Colorado Oral Health News – May 2022 – Strategy Planning, Sealants, Older Adults, & More
The Oral Health Unit at CDPHE
Letter from the Oral Health Unit
Dear friends,
February is Children’s Dental Health month! February is a time to raise awareness of the importance of youth oral health and remind families of what they can do to protect their oral health through good oral hygiene habits. Many partners have released resources for families such as the CDC’s Take Care of Your Teeth activity book and more resources that we have shared throughout the newsletter below.
Though vital, we know that individual health behaviors are only part of the strategy to achieving optimal oral health. Many other protective or harmful factors also impact oral health status. We have seen the effects of COVID on the oral health of Coloradans over the past couple of years. Many families had to put off care or experienced less access to health and oral health care. However, the strength and resiliency of Colorado communities in the? face of increased challenges to oral health, overall health, and well-being have served to mitigate the impact of these challenges for many.
We also want to gratefully acknowledge oral health partners across the state who serve families’ oral health and general health needs. Kelly Keeffe is among those oral health champions. She has announced her plans to retire after leaving a lasting impact on the oral health and wellness of her community and of Colorado. Kelly serves as a Regional Oral Health Specialist in Garfield County and surrounding areas. We highlight some of her extensive work in the community below, but many of her most important accomplishments for oral health are immeasurable.
Looking forward to the work underway in Oral Health Unit, we have continued our long search for a new Colorado Dental Director. We hope to have more to share on that process sometime soon.
We are grateful to all of the Colorado oral health partner network who have lent their insight, expertise, and oral public health passion to the conversations we have had over the past two years to create an oral health state plan. We are working with partners to incorporate the feedback we’ve received over the past year. A release of that version is coming soon and an open comment period will follow. Please watch for an invitation for your input and information about the community discussions that will follow the open comment period.
We also want to recognize Mango House and Safari Smiles for their partnership as the Cavity Free at Three program does an early pilot in the development of a new dental curriculum. We are grateful for their input on this program that has been in development for a couple of years and we are excited to share it with you when it is ready!
Many other programs have been integral to the Oral Health Unit’s work, including the Diabetes and Cadiovascular Disease Oral Health Integration project. Key partners on medical-dental integration work that was recently published include Colorado Community Health Network, Clinic Quality Improvement partners, and many clinics across the state. See this work highlighted on pages 24 through 25 of the December 2022 issue of the Journal of the California Dental Association.
As we look forward, we are excited to see what the next few months bring with the work in progress across the state with all of our partners in the oral health network.
Thank you for your partnership,
The Oral Health Unit
National Updates
- Free resources for National Children’s Dental Health month
In honor of National Children’s Dental Health Month, the American Dental Association has free bilingual posters available on this website. The ADA also has activity sheets and items available for purchase. - Earn Continuing Education Credits through the Centers for Disease Control (CDC) online training course
The Organization for Safety, Asepsis, and Prevention are offering three Continuing Education credits to learners who complete the CDC’s free, on-demand training course, Foundations: Building the Safest Dental Visit. The training provides an overview of the basic expectations for safe care, including the principles of infection prevention and control that form the basis for CDC recommendations for dental healthcare settings. - World Health Organization (WHO) Updates Model List of Essential Medicines
In 2021, the WHO Model List of Essential Medicines and Model List of Essential Medicines for Children was updated to include fluoride toothpaste, silver diamine fluoride, and glass ionomer sealant. For more information, read this article published by the American Dental Association earlier this year. The complete 22nd WHO list can be found here. - Spread The Word: Action May Be Needed To Renew Medicaid or CHIP Coverage
The Connecting Kids to Coverage National Campaign from the Centers for Medicare & Medicaid Services (CMS) was created to spread the word that families with health coverage through Medicaid or CHIP (Children’s Health Insurance Plan) should confirm their contact information with their state Medicaid offices in order to receive renewal notices that will go out once states resume eligibility reviews. Please help spread the word. Resources are available at https://medicaid.gov/unwinding. Families can visit www.medicaid.gov/renewals to find their state Medicaid office phone number.
News & Hot Topics
- Dental Collimator Implementation Rule Effective 01/01/2025
To promote the reduction of radiation expsoure and uphold radiation safety within Colorado, the Colorado Department of Public Health and Environment X-ray Certification Unit has developed this guidance document pertaining to a new rule, effective January 1, 2025. The new rule requires all facilities to use rectangular collimators on stationary intraoral x-ray imaging units to reduce patient dose from radiation traveling outside of the imaging area. This rule excludes handheld units, units used in endodontic procedures, and units requiring a broader exposure field.
Questions, comments, or concerns regarding the implementation of this rule can be directed to karen.george@state.co.us. - Free Water Filter Resource
Children’s Dental Health Month is a good time to remember to drink water that has an optimal level of fluoride in it to help keep teeth healthy. CDPHE has a free tap water flyer that is available in nine languages. The educational resource highlights the safety of tap water consumption and available water filtration devices that do not remove fluoride. You can learn more about the level of fluoride in your drinking water here. And learn about the ways Colorado is working to keep sources of drinking water safe and resources to test water quality including testing for lead in water and addressing perfluoroalkyl and polyfluoroalkyl substances (PFAS).
Stories from the Field
- Partner Spotlight: Regional Oral Health Specialist, Kelly Keeffe, RDH, BA
The Oral Health Unit would like to recognize Kelly Keeffe for her contributions as a Regional Oral Health Specialist (ROHS) and oral health champion in Colorado. A ROHS promotes oral health and the prevention of oral disease in select regions of the state. They do this through many interventions, including oral health education, screenings, school sealant programs, and community outreach. Kelly was one of the first ROHS in the state, covering Garfield county and surrounding areas. During her time, she has expanded their rural school sealant program to 16 schools, seeing nearly 1,000 students every year. Kelly’s contributions to school-based oral health also include pioneering glass ionomer sealants and silver diamine fluoride treatments.
In addition to her school outreach, Kelly has led efforts to provide telehealth, or TeleORALhealth, services to the community. The TeleORALhealth program offers oral evaluations, fluoride varnish, treatment referrals, and education to all ages.
Kelly has fostered numerous partnerships and embraced and navigated change. While the demand for oral health services continues, her contributions have lifted and empowered the community she serves. Kelly will be retiring from the ROHS role soon, but we know her influence will continue to be seen for years to come.
- Take Care of Your Teeth: An Activity Book for Children
The CDC’s Take Care of Your Teeth activity book provides parents with a fun, interactive way to talk to their children about taking care of their teeth. The book features coloring pages, mazes, word searches, and connect-the-dots to promote regular oral health habits in children. They will learn about how brushing their teeth, flossing, and visiting their dentist can prevent cavities.
The book is recommended for children 3-8 years of age and is available in 13 languages. - Research: Early Preventive Dental Visits
In a recent study by Hung et al., titled “Early Preventive Dental Visits: Do They Reduce Future Operative Treatments?,” researchers evaluated the impact that early preventive dental visits have on reducing the number of dental operative procedures children require. They found that, as the age of a patient’s first preventive visit increases, so does the number of dental operative procedures the patient requires. Additionally, the study results show that more dental cleanings and examinations are linked to decreased operative procedures. This research supports the American Academy of Pediatric Dentistry’s stance on early dental interventions and further reinforces the work done by CDPHE’s Cavity Free at Three program. View the full text from the Dentistry Journal.
HPV Data Summary Available
- The Alliance for HPV-Free Colorado has created a HPV Data Dashboard to support understanding of HPV vaccination trends, gaps, and opportunities for improvement in HPV vaccination rates. The public facing dashboard provides information on adolescents ages 9-17 who have received at least 1 dose and who are up-to-date on the HPV vaccine in Colorado. Data can be filtered at a regional and county level. To learn more about the Alliance for HPV-Free Colorado, visit their website.
Strong provider recommendations for the HPV vaccination at age 9 help increase vaccine completion success and cancer prevention. Visit the National HPV Vaccination Roundtable for additional information and resources.
Join the Alliance for HPV Free Colorado, Children’s Hospital Colorado School Health Program, and the Colorado Cancer Coalition HPV Vaccination Task Force on Wednesday, April 19 from 11:30am-12:30pm for the Colorado Cancer Coalition monthly peer sharing call. This call is being held in honor of Head and Neck Cancer Awareness month. Attendees will learn more about oral health professional training opportunities related to HPV vaccination efforts, how to utilize the Alliance’s data dashboard to understand the HPV vaccination rates in your area and across the state, school-based efforts related to HPV vaccination and education strategies, and available resources. Registration for the peer-sharing call is available here. - Research: COVID-19 Impact
In their research article, COVID-19 Pandemic Impact on US Childhood Caries and Potential Mitigation, Scherrer et al. examine the effect of reduced access to restorative dental care and sealants that occurred as a result of COVID-19. The study focuses on children from low-income households with an emphasis on race and ethnicity.
Simulation modeling found that COVID-19’s impact on first permanent molars of children seven years of age resulted in both increased disability-adjusted life years (DALYs) and increased dental caries rates for all children. Hispanic and non-Hispanic Black children are disproportionately impacted with higher DALYs and dental caries than their non-Hispanic White counterparts. The model used by researchers provides insight into how these disparities may be reduced to pre-COVID levels by placing dental sealants on half of the eligible first molars of children by September 2022. View the abstract from the Journal of Dental Research. - Article: Oral Health in America
The Journal of the American Dental Association recently published an article titled Oral Health in America: Implications for Dental Practice. The article highlights aspects of the National Institutes of Health report, Oral Health in America: Advancements and Challenges, discusses gains achieved toward improving oral health in the United States, identifies persisting challenges, and offers solutions.
Click here to access the article. - Update: 2022-23 Basic Screening Survey
The Basic Screening Survey (BSS) has once again resumed in Colorado. The BSS is an in-the-mouth screening performed on kindergarten and 3rd-grade students across the state. Historically, the BSS has provided invaluable information on the condition of oral health amongst young Coloradans (see figures 1 and 2).
The information gathered through this state-wide children’s oral health screening is vital to evaluating Colorado’s preventive oral health programs for children and informing policymakers on the importance of investing in children’s oral health.
The Colorado Oral Health Unit is coordinating with schools and oral health screeners to complete the 2022/2023 BSS and plans to continue the BSS efforts every three years. The successful implementation of this year’s BSS is crucial, as it is suspected that the COVID-19 pandemic has negatively impacted children’s oral health.
Figure 1: Trends in Oral Health Outcomes, Kindergarten Students, Colorado
- Figure 2: Trends in Oral Health Outcomes, Third Grade Students, Colorado
- Visual Report: How Depression Is Linked to Oral Health Care Quest Visual Report: How Depression is Linked to Oral Health
In their visual report, Care Quest Institute for Oral Health spotlights the growing link between mental and oral health. The report shares information regarding why adults with depression have high levels of dental caries and the connection between depression and temporomandibular disorder.
View the visual report to learn more about the links between mental and oral health.
- Mandatory Reporting Training for Older Adults
The Colorado Coalition for Elder Rights & Abuse Prevention (CCERAP) Steering Committee provided a virtual Mandatory Reporting Basics training last August. A link to the slides to virtual training is now available and link on the CDHS website here. Click here for the CCERAP training flyer.
