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Oral Health: Putting Teeth into the Health Care System

Friday, August 17, 2012

We don't often associate crowded emergency departments with dental complaints. But according to The Pew Center on the States, preventable dental conditions were the primary diagnosis in over 800,000 visits to ERs in the U.S. This makes sense, as more than 100 million Americans lack oral health coverage, and therefore have impaired access to dental care. What’s more, poor oral health is an integral factor in physical health, associated with conditions such as diabetes, heart and lung disease, stroke and preterm birth. So regular detection and treatment of oral health problems – which are received more regularly by those with coverage – can improve physical health and quality of life.

While millions of American adults will gain health insurance coverage under the Patient Protection and Affordable Care Act (PPACA), that coverage may not include oral health services for everyone. PPACA ensures dental benefits for children in the “essential health benefits” package, but challenges remain to improve dental health access and coverage for adults.

What does the lack of oral health access cost states? What are different states doing to improve access? With 15 percent of the U.S. population living in dental “Health Professional Shortage Areas,” how can dental workforce shortages be addressed? What are “alternative dental health providers”? How do these alternative models aim to improve access, and are they financially feasible? How can collaborations between dentists and primary care physicians strengthen oral health care in the U.S.? What provisions under PPACA will impact oral health care? What is the status of the oral health demonstration projects authorized by the Act? What are the gaps and disparities in access and care?

To address these questions and more, the Alliance for Health Reform and the Robert Wood Johnson Foundation (RWJF) sponsored an August 17 briefing. Panelists were: Lynn Mouden, Centers for Medicare and Medicaid Services; Monica Hebl, American Dental Association; Julie Stitzel, Pew Center on the States; and Christy Fogarty, Children’s Dental Services, Minnesota. David Krol of RWJF and Ed Howard of the Alliance co-moderated.


 Ed Howard, Alliance for Health Reform, Moderator
 David Krol, Robert Wood Johnson Foundation, Moderator
 Lynn Mouden, Centers for Medicare and Medicaid Services, Speaker
 Monica Hebl, American Dental Association, Speaker
 Julie Stitzel, Pew Center on the States, Speaker
 Christy Fogarty, Children's Dental Services, Minnesota, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Oral Health: Putting Teeth into the Health Care System (Adobe Acrobat PDF), 8/17/2012
Full Webcast/Podcast: Oral Health: Putting Teeth into the Health Care System

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Speaker Presentation-Christy Jo Fogarty (PowerPoint), 8/17/2012
Speaker Presentation-Monica Hebl (Adobe Acrobat PDF), 8/17/2012
Speaker Presentation-Julie Stitzel (Adobe Acrobat PDF), 8/17/2012
Speaker Presentation-Lynn Mouden (Adobe Acrobat PDF), 8/17/2012

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Materials List (Adobe Acrobat PDF), , 8/17/2012
Source List (Adobe Acrobat PDF), , 8/17/2012
Speaker Biographies (Adobe Acrobat PDF), , 8/17/2012

Offsite Materials (briefing documents saved on other websites)

10 Reasons to Fluoridate Public Water, American Dental Association, 7/1/2012
CMS Oral Health Strategy: Improving Access to and Utilization of Oral Health Services for Children in Medicaid and CHIP Programs (Adobe Acrobat PDF),Centers for Medicare and Medicaid Services, 4/11/2011
Most comprehensive review of dental therapists worldwide shows they provide effective dental care to millions of children, W. K. Kellogg Foundation, 4/10/2012
- Darby, Mary and Lowell Dempsey
―Efforts Under Way to Improve Children’s Access to Dental Services, but Sustained Attention Needed to Address Ongoing Concerns, Government Accountability Office, 11/1/2010
Statement before the U.S. Senate Committee on Health, Education, Labor and Pensions, Subcommittee on Primary Health and Aging (Adobe Acrobat PDF),Pew Children’s Dental Campaign, 2/29/2012
- Gehshan, Shelly
How can we close the oral health gap? (Adobe Acrobat PDF),Robert Wood Johnson Foundation, 9/1/2012
- Workforce Health Policy Snapshot
Improving Access to Oral Health Care for Vulnerable and Underserved Populations, Institute of Medicine, 7/1/2011
- Report Brief
Extended Medicaid Dental Care? Millions' Oral Health Badly Lacking, Medical News Today, 7/14/2011
- Kraft, Sy
Opportunities to Improve Access to Oral Care and Reduce Costs, American Dental Association , 8/1/2012
Oral Health and Low-Income Nonelderly Adults: A Review of Coverage and Access (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 6/1/2012
Oral Health Care Workforce – Current and Proposed Providers, American Dental Hygienists Association, 1/1/2010
Oral Health in the US: Key Facts (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 6/1/2012
States Implement Health Reform: Oral Health (Adobe Acrobat PDF),National Conference of State Legislatures, 3/1/2011
Dental Insurance, but No Dentists, New York Times, 4/8/2012
- Sullivan, Louis
A Costly Dental Destination: Hospital Care Means States Pay Dearly, The PEW Center on the States, 2/1/2012
Advancing Oral Health in America, Institute of Medicine, 4/1/2011
Oral Health Status and Access to Oral Health Care for U.S. Adults Aged 18–64: National Health Interview Survey, 2008 (Adobe Acrobat PDF),US HHS Center for Disease Control and Prevention , 7/1/2012
- Bloom, B et al
Quality Oral Health Care in Medicaid Through Health IT, NORC at University of Chicago, 9/1/2011
- Casnoff, Cheryl et al
A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States, W.K. Kellogg Foundation, 4/1/2012
- Nash, David et al.
Oral Health and Medicaid Beneficiaries: Coverage, Out-of-Pocket Spending, and Unmet Need (Adobe Acrobat PDF),Kaiser Family Foundation, 6/1/2012
- Issue Brief
Study of Alternative Dental Providers—Connecticut (Adobe Acrobat PDF),ECG Management Consultants, 4/9/2012
The State of Children’s Dental Health: Making Coverage Matter, The PEW Center on the States, 5/1/2011
Dental Crisis in America: The Need to Expand Access (Adobe Acrobat PDF),A Report from Chairman Bernard Sanders Subcommittee on Primary Health and Aging U.S. Senate Committee on Health, Education, Labor & Pensions February 29, 2012, 2/29/2012


Lynn Mouden, chief dental officer at CMS, described the CMS Oral Health Initiative at the Aug. 17 briefing on oral health cosponsored by the Robert Wood Johnson Foundation. (Photo by James Ryder.)

Monica Hebl, a Milwaukee dentist representing the American Dental Association, explained the ADA’s approach to improving access to dental care at the Aug. 17 briefing cosponsored by the Robert Wood Johnson Foundation. (8 min.) (Photo by James Ryder.)

Christy Fogarty, one of the nation’s first licensed dental therapists, described how dental therapists can help solve the nation’s dental care access problems at the Aug. 17 briefing cosponsored by the Robert Wood Johnson Foundation. (12 min) (Photo by James Ryder.)


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