Letter from the Dental Director

Hello from all of us at the Oral Health Unit!

We have many exciting updates for this quarter’s newsletter. The Oral Health Unit (OHU) has just wrapped up the last of our community discussions. Representatives from community organizations across Colorado came together to discuss the Framework to Advance Oral Health Equity in Colorado, how their work connects to the Framework, and what successful implementation of the Framework looks like within the communities they serve. We plan to follow up the community discussions with an Oral Health Network meeting to set measures of success, discuss the coordinated implementation of Framework strategies, and find ways to leverage the work that is being done within the Network to better enable collective impact efforts.

In connection with our stewardship of the Framework and efforts to promote a collective impact approach for oral health equity, the OHU has been working with the Delta Dental Foundation of Colorado and other partners to organize a new state-wide oral health coalition. A selection committee was convened to choose the new backbone organization that will help with the formation of the coalition, as well as provide administrative support. The selection committee has chosen the Public Health Institute at Denver Health for its background in supporting alliances that work toward health equity; experience in utilizing a collective impact approach in its work; and demonstrated ability to work with partners in communities across the state, public health, and professional association to enable systems change. Be on the lookout for updates on how you can get involved!

Additionally, some exciting legislation impacting oral health in Colorado has recently passed. Senate Bill 24-010, Dentist and Dental Hygienist Compact, was signed into law by Governor Jared Polis on May 17th. This bill will enable licensed dentists and dental hygienists to practice in states that participate in the compact without having to seek individual licenses for each state. The state of Colorado will have a representative on the commission that governs this compact, which is slated to meet sometime this fall. Governor Polis also signed into law Senate Bill 24-142, which creates a pilot program for oral health screenings in schools. This bill allows the Colorado Department of Public Health and Environment (CDPHE) to award grants to at least five schools to implement oral health screenings pilot programs. The OHU will select locations and applicants that represent a variety of school settings, with priority given to schools whose students are likely to face a higher burden of oral disease. The OHU will provide updates about the application process as we further develop the pilot. 

Lastly, the OHU is honored to announce that Colorado is one of eight states awarded grants by the Health Resources and Services Administration’s Maternal and Child Health Bureau for Improving Oral Health Integration. The projects will aim to improve access to preventive oral health care integrated into primary care services for the maternal and child health population at high risk for poor oral health. The projects will implement a two-tier, state and local, improvement approach that will address three core functions: (1) policy and practice; (2) education and outreach; and (3) data, analysis, and evaluation. CDPHE, in collaboration with Denver Health and the University of Colorado, and with the support of a network of oral health partners committed to eliminating oral health inequities, will work to improve access to preventive oral health care and oral health equity among the maternal and child health population, ages 1-21 years, living in communities underserved by oral health care.

Sincerely,

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

News & Hot Topics

• FDA Recall Alert: Homeopathic StellaLife Oral Care Spray Unflavored and Advanced Formula Peppermint Oral Care Rinse by HomeoCare Laboratories
  
  From the FDA: “HomeoCare Laboratories is recalling two batches of Homeopathic StellaLife Oral Care Products manufactured in 2024 due to FDA findings of microbial contamination.
  
  Risk Statement: The two (2) products were found to contain higher than acceptable levels of TAMC (found in the StellaLife Advanced Formula Peppermint Vega Oral Care Rinse) and Bacillus sp (found in the StellaLife Vega Oral Spray, Unflavored).
  
  While Bacillus is a common species found in the environment and are generally non-pathogenic, we understand the concerns regarding potential risks, especially among patients with oral disease, undergoing dental surgical procedures or with compromised immune systems.
  
  In the immunocompromised population, there is a risk that use of the product could result in severe or life-threatening adverse events due to the introduction of bacteria to the disrupted oral mucosa, possibly leading to bacteremia and sepsis.It is important to note that no adverse events related to these two (2) products have been reported to HomeoCare to date.” Read the recall information on the FDA website.
  
  
• Fluoride: Fact Sheet for Professionals
  
  The National Institutes of Health (NIH), Office of Dietary Supplements has released an updated fact sheet on fluoride for professionals, with easily accessible information on current scientific references. Read the fact sheet on the NIH website.

Partner Links

• Colorado Health Access Survey Results
  
  Drinking optimally fluoridated water helps keep teeth strong and reduces cavities in children and adults. The CDC My Water’s Fluoride website can help initiate conversations about community drinking water fluoridation levels, but another great source of information on fluoride levels The Colorado Health Institute has recently released the results of the Colorado Health Access Survey (CHAS). The survey found that disparities were linked to geographic area (rural vs. urban), lack of insurance, cost of care, lack of providers, and lack of representation within the provider pool. These findings are confirmed by the results of the OHU’s community and partner engagement efforts in the development of the Framework to Advance Oral Health Equity in Colorado. You can read more about the CHAS results here and you can find the OHU’s Community and Partner Engagement and Discovery Report on CDPHE’s oral health website.

Prenatal, Infant, and Toddler

• Colorado Dental Association Reimbursement Changes – Including Fluoride Varnish!
  
  For National Children’s Dental Health Month, the OHU wanted to spotlight specific Cavity Free at Three materials that you may find relevant to your work with children. The Cavity Free at Three Child Pamphlet provides education around how to keep an infant’s and toddler’s teeth The Colorado Dental Association (CDA) has recently announced that certain Medicaid dental rates will increase as of July 1, 2024. The dental codes include 15 preventive, perio, and endo codes, and 13 diagnostic and crown codes, including ‘D1206 Fluoride Varnish,’ a common code used for Cavity Free at Three visits. For D1206, the new rate is $41.96. Read more about these increases from the CDA.
  
• Resource – Adoption of New Oral Health Interventions in Primary Care: Qualitative Findings
  
  A new article published in the American Journal of Preventive Medicine discussed qualitative findings of implementing preventive oral health services training within a pediatric medical setting. This randomized trial studied 21 clinicians across nine practices and found that multi-level training was effective in increasing oral health prevention in pediatric settings. Read more on the NIH website.

• Master Trainer Recertification and Update Session
  
  The Cavity Free at Three team has scheduled the virtual Master Trainer Recertification Session for Monday, August 19th from 8am to 9am. Master Trainers need to attend this session or watch the recording in order to be considered an active Master Trainer. If you are a current Master Trainer who has not received the invite, or if you have any questions or topics you would like to be added to the agenda, please reach out to leah.brunner@state.co.us.

School-Age

• School-Based Oral Health Dashboard
  
  To better understand the landscape of school-based programs and update our School-based Oral Health Targeting Dashboard, the OHU is looking for input from dental providers who offer services in schools. We need your help! If you provide screening, fluoride varnish, and/or dental sealants in a school setting, please email the OHU at robyn.maestas@state.co.us. The OHU will follow-up with you to gather more information about what schools you serve and the services provided. This information is vital to understanding gaps in access to care for school-age children. We appreciate your assistance!