Oral Health Newsletter Volume 14

In the vast field of public health, few shine as brightly as Pedro X. Medina Cuevas, MPH. His journey in public health, which was initially rooted in microbiology and epidemiology, took a significant turn due to the challenges of the COVID-19 pandemic. This pivotal moment led him to focus on oral health, recognizing its profound impact on overall health.

With his expertise, Pedro has spearheaded changes that significantly impact oral health care on a population level. His tenure at the Oral Health Section saw the development of a customized data collection and analysis tool for the Basic Screening Survey. This tool, implemented in more than 120 schools across the state, will greatly enhance the ability to monitor and address the oral health needs of countless children.

Additionally, Pedro authored two essential annual oral health surveillance briefs. These briefs have become invaluable in guiding public health strategies and ensuring informed decision-making within the state. One of Pedro's most significant projects was the creation of the Illinois Oral Health Surveillance System. This project has improved data collection efficiencies and provided deep insights through the annual surveillance briefs. These insights have shaped public health discussions and interventions, demonstrating the effectiveness of data-driven public health advocacy.

Looking to the future, Pedro aims to continue his impactful work by leading initiatives designed to reduce health disparities and increase access to preventive care services. He is deeply committed to addressing systemic issues through policy advocacy, aiming to promote health equity locally and nationally. As Pedro continues contributing to public health, he aspires to leave a legacy of interventions that enhance the quality of life for underserved populations. By promoting a culture of collaboration and innovation, he aims to mentor the next generation of public health professionals, ensuring that his knowledge and passion are passed on to future leaders in the field.

Pedro’s journey with the Oral Health Section is a testament to dedication and innovation. It inspires many to pursue a path of service and continuous learning in this dynamic field. We celebrate his achievements and eagerly anticipate his ongoing contributions to public health.

The DeWitt/Piatt Bi-County Health Department is making great strides in improving oral health. Through expanded clinic hours, outreach at nursing homes, school-based programs, and the innovative use of community health workers (CHWs), the department is enhancing access to preventive dental care for families, children, and older adults.

The department's efforts include offering school-based dental screenings, fluoride treatments at Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics, and on-site dental care at nursing homes. This year, with support from the Illinois Department of Public Health’s Oral Health Promotion Program grant, the department expanded its in-school presentations, reaching more than 373 students with lessons on oral hygiene. “The need for education is still vital,” says Amanda Miller, public health dental hygienist (PHDH), who has managed the school program for nearly 20 years. While some schools have yet to engage with the program entirely, participation is growing, which reflects the community’s increasing awareness of the importance of oral health. Local WIC clinics offer fluoride treatments and follow-up education, helping families understand preventive dental care and how their Medicaid benefits can support oral health. “Many families didn’t realize how Medicaid benefits could support their dental care,” explains Michelle Whitted, the department’s CHW. Her follow-ups have led to more family appointments and have even encouraged extended family members to access preventive care.

These efforts are already showing results. During school screenings, students excitedly share what they’ve learned about brushing and flossing, often relaying this information to their families. In one case, a parent initially declined a fluoride treatment for her child, unsure of its benefits. After speaking with CHW Michelle Whitted, the parent learned how fluoride helps prevent cavities, which prompted her not only to accept the treatment but also to schedule preventive care for other family members.

The department's outreach to nursing homes is also expanding. Using portable dental equipment, Miller provides on-site cleanings and oral health evaluations for elderly residents, many of whom face barriers to accessing regular dental care. She also started training certified nursing assistants (CNAs) in primary oral health care, filling an essential gap in the daily care routines of nursing home residents. "Seeing the gratitude from nursing home residents is incredibly fulfilling," Miller says, "and it motivates us to continue growing our outreach efforts."

The department's activities align closely with the goals outlined in Illinois' Oral Health Plan. The plan focuses on prevention, education, and improving access to care for all residents, and the department's holistic approach is helping to build a foundation for lifetime oral health.

For more information on the DeWitt/Piatt Bi-County Health Department’s programs and services, visit https://dewittpiatthealth.com. To get in touch or schedule an appointment, visit their contact page.

Research studies taken from small samples have determined that the same bacterium, Porphyromonas gingivalis (P. gingivalis), which is commonly linked to periodontal disease, has been associated with and related to patients diagnosed with dementia and the possible development of Alzheimer's disease. The National Health and Nutrition Examination Survey (NHANES) studied the link between oral bacterial infections and gum disease and the correlation to dementia diagnoses. The analysis revealed that patients 65 years of age or older with oral health disease were more susceptible to death and the development of Alzheimer's disease, given the high antibodies against P. gingivalis.

P. gingivalis, an inflammatory bacteria in the oral cavity, passes into the bloodstream through normal activities, such as chewing and daily oral health care, and invasive dental procedures. A disturbance in the flora of the mouth causes the P. gingivalis bacteria to enter the bloodstream. The inflammatory response can disrupt the blood-brain barriers and allow the bacteria to cross the blood-brain barriers, increasing the sequence of effects that cause dementia. Studies propose that when the P. gingivalis cells contact the brain, the bacteria may trigger an immune response, causing the already affected cells to release additional chemicals known to destroy neurons. Early speculated studies indicate this one composition may create deterioration in the brain by generating symptoms of confusion that are characteristic of Alzheimer's disease, especially for those individuals who may already be at risk for the disease.

Additional long-term studies with more extensive study group populations are needed to prove this hypothesis further, and it cannot be determined at this time if poor oral health care is a high risk for dementia in healthy people. Findings have proved dementia could be the cause of oral infectious disease given the challenges individuals may encounter by not having the mental capacity to perform basic oral health care skills effectively, therefore increasing the chance of gum disease. Ongoing research studies will continue to explore whether P. gingivalis can be a guide to a marker with simple blood tests to predict the development of Alzheimer's disease in at-risk patients.

This December, our attention to an often-overlooked connection: the impact of attention-deficit hyperactivity disorder (ADHD) on oral health. According to a recent CareQuest Institute report, adults with ADHD—a condition affecting nearly 9 million in the U.S.—face distinct oral health challenges. These include higher rates of dental decay and gum disease, partly due to ADHD-related behaviors and the side effects of medication, which often reduce saliva production. Many also report embarrassment about their oral health and disproportionately rely on emergency dental services.

For dental professionals, this emphasizes the importance of tailoring care to the unique needs of this population. Dental providers also play a crucial role in supporting patients with ADHD. Strategies such as creating structured care routines, offering reminders, and using tools like fluoride varnish can make oral care more manageable. Understanding ADHD's influence on oral habits and working closely with patients to establish manageable routines can foster significant improvements.

The CareQuest Institute’s Stories of Impact highlights how collaborative efforts across communities, providers, and policymakers drive positive changes in oral health care. From integrating medical and dental services in Ohio to expanding Medicaid dental benefits in Arizona, these stories showcase the tangible results of advocacy and innovation. For instance, initiatives like teledentistry in North Carolina and support for individuals with disabilities emphasize equity and access.

These compelling narratives inspire action toward a more inclusive oral health system. Explore more at Stories of Impact | CareQuest Institute for Oral Health

Share this newsletter with colleagues, patients, and caregivers to spread awareness. Together, we can ensure oral health care is accessible and supportive for everyone, especially those with unique challenges.

Discover more insights and actionable recommendations by visiting ADHD and Oral Health | CareQuest Institute