Illinois Oral Health Plan IV: Eliminating Inequities in Oral Health (2021-2025)

Oral health is a crucial part of overall health. Oral health does far more than ensuring good breath, strong teeth, healthy gums, and a bright, white smile. Good oral health and hygiene can improve your overall health, lowering your risk of complications due to several serious diseases, such as diabetes, cardiovascular disease, and preterm or low weight births. While oral health professionals know this and oral health advocates promote it, many parents, children, other adults, and even medical professionals who treat them do not understand the critical relationship between oral and general physical health. As a result, too often in Illinois and across America, good oral health habits are lost, proper oral health care is inaccessible, and many measures to prevent adverse oral health outcomes remain unknown. Consequently, oral health problems too often go untreated, thereby burdening individual lives as well as the health care system.

Oral health as a serious health issue first came into focus with the 2000 U.S. Surgeon General’s landmark report, Oral Health in America. That seminal report documented America’s oral “burden of disease” and presented evidence of a “silent epidemic” of dental and oral diseases. It also referenced reported associations between chronic oral infections and diabetes, osteoporosis, heart and lung conditions, and several adverse pregnancy outcomes.

The report’s central message was that oral health is essential to general health and can be improved despite several significant barriers. The report concluded with a framework for action, calling for a national oral health plan to improve quality of life and eliminate oral health disparities and inequities. Illinois, like many states, used the Surgeon General’s report as a springboard to engage partners interested in improving oral health and was one of the first states to develop a state oral health plan. Illinois’ first oral health plan, Roadmap to the Future: Oral Health in Illinois (2002), used the five action steps from the framework established in Oral Health in America as policy goals and included scores of priorities and recommendations for strategic interventions, including a series of town hall meetings and a statewide summit. With the intent of building a culture of good oral health across the state and guiding actions aimed at improving oral health status, that initial effort was used as a model for other state oral health plans throughout the nation.

Several improvements in the workforce and oral health clinic infrastructure took place, in part by focused activity and advocacy that resulted from the Roadmap to the Future. For example, schools of dentistry and dental hygiene have increased in number and expanded their community-based service-learning experiences, which benefits both communities and students. In addition, IDPH’s Center for Rural Health (CRH) has served as the State Loan Repayment Program (SLRP) grantor in Illinois since the inception of the program in 1996. Further, philanthropic foundations and state agencies began to provide start-up and maintenance resources to help public dental clinics better address the unmet oral health needs of the Medicaid-insured population, the uninsured, and the underinsured.

Oral Health Care in Illinois, the IOHP II (2007) also followed the framework of the Surgeon General’s report, reviewing the state’s progress in addressing the original five‐year plan and making recommendations for the future. Again, a series of town hall meetings and a statewide summit informed the process. Oral Health Care in Illinois called for greater involvement of the medical provider community to help prevent oral disease. That effort resulted in the Illinois Chapter of the American Academy of Pediatrics (ICAAP)’s Bright Smiles from Birth fluoride varnish training program, which has reached thousands of children each year. Additional improvements in oral health tied to strategies identified in the second state oral health plan included the establishment of usable transportation services for Medicaid members; multi-million dollar investments in the statewide local health department, federally qualified health center (FQHC), and non-profit clinical infrastructure through public and private funding sources; and the expansion of dental sealant grant program that focuses on uninsured children.

Healthy People, Healthy Smiles: Assuring an Agenda for Action was Illinois’ third oral health plan (2012). It took a slightly different approach from past plans by modeling its framework after the Healthy People 2020 national oral health objectives but was still informed by the Surgeon General’s 2000 Call to Action. Healthy People, Healthy Smiles again provided a focus for action that resulted in several improvements. Examples include more access points for lowincome individuals, an increased number of persons with dental insurance (Medicaid expansion under the 2010 Patient Protection and Affordable Care Act, or ACA), and deepened collaboration between local hospitals and dental clinics.

Since the first IOHP, stakeholders have dedicated much time and effort to formulate and execute many ideas resulting in a better oral health future in Illinois. Instead of using wishful thinking to address the burden of oral diseases and enhance the oral health of Illinoisans, stakeholders leverage these thoughtfully constructed plans. The results of plan utilization include meeting many of the goals and objectives set forth. Other accomplishments spurred from these Illinois oral health plans include:

1. the emergence of strong advocates for oral health who fund clinics, programs, and research
2. development of a stronger and expanded safety net of oral health providers in FQHCs, local health departments, and other non-profit organizations
3. engagement of many more private practitioners in volunteerism activities, which translates to thousands of oral health care visits by low-income and uninsured persons
4. sizable growth in workforce and academic training programs for dentists and dental hygienists that are geographically distributed across the state