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	James L. Holly, M.D.

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Your Life Your Health - General Health Dependent upon Dental Health

James L. Holly,M.D.

April 07, 2016

Your Life Your Health - The Examiner

On March 22, 2016, The Texas Health Institute (THI) invited SETMA to participate in an initiative for the promotion of dental health as an integrated part of patient-centered care. The Oral Health 2020 project was convened by The DentaQuest Foundation, a not-for-profit organization, which promotes dental health. DentaQuest is a dental health plan through which individuals or groups can obtain dental health insurance with or without an underlying health insurance plan.

Founded on the Institute of Healthcare Improvement’s (IHI) Triple Aim, the DentaHealth Foundation describes today’s healthcare environment as:

“(One) that supported the passage of the Affordable Care Act (and) has led to a number of patient-centered care models and innovative financing methodologies. This includes increased focus on and adoption of health care models that aim to improve health outcomes while reducing cost and improving the patient’s experience. Because oral health is a component of health and impacts the outcomes and course of many diseases, it is important that oral health is addressed and included in the development of these emerging models of care and financing.”

DentaQuest Foundation mission is: “To improve the Oral Health of All.” The vision of Oral Health 2020 is “to eradicate dental disease in children and improve oral health across the lifespan.” The Oral Health 2020 goals are:

Goal 1 Eradicate dental disease in children. With the closing of disparity gaps, 85% of children reach age 5 without a cavity
Goal 2 Incorporate oral health into the primary education system. The 10 largest school districts have incorporated oral health into their systems
Goal 3 Include an adult dental benefit in publicly funded health coverage. At least 30 states have an extensive Medicaid adult dental benefit. Medicare includes an extensive dental benefit.
Goal 4 Build a comprehensive national oral health measurement system A national and state-based oral health measurement system is in place
Goal 5 Integrate oral health into person-centered healthcare. Oral health is integrating into at least 50% of emerging person-centered care models.
Goal 6 Improve the public perception of the value of oral health to overall health. Oral health is increasingly included in health dialogue and public policy.

SETMA will participate in this program which was launched in January, 2016. THI’s Dr. Ankit Sanghavi, DDS, is a member of the Oral Health 2020 network, is state representative for the network and is a member of the Southern Outreach and Connection team. Dr. Sanghavi and, Ms. Camille Miller, President and CEO of THI, have invited SETMA to participate in a regional convening meeting hosted by the DentaQuest Foundation May 18-20, 2016 in Atlanta, George. This meeting will build on the Oral Health 2020 national campaign for systems change.

The hope is to move toward achievement of the goals of Dental Health by weaving together a national network of national, regional, state, and community advocates who can educate the public and policymakers alike and coordinate their efforts for greater impact. Weaving this powerful network together will create the conditions under which we can tackle the structural patterns and the resulting issues of health inequity.

There are four regional teams engaging oral health stakeholders across the country. Ankit is a member of the team working to engage stakeholders from twelve southern states. At the South/Southeast regional meeting in May stakeholders will meet others from the region, share promising practices, work to assess regional strengths and weaknesses, and prioritize goals.

SETMA and Dental Health

In response to this invitation, SETMA reviewed our prior commitment to dental health as an integrated part of patient-centered medical home. SETMA tracks dental care in patients with diabetes as those who get annual teeth cleaning have better diabetes control. SETMA spends the largest amount of money from The SETMA Foundation for extensive dental care. SETMA has evidence of the value of dental care for overall health as illustrated by an experience six years ago when a patient presented with extensive healthcare needs, severe deteriorating health and rapidly rising cost of care. SETMA asked a dentist for the cost of properly repairing this patient’s teeth. He quoted a cost of $10,400. SETMA asked him to make a $4,000 contribution to out Foundation and we would pay him $10,400 for her care.

In the three prior years, she had been hospitalized ten times, was on nine medications, had poorly controlled diabetes and was getting sicker. After the extensive dental care she has not been hospitalized and is on only one medication. The overall savings on her healthcare has been in excess of $100,000. The overall improvement in the quality of her life and the state of her health has been immeasurable. When dental care is available to patients who cannot afford it, this story can be repeated thousands of times.

SETMA also screens pediatric patients for dental health. The recognition of the value of dental health was taught to me by my parents. Their training resulted in the following experience in my sophomore year of college. A boy in my dorm had totally rotten teeth. As we became friends, I went to a dentist and arranged a total extraction and dentures which contracted to pay for by working the following summer. The dentist agreed and I paid his fee the following summer. I was 18 years old when this project started.

Dental and General Health

In addition to its negative effect upon the treatment and control of diabetes, poor dental health creates other major areas of concern for your general health, such as:

Cardiovascular disease: The bacteria from inflammation of the gums and periodontal disease can enter your bloodstream and travel to the arteries in the heart and cause atherosclerosis. Atherosclerosis causes plaque to develop on the inner walls of arteries which thicken and decreases or may block blood flow through the body.
Dementia: The bacteria from gingivitis may enter the brain through either nerve channels in the head or through the bloodstream that might even lead contribute to the development of Alzheimer's disease.
Respiratory infections: Gum disease could cause you to get infections in your lungs, including pneumonia.

Poor dental care is also a possible factor in other conditions, such as immune system disorders, weak bones, and problems with pregnancy and low birth weight.

Conclusion

Oral Health 2020 has a worthwhile mission, vision and plan. There is little doubt that the fiscal significant of preventive and restorative dental care would be positive. The quality of health and of healthcare implications are equally positive.

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