Spurring Progress on Oral Health

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By Rick Valachovic, DMD, MPH, Clinical Professor and Director of the NYU Dentistry Center for Oral Health Policy and Management

 

Greetings! We’re only ten months into the life of the NYU Dentistry Center for Oral Health Policy and Management, and already, I have so much to share. Consider this the first of many updates I’ll be posting throughout the year, and please, let me know what you think!

The past year has changed many peoples’ lives profoundly, and I am no exception. I thought I was ready for retirement after stepping down from my role as President and CEO of the American Dental Education Association in 2019, but sitting on the sidelines was harder than I imagined, especially in the midst of a public health emergency. The COVID-19 pandemic underscored the urgency of attending to all public health concerns, so when Dean Charles Bertolami offered me the opportunity to collaborate in creating a new venture at the New York University (NYU) College of Dentistry to promote oral health, I jumped at the chance.

Those of you who know me won’t be surprised. As a dental educator actively involved in dental schools and associations, I’ve been working hard to influence policy throughout most of my career. We’ve accomplished a lot since I first entered the profession, but I’m acutely aware of the unfinished business that remains.

Putting the Mouth Back in the Body

Ever wonder why you need a separate dental insurance policy to cover the care of your mouth? Answering that question requires a history lesson I’ll save for another day, but the treatment of dental disease as an afterthought—as less essential than caring for the rest of the body—has profoundly negative consequences for our health. When people put off routine dental care until the pain in their teeth or gums becomes intolerable, those delays can lead to other serious problems. Inflammation in the mouth is linked to heart disease, stroke, and diabetes. In the worst cases, untreated infections in the mouth are deadly.

Care of the mouth and the body are moving closer together, but not fast enough, and I’m at the point in my life where I want to do everything I can to fuel the movement to integrate oral health into health care generally. There’s currently an effort in Congress to add dental benefits to Medicare—a move I wholeheartedly support—but it’s only one facet of what needs to be done.

The Center aims to develop a national agenda for oral health policy and management, one that recognizes the fundamental relationship between oral health and overall health and the responsibilities that the dental professions have for the overall well-being of the public. Specifically, we plan to:

  • elevate oral health as a public health issue,
  • promote the integration of dental care into routine health care and health coverage,
  • conduct and publish research on oral health policy and management, and
  • develop programs to prepare the next generation of leaders to carry on this work.

Who We Are

I am joined in this effort by Michael P. O’Connor, EdD, MPA, clinical professor and executive vice dean at the College of Dentistry. Before coming to NYU, Michael held various roles related to finance, organization, and professional development at the Columbia University Medical Center, and he remains clinical professor emeritus of health policy and management at the Columbia University Mailman School of Public Health. As you can see, our interests overlap, but our skills sets are complementary. Michael’s knowledge of organizational development, leadership, and management will be invaluable as we chart the Center’s course.

I’m thrilled to have Michael as a partner as co-director of the Center, and I can’t think of a better place to undertake this work than at NYU. As the largest dental school in the country, the College of Dentistry logs 300,000 visits a year. Its patient population is diverse, reflecting both the city’s demography and the college’s commitment to extensive community outreach and treating underserved populations. The data generated through these activities, and the presence of superb researchers among NYU’s faculty and students, create an unparalleled opportunity for research that can inform the Center’s policy and management initiatives.

It’s also great to be at an institution with a mission that extends beyond graduating highly competent professionals. As the College of Dentistry tagline says, “Imagine a world where everyone smiles.” If that sounds simply cosmetic, think again. For many people who lack access to dental care, a ready smile is a more ambitious goal than you might think. It represents the ability to drink and chew without pain, to talk without embarrassment, to engage socially, and for those in many industries, the ability to get a job and earn a living. A healthy smile not only signifies good oral health; it also functions as a social determinant of overall health and well-being.

More to Come

To kick off the Center’s work, we held a symposium in June with an extraordinary group of thought leaders who share our passion for public health. I’ll introduce you to a few of them in my next post and to others later this fall. Right now, I want to leave you with a story that highlights why improving the nation’s oral health matters in ways that extend far beyond each individual’s health and well-being.

Do you know that dental conditions, including not having enough teeth, have been among the most common medical reasons for deferment from military service since the Civil War? In fact, the military came up with the label “4-F” to classify recruits who lacked the requisite four front teeth. Without them, a soldier wouldn’t be able to bite down on a gun powder cartridge and tear it open with one hand—an essential skill for loading muskets in the heat of battle.

Loading today’s weapons no longer relies on the users’ dentition, yet even in the 21st century, dental readiness remains a concern. The deployment of National Guard and Army Reserve troops to Iraq in the early 2000s revealed significant deficits in their oral health. This prompted changes in Army regulations aimed at improving the dental readiness of our citizen soldiers.

I was heartened to see the military take that step, and it’s not the first time the government has recognized the importance of good oral health to national readiness. In fact, the National Institute of Dental and Craniofacial Research was established in 1948 out of concerns, which surfaced during the second world war, over the oral health of U.S. troops.

What will our nation do next to advance oral health? Expanding Medicare is one option, and other promising policies are within reach. The Center is committed to exploring all of these, to informing their development with data and research, and to cultivating leaders who will advocate for change. Are you with us? I hope so. Please stayed tuned to learn more about how we can spur progress and PROHmote oral health together.

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Rick

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