The National Vision for Oral HealthThe National Vision for Oral Health

William Bailey, DDS, MPHWilliam Bailey, DDS, MPH

RADM, USPHSRADM, USPHS

Chief Dental OfficerChief Dental Officer

Acting Director, CDC Division of Oral HealthActing Director, CDC Division of Oral Health

wdb9@cdc.govwdb9@cdc.gov

This presentation has not been cleared for dissemination and does not represent the opinion of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

What may influence our vision?What may influence our vision?

National BackdropNational Backdrop• Debt, Health Reform, Strategic Plans, Reviews, Debt, Health Reform, Strategic Plans, Reviews,

Data IssuesData Issues Competing prioritiesCompeting priorities Infrastructure and capacityInfrastructure and capacity

• Workforce challenges, succession planning, Workforce challenges, succession planning, new modelsnew models

PartnershipsPartnerships CommunicationCommunication

How far out can we see?How far out can we see?

HHS Strategic Plan – 5 yearsHHS Strategic Plan – 5 years HHS Oral Health Initiative – 5 yearsHHS Oral Health Initiative – 5 years Healthy People 2020 – 10 yearsHealthy People 2020 – 10 years

Goal 2: Transform Health CareGoal 2: Transform Health Care

Through its Departmental Oral Health Initiative, HHS is Through its Departmental Oral Health Initiative, HHS is promoting the incorporation of oral healthcare services promoting the incorporation of oral healthcare services and oral disease prevention into primary healthcare and oral disease prevention into primary healthcare delivery sites. delivery sites.

HHS will promote policies to integrate oral health into HHS will promote policies to integrate oral health into primary care, including prevention and improved health primary care, including prevention and improved health literacy. literacy.

Improved availability of oral health services, including Improved availability of oral health services, including disease prevention, treatment, and health promotion and disease prevention, treatment, and health promotion and education should be promoted for poor and underserved education should be promoted for poor and underserved populations as well as for the population at large. populations as well as for the population at large.

Goal 2: Transform Health CareGoal 2: Transform Health Care

Increase access to primary oral healthcare services and Increase access to primary oral healthcare services and to oral disease preventive services by expanding access to oral disease preventive services by expanding access to: to: • health centers, school-based health centers, and health centers, school-based health centers, and

Indian Health Service funded health programs that Indian Health Service funded health programs that have comprehensive primary oral healthcare services, have comprehensive primary oral healthcare services, and and

• State and community-based programs that improve State and community-based programs that improve oral health, especially for children and pregnant oral health, especially for children and pregnant women. women.

Goal 3: Advance Scientific Goal 3: Advance Scientific Knowledge and InnovationKnowledge and Innovation

Strengthen oral health research Strengthen oral health research Use evidence-based oral health promotion and disease Use evidence-based oral health promotion and disease

preventionprevention Clarify the interrelationships between oral disease and Clarify the interrelationships between oral disease and

other medical diseasesother medical diseases

Goal 5: Strengthen the Nation’s Health and Goal 5: Strengthen the Nation’s Health and Human Service Infrastructure and Human Service Infrastructure and

WorkforceWorkforce

Expand the primary oral healthcare team Expand the primary oral healthcare team Promote models, where appropriate, that: Promote models, where appropriate, that:

• incorporate new providers, incorporate new providers, • expand scope of existing providers, and expand scope of existing providers, and • utilize medical providers to provide evidence-based utilize medical providers to provide evidence-based

oral health preventive servicesoral health preventive services

The United States Public Health Service

Oral Health Coordinating Committee

• Indian Health Service

• Office on Disability

• Food and Drug Administration

• Agency for Healthcare Research and Quality

• Administration on Aging

• Office of Public Health and Science

• US Coast Guard

• Federal Bureau of Prisons

• National Institutes of Health

• Centers for Disease Control and Prevention

• National Center for Health Statistics

• Health Resources and Services Administration

• Centers for Medicare and Medicaid Services

• Administration for Families/Office of Head Start

Structure - Oral Health Coordinating Committee

HHS ORAL HEALTHINITIATIVE 2010

“PROMOTING AND ENHANCING THE ORAL HEALTH OF THE PUBLIC”

NationalNational Oral Health Surveillance Plan Oral Health Surveillance PlanProgress ReportProgress Report

NIDCR and CDC met with nationally-recognized experts NIDCR and CDC met with nationally-recognized experts Themes emerged from the meeting: Themes emerged from the meeting:

• Oral health data must serve a multiplicity of need — for research and for public Oral health data must serve a multiplicity of need — for research and for public health/practice and policy.health/practice and policy.

• Strengthening communications with advocates and stakeholders will help define goal-Strengthening communications with advocates and stakeholders will help define goal-directed data-capture methods and data analyses.directed data-capture methods and data analyses.

• The granularity and frequency of oral health surveillance data collection has resource The granularity and frequency of oral health surveillance data collection has resource implications.implications.

• Movement toward self-reported data collection and other non-invasive data collection Movement toward self-reported data collection and other non-invasive data collection may enhance the evenness of oral health data collected across populations. may enhance the evenness of oral health data collected across populations.

• Efforts must continue to integrate oral health with systemic health, with implications for Efforts must continue to integrate oral health with systemic health, with implications for both oral health monitoring and oral disease prevention and management.both oral health monitoring and oral disease prevention and management.

  A summary of the meeting and the background paper have been finalized A summary of the meeting and the background paper have been finalized and are under review prior to submission for publication in a major public and are under review prior to submission for publication in a major public health journal. health journal.

Communications and collaborations with CDC, NIDCR and NCHS Communications and collaborations with CDC, NIDCR and NCHS continuecontinue  

Innovative State Medicaid Dental ProgramsInnovative State Medicaid Dental ProgramsProgress ReportProgress Report

Review of successful practices and program innovationsReview of successful practices and program innovations• Partnerships and collaborations among State partners and stakeholders in Partnerships and collaborations among State partners and stakeholders in

addressing access to dental services; addressing access to dental services; • Collaboration with dental schools and loan repayment programs; Collaboration with dental schools and loan repayment programs; • Increased reimbursement; Increased reimbursement; • Simplifying administrative processes; Simplifying administrative processes; • Grant funding; Grant funding; • Educating families; Educating families; • Targeting young children; andTargeting young children; and• Dental home initiatives Dental home initiatives

Increase the rate  of low income children ages 1-20 enrolled in Medicaid or CHIP who Increase the rate  of low income children ages 1-20 enrolled in Medicaid or CHIP who received any preventive dental services by 10 percentage points over a five-year period. received any preventive dental services by 10 percentage points over a five-year period.

Increase the rate  of low income children ages 6-9 enrolled in Medicaid or CHIP who Increase the rate  of low income children ages 6-9 enrolled in Medicaid or CHIP who receive a dental sealant on a permanent molar tooth by 10 percentage points over a five-receive a dental sealant on a permanent molar tooth by 10 percentage points over a five-year period. year period.

National Study on Oral Health Access to ServicesNational Study on Oral Health Access to ServicesProgress ReportProgress Report

Hearings/meetings have been held for the:Hearings/meetings have been held for the: Assessment of the current oral health care system. Assessment of the current oral health care system. Development of strategies to improve access to and the Development of strategies to improve access to and the

effectiveness of oral health services to vulnerable populationseffectiveness of oral health services to vulnerable populations Preparation of a strategic plan for addressing issues and improving Preparation of a strategic plan for addressing issues and improving

the particular role of Federally Qualified Health Centers in meeting the particular role of Federally Qualified Health Centers in meeting the oral health needs of the underserved. the oral health needs of the underserved.

The IOM Oral Health Initiative Committee will recommend actions for The IOM Oral Health Initiative Committee will recommend actions for DHHS agencies and, if relevant and important, other actors to:DHHS agencies and, if relevant and important, other actors to:

  Design of a future system for providing oral health care for women Design of a future system for providing oral health care for women and children who are most vulnerable to oral diseaseand children who are most vulnerable to oral disease

The report is currently on track for March 2011 submission to HRSA The report is currently on track for March 2011 submission to HRSA and publication of the final report in August 2011.and publication of the final report in August 2011.

National Study on an Oral Health InitiativeNational Study on an Oral Health InitiativeProgress ReportProgress Report

Hearings/meetings have been held for the: Hearings/meetings have been held for the: Assessment of the current oral health care system. Assessment of the current oral health care system. Examination of preventive care interventions, their use and promotion, Examination of preventive care interventions, their use and promotion,

including greater health literacy; including greater health literacy; Review of the elements of a national oral health initiative encompassing Review of the elements of a national oral health initiative encompassing

regulations, statutes, programs, research, data, financing, and policy regulations, statutes, programs, research, data, financing, and policy

The IOM Oral Health Initiative Committee will recommend actions for The IOM Oral Health Initiative Committee will recommend actions for HHS agencies and, if relevant and important, other actors to HHS agencies and, if relevant and important, other actors to Improve Improve and expand the HHS Oral Health Initiativeand expand the HHS Oral Health Initiative

The report is currently on track for March 2011 submission to HRSA and The report is currently on track for March 2011 submission to HRSA and publication of the final report in August 2011.publication of the final report in August 2011.

Overall Goal: Reduce the prevalence of ECC among 0-5 Overall Goal: Reduce the prevalence of ECC among 0-5 year old AI/AN children by 25% by FY 2015.year old AI/AN children by 25% by FY 2015.

1.1. Increase dental access for 0-5 year old AI/AN children by 10% in FY Increase dental access for 0-5 year old AI/AN children by 10% in FY 2010 and 50% by FY 2015.2010 and 50% by FY 2015.

2.2. Increase the number of children 0-5 years old who received a Increase the number of children 0-5 years old who received a fluoride varnish treatment by 10% in FY 2010 and 25% by FY 2015.fluoride varnish treatment by 10% in FY 2010 and 25% by FY 2015.

3.3. Increase the number of sealants among children 0-5 years old by Increase the number of sealants among children 0-5 years old by 10% in FY 2010 and 25% by FY 2015.10% in FY 2010 and 25% by FY 2015.

4.4. Increase the number Interim Therapeutic Restorations provided for Increase the number Interim Therapeutic Restorations provided for children ages 0-5 by 10% in FY 2010 and 50% by FY 2015.children ages 0-5 by 10% in FY 2010 and 50% by FY 2015.

The Early Childhood Caries InitiativeThe Early Childhood Caries InitiativeProgress ReportProgress Report

ECC Initiative PacketECC Initiative Packet

Together we can prevent ECC!!!

Available now! www.doh.ihs.gov/ecc

Clinical and Translational Science ProgramClinical and Translational Science ProgramCreation of Dental Network ToolkitCreation of Dental Network Toolkit

Progress Report Progress Report

A clinical data management system to support:A clinical data management system to support:• Dental Clinical TrialsDental Clinical Trials• Patient RegistriesPatient Registries• Longitudinal & Observational StudiesLongitudinal & Observational Studies

Key functionality included:Key functionality included:• Study configuration Study configuration - - Protocol details, visit schedules, site specific Protocol details, visit schedules, site specific

definitions, eligibility determination & treatment assignmentdefinitions, eligibility determination & treatment assignment

• Case Report Form (eCRF) managementCase Report Form (eCRF) management - - online form design, custom online form design, custom and standard eCRFs from central libraryand standard eCRFs from central library

• Electronic data captureElectronic data capture - - custom field validation, complex conditional logic, custom field validation, complex conditional logic, automated data queriesautomated data queries

• Integration of external data feedsIntegration of external data feeds - - laboratory and reading center importslaboratory and reading center imports

• Data extract and reportingData extract and reporting - - CDISC ODM data interchange, standard and CDISC ODM data interchange, standard and ad hoc reportsad hoc reports

Oral health educational materials have been added to materials distributed Oral health educational materials have been added to materials distributed by OWH staff at all exhibits and in by OWH staff at all exhibits and in www.womenshealth.govwww.womenshealth.gov..

The OWH fact sheet on oral health and the OWH pregnancy module is in The OWH fact sheet on oral health and the OWH pregnancy module is in the final stages of revision for publication and distribution to the public at the final stages of revision for publication and distribution to the public at exhibits and also via the exhibits and also via the www.womenshealth.govwww.womenshealth.gov website. website.

  Quick Health Data OnlineQuick Health Data Online (QHDO), a database through (QHDO), a database through www.womenshealth.govwww.womenshealth.gov providing state- and county-level data has updated providing state- and county-level data has updated its list of oral health data sources and subcategories to increase the number its list of oral health data sources and subcategories to increase the number of oral health indicators for the database. of oral health indicators for the database.

An added link to An added link to QHDOQHDO provides data on women’s dental visits and dental provides data on women’s dental visits and dental cleaning as one of eleven indicators focusing on preventive measures cleaning as one of eleven indicators focusing on preventive measures women can take to improve their physical and mental health and prevent women can take to improve their physical and mental health and prevent disease.disease.

Oral Health as Part of Women’s Health Across the Lifespan

Progress Report

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Healthy People 2020Healthy People 2020

• There are 4 Overarching Goals:There are 4 Overarching Goals: Attain high quality, longer lives free of preventable Attain high quality, longer lives free of preventable

disease, disability, injury, and premature death.disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and Achieve health equity, eliminate disparities, and

improve the health for all.improve the health for all. Create social and physical environments that Create social and physical environments that

promote good health for all.promote good health for all. Promote quality of life, healthy development and Promote quality of life, healthy development and

healthy behaviors across all life stages.healthy behaviors across all life stages.

HP 2020 Oral Health ObjectivesHP 2020 Oral Health Objectives

Objectives Retained as is from HP 2010:• Oral Health HP2020 1: Oral Health HP2020 1: Increase the proportion of oral and pharyngeal Increase the proportion of oral and pharyngeal

cancers detected at the earliest stage. (21.6)cancers detected at the earliest stage. (21.6)

• Oral Health HP2020 2: Oral Health HP2020 2: Increase the proportion of the U.S. population Increase the proportion of the U.S. population served by community water systems with optimally fluoridated water. served by community water systems with optimally fluoridated water.

• Oral Health HP2020 3: Oral Health HP2020 3: Increase the proportion of children and adults Increase the proportion of children and adults who use the oral health care system each year. (21.9)who use the oral health care system each year. (21.9)

• Oral Health HP2020 4: Oral Health HP2020 4: Increase the proportion of low-income children Increase the proportion of low-income children and adolescents who received any preventive dental service during the and adolescents who received any preventive dental service during the past year. (21.12)past year. (21.12)

• Oral Health HP2020 5: Oral Health HP2020 5: Increase the number of States and the District Increase the number of States and the District of Columbia that have an oral and craniofacial health surveillance of Columbia that have an oral and craniofacial health surveillance system. (21.16)system. (21.16)

Objectives Retained but Modified from HP 2010:• Oral Health HP2020 6: Oral Health HP2020 6: Reduce the proportion of children and Reduce the proportion of children and

adolescents who have dental caries experience in their primary or adolescents who have dental caries experience in their primary or permanent teeth. (21.1)permanent teeth. (21.1)

• Oral Health HP2020 7: Oral Health HP2020 7: Reduce the proportion of children, Reduce the proportion of children, adolescents, and adults with untreated dental decay. (21.2)adolescents, and adults with untreated dental decay. (21.2)

• Oral Health HP2020 8: Oral Health HP2020 8: Increase the proportion of adults who have Increase the proportion of adults who have never had a permanent tooth extracted because of dental caries or never had a permanent tooth extracted because of dental caries or periodontal disease. (21.3/21.4)periodontal disease. (21.3/21.4)

• Oral Health HP2020 9: Oral Health HP2020 9: Reduce Periodontitis (21.5b)Reduce Periodontitis (21.5b)• Oral Health HP2020 10: Oral Health HP2020 10: Increase the proportion of children who Increase the proportion of children who

have received dental sealants on their molar teeth.have received dental sealants on their molar teeth. (21.8a/b)(21.8a/b)

HP 2020 Oral Health ObjectivesHP 2020 Oral Health Objectives

HP 2020 ObjectivesHP 2020 ObjectivesObjectives Retained but Modified from HP 2010:

• Oral Health HP2020 12: Oral Health HP2020 12: Increase the proportion of school-based Increase the proportion of school-based health centers with an oral health component. (21.13a/b)health centers with an oral health component. (21.13a/b)

• Oral Health HP2020 13: Oral Health HP2020 13: Increase the proportion of local health Increase the proportion of local health departments and Federally Qualified Health Centers, that have an departments and Federally Qualified Health Centers, that have an oral health component. (21.14)oral health component. (21.14)

• Oral Health HP2020 14: Oral Health HP2020 14: Increase the number of States, and DC that Increase the number of States, and DC that have a system for recording and referring infants and children with have a system for recording and referring infants and children with cleft lips and cleft palates to craniofacial anomaly rehabilitative teams. cleft lips and cleft palates to craniofacial anomaly rehabilitative teams. (21.15) (21.15)

• Oral Health HP2020 15: Oral Health HP2020 15: Increase the number of health agencies Increase the number of health agencies that have a public dental health program directed by a dental that have a public dental health program directed by a dental professional with public health training. (21.17a/b)professional with public health training. (21.17a/b)

HP 2020 ObjectivesHP 2020 Objectives

New Objective to HP 2020:•Oral Health HP2020 16: Oral Health HP2020 16: (Developmental) Increase the proportion of (Developmental) Increase the proportion of adults who receive preventive screening and counseling from dental adults who receive preventive screening and counseling from dental

professionals.professionals.• Increase the proportion of adults who received information from a Increase the proportion of adults who received information from a

dentist or dental hygienist focusing on reducing tobacco usage or dentist or dental hygienist focusing on reducing tobacco usage or smoking cessationsmoking cessation

• Increase the proportion of adults who received an annual cancer Increase the proportion of adults who received an annual cancer screening from a dentist or dental hygienist. (Formerly 21.7)screening from a dentist or dental hygienist. (Formerly 21.7)

• Increase the proportion of adults who are tested or referred for Increase the proportion of adults who are tested or referred for glycemic control from a dentist or dental hygienistglycemic control from a dentist or dental hygienist

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Resources:Resources: http://healthypeople.govhttp://healthypeople.gov http://cdc.gov/nchs/http://cdc.gov/nchs/ http://wonder.cdc.gov/http://wonder.cdc.gov/ Healthy People Listserve Healthy People Listserve

(HEALTHYPEOPLE@LIST.NIH.GOV)(HEALTHYPEOPLE@LIST.NIH.GOV)

HP 2020 ResourcesHP 2020 Resources

Vision for the Future – Vision for the Future – Other PossibilitiesOther Possibilities

National Oral Health PlanNational Oral Health Plan Quality measuresQuality measures Improved communication and Improved communication and

collaboration between public and private collaboration between public and private entitiesentities

Increased focus on older adultsIncreased focus on older adults Utilizing Health Information Technology to Utilizing Health Information Technology to

improve careimprove care

Questions?Questions?