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Tooth Talk: Strategies for Improving Oral Health Employee Benefits Planning Association April 3, 2014 2 © 2013 Washington Dental Service Foundation Washington Dental Service Foundation Mission: To prevent oral disease and improve overall health. We do this through innovative programs and policies that produce permanent changes in the health environment so that over the long-term oral disease is prevented Funding: Delta Dental of Washington - a non profit dental benefits company committed to improving oral health
Transcript

Tooth Talk: Strategies for Improving Oral

HealthEmployee Benefits Planning AssociationApril 3, 2014

2© 2013 Washington Dental Service Foundation

Washington Dental Service Foundation

Mission: To prevent oral disease and improve overall health. We do this through innovative programs and policies that produce permanent changes in the health environment so that over the long-term oral disease is prevented

Funding: Delta Dental of Washington - a non profit dental benefits company committed to improving oral health

3© 2013 Washington Dental Service Foundation

Why Oral Health?

HeartDisease

PhysicalActivity

Cancer

Children’s Development

Diabetes MentalHealth

CommunityEngagement

4© 2013 Washington Dental Service Foundation

The Opportunity

Oral disease is nearly 100% preventable

Oral disease is highly prevalent – opportunity toimprove health for a large # of people

Oral health impacts overall health and quality of life

Oral disease contributes to un necessary healthcarespending

5© 2013 Washington Dental Service Foundation

ChildrenIntense PainAnxietyFatigueWithdrawalDifficulty paying attention in school

51 million school hours lost nationally

Sleep Deprivation

Missed school days

Language development

Embarrassment

Nutrition problems

6© 2013 Washington Dental Service Foundation

Most Common Chronic Disease of Childhood

40% Start Kindergarten with toothdecay experience

15% of Kindergartener haverampant decay

Over 60% of 3rd graders havetooth decay experience

7© 2013 Washington Dental Service Foundation

Early Intervention Saves $

Children with severe dental decay often need to be treated in a hospital operating room, costing about $8,000 to $12,000 per child

8© 2013 Washington Dental Service Foundation

Adults

Employability and Productivity – Over164 million work hours/year lost

Linked with chronic health conditions:Diabetes, heart disease/stroke, pneumonia

Dry mouth (side effect of medications)can quickly lead to tooth decay

9© 2013 Washington Dental Service Foundation

Too Many Adults Have Oral Disease

Nationally:Nearly 1 in 4 adults in the U.S. has untreated tooth decayNearly 1 in 2 adults has periodontal disease (increases with age)

Washington:Nearly 40% of adults have had a tooth extracted due to disease1 in 5 adults over age 55 report a dental issue that needs treatment within the next monthAmong low-income seniors, this jumps to nearly 1 in 3.

10© 2013 Washington Dental Service Foundation

Poor Oral Health is Costly

One Cavity Costs $2,000 Over a lifetime(we have 32 teeth)

Dental pain is the number one reason uninsured adults visited Washington state emergency rooms – Dental-related Emergency room charges were

over $36 million in an 18 month period

11© 2013 Washington Dental Service Foundation

Oral Disease and Diabetes are Linked

Also, untreated gumdisease can increaserisk for developingtype II diabetes

12© 2013 Washington Dental Service Foundation

Cost Savings Opportunity

13© 2013 Washington Dental Service Foundation

Keys to Prevention

Good Home Care – Brushing and FlossingFluoride (can reverse early decay)Dental VisitsAddressing health issues (diabetes, dry mouth)Nutrition/Snacking habits

Time on Teeth mattersnormal meals vs. snacking/grazing

15© 2013 Washington Dental Service Foundation

Strategies

16© 2013 Washington Dental Service Foundation

Children

17© 2013 Washington Dental Service Foundation

Oral Health Partnerships

18© 2013 Washington Dental Service Foundation

Access to Baby and Child Dentistry

Goal: Improve young children’s oral health – more kids getting dental care

Medicaid-eligible children birth to 6years

Focused on prevention

Early intervention by age 1

Training for dental offices/clinics

Outreach & case management to families

19© 2013 Washington Dental Service Foundation

Early Learning: Cavity Free Kids

• Address oral health in places where children spend their time: Head Start, Child Care, Home Visiting

• Train early learning providers to educate children and families about oral health and connect them with dental care

20© 2013 Washington Dental Service Foundation

Pregnant WomenDid you know?

The bacteria that causes cavities can be spread from mother to child, usually in the first two years of life. GOAL: Improve pregnant women’s oral health to help prevent their babies from getting cavities

Prevent the spread of bacteria from mother to child

Engage mothers at a time they are especially receptive about caring for their babies

Strategies:Motivate and train dentists to serve pregnant women

Engage prenatal medical care providers in addressing oral health

Engage community based organizations in identifying and referring (WIC, home visiting)

Motivate pregnant women to demand services

– Education materials/media

21© 2013 Washington Dental Service Foundation

Baby Teeth Campaign

MEDIA CAMPAIGN:

Oral Health Screening by Age One• Paid Media: Parenting magazines (Seattle, Yakima, Centralia, Vancouver), Online

newspapers statewide, Spanish language newspapers, Spanish language radio, Ethnic Newspapers

• Earned Media: Articles in newspapers, parenting magazines, blogs, etc.

• New Media: Facebook ads

• KidsOralHealth.org website

• WA State Dept of Health—Child Profile mailing to families with 9 month olds

22© 2013 Washington Dental Service Foundation

Baby Teeth Campaign: Earned Media

23© 2013 Washington Dental Service Foundation

Educational Resources

24© 2013 Washington Dental Service Foundation

School Based Health Centers

• WHAT: Address the oral health of • school age children (6–18) in • School Based Health Centers (SBHC)

• WHY: As children age they:• Access dental care less often; • Have increased rates of decay.• In-school clinics remove barriers to care – children missing school or parents missing

work to attend appointments• ACA funds expansion; number of schools with on-site clinics growing

• HOW: Teach medical providers in school clinics to address oral health - educate, screen, and refer.

25© 2013 Washington Dental Service Foundation

SealantsWHAT: Improve the oral health of school-age children by increasing the number who have sealants

WHY: Sealants:• Reduce decay by up to 70%• Evidence-based, cost-effective• 50% of Washington’s school-age children do not have sealants

HOW: • Partner with dental providers and schools with over 50% free/reduced lunch to

deliver sealants• Motivate dentists to apply sealants• Educate parents, and motivate to request sealants

26© 2013 Washington Dental Service Foundation

Seniors

27© 2013 Washington Dental Service Foundation

Healthy Aging Includes Oral Health

People are living longer and more are keeping their teeth throughout life.

Ensuring older adults and their providers understand the connection between oral health and healthy aging:

• Medicare does not include dental –need to plan ahead

• Those with chronic health issues and on medications should talk with their medical and dental providers

• Some lower-cost dental care options exist

28© 2013 Washington Dental Service Foundation

Oral Health for Caregivers

Goal: Train caregivers to improve the oral health of their clients/residents to prevent disease

Home Care AidesAdult Family Home ProvidersCaregivers for Individuals with Developmental DisabilitiesFamily Caregivers

29© 2013 Washington Dental Service Foundation

Special Populations

30© 2013 Washington Dental Service Foundation

Latinos

A growing population:• Between 2000 – 2010, WA’s Latino population grew 71%

• By 2060, the population of Latinos will double – from 1 in 6 today to 1 in 3 (nationally)

Children have high rates of disease:

31© 2013 Washington Dental Service Foundation

Tribes

FluoridationOperating Room DiversionFoundation Strategies for Young Children, Pregnant Women, Seniors

Partnerships:Northwest Tribal Dental Support CenterLummi TribeKalispel TribePuyallup TribeHoh TribeMakah Tribe

The Issue: • 79% of 5 year old Native American children have tooth

decay;• 98% of elders had lost teeth because of dental disease or

oral trauma

32© 2013 Washington Dental Service Foundation

Community Health Workers

• WHAT: Improve the oral health of “hard-to-reach” populations by training community health workers (CHW) to address oral health

• WHY: An evidence-based approach that improves health outcomes of “hard-to-reach” groups with poor oral health outcomes; ACA funds and numbers expanding

• HOW: Train Community Health Workers • to address oral health with the communities• they serve

33© 2013 Washington Dental Service Foundation

Engaging Primary Care

34© 2013 Washington Dental Service Foundation

Putting the Mouth back in the BodyGOAL: Train medical providers to address oral health with

all their patients:- screening- risk assessment- oral health education- fluoride varnish- referral if needed

WHY?

– Already doing prevention & chronic disease management for rest of body

– Already looking in the mouth

– Oral health—related to nutrition and medications

35© 2013 Washington Dental Service Foundation

Oral Health in Medical Settings

BenefitsCatch disease early, early treatment = reduced cost of care, improved outcomesHelp patients understand the connection between poor oral health and other chronic diseases

Reduce dental-related ER visits Reduce medical costs (e.g. savings from reduced diabetes care)Increase access to preventive oral health care for those not receiving dental care

36© 2013 Washington Dental Service Foundation

Primary Care Trainings: 2002-2013

Trained:2,483 Primary CareProviders

3,191 clinic staff

Approximately 1/3of practicing primarycare MDs have beentrained

37© 2013 Washington Dental Service Foundation

Increasing Access

38© 2013 Washington Dental Service Foundation

Community Health Centers

Whatcom

Snohomish

Okanogan

Chelan

Douglas

Franklin

BentonYakima

Lewis

Thurston

Island

MasonSpokane

Whitman

Columbia

Garfield

King

SkagitStevens

Klickitat

SkamaniaCowlitz

Wahkiakum

Kittitas Grant

Pierce

Clark

FerryPendOreille

Lincoln

Adams

WallaWalla

Asotin

Clallam

Jefferson

Grays Harbor

Pacific

San Juan

Kitsap

WDSF has provided funding within the last seven years

$6.4 million infunding since 2005

39© 2013 Washington Dental Service Foundation

Community Health Centers

Expanding Capacity –In 2013, funded expansion grants totaling $1,098,000 – enabling over 33,000 additional patient visits annually

Northeast Washington Health ProgramsChewelah, WA

SonBridge Clinic Walla Walla, WA

International Community Health Services

Seattle, WA

40© 2013 Washington Dental Service Foundation

Impact

41© 2013 Washington Dental Service Foundation

Impact: Statewide Medicaid Dental UtilizationChildren Under Age Six

42© 2013 Washington Dental Service Foundation

Impact: Young Medicaid Insured Children Receiving Care

WA

43© 2013 Washington Dental Service Foundation

Increase in Medical Providers delivering Oral Health Preventive Services

44© 2013 Washington Dental Service Foundation

Recent decline in untreated decay

20.7

26.7 26.2

13

16.9

21.6

20.5

14.9

0

5

10

15

20

25

30

1994 2000 2005 2010

Low Income Preschool2nd/3rd Grade

*

*

*

* Statistically significant change from prior surveyWA Smile Survey

45© 2013 Washington Dental Service Foundation

Impact: Older Adult Oral Health Survey

46© 2013 Washington Dental Service Foundation

The Mighty Mouth Campaign

47© 2013 Washington Dental Service Foundation

The Challenge:

We are not the onlyones talking abouthealth risks.

48© 2013 Washington Dental Service Foundation

We need to offer more than this

49© 2013 Washington Dental Service Foundation

BEHAVIORAL FRAMEWORK (simplified)

Action!

You could get something pretty cool

All the cool kids are doing it

Let me help you make it happen

REWARD

NORMS

EFFICACY

People’s actions influence attitudes that influence future actions.

This is important.

I’m the kind of person that does

this.

Theory of Change

50© 2013 Washington Dental Service Foundation

OUR GOALSKnowledge:

Fewer than 1 in 5 participants knew that:• Most children in Washington start kindergarten without any cavities• A parent can pass bacteria to their children by sharing eating utensils.

Just over half knew:• Tooth decay can be reversed if it is caught early.• An oral health check up can reveal broader health problems such as

diabetes, cancer, and immune disorders.• Gum disease increases your risk for diabetes & that it’s linked to heart

disease, stroke, and pneumonia.

Focus Group Findings

51© 2013 Washington Dental Service Foundation

OUR GOALSKnowledge:

Fewer than 1 in 5 participants knew that:• Most children in Washington start kindergarten without any cavities• A parent can pass bacteria to their children by sharing eating utensils.

Just over half knew:• Tooth decay can be reversed if it is caught early.• An oral health check up can reveal broader health problems such as

diabetes, cancer, and immune disorders.• Gum disease increases your risk for diabetes & that it’s linked to heart

disease, stroke, and pneumonia.

Focus Group Findings

52© 2013 Washington Dental Service Foundation

Dental Visits: Valued for Kids, But Not Always Adults• Nearly everyone expressed strong agreement that it is important

for children to see a dentist regularly, even if parents didn’tregularly get dental care.

• Adults who get regular dental care universally saw their owndental visits as important. Non doers were mixed: Some agreed itis important but faced barriers, while others downplayed itsimportance for them.“As long as I can take care of my kids, it’sreally all I care about at the moment. I knoweventually I’ll have to take care of myself, butI can’t afford to do it right now.”

Non doer/Uninsured

“I don’t have any problems with myteeth… I went to the dentist in themilitary, and then 15 years later when Ihad my son and I’m good.”

Non doer/Insured

53© 2013 Washington Dental Service Foundation

Other Key Findings

• Information about new science (transmitting bacteria& connection to overall health) was of interest toparticipants.

• The concept of physicians conducting oral healthscreenings during patient visits was of interest toparticipants.

• Desire for health, fitness & youth.

54© 2013 Washington Dental Service Foundation

The Mighty Mouth Campaign

Increase public awareness of the value of oral health

Target Audience: Adults 25+

Position oral health as essential part of overall healthConnect oral health with issues people care about: fitness, beauty, saving moneyFrame it as easy, important and cost-effectivePresent new, surprising information Be fun and informative, not “preachy”

55© 2013 Washington Dental Service Foundation

Mighty Mouth Campaign - Tactics

Paid Media– TV/radio/cable/online

Earned/Social Media– Print articles, broadcast, – Facebook, Twitter

Partnerships– Commercial/retail– Non-profit/community-based

Promotional event (Teeth Week pilot)

56© 2013 Washington Dental Service Foundation

Resources for Partners

Website: TheMightyMouth.orgFloss kitsSample articles (Mighty Mouth Minutes)Social media postsInfographicsPostersOthers as requested

57© 2013 Washington Dental Service Foundation

Check out the Mighty Mouth Ads

Why

Tooth Fairy

Want to see all the Ads? Go to themightymouth.org/ads/


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