Oral Health Newsletter Volume 4

The Division of Oral Health (DOH) has published the Illinois Oral Health Plan IV: Eliminating Inequities in Oral Health (2021-2025). This plan provides an assessment of the current state of oral health care in Illinois and sets goals for reducing inequity and increasing oral wellness.

The Illinois Oral Health Plan IV (IOHP IV) sets five overarching goals to improve access, knowledge, wellness behaviors, infrastructure, and quality of care. These align with the National Institute of Dental and Craniofacial Research's new report Oral Health in America: Advances and Challenges.

IOHP IV was developed in collaboration with oral health providers and stakeholders across Illinois with an emphasis on the role of social determinants of health in creating unequal oral health outcomes. Social determinants of health are defined as "the conditions in which people are born, grow, live, work, and age." These determinants include socioeconomic status, awareness, education level, employability, ability level, experiences of racism, geographic location, access to services, and opportunities to succeed.

Oral health and social determinants of health often have a bi-directional impact on one another, as poor oral health may result in lost workdays, social embarrassment, and difficulties with speech, eating, and completing daily tasks.

We are all challenged with developing policies, collaborations, programs, and processes that improve the oral and overall health of Illinoisans.

IOHP IV is now available on the DOH website at https://dph.illinois.gov/topics-services/prevention-wellness/oral-health/oral-health-plans/oral-health-plan-iv.html

Oral Health in America: Advances and Challenges was released in December 2021 and documents the continued inequities in oral health, many of which are based on age, economic, geographic, and other variables. This report was written and edited by luminaries in the oral health field and again offers learnings, ideas, and specific recommendations that will improve the oral health of individuals, communities, the state, and the nation.

In this updated assessment of oral health in America, bacterial-mediated oral conditions are tied to overall health and well-being, social and economic success, and quality of life. The report highlights opportunities to improve access to oral health care through workforce innovations, collaborations across professional and lay groups, and bringing health promotion and prevention messaging outside the walls of the traditional dental office.

The report also challenges us to connect pain, mental health, and substance abuse to oral conditions and find ways to support and to provide timely care that addresses this constellation of challenges.

The report offers three important calls to action that will significantly improve oral health. Many of these ideas mirror oral health findings in Illinois and recommendations in IOHP IV. They include:

• To significantly improve the nation’s oral health, policy changes are needed to reduce or to 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, it is necessary to diversify the composition of the nation’s oral health professionals, address the cost of educating and training the next generation, and ensuring a strong research enterprise dedicated to improving oral health.
  

The whole of Oral Health in America and fact sheets are available at https://www.nidcr.nih.gov/oralhealthinamerica

For questions, comments, and to highlight your work on Illinois Oral Health Plan IV, contact us at DPH.OralHealth@illinois.gov.

Tyra Jones has always had a heart for helping others. She began her journey as a community health worker (CHW) and now serves as the Educational Lead for SIU’s Office of Community Care. As a CHW, Jones would hit the pavement to bring the most underserved patients into clinics and connect them with needed resources. “We are essential,” she said of CHWs, “because there's people out here who are in the street and in marginalized areas that need services. We don’t wait for the patient to come into our agency, we’re going out to get them.”

According to the American Public Health Association, a community health worker is a frontline public health worker who is trusted member of the community served. CHWs find medical and dental homes for patients, connect them with social services, and provide education to help patients take charge of their health. For Jones, this means being “the hands and feet of the doctors.”

“[We] create relationships with people that a physician or somebody may not have time to cultivate,” she said. “It’s more than just keeping people out of the emergency room. It’s helping people who need food, helping people who need housing. It’s helping people who have been devastated by life get hooked up with counseling services.”

In 2019, a Heath Resources and Services Administration (HRSA) workforce grant to IDPH allowed for an oral health module to be added to the SIU School of Medicine curriculum for CHWs. The module includes information about oral hygiene, oral diseases, the relationship between oral health and overall health, and overcoming common barriers to good oral health. To date, 139 CHWs have been educated in oral health concepts and 93% of them work or live in a dental health professional shortage area.

“When we introduced oral health to our ECHO curriculum, it was like a lightbulb went off.” said Jones. "We should have been doing this all along.” Many of her patients had never learned about the importance of going to a dentist or taking care of their oral health. “They need to know that it’s just as important as anything else that they may be dealing with,” she said.

Jones’ training with oral health has helped her better serve and educate her patients. She described one patient who had a toothache but was wary of seeing a dentist because she had no prior experience with them. Jones reassured her and explained what the dentist would do. Afterward, the client proudly carried a toothbrush in her bag and switched from soda to water to prevent further dental issues.

“It just takes being aware and having that education to share with your patients. I was able to talk to my patient about her visit. She and I visited the dentist together. This encouraged her and motivated her,” said Jones.

In the future, Jones would like to implement specialized training for CHWs interested in oral health. She imagines sending them out to educate and to advocate for oral health and care for patients who need more and complicated care. “We do have some CHWs who are interested in more of the technical side of oral health,” she said. “With further training, they would become experts for these patients.”

The next CHW oral health trainings are tentatively scheduled for February 17, (in Spanish) and Feb. 23 (in English). Reach out to DPH.OralHealth@illinois.gov for registration and more information.

February is National Children's Dental Health Month. The American Dental Association (ADA) has announced that the theme for 2022 is "Sealants Make Sense."

Dental sealants are thin coatings applied to the chewing surfaces of the back teeth to prevent decay. They stop 80% of dental caries/cavities from starting in the back teeth, where 9 in 10 cavities occur. Molar teeth should have a sealant put on as soon as they appear in the mouth to protect them from cavities. This is typically between ages 6 and 11-12 years of age.

Educational and promotional materials for National Children's Dental Health Month, including posters, activities, and a program planning guide, are available at https://www.ada.org/resources/community-initiatives/national-childrens-dental-health-month.

Like many rural counties in Illinois, Wabash County is a dental health professional shortage area for low-income patients, with the nearest Medicaid-accepting dental clinic more than 30 miles away. Wednesday's Child, a nonprofit group, is helping to address this issue for low-income children. They provide referrals, funding, and transportation for children experiencing dental emergencies.

Sandra Ward, the chair of Wednesday's Child Board, has become passionate about meeting the dental needs of children in her community. “If the child has a toothache, and it’s disrupting their school—and of course it’s disrupting their health—then we’ll do whatever it takes to get that child taken care of,” she said.

Ward stressed that many families experience barriers to dental access. "These families work, and if they don’t work, maybe they don’t have the transportation or the money to buy the gas to get out of town,” she said. In these cases, Wednesday's Child Board members often give families a ride themselves.

The Wednesday's Child Board consists of representatives from the local school district, health department, hospital, as well as local dentist practices, nonprofits, and banks. For Ward, this collaboration is key. “Everyone comes from a different background, but their background is important to our community," she said. “If you need something done, they’ll come together and get it done.”

This year, 16 children have received emergency care through the group's advocacy. Ward and other community members successfully advocated to bring an in-school dental provider to the district. Looking forward, she would like to see more preventative services and education, particularly for young children. "If we could catch them before preschool, it would help. That’s our goal," she said.

On January 26, IDPH's Comprehensive Cancer Control Program and Division of Oral Health will host a webinar entitled “Oral Health Practitioners and Cancer Prevention through HPV Vaccination.” The event will take place via Webex from 12-1pm CST. The webinar aims to improve oral health professionals’ understanding of current human papillomavirus (HPV) policies, guidelines, and resources and to help them develop strategies to promote HPV vaccination and to make referrals for eligible patients.

Each year, more than 33,000 Americans die from HPV-related cancers, and HPV-linked oropharyngeal cancer cases are increasing. The HPV vaccine is highly effective at preventing infection and related cancers. Healthy People 2030 aims to increase the HPV vaccination rate in adolescents ages 13-15 to 80%. In Illinois, the current vaccination rate is 50.1% for this population. HPV vaccination is recommended for children at age 11 or 12, or adults up to age 26 who have not yet been vaccinated against HPV.

Dr. Sharon Perlman, one of the webinar speakers, will emphasize the importance of oral health workers' involvement in this effort. “Oral health care professionals have the power to prevent cancer by promoting the HPV vaccination,” she said. “This training will outline easy-toimplement strategies for all members of the dental team and the oral health community to play an active role in reducing the incidence of this devastating cancer.”

The webinar will also feature Michael P West, J.D., who is a survivor of Stage IV throat cancer, and Christopher Morrow from the IDPH Division of Immunization. West will speak about the significant challenges that patients fighting oropharyngeal cancers often face.

One hour of continuing education will be offered to dentists and registered dental hygienists, provided they register individually. Participants may register at https://illinois.webex.com/illinois/j.php/RGID=rca41dade3b53ed1a5df5f0f509a18029. To learn more about oral health providers' role in preventing HPV-related cancers visit the National HPV Vaccination Roundtable’s resource guide for dental providers.