HEALTHY PEOPLE 2020: ORAL HEALTH

VILLAGE POINTE

Lauren New, Caroline Survill, Maggie Clough, Katherine Tan, Kendra Morris, Katelyn Onley, Mark Managuio,
Emily Sybert, Samantha Callahan, & Fran Paraguas

OBJECTIVE: OH-4
OH-4 Reduce the proportion of adults who have ever had a permanent
tooth extracted because of dental caries or periodontal disease
o OH-4.1 Reduce the proportion of adults aged 45 to 64 years who have
ever had a permanent tooth extracted because of dental caries or
periodontal disease
o OH-4.2 Reduce the proportion of adults aged 65 to 74 years who have lost
all of their natural teeth

STATUS OF THE PROBLEM FOR OTHER NATIONS
• Dental Caries major issue in most
industrialized countries
• Historically most important global
oral health burden
• Dental caries and periodontal
disease affect nearly 100% of adults
• While currently about 30% of the
world’s population aged 65–74 lose
all their natural teeth

http://www.who.int/oral_health/en/

Barriers

Strategies

• Impaired mobility

• Understand causes and
consequences
• Reduce burden of
disease
• Prevent
noncommunicable
diseases
• Develop systems to
improve outcomes
• Integrate and implement
policies to promote
health

• Unavailable resources
• Finances
• Poor attitudes
• Lack support or live
alone
• Decreased knowledge

http://www.who.int/oral_health/en/

STATUS OF THE PROBLEM WITHIN THE UNITED
STATES
Prevalence of untreated dental caries and
existing dental restorations in teeth, by age:
United States, 2005–2008

(Centers for Disease Control and Prevention, 2012)

Reasons for not obtaining dental care: United States,
(2014)

STATUS OF THE PROBLEM WITHIN THE UNITED
STATES

Barriers

Access to care
o Financial
o Physical
o Cultural

Education

Oral Health Literacy

Strategies

Federal and state assistance programs

Promoting prevention and education

Emphasize disease prevention and
oral health promotion
www.citylab.com

STATUS OF THE PROBLEM OF THE COMMUNITY
According to Virginia Healthcare Foundation:
o 3.8 million Virginians have no dental insurance.
o 66 Virginia localities have no dental safety net provider.
o Although 81 Virginia localities now have a common dental provider, in many
cases it’s only offered on a part-time basis!

Dental Statistics and Research. (2015).

STATUS OF THE PROBLEM OF THE COMMUNITY
Trends:
• 67% have not been to a dentist in 1-2 years!
• 50% described their teeth or denture condition as “fair”
• 50% have either partial or full dentures
• 34% do not have dental insurance, 34% have Medicaid insurance, 32% have private
insurance
• 34% do not have transportation to dentists
• 17% are fearful of the dentist
• 17% cannot afford dental care

DENTAL SAFETY NET
What is a dental safety net?
• Contract between the private dental
sector and Federally qualified health
centers

Benefits of dental safety nets:



Alleviates backlog
Increases efficiency during peak times
Decreases staff overhead
Private providers are paid by health
center
• Avoids billing patient or Medicaid

DENTAL SAFETY NET
• 66 localities do not have a DSN
o Over 4,000 licensed dentists in
Virginia
o Less than 25% accept
Medicaid coverage due to
reimbursements
o Not all clinics offer every
service
• $11 million has been donated to
enhance DSN programs.
In 2013:

• Partnership companies provide
discounted equipment, supplies &
technology to dentists




80 community based dental clinics
63 localities
35 free and charitable clinics serving adults
14 free standing clinics

LOCAL FREE DENTAL CLINICS
Who?

• Uninsured and low socioeconomic status

How?

• Independent, non-profit, volunteer driven
• Open on an individual clinic basis

Where?
Cost?

• Small fee or no fee
• Each clinic requirements vary
• Income restricted (based of Federal
Poverty Level)

FREE CLINICS

OTHER COMMUNITIES: SUCCESSFUL PROGRAMS
• Thrive Dentistry OnSite
o Targets the elderly population
o Mobile, local, year-round care
o Attends 7 sites
• ADA with MOM
o Annual clinic in US
o Extensive care
o Very popular
http://www.thrivedentistryonsite.com
http://www.ada.org/en/publications/ada-news/2014-archive/october/this-was-a-blessing/

OTHER COMMUNITIES: SUCCESSFUL PROGRAMS

MI Health Link
o Experimental clinics coordinating
all health care
o For low-income seniors
o Only 36,000 enrolled

San Antonio Christian Dental Clinic
o Year-round, stable clinic
o Reaches thousands of homeless,
elderly, and underserved
o Expanding work

https://sachristiandental.org/
http://www.freep.com/story/news/local/michigan/2015/11/08/dual-eligible-mi-program/75106230/

THE NATIONAL TRENDS FOR THE LAST DECADE
• 65 years and older have lost all of their
natural teeth due to tooth decay or gum
disease.
o 2002  22.2%
- 27.0%
o 2012 16.2%
• 65 years and older who had untreated
dental caries
o 2002 18.4%
o 2012 18.9%
+ 2.6%

(Centers for Disease Control and Prevention, 2015)

• 65 years and older who visited the
dentist each year.
o 2002  54.8%
o 2012  60.6%
+
9.5%

THE LOCAL TRENDS FOR THE LAST DECADE
• 65 years and older in Virginia have lost
all of their natural teeth due to tooth
decay or gum disease.
o 2002  21%
- 23.3%
o 2012  16.1%

• Virginian adults and older adults
who have dental insurance
coverage
o 2000  63%
o 2008  72%
+ 14.3%

• 65 years and older in Virginia who are
missing any teeth.
o 1999  55.2%
o 2010  38.6%
- 30.1%

• Medicaid Expenditures for
Dental Services in Virginia
o 2002  5%
o 2010  45%

(Centers for Disease Control and Prevention, 2015)

+ 800%

RECOMMENDATIONS FOR GAPS IN SERVICE
• Increase awareness of the available educational programs in Virginia available
for older adults in regards to dental care
o Senior Smiles, Virginia’s Oral Cancer Project, Diabetes & Oral Health Oral Health for
the Elderly and Disabled, & Oral Health & Overall Health – A Healthy Body Begins
Here

• Help Obtain Financial Assistance
o In a study it was found that 60% of older adults who did not get needed dental services
reported that financial constraints prevented them from accessing care (Montini, T., Tuo-Yen, T.,
Patel, H., & Shelley, D., 2014).

PACE PROGRAM
• PACE (Program of All-Inclusive Care for the Elderly) a Medicare and Medicaid
program that “helps people meet their health care needs in the community…”
o Includes dentistry
o Local PACE programs in community
o Sentara PACE
 665 Newtown Road South Suite 121 Virginia Beach, VA 23462
 Suzanne Coyner

o

Riverside PACE
 493C Oriana Road Newport News, VA 23608

GAPS IN SERVICE CONT.
• Virginia Oral Health Coalition
• Goals of Coalition:
o Increase Public Awareness
o Increase Provider Education
o Advocacy in VA for state laws to support dental care
• Virginia Dental Association Foundation
• Donated Dental Services (DDS): Provides comprehensive dental care to eligible

seniors and adults with disabilities
• “In Virginia, Medicaid and Medicare provide little or no dental coverage for
adults.”

GAPS IN SERVICE CONT.
• Access to Free Medical and Dental

Clinics
• Park Place Medical Center in
Norfolk, VA and other locations
• Opt for dental care from dental

schools for good low-cost care
• ODU provides dental clinics
attended by dental hygiene
students; provide basic oral care

PROGRAM IMPROVEMENT
• Access to transportation
o FQHC does not provide transportation for patients
• Expansion of dental services offered at safety net clinics
o physical expansion
o contracting with private practices
• Increasing familiarity among oral health professionals and other practices in order to
provide collaborative care

ADDITIONAL RESEARCH NEEDED
• Where are the most dental offices located (North vs South) - could be a contributing
problem to why the south had fewer dental visits in 2011
• Long-term feedback from newly emerging dental clinics/programs. How could these
ideals be applied to other programs - standardized model for a program in Virginia
• Any mobile clinics specific for Virginia
• Advertisement for these programs? - How is the knowledge reaching the community?
• Stats for local trends in Virginia

REFERENCES
Centers for Disease Control and Prevention.(2012). NCHS data brief. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db96.htm#among
Centers for Disease Control and Prevention (2015). Explore Oral Health Data by Topic. Retrieved November 12, 2015 from
http://nccd.cdc.gov/OralHealthData/rdPage.aspx?rdReport=DOH_DATA.ExploreByTopic&islTopic=ADT&islYear=2010&go=GO
Crozier, S. (2014, October 13). This was a blessing: Mission of mercy surpasses expectations, treating more than 1,200. ADA News. Retrieved from http://
www.ada.org/en/publications/ada-news/2014-archive/october/this-was-a-blessing
Dental Statistics and Research. (2015). Retrieved November 12, 2015, from http://www.vhcf.org/data/statistics-and-research-on-dental-access/
Erb, R. (2015, November 8). New program gives expanded care for low-income people. Detroit Free Press. Retrieved from http://www.freep.com
/story/news/local/michigan/2015/11/08/dual-eligible-mi-program/75106230/
Increasing Access to Dental Care through Public Private Partnerships: Contracting Between Private Dentists and Federally Qualified Health Centers. (n.d.). An
FQHC Handbook.
Montini, T., Tseng, T. Y., Patel, H., & Shelley, D. (2014). Barriers to Dental Services for Older Adults. American journal of health behavior, 38(5), 781-788.
Thomas Wall, Kamyar Nasseh, Marko Vujici. (2014). Most important barriers to dental care are financial, not supply related. American Dental Association.
Retrieved from http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_2.ashx