TxOHC E-brief

“Dental deserts are emerging across the country, especially in low-income and rural areas. Because of this, many people do not have access to necessary oral health care, which can lead to worse health outcomes over time. In order to accommodate the lack of dentists, some primary care practices are incorporating dental care in their health offerings.” 

The article titled, Doctors are Taking on Dental Duties in Low-income Areas, published on April 23, 2024, in The Week, explores the concept of dental deserts and highlights the efforts of medical professionals like Dr. Patricia Braun in integrating oral health care into primary care.  

Similarly, CBS News Health Watch published an article titled, Doctors Take on Dental Duties to Reach Low-income and Uninsured Patients on April 9, 2024 also discusses Dr. Braun’s work in integration.

Dr. Braun remarked, “federally qualified health centers have a long history of co-locating dental services within their systems, we’re taking that next step where care is not just co-located, meaning, say, we’re upstairs and dental is downstairs, but we’re integrated so that it becomes part of the same visit for the patient.”

You may access both articles below.

• Doctors are Taking on Dental Duties in Low-income Areas, The Week
• Doctors Take on Dental Duties to Reach Low-income and Uninsured Patients, CBS News

The Texas Tribune published the article,Proposed changes to state Medicaid plans could shake up health coverage for 1.8 million low-income Texans on April 18, 2024, discussing a proposed move by Texas health officials “to drop the state’s three largest nonprofit children’s health plans from multibillion-dollar Medicaid and children’s health insurance contracts — threatening the future of plans run by legacy children’s hospitals in Fort Worth and South Texas and shaking up health care coverage for low-income families throughout the state. […] The change would mean a reduction in the number of managed care organizations that administer the state’s Medicaid STAR and Children’s Health Insurance Program, a shift toward for-profit companies in most areas of the state, a smaller number of top-rated plans administering care, and the introduction of new national plans to regions historically served by local MCOs.”

Read the full Texas Tribune article here.

WalletHub posted their ranking of states’ children’s healthcare comparing “the 50 states and the District of Columbia across 33 key indicators of cost, quality, and access to children’s health care [ and] three key dimensions: 1) Kids’ Health & Access to Health Care, 2) Kids’ Nutrition, Physical Activity & Obesity and 3) Kids’ Oral Health.”  

Texas ranked 49th overall, 41st in children’s oral health, and showed the highest percentage of uninsured children. 

Please find the full state rankings from WalletHub here.

SchoolHouse Connection published in March the Infant and Toddler Homelessness Across 50 States: 2021-2022. “ This report is the most comprehensive look to date at homelessness among infants and toddlers, and is the first state-by-state collection of data on infant and toddler homelessness.” 

In Texas, (page 55 of the pdf report) 2.01% or 30,280 of all infants and toddlers (birth through age three) experienced homelessness and only 1,999 of that population are enrolled in a program. 

Read the full report here or find the Texs infographic here.

On April 22, 2024, Maine became the 7th state required to activate the Dentist and Dental Hygienist Compact (DDH Compact).  According to ADA News, “Now that seven states have joined the compact, a commission with one representative from each of the first seven states will create the application process and be in charge of vetting applications for license portability.” 

These seven states are Iowa, Tennessee, Virginia, Washington, Wisconsin, Kansas, and Maine. Additionally, nine other states have legislation pending. For further details regarding current and pending legislation, please refer to the DDH Compact map. 

The DDH Compact is not new to Texas, in 2023, Texas bill HB3039 relating to the Dentist and Dental Hygienist Compact was introduced and successfully passed the House during the 88th legislative session.

To delve deeper into the DDH compact and Maine’s involvement, you can read the ADA News article, Gaining Momentum: License Portability on the Horizon, or access the press release and video released by ADHA.

For more information on the Dentist and Dental Hygienist Compact or to see the status and progress, visit DDHcompact.org.

On April 19, 2024, ADA announced a new category in the ADA Seal of Acceptance program: Orally Administered Analgesics for the Temporary Management of Acute Dental Pain.  This “seal will help practitioners, [and] consumers identify non-opioid products for [the] management of acute dental pain.” 

Read the full ADA News article, New ADA Seal Category Announced, here.

TxOHC has also published a Dental Prescription Resource Fact Sheet covering both Opioid and antibiotic stewardship that discusses opioid alternatives, prescription monitoring, and resources.

In a recent article, Survey Shows Agreement in the Profession for Dental Assisting Advancement, published April 6, 2024, in Dentistry IQ, a “survey was conducted in October 2023, with dental assistants, dentists, and consumers responding.”

According to the article, “recent survey results from the Dental Assisting National Board (DANB) reveal that the dental assisting profession is making great strides in recognition and elevating the profession. [… Everyone surveyed] agrees that educated, qualified dental assistants are a top priority for the profession. Assistants want to pursue education, dentists want to hire qualified assistants, and the public wants credentialed assistants working in their mouths.”

“When it comes to the public, they prefer qualified assistants working in their mouths, with 73% responding that they want someone with formal education as their dental assistant, and 64% expecting their DA to have a certificate or associate degree.”

Read the full article here.

According to Sizeable Fee Increases for THSteps Medical Services Were Approved 2022/23, None for Dental Services, Texas Dentists for Medicaid Reform (TDMR) “compared the fee schedules for TMHP THSteps Medical services from 2019 and 2024 to determine if doctors are being hampered by the same reluctance from Texas HHS to increase fees that have plagued Medicaid dentists over the last several years. The results are in, and the answer is no. There is no such reluctance. Starting in 2022, medical fees were significantly increased for almost all THSteps medical services.”

View the full comparison read the full TDMR article here.

Sharing information and new resources below on community water fluoridation.

• As Bans Spread, Fluoride In Drinking Water Divides Communities Across The US – USA TODAY  contributed by the Kaiser Family Foundation: https://www.usatoday.com/story/news/nation/2024/04/10/with-fluoride-in-dental-products-so-we-still-need-it-in-drinking-water/73183454007/
  With fluoride in so many dental products, some say adding it to drinking water is no longer necessary. But health experts worry that like vaccines, fluoridation may be a victim of its own success.
• The American Fluoridation Society: the American Fluoridation Society (AFS) has launched its YouTube channel.
  https://m.youtube.com/channel/UCW2866kxD9TibiW5xajJ8aw
  AFS asks you to please consider: 
  • Visiting the AFS YouTube channel, and watching and “liking” the AFS videos. There are three and all are very short. (We suspect that anti-fluoride activists will “dislike” the videos once they become aware of them.)
  • Sharing the videos with your colleagues.
  • Subscribing to AFS’s YouTube channel as this will alert you once other videos are posted.
     
• TxOHC also has published CWF short videos on our YouTube channel in a dedicated playlist, please share widely.
  https://youtube.com/playlist?list=PLXEsGY3kW3mDzMKaOGELJNsMzr4OPysD-&si=mvgmRvUTjhPcXBIP.

UT Health San Antonio’s Dental Education Network for Texas (DENT) ECHO is hosting “Treating Kids vs. Adults with HIV” on Thursday, May 16, 2024, from 12:00 PM – 1:00 PM CST presented by Dr. Cara B. Gonzales, DDS, PhD.  

Please register below to attend via Zoom:
https://echo.zoom.us/meeting/register/tZUodO6uqzspHdfngaY62ADT45c1ZKNM-ypl
 
For those interested in obtaining 1 hour of continuing education (CDE) credit for attendance at no cost, register by clicking the link below:
https://smile.uthscsa.edu/course.php?rc=1026grbf

USE SUPERCODE: Echo2024

We are pleased to welcome the following new members since April 5, 2024. 

• Monica Martinez, RDA, CDA, RDH, BSDH, MPA
  Assistant Instructor Dental Hygiene, Del Mar College
  Corpus Christi, TX
• Carmen Martinez, DDS
  Associate Dental Director, Driscoll Health Plan
  Corpus Christi, TX

Job Opportunities 

• Full-time Dentist I Position
  Department of State Health Services (DSHS) Region 9/10 in El Paso, TX
• Full-time Community Health Dentist
  Harris County, Public Health Services Department in Baytown, TX

Find the full job postings at https://txohc.org/resources/career-center/.

TxOHC is excited to announce the publication of the Community Resource Guides for Dallas which are now available to download at https://txohc.org/get-involved/rohc/nct-rohc/. 

These guides target five different populations (perinatal, children, adults, older adults, and individuals with disabilities) that address social determinants of health factors to help address adverse experiences community members may be facing. We hope to release another set of guides for Fort Worth before the end of the year. 

Our sincere thanks and gratitude go out to Dr. Shirley Lewis from the Texas A&M School of Dentistry and 2nd-year dental students, Emily Tran and Phoebe Khong, for all of their hard work and diligence in researching social service organizations to include in these publications.

Oral health providers may obtain 1.0 CDE for every one(1) hour of self-instruction. Online courses to choose from include: 

• Substance Use Disorder– *NEW*
  • Screening, Brief Intervention and Referral for Treatment for Patients with Substance Use Disorders
• Tobacco Cessation with the Texas Quitline and eTobacco Protocol
  • Integrating Tobacco Cessation Support Resources to Improve Patient Access
• HPV – Healthy Smiles – Great series for Oral Cancer Awareness Month!
  • The Healthy Smiles Project: Increasing HPV Vaccination through Interprofessional Partnerships with Dental Hygienists 
  • Framing HPV Immunization Education for Maximum Patient Acceptance
• Teledentistry
  • Teledentistry in Texas: Opportunities to Increase Access to Care
  • Selection of Teledentistry Platforms and Utilization in Alternative Care Settings
  • Available for edification only – Taking the Mystery Out of Billing for Virtual Visits
• Treating Individuals with Intellectual or Developmental Disabilities (IDD)
  • Providing Dental Care under Advanced Anesthesia: Oral Sedation, IV Sedation, TIVA, IV Mac, and General Anesthesia
  • Special Conditions and Barriers and Challenges Providing Dental Care to Patients with IDD
  • Understanding and Working with Caregivers and Group Homes, Dental Desensitization/Advanced Behavior Techniques for Patients with IDD at AbSSLC
• Prescribers
  • Mental Health & Opioid Use Disorder: Using the PMP to improve patient-centered care & communication
  • Statewide Mandate Compliance Using the PMP to Provide Patient-Centered Care
  • Maximizing Your Limited Time: Navigating Challenging Patient Conversations
• Prenatal
  • Maternal Depression: Signs, Facts & Resources
  • Who Do You Call: Making the Referral Connection
  • Do No Harm: The Ethics, Myths & Business of Caring for Pregnant People
• Oral Pathology
  • Oral Cancer Update
  • Oral Manifestations of Systemic Diseases and Conditions
  • Common Lesions of the Oral Cavity, from Diagnosis to Treatment

To access any of these courses, please visit https://txohc.org/education/self-instructional-webinars/.

Oral Health Alert: Focus on Pregnancy

Articles

• An Assessment of Oral Health Training in Obstetrical Care in Massachusetts.
  Panda A, Silk H, Hayes C, Savageau JA. 2024. Maternal and Child Health Journal. DOI: 10.1007/s10995-024-03905-7. View abstract
• Association Between Dental Visits During Pregnancy and Setting for Prenatal Care.
  Byrappagari D, Cohn L, Sailor L, Clark S. 2024. Journal of Public Health Dentistry. DOI: 10.1111/jphd.12596. View abstract 
• Measuring Quality of Dental Care During Pregnancy.
  Herndon JB, Ojha D, Amundson C. 2024. Journal of the American Dental Association. DOI: 10.1016/j.adaj.2023.10.010. View abstract 

Materials and Other New Resources
Midwest Health Center Pioneers Integrated Oral Health Services (2024)
This blog post is part of HRSA’s Health Center Stories series.

Resources from the National Maternal and Child Oral Health Resource Center (OHRC)

• Integrating Oral Health Evaluation into Prenatal Care: Considerations and Examples (2024)
• Oral Health Resource Bulletin: Volume 51. (2024)
• Promoting Oral Health During Pregnancy: Using PRAMS to Collect Population-Based Data (2024)
• Promoting Oral Health Literacy: A Resource Guide (2024)
• A Way with Words: Tips for Writing Easy-to-Understand Oral Health Materials (2024)

Digital Library
OHRC’s online library contains over 3,000 resources to assist professionals (you!) in providing education and training, developing programs, and staying abreast of new developments. Featured topics include Oral Health During Pregnancy and Pregnancy Guidelines.

Oral Health Learning Café
Engage with other professionals about integrating oral health into primary care via a discussion list and monthly webinars.

OHRC Update
Subscribe to OHRC Update for announcements about new and updated resources, website features, and other resources of interest.

OHRC Staff
Reach out to OHRC staff for assistance on oral health issues such as educational materials, Head Start, integrating oral health care into primary care, prenatal care, Title V national performance measure on oral health, and adapting or reproducing OHRC materials.