Filling the Gap in Oral Health for Older Adults: A Community Guide to Program Implementation

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Filling the Gap in Oral Health for Older Adults: A Community Guide to Program Implementation

Oral Health America Webinar Series January 23, 2019


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/Oral Health America

@Smile4Health

/Oral Health America

@Smile4Health

2018


HOUSEKEEPING INFORMATION • •

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Please remember to MUTE your phone. Questions are welcome! We’ll allow 10-15 minutes after the presentation for questions. • Questions will be accepted in writing through the control panel on the upper right hand of your screen. • Submit questions at any time; we will address them at the end of the presentation. Webinar is being recorded; for rebroadcast on OHA’s website – OralHealthAmerica.org Your feedback is important to us. Please take our brief webinar evaluation after this session; link will be sent via email.

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CE Credit Available

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ABOUT ORAL HEALTH AMERICA America’s leading national oral health nonprofit focused on the nation’s oral and overall health for 63 years, with particular emphasis on children and youth, older adults and Americans whose voices are not wellrepresented in oral healthcare conversations. OHA employs strategic partnerships and communications to connect the dots between oral and overall health

SMILES ACROSS AMERICA®

CAMPAIGN FOR ORAL HEALTH EQUITY

WISDOM TOOTH PROJECT®

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Early Childhood Caries Prevention Project

School-Based Prevention Programs

Demonstration Projects

Product Donation

Enrichment

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toothwisdom.org

Advocacy

Health Education & Communications

Professional Symposia

Demonstration Projects

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Addresses oral health inequities in our society and identifies possibilities for closing the oral health divide in America. The campaign strives to: Educate and engage the public, including policymakers, about the importance of oral health for overall health Emphasize the need to prioritize oral disease alongside other chronic health conditions Lead, participate and observe on legislative issues impacting oral health policies critical to OHA, our programs and stakeholders 2018


Help Your Community Smile: A Resource for Starting or Enhancing Oral Health Programs for Older Adults Phantane Sprowls, MPA Administration on Aging (AoA) Office of Nutrition and Health Promotion Programs (ONHPP)


About the Administration for Community Living (ACL)  Mission – maximize the independence, well-

being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers  Commitment to one fundamental principle – people with disabilities and older adults should be able to live where they choose, with the people they choose, and participate fully in their communities

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About ACL (cont.)

Office of the Administrator

Administration on Aging

Center for Policy and Evaluation

ACL

Center for Management and Budget

Center for Integrated Programs

Administration on Disabilities

National Institute on Disability, Independent Living, and Rehabilitation Research 11


The Aging Network

Data Source: SPR 2014 and NSOAAP2015

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Background

“Oral health is a critical component of health and must be included in the provision of health care and the design of community programs.� Dr. David Satcher, MD, PhD former Surgeon General of the United States

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Background (cont.) – Why Does Oral Health Care Matter?  According to former Surgeon General, Dr. David Satcher “There is

no health without oral health.”

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 The Academy of General Dentistry: oral health is the “key to

general health.” Dental diseases = adverse physical, functional, emotional and social effects 2  Poor oral health may cause pain and difficulty speaking, chewing, swallowing, and sleeping  Loss of teeth is associated with loss of self-esteem  Poor oral health linked to many health problems, including stroke, heart attack, diabetes, and pneumonia (No. 1 cause of death in nursing homes) and development of several diseases in older adults.3 Footnotes 1. Oral Health in America: A Report of the Surgeon General (2000) http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/Documents/hck1ocv.@www.surgeon.fullrpt.pdf 2. http://agd.org/media/54365/7025accesstocarewhitepaper7_31_08.pdf 3. http://www.healthypeople.gov./2020/leading-health-indicators/2020-lhi-topics/Oral-Health/determinants

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The Statistics  Socio economic differences are large: 42% of individuals below the

Federal poverty line reported no remaining natural teeth compared with 22% above Federal poverty.  Almost 40% of American adults aged 65 and older have not visited a

dental professional in the past year.4  Estimated 20% adults 65+ had untreated tooth decay.5  Labor force participation is a strong predictor of dental coverage; 10,000 people enter Medicare daily/2% have a dental benefit.  Complete tooth loss is experienced by 15% of adults aged 65-74. 6  Stats re: oral health calls to n4a call center Footnotes 4. http://www.cdc.gov/nchs/data/databriefs/db104.htm#x2013;2010 5. http://www.cdc.gov/nchs/products/databriefs/db197.htm 6. http://www.cdc.gov/nchs/data/hus/hus14.pdf#084

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Prevalence of Dental Caries Among Older Adults

Prevalence of dental caries among older adults in the United States (CDC/NCHS, 2012)

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Prevalence of Tooth Loss Among Older Adults

Prevalence of complete tooth loss among older adults in the United States (CDC/NCHS, 2012)

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Oral Health Impacts Overall Health

Oral Health and Well-Being in the United States (ADA, 2015) 18


Access to Affordable Community Programs Can Make a Difference!

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Project Overview  Funding: Department of Health and Human

Services’ Office on Women’s Health (OWH) and Administration for Community Living (ACL) for three-year contract starting in October 2014  Purpose: Identify and promote vetted, low-

cost, community-based oral health programs for older adults Through this project, ACL and OWH hope to facilitate the development and enhancement of oral health programs serving older adults.

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Subject Matter Expert Working Group

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Key Project Components 1. Oral Health Programs Database: searchable

database of community-based oral health programs 2. Community Guide to Adult Oral Health

Program Implementation (Oral Health Guide): how-to guide that provides key steps for communities interested in starting or enhancing an oral health program for older adults Both of these tools are available on the Help Your Community Smile: Start or Enhance an Oral Health Program for Older Adults website at

https://oralhealth.acl.gov

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Environmental Scan Systematic review 

Reviewed national, state, local level organization websites

Conducted searches using pre-determined list of keywords

Program submission form 

Disseminated to over 500 stakeholders; received over 200 submissions

Key informant interviews 

Interviewed 11 individuals

In-depth program information research 

Collected all available programmatic online information

Contacted each program to request additional information 23


Programs Identified, by State (n=207)

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Oral Health Programs Database

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Program Profiles  All program profiles include:  Program overview  Website link  Information on program

model, target population, services delivered, etc.  Featured program profiles

include additional information on:  Program history and

development  Program sustainability  Program impact Sample Featured Program Profile

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Six Service Delivery Models Identified programs are organized into six common service delivery models: 1. Dental Clinic Model (e.g., permanent setting) 2. Mobile-Portable Model 3. Eligibility and Enrollment Model (e.g., referrals, care coordination) 4. Virtual Model (e.g., telehealth) 5. Event-based Model 6. Outreach and Education Model

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Dental Clinic Model  Walker Methodist Dental Clinic provides oral health care to older

adults in the Minneapolis, Minnesota community as part of the larger Walker Methodist Health Center network.  The dental clinic opened in 2006, and through a major grant-

funded expansion in 2015, the clinic doubled its capacity to provide oral health care and oral health education.  The clinic is open four days a week and is staffed by University of Minnesota School of Dentistry faculty and students, with additional support from Walker Methodist staff.  In addition to providing oral health care to older adults, the program teaches geriatric oral health care continuing education courses to dental professionals.

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Mobile-Portable Model ď Ž Senior Mobile Dental is a nonprofit organization that brings

portable dental equipment to community facilities and provides oral health services to older adults. ď Ž In 2013, the program expanded its staff and services to provide a

full range of oral health services, including fillings, extractions, and denture services. ď Ž The program is staffed by dentists, hygienists, a denture technician, and a full dental support team.

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Event-Based Model ď Ž Senior Dental Days is an annual event organized by the Area

Agency on Aging of Western Michigan that provides free dental cleanings, x-rays, screenings, and referrals to low-income older adults in the Grand Rapids, Michigan area. ď Ž The event is staffed by volunteer dental students, dental

school faculty, dentists, hygienists, and dental assistants.

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Community Guide to Adult Oral Health Program Implementation (Oral Health Guide)  Includes detailed steps for program design and

implementation, interviews with featured programs, and interactive resources  Content focused to help communities:  Conduct a needs assessment  Develop a vision, a mission, and goals  Establish partnerships  Design the program  Finance the program  Implement the program  Evaluate the program  Ensure sustainability of the program 31


Oral Health Guide Website Content

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Submit a Program

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Visit the website at https://oralhealth.acl.gov!

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Oral Health & Aging – Information for Caregivers Brushing

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Oral Health & Aging – Information for Caregivers Flossing

Dry Mouth

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Oral Health & Aging – Information for Caregivers Finding Low-Cost Dental Care

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Thank You! Have additional questions? Please contact oralhealth@acl.hhs.gov

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CE Credit Available

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Contact Information •

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Phantane J. Sprowls, MPA Office of Nutrition and Health Promotion Programs Administration on Aging | Administration for Community Living U.S. Department of Health and Human Services (202) 795-7443 phantane.sprowls@acl.hhs.gov

Tiffany Gadson Programs Associate Oral Health America Tiffany.Gadson@oha-chi.org

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THANK YOU! Let’s improve the oral and overall health of all Americans together.

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