Letter from the Dental Director

Dear Friends,

We hope that you are having a great start to the fall season. The past few months have included the start of some exciting projects for the Oral Health Unit (OHU). The OHU, in partnership with the Delta Dental of Colorado Foundation, has been working to support the formation of a state-wide oral health coalition. Through an RFA process, the Public Health Institute at Denver Health was chosen as the backbone organization to aid in this process and bring together partners from all over the state for this collective impact approach. The first meeting of the coalition was held in July, with partners giving input on mission, vision, and coalition structure. The Public Health Institute is looking for community-based organizations and others who would like to join the coalition and help create a voice that is representative of all Coloradans. If you are interested in joining this important work, please contact Andrea Pascual (andrea.pascual@dhha.org) for more information. 

The Oral Health Unit has also been busy with the implementation of Senate Bill 24-142, which enacts an Oral Health Screening in Schools Pilot Program in the state. The legislation outlines a program that funds schools to be able to provide oral health screenings. Currently, the OHU is working with the Colorado Department of Education on the school selection process, as well as dissemination of information on how to apply for the program. Another exciting program that the OHU is developing is an Oral Health Screening Standardization training which ensures that oral health screeners in schools have the basic tools needed to safely, accurately, and consistently screen children. This training has been piloted with several oral health screeners, including dental clinicians and school nurses. If you are interested in piloting this screening process, please contact Robyn Maestas at robyn.maestas@state.co.us. 

The Primary Care Office has partnered with the OHU to create a new state dental Health Professional Shortage Area (HPSA) model, which was recently passed by the Board of Health. This model updates our methodology for describing dental provider shortages and the definition of primary oral health care. It will be stewarded by the Primary Care Office. This new model will produce detailed, quantitative information regarding local shortages of dentists who provide general and preventive oral health care services. A dental hygiene model is in development. The federal HPSA model remains unaltered, but the state model can be utilized for certain state programs to be more responsive to local needs.

Finally, we would like to report some information about community water fluoridation, which you may already know is the single most effective population-level oral health disease prevention program offered to the public. The United States District Court, District of Northern California on September 25, 2024 ruled that community water fluoridation at optimal levels poses an unreasonable risk to public health under the Toxic Substances Control Act. The ruling referenced the findings of a National Toxicology Report that have been disputed by the American Dental Association, the American Association of Pediatrics, and many other professional and scientific organizations. Community water fluoridation has many decades of evidence to support its status as one of the ten greatest public health achievements of the 20th century. The Colorado Department of Public Health and Environment (CDPHE) maintains its recommendation that public water systems maintain fluoride levels at the recommended limits to protect against tooth decay. Water fluoridation is an important public health intervention that has the potential to reduce the burden of oral disease and improve oral health equity for all Coloradans. If you would like to read the full statement, please reach out to cdphe.psfluoridationsmf@state.co.us.

Sincerely,

Maryam Mahmood DMD, MPH
State Dental Director
Colorado Department of Public Health and Environment

News and Hot Topics

New! Toolkit for Antimicrobial Stewardship in Dental Settings

• General and specialty dentists are the third highest prescribers of antibiotics in outpatient care settings in the United States. The Colorado Department of Public Health and Environment (CDPHE) is excited to introduce a new toolkit designed to support dental professionals in promoting appropriate antibiotic use. This resource is a summary of existing, published, evidence-based guidance to support outpatient dental antimicrobial stewardship programs in prescribing the “right antibiotic,” “right dose,” and “right duration.” Based on the CDC’s Core Elements of Antibiotic Stewardship, we provide links to prophylaxis and treatment recommendations as well as patient education materials. CDPHE supports dental professionals in optimizing antibiotic use, improving health equity and patient outcomes, and combating antibiotic resistance.

• For additional information and resources to promote appropriate antibiotic use, visit Antimicrobial Stewardship in Colorado or contact cdphe_hai_ar@state.co.us.

Stories from the Field

Antibiotic Awareness Week – November 18-24

• Antibiotic Awareness Week: U.S. Antibiotic Awareness Week takes place November 18-24! The theme is “Fighting Antimicrobial Resistance Takes All of Us.” Join us for Antibiotic Awareness Week and spread the word about the importance of improving antibiotic use, improving health equity, and combating antimicrobial resistance. 
  
  For additional information and resources to promote appropriate antibiotic use, visit Antibiotic Awareness in Colorado or contact cdphe_hai_ar@state.co.us.

Partner Links

Colorado Welcome Back: Oral Health

• The Colorado Welcome Back: Oral Health program at Spring Institute supports internationally trained dental professionals to navigate licensure or alternative pathways as they reclaim their careers in Colorado. The cohort-based program includes support through one-on-one career coaching, licensure navigation, exam preparation (INBDE and TOEFL), employability skills training, and networking opportunities to six internationally trained dentists per year. The program seeks to enrich the diversity of Colorado’s oral health care industry, close healthcare workforce gaps, and advance intergenerational economic mobility. Current participants are seeking opportunities to volunteer, shadow, and/or connect with industry professionals in order to grow professionally and utilize their skills. All participants have advanced levels of English, vast dental professional experience, and strong motivation. If you are interested to learn more and connect, please contact Jenny Jessup at jjessup@springinstitute.org.

Dental Provider Recruitment: Health First Colorado

• The Colorado Department of Health Care Policy and Financing is recruiting non-participating dental providers to join Colorado’s Medicaid program, providing vital public coverage to 22% of Coloradans. If you are interested in learning more, benefits of becoming a Medicaid oral health network provider are described here. If you need accessibility support with this document, please reach out to Ashleigh.Kirk@state.co.us.

CareQuest Webinar: Exploring Minimally Invasive Procedures

• Learn more about minimally invasive dental procedures for children and adolescents from the CareQuest Institute and the American Association of Public Health Dentistry. This webinar will be Thursday, October 24 from 5-6 p.m. MT. You can register on CareQuest’s website.

Prenatal, Infant, and Toddler

Resource: Updated Cavity Free at Three Billing Guides

• The Cavity Free at Three (CF3) team has recently updated their CF3 Medicaid Billing Reference Sheets to reflect the reimbursement rates changes that have gone into effect as of 07/01. Please reach out to leah.brunner@state.co.us if you would like a copy of the Billing Reference Sheets.

Report: Integrating Oral Health Care into Primary Care: Five Successful, Longstanding, Statewide Programs Providing Care for Maternal and Child Health Populations

• The Consortium for Oral Health Systems Integration and Improvement recently published their report on five oral health integration programs, which features and highlights the Cavity Free at Three and the Colorado Medical-Dental Integration Project. 

Resource: Using Silver Diamine Fluoride on Children’s Teeth

• The Early Childhood Learning and Knowledge Network recently updated their resource on Silver Diamine Fluoride. This resource is a helpful guide on what silver diamine fluoride is, what the benefits of use are, and what it looks like when applied.

Cavity Free at Three Trains CU Dental Students

• The Cavity Free at Three team would like to thank the University of Colorado School of Dental Medicine for allowing us to come and train the first-year dental students again this year. 80 first-year dental students completed the training and received Cavity Free at Three certification this August. We were very excited to be able to provide the training in person once again. We would like to thank one of our Master Trainers, Karen Wells, for leading a great training this year.

Cavity Free at Three Recruiting Master Trainers

• The Cavity Free at Three team is seeking health care professionals who are passionate about oral health and are interested in becoming a Cavity Free at Three Master Trainer. If you are interested in being onboarded as a Master Trainer, please fill out this linked Google Form. If you have questions about the Master Trainer role, please reach out to leah.brunner@state.co.us.

School-Age

NSAIDs Recommended as First-Line Treatment of Acute Dental Pain

• Earlier this year, the American Dental Association (ADA) released a new clinical practice guideline that recommends nonsteroidal anti-inflammatory (NSAID) drugs taken with or without acetaminophen be used as a first-line treatment for management of acute dental pain. The ADA collaborated with the University of Pittsburgh School of Dental Medicine and the Center for Integrative Global Oral Health at the University of Pennsylvania School of Dental Medicine to develop the guideline. The guidance is recommended for individuals ages 12 and up. Read more about the guideline on the ADA webpage.

School Recruitment for the Oral Heath Screening Pilot Program

• The Oral Health Unit has been working to launch the newly created Oral Health Screening in Schools Pilot Program (SB24-142), and needs to identify interested schools to participate this school year. Please see the outreach letter for more details! We invite you to share this letter with schools in your community.

Adult

Free CE: Pain Management for Dental Providers

• The Colorado Consortium for Prescription Drug Abuse Prevention’s Provider Education Work Group seeks to increase knowledge around pain management, safe opioid prescribing, and substance use disorder treatment by using a variety of educational tools. Take the Consortium’s free 40 minute webinar “Pain Management for Dental Providers” to receive 0.75 Continuing Education (CE) credits. You can find this training and others on the Consortium’s webpage.