.org/resource/cost-race-and-the-persistent-challenges-in-our-oral-health-system/)Health EquityPublication, ResourceJune 28, 2023health-equitypublication resource[Children’s Use of Emergency Departments for Non-Traumatic Dental Conditions](https://carequest.org/resource/childrens-use-of-emergency-departments-for-non-traumatic-dental-conditions/)Dental Coverage, Health Equity, Medical-Dental IntegrationResource, Visual ReportJune 22, 2023dental-coverage health-equity medical-dental-integrationresource visual-report[Beyond a Nice Smile](https://carequest.org/resource/beyond-a-nice-smile/)Medical-Dental IntegrationResource, Visual ReportJune 20, 2023medical-dental-integrationresource visual-report[Addressing the Oral Health Needs of Hispanics in the U.S.](https://carequest.org/resource/addressing-the-oral-health-needs-of-hispanics-in-the-u-s/)Dental Coverage, Health EquityPublication, ResourceJune 15, 2023dental-coverage health-equitypublication resource[Effect of Self-Assembling Peptide P11-4 on Arrest, Cavitation, and Progression of Initial Caries Lesions](https://carequest.org/resource/effect-of-self-assembling-peptide-p11-4-on-arrest-cavitation-and-progression-of-initial-caries-lesions/)Clinical Practice, Minimally Invasive CareJournal Article, ResourceJune 13, 2023clinical-practice minimally-invasive-carejournal-article resource[Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States](https://carequest.org/resource/impact-of-covid-19-on-dental-care-utilization-and-oral-health-conditions-in-the-united-states/)Health EquityJournal Article, ResourceJune 2, 2023health-equityjournal-article resource[The State of Sleep and Obstructive Sleep Apnea: Myths and Facts](https://carequest.org/resource/the-state-of-sleep-and-obstructive-sleep-apnea-myths-and-facts/)Clinical Practice, Health Equity, Medical-Dental IntegrationResource, Visual ReportMay 30, 2023clinical-practice health-equity medical-dental-integrationresource visual-report[Dental Danger: Home Remedies to Avoid When Awaiting Care](https://carequest.org/resource/dental-danger-home-remedies-to-avoid-when-awaiting-care/)Health EquityPublication, ResourceMay 18, 2023health-equitypublication resource[Addressing the Role of Oral Health in Maternal Mortality and Pregnancy Outcomes](https://carequest.org/resource/addressing-the-role-of-oral-health-in-maternal-mortality-and-pregnancy-outcomes/)Clinical Practice, Health Equity, Medical-Dental IntegrationResource, Visual ReportApril 28, 2023clinical-practice health-equity medical-dental-integrationresource visual-report[The Role of Medicaid Adult Dental Benefits During Pregnancy and Postpartum](https://carequest.org/resource/the-role-of-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum/)Dental Coverage, Health Equity, Medical-Dental IntegrationPublication, ResourceApril 9, 2023dental-coverage health-equity medical-dental-integrationpublication resource[Medicaid Adult Benefits During Pregnancy and Postpartum and Birth Outcomes by State](https://carequest.org/resource/medicaid-adult-benefits-during-pregnancy-and-postpartum-and-birth-outcomes-by-state/)Dental Coverage, Health Equity, Medical-Dental IntegrationResource, ToolApril 7, 2023dental-coverage health-equity medical-dental-integrationresource tool[The Non-Invasive Caries Therapy Guide](https://carequest.org/resource/the-non-invasive-caries-therapy-guide/)Minimally Invasive CareResource, ToolApril 1, 2023minimally-invasive-careresource tool[American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease’](https://carequest.org/resource/american-indian-and-alaska-native-communities-face-a-disproportionate-burden-of-oral-disease/)Health EquityPublication, ResourceMarch 17, 2023health-equitypublication resource[Oral Hygiene Home Care Practices in America](https://carequest.org/resource/oral-hygiene-home-care-practices-in-america/)Clinical PracticePublication, ResourceFebruary 22, 2023clinical-practicepublication resource[Perceptions about HPV and Oropharyngeal Cancers](https://carequest.org/resource/perceptions-about-hpv-and-oropharyngeal-cancers/)Clinical Practice, Medical-Dental IntegrationJournal Article, ResourceFebruary 15, 2023clinical-practice medical-dental-integrationjournal-article resource[The Role of Algorithms in Oral Health Care and Disease Prevention and Management: Consumer and Provider Perspectives](https://carequest.org/resource/the-role-of-algorithms-in-oral-health-care-and-disease-prevention-and-management-consumer-and-provider-perspectives/)Clinical Practice, Medical-Dental IntegrationPublication, ResourceJanuary 27, 2023clinical-practice medical-dental-integrationpublication resource[Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Minnesota](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-minnesota/)Dental Coverage, Health Equity, Medical-Dental IntegrationResource, Visual ReportJanuary 9, 2023dental-coverage health-equity medical-dental-integrationresource visual-report[Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on North Carolina](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-north-carolina/)Dental Coverage, Health Equity, Medical-Dental IntegrationResource, Visual ReportJanuary 9, 2023dental-coverage health-equity medical-dental-integrationresource visual-report[The Relationship Between Vaping and Oral Health](https://carequest.org/resource/the-relationship-between-vaping-and-oral-health/)Clinical PracticeResource, Visual ReportJanuary 4, 2023clinical-practiceresource visual-report[Caries Risk and Social Determinants of Health: A Big Data Report](https://carequest.org/resource/caries-risk-and-social-determinants-of-health-a-big-data-report/)Health Equity, Minimally Invasive CareJournal Article, ResourceDecember 12, 2022health-equity minimally-invasive-carejournal-article resource[Family Affair: A Snapshot of Oral Health Disparities and Challenges in Individuals in Households Experiencing Disability](https://carequest.org/resource/family-affair-a-snapshot-of-oral-health-disparities-and-challenges-in-individuals-in-households-experiencing-disability/)Health EquityResource, Visual ReportDecember 7, 2022health-equityresource visual-report[Update on Alternative Payment Models in Oral Health Care](https://carequest.org/resource/update-on-alternative-payment-models-in-oral-health-care/)Value-Based CareJournal Article, ResourceDecember 6, 2022value-based-carejournal-article resource[2022: Consumers Experiences with and Attitudes toward Receiving Health Screenings at Dental Visits](https://carequest.org/resource/2022-consumers-experiences-with-and-attitudes-toward-receiving-health-screenings-at-dental-visits/)Medical-Dental IntegrationPresentation, ResourceNovember 30, 2022medical-dental-integrationpresentation resource[2022: US Adults’ Perceptions about HPV Vaccination and Dental Providers’ Role in HPV Prevention](https://carequest.org/resource/2022-us-adults-perceptions-about-hpv-vaccination-and-dental-providers-role-in-hpv-prevention/)Medical-Dental IntegrationPresentation, ResourceNovember 30, 2022medical-dental-integrationpresentation resource[2022: Screening for Diabetes in the Oral Health Care Setting: Developing a Predictive Algorithm to Identify High-Risk Patients](https://carequest.org/resource/2022-screening-for-diabetes-in-the-oral-health-care-setting-developing-a-predictive-algorithm-to-identify-high-risk-patients/)Medical-Dental IntegrationPresentation, ResourceNovember 30, 2022medical-dental-integrationpresentation resource[2022: Integration of Oral Health into Primary Care: Importance of Patients’ Perceptions and Attitudes](https://carequest.org/resource/2022-integration-of-oral-health-into-primary-care-importance-of-patients-perceptions-and-attitudes/)Medical-Dental IntegrationPresentation, ResourceNovember 30, 2022medical-dental-integrationpresentation resource[2022: Data and Storytelling: Supporting Equitable Access to Care for Veterans](https://carequest.org/resource/2022-data-and-storytelling-supporting-equitable-access-to-care-for-veterans/)Dental CoveragePresentation, ResourceNovember 30, 2022dental-coveragepresentation resource[Improving the Oral Health of Rural Veterans](https://carequest.org/resource/improving-the-oral-health-of-rural-veterans/)Dental Coverage, Health EquityResource, Visual ReportNovember 28, 2022dental-coverage health-equityresource visual-report[Refining the Process: Safety Net Dental Professionals’ Experiences with Teledentistry Implementation During the First Year of COVID-19](https://carequest.org/resource/refining-the-process-safety-net-dental-professionals-experiences-with-teledentistry-implementation-during-the-first-year-of-covid-19/)Practice ManagementJournal Article, ResourceNovember 18, 2022practice-managementjournal-article resource[Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Kentucky](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-kentucky/)Dental Coverage, Health EquityResource, Visual ReportNovember 4, 2022dental-coverage health-equityresource visual-report[Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Colorado](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-colorado/)Dental Coverage, Health EquityResource, Visual ReportNovember 1, 2022dental-coverage health-equityresource visual-report[Estimation of Oral Disease Burden from Claims and Self-Reported Data](https://carequest.org/resource/estimation-of-oral-disease-burden-from-claims-and-self-reported-data/)Practice ManagementJournal Article, ResourceOctober 24, 2022practice-managementjournal-article resource[The Importance of Being Ready: Lessons from Medicaid and Commercial Dental Claims Data](https://carequest.org/resource/the-importance-of-being-ready-lessons-from-medicaid-and-commercial-dental-claims-data/)Dental Coverage, Health Equity, Practice ManagementResource, Visual ReportOctober 19, 2022dental-coverage health-equity practice-managementresource visual-report[Another Billion Reasons for a Medicare Dental Benefit](https://carequest.org/resource/another-billion-reasons-for-a-medicare-dental-benefit/)Dental Coverage, Medical-Dental IntegrationPublication, ResourceSeptember 30, 2022dental-coverage medical-dental-integrationpublication resource[Pre-Doctoral Dental Faculty Perceptions Toward Value-Based Care: An Exploratory Story](https://carequest.org/resource/pre-doctoral-dental-faculty-perceptions-toward-value-based-care-an-exploratory-story/)Value-Based CarePublication, ResourceSeptember 29, 2022value-based-carepublication resource[Discussing HPV and Detecting Oral Cancer: The Role of Oral Health Providers](https://carequest.org/resource/discussing-hpv-and-detecting-oral-cancer-the-role-of-oral-health-providers/)Clinical Practice, Medical-Dental IntegrationResource, Visual ReportSeptember 22, 2022clinical-practice medical-dental-integrationresource visual-report[Unlocking Access to Oral Health](https://carequest.org/resource/unlocking-access-to-oral-health/)Dental CoverageResource, VideoSeptember 19, 2022dental-coverageresource video[Adult Use of Emergency Departments for Non-Traumatic Dental Conditions: Spotlight on Florida](https://carequest.org/resource/adult-use-of-emergency-departments-for-non-traumatic-dental-conditions-spotlight-on-florida/)Dental Coverage, Health EquityPublication, ResourceSeptember 8, 2022dental-coverage health-equitypublication resource[2022: Oral Health in Households with Disabilities](https://carequest.org/resource/2022-oral-health-in-households-with-disabilities/)Health EquityPresentation, ResourceSeptember 6, 2022health-equitypresentation resource[The Association Between Accessing Dental Services and Nonventilator Hospital-Acquired Pneumonia in Medicaid Beneficiaries](https://carequest.org/resource/the-association-between-accessing-dental-services-and-nonventilator-hospital-acquired-pneumonia-in-medicaid-beneficiaries/)Clinical Practice, Dental Coverage, Medical-Dental IntegrationJournal Article, ResourceAugust 16, 2022clinical-practice dental-coverage medical-dental-integrationjournal-article resource[Burnout among Dental Professionals Before and During a Public Health Crisis: Causes, Consequences, and Next Steps](https://carequest.org/resource/burnout-among-dental-professionals-before-and-during-a-public-health-crisis-causes-consequences-and-next-steps/)Clinical PracticeResource, Visual ReportAugust 8, 2022clinical-practiceresource visual-report[Value-Based Care: The Federally Qualified Health Center Story](https://carequest.org/resource/value-based-care-the-federally-qualified-health-center-story/)Value-Based CarePublication, ResourceAugust 2, 2022value-based-carepublication resource[Incidence, Mortality, and Cost Trends in Nonventilator Hospital-Acquired Pneumonia in Medicaid Beneficiaries, 2015-2019](https://carequest.org/resource/incidence-mortality-and-cost-trends-in-nonventilator-hospital-acquired-pneumonia-in-medicaid-beneficiaries-2015-2019/)Clinical Practice, Medical-Dental Integration, Practice ManagementJournal Article, ResourceJuly 18, 2022clinical-practice medical-dental-integration practice-managementjournal-article resource[Medicare Medically Necessary Fact Sheet](https://carequest.org/resource/medicare-medically-necessary-fact-sheet/)Dental CoverageResource, ToolJuly 14, 2022dental-coverageresource tool[Room to Grow: An Analysis of Dental and Health Care Claims in Medicaid-Enrolled Children in Arizona](https://carequest.org/resource/room-to-grow-an-analysis-of-dental-and-health-care-claims-in-medicaid-enrolled-children-in-arizona/)Dental Coverage, Health EquityPublication, ResourceJuly 12, 2022dental-coverage health-equitypublication resource[Repeated Use of Emergency Departments for Non-Traumatic Dental Conditions: Factors Associated with Being a “Superutilizer”](https://carequest.org/resource/repeated-use-of-emergency-departments-for-non-traumatic-dental-conditions-factors-associated-with-being-a-superutilizer/)Dental CoveragePublication, ResourceJuly 11, 2022dental-coveragepublication resource[The Glaring Scope of Racial Disparities in Oral Health](https://carequest.org/resource/the-glaring-scope-of-racial-disparities-in-oral-health/)Dental Coverage, Health EquityPublication, ResourceJuly 7, 2022dental-coverage health-equitypublication resource[Oral Health and the LGBTQ+ Community: A Snapshot of Disparities and Discrimination](https://carequest.org/resource/oral-health-and-the-lgbtq-community-a-snapshot-of-disparities-and-discrimination/)Health EquityResource, Visual ReportJune 28, 2022health-equityresource visual-report[Undermining Racism: A Road to Promoting Equity in Oral Health](https://carequest.org/resource/undermining-racism-a-road-to-promoting-equity-in-oral-health/)Health EquityJournal Article, ResourceJune 22, 2022health-equityjournal-article resource[Recent Trends in Hospital Emergency Department Visits for Non-Traumatic Dental Conditions](https://carequest.org/resource/recent-trends-in-hospital-emergency-department-visits-for-non-traumatic-dental-conditions/)Dental Coverage, Health EquityResource, Visual ReportJune 9, 2022dental-coverage health-equityresource visual-report[How Depression Is Linked to Oral Health](https://carequest.org/resource/how-depression-is-linked-to-oral-health/)Clinical PracticeResource, Visual ReportMay 24, 2022clinical-practiceresource visual-report[2022: Oral Health Integration: Attitudes on Medical-Dental Collaboration](https://carequest.org/resource/2022-oral-health-integration-attitudes-on-medical-dental-collaboration/)Medical-Dental IntegrationPresentation, ResourceMay 17, 2022medical-dental-integrationpresentation resource[Dentist Perceptions about the Value of Teledentistry](https://carequest.org/resource/dentist-perceptions-about-the-value-of-teledentistry/)Practice Management, Value-Based CareJournal Article, ResourceMay 17, 2022practice-management value-based-carejournal-article resource[2022: Interpretation of Ambiguous Dental Scenarios by Severity of Dental Anxiety](https://carequest.org/resource/2022-interpretation-of-ambiguous-dental-scenarios-by-severity-of-dental-anxiety/)Medical-Dental IntegrationPresentation, ResourceMay 17, 2022medical-dental-integrationpresentation resource[2022: Diabetes Treatment Costs Decrease after Periodontal Therapy: Medicaid and Commercial Claims Data](https://carequest.org/resource/2022-diabetes-treatment-costs-decrease-after-periodontal-therapy-medicaid-and-commercial-claims-data/)Medical-Dental IntegrationPresentation, ResourceMay 17, 2022medical-dental-integrationpresentation resource[2022: Exploring Connections to Value-Based Care in Dental Education](https://carequest.org/resource/2022-exploring-connections-to-value-based-care-in-dental-education/)Value-Based CarePresentation, ResourceMay 17, 2022value-based-carepresentation resource[Evaluating Trust in the Patient-Dentist Relationship: A Mixed-Method Study](https://carequest.org/resource/evaluating-trust-in-the-patient-dentist-relationship-a-mixed-method-study/)Clinical PracticeJournal Article, ResourceMay 2, 2022clinical-practicejournal-article resource[Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data](https://carequest.org/resource/oral-cancer-prevalence-mortality-and-costs-in-medicaid-and-commercial-insurance-claims-data/)Clinical PracticeJournal Article, ResourceApril 26, 2022clinical-practicejournal-article resource[Americans Are Still Not Getting the Dental Care They Need](https://carequest.org/resource/americans-are-still-not-getting-the-dental-care-they-need/)Health EquityPublication, ResourceApril 18, 2022health-equitypublication resource[Veteran Dental Care Stimulates the Economy and Improves Overall Health](https://carequest.org/resource/veteran-dental-care-stimulates-the-economy-and-improves-overall-health/)Dental CoverageResource, Visual ReportApril 8, 2022dental-coverageresource visual-report[Many Older Adults Delayed Dental Care During the Pandemic](https://carequest.org/resource/many-older-adults-delayed-dental-care-during-the-pandemic/)Dental CoveragePublication, ResourceMarch 15, 2022dental-coveragepublication resource[Missed Connections: Providers and Consumers Want More Medical-Dental Integration](https://carequest.org/resource/missed-connections-providers-and-consumers-want-more-medical-dental-integration/)Medical-Dental IntegrationResource, Visual ReportFebruary 24, 2022medical-dental-integrationresource visual-report[Teledentistry Helps Provide the Right Care at the Right Time](https://carequest.org/resource/teledentistry-helps-provide-the-right-care-at-the-right-time/)Practice ManagementPublication, ResourceFebruary 14, 2022practice-managementpublication resource[Dental Safety Net Providers’ Experiences with COVID-19 Should Inform Dental Pandemic Preparedness](https://carequest.org/resource/dental-safety-net-providers-experiences-with-covid-19-should-inform-dental-pandemic-preparedness/)Practice ManagementJournal Article, ResourceFebruary 10, 2022practice-managementjournal-article resource[Association Between Mental Health and Oral Health Status and Care Utilization](https://carequest.org/resource/association-between-mental-health-and-oral-health-status-and-care-utilization/)Medical-Dental IntegrationJournal Article, ResourceFebruary 10, 2022medical-dental-integrationjournal-article resource[Patient Portals: Patient Perspectives and Opportunities for Practices](https://carequest.org/resource/patient-portals-patient-perspectives-and-opportunities-for-practices/)Medical-Dental IntegrationResource, Visual ReportJanuary 31, 2022medical-dental-integrationresource visual-report[Large-Scale Dental Data Collection: Lessons Learned and Opportunities Gained](https://carequest.org/resource/large-scale-dental-data-collection-lessons-learned-and-opportunities-gained/)Value-Based CarePublication, ResourceJanuary 25, 2022value-based-carepublication resource[Oral Health Professionals Are Ready to Accept Teledentistry](https://carequest.org/resource/oral-health-professionals-are-ready-to-accept-teledentistry/)Practice ManagementPublication, ResourceJanuary 24, 2022practice-managementpublication resource[The Impact of Underutilization of Preventive Dental Care by Adult Medicaid Participants](https://carequest.org/resource/the-impact-of-underutilization-of-preventive-dental-care-by-adult-medicaid-participants/)Dental CoverageJournal Article, ResourceJanuary 11, 2022dental-coveragejournal-article resource[Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children](https://carequest.org/resource/age-of-first-oral-health-examination-and-dental-treatment-needs-of-medicaid-enrolled-children/)Medical-Dental IntegrationJournal Article, ResourceJanuary 10, 2022medical-dental-integrationjournal-article resource[Health Equity Needs Teeth](https://carequest.org/resource/health-equity-needs-teeth/)Health EquityJournal Article, ResourceJanuary 5, 2022health-equityjournal-article resource[Teledentistry: Opportunities for Expanding the Capacity and Reach of the Oral Health Care System](https://carequest.org/resource/teledentistry-opportunities-for-expanding-the-capacity-and-reach-of-the-oral-health-care-system/)Practice ManagementJournal Article, ResourceDecember 15, 2021practice-managementjournal-article resource[Identifying the Utility of Dental Providers in Human Papillomavirus Prevention Efforts: Results from the National Health and Nutrition Examination Survey 2015–2018](https://carequest.org/resource/identifying-the-utility-of-dental-providers-in-human-papillomavirus-prevention-efforts-results-from-the-national-health-and-nutrition-examination-survey-2015-2018/)Medical-Dental IntegrationJournal Article, ResourceDecember 15, 2021medical-dental-integrationjournal-article resource[Improving Care Coordination Between Oral and Medical Providers](https://carequest.org/resource/improving-care-coordination-between-oral-and-medical-providers/)Medical-Dental IntegrationResource, VideoDecember 14, 2021medical-dental-integrationresource video[Veteran Oral Health: Expanding Access and Equity](https://carequest.org/resource/veteran-oral-health-expanding-access-and-equity/)Dental Coverage, Health EquityPublication, ResourceDecember 13, 2021dental-coverage health-equitypublication resource[2021: Oral Health Information Technology Virtual Convening](https://carequest.org/resource/2021-oral-health-information-technology-virtual-convening/)Medical-Dental IntegrationPresentation, ResourceDecember 7, 2021medical-dental-integrationpresentation resource[Dental Fear Is Real. Providers Can Help.](https://carequest.org/resource/dental-fear-is-real-providers-can-help/)Health EquityResource, Visual ReportDecember 6, 2021health-equityresource visual-report[Why We (Still) Need to Add Dental to Medicare](https://carequest.org/resource/why-we-still-need-to-add-dental-to-medicare/)Dental Coverage, Health EquityPublication, ResourceNovember 15, 2021dental-coverage health-equitypublication resource[A Cross-Sectional Analysis of Oral Health Care Spending over the Life Span in Commercial- and Medicaid-Insured Populations](https://carequest.org/resource/a-cross-sectional-analysis-of-oral-health-care-spending-over-the-life-span-in-commercial-and-medicaid-insured-populations/)Dental CoverageJournal Article, ResourceNovember 11, 2021dental-coveragejournal-article resource[Achieving Health Equity Through Oral Health Value-Based Care: A Funder’s Perspective](https://carequest.org/resource/achieving-health-equity-through-oral-health-value-based-care-a-funders-perspective/)Health Equity, Medical-Dental IntegrationJournal Article, ResourceOctober 6, 2021health-equity medical-dental-integrationjournal-article resource[Time Is on the Side of Change in Dentistry](https://carequest.org/resource/time-is-on-the-side-of-change-in-dentistry/)Medical-Dental Integration, Value-Based CareJournal Article, ResourceOctober 6, 2021medical-dental-integration value-based-carejournal-article resource[The Wicked Problem of the Oral Health Care System: An Introduction](https://carequest.org/resource/the-wicked-problem-of-the-oral-health-care-system-an-introduction/)Value-Based CareJournal Article, ResourceOctober 6, 2021value-based-carejournal-article resource[Understanding Value in Oral Health: The Oral Health Value-Based Care Symposium](https://carequest.org/resource/understanding-value-in-oral-health-the-oral-health-value-based-care-symposium/)Value-Based CareJournal Article, ResourceOctober 6, 2021value-based-carejournal-article resource[MORE Care: An Evaluation of an Interprofessional Oral Health Quality Improvement Initiative](https://carequest.org/resource/more-care-an-evaluation-of-an-interprofessional-oral-health-quality-improvement-initiative/)Medical-Dental IntegrationJournal Article, ResourceOctober 6, 2021medical-dental-integrationjournal-article resource[More Than Meets the Eye: Oral Health, Eye Health, and Overall Health](https://carequest.org/resource/more-than-meets-the-eye-oral-health-eye-health-and-overall-health/)Medical-Dental IntegrationResource, Visual ReportOctober 1, 2021medical-dental-integrationresource visual-report[Spotlight on Arizona: Adult Use of Emergency Departments for Non-Traumatic Dental Conditions](https://carequest.org/resource/spotlight-on-arizona-adult-use-of-emergency-departments-for-non-traumatic-dental-conditions/)Dental Coverage, Health EquityResource, Visual ReportOctober 1, 2021dental-coverage health-equityresource visual-report[Addressing Oral Health of Low-Income Populations: A Call to Action](https://carequest.org/resource/addressing-oral-health-of-low-income-populations-a-call-to-action/)Health EquityJournal Article, ResourceSeptember 30, 2021health-equityjournal-article resource[A Primary Care Provider’s Role in Oral Cancer Screenings](https://carequest.org/resource/a-primary-care-providers-role-in-oral-cancer-screenings/)Clinical Practice, Medical-Dental IntegrationResource, VideoSeptember 29, 2021clinical-practice medical-dental-integrationresource video[Person-Centered Care for Oral Health](https://carequest.org/resource/person-centered-care-for-oral-health/)Clinical PracticeResource, VideoSeptember 29, 2021clinical-practiceresource video[The Challenges and Opportunities of Care Coordination](https://carequest.org/resource/the-challenges-and-opportunities-of-care-coordination/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[The Oral-Systemic Connection and Why It’s Important for Medical Professionals](https://carequest.org/resource/the-oral-systemic-connection-and-why-its-important-for-medical-professionals/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[Overcoming Barriers to Dental Care Access Through Community-Based Programs](https://carequest.org/resource/overcoming-barriers-to-dental-care-access-through-community-based-programs/)Access to Care, Health EquityResource, VideoSeptember 29, 2021access-to-care health-equityresource video[The Oral-Systemic Connection and Why It’s Important for Dental Professionals](https://carequest.org/resource/the-oral-systemic-connection-and-why-its-important-for-dental-professionals/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[Defining Interoperability](https://carequest.org/resource/defining-interoperability/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[Getting Started with Integration and Coordination of Physical Health in a Dental Setting](https://carequest.org/resource/getting-started-with-integration-and-coordination-of-physical-health-in-a-dental-setting/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[How Dental Practice Acts Impact Interprofessional Practice](https://carequest.org/resource/how-dental-practice-acts-impact-interprofessional-practice/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[Getting Started with Oral Health Integration in Primary Care](https://carequest.org/resource/getting-started-with-oral-health-integration-in-primary-care/)Medical-Dental IntegrationResource, VideoSeptember 29, 2021medical-dental-integrationresource video[The Connection Between Oral Health and Diabetes](https://carequest.org/resource/the-connection-between-oral-health-and-diabetes/)Clinical Practice, Medical-Dental IntegrationResource, VideoSeptember 29, 2021clinical-practice medical-dental-integrationresource video[The Importance of Oral Health During Pregnancy](https://carequest.org/resource/the-importance-of-oral-health-during-pregnancy/)Clinical Practice, Medical-Dental IntegrationResource, VideoSeptember 29, 2021clinical-practice medical-dental-integrationresource video[A Dental Provider’s Role in Supporting Patients with Diabetes](https://carequest.org/resource/a-dental-providers-role-in-supporting-patients-with-diabetes/)Clinical Practice, Medical-Dental IntegrationResource, VideoSeptember 29, 2021clinical-practice medical-dental-integrationresource video[Dental Data Exchange: HL7® Implementation Guides](https://carequest.org/resource/dental-data-exchange-hl7-implementation-guides/)Medical-Dental IntegrationResource, ToolSeptember 16, 2021medical-dental-integrationresource tool[The Push to Add Dental Coverage to Medicare](https://carequest.org/resource/the-push-to-add-dental-coverage-to-medicare/)Dental Coverage, Health EquityPublication, ResourceSeptember 15, 2021dental-coverage health-equitypublication resource[A Snapshot of the 76.5 Million Americans Without Dental Insurance](https://carequest.org/resource/a-snapshot-of-the-76-5-million-americans-without-dental-insurance/)Dental Coverage, Health EquityResource, Visual ReportSeptember 15, 2021dental-coverage health-equityresource visual-report[Association Between First Oral Examination Characteristics and Dental Treatment Needs in Privately Insured Children](https://carequest.org/resource/association-between-first-oral-examination-characteristics-and-dental-treatment-needs-in-privately-insured-children/)Clinical PracticeJournal Article, ResourceSeptember 14, 2021clinical-practicejournal-article resource[Expanding Dental Benefits Is Good for States.\*](https://carequest.org/resource/expanding-dental-benefits-is-good-for-states/)Dental Coverage, Health EquityPublication, ResourceSeptember 14, 2021dental-coverage health-equitypublication resource[A Learning Community That Aims to Change Oral Health](https://carequest.org/resource/a-learning-community-that-aims-to-change-oral-health/)Health Equity, Value-Based CarePublication, ResourceSeptember 10, 2021health-equity value-based-carepublication resource[Teledentistry: Removing Barriers and Moving Toward Implementation](https://carequest.org/resource/teledentistry-removing-barriers-and-moving-toward-implementation/)Practice ManagementResource, Visual ReportAugust 19, 2021practice-managementresource visual-report[A Geriatric Patient with Oral Health Issues Moves Through the Health System](https://carequest.org/resource/a-geriatric-patient-with-oral-health-issues-moves-through-the-health-system/)Medical-Dental IntegrationResource, ToolAugust 17, 2021medical-dental-integrationresource tool[Pandemic Drives Dental Provider Confidence in Telehealth](https://carequest.org/resource/pandemic-drives-dental-provider-confidence-in-telehealth/)Practice ManagementPublication, ResourceAugust 11, 2021practice-managementpublication resource[An Open-Ended Question During A Caries Risk Conversation](https://carequest.org/resource/an-open-ended-question-during-a-caries-risk-conversation/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Discussing Fluoride With a Parent](https://carequest.org/resource/discussing-fluoride-with-a-parent/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Engaging and Agenda Setting](https://carequest.org/resource/engaging-and-agenda-setting/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Engaging Around Patient Goals](https://carequest.org/resource/engaging-around-patient-goals/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Elicit-Provide-Elicit (Ask-Tell-Ask)](https://carequest.org/resource/elicit-provide-elicit-ask-tell-ask/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Open-Ended Questions and Affirmations](https://carequest.org/resource/open-ended-questions-and-affirmations/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Following Up on Patient Goals and Evoking During Planning](https://carequest.org/resource/following-up-on-patient-goals-and-evoking-during-planning/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Caries Risk Assessment vs Caries Risk Conversation](https://carequest.org/resource/caries-risk-assessment-vs-caries-risk-conversation/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Reflecting and Summarizing](https://carequest.org/resource/reflecting-and-summarizing/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Caries Risk Conversation](https://carequest.org/resource/caries-risk-conversation/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Using Motivational Interviewing in Dentistry Video Series](https://carequest.org/resource/using-motivational-interviewing-in-dentistry-video-series/)Practice ManagementResource, VideoAugust 10, 2021practice-managementresource video[Close-Ended Questions During A Caries Risk Assessment](https://carequest.org/resource/close-ended-questions-during-a-caries-risk-assessment/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Questions and Reflections While Discussing Patient Values](https://carequest.org/resource/questions-and-reflections-while-discussing-patient-values/)Clinical PracticeResource, VideoAugust 10, 2021clinical-practiceresource video[Teledentistry Use Beyond the Pandemic](https://carequest.org/resource/teledentistry-use-beyond-the-pandemic/)Practice ManagementResource, Visual ReportAugust 9, 2021practice-managementresource visual-report[A Systematic Review of Dental-Related Emergency Department Visits among Medicaid Beneficiaries](https://carequest.org/resource/a-systematic-review-of-dental-related-emergency-department-visits-among-medicaid-beneficiaries/)Dental CoverageJournal Article, ResourceAugust 9, 2021dental-coveragejournal-article resource[The Effect of Well Child Visit Location on Preventative Dental Visit](https://carequest.org/resource/the-effect-of-well-child-visit-location-on-preventative-dental-visit/)Health Equity, Medical-Dental IntegrationJournal Article, ResourceAugust 9, 2021health-equity medical-dental-integrationjournal-article resource[Emergency and Urgent Dental Visits Among Medicaid Enrollees from 2013 to 2017](https://carequest.org/resource/emergency-and-urgent-dental-visits-among-medicaid-enrollees-from-2013-to-2017/)Dental Coverage, Health EquityJournal Article, ResourceAugust 9, 2021dental-coverage health-equityjournal-article resource[Dental Visits during Pregnancy: Pregnancy Risk Assessment Monitoring System Analysis 2012–2015](https://carequest.org/resource/dental-visits-during-pregnancy-pregnancy-risk-assessment-monitoring-system-analysis-2012-2015/)Dental Coverage, Medical-Dental IntegrationJournal Article, ResourceAugust 9, 2021dental-coverage medical-dental-integrationjournal-article resource[Loss of Insurance Leads to Hard Decisions for Many Patients](https://carequest.org/resource/loss-of-insurance-leads-to-hard-decisions-for-many-patients/)Dental CoveragePublication, ResourceAugust 5, 2021dental-coveragepublication resource[Financial Impact of Emergency Department Visits for Dental Conditions in Maryland: An Update](https://carequest.org/resource/financial-impact-of-emergency-department-visits-for-dental-conditions-in-maryland-an-update/)Dental Coverage, Health EquityPublication, ResourceAugust 5, 2021dental-coverage health-equitypublication resource[Provider and Public Perceptions of Silver Diamine Fluoride (SDF)](https://carequest.org/resource/provider-and-public-perceptions-of-silver-diamine-fluoride-sdf/)Clinical Practice, Minimally Invasive CareResource, Visual ReportAugust 4, 2021clinical-practice minimally-invasive-careresource visual-report[Trends in National Opioid Prescribing for Dental Procedures among Patients Enrolled in Medicaid](https://carequest.org/resource/trends-in-national-opioid-prescribing-for-dental-procedures-among-patients-enrolled-in-medicaid/)Dental Coverage, Health EquityJournal Article, ResourceAugust 2, 2021dental-coverage health-equityjournal-article resource[Determinants of Tooth Loss in a Medicaid Adult Population](https://carequest.org/resource/determinants-of-tooth-loss-in-a-medicaid-adult-population/)Dental CoverageJournal Article, ResourceJuly 29, 2021dental-coveragejournal-article resource[Teledentistry: What to Know & How It Works](https://carequest.org/resource/teledentistry-what-to-know-how-it-works/)Health Equity, Practice ManagementResource, Visual ReportJuly 20, 2021health-equity practice-managementresource visual-report[Dental Insurance Is Out of Reach for Many](https://carequest.org/resource/dental-insurance-is-out-of-reach-for-many/)Dental Coverage, Health EquityResource, Visual ReportJuly 6, 2021dental-coverage health-equityresource visual-report[Oral Disease Is Common. Access to Care Is Not.](https://carequest.org/resource/oral-disease-is-common-access-to-care-is-not/)Dental Coverage, Health EquityResource, Visual ReportJuly 6, 2021dental-coverage health-equityresource visual-report[Inequities Remain Pervasive in Oral Health](https://carequest.org/resource/inequities-remain-pervasive-in-oral-health/)Health EquityResource, Visual ReportJuly 6, 2021health-equityresource visual-report[National Trends in Emergency Department Visits for Nontraumatic Dental Injuries](https://carequest.org/resource/national-trends-in-emergency-department-visits-for-nontraumatic-dental-injuries/)Dental Coverage, Health EquityJournal Article, ResourceJuly 1, 2021dental-coverage health-equityjournal-article resource[Care Coordination in a Community Health Center with Integrated Scheduling and Electronic Health Records](https://carequest.org/resource/care-coordination-in-a-community-health-center-with-integrated-scheduling-and-electronic-health-records/)Medical-Dental IntegrationResource, ToolJune 28, 2021medical-dental-integrationresource tool[Equity and Community Engagement in Statewide Oral Health Policy Advocacy](https://carequest.org/resource/equity-and-community-engagement-in-statewide-oral-health-policy-advocacy/)Health EquityPublication, ResourceJune 22, 2021health-equitypublication resource[New Survey Suggests Optimism about Teledentistry Experience and Access](https://carequest.org/resource/new-survey-suggests-optimism-about-teledentistry-experience-and-access/)Practice ManagementPublication, ResourceJune 8, 2021practice-managementpublication resource[Dental Providers Offer a Key Access Point for COVID-19 Booster Shots](https://carequest.org/resource/dental-providers-offer-a-key-access-point-for-covid-19-booster-shots/)Medical-Dental IntegrationPublication, ResourceJune 7, 2021medical-dental-integrationpublication resource[Trends in Adolescent Dental Care Use](https://carequest.org/resource/trends-in-adolescent-dental-care-use/)Dental CoveragePublication, ResourceJune 7, 2021dental-coveragepublication resource[Medicaid Adult Dental Benefit Forecasting Tool](https://carequest.org/resource/medicaid-adult-dental-benefit-forecasting-tool/)Dental Coverage, Practice ManagementResource, ToolJune 4, 2021dental-coverage practice-managementresource tool[Challenges in Implementing School-Based Oral Health Programs: Short- and Long-Term Impact of COVID-19](https://carequest.org/resource/challenges-in-implementing-school-based-oral-health-programs-short-and-long-term-impact-of-covid-19/)Health Equity, Practice ManagementPublication, ResourceMay 11, 2021health-equity practice-managementpublication resource[The Connection Between Oral Health and Mental Health](https://carequest.org/resource/the-connection-between-oral-health-and-mental-health/)Medical-Dental IntegrationPublication, ResourceMay 4, 2021medical-dental-integrationpublication resource[Dentists are an Untapped Resource for Delivering COVID-19 Vaccines](https://carequest.org/resource/dentists-are-an-untapped-resource-for-delivering-covid-19-vaccines/)Practice ManagementPublication, ResourceApril 28, 2021practice-managementpublication resource[Solutions to Oral Health Inequities](https://carequest.org/resource/solutions-to-oral-health-inequities/)Health EquityJournal Article, ResourceApril 23, 2021health-equityjournal-article resource[Mouths Matter More Than You May Know](https://carequest.org/resource/mouths-matter-more-than-you-may-know/)Medical-Dental IntegrationPublication, ResourceApril 8, 2021medical-dental-integrationpublication resource[A Coming Surge in Oral Health Treatment Needs](https://carequest.org/resource/a-coming-surge-in-oral-health-treatment-needs/)Practice ManagementPublication, ResourceApril 7, 2021practice-managementpublication resource[The COVID-19 Pandemic Deepens Oral Health Inequities](https://carequest.org/resource/the-covid-19-pandemic-deepens-oral-health-inequities/)Health Equity, Practice ManagementPublication, ResourceMarch 29, 2021health-equity practice-managementpublication resource[Medicaid Adult Dental Benefit Toolkit for Advocates](https://carequest.org/resource/medicaid-adult-dental-benefit-toolkit-for-advocates/)Dental CoverageResource, ToolJanuary 26, 2021dental-coverageresource tool[Common Scripting for the Community Health Dental Practice](https://carequest.org/resource/common-scripting-for-the-community-health-dental-practice/)Practice ManagementResource, ToolJanuary 11, 2021practice-managementresource tool[Sample Billing Flow Chart](https://carequest.org/resource/sample-billing-flow-chart/)Practice ManagementResource, ToolJanuary 11, 2021practice-managementresource tool[Three Domain Framework White Paper Executive Summary](https://carequest.org/resource/three-domain-framework-white-paper-executive-summary/)Practice Management, Value-Based CarePublication, ResourceJanuary 5, 2021practice-management value-based-carepublication resource[The Wicked Problem of the Oral Health Care System](https://carequest.org/resource/the-wicked-problem-of-the-oral-health-care-system/)Value-Based CareJournal Article, ResourceDecember 30, 2020value-based-carejournal-article resource[Oral Health Providers of Color Face Hardship From COVID-19](https://carequest.org/resource/oral-health-providers-of-color-face-hardship-from-covid-19/)Health EquityPublication, ResourceDecember 22, 2020health-equitypublication resource[System-Level Interventions to Reduce Utilization of General Anesthesia to Treat Dental Caries](https://carequest.org/resource/system-level-interventions-to-reduce-utilization-of-general-anesthesia-to-treat-dental-caries/)Clinical PracticeJournal Article, ResourceDecember 11, 2020clinical-practicejournal-article resource[Public Health Dental Providers Embrace COVID-19-Related Changes](https://carequest.org/resource/public-health-dental-providers-embrace-covid-19-related-changes/)Health Equity, Practice ManagementPublication, ResourceDecember 10, 2020health-equity practice-managementpublication resource[Teledentistry Is an Effective Tool to Triage Patients & Save Money](https://carequest.org/resource/teledentistry-is-an-effective-tool-to-triage-patients-save-money/)Practice ManagementPublication, ResourceDecember 10, 2020practice-managementpublication resource[Reshaping Dentistry in Turbulent Times](https://carequest.org/resource/reshaping-dentistry-in-turbulent-times/)Practice ManagementPublication, ResourceDecember 7, 2020practice-managementpublication resource[School Dental Programs Face Stiff Challenges](https://carequest.org/resource/school-dental-programs-face-stiff-challenges/)Practice ManagementPublication, ResourceDecember 2, 2020practice-managementpublication resource[COVID-19 Impacts on Dental Office Visits](https://carequest.org/resource/covid-19-impacts-on-dental-office-visits/)Practice ManagementPublication, ResourceDecember 2, 2020practice-managementpublication resource[Alternative Payment Models in Dentistry](https://carequest.org/resource/alternative-payment-models-in-dentistry/)Value-Based CarePublication, ResourceNovember 24, 2020value-based-carepublication resource[Provider Teledentistry Use Gains Traction During COVID-19](https://carequest.org/resource/provider-teledentistry-use-gains-traction-during-covid-19/)Practice ManagementPublication, ResourceNovember 13, 2020practice-managementpublication resource[Opioid Prescribing by TennCare Dentists](https://carequest.org/resource/opioid-prescribing-by-tenncare-dentists/)Health EquityPublication, ResourceNovember 12, 2020health-equitypublication resource[Discrimination Reduces Utilization of Routine Dental Care](https://carequest.org/resource/discrimination-reduces-utilization-of-routine-dental-care/)Health EquityPublication, ResourceNovember 9, 2020health-equitypublication resource[A Vaccine Can Prevent Throat Cancer](https://carequest.org/resource/a-vaccine-can-prevent-throat-cancer/)Clinical Practice, Medical-Dental IntegrationResource, Visual ReportOctober 23, 2020clinical-practice medical-dental-integrationresource visual-report[A Three Domain Framework to Innovating Oral Health Care](https://carequest.org/resource/a-three-domain-framework-to-innovating-oral-health-care/)Practice Management, Value-Based CareResource, Visual ReportOctober 14, 2020practice-management value-based-careresource visual-report[Cutting Medicaid Adult Dental Benefits Would Hurt States in Unexpected Ways](https://carequest.org/resource/cutting-medicaid-adult-dental-benefits-would-hurt-states-in-unexpected-ways/)Dental CoverageResource, Visual ReportOctober 7, 2020dental-coverageresource visual-report[Self-Care Tips After Teledentistry Appointment](https://carequest.org/resource/self-care-tips-after-teledentistry-appointment/)Practice ManagementResource, ToolOctober 6, 2020practice-managementresource tool[A Difficult Path to COVID-19 Recovery](https://carequest.org/resource/a-difficult-path-to-covid-19-recovery/)Practice ManagementPublication, ResourceOctober 1, 2020practice-managementpublication resource[The Link Between Ventilator-Associated Pneumonia and the Mouth](https://carequest.org/resource/the-link-between-ventilator-associated-pneumonia-and-the-mouth/)Clinical Practice, Health Equity, Medical-Dental IntegrationPublication, ResourceSeptember 18, 2020clinical-practice health-equity medical-dental-integrationpublication resource[Getting to the Heart of It](https://carequest.org/resource/getting-to-the-heart-of-it/)Medical-Dental IntegrationResource, Visual ReportJuly 28, 2020medical-dental-integrationresource visual-report[Impacts Beyond the Mouth](https://carequest.org/resource/impacts-beyond-the-mouth/)Medical-Dental IntegrationResource, Visual ReportJuly 7, 2020medical-dental-integrationresource visual-report[Dental Care’s New Normal: Survey Reveals the Need to Adapt](https://carequest.org/resource/dental-cares-new-normal-survey-reveals-the-need-to-adapt/)Special Patient CarePublication, ResourceJune 25, 2020special-patient-carepublication resource[Patients Give High Marks to Their Teledentistry Experience](https://carequest.org/resource/patients-give-high-marks-to-their-teledentistry-experience/)Practice ManagementPublication, ResourceJune 25, 2020practice-managementpublication resource[Teledentistry: Providing Access to Care During the COVID-19 Crisis](https://carequest.org/resource/teledentistry-providing-access-to-care-during-the-covid-19-crisis/)Practice ManagementPublication, ResourceJune 24, 2020practice-managementpublication resource[Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey](https://carequest.org/resource/trends-in-non-traumatic-dental-emergency-department-use-in-new-york-and-new-jersey/)Dental Coverage, Health Equity, Medical-Dental IntegrationJournal Article, ResourceJune 15, 2020dental-coverage health-equity medical-dental-integrationjournal-article resource[Different Levels of Associations Between Medical Co-morbidities and Preterm Birth Outcomes Among Racial/Ethnic Women Enrolled in Medicaid 2014-2015](https://carequest.org/resource/different-levels-of-associations-between-medical-co-morbidities-and-preterm-birth-outcomes-among-racial-ethnic-women-enrolled-in-medicaid-2014-2015/)Dental Coverage, Medical-Dental IntegrationJournal Article, ResourceJune 15, 2020dental-coverage medical-dental-integrationjournal-article resource[Fast-Track to Teledentistry: Removing Barriers While Maximizing Overall Health](https://carequest.org/resource/fast-track-to-teledentistry-removing-barriers-while-maximizing-overall-health/)Dental Coverage, Health Equity, Medical-Dental IntegrationPublication, ResourceJune 2, 2020dental-coverage health-equity medical-dental-integrationpublication resource[Expanding Oral Health: Teledentistry](https://carequest.org/resource/expanding-oral-health-teledentistry/)Dental Coverage, Practice ManagementPublication, ResourceJune 2, 2020dental-coverage practice-managementpublication resource[Answering that Dental Emergency Call Remotely](https://carequest.org/resource/answering-that-dental-emergency-call-remotely/)Practice ManagementResource, VideoJune 2, 2020practice-managementresource video[NHANES Oral Health Data Reflect Barriers & Inequities](https://carequest.org/resource/nhanes-oral-health-data-reflect-barriers-inequities/)Health EquityResource, Visual ReportMay 19, 2020health-equityresource visual-report[The Interprofessional Oral Health Referral](https://carequest.org/resource/the-interprofessional-oral-health-referral/)Medical-Dental IntegrationPublication, ResourceMarch 31, 2020medical-dental-integrationpublication resource[Hospital Utilization for Non-Traumatic Dental Conditions in Oregon from 2013 to 2015](https://carequest.org/resource/hospital-utilization-for-non-traumatic-dental-conditions-in-oregon-from-2013-to-2015/)Dental Coverage, Health Equity, Medical-Dental IntegrationPublication, ResourceMarch 11, 2020dental-coverage health-equity medical-dental-integrationpublication resource[The Burden of Out-of-Pocket Expenditures for Dental Care on Medicare-Enrolled Elderly and Disabled](https://carequest.org/resource/the-burden-of-out-of-pocket-expenditures-for-dental-care-on-medicare-enrolled-elderly-and-disabled/)Dental Coverage, Health EquityPublication, ResourceFebruary 19, 2020dental-coverage health-equitypublication resource[Healthy Mouths: Why They Matter for Adults and State Budgets](https://carequest.org/resource/healthy-mouths-why-they-matter-for-adults-and-state-budgets/)Dental Coverage, Medical-Dental IntegrationPublication, ResourceFebruary 5, 2020dental-coverage medical-dental-integrationpublication resource[Exploring Alternative Payment Models for Oral Health Care](https://carequest.org/resource/exploring-alternative-payment-models-for-oral-health-care/)Health Equity, Value-Based CareJournal Article, ResourceJanuary 21, 2020health-equity value-based-carejournal-article resource[Medicaid Adult Dental Benefits Increase Access and Reduce Out-of-Pocket Expenditures](https://carequest.org/resource/medicaid-adult-dental-benefits-increase-access-and-reduce-out-of-pocket-expenditures/)Dental Coverage, Health Equity, Medical-Dental IntegrationPublication, ResourceNovember 8, 2019dental-coverage health-equity medical-dental-integrationpublication resource[Poor Families Spend 10 Times More of Their Income on Dental Care than Wealthier Families](https://carequest.org/resource/poor-families-spend-10-times-more-of-their-income-on-dental-care-than-wealthier-families/)Health EquityPublication, ResourceSeptember 9, 2019health-equitypublication resource[Pediatric Primary Care and Oral Health](https://carequest.org/resource/pediatric-primary-care-and-oral-health/)Medical-Dental IntegrationPublication, ResourceAugust 26, 2019medical-dental-integrationpublication resource[Medical Well-Child Visits and Preventive Dental Visits](https://carequest.org/resource/medical-well-child-visits-and-preventive-dental-visits/)Health Equity, Medical-Dental Integration, Minimally Invasive CareJournal Article, ResourceApril 30, 2019health-equity medical-dental-integration minimally-invasive-carejournal-article resource[A Model for Better Health, Better Access, and Better Value: Advantage Dental’s Approach](https://carequest.org/resource/a-model-for-better-health-better-access-and-better-value-advantage-dentals-approach/)Health Equity, Value-Based CarePublication, ResourceNovember 7, 2017health-equity value-based-carepublication resource --- ### [Person-Centered Care](https://carequest.org/education/self-paced-courses/person-centered-care/) **Published:** April 17, 2026 **Author:** Chernise Harris **Content:** # Person-Centered Care ## Patients have unique backgrounds, experiences, and values, and the care you provide needs to connect with those individuals. Find tools and resources to create meaningful partnerships in our Person-Centered Care catalog. ![](https://carequest.org/wp-content/uploads/2026/01/self-paced-hero.png "self paced hero") ## Courses ![](https://carequest.org/wp-content/uploads/2026/04/Community-Water-Fluoridation_600x320.png "Community Water Fluoridation_600x320") ### Community Water Fluoridation: How Dental Professionals Can Lead the Conversation Dental professionals play a crucial role in supporting person-centered care and advocating for community health by engaging in clear, evidence-based conversations about fluoridation. This self-paced course will equip you with the tools and knowledge needed to communicate confidently and address any questions patients may have. $ #### Learn more ### Dental Fear and Anxiety: Why It Exists and What Providers Can Do to Help Fear and anxiety related to dental care often create a “cycle of avoidance,” which can lead to missed care, deterioration of oral health, and invasive, costly procedures that negatively impact patients and the overall oral health system. In this course, our experts will explore public perceptions of dental fear and anxiety and potential solutions for preventing and treating it. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Dental-Fear-and-Anxiety_600x320.png "Dental Fear and Anxiety_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/Dental-Therapy-Examining-the-Misconceptions-and-Opportunities_600x320.png "Dental Therapy Examining the Misconceptions and Opportunities_600x320") ### Dental Therapy: Examining the Misconceptions and Opportunities Dental therapy offers an evidence-based solution to expand the dental workforce and bring high-quality care to communities, particularly those that lack equitable access. This self-paced course explores the evolving legislative landscape, the scope of practice for dental therapists, and the role these professionals can play in expanding access to equitable oral health care. $ #### Learn more ### Examining the Connection Between Sleep and Oral Health Dental health professionals are often the first to notice symptoms indicative of sleep disorders due to their frequent, detailed interactions with patients. Those symptoms are not always clear, though. This course will provide practical guidance on identifying sleep health concerns during oral evaluations. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Connection-Between-Sleep-Oral-Health_600x320.png "Connection Between Sleep & Oral Health_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/Exploring-the-Myths-and-Misconceptions-About-Oral-Health-and-Pregnancy_600x320.png "Exploring the Myths and Misconceptions About Oral Health and Pregnancy_600x320") ### Exploring the Myths and Misconceptions About Oral Health and Pregnancy Despite the longstanding advocacy of the American College of Obstetricians and Gynecologists (ACOG) for routine dental care before and during pregnancy, there’s still a significant disconnect between the awareness and implementation of these recommendations in clinical practice. This gap in care can lead to suboptimal perinatal outcomes and overlooked oral health needs in pregnant patients. $ #### Learn more ### Understanding and Providing Trauma-Informed Oral Health Care This course will explore practical ways that providers can implement trauma-informed strategies in their oral health practice. We will discuss how trauma history can impact engagement in oral health care, the benefits of a universal approach to trauma precautions, and strategies to sensitively interact with trauma survivors. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Understanding-and-Providing-Trauma-Informed-Care_600x320.png "Understanding and Providing Trauma Informed Care_600x320") ## More Courses by Topic ## Practice Management 5 Courses Available [View courses](https://carequest.org/education/self-paced-courses/practice-management/) ## Clinical Practice 6 Courses Available [View courses](https://carequest.org/education/self-paced-courses/clinical-practice/) ## Special Patient Care 4 Courses Available [View courses](https://carequest.org/education/self-paced-courses/special-patient-care/) ## Accreditation CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [Practice Management](https://carequest.org/education/self-paced-courses/practice-management/) **Published:** April 17, 2026 **Author:** Chernise Harris **Content:** # Practice Management ## Data. Care coordination. Continuous improvement. Running your practice efficiently and successfully is about more than just budgets and billing. Our Practice Management courses help prepare you for the future of dentistry. ![](https://carequest.org/wp-content/uploads/2026/04/spc_practice-management-hero.png "spc_practice management hero") ## Courses ![](https://carequest.org/wp-content/uploads/2026/04/Creating-a-Culture-of-Improvement_600x320.png "Creating a Culture of Improvement_600x320") ### Creating a Culture of Improvement Improving provider and patient experiences in oral health requires a systematic approach to enhancing an organization’s model of care. This introductory course will explore the importance of adopting robust quality improvement processes. $ #### Learn more ### Integration and Coordination to Improve the Patient Experience By establishing care coordination and adopting integrated care protocols, dental professionals facilitate interprofessional collaboration. This course will explore dental care coordination and integrated care as critical components in addressing systemic issues that affect patient outcomes. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Integration-and-Coordination-to-Improve-the-Patient-Experience_600x320.png "Integration and Coordination to Improve the Patient Experience_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/Oral-Health-as-a-Driver-of-Population-Health_600x320.png "Oral Health as a Driver of Population Health_600x320") ### Oral Health as a Driver of Population Health What is population health? This course will explore that question and explain why focusing on the health of a specific group can help you provide better care to that group. We’ll also discuss the emerging connections between oral health and overall health, and how integrating care can benefit communities. $ #### Learn more ### The Role of Data in Oral Health Data plays a pivotal role in successful oral health practices. This foundational course will examine common health data sources and how they measure care quality, monitor health outcomes, and guide decision-making. We’ll also discuss the importance of high-quality data and conclude with a review of data privacy and the Health Insurance Portability and Accountability Act (HIPAA). $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/The-Role-of-Data-in-Oral-Health_600x320.png "The Role of Data in Oral Health_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/VBC-Self-Paced-Course_600x320.png "VBC Self-Paced Course_600x320") ### Value-Based Care in Oral Health: Principles and Practices Value-based care (VBC) is a model of care focused on improving health outcomes and the patient experience while lowering costs and reducing disparities compared to the traditional fee-for-service model. This introductory course will explore the need for transitioning to VBC in oral health and the factors driving this change. $ #### Learn more ## More Courses by Topic ## Clinical Practice 5 Courses Available [View courses](https://carequest.org/education/self-paced-courses/clinical-practice/) ## Person-Centered Care 6 Courses Available [View courses](https://carequest.org/education/self-paced-courses/person-centered-care/) ## Special Patient Care 4 Courses Available [View courses](https://carequest.org/education/self-paced-courses/special-patient-care/) ## Accreditation CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [Special Patient Care](https://carequest.org/education/self-paced-courses/special-patient-care/) **Published:** April 17, 2026 **Author:** Chernise Harris **Content:** # Special Patient Care ## Tailoring oral care to individuals with complex care needs — such as physical, developmental, and cognitive disabilities — is a team effort. Ensure you and your dental colleagues have the knowledge and skills to provide optimal care environments. ![](https://carequest.org/wp-content/uploads/2026/04/spc_Special-patient-care-hero.png "spc_Special patient care hero") ## Courses ![](https://carequest.org/wp-content/uploads/2026/04/Caring-for-Individuals-with-Disabilities_600x320.png "Caring for Individuals with Disabilities_600x320") ### Caring for Individuals with Disabilities: Practical Considerations for Dental Professionals This course explores practical strategies to help dental providers deliver equitable, high-quality care for individuals with disabilities. You will learn to recognize different types of disabilities and their implications on oral health, identify risk factors that contribute to higher rates of disease, and explore approaches to reduce these disparities. $ #### Learn more ### Oral Health and Dementia: Strategies to Care for Patients with Cognitive Decline Alzheimer’s disease (AD) and Alzheimer’s disease-related dementias (ADRD) can complicate both the delivery and outcomes of dental care. This course is designed to help with both aspects, examining how verbal and nonverbal techniques can enhance patient coordination and comfort, as well as how tailored treatment plans can address common oral health issues. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Oral-Health-and-Dementia_600x320.png "Oral Health and Dementia_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/Providing-Oral-Health-Care-to-Autistic-Individuals_600x320.png "Providing Oral Health Care to Autistic Individuals_600x320") ### Providing Oral Health Care to Autistic Individuals This course will equip you with proven strategies for providing oral health care to autistic patients. The course begins by delving into the basic characteristics that define the diagnosis of autism, exploring how these can influence the health care that individuals with autism receive. It provides an understanding of autism, not just as a condition, but in the larger context of neurodiversity. $ #### Learn more ### Treating Dental Patients with Head and Neck Cancer The path to optimal health often requires an integrative, empathetic approach. This is especially true when caring for patients undergoing cancer treatments, where oral health plays a pivotal role. This course will explore pre-treatment evaluation, nutrition and oral health care during treatment, and post-radiation oral care best practices. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Treating-Dental-Patients-with-Head-and-Neck-Cancer_600x320.png "Treating Dental Patients with Head and Neck Cancer_600x320") ## More Courses by Topic ## Practice Management 5 Courses Available [View courses](https://carequest.org/education/self-paced-courses/practice-management/) ## Person-Centered Care 6 Courses Available [View courses](https://carequest.org/education/self-paced-courses/person-centered-care/) ## Clinical Practice 4 Courses Available [View courses](https://carequest.org/education/self-paced-courses/clinical-practice/) ## Accreditation CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [Media](https://carequest.org/news/media/) **Published:** October 22, 2025 **Author:** Darren Edwards **Content:** # Media ## CareQuest Institute is influencing the oral health industry through its work and its thought leadership. ## CareQuest Institute in the News​ ### **NBC** ### If states ban fluoride, more kids will get cavities and Medicaid costs could soar, study finds March 19, 2026 [Read](https://www.nbcnews.com/health/kids-health/fluoride-ban-kids-cavities-medicaid-costs-millions-study-rcna264070) ### **KFF Health News** ### More Kids Are in ERs for Tooth Pain. Trump Cuts and RFK Jr.’s Anti-Fluoride Fight Aren’t Helping. March 10, 2026 [Read](https://kffhealthnews.org/news/article/dental-care-emergency-rooms-special-needs-medicaid-shortage-areas/) ### **Axios** ### Fluoride ban efforts show RFK Jr.’s reach. ### February 2, 2026 [Read](https://www.axios.com/2026/02/02/fluoride-ban-water-kennedy-rfk-epa) $ #### View all news ## CareQuest Institute Thought Leaders​ ### **Wade Rakes**, **MBA**, Chief Executive Officer Wade Rakes is the Chief Executive Officer of CareQuest Institute for Oral Health. He joined the organization in 2025, bringing deep expertise in health care, government, and community leadership.​​ Prior to joining CareQuest, Wade held various leadership positions at Centene Corporation, a leading health care enterprise delivering high-quality, cost-effective services to government and commercial programs. During his 15 years at Centene, Rakes rose to Chief Growth Officer and helped propel the company’s transformation from a 6-state Medicaid care management organization into a 30-state, multi-product health care entity deeply connected to local communities. As President and CEO of Peach State Health Plan, he guided one of Centene’s largest subsidiaries, delivering care to more than 1 million state residents. Earlier in his career, Wade served as a cabinet-level official in the State of Ohio and has remained a committed civic leader. He is Chair of the Board of LGBTQ+ Victory, Vice Chair of the Board of the High Museum, a Trustee of the Woodruff Arts Center, and a member of the Board of Advisors of the James A. Baker III Institute at Rice University. Wade earned a Bachelor of Arts degree from Princeton University and a Master of Business Administration degree from the University of Michigan.​ ![](https://carequest.org/wp-content/uploads/2025/09/Wade2.png "Wade2") - [Follow](https://www.linkedin.com/in/waderakes/ "Follow on LinkedIn") ### Areas of expertise: Health Care Leadership and Strategy​ Medicaid and Government Programs​ Health Equity and Access​ Oral Health Integration​ Civic and Community Leadership ### Featured work: Boston Globe: [Wade Rakes gives Boston’s CareQuest Institute a ](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bostonglobe.com%2F2025%2F10%2F27%2Fbusiness%2Fwade-rakes-carequest-institute-ceo%2F&data=05%7C02%7Ccstrang%40carequest.org%7Cf51ba30f1f40486ab16108de17027296%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638973496468078376%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=UTgy4JPgQ4zmOgKrZpapWvEfTR4k5oQ%2B8B%2FGgytHqXk%3D&reserved=0)[reason to smile](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bostonglobe.com%2F2025%2F10%2F27%2Fbusiness%2Fwade-rakes-carequest-institute-ceo%2F&data=05%7C02%7Ccstrang%40carequest.org%7Cf51ba30f1f40486ab16108de17027296%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638973496468078376%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=UTgy4JPgQ4zmOgKrZpapWvEfTR4k5oQ%2B8B%2FGgytHqXk%3D&reserved=0) Becker’s Dental Review: [We are at a crisis](https://www.beckersdental.com/featured-perspectives/we-are-at-a-crisis-carequest-ceo-zeroes-in-on-top-priorities-for-dental-care-access-in-2026/) Dental Bite: [Leading the future of oral health](https://www.dentalbite.co/leading-the-future-of-oral-health/) ### **Melissa Burroughs**, Senior Director, Policy & Advocacy Melissa Burroughs serves as senior director, policy & advocacy at CareQuest Institute for Oral Health. In this role, she leads the development and advancement of public health strategies and policy priorities that support the organization’s mission to improve oral health equity and outcomes nationwide. Melissa works closely with CareQuest Institute’s affiliates and partners to shape impactful policy initiatives that drive systemic change in oral health care. Melissa brings deep expertise in health policy, with a focus on Medicaid, Medicare, the Affordable Care Act, maternal and child health, and health care pricing reform. Prior to joining CareQuest Institute, she served as director of strategic partnerships at Families USA, a national advocacy organization dedicated to improving health and health care through policy change. There, she led collaborative efforts to advance equitable health policies across a broad coalition of stakeholders.​ Melissa holds a bachelor’s degree from the University of North Carolina at Chapel Hill. ![](https://carequest.org/wp-content/uploads/2025/04/Melissa-PNG.png "Melissa PNG") - [Follow](https://www.linkedin.com/in/melissa-burroughs-2084b663/ "Follow on LinkedIn") ### Areas of expertise: Oral Health Policy and Advocacy​ Access to Care and Health Equity​ Medicaid and Medicare Policy​ Government Relations and Stakeholder Engagement ### Featured work: CNN: [Prescription fluoride faces FDA scrutiny](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cnn.com%2F2025%2F07%2F24%2Fhealth%2Ffluoride-prescription-supplement-fda&data=05%7C02%7Ccstrang%40carequest.org%7Cf51ba30f1f40486ab16108de17027296%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638973496468161110%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=CJyJkuuqbeRWjCdn34FaBdQMq6ucoCdddwA0vC2v8TY%3D&reserved=0)​ TIME: [America’s Dental Health Is in Trouble](https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftime.com%2F7291226%2Famerica-dental-oral-health%2F&data=05%7C02%7Ccstrang%40carequest.org%7Cf51ba30f1f40486ab16108de17027296%7C70b8dad5c5e84be1af67ccc78aa80bba%7C0%7C0%7C638973496468277115%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=e%2Bm%2FquYJ1rshFrXVmDpJt8ad2ab5daUc%2BIZhlHqoO7M%3D&reserved=0) Axios: [Fluoride ban efforts show RFK Jr.’s reach](https://www.axios.com/2026/02/02/fluoride-ban-water-kennedy-rfk-epa) NBC News: [If states ban fluoride, more kids will get cavities and Medicaid costs could soar, study finds](https://www.nbcnews.com/health/kids-health/fluoride-ban-kids-cavities-medicaid-costs-millions-study-rcna264070) KFF Health News: [More Kids Are in ERs for Tooth Pain](https://kffhealthnews.org/news/article/dental-care-emergency-rooms-special-needs-medicaid-shortage-areas/) ​ ​ ## Media Inquiries --- ### [Terms & Conditions](https://carequest.org/terms-conditions/) **Published:** September 19, 2025 **Author:** Darren Edwards **Content:** # Terms & Conditions The use of this website is governed by the following terms and conditions (“Terms”) and our Privacy Policy. By using this website, you acknowledge that you have read these disclaimers and policies and that you accept and will be bound by their terms. CareQuest Institute for Oral Health, Inc. (“Institute”) and its affiliated organizations (collectively “CareQuest”) reserve the right to revise these Terms at any time without prior notice by updating this page and such revisions will be effective upon posting to this page and you agree to be bound by such revised terms. Please check this page periodically for any changes. User’s continued use of this website shall constitute acceptance of these Terms and any posted changes. User agrees to use this website only for lawful purposes. User is prohibited from posting on or transmitting through the Institute any unlawful, harmful, threatening, abusive, harassing, defamatory, vulgar, obscene, profane, hateful, racially, ethnically, or otherwise objectionable material of any kind, including, but not limited to, any material which encourages conduct that would constitute a criminal offense or otherwise violate any applicable local, state, national or international law. **Copyright and Trademark:** This website is Copyright ©2021 CareQuest Institute for Oral Health, Inc. All Rights Reserved. All content included on this site, including, but not limited to, all text, graphics, logos, images, and software, is the property of, or used pursuant to license to, the Institute and protected by law. Unless otherwise indicated, no portion of this site, nor any content appearing on this site may be reproduced, displayed, duplicated, copied, distributed, sold, transferred or otherwise exploited for any purpose without the express prior consent of the Institute. Under no circumstance may a user remove, delete, augment, add to, participate in the transfer or sale of, create derivative works from or in any way exploit any content, in whole or part. User may not upload, post, reproduce or distribute in any way content protected by copyright, or other propriety right. In addition, use of any software content shall be governed by the software license agreement accompanying such software. CareQuest Institute of Oral Health, Inc. services, programs or products referenced herein may also be either trademarks or service marks or registered trademarks or service marks of the Institute. The names of other companies, products and services mentioned herein may be the trademarks or service marks of their respective owners. No association with any company, organization, product, domain name, e-mail address, logo, persons, places, or events is intended or should be inferred. All rights not expressly granted herein are reserved. **Links to Other Websites and Services:** This website may contain links or references to other websites and outside services and resources. CareQuest Institute for Oral Health, Inc. does do not control the availability and content of websites, services or resources other than its own, nor does the Institute approve or endorse materials, products, services or information available at or through such other websites or third parties. Viewing other websites or utilizing outside services and resources is done at user’s own risk. **Disclaimer and Limitation of Liability:** The content of this website is provided for general information, is not intended to provide medical or dental advice and should not be relied upon as a substitute for professional medical or dental advice, diagnosis or treatment. No dentist/patient relationship is established by this content. No diagnosis or treatment is being provided. No guarantees or warranties, including insurance coverage or payment, are made regarding any of the information provided. We may provide links to other websites that are not under our control. In general, any website that has an address (or URL) not containing our domain name is such a website. These links are provided for convenience or reference only and are not intended as an endorsement by us of the organization or individual operating the website or a warranty of any type regarding the website or the information on the website. CAREQUEST INSTITUTE FOR ORAL HEALTH, INC. DOES NOT WARRANT THE ACCURACY, CURRENCY OR COMPLETENESS OF THE INFORMATION OR THE RELIABILITY OF ANY ADVICE, OPINION, STATEMENT OR OTHER MATERIALS DISPLAYED ON, OR DISTRIBUTED THROUGH, THIS WEBSITE. The information set forth on this website may contain inaccuracies and typographical errors. Any reliance on any such information, advice, opinion, statement, or other materials will be at your own risk. THIS SITE IS PROVIDED BY the Institute ON AN “AS IS” AND “AS AVAILABLE” BASIS. CAREQUEST INSTITUTE FOR ORAL HEALTH, INC. MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, AS TO THE OPERATION OF THE SITE, OR THE INFORMATION, CONTENT, MATERIALS OR PRODUCTS, INCLUDED ON THIS SITE. TO THE FULL EXTENT PERMISSIBLE BY APPLICABLE LAW, CAREQUEST INSTITUTE FOR ORAL HEALTH, INC. DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, ACCURACY OF INFORMATIONAL CONTENT, OR NON-INFRINGEMENT. CAREQUEST INSTITUTE FOR ORAL HEALTH, INC. WILL NOT BE LIABLE FOR ANY DAMAGES OF ANY KIND ARISING FROM THE USE OF THIS WEBSITE, INCLUDING, BUT NOT LIMITED TO, DIRECT, INDIRECT, SPECIAL, INCIDENTAL, PUNITIVE AND CONSEQUENTIAL DAMAGES, WHETHER BASED ON BREACH OF CONTRACT, BREACH OF WARRANTY, TORT, NEGLIGENCE, PRODUCT LIABILITY OR OTHERWISE, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE. The exclusion of damages under this section is independent of your exclusive remedy herein and survives in the event such remedy fails of its essential purpose or is otherwise deemed unenforceable. The Institute reserves the right to modify any and all portions of this website without notice. Under no circumstances shall the Institute be liable to any user or any other third party for such modifications. If you are dissatisfied with this website, you do not agree with any part of the Terms, or you have any other dispute or claim with or against CareQuest Institute for Oral Health, Inc. with respect to the Terms or the website, then your sole and exclusive remedy is to discontinue using the website. **General; Governing Law and Jurisdiction:** The Terms constitute the entire agreement between you and CareQuest Institute for Oral Health, Inc. and governs your use of the website. These Terms shall be governed by the laws of the Commonwealth of Massachusetts. User agrees to submit to the personal and exclusive jurisdiction of the courts located within the county of Suffolk in the Commonwealth of Massachusetts. The failure of CareQuest Institute for Oral Health, Inc. to exercise or enforce any right or provision of the Terms shall not constitute a waiver of such right or provision. If any provision of Terms is found by a court of competent jurisdiction to be invalid, the parties nevertheless agree that the court should endeavor to give effect to the parties’ intentions as reflected in the provision, and the other provisions of the Terms remain in full force and effect. Any claim arising under the Terms must be brought within one (1) year after such claim or cause of action arose or be forever barred. --- ### [Privacy Statement](https://carequest.org/privacy-statement/) **Published:** September 19, 2025 **Author:** Darren Edwards **Content:** # Privacy Statement The privacy of your personal information is important to us. The purpose of this statement (the “Privacy Statement”) is to let you know how CareQuest Institute for Oral Health, Inc. (“Institute”) handles the information we collect through the use of this website or other electronic communication methods. As used in this policy, terms such as “we” or “our” and “Company” refer to the Institute and its current affiliated entities. This Privacy Statement governs your access and use of all Institute websites (“Sites”) and services (“Services”), including extranet sites and other online tools that are associated with programs run by the Institute. Please read this Privacy Statement carefully so that you understand our online privacy practices. By accessing our Sites, you agree to be bound by the terms of this Privacy Statement. If you have any questions after you have read the Privacy Statement, please contact . The Institute respects your interest in privacy when visiting our Sites. We are responsible for protecting the security of the personal information we collect from you. You may occasionally receive other privacy-related notices from the Institute, its affiliates, or subsidiaries. These notices may also apply to the information collected through our Sites. This Privacy Statement does not apply to information collected through other means such as by telephone or in person. That information may be protected by other privacy policies. The Sites are intended for individuals located in the United States. Any information you provide, including any personal information, will be stored within the United States. ### 1. Commitment to Confidentiality We are committed to maintaining the confidentiality of all information we receive from the Sites’ users. We may partner with third parties and provide links to third-party websites to offer you additional information and services. You may see both the Institute logo and/or the third-party’s logo on these third-party websites. The Institute does not control how third-party websites use your information. Users of these websites should review the privacy policies of any third-party websites and be aware of who is collecting personal information and what privacy policies apply before providing personal information. ### 2. Your Personal Information Sites may include web pages that give you the option to provide us with information about yourself, including when creating an account. When you create an Account, we collect (i) personal identifiers such as your contact information, including your name, email address, telephone number, or text message number, and state; and (ii) additional information such as your employer (including whether you work at a Community Health Center/FQHC), industry, and areas of interest. You are not required to give us your personal information. However, that may limit your ability to use certain functions of the Sites or to request certain Services or information. We may use your personal information to contact you and for additional purposes such as: - To respond to your inquiries - To prepopulate information for transactions - To personalize the Sites for you - To process an employment application - To administer surveys and promotions - To provide you with information that we believe may be useful to you, such as information about products or Services provided by us or other businesses - To perform analytics and to improve our products, Sites, and advertising - To comply with applicable laws, regulations, and legal processes - To protect someone’s health, safety, or welfare - To protect our rights, the rights of affiliates or related third parties, or take appropriate legal action, such as to enforce our Terms and Conditions - To keep a record of our transactions and communications - For other lawful business. ### 3. Collection and Use of Personal Information/Cookies We may use and disclose information about your interactions with our Sites, such as pages visited and features used (“Activity Information”), unless restricted by this Privacy Statement or by applicable law. Some examples of the ways we use your Activity Information include: - Customizing your experience on the Sites, including managing and recording your preferences - Presenting more relevant content and tools based on your past choices - Marketing, product development, and research purposes - Tracking resources and data accessed on the Sites - Developing reports regarding Site usage, activity, and statistics - Assisting users experiencing Site problems - Enabling certain functions and tools on the Sites - Tracking paths of visitors to the Sites and within the Sites We also use analytics services such as Google Analytics to learn more about your use of the Sites, such as which pages are visited and how often they are visited. This information will be used to enable certain features on the Sites. Information is captured using various technologies and may include “cookies” – text files with small pieces of data that are used to identify your computer as you use a computer network and improve your web browsing experience. You can learn more about how Google Analytics uses your data by visiting . You may disable cookies and similar items by adjusting your browser preferences at any time, but this may limit your ability to take advantage of all the features on the Sites. We may also allow third-party service providers to use cookies and other technology to collect information, such as Activity Information, over time and across third-party websites, web browsers used to read our Sites and/or which third-party websites are referring traffic or linking to our Sites, or to deliver targeted advertisements to you. We do not control these third-party technologies and their use is governed by the privacy policies of third parties using such technologies. ### 4. Sharing Personal Information We will only share your personal information with third parties as outlined in this Privacy Statement and as otherwise permitted by law. The Sites may permit you to view your visitor profile and related personal information and to request changes to such information. If this function is available, we will include a link on the Sites with a heading such as “My Account” or similar words. Clicking on the link will take you to a page through which you may review your visitor profile and related personal information. We may share your personal information within the Institute, and/or combine information that you provide to us through the Sites with other information we have received from you, whether online or offline, or from other sources such as from our vendors. For example, if you have participated in a program with us, we may combine personal information you provide through the Sites with information regarding your program participation. We may also share personal information with other third-party companies that we collaborate with or hire to perform services on our behalf. For example, we may hire a company to help us send and manage email and/or SMS text messaging, and we might provide the company with your email address and certain other information in order for them to send you an email message or SMS on our behalf. Similarly, we may hire companies to host or operate some of our Sites and related computers and software applications. We may share personal information in response to a court order, subpoena, search warrant, law, or regulation. We may cooperate with law enforcement authorities in investigating and prosecuting activities that are illegal, violate our rules or may be harmful to other visitors. We may share personal information if all or part of the Institute is merged, dissolved, acquired or involved in a similar transaction. ### 5. Technology Use onThe Sites/ Internet Privacy Statement We strive to keep information that you share on the Sites confidential and secure. Your encrypted (encoded) sensitive information is protected using “Secure Socket Layers (SSL)” as it passes between your browser and the Sites. We take safeguards to protect the personal information submitted to us, both during transmission and once we receive it. No method of transmission over the internet, or method of electronic storage, is 100% secure. Therefore, while we strive to protect your personal information, we cannot guarantee its absolute security. Only authorized persons are permitted to access your personal information. All authorized persons must comply with applicable security, privacy, and confidentiality agreements. ### 6. Email and Online Communication If you send questions or comments to an email address listed on the Sites or via a contact form located within the Sites, we will share your correspondence with a colleague capable of addressing your questions and concerns. We will retain your communications until we have done our very best to provide you with a complete and satisfactory response. Ultimately, we will either discard your communication or, in some cases, archive it. We will keep your email address for future communications from our organization. We may periodically send electronic newsletters, notifications related to your account content and other communications. We may also send email communications regarding Site updates, industry news, and Institute updates. We will offer you appropriate consent mechanisms, such as opt-out options, for marketing and certain other communications. Please be aware that opt-outs may not apply to certain types of communications, such as account status, Site updates, or other communications. Unfortunately, standard internet email is not secure. For that reason, please do not use unsecured email to communicate information to us that you may consider confidential. ### 7. Children’s Privacy We will not intentionally collect any personal information from children under the age of 13 through the Sites without receiving parental or guardian consent. If you think that we have collected personal information from a child under the age of 13 through the Sites, please contact us at . ### 8. Location Tracking Providing useful, meaningful experiences is at the core of the Institute, and location information plays an important role in doing just that. Location tracking can make your experiences across our digital properties more relevant and helpful. Depending on the products you’re using and settings you choose, your use of our Sites may provide us with location information that is critical to making some Services and Site features work and making other Services more useful for you. Location tracking can come from real-time signals, like your Internet Protocol (IP) address, device location or even your past activity on our sites, allowing tailored experiences to be created. Below are the primary ways we may get information about your location: From your device’s IP address: IP addresses are part of the fabric of the internet and are assigned to a device whenever that device connects online. When the Sites need to send something to your computer (for instance, your Google search results), it needs your IP address to send it to the right computer. IP addresses are based around geography and may be used to approximate the general location of a device. Like many other internet services, we can use this information about your location to provide some basic services (even if precise location is not collected from your device). This can help us understand the state you are using our Services from and, for example, if there’s a sign-in from an unexpected place it allows us to detect unusual account activity. From your activity: As you use our Services, we may infer that you’re interested in a place even if your device isn’t telling us exactly where you are. For example, if you search for “Dental care in Dallas”, we may assume that you would like to learn more about programs improving care in Dallas. Depending on your settings, this type of information may be stored with your account. ### 9. Privacy Statement Changes This Privacy Statement is effective as of 04/14/2026 and is not intended to and does not create any contractual or other legal rights with or on behalf of any party. If we decide to make any material change to the Sites’ privacy practices, we will post those changes to this Privacy Statement and other places that we deem appropriate. The Institute wants you to be aware of what information is being collected, how the information is being used and under what circumstances, if any, the information may be disclosed. The Institute reserves the right to modify this Privacy Statement at any time, so please review it frequently. If you have any questions regarding this Privacy Statement or feel your privacy may have been violated, please contact . --- ### [FAQ](https://carequest.org/faq/) **Published:** October 3, 2025 **Author:** Darren Edwards **Content:** # Frequently Asked Questions ## Have a question? We’re here to help. Take a moment to browse through our Frequently Asked Questions below. If you don’t see what you’re looking for or need further assistance, please don’t hesitate to [contact us](#contact). ![](https://carequest.org/wp-content/uploads/2025/10/Health-Equity_1080x1080.png "Health Equity_1080x1080") ## Jump to: [General information](#general) [Grants](#grants) [Education & CEs](#education) [Focus areas](#focus) ## General Information ##### What is CareQuest Institute for Oral Health? CareQuest Institute is a nonprofit dedicated to transforming oral health care by advancing access, equity, and integration through research, education, grants, and advocacy. Learn more about [CareQuest Institute](https://carequest.org/about/). ##### Who does CareQuest Institute serve? We serve underserved communities, dental professionals, health organizations, policymakers, and advocates working to improve oral health equity. ##### How is CareQuest Institute connected to DentaQuest Partnership? DentaQuest Institute? DentaQuest Foundation? CareQuest Institute for Oral Health launched in March 2021, pulling forward and expanding upon the strengths and history of the DentaQuest Foundation, DentaQuest Institute, and the nonprofit programs of the DentaQuest Partnership for Oral Health Advancement. ##### How do I contact CareQuest Institute for more information? We’d love to hear from you! Complete the form on the [Contact Us](https://carequest.org/contact-us/) page and someone from our team will get back to you within two business days. ##### How can I stay updated on CareQuest Institute work and oral health news? We encourage you to [sign up](https://carequest.org/newsletter/) for our suite of newsletters, including special interest newsletters dedicated to oral health advocacy and philanthropy. We also share news, resources, and opportunities on our social media channels: [LinkedIn](https://www.linkedin.com/company/carequest-institute/about), [Facebook](https://www.facebook.com/CareQuestInstitute), [Instagram](https://www.instagram.com/carequestinstitute), [X](https://twitter.com/CareQuestInst), and [YouTube](https://www.youtube.com/@carequestinstitutefororalh4936). ##### I’m interested in expert comment, interviews, and/or securing a speaker. Who can I connect with? Please visit our [Media page](https://carequest.org/news-blog/media/) so see learn more about our spokespeople and complete the request form. Our communications team will review the request and be in touch to help secure the right representative. ##### I’m interested in using one of your resources in a publication or at a public conference. How can I request permission? Thank you for your interest in our resources! To proceed, please complete the [Contact Us](https://carequest.org/contact-us/) form on our website. Be sure to include a link to the specific resource you wish to use and a brief description of how you intend to use it. ##### How can I partner with CareQuest Institute to improve oral health in my community? You can explore collaboration opportunities by contacting us via the [Partnerships page](https://carequest.org/about/partner-with-us/). ##### Are there job opportunities at CareQuest Institute? You can find open positions on the [Careers page](https://carequest.org/careers/). ## Grants ##### Does CareQuest Institute offer grants for dental care? We don’t provide care, coverage, or loans directly to patients. Visit our [Grants page](https://carequest.org/grants2/) to learn more about the work we fund. ##### Where can organizations apply for funding? Organizations can apply for funding through our online grants management portal, Fluxx. Visit our [Apply page](https://carequest.org/grants/apply/) to learn more about the application process. ##### Where can I learn more about the grant process? You can find more information about the funding areas by visiting our [grants page](https://carequest.org/grants2/) or by getting in touch with a member of the CareQuest Institute [grants team](mailto:grants@carequest.org). ##### What types of organizations are eligible for funding? CareQuest Institute makes grants to nonprofit or not-for-profit organizations in the United States and US territories. The Institute does not make grants to for-profit organizations or individuals. ##### Should an organization submit a full budget as a part of the concept submission? No, you don’t need a full budget when submitting a concept. After any concept is approved, we collaborate with you on the full proposal and can clarify any budget questions. ##### Is there a maximum amount and/or a range for funding? We are flexible and consider the scope of your work as well as its alignment with our strategic priorities. ##### Which organizations need to submit a concept? We ask all interested organizations to submit a concept in the grant application process. We review concepts regularly and encourage prospective applicants to contact a member of the [grants team](mailto:grants@carequest.org) for more information about submitting a concept. ##### What budget line items are eligible/not eligible for funding? CareQuest Institute does not make grants directly to individuals and does not support capital expenses, direct service, mobile vans, or payments for procedures. ##### Can organizations have conversations with the grants team before applying for funding? Absolutely! We encourage all organizations to reach out to a member of the [grants team](mailto:grants@carequest.org) to discuss the program or project for which you are seeking funding. ##### What is the OPEN Network and how do I join? OPEN, an initiative of CareQuest Institute, is a diverse network of individuals and entities who are taking on America’s oral health challenges so that everyone has a chance to thrive. OPEN members use their unique experiences, knowledge, and skills to lead network activities every year, creating collective energy that is driving large-scale change. [Learn more about joining the network. ](https://carequest.org/policy-advocacy/open/) ## Education & CEs ##### What educational resources or trainings do you provide? We offer a [growing collection](https://carequest.org/education/) of oral health education programs, including webinars and self-paced online courses, in partnership with leading experts, researchers, and organizations within oral health. ##### What types of accreditation does CareQuest Institute offer? Many of our educational offerings support ongoing professional development and provide opportunities to earn Continuing Education (CE) credits. CareQuest Institute is an ADA CERP Recognized Provider of oral health care education (webinars and self-paced courses) and a Nationally Approved PACE Program Provider for FAGD/MAGD credit (webinars only). ##### Are there prerequisites for the self-paced courses? No, the self-paced courses do not have prerequisites. Learners can access any of the available courses, at any time. ##### How can I attend or watch webinars? Register for our free, live webinars or access recordings in our [growing webinar library](https://carequest.org/education/). ##### Is there a cost to access self-paced courses or participate in webinars? No, all continuing education offerings are available free of charge. ##### Which educational activities are eligible for CEs? Live webinars and self-paced online courses are eligible for continuing education (CE) credits. Recorded webinars are NOT eligible for CE credits. CareQuest Institute is an ADA CERP Recognized Provider of oral health care education and a Nationally Approved PACE Program Provider for FAGD/MAGD credit. ##### Where do I access my learning transcript and download my certificates? To access a transcript of your completed learning activities and download eligible certificates, visit [My Learning](https://learning.carequest.org/#/transcript). ## Focus Areas ##### What is “oral health equity,” and why is it important? Oral health equity means ensuring everyone has access to quality dental care; it’s vital to reduce disparities and improve overall health. Today, more than 76.5 million Americans have no dental coverage. Learn more about our research on [oral health equity](https://carequest.org/state-oral-health-equity-america-page/). ##### What is value-based care, and how does it reduce costs? Value-based care is a care delivery model in which providers are rewarded for quality health outcomes rather than the quantity of care delivered. In this system, quality and outcomes improve while costs remain the same (or fall). The healthier a person is, the fewer expensive (and often restorative and complicated) services they need. Learn more about [value-based care](https://carequest.org/about/value-based-care/). ##### What is minimally invasive care? Minimally invasive care (MIC) in dentistry is focused on preventing and healing tooth decay without removing any tooth structures. MIC includes prevention, counseling, and painless treatments, such as fluorides, antimicrobials, diagnostic solutions, and therapeutic fillings and sealants that are brushed onto teeth. Learn more about [MIC](https://carequest.org/about/minimally-invasive-care/). ##### What is medical-dental integration? CareQuest Institute’s focus on medical-dental integration, an approach to care that combines dental and medical services to treat the whole person, centers on transforming systems of care through partnerships. Our aim is to improve whole-person health, particularly for underserved populations and individuals with chronic and complex needs. We advance this work by focusing on initiatives that promote connectivity through integrated care delivery models, the development of shared health data, and communication platforms. Learn more about [medical-dental integration](https://carequest.org/about/medical-dental-integration/). ##### What is teledentistry, and how does it work? Teledentistry — using telehealth systems and methodologies for oral health care — is a flexible, convenient way to connect patients and providers in different physical locations. There are four forms of teledentistry: live video (synchronous), store-and-forward (asynchronous), remote patient monitoring (RPM), and mobile health (mhealth). Learn more about [telendentistry](https://carequest.org/teledentistry/). ##### What is preventive dental care? Preventive dental care is essential to maintaining good oral health and keeping teeth and gums healthy. Preventive dentistry includes oral exams, teeth cleaning, procedures such as fluoride applications and sealants, education, and diagnostic procedures. ##### What does Medicaid cover for dental for adults? Medicaid coverage varies by state. [The Checker](https://carequest.org/medicaid-adult-dental-coverage-checker/) looks at coverage to better understand how a given state’s Medicaid adult dental benefits package compares to others — from no dental benefits to extensive benefits. It looks at coverage of specific procedures and services, including allowed frequency, in eight service categories. ##### Does Medicaid cover dental benefits during pregnancy? During pregnancy, oral health care is essential, yet often underutilized — especially for people enrolled in Medicaid. Poor oral health during pregnancy has been linked to adverse birth outcomes, including preeclampsia (high blood pressure during pregnancy), preterm birth, and low-birth-weight infants. Visit the [Pregnancy and Oral Health page](https://carequest.org/pregnancy-and-oral-health/) to access key publications and a state-by-state dashboard of coverage. ##### Is fluoride in drinking water safe? Decades of research have proven that, at optimal levels, fluoride is safe and plays a critical role in preventing tooth decay and promoting good oral health. Visit our [Community Water Fluoridation page](https://carequest.org/policy-advocacy/community-water-fluoridation/) for more evidence and resources from CareQuest and industry leaders. ## Still Have Questions? Send us a message using the form below and a member of our team will get back to you. --- ### [Careers](https://carequest.org/careers/) **Published:** April 1, 2025 **Author:** Darren Edwards **Content:** # We’re on a mission to improve the oral health of all ## The oral health industry needs to change. Let’s change it together. ![](https://carequest.org/wp-content/uploads/2026/03/CQ-All-Staff-Photo-2026_web.png "CQ All Staff Photo 2026_web") ## Open Positions Visit **CareQuest Innovation Partners**, our for-profit subsidiary, for additional [open positions](https://carequestinnovation.com/careers/). *This link will lead you to a separate website.* **Equal Employment Opportunity:** CareQuest Institute of Oral Health provides equal employment opportunities to all employees and applicants without regard to race, color, religion, national origin, sex, gender identity, age, disability, marital status, sexual orientation, or any other protected characteristic. ## Together, We Will Transform the System CareQuest Institute for Oral Health is a national nonprofit championing a more equitable future where every person can reach their full potential through excellent health. The oral health industry needs to change – and together, we will make that change. Every day, we combine our passion and skillset to turn ideas into action. From industry-shaping research to practical education, from policy change to grants, we are uniquely positioned to change oral health. Our goal is create a more accessible, equitable, and integrated health system for everyone – and you could be the catalyst that brings it to life. By creating a more equitable system, millions of Americans – including children, underserved communities, veterans, and our own loved ones – will get the care they deserve. Join us to do meaningful, career-defining work alongside, health care providers, patients, and local, state, and federal stakeholders. ## Our Workplace Awards ### **2024-2025: Great Place to Work Certified®** CareQuest Institute is proud to be Certified™ by [Great Place To Work](https://www.greatplacetowork.com/)®, the global authority on workplace culture, employee experience, and the leadership behaviors proven to deliver market-leading revenue, employee retention, and increased innovation. The prestigious award is based on what employees said about their experience working here. Key highlights include: - 93% of our employees said that when you join the company, you are made to feel welcome. - 91% of our employees said they feel good about the ways we contribute to the community. - 90% of our employees said that people are encouraged to balance their work life and their personal life. ![](https://carequest.org/wp-content/uploads/2025/09/CareQuest_Institute_for_Oral_Health_US_English_2024_Certification_Badge-1-scaled.png "CareQuest_Institute_for_Oral_Health_US_English_2024_Certification_Badge (1)") ### **2021-2023: The Women’s Edge – Top 100 Women-Led Businesses in Massachusetts** CareQuest Institute is proud to be recognized in 2021, 2022, and 2023 among the top 100 women-led businesses in Massachusetts. The Women’s Edge, a nonprofit that supports female business leaders, examines revenue or operating budget as well as other variables, including number of full-time employees in the state, workplace and management diversity, and innovative projects. ![](https://carequest.org/wp-content/uploads/2025/04/Top-100-Web-Badge_smaller.png "Top-100-Web-Badge_smaller") ## Health, Wellness, and Benefits CareQuest Institute is committed to supporting the physical and mental well-being of our team. We offer a wide range of wellness benefits to employees, including: - Medical, Dental, Vision Insurance Plans - Health Savings Accounts (HSA) - Flexible Spending Accounts (FSA) - 401(k) Retirement Plan with Employer Match - Short-Term & Long-Term Disability Insurance (employer provided and supplemental) - Life Insurance (employer provided and supplemental) - Paid Parental Leave - Paid Time Off (PTO) and Holidays - Tuition Reimbursement - Optional Insurance (Auto & Home, Legal, Accident, Pet, Identity Theft) - Employee Assistance Program (EAP) While we do have a physical office in Charlestown, Massachusetts, our colleagues are based all over the country, so we continuously strive to create a connected virtual work experience. We offer home office reimbursements, send swag boxes, support colleague resources groups (CRGs), and host an annual in-person company retreat to encourage collaboration and community. ## Join Our Team ![](https://carequest.org/wp-content/uploads/2025/10/1.png "1") ![](https://carequest.org/wp-content/uploads/2025/10/2.png "2") ![](https://carequest.org/wp-content/uploads/2025/10/4.png "4") ![](https://carequest.org/wp-content/uploads/2025/10/5.png "5") ![](https://carequest.org/wp-content/uploads/2025/10/6.png "6") ![](https://carequest.org/wp-content/uploads/2026/04/DSC06186-scaled-e1776368282176.jpg "DSC06186") ![](https://carequest.org/wp-content/uploads/2026/04/MJM05156-scaled.jpg "MJM05156") ![](https://carequest.org/wp-content/uploads/2025/10/9.png "9") ![](https://carequest.org/wp-content/uploads/2025/10/10.png "10") ![](https://carequest.org/wp-content/uploads/2025/10/12.png "12") ![](https://carequest.org/wp-content/uploads/2026/04/DSC05453-scaled.jpg "DSC05453") ![](https://carequest.org/wp-content/uploads/2025/10/14.png "14") ![](https://carequest.org/wp-content/uploads/2025/10/15.png "15") ![](https://carequest.org/wp-content/uploads/2025/10/16.png "16") ![](https://carequest.org/wp-content/uploads/2025/10/17.png "17") ![](https://carequest.org/wp-content/uploads/2025/10/18.png "18") ![](https://carequest.org/wp-content/uploads/2026/04/DSC05069_cropped_600x400.jpg "DSC05069_cropped_600x400") ![](https://carequest.org/wp-content/uploads/2025/10/20.png "20") ![](https://carequest.org/wp-content/uploads/2025/10/21.png "21") ![](https://carequest.org/wp-content/uploads/2025/10/23.png "23") ![](https://carequest.org/wp-content/uploads/2025/10/24.png "24") ![](https://carequest.org/wp-content/uploads/2025/10/25.png "25") ![](https://carequest.org/wp-content/uploads/2025/10/26.png "26") ![](https://carequest.org/wp-content/uploads/2025/10/31.png "31") ![](https://carequest.org/wp-content/uploads/2025/10/32.png "32") ![](https://carequest.org/wp-content/uploads/2026/04/DSC07282-scaled.jpg "DSC07282") ![](https://carequest.org/wp-content/uploads/2025/10/39.png "39") ![](https://carequest.org/wp-content/uploads/2025/10/41.png "41") [Leadership Team](https://carequest.org/about/leadership-team/) [Board of Directors](https://carequest.org/about/board-of-directors/) ## Values That Drive Our Actions Our values are core to our work and central to how we measure our success. ![](https://carequest.org/wp-content/uploads/2025/04/CareQuest_Values_Descriptions_Web-e1758310468937.png "CareQuest_Values_Descriptions_Web") --- ### [Newsletter](https://carequest.org/newsletter/) **Published:** November 6, 2025 **Author:** Darren Edwards **Content:** # Subscribe to our Newsletter --- ### [Pregnancy and Oral Health](https://carequest.org/pregnancy-and-oral-health/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Pregnancy and Oral Health ## There is a strong connection between oral health, pregnancy, and birth outcomes, emphasizing the need to prioritize dental care during pregnancy. ![](https://carequest.org/wp-content/uploads/2025/11/pregnancy-header.jpg "Cropped shot of an attractive young mother to be looking uncomfortable while sitting on the sofa at home") ## The Issue Poor oral health during pregnancy is linked to several poor health outcomes: preeclampsia (high blood pressure during pregnancy), preterm birth, and low birth weight. Yet fewer than half of pregnant people receive dental care during their pregnancy, mainly due to financial barriers. Black people are particularly likely to [experience these barriers](https://www.carequest.org/resource-library/role-medicaid-adult-dental-benefits-during-pregnancy-and-postpartum). Adequate pre- and postnatal care, better interprofessional communication between oral health and maternal health providers, and policies to strengthen Medicaid coverage could significantly improve these poor outcomes, especially for Black people. The result? Better oral health for pregnant people and better outcomes for their babies. ## Stats 75% Approximately 60–75% of pregnant people experience oral health issues that raise the likelihood of poor birth outcomes and major complications. $ #### Learn more 44% Fewer than half of pregnant people received dental care during their pregnancy, primarily due to financial barriers. $ #### Learn more 80% More than 8 in 10 obstetricians don’t use oral health screenings in prenatal visits. $ #### Learn more 3x Black people in the US are 3 times more likely to die from pregnancy-related complications than white people. $ #### Learn more ## Continuing Education about Pregnancy and Oral Health: ### Exploring the Myths and Misconceptions about Oral Health and Pregnancy Despite the longstanding advocacy of the American College of Obstetricians and Gynecologists (ACOG) for routine dental care before and during pregnancy, there’s still a significant disconnect between these recommendations and their implementation in clinical practice. This gap in care can lead to suboptimal perinatal outcomes and overlooked oral health needs in pregnant patients. In this self-paced course, you will learn to apply the most recent guidelines for dental care in pregnant patients to clinical scenarios, integrating current research findings into treatment and care plans. Eligible for 1 free CE credit. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2025/11/pregnancy.jpg "Prenatal Check-Up") --- ### [Contact Us](https://carequest.org/contact-us/) **Published:** September 19, 2025 **Author:** Darren Edwards **Content:** # Contact Us Have a question? We’re here to help. Take a moment to browse through our [Frequently Asked Questions](https://carequest.org/faq/). If you don’t see what you’re looking for or need further assistance, please don’t hesitate to contact us. --- ### [State of Oral Health Equity in America](https://carequest.org/state-oral-health-equity-america-page/) **Published:** October 1, 2025 **Author:** Darren Edwards **Content:** # State of Oral Health Equity in America ## To treat the whole person, our health system must better recognize the link between oral health and systemic health. ![](https://carequest.org/wp-content/uploads/2025/10/Health-Equity_1080x1080.png "Health Equity_1080x1080") The State of Oral Health Equity in America is the largest nationally representative survey focused exclusively on adults’ knowledge, attitudes, experiences, and behaviors related to oral health. The latest survey of more than 9,300 adults across the United States also collects information on how insurance coverage, oral health literacy, and access to a trusted provider can improve oral health opportunities and affect outcomes. Findings from the survey allow oral health stakeholders to uncover and address oral health equity gaps. ## Key Findings 72M Approximately 72 million adults in the US (27%) do not have dental insurance — almost 3 times the percentage of adults who lack health insurance. $ #### Learn more 52% More than half of Black adults (52%) have lost one or more teeth due to decay or gum disease, compared with 43% of all adults. $ #### Learn more 1/4 One quarter of adults with a disability (25%) delayed care, missed an appointment, or were unable to obtain needed health care. $ #### Learn more $45B Lost productivity time due to untreated dental disease costs the US an estimated $45 billion each year. $ #### Learn more ## 2025 Reports [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Inequities-Among-LGBTQIA_612x792.png "Thumbnail_Inequities-Among-LGBTQIA+_612x792")](https://www.carequest.org/resource-library/inequities-among-lgbtqia-people-color) ### Inequities Among LGBTQIA+ People of Color How Race and Identity Shape Oral Health Outcomes [View report](https://www.carequest.org/resource-library/dental-home-where-good-oral-health-starts) [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Dental-Home_612x792.png "Thumbnail_Dental-Home_612x792")](https://www.carequest.org/resource-library/dental-home-where-good-oral-health-starts) ### The Dental Home Is Where Good Oral Health Starts Sociodemographic Factors Associated with Having a Usual Source of Dental Care [View report](https://www.carequest.org/resource-library/dental-home-where-good-oral-health-starts) [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Out-of-Pocket_SOHEA2024_612x792.png "Thumbnail_Out-of-Pocket_SOHEA2024_612x792")](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage) ### Out of Pocket A Snapshot of Adults’ Dental and Medical Care Coverage [View report](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage) [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Care-Access-Adults-Disabilities_612x792.png "Thumbnail_Care-Access-Adults-Disabilities_612x792")](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities) ### Exploring Oral Health and Care Access among Adults with Disabilities Adults with Disabilities Face Considerable Challenges Accessing Care [Read report](https://www.carequest.org/resource-library/exploring-oral-health-and-care-access-among-adults-disabilities) [![](https://carequest.org/wp-content/uploads/2025/10/ThumbnaiL_SOHEA_2024_System_Welcome_Everyone_612x792.png "ThumbnaiL_SOHEA_2024_System_Welcome_Everyone_612x792")](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone) ### Does Our Oral Health Care System Welcome Everyone? Persistent Barriers to Equitable Access for All [Read report](https://www.carequest.org/resource-library/does-our-oral-health-care-system-welcome-everyone) ## 2024 Reports [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_SOHEA-2024-Survey-Key-Findings_612x792.png "Thumbnail_SOHEA-2024-Survey-Key-Findings_612x792")](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024) ### State of Oral Health Equity in America Key Findings from the 2024 Survey [View infographic](https://www.carequest.org/resource-library/state-oral-health-equity-america-2024) [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Experiences-With-and-Outcomes-of-Oral-Health-Care_612x792.png "Thumbnail_Experiences-With-and-Outcomes-of-Oral-Health-Care_612x792")](https://www.carequest.org/resource-library/experiences-and-outcomes-oral-health-care) ### Experiences with and Outcomes of Oral Health Care Perspectives from Nationally Representative Data [Read report](https://www.carequest.org/resource-library/experiences-and-outcomes-oral-health-care) [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Hour-of-Need_612x792.png "Thumbnail_Hour-of-Need_612x792")](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs) ### The Hour of Need Productivity Time Lost Due to Urgent Oral Health Needs [View report](https://www.carequest.org/resource-library/hour-need-productivity-time-lost-due-urgent-oral-health-needs) ## Previous State of Oral Health Equity in America Reports [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Still-Searching_612x792.png "Thumbnail_Still-Searching_612x792")](https://www.carequest.org/resource-library/still-searching-meeting-oral-health-needs-rural-settings) ### Still Searching: Meeting Oral Health Needs in Rural Settings 2023 [Read report](https://www.carequest.org/resource-library/still-searching-meeting-oral-health-needs-rural-settings) [![](https://carequest.org/wp-content/uploads/2025/10/Cover_CareQuest_Institute_Glaring-Scope-of-Racial-Disparities-in-Oral-Health-612x792-1.png "Cover_CareQuest_Institute_Glaring-Scope-of-Racial-Disparities-in-Oral-Health-612x792")](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health) ### The Glaring Scope of Racial Disparities in Oral Health 2022 [Read brief](https://www.carequest.org/resource-library/glaring-scope-racial-disparities-oral-health) [![](https://carequest.org/wp-content/uploads/2025/10/CareQuest_Institute_How-Depression-is-Linked-to-Oral-Health_500x647.png "CareQuest_Institute_How-Depression-is-Linked-to-Oral-Health_500x647")](https://www.carequest.org/resource-library/how-depression-linked-oral-health) ### How Depression Is Linked to Oral Health 2022 [View report](https://www.carequest.org/resource-library/how-depression-linked-oral-health) [![](https://carequest.org/wp-content/uploads/2025/10/Cover_CareQuest_Institute_Oral-Health-and-the-LGBTQ-Community.png "Cover_CareQuest_Institute_Oral-Health-and-the-LGBTQ+-Community")](https://www.carequest.org/resource-library/oral-health-and-lgbtq-community-snapshot-disparities-and-discrimination) ### Oral Health and the LGBTQ+ Community 2022 [View report](https://www.carequest.org/resource-library/oral-health-and-lgbtq-community-snapshot-disparities-and-discrimination) [![](https://carequest.org/wp-content/uploads/2025/10/Thumbnail_Connection-Between-Oral-Mental-Health_612x792.png "Thumbnail_Connection-Between-Oral-Mental-Health_612x792")](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) ### The Connection Between Oral Health and Mental Health 2021 [Read brief](https://www.carequest.org/resource-library/connection-between-oral-health-and-mental-health) ## Methodology The State of Oral Health Equity in America 2024 survey was designed by CareQuest Institute for Oral Health. Information was collected by NORC at the University of Chicago from March through May 2024, from adults 18 and older on the AmeriSpeak panel. AmeriSpeak is a probability-based panel designed to be representative of the US household population. Randomly selected US households were sampled using area probability and address-based sampling, with a known, non-zero probability of selection from the NORC National Sample Frame. Sampled households were contacted by US mail, telephone, and field interviewers. An additional general population sample was selected at the state level to increase the number of complete interviews for individual state oversamples. In 2024, a sampling unit of 22,448 was used, with a final sample size of 9,307 and a final weighted cumulative response rate of 41.5%. All data presented account for appropriate sample weights. The margin of error for the survey is 1.44%. All results presented are statistically significant at the p < 0.05 level unless otherwise noted. ![](https://carequest.org/wp-content/uploads/2025/01/Care-Coordination-And-Interoperability_Provider-And-Couple_960x600.png "Care-Coordination-And-Interoperability_Provider-And-Couple_960x600+") --- ### [Consent and Release](https://carequest.org/consent-and-release/) **Published:** March 23, 2026 **Author:** Darren Edwards **Content:** # Consent & Release Form --- ### [Teledentistry](https://carequest.org/teledentistry/) **Published:** September 10, 2025 **Author:** Darren Edwards **Content:** # Teledentistry ## Teledentistry connects patients and providers remotely, offering a convenient and increasingly viable care option. ![](https://carequest.org/wp-content/uploads/2025/11/teledentistry-1.jpg "Doctor dentist working in office, using laptop, making video call conference") ## An Introduction to Teledentistry Going to the dentist’s office is not always feasible or desirable. Many people in the US encounter barriers to accessing oral health care: They may live in locations with few providers, lack transportation options, or have work schedules that make it difficult to visit the dentist. These barriers are often the largest for underserved populations — [including those who live in rural areas](https://carequest.org/teledentistry-what-to-know-how-it-works/) and those in communities of color. Without access to regular, preventive dental care, those populations often face mounting challenges: Minor dental problems can become severe and urgent and, in turn, lead to costly visits to the emergency department. And research continues to show that poor oral health [can hurt overall health](https://www.carequest.org/resource-library/impacts-beyond-mouth), reducing the quality of life for many. There is no one solution for all these problems, but one key innovation has been gaining traction: teledentistry. ## Forms of Teledentistry ![](https://carequest.org/wp-content/uploads/2025/06/Synchronous_teledentistry_520x360.jpg "Synchronous_teledentistry_520x360") **Live Video (Synchronous):**Two-way, “real-time” interaction between a dental provider and a patient, their caregiver, or another provider. ![](https://carequest.org/wp-content/uploads/2025/06/Asynchronous_teledentistry_520x360.jpg "Male dentist looking at teeth x-ray on the computer in a dentist") **Store-and-Forward (Asynchronous):** Patient care can be facilitated by transmitting photos, videos, X-rays, or other recorded information via a secure electronic system to a provider who reviews the information and/or updates a patient’s treatment plan. ![](https://carequest.org/wp-content/uploads/2025/06/RPM-placeholder_teledentistry_520x360.jpg "Dentist examining an x-ray on computer in dental clinic") **Remote Patient Monitoring (RPM):** Personal health or medical data is collected from an individual in a different location, allowing a health provider to monitor a vital sign or condition. ![](https://carequest.org/wp-content/uploads/2025/06/Mobile-Health_teledentistry_520x360.jpg "Teledentistry Revolution: Woman Consults Dentist via Smartphone") **Mobile Health (mHealth):** Smartphones or other mobile devices can be used in various ways, such as enabling people to test the pH of their saliva, which affects their risk of tooth decay. ## The Value of Teledentistry Teledentistry enables providers to triage patients, reserving office visits for those who need them most, while providing oral hygiene advice, prescriptions, or other services virtually as appropriate. Remote visits offer a safe alternative during crises such as the COVID-19 pandemic, but because of their numerous advantages, they are also becoming a permanent part of the oral health system. [Feedback from patients who have tried teledentistry](https://www.carequest.org/resource-library/teledentistry-what-know-how-it-works-sm) has been overwhelmingly positive. Teledentistry can also [be a valuable tool for dentists who care for people with disabilities](https://www.carequest.org/about/blog-post/team-effort-push-better-oral-health-care-individuals-disabilities). The patient can have a teledentistry appointment before they come in for an appointment, so that [dentists know the patient’s needs and dental treatment history ahead of time](https://www.carequest.org/about/blog-post/addressing-unmet-need-providing-oral-health-care-adults-disabilities). ![](https://carequest.org/wp-content/uploads/2025/06/Value_teledentistry_520x360.jpg "Value_teledentistry_520x360") Teledentistry can [also save money](https://www.carequest.org/education/resource-library/teledentistry-effective-tool). The cost of treating patients via teledentistry costs less annually than treating dental patients seen in person. And using teledentistry to connect patients with dental providers [could help ease the demands on emergency departments](https://www.carequest.org/resource-library/teledentistry-helps-provide-right-care-right-time) — creating more capacity for other cases and reducing wait times. ## Stats 76% The majority (76%) of teledentistry visits were synchronous audio (phone call). $ #### Learn more 56M More than 56 million people in the US live in areas with a shortage of dental professionals. $ #### Learn more 4% Only 4% of adults have had a teledentistry visit, but most (71%) of those adults would use this technology again if offered. $ #### Learn more 11% In one study, the cost of treating patients via teledentistry was 11% less annually than dental patients seen in person. $ #### Learn more ## The Future of Teledentistry ![](https://carequest.org/wp-content/uploads/2025/06/Future_teledentistry_520x360.jpg "Future_teledentistry_520x360") While teledentistry has proven to be a viable alternative, it still has a long way to go. [State governments can do much more to create a supportive environment for teledentistry](https://www.carequest.org/resource-library/teledentistry-regulation-and-policy-guidance). For example, states can update reimbursement policies, clarify legal issues, and facilitate sharing patient information. By thinking beyond the traditional visit to the dentist’s office, and taking advantage of new technologies, we can remove barriers to accessing dental care — and come one step closer to ensuring access for all. --- ### [Health Transformation Programs](https://carequest.org/health-transformation-programs/) **Published:** November 14, 2025 **Author:** Darren Edwards **Content:** # Health Transformation Programs ## We are working to transform the oral health system into one that is accessible, equitable, and integrated. ![](https://carequest.org/wp-content/uploads/2025/11/MORE-Care-child-exam.jpg "MORE Care - child exam") ## Transformation in Action To achieve that vision, we collaborate with public and private stakeholders and support individuals, communities, and health systems to create person-centered, integrated systems of care that lead to better health outcomes. Through collaboration and hands-on support, our programs have produced practical models that strengthen access, foster collaboration across medical and dental care, and improve patient outcomes. ## Medical Oral Expanded Care (MORE Care®) MORE Care (2015–2025) was an initiative that supported states in integrating oral health into primary care while strengthening local dental referral relationships. Using a collaborative learning model, MORE Care worked alongside state and community partners to help communities:[](https://carequest.org/unlocking-value-in-alternative-payment-models/) - Integrate oral health services into primary care workflows - Build reliable referral relationships with local dental providers - Strengthen communication and shared responsibility across care teams - Use health information tools to support coordinated, person-centered care - Test oral health focused [alternative payment models](https://carequest.org/unlocking-value-in-alternative-payment-models/) ![](https://carequest.org/wp-content/uploads/2026/01/Map-Black.png)  ### South Carolina (2015) In partnership with the South Carolina Office of Rural Health and the Medical University of South Carolina, MORE Care piloted medical–dental integration in six rural primary care practices. Over a 12-month learning collaborative, sites tested strategies to deliver preventive oral health services and coordinate referrals to dental care.  ### Pennsylvania & Colorado (2016) Building on early lessons, MORE Care expanded to 17 rural primary care sites in partnership with the Pennsylvania Office of Rural Health and the Colorado Rural Health Center. This phase explored how integration strategies could be adapted across different care settings and state contexts.  ### Pennsylvania & Colorado (2016) Building on early lessons, MORE Care expanded to 17 rural primary care sites in partnership with the Pennsylvania Office of Rural Health and the Colorado Rural Health Center. This phase explored how integration strategies could be adapted across different care settings and state contexts.  ### Virginia & Central Oregon (2019) The MORE Care model was adapted in collaboration with Virginia Health Catalyst and Central Oregon’s coordinated care organization (CCO). In Oregon, strong care coordination and data infrastructure supported more seamless collaboration between medical and dental providers, offering valuable insight into system-level integration.  ### Virginia & Central Oregon (2019) The MORE Care model was adapted in collaboration with Virginia Health Catalyst and Central Oregon’s coordinated care organization (CCO). In Oregon, strong care coordination and data infrastructure supported more seamless collaboration between medical and dental providers, offering valuable insight into system-level integration.  ### Ohio (2021–2024) Partnering with Oral Health Ohio, stakeholders identified MORE Care as a framework to advance integrated, value-based care that includes oral health. Seven practices participated, expanding access to preventive dental services, utilizing an alternative payment model, for nearly 20,000 children. Lessons learned offer a roadmap for scaling medical–dental integration at the state level. ## Community Oral Health Transformation (COrHT) COrHT (2020–2024) supported safety-net dental clinics in transforming care delivery to better meet the needs of underserved communities. Through structured support and shared learning, participating clinics from various regions: - Expanded access through innovations such as telehealth - Focused on prevention and minimally invasive approaches, including fluoride applications - Strengthened connections between dental and medical care to support whole-person health - Tested oral heath focused alternative payment models ![](https://carequest.org/wp-content/uploads/2025/11/USA-State-Outline-Map_white-scaled.png)  ### **2020** **Massachusetts: Continuing Care During a Pandemic** CareQuest Institute created COrHT during the COVID-19 pandemic, helping to continue the delivery of oral health care to patients of FQHCs in Massachusetts. [Learn more about the experiences and outcomes in Massachusetts](https://www.carequest.org/resource-library/learning-community-aims-change-oral-health).  ### **2021** **Ohio and Arizona: Preparing for Value-Based Payment Systems** In Ohio and Arizona, COrHT expanded on knowledge learned in Massachusetts to increase adoption of the Three Domain Framework and prepare teams for a value-based payment system. Following the initiative, participants reported positive outcomes including increased silver diamine fluoride (SDF) applications, increased completion of Caries Risk Assessments (CRAs), as well as heightened patient awareness, repurposed provider time, and more integrated workflow. A majority (84%) of participants said they felt confident in their knowledge about the clinical care components of oral health value-based care because of their participation.  ### **2021** **Ohio and Arizona: Preparing for Value-Based Payment Systems** In Ohio and Arizona, COrHT expanded on knowledge learned in Massachusetts to increase adoption of the Three Domain Framework and prepare teams for a value-based payment system. Following the initiative, participants reported positive outcomes including increased silver diamine fluoride (SDF) applications, increased completion of Caries Risk Assessments (CRAs), as well as heightened patient awareness, repurposed provider time, and more integrated workflow. A majority (84%) of participants said they felt confident in their knowledge about the clinical care components of oral health value-based care because of their participation.  ### **2022** **North Carolina: A Value-Based Approach to Equitable Oral Health Care** A partnership between the [North Carolina Oral Health Collaborative](https://oralhealthnc.org/), CareQuest Institute, and Blue Cross Blue Shield of North Carolina Foundation established a learning community of safety-net dental clinics to share best practices, support a network of champions for change management, and advance policy change. [Learn more about successes in North Carolina](https://www.carequest.org/resource-library/collaborative-effect-transforming-oral-health-north-carolina).  ### **2022** **Michigan: Building Confidence and Capacity in Value-Based Care** In Michigan, COrHT brought together executive and clinical leadership from three health centers to use their resources to deliver comprehensive patient care, inclusive of oral health, and increase confidence and capacity to engage in value-based care. The learning community focused on developing sustainable business models that prioritized oral health, expanded patient engagement and community partnerships, and elevated the utilization of data and oral health measures. [Learn more about lessons learned in Michigan](https://www.carequest.org/about/blog-post/health-center-michigan-shows-path-value-and-sustainability). CareQuest Institute partnered with clinics across states to provide practical tools, technical assistance, and learning opportunities that helped teams redesign their systems of care. Clinics improved patient outcomes, enhanced experiences for patients and providers, and reduced overall health care costs. ## Impact & Results Explore state-specific impact reports and case studies that highlight: - State and community strategies - Partnership approaches and implementation lessons - Measurable outcomes and system-level change - Insights to support scaling and sustainability **Explore Impact Reports** [MORE Care](https://carequest.org/more-care-an-evaluation-of-an-interprofessional-oral-health-quality-improvement-initiative/) [MORE Care Ohio](https://carequest.org/partners-in-progress-pursuing-medical-dental-integration-in-ohio/) [COrHT North Carolina](https://carequest.org/the-collaborative-effect-transforming-oral-health-in-north-carolina/) ## Get Started Our courses and learning opportunities are built from the experience generated through our transformation programs. They translate program insights into practical guidance, providing the foundational knowledge needed to begin implementing integrated, person-centered care. [Explore courses](https://carequest.org/education/self-paced-courses/) [Explore webinars](https://carequest.org/education/live-webinars/) ### Interested in partnering with CareQuest Institute? Collaboration and partnership are key to achieving our mission – to improve the oral health of all. [Partner with us](https://carequest.org/about/partner-with-us/) --- ### [Emergency Department Use](https://carequest.org/emergency-department-use/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Emergency Departments Are No Place for Dental Care ## The Issue Millions of Americans lack access to routine dental care and resort to visiting hospital emergency departments (EDs) for non-traumatic dental conditions (NTDCs). Most patient needs could be addressed more effectively in a dental office at a much lower cost. To expand oral health access for those (and all) patients, we need policy changes at the federal and state level. ## Stats 1.8M In 2019, there were more than 1.8 million ED visits for NTDCs. $ #### Learn more $3.4B Estimated total charges for ED visits for NTDCs was nearly $3.4 billion in 2019. $ #### Learn more 70% Nearly 7 in 10 ED visits for NTDCs among patients ages 21-64 are made by those enrolled in Medicaid or who are uninsured. $ #### Learn more 4 Only the District of Columbia and 3 states — Nebraska, Wisconsin, and Alaska — offer extensive Medicaid dental benefits for adults. $ #### Learn more ## Trends in ED Use for Dental Conditions [![](https://carequest.org/wp-content/uploads/2025/09/Thumbnail_Recent-Trends-in-Hospital-ED-Visits_612x792.jpg "Thumbnail_Recent-Trends-in-Hospital-ED-Visits_612x792")](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) [View report](https://www.carequest.org/resource-library/recent-trends-hospital-emergency-department-visits-non-traumatic-dental-conditions) ### Recent Trends in Hospital Emergency Department Visits for Non-Traumatic Dental Conditions Patients most likely to visit the ED for an NTDC are 25-34 years old, uninsured or have Medicaid coverage, live in a rural area, or have an income below $48,000 per year. These trends reflect persistent inequities in Americans’ access to dental care. [![](https://carequest.org/wp-content/uploads/2025/09/Thumbnail_FL-Pediatric-ED-use-NTDC-500x647-1.png "Thumbnail_FL-Pediatric-ED-use-NTDC-500x647")](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions) [View report](https://www.carequest.org/resource-library/childrens-use-emergency-departments-non-traumatic-dental-conditions) ### Children’s Use of Emergency Departments for Non-Traumatic Dental Conditions Florida had the highest rate of ED visits for children compared to all other states for which data is available. ## Spotlight on the States Use of emergency departments for dental conditions varies by state and is dependent on factors such as the [level of dental benefits available in the state Medicaid program](https://www.carequest.org/Medicaid-Adult-Dental-Coverage-Checker). These reports analyze data at the state level. $ #### Arizona $ #### Florida (children) $ #### Minnesota $ #### Colorado $ #### Kentucky $ #### New York & New Jersey $ #### Florida (adults) $ #### Maryland $ #### North Carolina --- ### [Impact Report](https://carequest.org/impact-report/) **Published:** December 19, 2025 **Author:** Darren Edwards **Excerpt:** Explore the 2025 CareQuest Institute Impact Report to find videos, stories, and statistics about how we’re improving the oral health system. **Content:** ![](https://carequest.org/wp-content/uploads/2025/12/IR-Cover-Spread.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft2.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft3.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft4.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft5.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2024/07/test.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft6.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/03/Empty-PH2-e1742407474255.png) ![](https://carequest.org/wp-content/uploads/2025/03/Empty-PH2-e1742407474255.png) ![](https://carequest.org/wp-content/uploads/2025/03/Empty-PH2-e1742407474255.png) ![](https://carequest.org/wp-content/uploads/2025/03/Empty-PH2-e1742407474255.png) ![](https://carequest.org/wp-content/uploads/2025/03/Empty-PH2-e1742407474255.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft7.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft8.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-800x150-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-600x200-1.png) ![](https://carequest.org/wp-content/uploads/2026/01/2025-Impact-Report-Draft9.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) ![](https://carequest.org/wp-content/uploads/2025/12/blank-300x600-1.png) [![](https://carequest.org/wp-content/uploads/2025/12/2025-Impact-Report-Draft-1.png "2025 Impact Report Cover")](https://carequest.org/2025-impact-report-1-16-26/) [Download the 2025 Impact Report PDF](https://carequest.org/2025-impact-report-1-16-26/) --- ### [OPEN Membership Form](https://carequest.org/open/membership-form/) **Published:** October 3, 2025 **Author:** Darren Edwards **Content:** # Join OPEN OPEN is a diverse network of individuals and entities who are taking on America’s oral health challenges so that everyone has a chance to thrive. OPEN members use their unique experiences, knowledge, and skills to lead network activities every year, creating collective energy that is driving large-scale change. Simply fill out the form below to become a part of our network. --- ### [Apply for a Grant](https://carequest.org/grants-overview/apply/) **Published:** September 24, 2025 **Author:** Darren Edwards **Content:** # Our Grant Application Process ## Through our grantmaking, we work with partners to catalyze oral health transformation. Together, we are guided by one vision: an oral health system that is just, equitable, and accessible to all. ## Step 1: Review Funding Eligibility and Proposal Alignment ### **Organization:** All grantees must: - Have demonstrated experience in, or willingness to begin engaging in, policy or systems-change work at the local, state, or national level - Have a proven track record of applying a health equity or racial equity lens in their work - Be committed to deepening their expertise in the social determinants of oral health - Be a 501c3 tax exempt organization in good standing with the IRS, a government agency or an educational/research institution that is tax exempt. - Be based in the 50 US states or Washington, DC. All funded activities must occur within the 50 US states or Washington, DC. ### **Approach:** Proposals should be led by, or strongly informed through trusted relationships with, communities that have historically been affected by oral health inequities. ### **Content:** The Advancing Equity Through Oral Health Fund supports work that: - Seeks to improve access to equitable care through federal and/or state oral health policy - Contributes to the development of new, innovative medical-dental integrated care models and/or a strong and diverse integrated health care workforce The Emergent & Relief Fund supports: - The ability of communities and partner organizations to provide immediate relief due to unforeseen circumstances (e.g. community displacement due to a natural disaster) - The response to urgent and unexpected clinical issues that impact the direct access to care, particularly for historically marginalized communities (e.g. sudden equipment failure) ## Step 2: Submit a Concept All applicants to any of the CareQuest Institute funds are invited to initiate the grant submission process by submitting a concept of a proposed project, up to 500-words. Within the concept, CareQuest Institute requests that applicants include: 1. Description of the issue you intend to address 2. Description of the project for which you are seeking funding 3. How the requested funds will be used to support the successful execution/implementation of the project Organizations can submit concepts at any time through our online grants management portal, Fluxx. After review, we will invite organizations whose work strongly aligns with CareQuest Institute’s priority areas to enter the next stage of the application process, to submit a full proposal. If you do not have a Fluxx account, please [register ](http://carequest.fluxx.io/)and set up an account. You will receive a username and password to log in to the portal within three business days. [Register for Fluxx](http://carequest.fluxx.io/) [Submit concept](https://carequest.fluxx.io/user_sessions/new) ## Step 3: Submit a Full Grant Proposal Upon invitation, applicants can submit a full proposal, which is a more comprehensive application that includes a project narrative, work plan, and budget. This detailed proposal allows applicants to fully describe the proposed scope of work and corresponding steps necessary for implementation. [Application guide](https://carequest.org/carequest_institute_2025-grant-proposal-guidance-document_1-28-26_date-edit-mc/) ## 2026-2027 Application Timeline **Concept Submission Deadlines** November 20, 2025 February 17, 2026 June 4, 2026 November 9, 2026 February 15, 2027 November 8, 2027 **Proposal Deadlines** January 7, 2026 April 13, 2026 July 22, 2026 January 4, 2027 April 12, 2027 2028 **Final Determination Anticipated** February 2026 June 2026 September 2026 February 2027 June 2027 TBD Please note that in 2026, CareQuest Institute will transition from four grantmaking cycles per year to three, and in 2027 and beyond, it will move to two cycles per year. More information will be provided to our existing grantees about the change in late 2025. However, existing grantees with questions may also reach out to their Grants team contact for further assistance. Dates are subject to change. ## Questions About the Grant Process? Visit our [FAQ page](https://www.carequest.org/faq/#grants) or connect with a member of the [grants team](mailto:grants@carequestordev.wpenginepowered.com). --- ### [Grants](https://carequest.org/grants-overview/) **Published:** September 24, 2025 **Author:** Darren Edwards **Content:** # Philanthropy: Grants in Oral Health ## Through our grantmaking, we work with partners to catalyze oral health transformation. [Learn more about funding eligibility](https://carequest.org/grants-overview/apply/) ![](https://carequest.org/wp-content/uploads/2025/11/Philanthropy-Hero.png "Philanthropy Hero") ## Funding Oral Health Systems Change “Oral health systems change” refers to a deliberate effort to significantly improve the overall oral health of a population by modifying the structure and delivery of dental care. That effort often includes initiatives like expanding access to preventive services, integrating oral health into broader medical systems, utilizing technology for early detection, and addressing disparities in access to care, ultimately aiming to achieve better oral health outcomes for everyone. We drive oral health transformation through grantmaking that creates systemic change and advances health equity in the following categories: ##### Policy & Advocacy **Advancing Federal and State Policies That Strengthen or Protect Access to Dental Care** [Approximately 72 million adults in the US (27%) do not have dental insurance](https://www.carequest.org/resource-library/out-pocket-snapshot-adults-dental-and-medical-care-coverage). Without dental coverage, individuals are less likely to obtain oral health care, which increases the risk for poor oral health outcomes. Strengthening dental benefits in publicly funded programs is a critical piece of our philanthropic strategy. Through this funding priority, we invite organizations to explore opportunities to: - [Advance federal health and oral health policy](https://www.carequest.org/about/blog-post/making-connections-improve-oral-health-care-alabama), including, but not limited to, adding a comprehensive dental benefit to Medicare. - Strengthen or maintain [access to dental benefits in state Medicaid programs](https://www.carequest.org/resource-library/state-oral-health-dashboard). - Meaningfully [engage community-driven partners to inform policies](https://www.carequest.org/about/blog-post/voice-unheard-improving-oral-health-connecticut) that affect their lives. ##### Community Capacity & Voice **Engagement of Community Voices, Specifically Underserved Populations** Historically underserved populations, including but not limited, to Black, indigenous, and other people of color (BIPOC), those living in rural communities, people with low incomes, and people with disabilities, are disproportionately affected by the lack of access to oral health care. These same voices are often left out of decision-making regarding their local community’s health and health care needs. However, powerful and positive disruption can and does occur when the voices of[ historically underserved communities are welcomed into spaces](https://www.carequest.org/about/blog-post/strength-stories-arizonas-journey-expand-medicaid-adult-dental-benefits) where decisions are made. We believe the inclusion of community voices in driving policy and systems change is critical to achieve oral health equity. Through this funding priority, we invite organizations to explore opportunities to: - Meaningfully [engage members of the communities they serve](https://www.carequest.org/about/blog-post/how-community-voices-are-improving-oral-health-utah) to generate solutions to improve their lives. - Develop solutions to address the health and racial inequities in the oral health system. - Utilize community organizing to drive systems change. ##### Care Delivery **Expand Access to Safe, Timely, and Effective Person-Centered Care and Promote Health Care Workforce Solutions** Oral health is inextricably linked to overall health, and CareQuest Institute is working to break down the silos of dental care and medical care. Our hope is that testing and refinement of models that incorporate the concepts of evidence-based care, patient-centeredness, value-based care, and a [focus on equity will advance innovation in oral health care](https://www.carequest.org/about/blog-post/how-can-you-promote-health-equity-your-organization). CareQuest Institute is particularly interested in opportunities to work in [historically underserved areas](https://www.carequest.org/about/blog-post/voices-field-dr-jessica-robertson-providing-care-rural-areas). Through this funding priority, we invite organizations to explore opportunities to: - Test or refine person-centered care models, especially those that focus on medical-dental integration and minimally invasive care. - Develop solutions addressing the oral health care workforce shortage to advance innovation in oral health care. - Use a health and racial equity lens when developing solutions to the inequities in the oral health system. ##### Research **Data and Insights to Advance Oral Health Systems Change** Research is critical to generating a compelling case for change, whether through quantitative evidence or qualitative stories. Through its research-focused grantmaking, CareQuest Institute aims to collaborate with organizations to tell data-informed stories that reveal timely insights and inspire transformation in oral health. Through this funding priority, we invite organizations that conduct community-based, participatory research to: - Explore factors that influence oral health inequities for historically underserved populations. - Conduct population oral health research. - Assess the efficacy of the integration of oral health care into overall health care. - Better classify and predict oral health outcomes. - Evaluate alternative care approaches (e.g., teledentistry or minimally invasive care) to improve patient access. - Assess the impact of oral health interventions on the total cost of care. - Evaluate value-based care approaches. ## How to Apply for Funding ### Learn more about the three-step grant application process, eligibility requirements, and benefits of becoming a grantee. ![](https://carequest.org/wp-content/uploads/2025/09/Step-1.png "Step 1") ![](https://carequest.org/wp-content/uploads/2025/09/Step-2.png "Step 2") ![](https://carequest.org/wp-content/uploads/2025/09/Step-3.png "Step 3") [Review the application process](https://carequest.org/grants-overview/apply/) ## Stats 42 Number of states represented among our 2025 grantees $14M+ Funding awarded in 2025 90 Grantee organizations funded in 2025 *Last updated December 17, 2025* ## Join OPEN Many grantees are also a part of [OPEN](https://www.carequest.org/policy-advocacy/open/), an initiative of CareQuest Institute, a diverse network of individuals and entities taking on America’s oral health challenges to provide everyone with an equitable chance to thrive. OPEN members use their unique experiences, knowledge, and skills to lead network activities every year, creating collective energy that is driving large-scale change. [Learn more about OPEN](https://carequest.org/open/) ![](https://carequest.org/wp-content/uploads/2025/09/OPEN-Hill-Day-Logo-pos-rgb-500_wbackground-e1758734322431.png "OPEN Hill Day Logo-pos-rgb 500_wbackground") --- ### [Search Grantees](https://carequest.org/grants-overview/search-grantees/) **Published:** September 25, 2025 **Author:** Darren Edwards **Content:** # Search All Grants ## Together, we have worked to drive systemic change and advance health equity. Search our past grants below. [Back to Grants page](https://carequest.org/grants-overview/) Search by grant year, organization name, or state. YearOrganizationStateAmount ($)Summary2026National Council of Urban Indian HealthDistrict of Columbia$150,000Support the National Council of Urban Indian Health to complete a landscape analysis of oral health care provided by Urban Indian Organizations and a policy roadmap for improving access to care and equitable outcomes within urban Indian communities.2026American Dental Therapy AssociationAlaska$235,895Support the American Dental Therapy Association to complete research, community engagement, and capacity building activities that support the expansion and promotion of dental therapy in communities nationwide.2026Texas Health InstituteTexas$234,909Strengthen statewide oral health policy readiness while designing a community-centered oral health equity network that positions Texas for a coordinated, community-anchored approach to the 2027 legislative cycle and long-term systems change.2026Suwannee River Area Health Education CenterFlorida$120,000Support Suwannee River Area Health Education Center to lead Floridians for Dental Access in authorizing dental therapy in Florida in 2026, coordinating college accreditation readiness, expanding coalition and policymaker engagement, and monitoring rulemaking.2026University of Florida FoundationFlorida$95,000Support the University of Florida Foundation to embed a required IDD care curriculum and clinical rotation at UF’s College of Dentistry, cocreated with families and advocates, while finalizing clinic space and tools to sustain and replicate an inclusive education model.2026Poverty Action c/o Solid GroundWashington$125,000Support Poverty Action to defend against cuts to the Medicaid Adult Dental program, protect community water fluoridation, operationalize dental therapy guidelines from the Department of Health, and integrate community voices to inform advocacy efforts for the 2026 legislative session.2026Community CatalystMassachusetts$550,000Support Community Catalyst to deliver responsive capacity building technical assistance, regional learning collaboratives, and other trainings to strategically elevate and integrate community voice within the oral health systems change movement.2026Center for Health Care Strategies, Inc.New Jersey$268,136Support the Center for Health Care Strategies to lead a peer learning community of eleven state dental offices and Medicaid agencies around workforce solutions to improve access, outcomes, and equity within their state oral health systems.2026NC ChildNorth Carolina$185,000Support NC Child to turn two years of community-informed research into a statewide public engagement and advocacy campaign that elevates children’s oral health and the need for expanded school-based oral health access, and builds 2027 policy momentum for increased Medicaid rates and dental hygiene scope.2026Louisiana Public Health InstituteLouisiana$150,000Support the Louisiana Public Health Institute to launch a Community of Practice integrating oral health into maternal and early childhood care, develop policy education and family resources, and coordinate multisector partners to advance equitable access to preve across Louisiana.2026Center for Medicare AdvocacyConnecticut$145,000Support the Center for Medicare Advocacy’s work to expand oral health coverage for Medicare beneficiaries through advocacy and regulatory changes, and to include oral health coverage in Medicare Part B.2026American Academy of PediatricsIllinois$198,965The purpose of this grant is to support the American Academy of Pediatrics’ engagement in community water fluoridation defense efforts and provide support to advocates and partners across the country.2026Center for Health Care Strategies, Inc.New Jersey$268,136The purpose of this grant is to support the Center for Health Care Strategies to lead a peer learning community of eleven state dental offices and Medicaid agencies around workforce solutions to improve access, outcomes, and equity within their state oral health systems.2026Center for Medicare AdvocacyConnecticut$145,000The purpose of this grant is to support the Center for Medicare Advocacy’s work to expand oral health coverage for Medicare beneficiaries through advocacy and regulatory changes, and to include oral health coverage in Medicare Part B.2026Children’s Action AllianceArizona$99,704The purpose of this grant is for Children's Action Alliance to advance dental coverage in Arizona by establishing a Medicaid Adult Comprehensive Dental Benefit Study Committee, build capacity in community advocates, and host the annual Oral Health Day through their support of the Arizona Oral Health Coalition.2026Community CatalystMassachusetts$550,000The purpose of this grant is to support Community Catalyst to deliver responsive capacity building technical assistance, regional learning collaboratives, and other trainings to strategically elevate and integrate community voice within the oral health systems change movement.2026Connecticut Oral Health Initiative (COHI)Connecticut$75,000The purpose of this grant is to support COHI to continue its advocacy leadership and activities through the organization's initial phase of transition toward sustainability.2026Families USADistrict of Columbia$350,000The purpose of this grant is to support Families USA to partner with policymakers and advocates to keep oral health central to health care affordability, protect Medicaid and Medicare dental benefits, mitigate harmful policies, and build oral health champions for the 120th Congress.2026Health Care For AllMassachusetts$275,000The purpose of this grant is to support Health Care For All in designing and launching a community-driven, equity-centered campaign to advance authorization and implementation of dental therapy in Massachusetts to expand access to dental care for MassHealth members and other underserved communities.2026Heart Ministry CenterNebraska$130,000The purpose of this grant is to support Heart Ministry Center build community power and launch an oral health-focused policy movement grounded in lived experience that will strengthen local advocacy capacity, elevate community voices, and advance policy solutions that address oral health inequities and their broader economic impacts.2026Kentucky Voices for HealthKentucky$125,000The purpose of this grant is to support Kentucky Voices for Health to lead statewide policy and administrative advocacy, rapid response communications, and community engagement to protect Medicaid dental access in Kentucky, with a focus on implementation‑phase reforms, navigation, and prevention.2026Kentucky Youth AdvocatesKentucky$130,000The purpose of this grant is to support the Kentucky Oral Health Coalition, housed within Kentucky Youth Advocates, to defend community water fluoridation and advance strategic oral health messaging that positions fluoridated drinking water as a protective choice for children and families.2026Louisiana Public Health InstituteLouisiana$150,000The purpose of this grant is to support the Louisiana Public Health Institute to launch a Community of Practice integrating oral health into maternal and early childhood care, develop policy education and family resources, and coordinate multisector partners to advance equitable access to preve across Louisiana.2026Montana Health Research and Education FoundationMontana$165,000The purpose of this grant is to support Montana Health Research and Education Foundation to develop a new model that integrates a registered dental hygienist into rural hospital settings to provide oral health education, training, and support for patients and staff.2026Montana State University FoundationMontana$99,750The purpose of this grant is to integrate fluoride varnish and silver diamine fluoride clinical decision support workflows into the electronic medical record at Blackfeet Nation school based health centers to make oral health a routine component of care.2026Murray Education FoundationUtah$91,422The purpose of this grant is to implement the Utah School District Dental Hygienist Integration Pilot, a model that integrates a licensed dental hygienist into the Murray City School District to provide universal prevention services for school aged children following Utah’s legislated removal of community water fluoridation.2026National Council of Urban Indian HealthDistrict of Columbia$150,000The purpose of this grant is to support the National Council of Urban Indian Health to complete a landscape analysis of oral health care provided by Urban Indian Organizations and a policy roadmap for improving access to care and equitable outcomes within urban Indian communities.2026NC ChildNorth Carolina$185,000The purpose of this grant is to support NC Child to turn two years of community-informed research into a statewide public engagement and advocacy campaign that elevates children’s oral health and the need for expanded school-based oral health access, and builds 2027 policy momentum for increased Medicaid rates and dental hygiene scope.2026Oral Health Kansas, Inc.Kansas$201,103The purpose of this grant is to support Oral Health Kansas in growing and sustaining equitable dental care access and building a system in which all Kansans can receive the services they need to support their oral and overall health.2026Poverty Action c/o Solid GroundWashington$125,000The purpose of this grant is to support Poverty Action to defend against cuts to the Medicaid Adult Dental program, protect community water fluoridation, operationalize dental therapy guidelines from the Department of Health, and integrate community voices to inform advocacy efforts for the 2026 legislative session.2026Public Health InstituteCalifornia$190,000The purpose of this grant is to support the Center to Advance Community Health and Equity and the Center on Disability within the Public Health Institute study the lack of provider utilization of teledentistry for serving individuals with IDD in California.2026Special Olympics ArkansasArkansas$100,000The purpose of this grant is to support the Arkansas Oral Health Coalition, a project of Special Olympics of Arkansas, to strengthen statewide oral health policy coordination and readiness through expanded coalition membership, deeper engagement with rural and safety‑net partners, and early‑stage policy exploration focused on prevention and access, including fluoride varnish delivery.2026Strategic Concepts in Organizing and Policy EducationCalifornia$200,000The purpose of this grant is for SCOPE to lead the California Oral Health Equity Coalition in efforts to authorize dental therapy in California. In the 12-month grant period, COHEC will secure a legislative sponsor, identify a bill author, and file a bill in 2027.2026Suwannee River Area Health Education CenterFlorida$120,000The purpose of this grant is to support the Support Suwannee River Area Health Education Center to lead Floridians for Dental Access in authorizing dental therapy in Florida in 2026, coordinating college accreditation readiness, expanding coalition and policymaker engagement, and monitoring rulemaking.2026Tennessee Justice CenterTennessee$150,000The purpose of this grant is to support the Tennessee Justice Center to increase awareness and utilization of TennCare’s adult dental benefit through education, direct assistance, data collection, and policy advocacy that removes structural barriers and expands equitable access for low-income adults statewide.2026Texas Health InstituteTexas$234,909The purpose of this grant is to strengthen statewide oral health policy readiness while designing a community-centered oral health equity network that positions Texas for a coordinated, community-anchored approach to the 2027 legislative cycle and long-term systems change.2026The Family Health Centers of Georgia, Inc.Georgia$135,000The purpose of this grant is to support The Family Health Centers of Georgia, Inc. to develop, pilot, evaluate, and disseminate a trauma-informed pediatric oral health model that integrates behavioral health into pediatric dental and school-based care through standardized, EHR-integrated screening.2026University of Florida FoundationFlorida$130,000The purpose of this grant is to support the UF Center for Oral Health Outcomes Research, through the University of Florida Foundation, to conduct a mixed‑methods study of urgent care utilization for non‑traumatic dental conditions and produce policy‑relevant evidence to inform understanding of oral health access gaps.2026University of Florida FoundationFlorida$95,000.00The purpose of this grant is to support the University of Florida Foundation to embed a required IDD care curriculum and clinical rotation at UF’s College of Dentistry, cocreated with families and advocates, while finalizing clinic space and tools to sustain and replicate an inclusive education model.2025Institute for Exceptional CareDistrict of Columbia$125,000Create—in partnership with patients, family members, clinicians, and educators—a new continuing education course for clinicians that builds knowledge around oral-systemic health and serving patients with intellectual and development disabilities (IDD).2025Ministerial Health Fellowship c/o Cross Street Training and Academic CenterConnecticut$100,000Support the Ministerial Health Fellowship to engage BIPOC communities in Connecticut through education and lead advocacy for oral health policy change at the state level to improve access to affordable, high-quality, preventive and restorative care through all stages of life.2025Indiana Community Action Poverty InstituteIndiana$115,000Support the Indiana Community Action Poverty Institute with a study to explore the relationship between medical debt and healthcare affordability from an oral health lens, as Indiana does not have specific data assessing oral health inequalities and their impact on medical debt. Their report will include statistical data, policy landscape analysis for Indiana, and stories from Hoosiers with policy recommendations based on the report’s findings.2025Children’s Oral Health Network of MaineMaine$125,000Support the Children’s Oral Health Network of Maine to scale and institutionalize Mainely Connection, a platform that connects children in the child welfare system to dental care through optimized care coordination and training.2025Hawaii Public Health InstituteHawaii$120,000Support the Hawaii Public Health Institute in advancing the strategic goals of the Hawaii Oral Health Coalition. Specifically, the funding will sustain HIPHI’s leadership in legislative advocacy, research, and community engagement aimed at improving oral health outcomes for priority populations—including children, individuals with intellectual and developmental disabilities, rural communities, and Medicaid recipients2025Partnership for Southern EquityGeorgia$150,000Support Partnership for Southern Equity to expand a youth-led oral health equity initiative across the South, building leadership through training, storytelling, and advocacy focused on Black, Brown, Indigenous, and low-wealth communities.2025Denver Health FoundationColorado$125,000Support the Colorado Oral Health Coalition to sustain coalition operations, establish a community advisory committee, and evaluate engagement efforts in order to advance oral health equity in the state of Colorado.2025Smiles Across MontanaMontana$125,000For Smiles Across Montana to standardize and scale their Community Health Worker model, expand the model to meet the needs of Montana’s Latino, Spanish speaking population, and measure outcomes and impact of the model in Native and Latino communities served.2025Alliance for a Healthier GenerationOregon$130,000Support Alliance for a Healthier Generation in the development and dissemination of a community-informed roadmap to integrate oral health services in Warren County schools, to improve access to care and inform scalable models for school-based oral health.2025Pennsylvania Chapter of the American Academy of PediatricsPennsylvania$85,000Support the Pennsylvania Chapter of the American Academy of Pediatrics’ SmileLink initiative, which aims to strengthen medical-dental collaboration by empowering healthcare and school professionals to integrate preventive oral health services into schools and trusted community institutions.2025New Hampshire Oral Health CoalitionNew Hampshire$100,000Support the New Hampshire Oral Health Coalition to serve as the statewide connector by collaborating with various partners to improve oral health access while supporting organizations impacted by federal funding cuts.2025Texas Association of Community Health CentersTexas$125,000For Texas Association of Community Health Centers to transform its BRIDGE Program (trauma informed care curriculum) into a modular, interactive e-learning series to support the spread of relationship-centered, integrated care across Texas community health centers.2025The American Institute of Dental Public HealthIllinois$215,000Create resources to support community engagement through advisory boards and to expand existing resources around oral healthcare for veterans that will support patients and policy change.2025Schuyler Center for Analysis and AdvocacyNew York$125,000Support the Schuyler Center for Analysis and Advocacy's participation in CareQuest Institute's 2025 funding initiative, Building Advocacy Capacity of Oral Health Coalitions, to strengthen the alignment and advocacy capacity of state oral health coalitions. The Schuyler Center will focus on revitalizing the New York State Oral Health Coalition through the creation of a diverse, community-based steering committee that is focused on oral health equity.2025Florida Voices for HealthFlorida$170,000Support Florida Voices for Health to advance oral health equity through a three-part advocacy strategy that expands its storyteller network, strengthens the Florida Oral Health Alliance, and deepens legislative engagement to protect Medicaid funding and promote adult dental benefits.2025Illinois Primary Health Care AssociationIllinois$100,000Support Illinois Primary Health Care Association to partner with a consulting firm to lead a Dental Revenue and Operations Optimization Learning Collaborative for 5-10 Federally Qualified Health Centers, as well as arrange learning opportunities for health centers on the importance of oral health integration into nutrition, cancer prevention and screening, and maternal health services.2025Nebraska AppleseedNebraska$133,000Support Nebraska Appleseed to continue collaborating with underserved communities to advance systemic change that improves health and increases equity in their state. Nebraska Appleseed will prioritize growing capacity and voice, deepening oral health advocacy, expanding and strengthening health care partnerships, and improving Medicaid access and processes.2025Missouri Coalition for Oral HealthMissouri$125,000Support the Missouri Coalition for Oral Health’s participation in CareQuest Institute's 2025 funding initiative, Building Advocacy Capacity of Oral Health Coalitions, to strengthen the alignment and advocacy capacity of state oral health coalitions.2025American Network of Oral Health CoalitionsKansas$467,164Support ANOHC’s participation in CareQuest Institute’s 2025 initiative, Building Advocacy Capacity of Oral Health Coalitions, to strengthen the alignment and advocacy capacity of state oral health coalitions and develop a set of resources related to coalition sustainability, advocacy best practices, and community engagement.2025Utah Health Policy ProjectUtah$125,000Support the Utah Health Policy Project in advocacy efforts to defend the adult dental Medicaid benefit and need for fluoride in public water systems.2025NC Foundation for Health Leadership and InnovationNorth Carolina$125,000Support NC Foundation for Health Leadership and Innovation's participation in CareQuest Institute's 2025 funding initiative, Building Advocacy Capacity of Oral Health Coalitions, to strengthen the alignment and advocacy capacity of state oral health coalitions. NC Foundation for Health Leadership and Innovation will advance policy reforms that expand Medicaid dental benefits, modernize workforce regulations, and strengthen data systems to improve equitable access to oral health care across the state.2025National Network for Oral Health AccessColorado$189,255Support the National Network for Oral Health Access facilitation of continued networking and collaboration among the Primary Care Associations’ oral health specialists, and continued development and dissemination of training and best practices related to integration, value-based care, teledentistry, workforce, quality, equity and expanding access to oral health care.2025Virginia Health CatalystVirginia$150,000Support Virginia Health Catalyst’s to provide guidance and technical assistance to safety net clinics expanding the use of patient-centered, culturally humble care coordination techniques and tools. 2025Pennsylvania Coalition for Oral HealthPennsylvania$96,508Support the Pennsylvania Coalition for Oral Health (PCOH) to protect existing Medicaid coverage and restore comprehensive adult dental benefits in Medicaid through a multi-pronged advocacy strategy that includes legislative action, administrative reform, and stakeholder engagement. 2025University of Missouri – Kansas City, Institute for Human DevelopmentMissouri$126,946Support the continuation of a project overseen by the University of Missouri – Kansas City Institute for Human Development (UMKC). UMKC was previously funded to conduct a one-year needs assessment to identify gaps in maternal-infant oral health care within the Kansas City metro area. Building on findings from the needs assessment, UMKC proposes a multi-faceted intervention to expand the oral health workforce and enhance access to oral health education.2025Medical University of South Carolina FoundationSouth Carolina$125,000Strengthen and sustain pathways into dental education for underrepresented students by equipping HBCU faculty with comprehensive advising resources, expanding experiential learning opportunities, and integrating student-centered supports to promote diversity and retention in South Carolina’s oral health workforce.2025Refugee Community PartnershipNorth Carolina$123,000Support Refugee Community Partnership to expand its Language Navigation program, improving oral health access for migrant and refugee communities through direct services and data-driven advocacy that demonstrates interpretation equity as a cost-effective strategy for Medicaid systems.2025Regents of the University of MinnesotaMinnesota$104,094Support the Regents of the University of Minnesota in their study to measure the impact of screening patients for unmet need on dental student perspectives and on patient’s acceptance of treatment plans and the completion of treatment plans.2025NORCIllinois$127,000Support NORC gather, analyze, and disseminate research to understand the impact of Medicaid dental coverage expansions on access, utilization, and oral health outcomes for adults with intellectual and developmental disabilities.2025Oral Health Kansas, Inc.Kansas$194,905Support Oral Health Kansas as they embark on a new phase of their Pathways to Oral Health Program focused on education, enhancing communication between providers and consumers and Medicaid network capacity building. They will also continue to advocate for an increase in Medicaid reimbursement rates and build upon momentum created by their Sedation Dental Care Task Force.2025Montana Health Research and Education FoundationMontana$125,000Support the Montana Health Research and Education Foundation in a pilot program to embed a registered dental hygienist into a hospital inpatient setting as a member of the comprehensive care team. The pilot program is anticipated to serve patients of all ages, with most Montana residents coming from rural and underserved areas.2025American Association for Dental, Oral, and Craniofacial ResearchVirginia$175,000The American Association for Dental, Oral, and Craniofacial Research (AADOCR) Mind the Future program has been instrumental in fostering five cohorts of early-career investigators in dental, oral, and craniofacial (DOC) research workforce. The network's principal purpose has been to establish a robust and enduring national mentoring program centrally managed by AADOCR. The overarching goal is to develop a sustainable, nationally recognized mentoring network that enhances the career development of early-career DOC researchers with merit- based opportunities for all. The program aims to continue to cultivate a robust pathway of future DOC researchers who can address critical scientific challenges.2025State University of Iowa FoundationIowa$200,000Support the State University of Iowa Foundation (University) in advancing value-based dental care by developing and implementing valid, reliable measures aligned with the definition of a patient-centered dental home (PCDH). Building upon previous work defining PCDH and piloting a child-focused measure set, the project proposes four goals: adult measure set pilot, standards component pilot, learning collaboratives, and patient-reported measures evaluation.2025Kentucky Youth AdvocatesKentucky$100,000For the Kentucky Oral Health Coalition, supported by Kentucky Youth Advocates (KYA), to develop regional workgroups to ensure successful implementation of expanded benefits, build on their landscape assessment, and develop an updated policy agenda for the 2026 session.2025National Conference of State LegislaturesColorado$80,000Inform and engage state legislators as essential stakeholders in oral health policy and to inform OPEN members about state-level oral health policy.2025American Children’s CampaignFlorida$160,000Support American Children’s Campaign to carry out an integrated public education and advocacy campaign to authorize and implement dental therapy in Florida.2025Children’s Action AllianceArizona$99,429For the Arizona Oral Health Coalition (AZOHC), with support from Children’s Action Alliance (CAA), to lead efforts to advance oral health equity in Arizona by continuing a multi year advocacy strategy to enact a comprehensive adult Medicaid dental benefit, build champions within the Arizona legislature, and engage storytellers and advocates with lived experience to influence oral health policy decisions.2025Health Disparities Collaborative of Ohio Inc.Ohio$130,000Support the Ohio Federation for Health Equity and Social Justice (Federation) in creating an advocacy campaign to build upon previous years’ effort to protect gains made in Medicaid regarding oral health that will face possible efforts to pull back, including school-based health care centers with an oral health component, oral health services, and eligibility expansion.2025Heart Ministry CenterNebraska$130,000Support Heart Ministry Center in uplifting the experience of Nebraskans who are facing oral health challenges within the context of their social and political determinants of health. By partnering with two statewide advocacy organizations in Nebraska, Heart Ministry Center is elevating the voice of the community they serve to create and progress meaningful change.2025Dignity Health Foundation – East ValleyArizona$199,095Support the second year of research funded by CareQuest Institute for Oral Health, which embeds Critical Care Dental Hygienists in the ICUs at Chandler Regional Medical Center. The study aims to evaluate an interprofessional care model, develop a business case, advocate for policy change, and scale the model.2025Alabama AriseAlabama$125,000Support Alabama Arise to advance oral health equity through Medicaid dental benefit advocacy and the launch of a statewide oral health network, combining proactive policy development with cost-conscious strategies to strengthen care access and delivery.2025University of Pennsylvania School of Dental MedicinePennsylvania$360,000Support the University of Pennsylvania School of Dental Medicine to partner with CareQuest Institute to advance medical dental integration and develop a framework for medically-necessary oral health services for inclusion in Medicaid programs.2025Maryland Dental Action Coalition, Inc.Maryland$125,000Support Maryland Dental Action Coalition’s expanded Medicaid implementation efforts, which include advocacy and legislation, interprofessional collaboration, and oral health literacy and education, all done in coordination with a diverse statewide network of oral health stakeholders. 2025Michigan Primary Care AssociationMichigan$155,550Support the Michigan Primary Care Association in implementing value-based care initiatives. The primary focus is to identify and leverage opportunities to develop an oral health value-based Alternative Payment Methodology pilot program and continuing to solidify this foundation through targeted training and resource-sharing at Community Health Centers across Michigan.2025Center for Health Policy Development dba National Academy for State Health PolicyMaine$150,000Support the Center for Health Policy Development d/b/a National Academy for State Health Policy (NASHP) convene and provide technical assistance to state leaders through the Oral Health Policy Workgroup, discussing barriers and opportunities to navigate emerging challenges to oral health access.2025University of Maryland, School of DentistryMaryland$102,000Advance equitable oral healthcare access for underserved prenatal and postpartum populations in Maryland by integrating community health workers (CHWs) and dental hygiene education programs into primary care settings.2025Alaska Primary Care AssociationAlaska$125,000Assist the Alaska Primary Care Association and Alaska’s health centers in strengthening oral health integration through the introduction of the Smiles for Life for Frontline Workers to Community Health Workers (CHWs). The CHWs will utilize the training in health centers and in their communities which will help reduce the workload of clinical staff, lead to improved care coordination, and better health outcomes across Alaska’s communities.2025Special Care Dentistry AssociationTexas$58,144Support the Special Care Dentistry Association in the creation of Entrustable Professional Activities (EPA) in Geriatric Dentistry. The EPAs will provide practice guidelines and unified training standards for dental professionals to ensure competency in providing care for the frail geriatric population.2025United Way of Northern New JerseyNew Jersey$145,000Support research conducted by the United Way of Northern New Jersey, aimed at developing a more accurate and nuanced understanding of how financial hardship affects families and their ability to access quality, affordable oral health care.2025Maine Primary Care AssociationMaine$100,000Support Maine Primary Care Association’s efforts to transform the delivery of oral health services within Maine's largest primary care network through integration, collaboration, and quality improvement.2025Center for Health Care Strategies, Inc.New Jersey$140,812Support the Center for Health Care Strategies to develop and deliver an “Oral Health Workforce Implementation Learning Series.” This learning series will support Medicaid agency staff and their partners to develop, implement, and strengthen oral health workforce initiatives that advance health equity for individuals served by Medicaid and are feasible, sustainable, and scalable.2025Children NowCalifornia$80,000For Children Now to advocate and build legislative support for children’s access to oral health prevention, including non-dental provider applied fluoride varnish and oral health supports in kindergarten.2025Special Olympics ArkansasArkansas$100,000Help Special Olympics Arkansas, acting as a fiscal agent for the Arkansas Oral Health Coalition, hire an executive director to establish a sustainable infrastructure for the coalition. The executive director will lead the coalition in policy change and advocacy efforts, grant management, resource development, fundraising, and will play a pivotal role in shaping the coalition’s strategic direction, fostering community partnerships, and ensuring continued success of oral health programs.2025Community CatalystMassachusetts$500,000Support Community Catalyst to continue their efforts to engage with communities and coordinate, mobilize, and strengthen efforts at the state, local, and federal levels, particularly in response to threats to oral health programs and regulatory progress.2025Families USADistrict of Columbia$500,000Support Families USA to continue to advocate for access to comprehensive oral health coverage across the country, defend gains in Medicaid coverage, cultivating new Senate oral health champions, and developing resources for state and grassroots advocates.2025Regents of the University of MinnesotaMinnesota$172,500Support the continuation of a research project overseen by the Regents of the University of Minnesota. American Indian and Alaska Native (AI/AN) communities continue to experience a disproportionate burden of poor oral health outcomes.2025Trustees of Tufts College: Tufts University School of Dental MedicineMassachusetts$175,000Support Tufts University School of Dentistry to pilot a model of oral health care for adults with medical complexity and/or intellectual or developmental disability (I/DD).2025Suwannee River Area Health Education CenterFlorida$115,464Support Suwannee River Area Health Education Center as the fiscal sponsor for Floridians for Dental Access (FLDA), and to advocate for the passage of dental therapy legislation in Florida.2025Voices for Vermont’s ChildrenVermont$125,000Support Voices for Vermont's Children's ongoing outreach and awareness campaign that reflects community-identified oral health policy priorities, promotes the use of medical management for dental disease, and improves access to care for Medicaid-enrolled and uninsured patients.2025Tennessee Primary Care AssociationTennessee$125,000Support the Tennessee Primary Care Association in strengthening and supporting Tennessee’s 30 Federally Qualified Health Centers to improve access to adult dental benefits coverage through TennCare.2025Illinois Primary Health Care AssociationIllinois$200,000Support the Illinois Primary Health Care Association, acting as a fiscal agent for IFLOSS (Illinois’ state oral health coalition), in hiring a full-time executive director.2025Texas Health InstituteTexas$203,164Support Texas Health Institute in their aim to improve access to equitable, person-centered oral health care for all Texans. Their focus priorities for this year are advancing public policy, strengthening workforce and access to care, and charting the path forward for oral health in Texas.2025American Dental Therapy AssociationAlaska$75,000Support the American Dental Therapy Association to complete a dental therapist compensation report in collaboration with CareQuest Institute’s Analytics and Data Insights team and conduct a research survey and report that will inform how dental therapists can help lead the way to accelerate the adoption of MIC services for underserved communities.2025American Academy of PediatricsIllinois$175,000Support the American Academy of Pediatrics in the continuation of their pilot of Silver Diamine Fluoride application in four pediatric medical practices, the development and delivery of a caries management education program, and continued support of network building focused on medical-dental integration, collaboration and referrals.2025Kentucky Voices for HealthKentucky$100,000Support Kentucky Voices for Health in their Medicaid defense advocacy and to promote the inclusion of routine adult dental benefits as Essential Health Benefits, potentially making Kentucky the first state to recognize dental care as an Essential Health Benefit.2025The Fund for a Healthier ColoradoColorado$100,000Support Fund for a Healthier Colorado to continue to advance oral health access in Colorado by implementing dental therapy and defending the Medicaid budget for adult oral health benefits. The project includes developing educational content and engaging stakeholders to maintain dental therapy provisions during the Dental Practice Act review.2025Apple Tree DentalMinnesota$287,530Support Apple Tree Dental with a third year of funding to strengthen their research infrastructure in three specific ways: branding, communication, and stakeholder engagement, advancing security systems, critical data linkage, and storage capabilities, and creating strategic opportunities to network with professional colleagues to foster further collaboration.2025Center for Medicare AdvocacyConnecticut$145,000Support the Center for Medicare Advocacy’s work to expand oral health coverage for Medicare beneficiaries and to continue the organization’s diversity, equity, and inclusion focused policy work and internal capacity efforts.2025Health Care For AllMassachusetts$184,390Support Health Care for All in its efforts to enhance oral health integration and promote teledentistry, protect and defend adult dental Medicaid benefits, advocate for state and federal policies aimed at expanding access to vulnerable populations, and conduct listening sessions with community members and organizations to inform the organization's 2025-2026 oral health legislative agenda.2025KINDColorado$143,000Support Kids in Need of Dentistry to expand its promotora-centered model of oral health care, lead advocacy efforts around oral health integration, and create and scale viable, effective pathways to professional development for promotoras interested in becoming certified community health workers and/or community dental health coordinators.2025NC ChildNorth Carolina$175,000Support the expansion of NC Child’s community engagement efforts by continuing and enhancing a statewide listening tour. This tour aims to engage community health providers, civic leaders, faith leaders, and families, gathering data to build reports on social determinants of health within key communities and regions.2025Michigan Oral Health CoalitionMichigan$150,000Assist the Michigan Oral Health Coalition in executing a comprehensive strategy aimed at enhancing access to clinically appropriate care with a strong emphasis on proven strategies to protect public health. Their approach is designed to address the systemic barriers that have historically marginalized underserved communities, particularly those reliant on Medicaid.2025Connecticut Oral Health Initiative (COHI)Connecticut$175,000Support the Connecticut Oral Health Initiative (COHI) to expand its community engagement efforts and continue important oral health advocacy to preserve and expand coverage and access to oral health care for historically marginalized populations throughout the state.2025Schuyler Center for Analysis and AdvocacyNew York$175,442Support the Schuyler Center for Analysis and Advocacy’s efforts to increase availability of oral health care to populations with the greatest need through comprehensive changes to health workforce laws, improved Medicaid policies, and a strategic workforce pipeline to meet future needs.2025Asian Resources, Inc. (ARI)California$150,000The purpose of this grant is for Asian Resources Inc. to protect and expand access to oral health care by increasing linguistic and cultural access to the Medi-Cal dental program, defending coverage amid budget cuts, and to work to diversify California’s oral health workforce by advancing integration of Community Health Workers and Dental Therapists into California’s dental workforce.2025Brigham and Women’s HospitalMassachusetts$46,436Evaluating Silver Diamine Fluoride Uptake by Medical and Dental Clinicians2025California Pan-Ethnic Health NetworkCalifornia$160,000The purpose of this grant is for California Pan-Ethnic Health Network to build an advocacy campaign to restore Medi-Cal dental benefits for all regardless of immigration status and prevent further cuts to the Medi-Cal dental benefit.2025Cambridge Health Alliance FoundationMassachusetts$125,000The purpose of this grant is to support Cambridge Health Alliance in integrating a public health dental hygienist into one of its primary care sites to increase access, enhance prevention, and better coordinate oral health services for historically marginalized communities, while demonstrating the care delivery and financial benefits of integrated oral health and advocating for the broader adoption of higher-tier oral health requirements across the state’s Accountable Care Organizations.2025Children’s Oral Health Network of MaineMaine$125,000The purpose of this grant is to support the Children’s Oral Health Network of Maine to scale and institutionalize Mainely Connection, a platform that connects children in the child welfare system to dental care through optimized care coordination and training.2025Colorado Consumer Health InitiativeColorado$100,375The purpose of this grant is for the Colorado Consumer Health Initiative to continue to support a strong community-driven oral health coalition that amplifies policy opportunities, threats, education, and storytelling efforts to improve community oral health through Medicaid.2025Hawaii Public Health InstituteHawaii$120,000The purpose of this grant is to support the Hawaii Public Health Institute in advancing the strategic goals of the Hawaii Oral Health Coalition. Specifically, the funding will sustain HIPHI’s leadership in legislative advocacy, research, and community engagement aimed at improving oral health outcomes for priority populations—including children, individuals with intellectual and developmental disabilities, rural communities, and Medicaid recipients2025Indiana Community Action Poverty InstituteIndiana$115,000The purpose of this grant is to support the Indiana Community Action Poverty Institute with a study to explore the relationship between medical debt and healthcare affordability from an oral health lens, as Indiana does not have specific data assessing oral health inequalities and their impact on medical debt. Their report will include statistical data, policy landscape analysis for Indiana, and stories from Hoosiers with policy recommendations based on the report’s findings.2025Institute for Exceptional CareDistrict of Columbia$125,000The purpose of this grant is to create—in partnership with patients, family members, clinicians, and educators—a new continuing education course for clinicians that builds knowledge around oral-systemic health and serving patients with intellectual and development disabilities (IDD).2025Ministerial Health Fellowship c/o Cross Street Training and Academic CenterConnecticut$100,000The purpose of this grant is to support the Ministerial Health Fellowship to engage BIPOC communities in Connecticut through education and lead advocacy for oral health policy change at the state level to improve access to affordable, high-quality, preventive and restorative care through all stages of life.2025Missouri Coalition for Oral HealthConnecticut$200,010The purpose of this grant is to support the Missouri Coalition for Oral Health in continuing the design and implementation of a dental alternative payment model (APM) for people with intellectual and developmental disabilities (I/DD) by testing incentivized payments for dental providers, as well as consolidating case studies and lessons learned so far to inform state advocacy efforts. This is the third year of funding of phase two of their current grant with CareQuest Institute, laying the groundwork for future implementation of an APM in Missouri.2025Slippery Rock UniversityPennsylvania$50,000Research project: Factors Influencing Preferences for Integrated Medical and Dental Care Models Among U.S. Adults2025Society of American Indian DentistsNevada$150,000The purpose of this grant is to build capacity within SAID through a leadership transition, including onboarding a new executive, building their efficacy in the role, appearing at key national events, and creating a strategic plan.2025Southern Plains Tribal Health BoardOklahoma$160,000The purpose of this grant is to support the Southern Plains Tribal Health Board to investigate where racial misclassification may occur in the Medicaid patient mapping framework, write a paper based on recommendations from the findings in the previous phase of this work, continue to monitor and report oral and pharyngeal cancer mortality data before and after misclassification, and expand findings and extrapolate them into other datasets.2025University of Alabama at BirminghamAlabama$50,000Research project: Effects of Federally Qualified Health Center Expansion on Emergency Department Visits for Nontraumatic Dental Conditions2025University of California San FranciscoCalifornia$50,000Research project: Dental Care Disparities and Quality Among Children with Autism Spectrum Disorder: A National Claims Based Analysis2025University of Utah Health, School of DentistryUtah$50,000Research project: Oral Health Predicting Diabetes Complications in a Medicaid Population2025Vista Community ClinicCalifornia$135,900The purpose of this grant is to support Vista Community Clinic to expand its medical-dental integration program, designed to improve access to oral health care for underserved populations, particularly pediatric and prenatal patients, by embedding dental care coordination into primary care settings.2024Cambridge Health Alliance FoundationMassachusetts$95,000Support Cambridge Health Alliance to pilot the integration of a dental hygienist into primary care within one of Massachusetts’ Accountable Care Organizations (ACOs) with the goals of increasing access to care, enhance prevention, and better coordinate services for historically marginalized communities.2024Society of American Indian DentistsNevada$150,000Support the Society of American Indian Dentists (SAID) implement a call to action in their 2023 white paper (“American Indian and Alaska Native Communities Face a ‘Disproportionate Burden of Oral Disease’”) to “…interpret [research] results… with Indigenous communities.” In partnership with CareQuest Institute’s Analytics and Data Insights Team, SAID will take the data from recent research and present in the language and methods appropriate for the unique communities it serves – SAID’s membership, Indigenous communities, and policymakers.2024University of MichiganMichigan$132,708Support the University of Michigan in conducting a qualitative research project exploring the relationship between psychological trauma and dental care challenges. Funding will be used for data collection, analysis, synthesis, and dissemination of research findings.2024Poverty Action c/o Solid GroundWashington$125,000Support Poverty Action c/o Solid Ground in the coordination of the Washington Dental Access Campaign (WDAC) to create a sustainable and equitable oral healthcare system in Washington State. WDAC will do this by implementing Dental Therapy licensure and improving Medicaid dental coverage to increase access to care, reduce disparities, and integrate community-driven advocacy with systemic policy changes.2024New Mainers Public Health InitiativeMaine$125,000Support the New Mainers Public Health Initiative to host health literacy groups, educate and train community members in advocacy toward expanded access to oral health care, and conduct further evaluation of the impact of its oral health-focused community engagement.2024California Pan-Ethnic Health NetworkCalifornia$175,000Support The California Pan-Ethnic Health Network’s capacity building for grassroots partners to advocate for the preservation of expanded Medi-Cal dental benefits while also launching a campaign to diversify the dental workforce through the authorization of dental therapy in California.2024Schuyler Center for Analysis and AdvocacyNew York$175,292Support the Schuyler Center for Analysis and Advocacy’s efforts to increase availability of oral health care to populations with the greatest need through comprehensive changes to health workforce laws, improved Medicaid policies, and a strategic workforce pipeline to meet future needs.2024University of Florida FoundationFlorida$143,000Support the University of Florida in conducting a comparative study to provide evidence-based data to help authorize dental therapy in Florida. Authorization of dental therapy will improve access to affordable dental care for underserved populations and influence state-level policies for broader integration of dental therapists.2024University of Florida FoundationFlorida$125,000Support the University of Florida Foundation continued implementation of the D-CARE project. Grant funding will help establish a sustainable and scalable model for mobile dental clinics that provide accessible, preventive, and minimally invasive dental care for individuals with disabilities, while promoting best practices and contributing to broader advocacy and policy efforts to enhance oral health equity.2024Missouri Coalition for Oral HealthMissouri$180,000Support the Missouri Coalition for Oral Health in continuing the design and implementation of a dental alternative payment model (APM) for people with intellectual and developmental disabilities (IDD) by testing incentivized payments for dental providers. This is the second year of funding of phase two of their current grant with CareQuest Institute, laying the groundwork for future implementation of an APM in Missouri.2024American Dental Hygienists’ AssociationIllinois$50,0002024Vista Community ClinicCalifornia$125,000Support Vista Community Clinic in the expansion and enhancement of its pediatric-focused medical-dental integration project at its current location and four additional clinics.2024Colorado Consumer Health InitiativeColorado$175,000The Colorado Consumer Health Initiative seeks to advance equitable oral health policy and systems change efforts through advocacy by advancing access to adult dental coverage and care, integrating dental into the state’s essential health benefits benchmark, improving access to key services and minimally invasive care for children, and supporting the growth and direction of the new statewide oral health coalition by ensuring all community voices are heard.2024Asian Resources, Inc. (ARI)California$150,000Support Asian Resources, Inc. drive systemic changes that improve oral health outcomes for Asian American, Native Hawaiian and Pacific Islanders communities by advocating for policy changes, diversifying the oral health workforce, and enhancing the collection and reporting of disaggregated race and ethnicity data.2024The Arc of the United StatesDistrict of Columbia$125,000Support The Arc of the United State in raising awareness about oral health disparities within the disability community, advocating for legislative improvements to service access, and establishing a network of providers better equipped to meet the needs of this community. Cornerstone to this project is incorporating and elevating the voices and lived experiences of individuals with IDD, their caretakers and family members.2024Banner Health FoundationArizona$50,000To continue the work of the Hospital Oral Care and Proactive Education (HOPE) program to gather patient feedback to inform outcomes, prove program efficacy by capturing data for analysis, build more provider training, and standardize oral care hygiene treatment throughout six Banner’s hospitals in Arizona.2024Healthy Mothers Healthy Babies Coalition of Georgia, Inc.Georgia$70,000Support the capacity of Healthy Mothers, Healthy Babies Coalition of Georgia’s Working Group to continue to bring together key decision makers, perinatal and oral health professionals, providers, and pregnant and postpartum people to build upon identified solutions through the development of an Oral Health and Pregnancy Awareness campaign.2024Southern Plains Tribal Health BoardOklahoma$125,000Support the Southern Plains Tribal Health Board to establish and maintain a racial misclassification advisory group (RMAG), made up of tribal and clinical oral health stakeholders, to map and propose solutions to instances of misclassification throughout the care process.2024Hawaii Public Health InstituteHawaii$205,970Support the Hawaii Public Health Institute (HPHI) and the Hawaii Oral Health Coalition to explore new policy options for expanding functions among existing dental workforce, conduct a community oral health needs assessment, and improve oral healthcare prevention and access for Hawaii children.2024Nicklaus Children’s Hospital FoundationFlorida$125,000Support Nicklaus Children’s Hospital Pediatric Dentistry Department (NCHPDD) in partnership with Borinquen Medical Center (BMC) and eight elementary public schools in Miami-Dade County increase access to oral health care for recent immigrant children.2024East Carolina UniversityNorth Carolina$125,000Support East Carolina University in its aims to inform policy changes that improve veterans’ oral health by creating a care model that employs multidisciplinary teams to facilitate comprehensive care for veterans with chronic illnesses and disabilities. East Carolina University plans to demonstrate that reduced net costs and improved quality of life for veterans can be achieved by focusing on prevention and early intervention in medical-dental integration.2024University of Massachusetts FoundationMassachusetts$56,364Support research at the University of Massachusetts Amherst to determine the prevalence of oral and dental problems, as well as potential solutions, for and with older adults living in long-term care and community settings.2024Illinois Primary Health Care AssociationIllinois$100,000Support the Illinois Primary Health Care Association’s work in three key areas: developing an oral health policy strategic plan to inform their work over the next few years, improving the integration between oral health and behavioral health services, and supporting the oral health safety-net in Illinois by hosting the Illinois Oral Health Conference and by supporting continuing education for Dental Assistants.2024Trustees of Boston University, Office of Sponsored ProgramsMassachusetts$21,574Support research conducted at Boston University that will explore the social (cultural) and structural (political and economic) drivers and mechanisms of inequitable access, utilization, and clinical oral health outcomes among Latino/a/e adults across two related studies.2024The American Institute of Dental Public HealthIllinois$210,882Support The American Institute of Dental Public Health (AIDPH) use data-driven advocacy to improve veteran oral health through the development of federal policy priorities and to build the capacity of the oral health workforce for community engagement.2024Pennsylvania Chapter of the American Academy of PediatricsPennsylvania$125,000Support the Pennsylvania Chapter of the American Academy of Pediatrics in the education and empowerment of school nurses to implement a school-based oral health program. This will include preventive education, topical fluoride varnish application, and dental referral through targeted educational resources for school nurses.2024Florida Voices for HealthFlorida$175,000Support Florida Voices for Health in their work to support community members and coalition advocacy for a Florida Medicaid adult dental benefit and other policy opportunities that support oral health in Florida.2024Well Child CenterIllinois$125,000Support Well Child Center in forming and convening a Community of Practice to improve oral health in the second largest school district in Illinois (western suburbs of Chicago).2024Upper Peninsula Commission for Area ProgressMichigan$125,000Support work by the Upper Peninsula Commission for Area Progress (UPCAP) to conduct community forums in multiple locations across a 15-county region to engage veterans, service members, family/caregivers, dental providers, insurers/health plan providers, and policy makers regarding the state of veteran oral health care and barriers to access.2024Oral Health Unit at CDPHEColorado$125,000Support the Colorado Department of Public Health and Environment’s Oral Health Unit, in collaboration with Youth Healthcare Alliance, to further expand school based oral health through engaging schools and communities to address systemic barriers to oral health for children and their families.2024Family Medicine Education ConsortiumOhio$125,000Support the Family Medicine Education Consortium to work with the academic family medicine system to affect change in how primary care providers approach the oral health care of patients, with a focus on access to appropriate and comprehensive care for veterans.2024Montana State University FoundationMontana$125,000Launch the Youth Voice Project, which will conduct focus groups with 7th-12th grade students to identify their perceptions of oral health in their community. Students will develop oral health outreach initiatives, campaigns, and messages delivered via Native Reach TV, and a Project Advisor will engage in workforce development programming to nurture interest in oral health careers. The Foundation will also pilot a same day treatment protocol in the School Based Health Center to disrupt current model where students are referred to treatment over 100 miles away in Billings.2024More Smiles WisconsinWisconsin$125,000Support More Smiles Wisconsin in the expansion of oral health collaborations between schools, school-based prevention programs, and local dentists through the existing and recently established Hometown Smiles program.2024Dentistry 4 VetsCalifornia$125,000Support Dentistry4Vets to address system-level barriers to oral health for veterans and spotlight their care delivery model that delivers cost-effective, comprehensive dental treatment tailored specifically for veterans2024Everyone For VeteransWashington$125,000Support Everyone for Veterans in training dental schools and students on veteran-specific oral care, speaking engagements that focus on the voices of veterans, and advocacy for veterans' oral health.2024Refugee Community PartnershipNorth Carolina$123,000Support the Refugee Community Partnership to counter language-based exclusion in oral and medical healthcare settings through the deployment of Language Navigators from the refugee and migrant community to capture and assess the availability and quality of interpretation services toward establishing a full reimbursement benefit for interpretation in Medicaid.2024MCD Global HealthMaine$125,000Support MCD Global Health in the integration of oral health with health, dental, and school partners, and increased access to care for Maine children utilizing school nurses to provide screenings and preventive services.2024Center for Oral HealthCalifornia$125,000Support Center for Oral Health to harness the success of the Early Smiles Program to advocate for critical policy reforms at local and state levels in California. This initiative seeks to expand and enhance oral health services provided through their school based program, which has demonstrated significant impact in Sacramento, Yolo, Alpine, and Trinity counties (California).2024Marshall University Research CorporationWest Virginia$125,000Support Marshall University to assess the knowledge gaps around veterans’ oral health access and capture veteran perspectives on care in West Virginia to inform statewide and national oral health systems change efforts.2024EXCELth, Inc.Louisiana$125,000Support EXCELth in the implementation of the Louisiana Smile Krewe School-Linked Initiative with the goal of increasing the number of children utilizing dental services as well as promote widespread use of teledentistry to address barriers to oral health for rural communities.2024Mercy FoundationOregon$125,000Support Mercy Foundation to address the oral health needs of local veterans admitted to Mercy Medical Center. The Foundation seeks to increase access to care and connections to care for in hospital patients, advocate for increasing number of veterans eligible for Veterans Dental Program, share best practices via a public awareness campaign, and to create an online hub dedicated to oral health for veterans.2024American Academy of PediatricsIllinois$125,000Support the American Academy of Pediatrics (AAP) in the adaption of their Training, Education, Assistance, Mentorship, and Support (TEAMS) model to improve oral health in schools and development of an oral health micro-module for the AAP Health services Assessment Tool for Schools (HATS).2024Alliance for a Healthier GenerationOregon$142,600Support the Alliance for a Healthier Generation in the creation of a community-informed pathway to update the Model Local School Wellness Policy to include oral health, creating increased access to oral health services and early screenings, ultimately reshaping how school districts across the country address oral healthcare.2024Oral Health Kansas, Inc.Kansas$172,647Support Oral Health Kansas in addressing oral health access issues, continued convening of the “Sedation Dental Care Task Force” and Lived Experience Advisory Group to identify gaps and obstacles in accessing sedation dentistry, and advocating for expanded access to dental services for the Kansas Medicaid population.2024University of Texas Health Science Center at HoustonTexas$125,000Support the University of Texas Health and Science Center at Houston to pilot a study to investigate the impact of dental care in behavioral health treatment among veterans.2024Advocates Building Lasting Equality in NHNew Hampshire$100,000Support ABLE NH to champion better access to appropriate and inclusive oral healthcare services for individuals with disabilities and provides leadership to the New Hampshire Oral Health Care Task Force.2024West Virginia Oral Health CoalitionWest Virginia$10,0002024American Children’s CampaignFlorida$175,000Support American Children’s Campaign to carry out an integrated public education and advocacy campaign to authorize and implement dental therapy in Florida.2024Medical University of South Carolina FoundationSouth Carolina$130,000Support the Medical University of South Carolina to conduct and evaluation of its Dental Pathways for Faculty Campions for Diversity and Mentorship project phase one and develop course materials for the spread of this model to other Historically Black Colleges and Universities and Minority Serving Institutions.2024Pennsylvania Coalition for Oral HealthPennsylvania$98,000Support the Pennsylvania Coalition for Oral Health (PCOH) to address oral health disparities through advocacy for expanded Medicaid dental benefits for adults and those with disabilities as well as the enhancement of school-based dental services, particularly through the role of public health dental hygienists.2024University of Texas Health Science Center at HoustonTexas$150,000Integrate oral health and overall health through medical/dental collaboration and community input at the University of Texas Health Houston School of Dentistry’s Center for Health Promotion to create a care model that will be utilized to influence oral health and healthcare policy.2024Utah Health Policy ProjectUtah$150,000Support Utah Health Policy Project (UHPP) in the expansion of the Oral Health Consumer Coalition, ensure Utah's newly passed adult dental Medicaid benefit is implemented properly, create broad awareness of program eligibility, and to strengthen oral health coverage and access to UHPP clients who receive direct health care enrollment assistance.2024Virginia Health CatalystVirginia$135,000Support Virginia Health Catalyst to provide guidance and technical assistance to safety net clinics expanding the use of patient-centered, culturally humble care coordination techniques and tools.2024West Virginians for Affordable Health CareWest Virginia$150,000Build a grassroots advocacy base for West Virginians for Affordable Health Care’s Medicaid Buy-In Proposal which will protect Medicaid beneficiaries from losing coverage due to modest income increases by providing additional affordable coverage options.2024Kentucky Youth AdvocatesKentucky$125,000For the Kentucky Oral Health Coalition, supported by Kentucky Youth Advocates (KYA), to develop regional workgroups to ensure successful implementation of expanded benefits, build on their landscape assessment, and develop an updated policy agenda for the 2025 session.2024Children’s Action AllianceArizona$170,118For the Arizona Oral Health Coalition (AZOHC), with support from Children’s Action Alliance (CAA), to lead legislative and administrative efforts in pursuit of oral health equity by continuing to advocate for a comprehensive adult dental benefit in Arizona’s Medicaid program.2024Dignity Health Foundation – East ValleyArizona$134,000Support Dignity Health in the expansion their ICU Oral Care project. This project will embed Registered Dental Hygienists into the Medical and Trauma Intensive Care Units at Dignity Health Medical Center to provide oral health care to patients with advanced airways to reduce the incidence of Infection-Related Ventilator Association Complications (IVAC) and Possible Ventilator-Associated Pneumonia (PVAP).2024Smiles Across MontanaMontana$149,950Smiles Across Montana is to develop a pilot program to deploy non-dental professionals as Community Health Care Workers who will provide education, preventive measures, and referrals to the underserved communities identified.2024Heart Ministry CenterNebraska$150,000Support Heart Ministry Center as they determine their oral health policy and advocacy priorities through trauma-informed story gathering of community members impacted by oral health challenges.2024ITNAmericaMaine$150,000Support ITNAmerica to study the relationship between transportation and access to healthcare, focusing on oral health and develop a research design for a cost-effective longitudinal study of the relationship between transportation and access to healthcare.2024National Conference of State LegislaturesColorado$70,000Inform and engage state legislators as essential stakeholders in oral health policy and to inform OPEN members about state-level oral health policy.2024Maryland Dental Action Coalition, Inc.Maryland$150,000Support Maryland Dental Action Coalition’s expanded Medicaid implementation efforts, which include advocacy and legislation, interprofessional collaboration, and oral health literacy and education, all done in coordination with a diverse statewide network of oral health stakeholders.2024National Rural Health AssociationMissouri$245,000Support the National Rural Health Association in their work to improve rural oral health equity through the continuation of the National Rural Oral Health Initiative and its key pillars of advocacy, communications, education, and research.2024Children NowCalifornia$150,000For Children Now to ensure effective and widespread implementation of policies related to the California Advancing and Innovating Medi-Cal (CalAIM) Initiative, specifically the Community Healthcare Worker Benefit, to better serve all 5.6 million children and youth in Medi-Cal.2024Massachusetts League of Community Health Centers, Inc.Massachusetts$150,000Support the Massachusetts League of Community Health Centers to expand and pilot a four-part curriculum developed to equip oral health staff within community health center dental clinics with culturally sensitive communication skills to improve patient-providers relationships and care outcomes.2024Families USADistrict of Columbia$500,000Support Families USA to 1) Grow and reinforce the strategic infrastructure that ensures community voices and equity are at the center of oral health policymaking; 2) Position oral health coverage as a prominent policy issue heading into the 2024 election season; 3) Prepare for the various alternative legislative and administrative scenarios that may arise in 2025 at the federal and state level.2024Harvard School of Dental MedicineMassachusetts$100,000Support the Center for the Integration of Primary Care and Oral Health (CIPCOH), as a part of Harvard School of Dental Medicine, implement the fourth year of the 100 Million Mouths Campaign, expanding the number of states with designated primary care oral health champions to 26.2024ACHIEVA/The Arc of Greater PittsburghPennsylvania$149,740Support Achieva’s advocacy efforts to designate people with disabilities as a Medically Underserved Population on a state-wide and national scale, which would increase access to primary, behavioral, and oral healthcare through federal funding opportunities.2024Suwannee River Area Health Education CenterFlorida$112,488Support Suwannee River Area Health Education Center as the fiscal sponsor for Floridians for Dental Access (FLDA), to advocate for the passage of dental therapy legislation in Florida. Additionally, the activities outlined in this proposal will support Florida in joining the Dentist and Dental Hygienist Compact. This compact creates reciprocity among participating states which reduces barriers to license portability, ultimately increasing workforce availability through decreased licensure restrictions.2024Alabama AriseAlabama$150,000To continue support of Alabama Arise’s work to advocate for expanded Medicaid coverage including educational advocacy efforts around oral health, opportunities to advance teledentistry and medical-dental integration.2024American Network of Oral Health CoalitionsKansas$13,3652024Ready Set SmileMinnesota$125,000Support Ready Set Smile’s design of a dental home network of community clinics and private/pediatric practitioners and a referral system with follow up policies and procedures to ensure children continue to receive clinically appropriate oral health care.2024University of Colorado DenverColorado$150,000Support the University of Colorado School of Dental Medicine to strengthen the community voices of the American Indian community on Pine Ridge, in South Dakota, through authentic partnership development and test a theoretical framework on perceived discrimination and other dental care-related experiences in the utilization of dental care among adults in this population.2024Hispanic Dental AssociationNew York$278,535For the Hispanic Dental Association to inform evidence-based policy decisions and support Hispanic dental providers as equity driven advocates for oral health.2024Pacific Northwest University of Health SciencesWashington$78,500Support the teams at PNWU-SDM and NIHC to develop, implement, measure, and share a comprehensive, multi-year interprofessional education (IPE) curriculum for DMD students and professionals.2024Texas Health InstituteTexas$184,848Support Texas Health Institute in the development of a state level dashboard with population health data that will inform advocacy efforts in the 2025 legislative session. The proposed activities of this grant will also address access gaps for minority populations in Texas by conducting a landscape scan of current efforts, develop a learning collaboration for providers to advance solutions to these gaps, and engage with academic institutions to advance policies to address care gaps.2024Maine Equal Justice PartnersMaine$98,552Support Maine Equal Justice Partners to gather and integrate consumer input in the implementation of Maine’s Medicaid adult dental benefit and advocacy for expansion of Medicaid to all Mainers regardless of immigration status.2024Community CatalystMassachusetts$546,334Support Community Catalyst to continue federal and state advocacy for comprehensive health coverage, inclusive of oral health, that is centered on the needs and perspectives of community, as well as provide technical assistance and training around equity-driven community engagement in service of oral health systems change.2024Voices for Vermont’s ChildrenVermont$125,000Support Voices for Vermont's Children's creation of an outreach and awareness campaign that reflects community-identified oral health policy priorities, promotes the use of medical management of dental disease, and improves access to care for Medicaid-enrolled and uninsured patients through intentional medical-dental integration policy design.2024Berkeley Free ClinicCalifornia$13,0002024Health Care For AllMassachusetts$150,000Support Health Care for All in its efforts to enhance oral health integration and promote teledentistry, protect and defend adult dental Medicaid benefits, advocate for state and federal policies aimed at expanding access to vulnerable populations, and conduct listening sessions with community members and organizations to inform the organization's 2025-2026 oral health legislative agenda.2024Center for Medicare AdvocacyConnecticut$145,000Support the Center for Medicare Advocacy’s work to expand oral health coverage for Medicare beneficiaries.2024Kentucky Voices for HealthKentucky$125,000Support the efforts of Kentucky Voices for Health as they advocate to prevent the unraveling of Medicaid expansion including expanded dental benefits through the leveraging of community voice.2024International Association for Dental, Oral, and Craniofacial ResearchVirginia$3,7502024Strategic Concepts in Organizing and Policy EducationCalifornia$150,000Support SCOPE to build grassroots power and mobilize for a community-driven solution to address oral health inequities in BIPOC, rural, and tribal communities in California.2024Northwest Portland Area Indian Health BoardOregon$150,000Support the Northwest Portland Area Indian Health Board in creating a sustainable, culturally centered oral healthcare workforce that addresses social determinants of health and reduces inequities in American Indian and Alaska Native communities through integrated dental, behavioral, and community health training.2024Nebraska AppleseedNebraska$130,000Support Nebraska Appleseed in their efforts to continue collaborating with underserved communities to advance systemic change that improves health and increases equity in their state. Nebraska Appleseed will continue to prioritize growing capacity and voice, deepening oral health advocacy, expanding and strengthening health care partnerships, and improving Medicaid access and processes.2024Missouri Department of Health and Senior ServicesMissouri$125,000Support the Missouri Office of Dental Health (MODH) in evaluating their current work with A.T. Still University’s dental clinic (led by former marine, Dr. Herb Silva), which provides dental care to veterans through the Smiles for Vets program. The goal of the evaluation is to learn why veterans seek dental treatment, how dentists can improve care provided, why dental students want to provide care to veterans and what would encourage them continue to provide care post-graduation.2024Missouri Department of Health and Senior ServicesMissouri$125,000Support the Missouri Coalition for Oral Health (MCOH) in their efforts to gather and apply data-driven and lived experience insights to better understand and address the unmet dental needs of Missouri veterans while elevating the importance of veteran oral health among MCOH members, partners, and stakeholders.2024Justice in AgingDistrict of Columbia$120,000Influence the Medicare system to expand dental coverage in Medicare, influence the Medicaid system to expand dental services through Medicaid waivers, and engage the Aging and Disability Network in oral health advocacy. Justice in Aging does this through a model of change that relies on the interplay of education and training, policy advocacy, and litigation.2023Vista Community ClinicCalifornia$125,000Support Vista Community Clinic in the advancement of whole person care in pediatric patients.2023Virginia Health CatalystVirginia$135,150Support Virginia Health Catalyst’s efforts to provide guidance and technical assistance for safety net clinics to expand the use of patient-centered, culturally humble care coordination techniques and tools.2023University of Pennsylvania School of Dental MedicinePennsylvania$125,000Support the University of Pennsylvania School of Dental Medicine to address prevention, oral health stabilization and interceptive and restorative oral health care to address dental issues for the disability community through a community-driven project.2023University of Missouri – Kansas City, Institute for Human DevelopmentMissouri$80,000Support University of Missouri-Kansas City (UMKC) Institute for Human Development perform a needs assessment to inform the design of a community-based intervention that addresses barriers for minority pregnant and postpartum mothers and infants to improve oral health outcomes.2023University of Maryland, School of DentistryMaryland$200,000Support medical-dental integration pilots, led the University of Maryland School of Dentistry, that respond to the expressed needs of prenatal and post-partum people in Maryland as well as the state's ongoing workforce shortage.2023University of Florida FoundationFlorida$125,000Support the University of Florida Foundation to address access to care for the disability community through telehealth, mobile services, and medical-dental integration.2023University of Colorado DenverColorado$125,000Support the University of Colorado Denver to (1) build a coalition of stakeholders and champions for advocacy and investment for the disability community, (2) improve access to care, and (3) confront discrimination (e.g., ableism) through education.2023University of Cincinnati FoundationOhio$125,000Support the University of Cincinnati Foundation to address financial sustainability for oral academic-based oral health providing services for the disability community through a community-driven project.2023UCLA School of DentistryCalifornia$125,000Support the UCLA School of Dentistry to address culturally relevant and accessible oral health education and advocacy for the disability community through a community-driven project.2023Trustees of Tufts College: Tufts University School of Dental MedicineMassachusetts$175,000Support Tufts University School of Dentistry to pilot a model of oral health care for adults with medical complexity and/or intellectual or developmental disability (I/DD).2023The Massachusetts General HospitalMassachusetts$100,000Support the Lunder-Dineen Health Education Alliance of Maine (Lunder-Dineen) adapt and scale its MOTIVATE at Home online learning curriculum for use beyond care settings, such as Area Agencies on Aging and professional dental education programs.2023The Fund for a Healthier ColoradoColorado$99,176Support The Fund for a Healthier Colorado to initiate dental therapy training programs at institutions of higher education to support the legislative and regulatory steps completed in 2023 to license dental therapists in Colorado.2023The Arc of the United StatesDistrict of Columbia$125,000Support The Arc of the United States (Arc US) to address access to care, specifically though the lens of fear and distrust of clinical oral health care prominently found in the disability community, through a community-driven project. The Arc of the United States will work with three Arc chapters across the country that are located in areas with poor health outcomes: Arc of Louisiana, Arc of Pennsylvania, and Arc of San Antonio.2023The American Institute of Dental Public HealthIllinois$125,000Support AIDPH and Coalition of Texans with Disabilities to develop tools and resources for state advocates to advance access to care for the disability community through Medicaid.2023Texas Native HealthTexas$125,000Support Texas Native Health in the implementation of community engagement in its efforts to advance medical-dental integration.2023Texas Association of Community Health CentersTexas$125,000Support the Texas Association of Community Health Centers (TACHC) in its efforts to advance the creation of a scalable, replicable, and community-informed, Trauma Informed Care training certification process.2023State University of Iowa FoundationIowa$275,000To move from conceptualization to implementation of the Patient Centered Dental Home model in clinics and evaluate pilot implementation for further spread of the framework of care.2023St. John’s Community HealthCalifornia$125,000Support St. John’s Well Child and Family Center in the implementation of community engagement in its efforts to advance medical-dental integration and performance improvement.2023Society of Teachers of Family MedicineKansas$37,741Support the addition of a module to the Smiles For Life curriculum related to the provision of Silver Diamine Fluoride in clinical settings.2023Society of American Indian DentistsNevada$125,000Support the Society of American Indian Dentists (SAID) in building its presence and recognition as an advocate on behalf of American Indian and Alaska Native dentists.2023Schuyler Center for Analysis and AdvocacyNew York$175,264Support the Schuyler Center for Analysis and Advocacy to create a comprehensive landscape of oral health data for New York. This data will be recorded, analyzed, and disseminated to policymakers in New York to promote oral health workforce expansion and regular data collection on oral health outcomes by the state moving forward.2023Santa Fe GroupFlorida$125,000Provide support to Santa Fe Group for the continued development of the Coalition for Oral Health Policy (COHP), an organization that will provide unbiased, community-focused, and evidence-based information regarding policies and funding strategies to improve access to preventive and therapeutic oral health care services for the U.S population.2023Regents of the University of MinnesotaMinnesota$121,504Support the University of Minnesota School of Dentistry (UMSD) determine how social and economic determinants of health (SoDH) intersect with health literacy and selected health conditions at the zip code level and, based on those findings, create interventions to improve oral health access and status.2023Poverty Action c/o Solid GroundWashington$125,000Support Poverty Action in its advocacy efforts to ensure strong implementation of a new allowance for statewide dental therapy licensure in community health clinics, to leverage the coalition to compile practice agreement templates and other resources for community health clinics implementing dental therapy, and to convene the coalition to engage in a priority-setting process for policy ideas to increase access to oral health.2023Pennsylvania Coalition for Oral HealthPennsylvania$48,721Support advocacy for legislation reinstating Medicaid adult dental benefits, and simultaneously allow Pennsylvania Coalition for Oral Health perform administrative advocacy toward incremental expansion of dental benefits in Medicaid in Pennsylvania.2023Pennsylvania Chapter of the American Academy of PediatricsPennsylvania$95,000Build an open-access compendium of validated virtual oral health resources that pediatricians can integrate into well-child visits that will promote preventative oral hygiene practice at an early age.2023Partnership for Southern EquityGeorgia$175,500Sustain and expand the Partnership for Southern Equity's engagement of youth leaders, adult allies, and community-based organizations to advocate for improve access to equitable and integrated oral health that responds to the unique geographic landscape of the South, beginning with Georgia and North Carolina.2023Oral Health Nursing Education and Practice (OHNEP)New York$99,402Transition the infrastructure, resources, and products of the Oral Health Nursing Education and Practice into the National Interprofessional Initiative on Oral Health.2023Oral Health Kansas, Inc.Kansas$170,000Support Oral Health Kansas’ leadership around the ongoing implementation of Medicaid adult dental benefits, including the projected addition of dentures, as well as consumer-driven dental access initiatives and policy advocacy.2023Northwest Portland Area Indian Health BoardOregon$200,000Support the Northwest Portland Area Indian Health Board’s efforts to implement the Community Health Aide Program (CHAP) throughout tribes in the lower 48 states, provide technical assistance to guide the successful and equitable implementation of dental therapy in Washington, and establish dental health aide (DHA) training curricula for tribal high schools and colleges in the Pacific Northwest.2023NIIOHColorado$115,125Support National Interprofessional Initiative on Oral Health (NIIOH) sustainability and growth, helping to reestablish NIIOH as the national voice and backbone organization for workforce transformation that integrates oral health into overall health to improve health equity and overall well-being.2023New Mexico Dental Association FoundationNew Mexico$125,000Support the New Mexico Dental Association Foundation to address access to care for the disability community through a community-driven project.2023New Mainers Public Health InitiativeMaine$128,563Support the New Mainers Public Health Initiative to operationalize a community outreach framework that is centered on oral health and delivered by Community Health Workers.2023New Hampshire Oral Health CoalitionNew Hampshire$100,000Support New Hampshire Oral Health Coalition (NHOHC) to conduct a landscape analysis of current school-based oral health programs (SBOHP) to determine the key factors and efforts needed to re-establish and strengthen school-based programs as an evidence-based first line of defense in the prevention of dental disease for children utilizing minimally invasive techniques.2023Nebraska AppleseedNebraska$128,000Support community organizing and community power-building around key oral health issues and barriers in Nebraska Medicaid.2023NC ChildNorth Carolina$175,000Support the expansion of NC Child’s community engagement work through the addition of a 5th regional Child Advocacy Network (CAN) hub and a statewide listening tour to engage community health providers, civic leaders, faith leaders, and families on data to help build reports on social determinants of health within key communities and regions.2023National Conference of State LegislaturesColorado$52,000Inform and engage state legislators as essential stakeholders in oral health policy and to inform OPEN members about state-level oral health policy.2023National Association of Community Health CentersMaryland$275,000Support National Association of Community Health Centers (NACHC) in advancing oral health integration within the broader community health center field; educating and advocating for an oral health workforce that reflects the populations served; advancing a culturally responsible approach for Asian Americans, Native Hawaiians, and Pacific Islanders (AA NH/PI) in a value-based care environment; promoting data driven decision making including improved oral health data collection, benchmarking for value-based care, utilizing social determinants of health (SDoH) to address access and quality of care and; and advocating for inclusion of adult dental benefits in Medicaid and Medicare.2023Missouri Coalition for Oral HealthMissouri$220,488Support the Missouri Coalition for Oral Health to expand its pilot project efforts of establishing, testing, and refining a value-based, dental alternative payment model (APM) to a total of three clinical site with the goal of improving the oral health experiences and outcomes of people with intellectual and/or developmental disabilities.2023Ministerial Health Fellowship c/o Cross Street Training and Academic CenterConnecticut$150,000Support Ministerial Health Fellowship to engage BIPOC communities in Connecticut through education and lead advocacy for oral health policy change at the state-level to improve access to affordable, high-quality, preventive and restorative care through all stages of life.2023Michigan Oral Health CoalitionMichigan$150,000Develop community-driven oral health workforce solutions to expand access to care in the state of Michigan.2023Medical University of South Carolina FoundationSouth Carolina$150,000Support the establishment of the Pipeline Dental Champions for Diversity and Mentorship between the Medical University of South Carolina and five historically black colleges and universities to increase the number of admissions to dental school and improve diversity in the oral health workforce.2023Massachusetts League of Community Health Centers, Inc.Massachusetts$150,000Support the Massachusetts League of Community Health Centers to launch a multi-year project to design, implement, and spread the use of new tools to strengthen communication strategies within racially discordant patient-provider relationships to reduce the impacts of structural racism in health care2023Maryland Dental Action Coalition, Inc.Maryland$150,802Support Maryland Dental Action Coalition’s expanded Medicaid implementation efforts, which include consumer outreach and education, care coordination engagement, and continued advocacy for policies that address barriers that impede access to care for the most vulnerable adults.2023Maine Primary Care AssociationMaine$100,000Support Maine Primary Care Association's (MPCA) implementation of the adult dental benefit in MaineCare as well as expand oral health practices’ understanding of and capacity for value-based payment/care (VBP/C), including the development of a capitated alternative payment methodology (APM) to maximize medical-dental integration efforts.2023Maine Equal Justice PartnersMaine$105,358Support consumer input in the implementation of Maine’s Medicaid adult dental benefit and advocacy for expansion of Medicaid to all Mainers regardless of immigration status.2023KINDColorado$137,500Support Kids in Need of Dentistry to launch a targeted patient-and- community engagement strategy to design new models of community-based care while facilitating opportunities patients and communities to be more deeply engaged in oral health and public health policy in Colorado.2023KINDColorado$182,280Support Kids in Need of Dentistry to expand its promotora-centered model of oral health care, lead advocacy efforts around oral health integration, and establish viable, effective pathways to professional development for promotoras interested in becoming certified community health workers and/or community dental health coordinators.2023Kentucky Youth AdvocatesKentucky$125,000Support the Kentucky Oral Health Coalition to conduct a statewide oral health landscape assessment, develop a collaborative oral health policy agenda, and raise awareness of the coalition’s advocacy priorities to consumers, providers, and policymakers throughout Kentucky.2023Justice in AgingDistrict of Columbia$120,000Influence the Medicare system to add comprehensive oral health benefits to Medicare and to influence the Medicaid system to improve oral health coverage. Justice in Aging does this through a model of change that relies on the interplay of education and training, policy advocacy, and litigation.2023Indiana University FoundationIndiana$118,068Assess and address cultural competency gaps in the pre-doctoral dental curriculum at Indiana University School of Dentistry in relevance to oral health access issues among LGBTQ+ individuals.2023Illinois Primary Health Care AssociationIllinois$125,500Expand the oral health workforce, and the skills and practice modalities within said workforce, within Community Health Centers and Federally Qualified Health Centers in Illinois.2023Hispanic Dental AssociationNew York$264,500Perform secondary research on topics related to oral health outcomes and access for the U.S. Hispanic and Latinx population, widely disseminate the White Paper and Gallery Report developed in 2022 to national and international oral health stakeholders, and build the reputation of the Hispanic Dental Association as the go-to source for oral health data regarding this population.2023Henry J. Austin Health CenterNew Jersey$125,000Support Henry J. Austin Health Center in the implementation of community engagement in its efforts to advance teledentistry.2023Health Disparities Collaborative of Ohio Inc.Ohio$138,000Support Ohio Federation for Health Equity and Social Justice (OFHESJ) to conduct a mixed-methods survey to explore the differences in experiences and outcomes between kinship families who have access to school-based dental services and those that do not, with the goal of supporting this population to advocate for improved access to oral health services.2023Health Choice Network, Inc.Florida$125,000Support Health Choice Network, Inc. in the implementation of community engagement in its efforts to advance behavioral-dental integration.2023Health Care For AllMassachusetts$215,000Expand access to oral healthcare in Massachusetts through community-driven policy advocacy related to integration, telehealth, coalition-building, workforce solutions, and expansion of benefits to all children in MA regardless of their immigration status.2023Hawaii Public Health InstituteHawaii$220,000Support Hawaii Public Health Institute’s management of the Hawaii Oral Health Coalition and lead the Hawaii Oral Health Coalition’s advocacy around Medicaid adult dental benefit implementation, workforce solutions, and value-based care.2023Florida Voices for HealthFlorida$175,000Support community members and coalition advocacy for a Florida Medicaid adult dental benefit and other policy opportunities that support oral health in FL.2023Families USADistrict of Columbia$525,000Grow and reinforce the infrastructure that ensures community voices and equity are at the center of oral health policymaking and to position oral health coverage as a prominent policy issue heading into the 2023 election season.2023Denver Health FoundationColorado$78,160Pilot integration of influenza vaccination in routine dental visits for children ages 18 months to 5 years within Denver Health and develop resources to share the model for spread and scale.2023Connecticut Oral Health Initiative (COHI)Connecticut$175,000Support the Connecticut Oral Health Initiative (COHI) to expand its community engagement efforts and continue important oral health advocacy to preserve and expand coverage and access to oral health care for historically marginalized populations throughout the state.2023CommUnityCareTexas$125,000Support CommUnityCare in the implementation of community engagement in its efforts to advance medical-dental integration and workforce.2023Community CatalystMassachusetts$480,575Support Community Catalyst to continue federal and state advocacy for comprehensive health coverage, inclusive of oral health, as well as provide technical assistance and training around equity-driven community engagement in service of oral health systems change.2023Colorado Consumer Health InitiativeColorado$175,000Support Colorado Consumer Health Initiative (CCHI) to ensure there are robust opportunities for community participation and community-driven decision making to inform policy changes to address community oral health needs in Colorado.2023Children’s Oral Health Network of MaineMaine$125,000Support Children's Oral Health Network of Maine in the implementation of community engagement in its efforts to advance integrated and minimally invasive oral health care solutions among foster children.2023Children’s Health Alliance of WisconsinWisconsin$124,991Implement and strengthen community engagement within Children's Health Alliance of Wisconsin's Wisconsin Medical-Dental Integration initiative, and further utilize this group to address billing issues related to integration in WI clinics.2023Children’s Action AllianceArizona$178,591Support advocacy related to dental benefits, workforce, and teledentistry, education for the current and upcoming dental workforce, and engagement of new community organizations in the Arizona Oral Health Coalition.2023Children NowCalifornia$150,000Support Children Now to expand the infrastructure for care coordination across San Joaquin County, California by piloting the Medical-Dental Referral Action Network to connect patients, providers, and healthcare professionals to each other and to meaningful data.2023Center for Health Policy Development dba National Academy for State Health PolicyMaine$150,320Reinforce the need to improve equitable access to value-based, minimally invasive, oral health care through state Medicaid and departments of insurance as well as to promote information sharing around best practices and effective policies in oral health coverage.2023Center for Health Care Strategies, Inc.New Jersey$124,374Support the Center for Health Care Strategies (CHCS) to collect data on the needs and interests of Medicaid staff and stakeholders, including oral health providers, community-based organizations, and health plans, to increase their understanding of how to support workforce capacity building while advancing health equity in Medicaid.2023Cambridge Health AllianceMassachusetts$125,000Investigate the feasibility and effectiveness of a patient-centered teledentistry intervention, supported by a virtual dental platform, to increase access to oral healthcare services for Medicaid-insured adult and pediatric patients as part of a safety net system-wide oral health screening program.2023California Pan-Ethnic Health NetworkCalifornia$200,000Support ongoing community advocacy for equitable oral health policies within California’s Medicaid program (Medi-Cal) and capacity building for grassroots partners to develop and successfully advance a community-driven oral health policy agenda.2023Boston Children’s HospitalMassachusetts$125,000Support Boston Children’s Hospital to advance tele-dentistry, value-based care, and medical-dental integration and, in partnership with the Amego School, improve oral health care coordination for patients with autism spectrum disorder (ASD).2023Asian Resources, Inc. (ARI)California$150,000Support Asian Resources, Inc., in its efforts to increase access to quality, affordable, oral and health care services for Asian American, Native Hawaiian and Pacific Islanders (AANHPI) communities by monitoring the Medi-Cal expansion and renewal programs, developing a statewide AANHPI Statewide Health Equity Policy Agenda, and implementing strategies to diversify the oral health workforce.2023American Children’s CampaignFlorida$190,000Support American Children’s Campaign to create public awareness about Florida’s dental access crisis and garner legislative support to change the Florida Dental Practice Act, which will expand the number of licensed and trained professionals who can provide evaluative, preventive, restorative, and minor surgical dental care.2023American Academy of PediatricsIllinois$166,534Support of the next phase of its Silver Diamine Fluoride (SDF) awareness and implementation work within pediatric and primary care settings.2023AltaMed Health ServicesCalifornia$150,000For AltaMed to conduct community-led research in the Southeast Los Angeles (SELA) area to understand the experiences of community members while accessing oral health care, to leverage this research to create a comprehensive advocacy toolkit including resource mapping, and to collect narratives for a Radio-Novela that will highlight obstacles, fears, breakthroughs, and perceptions of oral health services.2023Alaska Primary Care AssociationAlaska$100,000Expand data mining to include Maternal/Child health, run gap analyses, and use data to drive outcome and performance improvement in all areas of the organization's work.2023Alameda Health System FoundationCalifornia$125,000Support Alameda Health System Foundation to address communication barriers to equitable oral health for the disability community through a community-informed project.2023Alabama AriseAlabama$148,500Support the Cover Alabama Campaign for Medicaid Expansion, engagement of community advocates to identify administrative opportunities to improve health care and oral health through Medicaid, and to continue to build capacity of Alabama Arise and its stakeholders to participate in oral health policy advocacy.2023ACHIEVA/The Arc of Greater PittsburghPennsylvania$148,000Support Achieva’s advocacy efforts to designate people with disabilities as a Medically Underserved Population on a state-wide and national scale, which would increase access to primary, behavioral and oral healthcare through federal funding opportunities.2023AAPD FoundationIllinois$125,000Support the AAPD Foundation to address policy and systemic barriers for adults with disabilities transitioning out of pediatric dental benefits through a community-driven project.2023A.T. Still University of Health SciencesMissouri$125,000Support A.T. Still University of Health Sciences in the implementation of community engagement in its efforts to advance teledentistry.2022American Network of Oral Health CoalitionsKansas$12,375Supports programming from the American Network of Oral Health Coalitions, including the Peer Support Mentoring Program, the new Emerging Coalitions Learning Collaborative, and the annual meeting.2022Zufall HealthNew Jersey$20,000Support Zufall Health’s Annual Rural Oral Health Symposium focusing on diversity and inclusion within the rural oral health setting.2022West Virginians for Affordable Health CareWest Virginia$150,075Build a grassroots advocacy base for West Virginians for Affordable Health Care’s Medicaid Buy-In Proposal which will protect Medicaid beneficiaries from losing coverage due to modest income increases by providing additional affordable coverage options.2022West Virginia University Research CorporationWest Virginia$130,938Support a robust, multi-year impact analysis of the newly implemented Medicaid Adult Dental Benefit in West Virginia including its effects on cost of care, benefit utilization rates, Emergency Department (ED) utilization, chronic conditions, and utilization of social safety net programs.2022Voices for Vermont’s ChildrenVermont$125,000Support Voices for Vermont's Children's community-based quantitative and qualitative data collection project which will inform oral health policy recommendations and advocacy for Medicaid-eligible populations in Vermont.2022Utah Health Policy ProjectUtah$135,000Strengthen the oral health capacity of Utah Health Policy Project’s Health Access Assisters, strengthen a coalition of community-driven oral health advocates, and elevate consumer stories around oral health policy opportunities in Utah.2022University of Pennsylvania School of Dental MedicinePennsylvania$83,518Refine, expand, and measure the impact of the implementation of the Teledentistry Assessment Portal (TAP) for Individuals with Disabilities model as part of care protocol within the Care Center for Persons with Disabilities.2022University of New HavenConnecticut$133,864Pilot an integrated model of oral health care with sexually transmitted infection/disease (STI/STD) identification, care, and referral, and to advance policy and payment in order to expand adoption and spread of the model.2022University of Maryland, School of DentistryMaryland$175,293Support year two of the statewide Prenatal and Post-partum Advisory Board (PPAB) in assessing barriers to care for this population and developing solutions for these systemic issues.2022Trustees of Boston University, Office of Sponsored ProgramsMassachusetts$186,400Implement and assess a Continuing Education program for Massachusetts oral health providers that will increase providers serving as dental homes for children under 3, as well as piloting a complimenting value-based payment model.2022The University of Texas Health Science Center at HoustonTexas$10,000Support the “OpenWide: Learning from Data in Dentistry” symposium, put on by UTHealth Houston, and provide a community engagement and equity lens to the event.2022The Fund for a Healthier ColoradoColorado$103,600Support the Fund for a Healthier Colorado to co-lead the development of a statewide oral health coalition, partner with the state’s Dental Association to create a medical loss ratio for dental insurance, and to oversee the implementation of recently passed dental therapy legislation, in partnership with local, community-driven organizations.2022Texas Health InstituteTexas$163,067Support Texas Health Institute in implementing a multi-pronged strategy to partner with both local organizations and decision-makers across the state to build an oral health policy agenda while implementing efforts to specifically strengthen the Texas safety net.2022Suwannee River Area Health Education CenterFlorida$110,100Support general operations as the organization develops its operational structure, creates content for engaging its membership, and works to increase the size and diversity of its membership.2022Strategic Concepts in Organizing and Policy EducationCalifornia$100,000Capitalize on historic base-building efforts in South Los Angeles to transition communities and partners into a statewide campaign for expanding the oral health workforce and economic opportunities for low-income Californians.2022Southern Plains Tribal Health BoardOklahoma$80,625Examine the state and national American Indian/Alaska Native (AI/AN) data collection systems, as well as the scope and impact of racial misclassification within data sets and will design a series of priority strategies for advancing data equity.2022Society of American Indian DentistsNevada$124,600Support the Society of American Indian Dentists to strengthen internal organizational infrastructure, develop and implement a diverse fund development plan, and step into a position of national leadership to influence oral health policy at the local, state, and national level2022SC AppleseedSouth Carolina$135,520Support South Carolina Appleseed Legal Justice Center to carry out a statewide oral health landscape analysis, engage communities and organizational partners for the Healthcare Stories Project, and to advocate for Medicaid expansion that includes dental benefits in South Carolina.2022Public Health Foundation Enterprises Inc. dba Heluna HealthAlaska$160,707Support the American Dental Therapy Association to strengthen its internal organizational and financial infrastructure while launching a strategy to strengthen the alignment and capacity of the practice of dental therapy.2022Poverty Action c/o Solid GroundWashington$125,001For Poverty Action to implement a statewide, community-driven, legislative policy campaign to authorize dental therapy in tribal and non-tribal communities to address the growing gaps in access and oral health workforce disparities.2022Poverty Action c/o Solid GroundWashington$125,000Support Poverty Action, a leading organization within the Washington Dental Access Campaign, to engage new community and legislative stakeholders with an expanded set of oral health policy goals, advocacy training opportunities, and data collection activities that promote equity and racial justice in and beyond the state of Washington.2022Pennsylvania Coalition for Oral HealthPennsylvania$48,300Support Pennsylvania Coalition for Oral Health's collaborative efforts to restore comprehensive dental benefits in Medicaid and to raise awareness of upcoming changes to the state's Managed Care Organizations (MCOs) for patients from and providers serving Medicaid-eligible populations.2022Oral Health Kansas, Inc.Kansas$156,147Ensure consumer and community voice are elevated as Kansas implements the new Medicaid adult dental benefit and assesses its preliminary implementation.2022NYU College of NursingNew York$204,522Support the Oral Health Nursing Education Program (OHNEP) at New York University (NYU) in deepening oral health within the nursing standards of care, expanding nursing curricula to be inclusive of serving the oral health needs of patients with special health care needs, and further institutionalizing oral health within care for Veterans.2022Northwest Portland Area Indian Health BoardOregon$200,000Support the Northwest Portland Area Indian Health Board’s efforts to implement the Community Health Aide Program (CHAP) at the federal level, as well as design and implement indigenized Health Aide programs to improve oral health access in the Pacific Northwest.2022NIIOHColorado$167,545Strengthen the integration of oral health within the community health worker workforce at a national level, to build a new national partnership focused on interprofessional education, and to advance the recommendations from the HRSA Advisory Committee on Training in Primary Care Medicine and Dentistry.2022New Hampshire Public Health AssociationNew Hampshire$115,487Support the successful implementation of the New Hampshire Medicaid Adult Dental Benefit by growing enrollment and competencies within the Medicaid provider network through training and partnership development, and advocate for the reauthorization of Medicaid Expansion in 2023.2022Nebraska AppleseedNebraska$120,000Support Nebraska Appleseed to build a health policy agenda that includes oral health using their historically successful community organizing strategies to engage and collaborate with communities and consumers across Nebraska.2022NC ChildNorth Carolina$140,000Support NC Child to distill feedback from historically marginalized communities across North Carolina into a policy advocacy agenda and galvanize local and statewide support for advancing oral health policy targeted at oral health system transformation.2022National Rural Health AssociationMissouri$250,000Advance momentum for oral health integration to improve rural oral health equity through implementation of the National Rural Oral Health Initiative and its key pillars of advocacy, communications, education, and research.2022National Network of Public Health InstitutesDistrict of Columbia$2,000,000For the National Network of Public Health Institutes to support the Oral Health Progress and Equity Network (OPEN) in finalizing the necessary steps towards organizational independence, implementing a newly established fund development strategy, and advancing local, state, and federal oral health policy through engagement of the national OPEN network.2022National Dental Association, Inc.Maryland$125,000Support the NDA in partnering with a variety of partners across Louisiana to advocate for Medicaid policy changes that will increase access to care, while at the same time, strengthen the capacity of the NDA to be a leading voice for health and racial equity within the field of oral health2022National Conference of State LegislaturesColorado$52,000Support learning opportunities around emerging oral health policy issues for the National Conference for State Legislators’ members, state legislators, and legislative staff.2022National Association of Community Health CentersMaryland$250,000Support the National Association of Community Health Centers to advance oral health integration within the broader community health center field, design new roles within the oral health workforce, and advocate for federal and state policies that advance oral health equity2022Missouri Coalition for Oral HealthMissouri$165,919Support the Missouri Oral Health Coalition in piloting a value-based, dental alternative payment model specifically to serve people with disabilities through teledentistry.2022Ministerial Health Fellowship c/o Cross Street Training and Academic CenterConnecticut$117,472Support Ministerial Health Fellowship to provide education to and build advocacy capacity among BIPOC community members, oral health advocates, and faith-based organizational partners in Connecticut around systemic oral health issues through its recently created Community Health Worker role.2022Michigan Primary Care AssociationMichigan$156,777Support the Michigan Primary Care Association to partner with the CareQuest Institute Health Transformation Team to implement the Community Oral Health Transformation (COrHT) Initiative through implementing an intentionally designed capacity-building initiative for Michigan community health centers to position the safety net for implementing new models of oral health value-based care and payment (VBC/P)2022Michigan Oral Health CoalitionMichigan$150,000Support Michigan Oral Health Coalition's advocacy to increase funding for adult Medicaid dental services and to host community conversations in key areas of the state exploring barriers to care.2022Maryland Dental Action Coalition, Inc.Maryland$150,975Secure a Medicaid adult dental benefit in Maryland and to improve access to oral health care for pregnant people by expanding the scope of practice of certain key members of oral health care teams.2022Maine Primary Care AssociationMaine$103,712Support the Maine Primary Care Association in developing workforce and infrastructure in new and equitable ways to respond to implementation of Maine’s new Medicaid adult dental benefit and positioning the safety net dental practices to re-engage in efforts to pilot value-based care.2022Maine Equal Justice PartnersMaine$115,579Ensure that the implementation of the Medicaid dental benefit is informed by the needs of community members, to promote the benefit to newly eligible Medicaid beneficiaries, and to secure Medicaid benefits for Maine immigrants regardless of immigration status.2022Kentucky Youth AdvocatesKentucky$125,000Support the Kentucky Oral Health Coalition (KOHC) to advocate for Medicaid investments in oral health and support for the Kentucky Children’s Health Insurance Program (KCHIP) by the state of Kentucky.2022Kentucky Youth AdvocatesKentucky$75,000Support Kentucky Youth Advocates’ and the Kentucky Oral Health Coalition's capacity to conduct a statewide oral health landscape assessment and play a leading, supervisory, and guiding role to the state as it begins implementing an expanded Medicaid adult dental benefit.2022KC CARE Health CenterMissouri$5,390Support KC Care Health Center’s Cancer Prevention Initiative to implement oral cancer screening and outreach.2022Justice in AgingDistrict of Columbia$120,000Maintain momentum for a dental benefit in Medicare Part B and promote medically necessary coverage through the Centers for Medicaid and Medicare Services, to increase access to dental services for vulnerable populations through Home-Based and Community Services Waivers, and to build and strengthen oral health partnerships with aging and disability advocates.2022Illinois Primary Health Care AssociationIllinois$125,000Support the Illinois Primary Health Care Association equitably expand the oral health workforce to sustainably address pervasive shortages and advance new models of integrated, prenatal oral health care in the dental safety net.2022Idaho Primary Care AssociationIdaho$152,988Support the Idaho Primary Care Association in implementing the CareQuest Institute Three Domains Framework through piloting teledentistry to increase access to care in a frontier community, testing the use of minimally invasive care procedures within community health centers and advancing the integration of dental data into the state Health Information Exchange.2022Hoosier Action Resource CenterIndiana$108,382Support Hoosier Action Resource Center to deepen the base of directly impacted leaders, train and mobilize community-based advocates across the state of Indiana and introduce an oral health component to the statewide Medicaid advocacy coalition.2022Hispanic Dental AssociationNew York$306,965Support the Hispanic Dental Association to build a robust set of data, evidence, and capacity to elevate the oral health disparities for Hispanic providers and consumers in order drive equitable state and national policy change.2022Henry Schein Cares FoundationNew York$27,823Support the SHE: Successful Healthcare Entrepreneurship event, bringing together key practitioner stakeholders from the Medical and Dental professions to energize collaboration around employing an integrated, holistic approach to healthcare.2022Health Disparities Collaborative of Ohio Inc.Ohio$142,765Support Ohio Federation for Health Equity and Social Justice to sustain its engagement of kinship caregivers and the youth in their care through story collection, policy advocacy, and the development and distribution of an oral health advocates toolkit designed to mobilize communities.2022Health Care For AllMassachusetts$185,991Support Health Care For All’s oral health policy and advocacy work promoting integration within the Medicaid 1115 waiver, to maintain a comprehensive adult dental benefit, to establish a statewide oral health equity commission, and to explore teledentistry and innovative workforce models.2022Hawaii Public Health InstituteHawaii$132,574Capitalize on the momentum created from passing a comprehensive Medicaid adult dental benefit by assessing and advancing network adequacy, engaging communities to identify opportunities to employ new models of care and strengthening data equity across the state.2022Hawaii Children’s Action NetworkHawaii$100,000Support the Hawaii Oral Health Coalition's (HOHC) Prevention and Access Committee to develop policy recommendations and advocacy toward sustainable school-based sealant programs and bolster community engagement within the HOHC Neighbor Islands.2022Harvard School of Dental MedicineMassachusetts$29,958Support Harvard School of Dental Medicine and its summit and learning collaborative on “Integrating Care to Meet Universal Health Coverage Goals.”2022Harvard School of Dental MedicineMassachusetts$200,000Support the Center for the Integration of Primary Care and Oral Health (CIPCOH), as a part of Harvard School of Dental Medicine, implement the third phase of the 100 Million Mouths Campaign, expanding the number of states with designated Champions by eight.2022Florida Voices for HealthFlorida$179,300Support Florida Voices for Health to collect and disseminate patient stories, convene community and state organizations to develop a state oral health plan, and improve their legislative and community advocacy capacity in preparation for future policy opportunities to create a Medicaid Adult Dental Benefit.2022Families USADistrict of Columbia$525,000Build upon the existing momentum of Families USA’s Oral Health for All Campaign, a long-term, multi-faceted campaign to expand access to oral healthcare through Medicaid and Medicare policy.2022Denver Health FoundationColorado$152,359Support the Denver Health Foundation, in partnership with Denver Health, to demonstrate the impact of a new integrated approach to delivering HPV vaccines in dental settings to expand access to new, whole-person care models.2022Connecticut Oral Health Initiative (COHI)Connecticut$140,000Support the Connecticut Oral Health Initiative to advance a new oral health policy agenda that was developed through a 2022 Medicaid Gap Analysis that focused on expanding benefit caps, revising the dental therapy licensure, and building public and provider support for alternative payment models in oral health.2022Community Health Center, Inc.Connecticut$150,000Support Community Health Center, Inc., to advance an equity-grounded, patient-centered approach to improving dental care access, utilization, and outcomes among people living with HIV and AIDS.2022Community CatalystMassachusetts$500,000Supports Community Catalyst to serve as a critical and strategic partner to CareQuest Institute through advancing federal oral health policy, strengthening the capacity of CareQuest Institute grantees to engage in community-driven policy advocacy, and supporting and expanding consumer-driven demand for new, integrated, minimally invasive, person-centered models of care.2022Colorado Consumer Health InitiativeColorado$175,000Support the development of a community-driven Colorado oral health agenda and ensuring community voices in the development of the Colorado Oral Health Coalition infrastructure.2022Coalition of Texans with DisabilitiesTexas$73,858Support advocacy for the timely implementation of two 2021 Texas Medicaid omnibus bills that include provisions for an annual preventative visit for 400,000 STAR+PLUS beneficiaries (low-income adults with disabilities).2022Children’s Alliance (WA)Washington$124,963Support the continued momentum and engagement of the Washington Dental Access Coalition, the main goal for which is to expand authorization of dental therapists in Washington.2022Children’s Action AllianceArizona$175,000Support Children’s Action Alliance and Arizona Oral Health Coalition’s (CAA/AZOHC) efforts to advocate for comprehensive Medicaid adult dental coverage, access to care for underserved and under-resourced populations, and enhanced emphasis on provider cultural competency.2022Children NowCalifornia$150,000Support Children Now in protecting and advancing California health policies and regulations related to accountable care coordination, funding for coverage, and school-based oral health programming.2022Center for Medicare AdvocacyConnecticut$100,000Support the Center for Medicare Advocacy’s efforts to expand Medicare coverage to include a comprehensive oral health benefit.2022Center for Medicare AdvocacyConnecticut$100,000Support the implementation of the recently approved Physician Fee Schedule Fiscal Year 2023 proposed rule, which will expand medically necessary dental services covered through Medicare.2022California Pan-Ethnic Health NetworkCalifornia$200,000Support advocacy efforts to protect and expand Medicaid coverage of oral health care as well as strengthen the linguistic and cultural quality of care through community advocacy training and grassroots capacity building.2022Asian Resources, Inc. (ARI)California$150,000Support efforts to advance equity through language access policy, improved statewide data collection and reporting systems, and the elevation of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) community voices in oral health in California.2022Arkansas Medical Dental Pharmaceutical AssociationArkansas$95,200Support Arkansas Medical Dental Pharmaceutical Association (AMDPA) to facilitate change in the areas of education, dental workforce, and community data collection.2022American Children’s CampaignFlorida$150,000Support American Children’s Campaign (ACC) to execute its strategic advocacy work, which focuses primarily on a scientific polling effort and ensuing communications campaign in support of dental therapy authorization in Florida.2022American Academy of PediatricsIllinois$143,795Support the American Academy of Pediatrics to deepen understanding, elevate opportunities, and build consensus around new clinically integrated opportunities for pediatricians applying silver-diamine fluoride to advance the integration of oral health into primary care2022American Academy of CariologyCalifornia$30,000Support three events – a fall webinar, a spring webinar, and the AAC’s 7th annual Spring Conference, themed Biomaterials Therapeutics in the World of Dental Caries.2022AltaMed Health ServicesCalifornia$150,000Support AltaMed’s advocacy training initiatives for residents of Southeast Los Angeles and the development and dissemination of an equity-based, systems-change toolkit to federally qualified health centers in and beyond Southern California.2022Advocates Building Lasting Equality in NHNew Hampshire$102,919Mobilize disability self-advocates in the implementation of the new Medicaid adult dental benefit, increase the size of the dental provider network in New Hampshire, and build the competency of providers serving people with disabilities.2022ACHIEVA/The Arc of Greater PittsburghPennsylvania$144,442Expand access to oral health care for individuals with intellectual and developmental disabilities (IDD) through the designation of this population as a Medically Underserved Population.2022Tides Center/Latino Coalition for a Healthy CaliforniaCalifornia$2,000Support Latino Coalition for Health California’s 2021 Virtual Latinx Health Policy Summit.2021National Dental Association, Inc.Maryland$25,000Support the National Dental Association’s 2021 programs.2021West Virginia University Research CorporationWest Virginia$176,902Assess West Virginia’s newly implemented Medicaid dental benefit, its implementation, and its effects on oral health, chronic disease management, emergency department usage and workforce outcomes.2021Vision y CompromisoCalifornia$10,000Support Vision y Compromiso’s 19th annual conference, “Promotoras Unived in Hope and Love Towards a Healthy and Dignified Life.”2021Virginia Health CatalystVirginia$140,000Support Virginia Health Catalyst in optimizing the implementation of Virginia’s new Medicaid adult dental benefit and positioning the Virginia safety net for moving towards oral health value-based care.2021University of North Carolina at Chapel Hill School of Dentistry Department of Dental EcologyNorth Carolina$200,000Support a collaborative research effort between the University of North Carolina School of Dentistry and Access Dental to study the comparison of initial dental assessments of people with special healthcare needs within on-site mobile dentistry versus teledentistry.2021University of Maryland, School of DentistryMaryland$141,676Launch a diverse prenatal and post-partum advisory board (PPAB) in coalition with other Maryland oral health stakeholders to assess health disparities during and after pregnancy and identify solutions.2021University of California San FranciscoCalifornia$52,016Supports the Oral Oncology Fellowship program at the University of San Francisco Sol Silverman Oral Medicine Clinic.2021The Massachusetts General HospitalMassachusetts$100,000The Lunder-Dineen Health Education Alliance of Maine will adapt its MOTIVATE program for at-home caregivers of older adults in Maine.2021The Kearney CenterFlorida$12,607Provides support to CESC, Inc. to purchase equipment to replace and repair broken equipment pieces to better serve the patients at CESC’s homeless shelter.2021The HealthPath Foundation of OhioOhio$120,000Support Oral Health Ohio in advancing new alternative models of payment to facilitate broader adoption of oral health value-based care, as well as deepen their partnership with historically marginalized communities through the development of two local oral health coalitions.2021The Fund for a Healthier ColoradoColorado$106,500The Fund for a Healthier Colorado will work in coalition with partners and healthcare consumers to develop an equity-based dental therapy policy and foster public and legislative support for dental therapy with an advocacy campaign.2021The Arc of PhiladelphiaPennsylvania$5,000Supports the implementation of training sessions through the Arc of Philadelphia’s HealthMeet program to promote inclusive healthcare and education for individuals with disabilities.2021Suwannee River Area Health Education CenterFlorida$122,968Support Floridians for Dental Access’s (FLDA) efforts in promoting workforce development through advocacy and education efforts, specifically focused on authorizing the practice of dental therapy in Florida.2021Strategic Concepts in Organizing and Policy EducationCalifornia$100,000Support Strategic Concepts in Organizing and Policy Education (SCOPE), in building local and statewide partnerships and implementing a campaign to advance policy related to expanding the oral health workforce in California.2021State University of Iowa FoundationIowa$185,000Support the State University of Iowa in moving the Patient-Centered Dental Home (PCDH), a framework for quality measurement and care integration in dentistry like the Patient-Centered Medical Home (PCMH), from design to implementation.2021St. Coletta’s of IllinoisIllinois$2,575Supports the implementation of an oral health program and curriculum for students with disabilities at the Kennedy School.2021South Carolina Primary Health Care AssociationSouth Carolina$85,800Support the South Carolina Primary Health Care Association in strategically building readiness within the South Carolina FQHCs for value-based payment models through expanding health-information technology capacity and data use capabilities.2021Santa Fe GroupFlorida$25,000Supports the Santa Fe Group’s Continuum on Integrating Oral Health into Healthcare, which includes webinars, white papers, and resources leading up to a salon on September 8 and 9, 2021.2021RIZE Massachusetts FoundationMassachusetts$333,333Support RIZE Massachusetts Foundation to integrate oral health into its programming and grantmaking strategy in order to end the opioid epidemic in Massachusetts and reduce its impact on people, communities, and the economy.2021Poverty Action c/o Solid GroundWashington$103,934Poverty Action c/o Solid Ground will develop an equity-based dental therapy bill in the state of Washington, along with developing the tools to campaign for the bill.2021Penobscot Community Health CareMaine$4,980Support to Penobscot Community Health Center (PCHC) to purchase equipment to replace damaged and outdated equipment pieces to better serve the needs of their patients.2021Partnership for Southern EquityGeorgia$150,000Partnership for Southern Equity (PSE) is an Atlanta-based nonprofit that seeks to advance equity through an ecosystem-based model. PSE will launch the Just Youth Circle (JYC), a cohort of organizations that will collaborate with youth-adult teams across the American South (east of Texas, south of Virginia), to support and carry out policy advocacy efforts around oral health equity.2021Oral Health Kansas, Inc.Kansas$146,438Support Oral Health Kansas’ broad scope of advocacy activities focused on passing an adult dental benefit policy in Medicaid.2021NYU College of NursingNew York$225,000Supports the New York University College of Nursing (NYUCN) to continue to lead the Oral Health Nursing Education and Practice (OHNEP) Initiative aimed at developing, implementing, and evaluating the impact of a replicable interprofessional model for integrating interprofessional oral health competencies in undergraduate and graduate nursing programs.2021Northwest Portland Area Indian Health BoardOregon$200,000Support the Northwest Portland Area Indian Health Board to expand equitable access to a community-based and representative health provider base through building and implementing the newly authorized Tribal Community Health Aide Program (CHAP) in the three-state region of Washington, Oregon, and Idaho.2021New Hampshire Public Health AssociationNew Hampshire$120,000Advocate for funding for an Extensive Medicaid Adult Dental Benefit in New Hampshire’s state budget and to expand access to oral healthcare for “special populations” in New Hampshire by engaging the provider network.2021New England Medical AssociationMassachusetts$52,976Support the development of a strategic plan for the New England Medical Association.2021NC ChildNorth Carolina$125,000Support NC Child in co-creating a community-driven definition of oral health value and quality that will then be leveraged to advance oral health policy and payment over the next two to three years.2021National Network of Public Health InstitutesDistrict of Columbia$2,673,059Support the financial and programmatic sustainability of the Oral Health Progress and Equity Network (OPEN) as it transitions to a fully independent nonprofit organization.2021National Network of Public Health InstitutesDistrict of Columbia$10,000Support the OPEN National Meeting to bring together the network and advance OPEN’s mission.2021National Council for Mental WellbeingDistrict of Columbia$249,939Support the National Council for Mental Wellbeing (National Council) in implementing a national ECHO learning series focused on testing and expanding new models of integrating oral health care, behavioral health and substance use treatment.2021National Conference of State LegislaturesColorado$50,500Supports the National Conference of State Legislatures (NCSL) to develop new resources, learning, and convening opportunities for state legislators and legislative staff designed to increase their awareness of oral health and policy opportunities adopted by other states.2021National Coalition of Dentists for Health EquityOhio$102,132Support general operations as the organization develops its operational structure, creates content for engaging its membership, and works to increase the size and diversity of its membership.2021National Association of Community Health CentersMaryland$250,000Support the National Association for Community Health Centers (NACHC) to support the safety net in scaling new models of integrated care, expanding the use of population health management tools in safety net dental practices, and exploring new oral health workforce opportunities to expand the diversity in health center workforce.2021Missouri Coalition for Oral HealthMissouri$2,500Supports the 2021 Missouri Oral Health Policy conference, hosted virtually by the Missouri Coalition for Oral Health, with the theme of “Driving Innovation – Meeting Challenges.”2021Ministerial Health Fellowship c/o Cross Street Training and Academic CenterConnecticut$112,275Utilize a Community Health Worker strategy to educate BIPOC community members, oral health advocates, and legislators in Connecticut about systemic issues in oral health, and build community-based connections in order to advocate for policy solutions in collaboration with Connecticut Oral Health Initiative.2021Michigan Primary Care AssociationMichigan$200,000Support the Michigan Primary Care Association to partner with the CareQuest Institute Health Improvement Team to implement the Community Oral Health Transformation (COrHT) Initiative through assessing readiness and building capacity within Michigan community health centers for new models of oral health value-based care and payment.2021Michigan Oral Health CoalitionMichigan$125,000Support the Michigan Oral Health Coalition to advance new, equitable, payment models in oral health for adults on Medicaid, expanding the Michigan oral health data dashboard, and strengthening internal capacities to ensure meaningful use of a health and racial equity lens.2021Massachusetts League of Community Health Centers, Inc.Massachusetts$98,835Support the Massachusetts League of Community Health Centers (Mass League) in expanding use of telehealth and teledentistry in health center dental practices, continuing to build on initiatives that integrate the social determinants of health, and responding to health equity gaps in oral health care.2021Maryland Dental Action Coalition, Inc.Maryland$150,976Maryland Dental Action Coalition will support the expansion of the state’s Medicaid Adult Dental Benefit, the integration of Maryland’s new post-partum benefit, and work to establish a Maryland Coalition on Health Equity.2021Maine Primary Care AssociationMaine$99,183Support to the Maine Primary Care Association advance the operationalizing of oral health value-based metrics, expand capacity and use of interoperability, and strengthen the use of population health management techniques in the Maine safety net.2021Magic Tooth BusCalifornia$4,480Support Magic Tooth Bus with dental equipment repairs and replacements to best serve the needs of their patients.2021Kentucky Youth AdvocatesKentucky115,000.00Kentucky Youth Advocates will develop and advance an oral health advocacy policy agenda using the data procured through policy/advocacy groups. Kentucky Youth Advocates will advocate for a state budget that will optimize the implementation of Medicaid/KCHIP services, fluoridation and teledentistry, as well as increased broadband infrastructure across the state of Kentucky.2021Justice in AgingDistrict of Columbia$90,000Supports Justice in Aging as they deliver a robust advocacy campaign centered around the inclusion of a dental benefit in Medicare.2021Illinois Primary Health Care AssociationIllinois$100,000Support the Illinois Primary Health Care Association in advancing policy and implementation of new interprofessional practice models within the Illinois safety net.2021Hoosier Action Resource CenterIndiana$108,900Hoosier Action Resource Center will create a grassroots movement in Indiana to maintain dental benefits in the Healthy Indiana Plan.2021Hispanic Dental AssociationNew York$150,000Support the Hispanic Dental Association to build a robust set of data, evidence, and capacity to elevate the oral health disparities for Hispanic providers and consumers in order drive equitable state and national policy change.2021Heart and Soul Clinic, IncIndiana$5,000Support general operations as the organization develops its operational structure, creates content for engaging its membership, and works to increase the size and diversity of its membership.2021HealthLink Dental ClinicPennsylvania$2,388Support replacement and repair costs for dental equipment to better serve the patients of HealthLink Dental Clinic.2021Health Disparities Collaborative of Ohio Inc.Ohio$144,900Support data collection from kinship care families across the state of Ohio as part of a larger advocacy plan focused on increased and sustained funding for school-based health services, including oral health services, that are critical for this population of youth and their caregivers.2021Health Care For AllMassachusetts$187,616Health Care For All will work toward equitable oral healthcare in Massachusetts by advocating for policy in four specific issue areas.2021Hawaii Public Health InstituteHawaii$133,392Support the Hawai’i Public Health Institute in advancing oral health equity in Hawaii by advocating for a comprehensive Medicaid adult dental benefit, assessing and advancing new models of person-centered care in the safety net, and supporting policy to address the social determinants of oral health.2021Hawaii Children’s Action NetworkHawaii$99,979Strengthen the Hawaii Oral Health Coalition’s infrastructure, particularly expanding the capacity in the neighbor island coalitions (Maui, Kauai and Hawaii Island) to engage in oral health policy advocacy.2021Harvard School of Dental MedicineMassachusetts$189,122Support the partnership between the Harvard School of Dental Medicine and the Center for Integration of Primary Care and Oral Health in expanding the 100 Million Mouths Campaign which will build champions who will advance efforts for the integration of oral health education into primary care curricula within their state.2021Gennesaret Free ClinicsIndiana$9,304Support to Gennesaret Free Clinic to purchase a new x-ray developer to replace damaged and outdated equipment to better serve the needs of their patients.2021Florida Voices for HealthFlorida$170,000Florida Voices for Health will coalition-build around issues of oral health in Florida, including a Medicaid Adult Dental Benefit expansion, and execute a comprehensive public/legislative support campaign highlighting the voices of Medicaid consumers to advocate for the benefit.2021Florida Public Health Institute d/b/a Florida Institute for Health InnovationFlorida$148,362Support the Florida Institute for Health Innovation in leading statewide oral health advocacy efforts in partnership with the Florida Oral Health Alliance, building new tools to support deeper community and consumer engagement and designing new oral health curricula to support more equitably oral health care for children with special health care needs.2021Families USADistrict of Columbia$675,000Advance federal oral health policies in 2021 through the Oral Health Care for All Campaign, which focuses on timely opportunities to impact Medicaid and Medicare.2021Connecticut Oral Health Initiative (COHI)Connecticut$125,000Support the Connecticut Oral Health Initiative (COHI) in their work to expand the integration of oral health measurement within state infrastructure, building support for value-based payment in oral health, and leading a Medicaid access gap analysis in the state.2021Community CatalystMassachusetts$498,548Support Community Catalyst in implementing a multi-tiered capacity building strategy within CareQuest Institute grantees that focuses on deepening the engagement between historically marginalized communities and state advocacy efforts, while also supporting the federal policy work of the Oral Health Progress and Equity Network (OPEN).2021Colorado Consumer Health InitiativeColorado$100,000Support Colorado Consumer Health Initiative to build a consumer, BIPOC-focused health equity committee in Colorado, develop an oral health organizing plan, and create an oral health equity agenda in collaboration with Colorado Latino Leadership Advocacy and Research Organization.2021Colorado Association for School-Based Health CareColoradoColorado Association for School-Based Health CareSupports Colorado Association for School-Based Health Care’s virtual conference with the theme of “Collective Resiliency and Renewed Focus on Equity.”2021Children’s Alliance (WA)Washington$97,750Support the Children’s Alliance of Washington to engage consumers and coalition members to advance oral health policy in Washington, including dental therapy and community water fluoridation.2021Children’s Action AllianceArizona$175,000Support Children’s Action Alliance in advancing Medicaid policies and regulations in support of comprehensive coverage for pregnant women, scope of practice policies for Affiliated Practice Dental Hygienists, reduce implicit bias within the program and providers, and address specific administrative barriers that are preventing current and former foster youth in accessing necessary orthodontic care.2021Children NowCalifornia$100,000Support Children Now in leading in leading efforts to advance policy in California related to the expansion of telehealth capabilities, the interprofessional practice opportunities for registered dental hygienists in alternative practice, and the planning for the states next 1115 waiver.2021Children NowCalifornia$105,001Support the Children Now in implementing their web-based medical-dental referral and navigation system (MDRAN) in collaboration with a care coordination strategy, built into a fee-for-service payment environment, to improve equitable access to care for low wealth and communities of color in San Joaquin County, California.2021Center for Medicare AdvocacyConnecticut$80,000Support to the Center for Medicare Advocacy to advocate for the coverage of medically necessary oral health care by Medicare and continue to engage with a group of national stakeholders working to include a comprehensive oral health benefit in Medicare.2021Center for Health Policy Development dba National Academy for State Health PolicyMaine$138,448Research models for incorporation of social determinant of health factors in Medicaid dental contracts, learn from state policymakers, and disseminate information nation-wide about concrete solutions for implementation of social determinant of health factors into Medicaid dental contracts.2021Center for Health Care Strategies, Inc.New Jersey$89,974Support the Center for Health Care Strategies to build off of its 2020 research and publication on current trends in value-based payment in oral health to lead research efforts into the barriers and facilitators of oral health inequities within state Medicaid programs, with a focus on adults.2021California Pan-Ethnic Health NetworkCalifornia$150,000Support the California Pan Ethnic Health Network in designing and advancing an anti-racist oral health agenda in California through advocacy coalition activation.2021Asian Resources, Inc. (ARI)California$150,000Support equitable access to healthcare in the Asian American, Native Hawaiian, and Pacific Islander (AANHPI) community by advocating for improved access to disaggregated demographic data collection by government entities, the removal of cultural and linguistic barriers to accessing care, an expansion of Medi-Cal to additional populations, and strategies to foster a more diverse oral health workforce.2021Arkansas Medical Dental Pharmaceutical AssociationArkansas$75,000Support the Arkansas Medical Dental and Pharmaceutical Association expanding the use of a community-based, health equity lens within health care institutions in Arkansas as well as leading the development of an oral health policy agenda.2021Arcora FoundationWashington$208,263Supports a co-funding relationship with the Arcora Foundation in the maintenance and growth of the National Interprofessional Initiative on Oral Health (NIIOH) and the Smiles for Life training program.2021American Dental Hygienists’ AssociationIllinois$15,000Supports the 2021 Opening General Session remarks from Dr. Cara V. James at the American Dental Hygienists’ Association’s annual conference.2021American Academy of PediatricsIllinois$155,597Support the American Academy of Pediatrics in implementing a multi-tiered project to advance oral health integration into pediatric primary care through member-based learning, implementation of a new electronic oral health risk assessment, and strengthening pediatric capacity around population health management.2021American Academy of CariologyCalifornia$20,000Supports the American Academy of Cariology’s annual event, scheduled as two virtual webinars to advance the profession and academy.2021AltaMed Health ServicesCalifornia$150,000Support AltaMed Health services in advancing regional policy and systems change to address the social determinants of oral health through a care-and-community integrated approach that centers racial equity.2021Alaska Primary Care AssociationAlaska$100,000Support the Alaska Primary Care Association in advancing policy and payment associated with oral health value-based care within the dental safety net through advocacy and strengthening interoperable data systems with Alaska health centers.2021Alabama AriseAlabama$150,000Advocate for expanded Medicaid benefits in Alabama, to further develop Arise’s infrastructure around community engagement, train 16 healthcare advocates, and lay the groundwork for oral healthcare advocacy in Alabama.2021ACHIEVA/The Arc of Greater PittsburghPennsylvania$149,803ACHIEVA/Arc of Greater Pittsburgh intends to increase access to oral healthcare for people with intellectual and developmental disabilities in Pennsylvania by applying for a Governor’s Exception Medically Underserved Population (EMUP) designation, as well as develop educational resources for Direct Service Professionals (DSPs) about appropriate oral healthcare support. --- ### [Self-Paced Courses](https://carequest.org/education/self-paced-courses/) **Published:** January 7, 2026 **Author:** Darren Edwards **Content:** # Self-Paced Courses ## On your own time, explore our interactive, self-paced courses — featuring experts from across the industry — on topics shaping the future of oral health (and earn free CEs). ![](https://carequest.org/wp-content/uploads/2026/01/self-paced-hero.png "self paced hero") ## Featured Course ![](https://carequest.org/wp-content/uploads/2026/04/Dental-Fear-and-Anxiety_600x320.png "Dental Fear and Anxiety_600x320") ### Dental Fear and Anxiety: Why It Exists and What Providers Can Do to Help Fear and anxiety related to dental care often create a “cycle of avoidance,” which can lead to missed care, deterioration of oral health, and invasive, costly procedures that negatively impact patients and the overall oral health system. In this course, our experts will explore public perceptions of dental fear and anxiety and potential solutions for preventing and treating it. $ #### Learn more ## All Courses by Topic From minimally invasive care to innovative approaches to treat pediatric patients, our Clinical Practice courses provide the knowledge and skills you need to deliver evidence-based care. [View courses](https://carequest.org/education/self-paced-courses/clinical-practice/) Patients have unique backgrounds, experiences, and values, and the care you provide needs to connect with those individuals. Find tools and resources to create meaningful partnerships in our Person-Centered Care catalog. [View courses](https://carequest.org/education/self-paced-courses/person-centered-care/) Data. Care coordination. Continuous improvement. Running your practice efficiently and successfully is about more than just budgets and billing. Our Practice Management courses help prepare you for the future of dentistry. [View courses](https://carequest.org/education/self-paced-courses/practice-management/) Tailoring oral care to individuals with complex care needs — such as physical, developmental, and cognitive disabilities — is a team effort. Ensure you and your dental colleagues have the knowledge and skills to provide optimal care environments. [View courses](https://carequest.org/education/self-paced-courses/special-patient-care/) ## Accreditation CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [Board of Directors](https://carequest.org/about/board-of-directors/) **Published:** September 24, 2025 **Author:** Darren Edwards **Content:** # Board of Directors ![](https://carequest.org/wp-content/uploads/2025/09/Andrew.png "Andrew") ### Andrew Agwunobi, MD Executive Vice President, Health Affairs and Chief Executive Officer, UConn Health ![](https://carequest.org/wp-content/uploads/2025/09/Kathleen.png "Kathleen") ### Kathleen Betts President, Prizm Advisors LLC ![](https://carequest.org/wp-content/uploads/2025/09/Roderick-1.png "Roderick") ### Roderick King, MD, MPH Senior Vice President, Chief Mission and Engagement Officer, University of Maryland Medical System ![](https://carequest.org/wp-content/uploads/2025/09/Todd.png "Todd") ### Todd Marshall, DDS, MBA Independent Advisor and Consultant ![](https://carequest.org/wp-content/uploads/2025/09/Evelyn.png "Evelyn") ### Evelyn Henry Miller, CPA Board Director, TDIndustries ![](https://carequest.org/wp-content/uploads/2025/09/William.png "William") ### William Mills Chairman of the Board of Managers, Ascension Ventures IV, L.P. ![](https://carequest.org/wp-content/uploads/2025/09/Pam.png "Pam") ### Pam Reeve, MBA Board Chair ![](https://carequest.org/wp-content/uploads/2025/09/Bob.png "Bob") ### Bob Weyant, MS, DMD, DrPH Professor & Chair, Dental Public Health, School of Dental Medicine, University of Pittsburgh ![](https://carequest.org/wp-content/uploads/2025/09/Jessica.png "Jessica") ### Jessica Zeaske, MHS, PhD, MBA Echo Health Ventures, Partner ## Learn More [![](https://carequest.org/wp-content/uploads/2025/11/About__what-we-do.jpg "About__what we do")](https://carequest.org/about/) $ #### What we do [![](https://carequest.org/wp-content/uploads/2025/11/About__leadership.png "About__leadership")](https://carequest.org/about/leadership-team/) $ #### Leadership team [![](https://carequest.org/wp-content/uploads/2025/11/About__careers.png "About__careers")](https://carequest.org/careers/) $ #### Careers --- ### [Value-Based Care](https://carequest.org/about/value-based-care/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Value-Based Care ## Shifting to value-based care — a system focused on quality over quantity — can lower costs and improve patient outcomes. ![](https://carequest.org/wp-content/uploads/2025/11/VBC-Header.jpg "VBC - Header") ## The Shift to Value-Based Care In recent years, both medicine and dentistry have experienced a push to begin rewarding not the quantity of services but the quality of outcomes — a model known as value-based health care. This approach incentivizes prevention and personalization, and typically involves alternative payment models (APMs). APMs can use different frameworks to: ![](https://carequest.org/wp-content/uploads/2025/11/Transforming-OH-vbc-pay.png "Transforming OH - vbc pay") Link financial incentives to improvements in care quality and health outcomes ![](https://carequest.org/wp-content/uploads/2025/11/transforming-OH-vbc-disease-management.png "transforming OH - vbc disease management") Focus on disease management and prevention to lower spending ![](https://carequest.org/wp-content/uploads/2025/11/transforming-OH-vbc-fin-incentives.png "transforming OH - vbc fin incentives") Pay for comprehensive and coordinated services The advantages of a value-based care model are clear: less waste, lower costs, and, most importantly, better oral health for patients. Getting to that reality will take innovation, persistence, and a [redesigned oral health care system](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care). But the shift to [value-based care is already showing promise](https://www.carequest.org/about/blog-post/health-center-michigan-shows-path-value-and-sustainability). ## The Benefits of Value-Based Care Value-based approaches in dentistry focus on prevention and outcomes. They also involve integration of data, care across the continuum, and technological innovations such as teledentistry. A successful value-based care model prevents dental disease and keeps patients healthy. And the payment model ensures a steady revenue stream even if there are fluctuations in care related to any disruptions to practice operations. ![](https://carequest.org/wp-content/uploads/2025/11/vbc.jpg "Cute girl at doctor's office.") ## Improving the Patient Care Experience For more than two centuries, dentists have practiced in a fee-for-service reimbursement environment. Workflows, care delivery, business planning, staffing, documentation, health information technology, scheduling, billing, policies, procedures, and communication have all been designed and implemented around a care and financing model that emphasizes volume over value. The transition to value-based care has the potential to change each of these areas in a significant way. ![](https://carequest.org/wp-content/uploads/2025/11/Traditional-vs-OHVBC-e1762371612154.png "Traditional-vs-OHVBC") ## Signs of Progress Federally Qualified Health Centers (FQHCs), which provide both medical and dental care, have been at the forefront of shifting toward an integrated model that includes value-based care. In Michigan, for example, [MyCare Health Center, a participant in CareQuest Institute’s Community Oral Health Transformation (COrHT) initiative](https://www.carequest.org/about/blog-post/health-center-michigan-shows-path-value-and-sustainability), decreased their cost per visit, decreased their no-show rates, and increased their net revenue within a system that provided quality care and yielded financial success. COrHT, which also operated in North Carolina from 2022–2024, provided a [framework](https://www.carequest.org/resource-library/three-domain-framework-innovating-oral-health-care) for safety net dental clinics to help transform oral health care delivery so it is: 1. Accessible to everyone through innovations ― like [telehealth](https://www.carequest.org/topics/teledentistry) ― that provide care to people who have been traditionally underserved. 2. Focused on prevention and minimally invasive care, including [fluoride applications](https://carequest.org/answers-to-17-of-your-silver-diamine-fluoride-questions/). 3. [Integrated with medical care](https://www.carequest.org/topics/medical-dental-integration) to treat the whole person, because oral health and systemic health are connected. ## Stats 51% In a recent survey, half of (51%) of responding providers had never heard of APMs in dentistry, while 35% had only heard of APMs or knew a little about them, showing that building awareness will be critical in the coming years. $ #### Learn more 635% Teledentistry visits increased by 635% in participating North Carolina practices during COrHT, significantly expanding access to preventive care for underserved and rural populations. $ #### Learn more 70% APMs are increasingly being used both in Medicaid and Medicare. Nearly 70% of Medicaid beneficiaries are enrolled in managed care plans — plans focused on managing costs and patient utilization. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2025/11/vbc-signs-of-progress.jpg "Black man with toothache seeking medical stomatologist health advice") ## The Path Ahead for Value-Based Care Shifting to value-based care and APMs in dentistry involves a significant transformation. Education and outreach will play a critical role. In addition, we need further testing and piloting of value-based care models in dentistry. To make the shift, dental practices will need appropriate technology infrastructure, reporting and analytics systems, and methods to predict utilization and costs. --- ### [CareQuest Innovation Partners](https://carequest.org/about/carequest-innovation/) **Published:** November 6, 2025 **Author:** Darren Edwards **Content:** # CareQuest Innovation Partners ## CareQuest Innovation Partners® is our for-profit subsidiary that funds, scales, and convenes transformative solutions to improve overall health through oral health — for all. ![](https://carequest.org/wp-content/uploads/2025/12/Innovation-Hero.png "Innovation Hero") ![](https://carequest.org/wp-content/uploads/2026/04/FW-1.png "FW (1)") Working with mission-aligned partners, startups, and investors, Innovation Partners helps make oral health more accessible, equitable, and integrated through 3 key focus areas: **Fund:** We mobilize capital, including our own, to accelerate innovation and investments in oral and integrated health. **Scale:** We work with industry leaders to implement sustainable solutions that help people. **Convene:** We source and connect innovators, creating thriving environments and solutions that influence whole-person health. [Learn more at carequestinnovation.com](http://www.carequestinnovation.com/) The link above will lead you to a separate website. --- ### [Minimally Invasive Care](https://carequest.org/about/minimally-invasive-care/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Minimally Invasive Care ## Minimally invasive care (MIC) offers a gentler, more accessible alternative to traditional dental procedures — preventing and treating decay without removing tooth structure. ![](https://carequest.org/wp-content/uploads/2025/11/MIC-header.jpg "Child Boy Receiving Fluoride Treatment from Dentist") ## What Are the Advantages of Minimally Invasive Care? The [simple treatment options](https://learning.carequest.org/#/online-courses/5d7a4d33-b54c-4d65-b3b7-f50becee9b35) of MIC can reduce anxiety, save money, and result in better long-term outcomes. MIC can also help patients (and providers) avoid the cycle of repairs that are often needed with other restorative work, detecting and treating small cavities early. What’s more, MIC can be delivered by different members of the care team, including dental hygienists, dental therapists, dental assistants, and medical providers, which can expand access for patients — especially in rural areas. ## Types of Minimally Invasive Care ### **Silver Fluoride** Silver fluoride is a water-based liquid professionally applied to teeth using a small brush. It contains silver, which kills germs that can cause tooth decay, as well as fluoride, to prevent, slow down, or stop decay. Providers commonly use silver diamine fluoride (SDF) as a treatment for children (and is a valuable option for adults) because it provides less discomfort than the “drill and fill” methods, and many [appreciate its ease of use](https://www.carequest.org/resource-library/provider-and-public-perceptions-silver-diamine-fluoride-sdf). However, SDF is not without downsides: It leaves a black stain on these lesions and may burn or stain the soft tissue surrounding them. ### **Fluoride Varnish** Fluoride varnish is a highly concentrated form of fluoride professionally applied to teeth to prevent tooth decay. It is especially effective with multiple applications. ### **Povidone-Iodine** Povidone-iodine is a water-based liquid that can prevent tooth decay when applied with a cotton swab onto the surface of the tooth. Povidone-iodine treats the disease rather than just repairing its damage. People with elevated caries risk are good candidates for povidone-iodine. ### **Guided Enamel Regeneration** Guided enamel regeneration treats the first stage of tooth decay, known as initial caries. At this stage, there is demineralization, but a cavity hasn’t yet formed that would let bacteria into the tooth. Application of self-assembling peptide (SAP) P11-4 helps to avoid repeated cycles of decay and repair. [Learn more about MIC in our growing collection of self-paced courses. ](https://carequest.org/education/self-paced-courses/) ## CPT Code for Medical Professionals to Apply Silver Diamine Fluoride The addition of [a code for the application of silver diamine fluoride (SDF)](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained) by medical professionals to arrest cavities was a major milestone in advancing an integrated approach to oral health inequities. In 2022, CareQuest Institute, in partnership with several leading oral health and medical organizations including the American Medical Association, championed the change. [Read more about the CPT code ](https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained) ![](https://carequest.org/wp-content/uploads/2025/11/mic-fluoride-app-boy.jpg "Dentist making fluoridation of child boy's teeth after cleaning for protection.") ## Stats 97% Dental caries, or dental decay, is one of the most prevalent human diseases, affecting 97% of the global population throughout their lifetime. $ #### Learn more 90% 90% of 377 dental providers agreed that SDF is an effective choice of treatment. $ #### Learn more 0-3 The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentists (AAPD) encourage medical providers to apply fluoride varnish to infants’ teeth, from birth to age 3. $ #### Learn more 60% Among older adults, SDF prevented 60% of root caries, according to a 2018 study. $ #### Learn more ## The Non-Invasive Caries Therapy (NICT) Guide & Resources ![](https://carequest.org/wp-content/uploads/2025/11/MIC.jpg "Complaining to the doctor about a toothache") The [NICT Guide](https://www.carequest.org/content/non-invasive-caries-therapy-guide) is an illustrated manual on diagnostics, preventives, and therapeutics to fight dental caries without removing any tooth structure. It includes step-by-step instructions on how to: - Differentiate active vs. arrested caries lesions - Apply SDF, SAP P11-4, and more - Perform the Hall technique, which restores decayed primary molars using a metal crown [The Non-Invasive Caries Therapy (NICT) Guide & Resources](https://carequest.org/the-non-invasive-caries-therapy-guide/) --- ### [Medical-Dental Integration](https://carequest.org/about/medical-dental-integration/) **Published:** September 26, 2025 **Author:** Darren Edwards **Content:** # Medical-Dental Integration ## Treating the whole person requires breaking down silos between medical and dental care. ![](https://carequest.org/wp-content/uploads/2025/11/mdi-header.jpg "team of dentists is diagnosing inside conference room treating patient toothache. team of doctors and dentists are meeting to find a way to treat root canals that cause pain due to inflammation.") ## The Connection Between Oral Health and Overall Health Oral health is inextricably connected to overall health. Dental disease can lead to high blood pressure, make it harder to manage diabetes, raise the risk of developing Alzheimer’s disease, and result in pregnancy complications. Good oral health practices and preventive dental care, on the other hand, can benefit overall health. But despite the growing understanding of this relationship, oral health care often remains isolated from the rest of the health care system. Medical-dental integration can help build that critical bridge between oral health and overall health. This approach to care integrates dental medicine into primary care and behavioral health, while also integrating services such as screenings for chronic diseases into dental care. It is an approach to care that encourages providers to come up with comprehensive care plans for the whole person. ## Stats 2-3x People with gum disease have 2 to 3 times the risk of having a heart attack, stroke, or severe cardiovascular event. $ #### Learn more 22% At least one preventive dental visit within three years reduced the likelihood of a ventilator-associated pneumonia (VAP) diagnosis by 22%. $ #### Learn more 10 Having 10 years of chronic gum disease (periodontitis) was associated with a higher risk of developing Alzheimer’s disease. $ #### Learn more 86% Diabetes raises the risk of developing gum disease (periodontitis) by 86%. $ #### Learn more $520M Medicaid spends $520 million annually on dental emergency department visits. $ #### Learn more 27M 27 million people see a dentist but not a physician each year. $ #### Learn more ## The Value of Medical-Dental Integration In addition to improving health outcomes, medical-dental integration can reduce costs. Every year, Medicaid spends $520 million on dental emergency department visits, many of which could be avoided if symptoms were addressed before they became severe. Oral health problems make other conditions worse, leading to [increased expenditures](https://www.carequest.org/resource-library/healthy-mouths-why-they-matter-adults-and-state-budgets) and [negative outcomes](https://carequest.org/the-link-between-ventilator-associated-pneumonia-and-the-mouth/) in other areas of health care, as well. An integrated approach can catch and manage problems earlier. For example, when patients visit their primary care provider, there’s an opportunity to assess oral health risk and reinforce at-home care messaging. This creates an access point for patients who might not otherwise seek dental care, particularly for the most vulnerable populations. ## Recent Progress Toward Integration ![](https://carequest.org/wp-content/uploads/2025/11/mdi-recent-progress.jpg "Prenatal Check-Up") Many community health programs and Federally Qualified Health Centers (FQHCs) are already working toward medical-dental integration. For example, CareQuest Institute’s [MORE Care](https://carequest.org/health-transformation-programs/) initiative engaged primary care practices across the country to integrate oral health competencies and capabilities into their offices while building patient-centered referral networks with local dental providers. These collaborative approaches educate patients about the connections between oral health and overall health, promoting prevention behaviors and strategies. In addition, some dentists provide screenings for chronic diseases such as diabetes, high blood pressure, and cholesterol. [Learn more about medical-dental integration](https://carequest.org/about/medical-dental-integration/mdi-in-action/) ## Care Coordination & Interoperability In order to make medical-dental integration a reality, providers from across the system need tools to coordinate care. This includes ensuring that health information systems are interoperable — that is, that different devices and information systems can access, exchange, integrate, and use data in a coordinated manner. All providers caring for a given patient must have access to the same information and be able to communicate seamlessly with one another. That coordination is critical to providing the right care in the right place at the right time. Interoperability in health care helps make that possible. ![](https://carequest.org/wp-content/uploads/2025/11/mdi-care-coordination.jpg "Dentist examining an x-ray on computer in dental clinic") ![](https://carequest.org/wp-content/uploads/2025/11/mdi-1.jpg "A dentist with dental assistant in modern dental surgery, working.") The oral health system is behind the medical system when it comes to sharing information electronically. One of the major restrictions for information exchange standards in dentistry is the limited use and slow adoption of electronic health records (EHRs) by the industry. In fact, it wasn’t until about 2017 that more than half of dentists utilized EHRs in practice. Dentistry is now in a position of playing catch-up and trying to integrate with the medical system. ## Improving Coordination and Interoperability CareQuest Institute is working with innovators and leading health care organizations — through initiatives such as [MORE Care](https://www.carequest.org/how-we-work/health-improvement-programs/more-care) and [COrHT](https://www.carequest.org/how-we-work/health-improvement-programs/corht) — to identify emerging technologies that will advance care coordination. Also, as part of the Dental Data Exchange Project, CareQuest Institute helped develop the first implementation guides to bridge the communication gap between primary care and oral health care. [View implementation guides ](https://carequest.org/dental-data-exchange-hl7-implementation-guides/) --- ### [In The News](https://carequest.org/news/in-the-news/) **Published:** June 3, 2025 **Author:** Darren Edwards **Content:** # In the News ## Oral health highlights from the world of media, including online news sites, magazines, and TV. [Subscribe to our Newsletter](#subscribe) ## [Becker’s Hospital Review: Nearly 9.6 million Americans have sought dental care abroad: Study](https://carequest.org/in-the-news/beckers-hospital-review-nearly-9-6-million-americans-have-sought-dental-care-abroad-study/) Jun 24, 2026 Nearly 9.6 million people, or 4% of U.S. adults, have traveled outside the country for dental care, primarily seeking lower cost dental treatment, according to a new report from the CareQuest Institute for Oral Health. CareQuest released its “State of Oral Health Equity in America” report June 16 based on a survey of more than 9,300 adults in... [Read more](https://carequest.org/in-the-news/beckers-hospital-review-nearly-9-6-million-americans-have-sought-dental-care-abroad-study/) --- ### [Press Releases](https://carequest.org/news/press-releases/) **Published:** June 3, 2025 **Author:** Darren Edwards **Content:** # Press Releases ## Our press releases will keep you up to date on CareQuest Institute news, issues, and research. [Subscribe to our Newsletter](#subscribe) [Media inquiries](#media) ## [CareQuest Institute Launches National Campaign to Improve Veterans’ Oral Health](https://carequest.org/press-release/carequest-institute-launches-national-campaign-to-improve-veterans-oral-health/) Jun 30, 2026 | 3 min read Veteran-led video, coalition of supporters, and new report highlight urgent need for change June 30, 2026 (Boston, MA) – CareQuest Institute for Oral Health® today launched a major national campaign highlighting the urgent need to improve dental care access for millions of veterans nationwide. At the center of the campaign is a video... [Read more](https://carequest.org/press-release/carequest-institute-launches-national-campaign-to-improve-veterans-oral-health/) --- ### [Clinical Practice](https://carequest.org/education/self-paced-courses/clinical-practice/) **Published:** April 3, 2026 **Author:** Chernise Harris **Content:** # Clinical Practice ## From minimally invasive care to innovative approaches to treat pediatric patients, our Clinical Practice courses provide the knowledge and skills you need to deliver safe, effective care. ![](https://carequest.org/wp-content/uploads/2026/04/spc_clinical-practice-hero.png "spc_clinical practice hero") ## Courses ![](https://carequest.org/wp-content/uploads/2026/04/Connecting-Caries-Risk-Assessments-and-Cultural-Awareness_600x320.png "Connecting Caries Risk Assessments and Cultural Awareness_600x320") ### Connecting Caries Risk Assessments and Cultural Awareness As a key component of preventive care, evaluating a patient’s caries risk is pivotal for their overall health and well-being. But how can one determine the most effective assessment method? Once risks are identified, how can they be communicated to patients using a culturally humble approach? Learn more in this course. $ #### Learn more ### Glass Ionomer Cement: Prevention and Beyond This course is for dental professionals and students who want to learn about using glass ionomer cement (GIC) in clinical dentistry. The course highlights the unique properties of GIC, including prolonged fluoride release, remineralization, and antibacterial activity. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Glass-Ionomer-Cement-Prevention-and-Beyond_600x320.png "Glass Ionomer Cement Prevention and Beyond_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/Innovative-Pediatric-Dental-Care-Exploring-Minimally-Invasive-Procedures_600x320.png "Innovative Pediatric Dental Care Exploring Minimally Invasive Procedures_600x320") ### Innovative Pediatric Dental Care: Exploring Minimally Invasive Procedures Despite their proven benefits, minimally invasive care techniques remain underutilized in clinical practice. This course will equip dental professionals with the knowledge and tools to integrate evidence-based, minimally invasive solutions into pediatric care. $ #### Learn more ### Managing Dental Caries: Evolving Strategies and Proven Techniques This course will cover caries management strategies, including screening, prevention, nonrestorative treatment, and minimally invasive care. It will examine the risks, benefits, and mechanisms of current preventive chemotherapeutics for nonrestorative caries management while emphasizing the practice of personalized prevention recommendations for patients. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Managing-Dental-Caries-Evolving-Strategies-and-Proven-Techniques_600x320.png "Managing Dental Caries Evolving Strategies and Proven Techniques_600x320") ![](https://carequest.org/wp-content/uploads/2026/04/Minimally-Invasive-Care-in-Dentistry-Healthing-Tooth-Decay-with-Brush-On-Therapies_600x320.png "Minimally Invasive Care in Dentistry Healthing Tooth Decay with Brush-On Therapies_600x320") ### Minimally Invasive Care in Dentistry: Healing Tooth Decay with Brush-On Therapies Minimally invasive care emphasizes early detection of caries (tooth decay) and uses therapeutic techniquest to prevent and stop caries from progressing. In this course, we’ll explore methods such as silver fluoride, fluoride varnish, self-assembling peptide P11-4, and povidone-iodine. $ #### Learn more ### Updating Your Knowledge of Dental Caries: Causes, Concerns, and Considerations This course will provide updated information and insights on dental caries. The lessons will summarize the newest findings on the epidemiology of caries disease and explore the etiology of dental caries, including the role of host factors, saliva, diet, and oral hygiene. $ #### Learn more ![](https://carequest.org/wp-content/uploads/2026/04/Updating-Your-Knowledge-of-Dental-Caries-Causes-Concerns-and-Considerations-Course_600x320.png "Updating Your Knowledge of Dental Caries Causes, Concerns, and Considerations Course_600x320") ## More Courses by Topic ## Practice Management 5 Courses Available [View courses](https://carequest.org/education/self-paced-courses/practice-management/) ## Person-Centered Care 6 Courses Available [View courses](https://carequest.org/education/self-paced-courses/person-centered-care/) ## Special Patient Care 4 Courses Available [View courses](https://carequest.org/education/self-paced-courses/special-patient-care/) ## Accreditation CareQuest Institute for Oral Health is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at [ADA.org/CERP](http://www.ADA.org/CERP). ![](https://carequest.org/wp-content/uploads/2025/08/ADA_AGD-logos-1.png "ADA_AGD logos (1)") ### Have questions about our educational offerings? Check out our FAQs page to learn more. [FAQs](https://carequest.org/faq/) --- ### [About CareQuest Institute](https://carequest.org/about/) **Published:** September 19, 2025 **Author:** Darren Edwards **Content:** # About CareQuest Institute ## At CareQuest Institute, we are working to improve everyone’s oral health — because oral health *is* health. ## We Champion Oral Health Transformation Our health care system is not built to work for everyone — people of color, those living in rural communities, people with disabilities, older adults, and other historically underserved groups have been left behind. And many chronic diseases — like diabetes and high blood pressure — are connected to poor oral health. To help people stay healthy, we are working to create a system that is accessible, equitable, and integrated. How do we do that work? We advocate for policy changes, support communities through grants, conduct research, educate providers, and invest in innovative products and services. Together, every day, that work is focused on creating a health care system that is designed for everyone. ## Our Areas of Focus We partner with thought leaders, health care providers, patients, and stakeholders at all levels to change oral health care through our Focus Areas. ![](https://carequest.org/wp-content/uploads/2025/10/CQI-Org-Graphic_FINAL_wheel_old-language_innovation.png "CQI Org Graphic_FINAL_wheel_old language_innovation") [![](https://carequest.org/wp-content/uploads/2025/11/PA.png "P&A")](https://carequest.org/policy-advocacy/) ### Policy & Advocacy We drive federal and state oral health policy change through in-depth analysis, strategic policymaker engagement, supporting coalitions, and mobilizing advocacy networks. $ #### Learn more [![](https://carequest.org/wp-content/uploads/2025/11/grantmaking.png "grantmaking")](https://carequest.org/grants-overview/) ### Philanthropy We address complex and upstream drivers of oral health disparities by investing strategically and providing collaborative, capacity-building support that leads to healthier communities. $ #### Learn more [![](https://carequest.org/wp-content/uploads/2025/11/Innovation.png "Innovation")](https://carequest.org/about/carequest-innovation/) ### Innovation Our for-profit subsidiary, CareQuest Innovation Partners, focuses on funding, scaling, and convening transformative solutions to improve overall health through oral health — for all. $ #### Learn more [![](https://carequest.org/wp-content/uploads/2025/11/ADI.png "ADI")](https://carequest.org/research-and-analytics/) ### Analytics & Data Insights We use our extensive database and unique analytical skills to tell data-driven stories that reveal timely insights and inspire change in oral health. $ #### Learn more [![](https://carequest.org/wp-content/uploads/2025/11/Education.png "Education")](https://carequest.org/education/) ### Education We educate dental and medical professionals, students, and community partners who are committed to gaining the knowledge and skills required to improve their individual practices and contribute to the broader transformation of our oral health care system. $ #### Learn more ## Values That Drive Our Actions Our values are core to our work and central to how we measure our success. ![](https://carequest.org/wp-content/uploads/2025/11/carequest-values-scaled.png "carequest values") ## Learn More [![](https://carequest.org/wp-content/uploads/2025/11/About__leadership.png "About__leadership")](https://carequest.org/about/leadership-team/) $ #### Leadership team [![](https://carequest.org/wp-content/uploads/2025/11/About__BOD.png "About__BOD")](https://carequest.org/about/board-of-directors/) $ #### Board of Directors [![](https://carequest.org/wp-content/uploads/2025/11/About__careers.png "About__careers")](https://carequest.org/careers/) $ #### Careers --- ## Categories ### [Uncategorized](https://carequest.org/category/uncategorized/) --- ### [Press Release](https://carequest.org/category/press-release/) --- ### [Blog](https://carequest.org/category/blog/) --- ### [In The News](https://carequest.org/category/in-the-news/) --- ### [Resource](https://carequest.org/category/resource/) --- ### [Dashboard](https://carequest.org/category/resource/dashboard/) --- ### [Journal Article](https://carequest.org/category/resource/journal-article/) --- ### [Presentation](https://carequest.org/category/resource/presentation/) --- ### [Tool](https://carequest.org/category/resource/tool/) --- ### [Video](https://carequest.org/category/resource/video/) --- ### [Visual Report](https://carequest.org/category/resource/visual-report/) --- ### [Publication](https://carequest.org/category/resource/publication/) --- ## Tags ### [Clinical Practice](https://carequest.org/tag/clinical-practice/) --- ### [Health Equity](https://carequest.org/tag/health-equity/) --- ### [Medical-Dental Integration](https://carequest.org/tag/medical-dental-integration/) --- ### [Minimally Invasive Care](https://carequest.org/tag/minimally-invasive-care/) --- ### [Person-Centered Care](https://carequest.org/tag/person-centered-care/) --- ### [Practice Management](https://carequest.org/tag/practice-management/) --- ### [Special Patient Care](https://carequest.org/tag/special-patient-care/) --- ### [Value-Based Care](https://carequest.org/tag/value-based-care/) --- ### [Dental Coverage](https://carequest.org/tag/dental-coverage/) --- ### [Access to Care](https://carequest.org/tag/access-to-care/) ---