Please visit https://www.cdhp.org/blog/505-new-multi-generational-effort-for-oral-health for more information!

Program Manager Dr. John Girdwood was mentioned in the Section on Children and Youth Spring 2018 Newsletter, a publication of the American Sociological Association.  Click here to see a list of newsletters.  Click here to access the Spring 2018 newsletter directly.  Scroll down to page 20!

About the ASA

Copied directly from http://www.asanet.org/about-asa

“The American Sociological Association is:

• a non-profit membership association based in Washington, DC
• dedicated to advancing sociology as a scientific discipline and profession serving the public good
• over 100 years old (ASA was founded in 1905)
• an association of over 13,000+  members
• home to 52 special interest sections with more than 21,000 members
• host of an annual meeting with more than 6,000 participants
• publisher of 10 professional journals and magazines, plus 4 section journals”

“Members include:

• community college, college, and university faculty
• researchers
• students
• high school teachers
• practitioners
• about 20 percent of the members work in government, business, or non-profit organizations”

For more info on ASA, please visit http://www.asanet.org/about-asa

We learned about the “TYKE: Treating Young Kids Everyday” program through a recent webinar.  Click here for full details.

“The TYKE program is designed to increase dentists’ confidence to see babies and young children and inspire a commitment to decreasing the prevalence of dental caries in California’s children. This online course offers effective educational tools and training to support dental teams in using caries risk assessment, disease prevention and early interventions to reduce tooth decay among children ages birth to six years.”

There are a lot of relevant points made on the site and through the learning portal but you’ll have to click here for full details.

We submitted the material below to the Michigan Primary Care Association to present information about our project at their annual conference.  Of course, if you want to learn more, go to the event!

MPCA Call for Presentations

• 2018 Annual Conference
• Community Health Trends and Innovations
• July 22-24, 2018
• Grand Traverse Resort & Spa
• Click here to submit a proposal (Due 3/16/18)

Conference Theme (Partial List)

• Best practices and case studies related to:
  • General medical topics, including oral health. Current trends in treating a wide range of conditions; success stories on the expansion of services
• Programs that address various subpopulations and their unique health needs
  • Subpopulation: Pregnant mothers and their families

Selection Criteria

• Innovative
• Relevant
• Adaptable
• Results
• Engaging

Target Audience

• Medical/Physical Health
• Dental Health
• Finance/Operations
• Other: Medical directors, Dental directors, clinicians from either medical or dental clinics; While our presentation shows OBGYN/Dental integration, our programs can be expanded to various primary care clinics like FM and PED so those are targets.

Presentation Level and Type

• Intermediate
• Lecture

Title

Michigan Initiative for Maternal and Infant Oral Health

Description

• 2,000 Characters
• Summarize what will be covered in your presentation.
• Emphasize why your target audience needs to know what you have to present.
• What makes the subject matter appropriate, or unique?
• Compelling

The Michigan Initiative for Maternal and Infant Oral Health is a grant-funded effort that places a registered dental hygienist (RDH) in an OBGYN medical clinic to provide oral health care to pregnant mothers. The project leveraged prior work that trained pediatricians how to apply fluoride varnish to the teeth of children ages 0-3 years old. Both programs are aimed at reducing disparities in the prevalence of early childhood caries, the disease that causes cavities, among under-served children who display multiple risk factors. Both projects involve medical-dental integration (MDI) at federally qualified health centers (FQHCs) and deliver patient education to children and their families.

This session adds a life course perspective to the application of inter-professional care.  Attendees will gain new knowledge about how to integrate oral health care within medical clinic visits for patients at various points in life during their earliest medical visits.  We will present a case study covering 6 pilot sites across Michigan where an RDH was integrated into OBGYN patient workflow.  While many medical practitioners know that oral health care is important to overall health, few understand how to implement an interdisciplinary program in their clinic.  This session will provide results from the first 10 months of care provided through the Michigan Initiative for Maternal and Infant Oral Health and will give participants practical information to begin medical-dental integration at OBGYN, Pediatrics, Family Medicine, and other primary care clinics.

Three Learning Objectives

1. As a result of attending this session, participants will know how to launch a medical-dental integration program at their primary care clinic.
2. As a result of attending this session, participants will understand the importance of providing oral health care at various stages during the life course.
3. As a result of attending this session, participants will have current MDI data to make informed decisions and tools that can be adapted to a variety of clinical settings.

Presentation Style and Presenters

How will you convey the content to your intended audience? What delivery format will you use for your presentation? How will the format or style involve the audience and stimulate discussion? How will you keep the energy in the room, even if you are the last session of the day?

This presentation will be presented via a PowerPoint presentation in conjunction with story sharing and facilitated discussion. Facilitated by a group of high energy speakers, participants will remain engaged through an interactive session that examines the success and challenges of medical-dental integration in “real life” application.

John Girdwood

Dr. John Girdwood is currently the Statewide Project Manager of the Maternal and Infant Oral Health project based at the University of Detroit Mercy School of Dentistry.  Prior to that, he was funded through a 3-year grant from CMS to support the Michigan Caries Prevention Program at the University of Michigan.  His recent initiatives to integrate dental care in medical clinics were a natural progression after his fellowship at Central Michigan University College of Medicine overseeing quality improvement in medical clinics.  As a sociologist trained at Michigan State University, he supports work that strengthens ties between clinicians and patients to produce better outcomes for marginalized populations.

Emily Norris

Emily Norrix currently serves as the Perinatal Oral Health Consultant and subject matter expert with the Michigan Department of Health and Human Services-Oral Health Program, leading the development of a comprehensive perinatal oral health initiative for the state of Michigan.  She has had a wide variety of public health experiences and has previously worked in community health and outreach to migrant families and children throughout northern Michigan as well as conducted outbreak investigation, data analysis, and community outreach activities with local health departments. Emily has also assisted in the implementation of a statewide, children’s health insurance retention initiative utilizing mobile technology with the Michigan Primary Care Association. Emily holds a B.S in Health Sciences and a Master’s in Public Health, both from Michigan State University.

Placing registered dental hygienists in OBGYN medical clinics to provide care for pregnant mothers, meeting patients where they are to improve access and outcomes.

Purpose of the Project

The purpose of the Michigan Initiative for Maternal and Infant Oral Health is to improve oral health of mothers and children in under-served areas.  The grant-funded effort began as a 1-year project at 6 pilot sites.  The initial aim was to examine the feasibility and impact of placing a registered dental hygienist within an OBGYN medical clinic.  While the approach was an important first step toward reaching patients in the inaugural year, it was essential to strategically plan a more robust sustainable model while concurrently building the new program.

Quality Care

Hardworking well-educated healthcare clinicians who provide medical and dental services to families often experience difficulties in care delivery due to loosely organized inter-professional collaborations.  Prioritizing the environment and processes at clinics can help ensure better quality care.  Healthcare quality is generally measured by five characteristics: safe, timely, effective, efficient, equitable, patient-centered (STEEEP).  While specific applications of these components vary, the Michigan Initiative for Maternal and Infant Oral Health addressed all five during implementation and strategic planning.

Implementation

The Grace Health Model for Pregnant Mothers began in November 2014 when dental hygienists started seeing patients in the OB/GYN department.  This successful program established a template for five other Federally Qualified Health Center (FQHC) pilot sites to build from and mimic throughout Michigan.

Strategic Planning

Other pilot sites contributed input to (i) enhance and standardize current workflow; (ii) expand the scope of services rendered; and (iii) include pregnant mothers and their children up to age 3 years.  The Muskegon Family Care Dental Coach Model supplemented the Grace Health Model and bridged the gap between the OBGYN and pediatric clinical teams.  New processes help all family members establish a dental home.

Mission and Vision

The University of Detroit Mercy School of Dentistry, Michigan Department of Health and Human Services, and Michigan Primary Care Association will improve oral health outcomes for mothers and children through organization quality care.

Disclosure: The content in this section is adapted from the grant application submitted to the Michigan Department of Health and Human Services titled “At-Risk Mothers and Children Dental Program.”

During pregnancy, physical and physiological changes occur that can adversely affect the mouth.  Gingivitis is the most common oral condition of pregnancy, effecting about 3 in 4 pregnant women.[1]  Left untreated, gingivitis may progress to periodontal disease which may destroy both soft and hard tissues.  Other oral conditions commonly occurring during pregnancy include benign oral gingival lesions, tooth mobility, tooth erosion and dental caries (cavities).  Pregnant women are at high risk for dental caries due to a variety of reasons including inadequate amounts of fluoride, high intake of sugary food or beverages, and a lack of oral health care.

To effectively improve oral health among pregnant women and children, it is important to understand and address two contributing factors: health literacy and oral health disparities by race, ethnicity and income.  Often, those with low levels of health literacy are found among these same vulnerable populations.  Several national organizations have undertaken efforts to promote oral health among pregnant women and children.  They developed statements, guidelines, educational materials, and tools to improve oral health.  These include: the American Congress of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatric Dentistry (AAPD),[2] the American Academy of Pediatrics (AAP),[3] the American Academy of Periodontology, the American Academy of Physician Assistants (AAPA), the American College of Nurse-Midwives (ACNM), the Society of Teachers in Family Medicine (STFM), and the American Dental Association (ADA).

In 2008, an expert panel convened by the U.S. Maternal and Child Health Bureau (MCHB) developed strategies for improving perinatal oral health.  One strategy was to “promote the use of guidelines addressing oral health during the perinatal period and to disseminate guidelines to Maternal and Child Health and Oral Health professionals.”  This led to the development of a national consensus statement in collaboration with ACOG and the ADA “Oral Health Care during Pregnancy: A National Consensus Statement,” as well as a Committee Opinion from ACOG “Oral Health Care During Pregnancy and Through the Life Span.”  Several states including New York, California, South Carolina, and Washington developed statewide practice guidelines for perinatal oral health.

Health professionals often do not provide oral health care to pregnant women and pregnant women often do not seek or receive oral health care.  Some pregnant women and health professionals do not understand that oral health care is an important component of a healthy pregnancy.  Early childhood caries is a preventable infectious disease, and this project proposes to provide perinatal and prenatal preventative oral health care to high-risk populations.  We will study the attitudes of high risk populations and their physician providers to educate them about the importance of an oral health program as a part of the comprehensive oral health plan.

Goals

1. Pregnant women are provided dental services and referrals made to the dental providers for follow-up care
2. Develop and/or locate materials to educate pregnant women who receive services and chair-side curriculum to educate pregnant women
3. Collect demographic, caries risk, and dental disease data using EHR
4. Collect saliva samples from participants
5. Develop a brief, plain language client satisfaction survey or equivalent evaluation methodology

Measurements

1. # of women who participate in the program, number of women who receive services and pre- and post-natal oral health education
2. # of women who have received the educational material
3. Data for all participants will be collected
4. Database will be maintained
5. Report will be completed on patient experiences and satisfaction

Sources

[1]Patton LL. The ADA Practical Guide to Patients with Medical Conditions. John Wiley & Sons; 2015.

[2]Guideline on Perinatal and Infant Oral Health Care. Pediatric Dentistry. 2016;38(6):150-154.

[3]American Academy of Pediatrics, American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Guidelines for Perinatal Care. American Academy of Pediatrics; 2017.

The Michigan Maternal Infant Health Summit took place at the Lansing Center on March 5, 2018.  Emily Norrix (MI DHHS) and Kevin Steely, DDS (Grace Health) presented “MI Mom’s Mouth: Addressing Oral Health Needs During Pregnancy.”  The plenary and keynote talks are available on YouTube (see below).  The Michigan Council for Maternal and Infant Oral Health was prominent at the event.

We received some great information from the Children’s Dental Health Project email list yesterday!  They are a great group and a wonderful resource for information including videos and printable posters.  We’d like to share those with you here.

“CDHP’s infographic offers key data and tips about pregnant women’s oral health. Whether you are a health provider, policymaker, or oral health advocate, share it on social media or print out hard copies to educate patients and your community.”

Click here to view and print the info-graphic

There’s also a fantastic short YouTube video!

“CDHP’s Colin Reusch discusses the important ways in which people outside of a dental office can help keep young children healthy and cavity-free.”

Click here to find out more about CDHP

We had the opportunity to attend a wonderful webinar presented by the American Dental Association (ADA) this week and wanted to convey some great resources that the ADA provides for public health dental programs including material on health literacy.  (Click here)

“ADA policy defines oral health literacy as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate oral health decisions. It also recognizes that by improving health literacy, patients are better stewards of their own health. You can improve health literacy by using simple communication with the patient and confirming comprehension so that the risk of miscommunication is minimized. You can support patients’ efforts to improve their oral health by using strategies that make the dental office environment and health care system easier to navigate.”

Click here to access more ADA resources!

“Mark Deutchman, M.D., a Professor in the Department of Family Medicine at the University of Colorado School of Medicine… founded an obstetrics fellowship to train rural Family Physicians in surgical obstetrics… In addition to an emphasis on rural physician workforce development, he is engaged in interdisciplinary training and works with programs to integrate oral health into primary care.”

Read more at http://rhlradio.libsyn.com/82-a-conversation-with-mark-deutchman#Jy2QkchEQrDw4xsC.99

Or, visit  http://www.nnoha.org/

“Learn how community dental health coordinators (CDHC) are helping patients understand the value of dentistry, navigate dental care and take control of their oral health. ADA.org/CDHC”

“Another option is to utilize the new ‘front line health worker’ modules of the Smiles for Life oral health curriculum. These modules are for those who provide outreach, advocacy, patient education, care coordination, health care navigation, and social support for the communities they serve. This workforce includes community health workers and representatives, promotores de salud, health educators, case managers, care coordinators, public health workers, community health advocates, health advisors or advocates, patient navigators, outreach workers, family resource workers, and peer health promoters. For more information, contact Dr. Jane Grover, director of the ADA Council on Advocacy for Access and Prevention and former FQHC dental director in Jackson, Michigan, at groverj@ada.org or Steve Geiermann, DDS; Member, NNOHA Board of Directors; geiermanns@ada.org”  Read more at http://www.nnoha.org/