a quarterly newsletter winter 2011 president’s · pdf filea quarterly newsletter winter...

ASTDD — The ASSociATion of STATe AnD TerriToriAl DenTAl DirecTorS

A quArterly newsletter wInter 2011

President’s Message:Margaret Snow, DMD, MBA, MPH is the Dental Director for the New Hampshire Department of Health & Human Services

The ASTDD sends greetings and wishes for health and prosperity for all our members and friends in the New Year.

The Winter of 2011 roars in with winds of change and a shifting

landscape for oral health nationwide. There are significant changes in leadership and organizational structure in all three major federal agencies. This is occurring just as the HHS Oral Health Initiative is gaining steam and CMS is kicking off its strategy to improve access and utilization of oral health services for children in Medicaid and CHIP programs.

The ASTDD is bidding grateful farewell and wishing continuing success to three of our greatly admired colleagues. Dr. Jay Anderson has left his post as Chief Dental Officer at HRSA to join DentaQuest in Massachusetts. It is as yet uncertain how the oral health role at HRSA will be structured, yet we are hopeful that our members will be able to continue to count on the strong leadership of a knowledgeable oral health professional in HRSA’s Chief Dental Officer.

Dr. Conan Davis has been drawn homeward to Alabama, leaving his position as CMS Chief Dental Officer to become Director of Community Collaborations and Head of Behavioral and Population Sciences at the University of Alabama’s Dental School. It appears that CMS is seeking to assign a new

Chief Dental Officer on the Medicaid side of the agency and in the Quality Division. The new Chief Dental Officer will become an especially important liaison between ASTDD and CMS, as the benefit of the ASTDD’s and our members’ expertise in sealant and school programs will greatly assist CMS in implementing its new strategy to improve access and utilization of oral health services for children in Medicaid and CHIP programs.

With less assurance of a bright horizon, we have learned not only of the resignation of Dr. William Kohn as CDC Director of the Oral Health Division, but also of the proposed demotion of the Oral Health Division into a branch within another division. Dr. Thomas Friedan has announced that he is proposing that oral health become a part of the Division of Adult and Community Services, thus implying a diminution of the perception of oral health as a significant public health challenge across the lifespan. We remain hopeful that Dr. Friedan will hear the message in the many letters he has received and will reconsider and restore Oral Health as a Division. On the bright side, Dr. William Bailey has been named Acting Director of the Division of Oral Health at CDC.

The ASTDD will continue to provide leadership to create opportunities in this environment to strengthen our state oral health programs and provide counsel to our federal partners in order to achieve our common goal of improving our nation’s oral health. It surely will be an exciting year!

In t

his

iss

ue: Executive Director’s

Message —Page 2

Cooperative Agreement Manager’s Report — Page 4

Photos from the ASTDD Partners Meeting — Page 6

STATEShot: Indiana — Page 8

Partner: Organization for Safety, Asepsis and Prevention — 1

ASTDD — THe ASSOCIATION OF STATe AND TeRRITORIAl DeNTAl DIReCTORS

Oral Health Matters |

This is the fourth in a series of Oral Health Matters messages from the ASTDD executive Director highlighting how ASTDD is working to implement the ASTDD Strategic Plan. For this issue I will provide an overview of what ASTDD is doing to support our first key direction, “Influence Policy.”

ASTDD is working to influence policy through the development of ASTDD

policies and in partnership with other organizations. In the past year ASTDD has signed onto 24 letters related to both policy and administrative action. These included letters addressing health care reform; the exemption of certain classes of medical devices from a proposed tax on device manufacturers; the retention of Senate language for Sec. 5303 of H.R. 3590, especially with regard to the funding line for “training in general, pediatric, and public health dentistry;” an ASTHO issue brief on State Health Agency Technical Comments for National Health Reform legislation; a Notice of Proposed Rulemaking for Medicare and Medicaid Programs related to the electronic Health Record Incentive Program; support for an appropriation of $730 million for the Title V Maternal and Child Health (MCH) Services Block Grant in FY 2011; a request for $67.1 billion for public health programs in FY 2011; ensuring that the pediatric dental benefit in the health care reform bills is delivered in a way that protects consumers, assures affordability, and ensures competition; a request for adequate funding of federal dental programs; a request that dentists, hygienists, and other allied dental professionals be included as part of the provider community affected by low Medicaid reimbursements; the Family and educational Rights and Privacy Act; the Proposed establishment of Certification Programs for Health Information Technology; support for efforts to improve the oral health of children in the reauthorization of the Child Nutrition Act of 1966; a request that the oral health provisions in the Patient Protection and Affordable Care Act are realized with sufficient funding in FY’11; a request for an allocation of at least $93 million to the Centers for Disease Control and Prevention’s (CDC) Division of Oral Health (DOH) and $30 million to the Health Resources and Services Administration (HRSA); support for a provision in the American Jobs and Closing loopholes Act (H.R. 4213) that would extend the federal medical assistance percentage (FMAP) enhancement to states through June 30, 2011; support for the Special Care Dentistry Act of 2010; a letter expressing surprise and disappointment that the Administration directed $250 million from the Prevention and Public Health Fund, provided through the Patient Protection and Affordable Care Act, to support the Primary Care Workforce; a letter to senators opposing the use of the Prevention and Public Health Fund from the Affordable Care Act (ACA) as an offset for an amendment offered by Senator Johanns; a letter to Members of the National Commission on Fiscal Responsibility and Reform urging them to take a balanced approach to deficit reduction; a letter to the Speaker, leaders, Chairmen and Ranking Members of the House from 360 organizations representing patients and families, health care providers, public health professionals, educators, scientists, and employers thanking them for their support of the U.S. Public Health Service and its agencies and programs, and urging them to swiftly complete action on the FY 2011 appropriations bills; and a

letter urging the highest possible FY 2011 funding level for the Health Resources and Services Administration and the CDC.

In addition to signing onto multi-organization letters, a significant effort to identify and prioritize potential national oral health policy occurred on December 9, 2010 when the ASTDD Board of Directors met in Washington, DC with representatives from the following organizations: American Association of Public Health Dentistry (AAPHD); American Dental Association (ADA); American Dental education Association (ADeA); American Dental Hygienists’ Association (ADHA); Association of Maternal and Child Health Programs (AMCHP); Association of State and Territorial Health Officials (ASTHO); Centers for Disease Control and Prevention (CDC); Centers for Medicaid and Medicare Services (CMS); the Chief Dental Officer of the United States Public Health Service; Children’s Dental Health Project (CDHP); Health Resources and Services Administration, Maternal and Child Health Bureau (HRSA MCHB); Hispanic Dental Association (HDA); Medicaid/SCHIP Dental Association (MSDA); National Association of Chronic Disease Directors (NACDD); National Maternal and Child Oral Health Resource Center (NMCOHRC); National Network for Oral Health Access (NNOHA); Oral Health America (OHA); Organization for Safety and Asepsis Prevention (OSAP); Pew Children’s Dental Campaign; and Special Care Dentistry Association (SCDA). The meeting provided the first opportunity for oral health advocates at the national level to discuss political and oral health issues, and to facilitate critical thinking about the country’s ongoing oral health policy and set national priorities, using a Policy Tool developed by CDHP and CDC. After a half day of structured discussion and voting, which was facilitated by Dr. lynn Mouden, Arkansas State Dental Director, the following policy priorities were identified:

• Encourage governmental and non-governmental programs developing dental public health infrastructure to meet the needs of state, local and/or tribal programs, to seek leadership by a dental professional with credentialed public health training, and to continue to advocate for needed federal funding in Title VII and other programs to provide increased educational opportunities for individuals interested in pursuing dental public health residency training.

• Increase oral health coverage in Health Care Reform Parts A & B clinical preventive services.

• Provide federal funding for state oral health program infrastructure in all states and territories.

• Increase awareness of the connection between oral health and chronic disease prevention and management.

• Appropriate funding for authorized spending under the Affordable Care Act.

• Create a national oral health plan.

ASTDD will work with partner organizations to identify next steps in moving these policy priorities forward. A first step is to present these recommendations to the Department of Health and Human Services’ Oral Health Coordinating Committee.

Internally, the ASTDD Policy Committee continues to work on the development of policies for ASTDD. Currently ASTDD has

ASTDD Strategic PlanChristine Wood, RDH, BS is the Executive Director of ASTDD

Continued on next page.



BJ Tatro, PhD, ASTDD Evaluation ConsultantHRSA, MCHB provided funding through the ASTDD Cooperative Agreement for development and implementation of a National Oral Health leadership Institute (NOHlI); sessions were held in 2007, 2008, and 2009, with other one-time workshops in previous years. During the last three years, 35 ASTDD members (state dental directors and associate members) and the HRSA project officer participated. extensive evaluation was conducted each year. In November 2010, a retrospective survey was sent to all participants to obtain their feedback on the benefits. Following is a summary of the responses received from 21 persons. Some of the non-respondents have also embraced new leadership responsibilities but did not answer the survey.

Year Attended: 7 in 2007; 8 in 2008; 9 in 2009; some attended multiple years and are included in each year they attended; 1 did not respond to the question.

Place/Type of Employment• 90.5% (19/21) are employed in the same organization now as

when they participated in NOHlI.

• 76.2% (16/21) are in the same position now as when they participated in NOHlI; three have moved into higher level administrative positions; one has moved from the State to a community program; and one went into private practice.

New Leadership Responsibilities• 90.5% (19/21) have taken on new leadership responsibilities since

participating in NOHlI, including taking on roles within ASTDD, other organizations, and community groups, and accepting new positions and job responsibilities.

• 83.3% (15/18) noted that NOHLI contributed to taking on the new leadership responsibilities, primarily through the skills and confidence they acquired.

Use of Knowledge/Skills• 95.2% (20/21) have used the knowledge and skills gained

through NOHlI; many reported using the skills to improve communications, both internally and externally to their programs.

• 40.0% (8/20) have experienced barriers to using the knowledge and skills gained, including state structures, staff turnover, current political climate, etc.

• 85.0% (17/20) have seen benefits from putting the knowledge/skills gained into practice, including better employee relations, more cohesive staff and planning, strengthened relationships with coalition members, increased media savvy, being more careful in delicate negotiations, increased ability to participate in policy change at the local and state level, etc.

Most Beneficial NOHLI Topics/Activities• The following three topics were noted as the most beneficial:

- Strategic leadership/leadership skills: 76.2% (16)

- Critical thinking and problem solving: 61.9% (13)

- Working with the media: 42.9% (9)

• Types of activity that were most beneficial:

- Presentations: 85.7% (18)

- Networking: 57.1% (12)

- Assessments such as the self-assessment or 360: 42.9% (9)

- Written materials: 38.1% (8)

Self-Assessed Improvement• Respondents were asked to compare their current competencies in

the areas covered in the leadership self-assessment they completed before and shortly after their participation in NOHlI. More than 50% noted improvement in all eight leadership categories.

Future Leadership Development• 81.0% (17/21) said there were barriers to future participation.

Most frequent barriers included:

- Funding: 88.2% (15)

- Travel restrictions: 52.9% (9)

- Time: 29.4% (5)

- Lack of organizational support: 23.5% (4)

Although HRSA is no longer supporting ASTDD for leadership development or the NOHlI, ASTDD is working with the Children’s Dental Health Project and other groups to develop and offer other leadership development opportunities.

policies on Community Water Fluoridation, Dental Amalgam, Fluoride Varnish, School Dental Sealant Programs and Health Care Reform. These are posted on our website at http://www.astdd.org/policy-committee/. The ASTDD membership is currently in the process of voting on a policy on Dental Sealants and BPA. The Policy Committee is finalizing policy statements on Fluoride Mouthrinse programs and Coordinated School Oral Health policy. In addition they have initiated work on, or are planning policy statements on Workforce, Amalgam Waste, Sugar-Sweetened Foods in Schools, Federal Infrastructure/Regional Dental Consultants, HP2020, early

Childhood Caries and Nutrition, and Oral Health and Chronic Disease. In addition, the Policy Committee has developed documents to guide the policy statement development and review process. These documents are also available on the website.

Suggestions for ASTDD policy statements can come from ASTDD committees, the ASTDD Board of Directors (BOD) or from ASTDD Members or ASTDD Associate Members. I encourage you to contact Harry Goodman, Chair of the ASTDD Policy Committee or Kathy Mangskau, Consultant to the Policy Committee with suggestions or requests.

Retrospective evaluation of the ASTDD National Oral Health leadership Institute

continued from previous page



HRSA FundingHRSA, MCHB awarded ASTDD $250,000 as a cost-extension to our current cooperative agreement through July 2011 to build on some current projects and

complete a few new activities. However, HRSA, MCHB will no longer be providing funding to ASTDD as a sponsor for the NOHC or for the National Oral Health leadership Institute. Kathy Geurink has increased her hours with ASTDD to be the program coordinator for the cooperative agreement, and ASTDD has contracted with Michelle landrum, RDH, BS from Austin, Texas to serve as a project assistant. Michelle is in the process of completing a Med in Health education and also works part-time as the Head Start Oral Health Program Manager for the City of San Antonio Metropolitan Health District and serves as Dental Hygiene Faculty for Austin Community College. We are excited to have Michelle as part of the team and to staff our new early Childhood Workgroup.

National Oral Health Conference EventsASTDD Committees and partners have been busily developing abstracts for various sessions for the NOHC. The Healthy Aging Committee, School and Adolescent Oral Health Committee and the Fluorides Committee will be hosting concurrent sessions on Wednesday, while other committees have submitted abstracts for posters or roundtables. ASTDD is co-sponsoring with HRSA, MCHB and the Association of Maternal and Child Health Programs (AMCHP) a preconference workshop, Integration of Oral Health into Title V in a Broader Post-Health Reform environment, on Saturday from 1:30-4:30 pm. In addition, the Hispanic Dental Association is co-sponsoring Hispanic Cultural Awareness for Oral Health Professionals on Sunday afternoon from 1:30-4:30 pm. Since this will be opposite the ASTDD business meeting and state sharing session, they have agreed to host a separate webinar on the topic at another time for ASTDD members. Check the NOHC website for more information and to register online.

ASTDD Communication Plan Webinar and Templates On November 17 the ASTDD Communications Committee sponsored a webinar on Communication Plans for State Oral Health Programs, presented by Kimberlie Yineman and Gregg Reed from North Dakota, and myself. The Communications Plan webinar is now posted on the Communications Committee page at http://www.astdd.org/health-communications-committee/. We encourage oral health programs and others to use these resources to engage in a planning process for all of your communication strategies. They will be particularly useful when trying to prioritize strategies, assign responsibilities and allocate resources.

Policy CommitteeChris Wood has outlined many activities of the Policy Committee in her column this month. One other piece of exciting news is the participation of students from various dental public health residency programs in developing some of the ASTDD policy statements. Susan McKernan and elham Kateeb, under the direction of Ray Kuthy from the University of Iowa, and Baharak Amanzadeh, under the direction of Jane Weintraub from UCSF, are assisting the committee. Other residents interested in helping can contact Harry Goodman or Kathy Mangskau.

Data CommitteeThe Committee has just released the 2011 SOHP Salary Survey forms and the 2011 State Oral Health Program Synopsis forms to state dental directors for completion. Please try to return both forms by the deadline. This information is particularly important this year as we work to complete a CDC-funded project that updates the document Building Infrastructure and Capacity in State and Territorial Oral Health Programs that was published in 2000. We really need information from every state and DC to highlight states’ unique needs and approaches. The Infrastructure Report updates will not include the territorial programs. Note that state submissions of BSS data to the NOHSS are now being uploaded to the NOHSS website on a quarterly basis to improve the currency of the data. Members of the ASTDD Data Committee also have begun to work with the new Medicaid/SCHIP Dental Association (MSDA) Data Committee on some joint projects.

Oral Cancer and Tobacco Risk Factors CommitteeThe committee has been approached by legacy, a national independent public health foundation created in 1999 out of the landmark Tobacco Master Settlement, to engage in collaborative activities around tobacco cessation such as links on websites, policy statements, tobacco cessation resources and issue briefs. They are having ongoing conference calls and have submitted an abstract for an NOHC roundtable. In addition, as part of her MPH capstone project at the University of Iowa, Bhagyashree Pendharkar will be working with the committee to develop a policy brief and then a policy statement concerning tobacco use and oral health. The Committee also will be working with Jenny Cleveland at CDC on an oral cancer surveillance project. Michelle Younger, a CDC DPH resident, will be doing this as a residency project to document what is occurring and not occurring in states.

State Program Assistance and Resources Committee (SPARC)This committee will be taking on new responsibilities so that ASTDD orientation, mentoring, professional development, program reviews and certain types of technical assistance are better integrated and based on the ASTDD Guidelines and ASTDD Competencies. Committee consultants are in the process of developing a new logic model and workplan to reflect the new responsibilities. Since September the following mentoring pairs have been assigned: linda Altenoff with Julia Wacloff (AZ); Harry Goodman with Jason Rousch (WV); Julie Janssen with Merry Jo Thoele (MN).

State Infrastructure Evaluation ProjectIn the last issue of Oral Health Matters we outlined the goals and structure of this project that is supported by CDC supplemental funding. Both the Project Team and the Advisory Group have had multiple conference calls and developed a framework for the report and a resource list. Members will begin working on specific assignments in mid-January. The Best Practices Committee and SPARC are co-leads on this project.

Children and Youth with Special Health Care NeedsASTDD consultant, Jay Balzer, and HRSA, MCHB staff, Pam Vodicka, will be doing a

Cooperative Agreement Manager’s ReportBeverly Isman, RDH, MPH, ELS — Cooperative Agreements Manager

Continued on next page.



presentation on Promising State Strategies to Improve the Oral Health of CYSHCN at the joint AMCHP/Family Voices conference in February. Jay is also working on a Policy Brief with Children’s Dental Health Project staff on how health care reform might impact the oral health of people with various special health care needs.

Perinatal CommitteeThe committee is working with MSDA to acquire additional data on perinatal activities in states. They have submitted an abstract to present information on state and committee activities during a roundtable at the NOHC. The Committee also is working with the Best Practices Committee to develop a Best Practice Approach Report on Perinatal Oral Health. A first draft outline of the report content and organization has been completed.

School and Adolescent Oral Health CommitteeThe committee is working closely with

partners such as the National Association of School Nurses (NASN), the National Assembly on School Based Health Care (NASBHC), the American School Health Association (ASHA), the National Parent Teachers Association (NPTA) and the National Network of State Adolescent Health Coordinators (NNSAH). Some of these groups will be presenting during the NOHC panel School Oral Health Programs…looking Beyond Dentistry to ensure Success, and committee members have submitted abstracts to present at their meetings. Marcia Manter exhibited for the committee at the ASHA meeting this fall. The committee is also working on multiple policy statements regarding school oral health.

Fluorides CommitteeThe Fluorides Committee is working on their panel presentation for the NOHC, The Future of School Based Fluoride Mouthrinse Programs, as well as an accompanying policy statement and a fact sheet with the National

Maternal and Child Oral Health Resource Center on fluoride mouthrinse programs. Other policy statements are in process. The committee has uploaded a Fluoridation Awards database to the Members Only section of the website to capture the state and community information from previous years.

Healthy Aging CommitteeA webinar on the new Older Adult Basic Screening Survey was held on January 20; copies of the PowerPoint slides have been posted on the ASTDD website (see separate article about the BSS in this newsletter.) The Older Adult BSS will also be discussed in an NOHC panel, as will an analysis by CDC of NHANeS data that highlights the intricate relationship between senior oral health and co-morbidities. linda Ferraro, co-chair of the committee, attended the National Coalition Consensus Conference on Oral Health of Vulnerable Older Adults and Persons with Disabilities, which will also be discussed.

On-line registration is now open for the 2011 National Oral Health Conference (www.nationaloralhealthconference.com/). Be sure to complete your on-line registration by February 28, 2011 to receive the early-bird rates

Make your plans now to join your friends and colleagues for the premier dental public health meeting that promises a wide variety of educational sessions, expert speakers and plenty of networking in the city known as the “Gateway to the West”, Pittsburgh, Pennsylvania.

Three full days of conference sessions are planned April 11-13, 2011 with Pre-conference sessions offered April 9-10, 2011, by the American Association for Community Dental Programs (AACDP) and ASTDD. The American Board of Dental Public Health will be offering the Specialty Board exam to candidates on April 9-10, 2011.

This is the twelfth joint meeting of ASTDD and the American Association of Public Health Dentistry (AAPHD) along with its major sponsor – the Centers for Disease Control and Prevention (CDC). Over 700 participants and 30 exhibitors are expected over the five days of programming.

The National Oral Health Conference will offer scientific sessions in a variety of formats including large plenary sessions, smaller concurrent sessions, poster sessions, and the popular roundtable luncheon. Sessions will focus on issues and topics relevant to research, education and programs, highlighting how all these areas of public health integrate toward achieving “optimal oral health” for the nation’s citizens.

This conference is designed for dentists, dental hygienists, health researchers, dental or health educators, legislators, public health officials, Medicaid/CHIP dental program staff or consultants, state/territorial dental directors, county/city/local dental directors, community health center personnel, students, federally-employed dental personnel, as well as dental manufacturers and dental insurance companies--anyone interested in learning and collaborating to improve the oral health of the public.

National Oral Health Conference

continued from previous page



Marcy Frosh, Children’s Dental Health Project

Harry Goodman, Maryland, and Emanuel Finn, Washington DC

Pam Tolson, American Association of Public Health Dentistry, and Judy Feinstein, Maine

Judy Sherman, American Dental Association, and Kimberlie Yineman, North Dakota

Lynn Mouden, Arkansas

Peg Snow, New Hampshire, and Mark Nehring, HRSA

Mark Nehring, HRSA, and Warren LeMay, Wisconsin

The Board of Directors of ASTDD convened its annual meeting with partners on December 9, 2010 in Washington, DC. Building on the success of previous meetings, there was discussion on collaboration strategies with various partners. A facilitated discussion was conducted around national oral health policy using the Oral Health Policy Tool Guidebook. The meeting also included sharing by partner organizations related to the following topics: coordinated advocacy efforts; promoting and documenting a greater awareness of resources, newsletters, websites, and email distribution lists; increased awareness of state oral health programs and their needs; coordinated data collection and use of data; topics for joint publications; and leadership development. Please see the executive Director’s Message in this issue of the newsletter for additional information regarding the meeting.

ASTDD Partners Meeting



Beverly Isman, RDH, MPH, ELSThanks to those of you who provided valuable feedback to ASTDD on the survey this Fall. The response to the Annual Member Survey was 37/51 states & DC and 43/85 associate members. We use the information to document use of/value of the resources and assistance that were created by or are supported by federal funds or ASTDD funds. We also use the responses to plan and prioritize activities and allocation of resources for the upcoming year. Here are a few findings.

Most significant areas of improvement in the state as a result of direct or indirect activities, resources or advocacy by ASTDD or national organizations of federal agency partners:

• effectiveness of oral health coalitions

• access to accurate, relevant and timely data

• use/citation of oral health data for making decisions, advocacy or highlighting successes or gaps

• cooperation/coordination among oral health stakeholders

• capacity to conduct needs assessments such as BSS, workforce, etc

• strategic thinking/planning/visioning

• knowledge and skills of state oral health program personnel or consultants

Thanks to everyone for noting your top three priorities for the upcoming year so we can share this information with our partners to help increase resources and technical assistance to our members.

Specific Areas of Expertise or InterestThe ASTDD membership displays diverse interests and a wealth of experience. ASTDD leadership is using the responses to invite

members to join committees, represent ASTDD at meetings or work on specific projects or materials.

Specific Uses of ASTDD Assistance and Resources and Any Barriers to their UseThanks for the many responses such as templates, BSS and evaluation TA, the National Oral Health Conference, resources for grant applications and presentations, policies and best practices, and much more. Responses were shared with the Board of Directors and the State Program Assistance and Resources Committee to help make decisions about how to continue to help members and how to reduce potential barriers. Unfortunately we can’t create any more hours in the day to respond to the “not enough time” comments!

Use of ASTDD ListservMembers average use is multiple times a week or every day; most valuable functions are to provide a venue for getting input from peers and to keep informed about ASTDD and national resources and activities. Associate members average use is multiple times a month; most valuable functions are to keep informed of ASTDD resources and activities and to receive legislative updates and alerts.

Use of ASTDD Publications and ProductsUse of the majority of resources was high, particularly the ASTDD Guidelines and Competencies; various policy statements; the newsletter; BSS materials; the NOHSS and Synopsis websites; Best Practice Approach Reports; Fluoride varnish, school health and healthy aging materials; and the online dental manuals. Many people noted they hadn’t seen some of the items and would subsequently view them. When resources are posted on the website, or available from partners, there is usually an announcement on the listserv, so check it often.

Use of ASTDD Annual Member Survey Responses

On December 2, 2010, the U.S. Department of Health and Human Services (HHS) launched the Nation’s new 10-year goals and objectives for health promotion and disease prevention. Healthy People 2020 is committed to the vision of a society where all people live long, healthy lives.

Healthy People 2020 has a renewed focus on health disparities and health equity that addresses the social determinants of health and promotes general health and quality of life across all stages of life. There are 42 topic areas. The Oral Health Topic Area has 17 objectives and is linked to related topic areas of cancer, diabetes and tobacco use.

For more details about the initiative and how you can get involved, visit the newly redesigned Healthy People Web site at www.healthypeople.gov. The Web site has a variety of resources to assist users in tailoring information to their needs, and exploring evidence-based resources for implementation. Throughout the decade new resources and companion documents will continue to be developed to assist with implementation of the objectives.

To stay abreast of new Healthy People information you can:

Subscribe to the Healthy People E-mail Updates Get the latest information about Healthy People 2020. Sign up for the Monthly e-Bulletin or the periodic News You Can Use, which features new tools, events, and resources to help you implement Healthy People.

Connect With Healthy People on LinkedInFind other professionals implementing Healthy People, share ideas, and network. Join the Healthy People 2020 linkedIn group and invite your colleagues to do the same.

Follow Healthy People on TwitterStay current with the latest Healthy People information on Twitter; @GoHealthyPeople

Healthy People 2020 Objectives launched


STATeshot: Indiana


James R. Miller, DDS, MSD, PhD - State Oral Health Director, Indiana State Department of Health

The Indiana State Board of Health dedicated their Monthly Bulletin in October 1945 to dental health. The cover featured the members of the newly formed Council on Dental Health of the Indiana State Dental Association. The bulletin also announced that a dental representative had been appointed to the Board and that a Director had been appointed to the newly formed Division of Dental Health.

Contributors to this issue made some interesting observations for 1945. l.e. Burney, M.D., the State Health Commissioner at the time, came to the following conclusion concerning dental health in Indiana, “We do not need more surveys, more noise as it were. We know the problem - what we need is more light upon how to solve the problem and then do something about it.” This was an admirable call to action.

In the same issue, ee ewbank, DDS, the Secretary of the Indiana State Dental Association, reported that funds would be made available through the US Public Health Service for the “determination of the dental service needs which occur during childhood. This determination would be made on the basis of the annual increment of dental defects and should not include the added and complicated needs accumulated from neglect…. It is planned that this demonstration be held in a community of suitable size and where the population can be depended upon to be relatively stable.” Few epidemiologists alive today could have said it better.

Over sixty-five years later oral health is still an integral part of the Indiana State Department of Health. Currently, the Oral Health Program is located within the Health and Human Services

Commission; it consists of the State Oral Health Director and an administrative assistant. We hope to welcome a health educator in the near future. environmental Public Health, located within the Public Health and Preparedness Commission, is responsible for monitoring community water fluoridation systems within Indiana.

The Oral Health Program is in the process of redirecting its efforts to emphasize the periodic collection of population-based data to help establish the burden of oral disease in the state, as well as supporting the primary prevention of oral disease.

Probably the most important effort at primary prevention since the formal recognition in 1945 of oral health as a component of public health in Indiana has been the emphasis on the fluoridation of community water systems. Indiana’s water fluoridation program began in 1951, and has evolved to the point where currently about 95% of Hoosiers who receive their water from community water systems receive fluoridated water. This has occurred in a state where each local community decides whether or not to fluoridate its water.

low-income children in Indiana who are enrolled in Medicaid are eligible for several primary preventive dental services that include the placement of dental sealants on newly erupted permanent molars. By 12 years of age over 50% of children enrolled in Medicaid have had a dental sealant placed on at least one permanent molar.

To augment these efforts at primary prevention, the Indiana State Department of Health supports a program run through the Indiana University School of Dentistry to place dental sealants on the permanent molars of low-income children. The Indiana State Department of Health also supports two other smaller programs with preventive components. These programs are currently funded through a Preventive Health and Health Services Block Grant and a Maternal and Child Health Services Title V Block Grant. The residents of Indiana are also fortunate that the state supports Donated Dental Services, which allows eligible residents to obtain dental care that they otherwise would not have been able to afford.

The Oral Health Program also collaborates with many individuals, organizations, and institutions to promote oral health in Indiana. To enhance collaboration among these entities the Oral Health Program recently helped establish the Indiana Oral Health Coalition that meets quarterly. The Indiana State Department of Health supports the Indiana Oral Health Coalition in many ways, including providing the Coalition with an online site for communication and collaboration.

The Oral Health Program at the Indiana State Department of Health continues to work for the oral health of the residents of Indiana, indebted to the insights and hard work provided by our predecessors.



Growing up with both parents as health professionals, life has taken the natural path for Pamela’s career. Her father was a dentist, her mother a nurse, so when she brought home her college boyfriend, an endodontist, the oral health connection solidified the visit. Now after 28 years, Pamela is still married to her favorite dentist, Arthur Fox! They have two daughters, Shayna, a high school science teacher studying for her doctoral degree in education, and Aleah who is a doctoral student in

the field of genomics and computational biology.

Pamela graduated from Forsyth Dental Center in Boston and is a Registered Dental Hygienist. She also graduated with an Associates Degree from Northeastern University, a Bachelor’s Degree from Boston University and a Masters Degree in Public Health from the University of Connecticut.

Pamela worked for the City of New london for over twenty years, serving the last eleven years as the Director of Health and Social Services. As the Director, Pamela was active in forming several collaboratives including New london County Safe Kids, Putting on AIRS (an asthma initiative), Smiles Across Southeastern Connecticut, an oral health project which delivers oral preventive health services to more than 20 towns using portable dental units and hygienists from the two largest community health centers in the region. This successful school-linked program has become self-sustaining.

In November, 2004, Pamela began in her current position as Branch Chief for local Health Administration for the State of Connecticut,

Department of Public Health. In this position, Pamela is the liaison between the 77 local Health Directors and the Commissioner of the Department of Public Health. Pamela is working on the Transition Program to encourage part time health departments to form or join health districts to provide full time health services to the citizens of Connecticut. She and her staff assist local health directors in public health preparedness as well as providing the day-to-day public health services related to Connecticut General Statutes and the Public Health Code. Pamela and the members of the local Health Administration Branch took the lead with the Commissioner to complete the National Public Health Performance Standards Assessment at the state level.

In June of 2009, the former Dental Director retired and as Connecticut was in a hiring freeze, Pamela was chosen to be the Interim Dental Director and is enjoying the added responsibilities and reconnecting with her oral heath roots! She is thankful for a terrific staff in the Office of Oral Heath to keep the operations running smoothly. The team works hard on facilitating the statewide Connecticut Coalition for Oral Health (CCOH), educating water operators on the benefits of water fluoridation, connecting children to a dental home by age one (our Home by One program), coordinating the second Basic Screening Survey on kindergarten and third graders, updating our burden document, working with the Task Force for Older Adults and the many activities related to oral health advocacy. The strength of the team is Pamela’s support as she continues to strategize for the future, as well as educating the local health departments in their role to increase oral health awareness and assist in the distribution of resources throughout Connecticut.

Pamela can be reached at [email protected] and you can enjoy the website at www.ct.gov/dph and click on oral health.

ASTDD Member Profile: Pamela Kilbey-Fox, RDH, MPH – Interim State Dental Director, Office of Oral Health, Connecticut Department of Public Health

International Association for Dental Research (March 14-17, 2011) San Diego Convention Center – San Diego, CA http://www.iadr.org/i4a/pages/index.cfm?pageid=3912

National Oral Health Conference (April 9-13, 2011) Pittsburgh, PA http://www.nationaloralhealthconference.com/

MSDA National Medicaid and CHIP Oral Health Symposium (June 27-28, 2011) Washington Marriott Wardman Park – Washington, DC http://medicaiddental.org/Conferences/index.html

National Conference on Health Communication, Marketing, and Media (August 9-11, 2011) Atlanta, GA http://www.cdc.gov/NCHCMM

American Public Health Association Annual Meeting (October 29 – November 2, 2011) Washington, DC http://www.apha.org/meetingsU

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Marcia Manter is the Community Development Specialist with Oral Health Kansas (OHK), the state advocacy organization. Her role is to contribute to the public awareness and education services OHK provides. She coordinates population-centered projects designed to build systems so that all Kansans may have optimum oral health as well as supports the development of statewide advisory councils and community oral health coalitions. Her project management

roles involve recruiting experts to guide the development of the project, facilitating planning and problem solving meetings, writing materials, designing workshops, speaking and exhibiting at conferences, and preparing proposals to fund aspects of a project.

Marcia grew up on the south side of Chicago, and even today, spending time in downtown Chicago gives her an energy burst that comes from no other place. After going to college in Ohio, she lived in Cincinnati, she moved back to Chicago, then on to Newport, Rhode Island, lenexa, Kansas and now in Topeka. Her career background is just as varied, being a liberal arts major. She taught writing and speech at community colleges, served as a human resource manager at the American Hospital Association, and operated her own organizational development consulting business for ten years before joining the Region VI Head Start consulting firm.

She didn’t plan to work in the oral health field. It found her and fired up a passion for a cause she had no idea existed--to improve the oral health of all the people going without care. In 1997 as an organizational development consultant for Region VII Head Start, Marcia first began designing projects to improve systems for oral health. That launched several demonstration projects in Iowa, Missouri, Nebraska and Kansas. Many statewide organizations and

Head Start programs responded to the invitation to develop their own educational resources and programs. She continues to contribute to Kansas Head Start Association’s oral health initiatives, having recently co-written a Home Visiting Oral Health Curriculum with Kathy Hunt, RDH, eCP II, director of Kansas Cavity Free Kids. Marcia served on the ASTDD Head Start Committee for many years and currently serves on the School and Adolescent Oral Health Committee.

In 2004, Oral Health Kansas offered her a career-changing opportunity to establish a system to implement new legislation permitting Registered Dental Hygienists to bring their services into the community. It is known as the extended Care Permit (eCP). That program has resulted in more than 100 hygienists with an eCP who serve in early childhood programs, schools, centers for people with disabilities and programs for older adults. Now, she is also passionate about the roles dental hygienists play in preventing oral disease.

Other projects came along as well as a full-time job with OHK: Kansas School Coordinated Oral Health Guidelines, designed to incorporate oral health into all levels of health policy and practices for students; Optimum Oral Health for Children with Special Health Care Needs, a parent and staff oral education program in partnership with Kansas Bureau of Oral Health; and Oral Health for People with Developmental Disabilities, with Kansas Council on Developmental Disabilities. In addition, for the past three years Marcia has kept a focus on oral health for seniors -- being one herself -- working closely with Kansas Area Agencies on Aging, Kansas Department on Aging, Kansas Home Care Association and Kansas Health Care Association. This partnership just completed a planning session to expand strategies that model medical-dental integration services for vulnerable elders.

She is a widow of four years, with three adult/aging step-sons and wonderful daughters-in-law, five adult grandchildren, and a great grandchild on the way… and a large group of friends in Kansas and scattered around the country. She delights in anything that is a story, as in novels, plays, movies, and people. This past year, Marcia organized a group of volunteers to collect stories from more than 40 Women Military Veterans, from WWII to current wars.

Connect with your colleagues at the top social and philanthropic event in dentistry on Wednesday, February 23 at Chicago’s historic Field Museum. Hosted by Oral Health America (OHA), the goal of the 21st annual gala is to raise funding for communities in need through a proven mix of superb fare, unbeatable networking and the chance to share Steven Spielberg’s delight in the neoclassical home turf of the intrepid archaeologist and adventure hero, Indiana Jones.

Belle of the ball, 67 million-year-old Sue will be on hand to welcome you to the Stanley Field Hall’s gleaming white marble interiors, skylit vaulted ceilings and stately columns. Over 900 guests will “party for a cause” in support of OHA’s mission to change lives by connecting communities with resources to increase access to oral health care, education, and advocacy. OHA and its community-based program partners routinely go above and beyond the call of duty in preventing and treating dental disease for at-risk children and families.

To obtain your tickets contact Joe Donohue at 312-836-9900 or [email protected].

Funds raised through the Gala will go towards OHA’s 2011 Annual Fund Campaign which supports all of OHA’s programs. A donation to OHA through the purchase of Gala tickets, auction items, or raffle tickets will benefit OHA’s signature programs which improve oral health for all Americans, especially those most vulnerable: Smiles Across America®, Medical Dental Dialogues, The Wisdom Tooth Project, NSTeP® (National Spit Tobacco education Program), and Campaign for Oral Health equity.

More information on the Gala may be obtained at www.oralhealthamerica.org. Be sure to sign up for OHA’s monthly eNewsletter on-line, follow our tweets at “smile4health” and become an OHA fan on Facebook today!

ASTDD Associate Member Profile: Marcia Manter, Kansas

Reserve February 23 for an evening with Destiny



When SARS, MRSA and more recently, Novel H1N1, emerged as current issues, the Organization for Safety, Asepsis and Prevention (OSAP) responded by providing a rich online resource that was updated on a daily basis for dental professionals. OSAP did the legwork to survey the literature, vet and collate trusted information, checklists, Q&A and how-to’s to help dental professionals meet the challenges head-on.

Immediate response to emerging pathogens of concern is but one of the many services OSAP provides. Strategically, OSAP’s goals are to:

• Identify, foster and build a strong community of recognized infection prevention and safety experts/facilities within oral healthcare,

• Improve infection prevention and safety compliance within dental practices, organizations, academic institutions, and companies involved in the provision of oral care, and

• Develop sustainable resources to support achievement of OSAP’s organizational mission.

OSAP is the world’s leading membership association exclusively dedicated to preventing disease transmission and ensuring the safe delivery of oral care for all. This razor-sharp focus on infection prevention comes from a diverse membership comprised of oral and other healthcare professionals, consultants, researchers and organizations that include non-governmental organizations, manufacturing and distribution companies, government agencies and academia. ASTDD members will undoubtedly recognize OSAP’s educational foundation chairman, Don Marianos. Don and other OSAP members share a vision of Safe Dental Care for People everywhere. The organization’s mission is “to be the world’s leading advocate for the safe and infection-free delivery of oral care.”

Recently, OSAP completed and posted on its website an infection control checklist for programs using portable dental equipment such as those targeted for community-based dental programs. ASTDD member, Bev Isman, was the project coordinator for this valuable new resource.

A selection of OSAP programs for which ASTDD members may have some familiarity include:

• If Saliva Were Red, the powerful visual lesson on cross-contamination. No one who has viewed this 7-minute video ever forgets its important message,

• From Policy to Practice – OSAP’s ONLINE Guide to the CDC Guidelines (Free and available in english and Spanish),

• OSAP’s Traveler’s Guide for Safe Dental Care, and

• OSAP Guide for Safety and Infection Control for Oral Healthcare Missions.

OSAP is a valuable resource for dentistry. Its many resources provide practical, scientifically sound information and

recommendations on specific issues like H1N1, dental unit water quality, “green” infection control, instrument processing, surface asepsis, percutaneous injuries, and much more.

OSAP’s continuing-education-accredited publications include a bi-monthly newsletter, Infection Control in Practice (ICIP), containing information, charts and resources on specific issues of interest in dental practice as well as an opportunity to earn continuing education credit. ICIP’s editorials tackle infection control with different approaches including compartmentalizing issues and procedures (2008), examining different circumstances that can occur in a typical dental practice (2009), and examining the consequences that could occur with infection control lapses (2010). The theme for 2011 will be empowerment to assist the member(s) of the dental team who is generally responsible for infection control to be a more effective leader of infection prevention and patient safety.

OSAP also provides relevant news, articles and research from around the world and organizes it by topic for speedy retrieval. Members receive The OSAP Report Online (TORO), a monthly online compilation of important and timely news, research and information as well as weekly INFOBITeS of two to three breaking news items. And, members enjoy a special “Ask OSAP” benefit, obtaining written, referenced answers to their infection control questions within 24-48 hours.

live educational programming includes a Symposium every June and a four-day foundation course that is co-sponsored with the US Air Force and Federal Dental Services in January. The upcoming June Symposium will bring together experts from around the world to provide the latest information on current issues, guidance and products. The Symposium also will deliver valuable educator and consultant tools, training tips and networking opportunities to build a solid base of support within the profession. ASTDD members should consider sending one representative from each state to the June 9-12 Symposium in Plano (Dallas), TX to bring home these key preventive and management messages to their constituents.

OSAP invites all ASTDD members to visit www.OSAP.org for infection control resources and, especially, to join as members of this important community for news, education and support to meet today’s…and tomorrow’s infection control and safety challenges.

Check www.OSAP.org for a complete selection of OSAP programs.

Meet an ASTDD Collaborating Partner — Organization for Safety, Asepsis and Prevention (OSAP)

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The National Maternal and Child Oral Health Resource Center (OHRC) in collaboration with the Maternal and Child Health library at Georgetown University released a new edition of the knowledge path about oral health for infants, children, adolescents, and pregnant women. Presented in time for National Children’s Dental Health Month in February, this electronic resource guide points to resources that analyze data, describe effective programs, and report on policy and research aimed at improving access to and the quality of oral health care. The knowledge path can be used by health professionals, program

administrators, educators, and policymakers to learn more about oral health, for program development, and to locate training resources and information to answer specific questions. Separate sections present resources for families, schools, and child care and Head Start programs as well as resources about dental caries, dental sealants, fluoride varnish, pregnancy, and special health care needs. The knowledge path is available at http://www.mchoralhealth.org/knwpathoralhealth.html. Knowledge paths on other topics are available at http://www.mchlibrary.info/KnowledgePaths/index.html.

New Guide to Oral Health Resources for Professionals

The US Department of Health and Human Services (HHS) and the US environmental Protection Agency (ePA) have announced important steps to ensure that standards and guidelines on fluoride in drinking water continue to protect the American people while promoting good dental health, especially in children. HHS is proposing that the recommended level of fluoride in drinking water can be set at the lowest end of the current optimal range (0.7 to 1.2 milligrams per liter) to prevent tooth decay, and ePA is initiating review of the maximum amount of fluoride allowed in drinking water. This updated recommendation is based on recent ePA and HHS scientific assessments to balance the benefits of preventing tooth decay and limiting any unwanted health effects. These scientific assessments will also guide ePA in making a determination of whether to lower the maximum amount of fluoride allowed in drinking water, which is set to prevent adverse health effects. A prepublication version of the proposed recommendation is available online. Comments on the proposed change will be accepted for 30 days after publication in the Federal Register. Comments can be sent to [email protected]. Final guidance for community water fluoridation is expected by Spring 2011.

Dr. Raymond Flanders, former dental director for the state of Illinois, has published a novel on the Korean War. The title of the book is “The Korean Pipeline” and the book follows three enlisted men from their initial recall to active duty, to their combat service in Korea, and to what finally happens to each of them.

Dr. Flanders served in the United States Army as an enlisted man with the 24th Division in Korea. Flanders earned the World War II Victory Medal, the Korean War Victory Medal, and was awarded the Bronze Service Star for service in the Korean War. Dr. Flanders and his wife, Anne-liss, now live in Williamsburg, Virginia.

“The Korean Pipeline” is available at www.amazon.com.

HHS and ePA Announce New Scientific Assessments and Actions on Fluoride

Former Illinois State Dental Director Publishes Novel on Korean War

This packet, which consists of a CD and DVD, includes all the information you will need to plan and conduct a Basic Screening Survey of high risk older adults at congregate meal sites or long-term care facilities. We recommend that each organization conducting a BSS order one complete packet from the ASTDD website. A $5 fee covers shipping and handling. The CD and DVD may be replicated if you need additional copies.

The CD contains:• BSS Manual; A step-by-step guide for the process of conducting

an oral health survey of older adults. If you interested in the manual but not in the full BSS Tool, you can download the manual from the ASTDD website.

• Information on the impact of HIPAA and IRB review on oral health surveys. This is a short synopsis that gives general guidance and resources on IRB review and HIPAA compliance for oral health surveys.

The DVD contains an examiner training video for dental professionals. It can be viewed online.

Thanks to the Data Committee and the Healthy Aging Committee for completing this joint project. Thanks also to SOS Video Communications for the video shoots and production and to the Connecticut Oral Health Program staff for arranging and participating in the video shoot.

New Older Adult Basic Screening Survey Packet

Board of DirectorsMargaret M. Snow, DMD, MBA, MPH – PresidentHarry S. Goodman, DMD, MPH – President electSteven J. Steed, DDS – Immediate Past-PresidentKimberlie J. Yineman, RDH, BA - SecretaryChristine H. Veschusio, RDH, MA – TreasurerKatherine Weno, DDS, JD – DirectorJudith A. Feinstein, MSPH - Directoremanuel Finn, DDS, MPH – Director Raymond l. Kuthy, DDS, MPH - Associate Member DirectorChristine Wood, RDH, BS – executive Director, ex OfficioM. Dean Perkins, DDS, MPH – executive Director emeritus, ex OfficioWarren R. leMay, DDS, MPH – Newsletter editor, ex OfficioBeverly Isman, RDH, MPH – Cooperative Agreement Manager, ex Officio

Newsletter StaffWarren leMay, DDS, MPH – editorlynn Bethel, RDH, BSDH, MPH – Assistant editor Bill Zillmer/Anunci Creative Group, llC – Design/layout

Executive DirectorChristine Wood, RDH, BS

ASTDD Central Office1838 Fieldcrest DriveSparks, NV 89434Telephone: 775-626-5008FAX: 775-626-9268email: [email protected]

Funding for Oral Health Matters is provided through cooperative agreements from the CDC Division of Oral Health

and HRSA Maternal and Child Health Branch.


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