2. Oral Health Capacity and Infrastructure in the States Lynn Douglas Mouden, DDS, MPH Director, Office of Oral Health Arkansas Department of Health Immediate Past President, ASTDD

3. Institute of Medicine (IOM)  Future of Public Health (1988)  Assessment  Policy Development  Assurance

4. Guidelines for State and Territorial Oral Health Programs Produced by the Association of State and Territorial Dental Directors (ASTDD) and Approved by the Association of State and Territorial Health Officials (ASTHO) Revised July 2001 Guidelines for State and Territorial Oral Health Programs Produced by the Association of State and Territorial Dental Directors (ASTDD) and Approved by the Association of State and Territorial Health Officials (ASTHO) Revised July 2001

5. State oral health programs will be better prepared to achieve HP 2010 Oral Health Objectives for their state and for the nation when they have:  competence in surveillance  a full-time dental director  skilled staff  a state oral health plan  the support of policymakers  strong public/private partnerships and community coalitions  and an ability to obtain funds for services (from “Guidelines” ASTDD/ASTHO 2001)

7. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system.

8. Assessment on the Cheap Arkansas  1999 and 2000  300 children, total cost <$1,000  (not including Director’s salary)  2001  600 children, total cost <$1,000  (not including Director’s salary)  2003  7,000 children, total cost $27,000

9. Surveillance System

10. Arkansas Oral Health Burden Document

11. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.

12. Oral Health Leadership Total number of State Dental Directors 39 Full-time 4 Part-time 4 Part-time 6 Acting 6 Acting 1 Vacant 1 Vacant Job postings: Arizona, Connecticut, Iowa, Kansas, Michigan, Oregon, South Carolina, Vermont

13. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.

15. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems.

16. Arkansas Policy Changes  2000 – private water source testing  2001 – Act 715, budget cuts  2004 – general supervision  2004 – fluoridation mandate???

17. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems. Assurance  Provide oral health communications and education to policymakers and the public.

19. Tobacco Prevention and Cessation

20. Family Violence Prevention Artwork and acronym used by permission of the P.A.N.D.A. Coalition developed by Delta Dental of Missouri, copyright 1992 P revent A buse and N eglect through D ental A wareness

21. got teeth? get fluoride!

22. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems. Assurance  Provide oral health communications and education to policymakers and the public.  Build linkages with partners interested in reducing the burden of oral diseases.

23. Linkages  Advisory committees  Legislative panels  Faith-based organizations  and….

24. Coalitions!

25. Arkansas Academy of General Dentistry Arkansas Advocates for Children and Families Arkansas Cancer Research Center Arkansas Center for Health Improvement Arkansas Child Abuse, Rape and Domestic Violence Commission Arkansas Dental Assistants’ Association Arkansas Dental Assistants’ Association Arkansas Department of Education Office of Comprehensive Health Education Arkansas Department of Health, Office of Oral Health Arkansas Department of Health, Office of Oral Health Arkansas Department of Health, Office of Rural Health and Primary Care Arkansas Department of Human Services Arkansas Department of Human Services Arkansas Department of Human Services, Division of Medical Services Arkansas Department of Higher Education Arkansas Foundation for Medical Care Arkansas Head Start Association Arkansas Health Care Access Foundation Arkansas School Nurses Association Arkansas State Board of Dental Examiners Arkansas State Board of Dental Examiners Arkansas State Dental Association Arkansas State Dental Association Arkansas State Dental Hygiene Association Arkansas State Dental Hygiene Association Community Dental Clinic (Ft. Smith) Community Health Centers of Arkansas, Inc. Delta Dental Plan of Arkansas Donald W. Reynolds Center on Aging Healthy Connections, Inc. Interfaith Clinic of Eldorado Interfaith Clinic of Eldorado Partners for Inclusive Communities Pulaski Technical College Dental Assisting Department UALR Share America UAMS College of Public Health UAMS College of Public Health UAMS Dental Hygiene Department Vision 2010

26. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems. Assurance  Provide oral health communications and education to policymakers and the public.  Build linkages with partners interested in reducing the burden of oral diseases.  Integrate, coordinate, and implement population-based interventions.

27. Population-based Interventions

28. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems. Assurance  Provide oral health communications and education to policymakers and the public.  Build linkages with partners interested in reducing the burden of oral diseases.  Integrate, coordinate, and implement population-based interventions.  Build community capacity to implement community-level interventions.

29. Community Capacity

30. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems. Assurance  Provide oral health communications and education to policymakers and the public.  Build linkages with partners interested in reducing the burden of oral diseases.  Integrate, coordinate, and implement population-based interventions.  Build community capacity to implement community-level interventions.  Develop health systems interventions to facilitate quality dental care services.

31. Health Systems Interventions  School-based health centers  Head start collaborations – forums, screening AND referral  “Take Five”

32. Ten Essential Elements to Build C & I Assessment  Establish and maintain a state-based oral health surveillance system. Policy Development  Provide leadership to address oral health problems.  Develop and maintain a state oral health improvement plan.  Develop and promote policies for better oral health and to improve health systems. Assurance  Provide oral health communications and education to policymakers and the public.  Build linkages with partners interested in reducing the burden of oral diseases.  Integrate, coordinate, and implement population-based interventions.  Build community capacity to implement community-level interventions.  Develop health systems interventions to facilitate quality dental care services.  Leverage resources to adequately fund public health functions.

33. Resources  ASTDD  HRSA  SPRANS Grants  SOHCS Grants  RWJ  Pipeline  State Action for Oral Health Access  CDC  Capacity and Infrastructure Cooperative Agreements

34. CDC State Oral Health Program Infrastructure and Capacity Grants  13 Recipients  Alaska, Arkansas, Colorado, Illinois, Michigan, Nevada, New York, North Dakota, Oregon, Rhode Island, South Carolina, Texas and the Republic of Palau  Average award ~ $200,000 / year

35. CDC State Oral Health Program Infrastructure and Capacity Grants  Assessment  Surveillance System  Burden Document  Policy Development  Leadership  State Oral Health Plan  Statewide Oral Health Coalition  Systems and Policy Change  Assurance  Fluoridation Program Management and Promotion  Sealant Program Management

36. National Exposure

37. Oral Health in America: A Report of the Surgeon General May 2000

38. National Call to Action on Oral Health A Template for Action

41. The Springboard Simple Physics