1. Public Health Perspective on an Integrated Approach to Oral Health Bruce Gutelius, MD, MPH Deputy State Epidemiologist October 2, 2015

2. Public Health Division 2

4. Percentage of adults aged > 65 years with no teeth, Oregon, 2002-2012

5. Largest Impact Smallest Impact Examples Advice to eat healthy, be physically active Rx for high blood pressure, high cholesterol, diabetes Poverty, education, housing, inequality Immunizations, brief intervention, smoking cessation, colonoscopy Fluoridation, 0g trans fat, iodization, smoke- free, cigarette tax Socioeconomic Factors Changing the Context to make individuals’ default decisions healthy Long-lasting Protective Interventions Clinical Interventions Counseling & Education Factors that Affect Health

6. Public Health Division 6 Cigarette Smoking Prevalence by Year, Oregon 1996 - 2011

7. Public Health Division 7 Guide to Community Preventive Services Recommended oral health practices –Community water fluoridation –School-based dental sealant programs

8. Public Health Division 8 Oregon State Health Improvement Plan Population interventions –Increase the number of fluoridated public water districts Health equity interventions –Provide dental sealants in schools that serve students at high risk of tooth decay –Enhance oral health services through community clinics, including SBHCs –Ensure that Oregon has an adequate number of oral health professionals –Reduce the number of dental-related visits to emergency departments

9. Public Health Division 9 Oregon State Health Improvement Plan (2) Health system interventions –Create incentives for private and public health and health care providers to improve oral health –Increase early preventive care for children

10. Professional Panel – Q&A Gary Allen, DMD – Moderator Pat Berry, PhD, RN Kevin Cahill, PhD, MA Bruce Gutelius, MD, MPH

12. 10 th Annual Oral Health Conference Michael Glick, DMD NYU, University at Buffalo