Viewing posts from: February 2017

A Youth Leader’s Perspective on Access to Oral Health Care

Jacquelyn Hedrick, YES! Youth Staff

According to data collected in 2008 from North Carolina schools, students with poor oral health were three times as likely as those with good oral health to miss school. What this means is that over 3.4 million academic hours were missed due to dental care, and approximately 720,000 of those hours were missed due to pain. Regardless the quality of the school or education, if students aren’t mentally and physically present, they aren’t able to learn. Absences can significantly impact a student’s performance in school; dental decay, dental pain, and other conditions, while completely preventable, can and are adversely affecting the lives of me and my North Carolina peers.

Lack of access to oral health care plagues North Carolinian students and hinders them from reaching their full potential as learners. There are four counties within the state that do not have a single dentist within their borders. For those without access to transportation or the ability to take off work, this is a major obstacle to care. Even for those people who do live in areas that do have dentists, disparities exist. In 2014, the American Dental Association highlighted that only 27% of NC dentists accepted public forms of insurance because of its low reimbursement rates, leaving those in lower income brackets still without care despite being close to a dentist. While the argument often made is that people can visit free clinics or mobile dental offices, this is not always an option. Nothing better exemplifies this struggle than the tragedy that befell Deamonte Driver.

Alyce Driver of Maryland, Deamonte’s mother, was searching high and low for a dentist that would treat her other son’s six rotting teeth. As they experienced homelessness, lacked transportation, lapsed out of Medicaid, and struggled to maintain phone numbers or addresses, Alyce Driver’s search proved fruitless and exhausting. Even those the Driver family sought help from at shelters could not find a dentist that would treat them. On January 11, 2007, twelve-year old Deamonte Driver arrived home from school complaining of a headache. After visiting the hospital, he was given medicine to treat his headache, a dental abscess, and sinusitis. However, the next day, things were much worse, and they returned to the hospital where he was rushed into emergency brain surgery. He then experienced severe seizures and underwent a second operation to remove his abscessed tooth. It was at this point that his condition began to improve. One morning, at 6 AM, Alyce Driver received a call from Deamonte’s grandmother. He was unresponsive. When she arrived, her son was dead. His causes of death were listed as “meningoencephalitis” and “subdural empyema,” both associated with brain infections. Today, many advocates argue that his cause of death was really a lack of access to preventative care.

It is important to analyze which students these issues most often affect. The study listed above found that the variables most often associated with poor school performance were “gender (male), race (Black), grade in school (6–12), parental educational level (high school), health insurance (public), and those with special health care needs”.

Eliminating the dental pain a student experiences, ensuring they receive preventative care at a permanent dental home for the student, and guaranteeing the student is covered by health insurance which provides for oral health care can improve the attendance, performance, and confidence of a student who would otherwise struggle. This statement begs the question of how we, as a community of students, parents, and teachers, can support the provision of these things for and improve the oral health of all students of North Carolina.

One of the most attainable solutions to this problem focuses on the variable of health insurance, especially in the current legislative climate. Raising reimbursement rates for Medicaid would make accepting this form of insurance a more attractive and viable option for dental practices across North Carolina. 1,833,630 people were enrolled in Medicaid as of July 2015, but only a quarter of dental practices in NC accepting Medicaid. Another strategy that is being implemented in 39 other states is modernizing North Carolina’s Dental Practice Act to allow all dental health providers to practice up to their educational capacity, and therefore increasing access to care. These strategies would allow a greater proportion of that already large population to receive regular, preventative care which greatly reduces the chance of what happened to Deamonte, happening to a North Carolina student.

To get involved with our movement, go to OralHealthNC.org and join the mailing list. Also, mark your calendar for April 5th when North Carolinians will gather for Oral Health Day at the Legislature. Together, our voice is powerful.

Top 5 Things Your Family Can Do to Promote Healthy Dental Habits

Archie Cook, Jr. DDS,
Signature Smiles of Cary, NC

As a new dad, I am learning how important it is to be a positive example of healthy habits and hygiene for our daughter. She really does watch and mimic everything we do! Why not give her a set of habits to learn and mimic that will give her a head start on healthy living? At Signature Smiles of Cary, NC, we believe in educating and making each patient aware of the best things that they can do to improve their oral care, which leads to overall healthcare. We spend time with each patient to help answer questions and ensure that he or she understands recommended treatments and next steps – it’s your health after all and we believe every patient deserves the best!

To kick off 2017 and to help celebrate National Children’s Dental Health Month, we wanted to share with you the top 5 tips that we share with our families at Signature Smiles!

  1. Brush and floss twice a day, and most important, brush and floss before bed! This goes for your entire family, including your children, once they learn to floss. Overnight, while you are sleeping, the salivary flow in your mouth decreases. Saliva acts as a buffer to help block acids produced by bacteria in the food and drinks we consume. However, the decreased flow of saliva at night makes your teeth more prone to decay if you do not brush and floss before bedtime. Brushing also gives your teeth fluoride to further protect against these acid producing bacteria overnight. Make brushing and flossing a family event and make it FUN! Reinforce positive behavior and be an example for your little ones.
  1. See your dentist on a regular basis, and find a dentist who your family trusts, and someone who can help to put your family at ease. We often hear people complain about how expensive dental work is, and the old saying “prevention is less expensive than intervention” is very true! Regular visits along with proper dental care at home really are the best ways you can help keep your families’ dental care needs to a minimum.
  1. Eat more cheese! Did you know that cheese helps to increase the pH levels in your mouth, which help to neutralize the acids caused by bacteria that cause decay? Acidic mouth environments are more likely to see tooth decay, so having a bit of cheese after your meal whenever you are not able to brush is a great way to buffer those acids and reduce potential decay. String cheese and cube cheese are fun lunch options for not only your children, but for you too!
  1. Maintain a healthy, clean diet in order to help promote total body and oral health. The same foods and drinks that are “good for your body” are also great for your family’s teeth! Crunchy fruits and veggies, cheeses, meats, nuts, milk and water are all great foods and drinks to incorporate into your family diet.
  1. Oral care is a gateway to the rest of your body’s health. Multiple studies have shown links between bacteria, infections and decay in our mouths and other serious health conditions. Did you know that people who have serious gum disease are 40% more likely to have a chronic health condition? We often want to make sure our families exercise, eat healthy and get good sleep to be health. Don’t neglect your oral care when thinking of your family’s health. Foods and drinks that are high in calcium and phosphorus help to protect tooth enamel, and food and drink with high water content help to dilute the sugar we consume and also stimulate saliva flow. As you know, sugary foods and drinks can contribute to bacteria and tooth decay. Find fun healthy options for your family and when you do enjoy special treats, be sure to brush and floss afterwards!

We know your family’s health and well-being is important to you. It’s important that your children learn healthy habits so that it becomes a priority for them too. At Signature Smiles, we work very hard to ensure that all our patients, from 2 to 82, learn about healthy oral care habits and have a head start at a healthy life. Here’s to a healthy and happy 2017!

Courage + Love = Essential Ingredients to Achieving Oral Health Equity

Zulayka Santiago, MPA
Director, NC Oral Health Collaborative

When I was nine years old I began to see the world for what it is: heartbreaking and beautiful, all at the same time. We had been living in Kenner, LA for three years by then, having moved there from my birthplace, Puerto Rico. My sister and I had just begun to acclimate to the new language, our new school, and the cold weather. My mother was working as a housekeeper and nanny for the Blooms, a family in town that had 5 adopted children, the father was a lawyer, and the mother was dying of cancer.

At this young age I began to see the stark differences between their large home (my mom sometimes brought my sister and I along to help) and our small 2-bedroom public housing apartment. Their private school (all 5 children went to an impressive looking catholic school) and our public school. We were lucky enough to have Medicaid for a period of time, which enabled us to get the medical care we needed, but dental care was another story.

I remember having to accompany my mother one time as she drove one of the older Bloom kids, David, to his dentist appointment. The office was located in a new office building, everything was clean, colorful and sparkly. Much to my delight, the waiting area was filled with books and toys. The appointment went quickly, and when David came out of his appointment, he had a huge smile on his face and was thrilled to report that he had no cavities!

A few months later, it was time for our dental visit. We didn’t head to a shiny office building, instead we went to somebody’s home across town. More specifically, we went to their garage. There, a make-shift dental office had been established. A gently used dentist chair, a sink near the wall, and all the basic equipment need to provide the dental care we were seeking at a much lower price. Overall it was a positive experience—aside from the needles and drilling (my sister and I were not cavity-free). The dentist was kind, his wife was welcoming to us, they were both warm, and most importantly, spoke to my mother in her native language.

I’ve now learned that those clinics are ‘clandestine dental clinics’, established by dentists trained in Latin America, who are unable to get their licensure/credentials in the US due to language or other barriers. There have been some horror stories associated with these clinics, but I’m grateful to report that our family had no complaints. Which is a good thing, because I don’t think we would have been able to access care otherwise.

These differences in access to healthcare, education, and living situations are still quite prevalent across the US. Differences that result in the exacerbation of health disparities, which are particularly heartbreaking in low-income communities because of the many other barriers they contend with. Health equity is defined by the Oral Health 2020 network as the attainment of the highest level of health for all people. At the heart of the concept of health disparities is a concern about social justice—that is, justice with respect to the treatment of more advantaged vs. less advantaged socioeconomic groups when it comes to health and health care.

Part of our work at the NC Oral Health Collaborative is to help highlight some very important facts:

  1. The mouth is indeed part of the body, and oral health is an essential part of overall health.
  2. Tooth decay is the most common chronic disease of early childhood. In fact, it’s a condition that is 2-3 times more common than asthma or obesity.
  3. Dental care remains the greatest unmet health need among U.S. children. Children with untreated tooth decay not only suffer pain and infection, they have trouble eating, talking, socializing, sleeping, and learning, all of which can impair school performance.
  4. Left untreated, dental disease can lead to emergency room (ER) visits, hospitalizations, and even death.

The saddest, or perhaps the most inspiring aspect of this situation is that it is TOTALLY PREVENTABLE. Sad because we’ve let things get this bad, inspiring because we can now choose to make things better. We can harness our tremendous wisdom, skills and resources to ensure that ALL of our children have access to essential preventive services. In NC we’ve done a great job of ensuring that young children have access to fluoride varnish treatments in their pediatric visits through the nationally-recognized Into the Mouths of Babes program. However, there is another essential aspect to prevention that we are not doing so great at: dental sealants: plastic coatings placed on the chewing surfaces of teeth

According to the Centers for Disease Control and Prevention, dental sealants can reduce decay by 80 percent in the two years after placement, and continue to be effective for nearly five years. Because sealants are such an effective means of preventing tooth decay, they have been endorsed by the American Dental Association. Dental sealants are one-third the cost of a filling, so their use can save patients, families, and states money. Sealant programs based in schools are an optimal way to reach children—especially low-income children who have trouble accessing dental care.

Yet despite all of this compelling evidence, NC has not yet maximized access to and use of this preventative measure. It is time for us to do everything within our power to ensure that as many children as possible can easily access this service that could have significant impact on children’s performance in school and their future contribution to the economic base of our state as adults. This will require both a change of mindset and a willingness to address systemic barriers to progress. This is one of the main priority areas for the NCOHC in 2017, and of course we’d invite all of you to join us in this endeavor!

Achieving oral health equity will require focused and ongoing efforts to address historical and contemporary injustices-AND the systems that perpetuate inequities. This is not easy work, but in this time of political upheaval and uncertainty in the US, it is more important than ever that we did deep to connect with our courage to take on this necessary work. “Love” becomes an active verb when we are willing to engage the work required to bring it to life. In the words of Martin Luther King Jr.:

“What is needed is a realization that power without love is reckless and abusive, and that love without power is sentimental and anemic. Power at its best is love implementing the demands of justice, and justice at its best is love correcting everything that stands against love.”  

162 PTAs Win Gold Key Membership Award from NCPTA

The North Carolina PTA annually recognizes PTAs across the state for building strong teams of parent and teacher volunteers. The Gold Key Award acknowledges PTAs who received the Blue Key Award for 2016-2017 and added 25 new members by January 15.

Read the full list of recipients for the 2016-2017 Gold Key Award.