Table of Contents

Practice Building
Roundtable
Esthetics

Inside Dentistry

December 2011, Volume 7, Issue 11
Published by AEGIS Communications

DTA Leads Coalition for Major Public Awareness Campaign

Ad Council will conduct a three-year campaign aimed at improving children’s oral health.

JUNE—The Ad Council, known for such iconic advertising campaigns as McGruff the Crime Dog’s “Take A Bite Out Of Crime,” will conduct a national campaign to improve children’s oral health. The goal of the three-year campaign will be to raise awareness and educate parents and caregivers about the value of good oral health for their children and how it can be achieved.

The campaign is the brainchild of the Partnership for Healthy Mouths, Healthy Lives dental coalition, which is made up of more than 20 dental organizations led by the Dental Trade Alliance Foundation. The Ad Council accepted the coalition’s proposal in June. The coalition members hope that the Ad Council’s commitment to an extensive multi-year, national public service advertising campaign will help improve the oral health of America’s children through oral health messages stressing prevention and the ways parents and caregivers can instill behaviors that will result in a lifetime of good oral health.

The Partnership for Healthy Mouths, Healthy Lives dental coalition joins other notable organizations that have worked with the Ad Council to address social issues through public service campaigns. Some unforgettable slogans from the Ad Council’s previous campaigns include the United Negro College Fund’s “A Mind is a Terrible Thing to Waste,” and the U.S. Department of Transportation’s National Highway Traffic Safety Administration’s “You Could Learn A Lot From A Dummy” and “Friends Don’t Let Friends Drive Drunk.”

The Partnership for Healthy Mouths, Healthy Lives dental coalition also includes the Academy of General Dentistry, American Academy of Oral and Maxillofacial Pathology, American Academy of Pediatrics, American Academy of Pediatric Dentistry, American Academy of Periodontology, American Association for Dental Research, American Association of Endodontists, American Association of Oral and Maxillofacial Surgeons, American Association of Orthodontists, American Association of Public Health Dentistry, American Association of Women Dentists, American College of Prosthodontists, American Dental Association, American Dental Education Association, American Dental Hygienists Association, Association of State and Territorial Dental Directors, California Dental Association, Children’s Dental Health Project, Dental Trade Alliance Foundation, Hispanic Dental Association, Medicaid SCHIP Dental Association, National Children’s Oral Health Foundation, National Dental Association, National Network for Oral Health Access, Oral Health America, Organization for Safety, Asepsis and Prevention, Society of American Indian Dentists and the U.S. Department of Health and Human Resources/Office of Minority Health.

The campaign is slated to begin appearing in national media and on a customized website by Spring of 2012.

Source: The Ad Council/Dental Trade Alliance

AAPHD Proposes New Curriculum Guidelines

JUNE—The American Association of Public Health Dentistry has proposed curriculum guidelines for the training of a new workforce model, dental therapists. AAPHD believes that adding dental therapists as members of the dental team may help meet growing U.S. oral health needs, particularly among underserved populations. The papers are the work of an 11-person academic panel that was selected for expertise, experience, and in-depth knowledge of dental education. The panel’s work was funded in part by the W.K. Kellogg Foundation and the Josiah Macy Jr. Foundation. The entire collection of papers is available online will also be published in a special issue, Volume 71:S2, of the peer-reviewed Journal of Public Health Dentistry in June 2011.

The panel considered the course of study for dental therapists in programs already in the United States (Minnesota and the Alaska Native Tribal Health Consortium/University of Washington program) and throughout the world. The dental therapist designation is a professional, accredited position in 55 countries in the world.

Caswell Evans Jr., DDS, MPH, associate dean for prevention and public health sciences at the University of Illinois at Chicago and convener of the panel, said, “There has been a growing interest in adding a new oral health professional designation to the dental workforce by both state and federal legislatures. The AAPHD and the panel it convened believe that such a designation could add value to the dental profession as a whole, and could assist the profession in its efforts to improve access to care for difficult-to-reach sectors of the population.”

Source: American Association of Public Health Dentistry

Haywood Testifies at FTC Hearings

MARCH—Van B. Haywood, DMD, who is a professor in the Department of Oral Rehabilitation, School of Dentistry, at the Medical College of Georgia and an ADA Council on Scientific Affairs consultant, testified at FTC administrative proceedings March 9 and 10 as an expert witness for the North Carolina State Board of Dental Examiners (NCSBDE). In June 2010 the FTC issued an administrative complaint charging that the Board “has acted in various ways to eliminate the provision of teeth whitening services by non-dentists.”

Both the FTC and the NCSBDE called on expert dental witnesses to testify before the administrative law judge hearing the case. The FTC’s lead witness, Martin Giniger, DMD, PhD, MsD, FICD, who is the chief science officer and director of oral health research for White Smile Global Inc, testified in February.

As the NCSBDE’s expert witness, Haywood told the administrative court, “I am not in favor of anyone bleaching their teeth without having a proper dental exam. Whitening is best performed in a professionally supervised manner, with a proper examination and diagnosis, using appropriate materials for the patient and situation, with a fair fee for service.”

Haywood also testified that, “Low concentrations of peroxide, especially 10% carbamide peroxide in a custom-fitted tray, are generally the safest, most cost-effective, best-researched whitening treatments available. Other bleaching treatments such as in-office may be indicated based on patient preference, lifestyle, finances, or other limitations, but require informed consent after presenting cost/benefit and risk/benefit ratio. Non-dentist bleaching does not have a good risk/benefit or cost/benefit ratio and misleads the public as to safety and efficacy.”

Having testified earlier as the FTC’s expert witness, Giniger said, “Consumers want whiter teeth, demand keeps growing and consumers want a bright, white smile, and there are different ways to achieve that result. Public safety is not threatened by the availability of non-dentist teeth bleaching products and services. Teeth bleaching can be safely performed by or with the assistance of non-dentist providers...and by consumers.”

Source: Craig Palmer, ADA News Staff, American Dental Association; Federal Trade Commission Deposition

W.K. Kellogg Releases Survey Results

OCTOBER—According to a national survey released by the W.K. Kellogg Foundation, millions of Americans cannot find affordable dental care in their communities and many want to explore mid-level providers as a way to improve their access to oral healthcare. The survey revealed that many Americans are struggling to get needed care, with 41% reporting that they or someone in their household has put off dental care because of cost and 30% saying they do not have a place to go for care.

Based on a poll of 1,023 adults, the survey, conducted by Lake Research Partners, found that more than 80% of Americans believe it is difficult for people to get free or low-cost dental care in their communities, and think the number of Americans who cannot access dental care is a problem. With close to 50 million Americans living in federally designated dentist shortage areas, the majority of respondents say they support mid-level dental providers, such as dental therapists, to help fill the nation’s shortage gaps.

“This survey clearly shows that people throughout the country are struggling to get dental care,” Sterling K. Speirn, president and CEO of the W.K. Kellogg Foundation, said. “We know the impact that poor oral health has on overall health and well-being, so we must look at using mid-level providers such as dental therapists to ensure that children can get the preventive dental care they need.”

The survey, titled “The Dental Access Gap,” also found that in addition to affordability, most Americans value regular dental care, but 4 in 10 lack dental insurance. In fact, 100 million Americans, including 25 million children, do not have dental insurance. Most Americans support dental therapy as one way to help address the dental gap, with 76% of respondents saying they support the training of mid-level dental providers such as dental therapists to provide preventive, routine dental care to people without it.

The W.K. Kellogg Foundation is currently working with Ohio, New Mexico, Kansas, Washington, and Vermont to establish dental therapists to help expand access to needed dental care. More than a dozen states are considering similar options.

Source: W.K. Kellogg Foundation

ADA Statement on W.K. Kellogg Survey

OCTOBER— Raymond F. Gist, ADA president, released this statement in response to the W.K. Kellogg Foundation’s survey results: “Kellogg’s reported findings on people’s need for better access to care are consistent with what the ADA, federal and state governments, and numerous other stakeholders have said for years, and it is good to have that message reinforced. Breaking down the barriers that impede people’s ability to attain good oral health is our highest priority. State and local dental societies and our 156,000 members share this priority, and understand that it will take multiple solutions to achieve it.

“Unfortunately, there is no single or simple solution. Barriers to oral health vary from region to region, state to state, city to city, neighborhood to neighborhood...The nation will never drill, fill, and extract its way out of what Surgeon General David Satcher, MD, famously called a ‘silent epidemic’ of oral disease. Oral health education and prevention are the two most important measures that can end that epidemic. Regular care by dentists and their teams will prevent disease from recurring. The ADA believes that everyone deserves a dentist.

“The Kellogg Foundation’s narrow focus on a single idea—so-called ‘dental therapists’—and its claim that a vast majority of Americans favor creating dental therapists lacks credibility. [One question] implied that care by therapists would somehow cost less than care by dentists. We know of no data to support this. If such data exists, Kellogg should release it. Kellogg also declined to describe therapists’ level of training...or what types of surgical procedures they would perform. Absent that information, the survey respondents could not provide informed opinions.

“We recognize that calling for large increases in government support for anything during a major economic downturn is simply unrealistic. But it is totally appropriate to call on state and federal governments to at least maintain their existing commitments to providing oral healthcare for the millions of Americans...who are most in need. The ADA and its allies will continue to lead the fight to break down the barriers to oral health for all Americans. We welcome well-meaning, well-resourced, and respected allies like the W.K. Kellogg Foundation to join us in advocating and implementing the comprehensive solutions that will accomplish this.”

Source: American Dental Association

IOM Releases Access to Care Report

JULY—Millions of Americans are not receiving needed dental care services because of “persistent and systemic” barriers that limit their access to oral healthcare, according to a new report by the Institute of Medicine and National Research Council. To remove these barriers— which disproportionately affect children, seniors, minorities, and other vulnerable populations— the report recommends changing funding and reimbursement for dental care; expanding the oral health workforce by training doctors, nurses, and other non-dental professionals to recognize risk for oral diseases; and revamping regulatory, educational, and administrative practices.

“The consequences of insufficient access to oral healthcare and resultant poor oral health—at both the individual and population levels—are far-reaching,” said Frederick Rivara, Seattle Children’s Guild Endowed Chair in Pediatrics at the University of Washington School of Medicine, Seattle, and chair of the committee that wrote the report. “As the nation struggles to address the larger systemic issues of access to healthcare, we need to ensure that oral health is recognized as a basic component of overall health.”

To maximize access to oral healthcare, the report recommends that state legislatures amend existing laws so that hygienists, assistants, and other dental professionals can practice to the full extent of their training and can work in a variety of settings under appropriate evidence-based levels of supervision. In spite of national accreditation standards for education and training of oral health professionals, regulations defining supervision and scope-of-practice parameters vary widely from state to state and even by procedure.

The uneven distribution of the dental work force, both in geographic dispersion as well as in specialization, is a long-recognized challenge, the report notes. In addition, graduating dental students report that they feel unprepared to care for older patients and those with special needs. The report says that efforts should be made to increase recruitment and support for dental students from minority, lower-income, and rural populations, as well as to boost the number of dental faculty with expertise caring for underserved and vulnerable populations.

Source: Institute of Medicine and National Research Council

Initial Decision Reached in North Carolina Teeth-Whitening Case

JULY—In an initial decision, Chief Administrative Law Judge D. Michael Chappell concluded that the North Carolina State Board of Dental Examiners violated the law by trying to block non-dentists in the state from providing teeth-whitening goods or services. Ruling that the board does not have the authority to order non-dentists to discontinue providing teeth-whitening goods or services, Chappell issued an order in connection with the decision barring the board from engaging in the same anticompetitive conduct in the future. The order also requires the board to send follow-up letters to non-dentists whom it had previously warned would or might be violating state law by providing teeth-whitening services.

In North Carolina, teeth-whitening services provided by non-dentists often are available at salons, retail stores, and mall kiosks. The state’s dentists offer whitening services in their offices, and also provide take-home kits. According to the June 2010 complaint, the North Carolina State Board of Dental Examiners sent 42 letters instructing non-dentist teeth-whitening providers that they were practicing dentistry illegally, and ordered them to stop. In at least six cases, the complaint alleged, the board threatened or discouraged non-dentists who were considering opening teeth-whitening businesses.

Chappell determined that complaint counsel “has demonstrated by a preponderance of the evidence that dentist members of the Dental Board had a common scheme or design, and hence an agreement, to exclude non-dentists from the market for teeth whitening services and to deter potential providers of teeth-whitening services from entering the market.”

Source: Federal Trade Commission