1. Draft State Oral Health Plan
Rural Health Association of Tennessee Workshop
May 12, 2017
Veran Fairrow, DDS, MPH, Director of Oral Health Services; 05/11/17

2. Legislation

3. What the Initial Plan May Contain:
State-specific data
Current and relevant; updates every 5 years
Distributed broadly to public partners
S.M.A.R.T. Objectives

4. Where to Start: Centers for Disease Control & Prevention
Association of State & Territorial Dental Directors
National Public Health Performance Standards

5. What Path Do We Take:

6. Tennessee State Health Plan
“We can’t wait until we fix our massively expensive and broken health care system to prevent preventable disease. We must focus as a culture on primary ‘upstream’ prevention.” TN Commissioner of Heath, Dr. John Dreyzehner

7. Draft: State Oral Health Plan

8. Draft: Purpose and Use 1. Monitoring Dental Disease in Tennessee
Framing the Issue of Dental Disease
1. Monitoring Dental Disease in Tennessee
2. Oral Health Education & Advocacy
3. Prevention
4. Oral Health Resources & Workforce

9. Draft: Efforts of the Tennessee Department of Health
Oral Health Objectives-may be revisited
Local Health Departments
School-Based Sealant Program
Funding for Safety Net Providers

10. Draft: Tennessee Oral Health Timeline

11. Draft: Framing the Issue of Dental Disease
Dental Disease, better known as tooth decay
Transmission of Dental Caries Bacteria
Infections, Dry Mouth, Prescriptions and Over the Counter Medications
Diet and Nutrition and Oral Health
Community Water Fluoridation-Primary Prevention
Oral Health Literacy and Comprehension
True Cost of a Cavity
Oral Health and Chronic Disease

12. Is Tooth Decay Still an Issue?

13. Facts About Tooth Decay
“It is the most common chronic disease of children 6 to 11years and adolescents aged 12 to 19 years.”
“It is 4 times more common than asthma among adolescents 14 to 17 years.”
“9 out of 10 over the age of 20 have some degree of tooth decay.”
“By age 34, more than 80% of people have had at least one cavity.”
“Over $6 billion of productivity is lost each year because of people miss work to get dental care.” CDC.org

14. The Burden of Oral Disease
Poor oral health can affect an adults’ job prospects and social life. It has been shown that most employers “make instant judgements based on appearance, including one’s simile and teeth.” A 2008 study found that people with missing front teeth were viewed as less intelligent, less desirable and less trustworthy than people with a healthy smile. CDHP.org

15. The Burden of Oral Disease
Due to limited access to oral health services teeth are often left untreated or are extracted because of pain or discomfort. Throughout the world, losing permanent teeth is still seen as a natural consequence of ageing *WHO
“Dentistry is the only profession that accepts amputation as treatment.” =

17. The Cause of Tooth Decay

18. The Cycle of Tooth Decay
Dental caries (decay) is largely preventable.
Fluoride re-mineralizes tooth enamel, after it has been demineralized by bacteria and acid.

19. Draft: Development of the Oral Health Plan

20. Draft: Recommendations
Monitoring Dental Disease in Tennessee
Recommendation 1: Develop a TN oral health data source grid specific for TN
Recommendation 2: Caries Risk Assessment performed by all providers
Recommendation 3: Research and review best practices for an oral health surveillance system
Recommendation 4: Develop TDH surveillance system to monitor the Tennessee Cancer Registry and craniofacial health in Tennessee

21. Draft: Recommendations
Oral Health Education and Advocacy
Recommendation 1: Raise dental providers awareness of their role in substance abuse
Recommendation 2: Work internally with TDH Tobacco program, partner on messaging for public awareness of the effects of tobacco in the oral cavity
Recommendation 3: Work internally with TDH Family Health and Wellness program and TN Department of Education, partner on messaging for public awareness of sugary drinks and the dietary impact on oral health
Recommendation 4: Work internally with TDH Chronic Disease program to develop messaging and an educational course for providers
Recommendation 5: Highlight the Meharry Dental-Medical model

22. Draft: Recommendations
Prevention
Recommendation 1: Organize state-wide information and support meeting with TN Dental Association, TN Department of Health and TN Dept of Environment and Conservation to raise awareness of community water fluoridation and the prevention vs. treatment model
Recommendation 2: Advocate the usage of Silver Diamine Fluoride and its effectiveness as a preventive measure, similar to the UTHSC Silver Diamine Fluoride model
Recommendation 3: Organize efforts to adapt the Tooth Wisdom Project model for the elderly population
Recommendation 4: Advocate the “lift the lip” and fluoride varnish campaigns for medical providers

23. Silver Diamine Fluoride

24. Draft: Recommendations
Oral Health Resources and Workforce
Recommendation 1: Map existing providers/activity/services/oral health efforts and develop a hub
Recommendation 2: Actively seek funding for TDH dental clinics to expand target population to include uninsured adults and partner with FQHCs to expand their oral health reach
Recommendation 3: Request TDH, Health Related Boards mandate employment status during licensure for dentist and hygienist
Recommendation 4: Provide CDC Summary of Infection Prevention Practices in Dental Setting on TDH and other websites
Recommendation 5: Raise awareness and provide access to the ADA Center for Evidence-Based Dentistry Guidelines

25. Accessibility to Current Resources:

26. Oral Health Prevention
Oral bacteria can be spread from person to person
If brushing is not possible, rinse the mouth with water
If brushing is not possible, chew sugar-free gum for 10 mins
Drink all drinks, except water, within a small timeframe
PLEASE Do not lick pacifiers to clean them
PLEASE Do not share spoons or cups