Fluoride in Practice—Resources from the Association of State and Territorial Dental Directors

Oral Health America Webinar Series

Fluoride in Practice—Resources from the Association of State and Territorial Dental Directors

December 7, 2017

Connect with OHA! /Oral Health America

@Smile4Health

/Oral Health America

@Smile4Health

HOUSEKEEPING INFORMATION • •

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.

CE Credit Available

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 well-represented in oral healthcare conversations. © 2017 Oral Health America

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®

© 2017 Oral Health America

Early Childhood Caries Prevention Project

School-Based Prevention Programs

Human Centered Design Project

Product Donation

Technical Assistance

Š 2017 Oral Health America

toothwisdom.org

Advocacy

Health Education & Communications

Professional Symposia

Demonstration Projects

© 2017 Oral Health America

CAMPAIGN FOR ORAL HEALTH EQUITY 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

Š 2017 Oral Health America

LeeAnn Hoaglin Cooper, RDH, BS Fluorides Committee Consultant, ASTDD

Chris Wood, RDH, BS

Executive Director, ASTDD

FLUORIDATION AND FLUORIDE- RESOURCES ORAL HEALTH AMERICA DECEMBER 7TH, 2017

ACKNOWLEDGEMENT Supported by Cooperative Agreement 1U58DP004919-04 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.

OBJECTIVES Participants will be able to: ▪

describe the fluoride resources available on the ASTDD website.

▪

describe the process used to develop reliable and valid issue briefs and white papers

▪

identify critical elements for cost-effective fluoride programs including: community water fluoridation, fluoride mouthrinsing, fluoride supplements, fluoride toothpaste, fluoride varnish, and or silver diamine

WHO IS ASTDD?

ASSOCIATION OF STATE AND TERRITORIAL DENTAL DIRECTORS 

directors and staff of state public health agency.



affiliate of the Association of State and Territorial Health Officials (ASTHO) since 1948



formulates and promotes national dental public health policy



assists state dental programs in the development and implementation of programs and policies for the prevention of oral diseases;



builds awareness and strengthens dental public health professional knowledge and skills by: 

developing position papers and policy statements



provides information on oral health to health officials and policy makers



conferences for the dental public health community

ASTDD FLUORIDES COMMITTEE The Fluorides committee assures that ASTDD positions and policies are presented in appropriate venues and oversees activities the association may be involved in regarding fluorides, including the fluoride awards at the annual meeting.

2017 Volunteer Members: Jason Roush, DDS, Chair, • Bruce Austin, DDS, Oregon • William Bailey, DDS University of Colorado • Susan Deming RDH, Michigan • Kip Duchon, PE Centers for Disease Control • Judy Feinstein, Consultant, (formerly Maine) • Stephanie Holmquist, Alaska • Jay Kumar DDS, MPH, California • Clare Larkin, RDH MSEd, Minnesota • Jane McGinley, RDH, MBA, American Dental Association

• • • • • • • •

Dixianne Parker, RDH, MEd, Georgia Howard Pollick BDS, MPH, University of California San Francisco Jaclyn Seefeldt, BS, RDH, North Dakota Gina Sharps, MPH, RDH, West Virginia Lyubov Slashcheva, DDS, University of Iowa Bradley Whistler, DMD, Alaska Beth Wyatt, Colorado Kimberlie Yineman, RDH, BA North Dakota

LOGIC MODEL

For more information: www.cdc.gov/tools/logic-models/index.html

ASTDD Membership

HOW WE DEVELOP OUR DOCUMENTS

Executive Board

A COMMUNITY AFFAIR Experts Partner organizations Committee

PROCESS

Dental Public Health Resource Committee

Consultant

http://www.astdd.org/dental-public-health-resources-committee/ Guidance Document for Drafting Dental Public Health Resource Documents

How we REALLY DO IT – Details!

FLUORIDATION AND FLUORIDE WEB PAGE

WWW.ASTDD.ORG

LOOK AT SEARCH: A-Z TOPICS……

Basic Screening Best Practices • Community Water Fluoridation • Improving Children’s Oral Health Through Coordinated School Health Programs • School Fluoride Programs-currently under review • Collaborations • Data Collection FLUORIDES and FLUORIDATION Head Start Mobile and Portable Dental Services in Pre-School and School Settings School Screenings

FLUORIDES and FLUORIDATION Webpage Navigation • Current fluoride information first • Other organizations and fluoride-related information • Other organization fluoride related policy statements • Other organization resources

www.ilikemyteeth.org

COMMUNITY WATER FLUORIDATION •

Natural Fluoride in Drinking Water 9/2016

•

Best Practice Approach Report-Use of Fluoride: Community Water Fluoridation 06/2016

•

Policy on Community Water Fluoridation 06/2015

•

Fluoridation Awards Database –Current

•

Fluoridation Rollback Database

In the United States, less than one-half of one percent of U.S. residents on community water systems have drinking water exceeding 2 ppm and less than one-tenth of one percent have water exceeding 4 ppm

The Association of State and Territorial Dental Directors (ASTDD) fully supports and endorses community water fluoridation in all public water systems at the optimal level recommended by the US Public Health Service.

SUPPLEMENTS AND TOOTHPASTE ▪

Fluoride Toothpaste-2016 ASTDD supports twice daily use of toothpaste containing 1000-1500 ppm fluoride, in fluoridated and non-fluoridated communities, for the prevention of tooth decay beginning with the eruption of the first tooth and throughout life.

▪

Fluoride Supplements-2013

ASTDD supports the use of fluoride supplements for children who are at high-risk for dental caries, whose primary source of drinking water has suboptimal levels of fluoride and whose other ingested sources of fluoride are low. Fluoride supplements should be prescribed based on caries risk assessment and fluoride history. Healthcare professionals should monitor parents’ compliance with the current supplement dosage schedule on an ongoing basis

FLUORIDE VARNISH •

School-based Fluoride Varnish Program Report and Catalog-2017

•

Fluoride Varnish Policy Statement-2015

•

Fluoride Varnish Issue Brief-2014

SILVER DIAMINE FLUORIDE- used “off label” for treatment/arrest of caries in children and adults.

Webinar 01/2017

Fact Sheet 07/2017

Horst JA, Ellenikiotis H, Milgrom PL. UCSF protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc.

2016;44(1):16-28.

AAPD Guideline For using Silver Diamine Fluoride to Treat Dental Caries. Oct. 2017. www.aapd.org/media/Policies_ Guidelines/G_SDF.pdf Photos: Courtesy of Steve Duffin

All fluoride products

GENERAL PRINCIPLES

•

have a systemic AND a topical effect

•

prevent dental caries in the primary AND permanent teeth, particularly when initiated before tooth decay develops

•

are more effective on smooth surfaces than pits/fissures.

•

require reapplication to achieve and maintain efficacy

•

use in combinations •

do not provide additive benefits

•

increase costs

SCHOOL-BASED FLUORIDE PROGRAMS  No

school-based fluoride program outcome evaluation since 1986 National Preventive Dentistry Demonstration Program (NPDDP) demonstrated results contrary to conventional wisdom. 

Disney JA, Bohannan HM, Klein SP, Bell RM. A case study in contesting the conventional wisdom: schoolbased fluoride mouthrinse programs in the USA. Community Dent Oral Epidemiol. 1990 Feb;18(1):46–54.



APHA Technical Report. Review of the National Preventive Dentistry Demonstration Program. Am J Public Health. 1986 Apr;76(4):434-47.

 School-based

programs outside the US have fewer fluoride resources and are not directly comparable 

Mathu-Muju, R, Friedman JW, Nash DA. Oral Health Care for Children in Countries Using Dental Therapists in Public, School-Based Programs, Contrasted with That of the United States, Using Dentists in a Private Practice Model. AJPH 2013 Sep;103(9) e7-e1.

 CDC.

Recommendations for using fluoride to prevent and control dental caries in the United States. 2001 Available from:

 ADA,

Council of Scientific Affairs Expert Panel on Topical Fluoride Caries Preventive Agents. Weyant RJ, et al. Topical fluoride for caries prevention: Executive summary of the updated clinical recommendations and supporting systematic review. Am Dent Assoc.

2013 Nov;144(11):1279-91.

 Cochrane

Database of Systematic Reviews. Marinho VC, Higgins JT, Sheiham A. and Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. 2004

FAVORITE CITATIONS

THANK YOU!

Question and Answer Session • Questions are welcome! This session may last for 10-15 minutes.

• Write your questions in your control panel on the upper right hand of your screen.

• Submit questions at any time.

CE Credit Available

Contact Information • LeeAnn Cooper • lahcooper@comcast.net • Chris Wood • cwood@astdd.org • Eamari Bell • eamari.bell@oralhealthamerica.org