This document discusses improving oral health outcomes through a dental wellness plan approach. It begins by outlining the chronic infectious nature of dental diseases and how current treatment methods do not effectively address the underlying causes. It then proposes a dental wellness plan that would identify high-risk plan members through shared risk assessment, treat the infections causing dental decay through an evidence-based antibacterial coating, and differentiate care levels based on risk status. The goal is to contain costs and improve outcomes by shifting from a surgical response to managing the oral infections driving dental diseases.
Perception of Dental Visits among Jazan University Students, Saudi Arabiainventionjournals
Background:regular dental check-ups is fundamental in preventing and detecting dental diseases.Majority of Saudi patients do not have the trend to visit dentist frequently and they go only for emergency treatment and mostly pain is the driving factor. Aim: to evaluate the knowledge, beliefs and attitude of Jazan university students towards dental visits. Materials and Methodology:This descriptive cross-sectional; questionnaire based survey was carried out to evaluate the perception of Jazan university Saudi students towards dental visits. 352 students participated, age range of 20-24 years old. Results: The study revealed pain is the driving factor for most of the dental visits. 47.9%, their 1 stvisits complain was pain, 58% the driving factor for last visit is also pain. Although 29.1% occasionally visit dentist; 43% of them their last visit to dentist was 6 month ago. 47.6% were irregular visitors to dentist because they are afraid from dental needle and pain. 75% of the participants described their feeling at1st visit to dentist to be anxious and afraid. Although 88% of the participants knew that regular dental check-ups is important but this knowledge was not practiced.Only4.3% of the participants are driven to dental visit by dentist advice. Conclusion: there are lack of knowledge, wrong beliefs and negligence of dental visits in our study participants. Dental professional and mass media are not playing their role to change the knowledge and beliefs of the population.Recommendation: dental professionals’ media should be utilized spread knowledge of proper dental care.
Tooth loss and importance of retaining teeth for vitality, quality of life an...fdiworlddental
ORAL HEALTH FOR AN AGEING POPULATION FORUM
Tooth loss and importance of retaining teeth for vitality, quality of life and longevity
Martin Schimmel
FDI World Dental Congress 2016 Poznań
Prevention of tooth loss and dental pain for reducing the global burden of or...fdiworlddental
ORAL HEALTH FOR AN AGEING POPULATION FORUM
Prevention of tooth loss and dental pain for reducing the global burden of oral disease
Susan Hyde
FDI World Dental Congress 2016 Poznań
The Importance of Oral and Dental Health in College StudentsMessiMasino
This note covers the following topics: Bacterial Diversity in the Oral Cavity, Oral-Systemic Link, Tooth Brushing, Flossing, Common Oral Hygiene Mistakes, Oral Cavity and Oropharyngeal Cancers, Oral Cavity and Oropharyngeal Cancer, Acute Dental Trauma, Controlling Bleeding and Swelling, Complications of Oral Piercings.
Perception of Dental Visits among Jazan University Students, Saudi Arabiainventionjournals
Background:regular dental check-ups is fundamental in preventing and detecting dental diseases.Majority of Saudi patients do not have the trend to visit dentist frequently and they go only for emergency treatment and mostly pain is the driving factor. Aim: to evaluate the knowledge, beliefs and attitude of Jazan university students towards dental visits. Materials and Methodology:This descriptive cross-sectional; questionnaire based survey was carried out to evaluate the perception of Jazan university Saudi students towards dental visits. 352 students participated, age range of 20-24 years old. Results: The study revealed pain is the driving factor for most of the dental visits. 47.9%, their 1 stvisits complain was pain, 58% the driving factor for last visit is also pain. Although 29.1% occasionally visit dentist; 43% of them their last visit to dentist was 6 month ago. 47.6% were irregular visitors to dentist because they are afraid from dental needle and pain. 75% of the participants described their feeling at1st visit to dentist to be anxious and afraid. Although 88% of the participants knew that regular dental check-ups is important but this knowledge was not practiced.Only4.3% of the participants are driven to dental visit by dentist advice. Conclusion: there are lack of knowledge, wrong beliefs and negligence of dental visits in our study participants. Dental professional and mass media are not playing their role to change the knowledge and beliefs of the population.Recommendation: dental professionals’ media should be utilized spread knowledge of proper dental care.
Tooth loss and importance of retaining teeth for vitality, quality of life an...fdiworlddental
ORAL HEALTH FOR AN AGEING POPULATION FORUM
Tooth loss and importance of retaining teeth for vitality, quality of life and longevity
Martin Schimmel
FDI World Dental Congress 2016 Poznań
Prevention of tooth loss and dental pain for reducing the global burden of or...fdiworlddental
ORAL HEALTH FOR AN AGEING POPULATION FORUM
Prevention of tooth loss and dental pain for reducing the global burden of oral disease
Susan Hyde
FDI World Dental Congress 2016 Poznań
The Importance of Oral and Dental Health in College StudentsMessiMasino
This note covers the following topics: Bacterial Diversity in the Oral Cavity, Oral-Systemic Link, Tooth Brushing, Flossing, Common Oral Hygiene Mistakes, Oral Cavity and Oropharyngeal Cancers, Oral Cavity and Oropharyngeal Cancer, Acute Dental Trauma, Controlling Bleeding and Swelling, Complications of Oral Piercings.
By 2030, there will be over 72 million senior citizens in the United States. Most won’t have easy access to dental care. Oral Health America's "State of Decay Report" shows older adults face many barriers to accessing oral healthcare. Check out this infographic, which provides a summary of the issues preventing older Americans from accessing dental care.
Knowledge to action: changing the dynamic between patients and providers - en...Paul Gallant
This presentation provides tips, examples and extensive resources on taking action for better patient and health provider engagement. As part of my invited keynote presentation for Choosing Wisely Alberta/Alberta Medical Association. I hope you find the presentation deck useful. Brief video clips & words of wisdom from my friend and colleague, Annette McKinnon are included in the presentation to accompany the slides.
Men with Eating Disorders: Deepening Our Understanding to Improve CaringPaul Gallant
This invited presentation was part of the 2020 6th Annual Interior Region Eating Disorder (Virtual) Forum, September 2020. The presentation addresses recent research, community and clinical experiences of men with eating disorders to deepen our understanding to improve caring. Stories, stats, questions, video clips and polls were included to seek input from those participating.
For example: Do males comprise 33-40% of those we are caring for? If NO, WHY NOT?
You may find use for some of these in future presentations or team discussions.
Tips to Improve Caring include:
*Team based interest/working groups to plan better for
males; include cross site/jurisdiction knowledge
exchange/peer support for clinicians/mentorship
*Include male former patients/MWED in planning/advising
*Include males in research AND disseminate this research to honor their contribution
rather than “the number of males were insufficient to report on”
*Include retrospective reviews on past males for quality improvement
*Review non-published findings on males in your own research
*Demonstrate that you’re informed/comfortable working with MWED
*Know the literature/resources & limits of both for males with eating disorders
*Use your creativity & planning to consider all-male therapeutic groups including online therapeutic or support groups?
*Schedule male appointments back to back/same time. Males see they are not the only male in treatment/care
*Seize the moment to engage the person who is seeking support (hope, optimism and repeat check-in)
A take away team or self-reflection exercise asks:
What are we doing in our own practice or setting to__
-Demonstrate a “male friendly” welcoming environment for
boys/men with Eating Disorders?
-Better understand… boys/men with Eating Disorders?
-Better support/treat/demonstrate caring … boys/men with
Eating Disorders?
Health innovation for all conference sustaining and transforming our health s...Paul Gallant
IHI Open School UBC Chapter, Health Innovation for All Conference. Sustaining and Transforming Our Health System(s)
Presentation by: Paul W. Gallant, Gallant HealthWorks
Session Summary:
This interactive workshop encourages participants to contribute their knowledge, views and experiences as health system(s) stakeholders to discuss questions based on the concepts and trends presented.
Better Healthcare Through Community and Stakeholder Engagement, 2015 Webinar ...Paul Gallant
"An enjoyable presentation, well-delivered with excellent insight into community and stakeholder engagement strategies. Terry Dyni - July 23, 2015" on the webinar version. This version is my complete slide deck from a live webinar presentation requested by the Conference Board of Canada. April, 2015. Thanks for your interest in Better Healthcare Through Community and Stakeholder Engagement.
Compliments of Paul W. Gallant, CHE, GALLANT HEALTHWORKS & Associates (GHWA), Vancouver, BC, Canada. PS See the last slide for contact details or to arrange customized training/facilitation or advice on your organizational needs.
This Webinar is the first in the Enhancing Linkages to HIV Primary Care and Services Webinar series, produced in association with the Health Resources and Services Administration's (HRSA's) Integrating HIV Innovative Practices (IHIP) project. The series’ three sessions each focus on a different aspect of linking people living with HIV/AIDS to HIV primary care and services in the jails setting.
This Webinar series is part of a collection of dissemination materials on the SPNS EnhanceLink Jail Linkage Initiative (http://hab.hrsa.gov/abouthab/special/carejail.html). These include:
- Training manual: https://careacttarget.org/library/creating-jail-linkage-program-training-manual
- Curriculum: https://careacttarget.org/library/creating-jail-linkage-program-curriculum, and
- Pocket guide: https://careacttarget.org/sites/default/files/JailsLinkageIHIPPocketCard.pdf
All of these resources can be found on the IHIP landing page (http://www.careacttarget.org/ihip) on the TARGET Center Web site. In addition, all Webinar sessions in this series will be recorded and also made available on the IHIP page.
Improving the Health of Adults with Limited Literacy: What's the Evidence?Health Evidence™
Health Evidence, in partnership with the National Collaborating Centre for Determinants of Health (NCCDH), hosted a 60 minute webinar, funded by the Canadian Institutes of Health Research (KTB-112487), on interventions to improve the health of adults with limited literacy, presenting key messages, and implications for practice on Wednesday October 31, 2012 at 1:00 pm EST. Maureen Dobbins, Scientific Director of Health Evidence, lead the webinar, which included interactive discussion with Karen Fish, Knowledge Translation Specialist, and Connie Clement, Scientific Director, both from the NCCDH.
This webinar focused on interpreting the evidence in the following review:
Clement, S., Ibrahim, S., Crichton, N., Wolf, M., Rowlands, G. (2009). Complex interventions to improve the health of people with limited literacy: A systematic review. Patient Education & Counseling, 75(3): 340-351.
The results of investment in small companies have been analyzed. The characteristics of innovative enterprises and possible funding sources for innovations have been developed.
By 2030, there will be over 72 million senior citizens in the United States. Most won’t have easy access to dental care. Oral Health America's "State of Decay Report" shows older adults face many barriers to accessing oral healthcare. Check out this infographic, which provides a summary of the issues preventing older Americans from accessing dental care.
Knowledge to action: changing the dynamic between patients and providers - en...Paul Gallant
This presentation provides tips, examples and extensive resources on taking action for better patient and health provider engagement. As part of my invited keynote presentation for Choosing Wisely Alberta/Alberta Medical Association. I hope you find the presentation deck useful. Brief video clips & words of wisdom from my friend and colleague, Annette McKinnon are included in the presentation to accompany the slides.
Men with Eating Disorders: Deepening Our Understanding to Improve CaringPaul Gallant
This invited presentation was part of the 2020 6th Annual Interior Region Eating Disorder (Virtual) Forum, September 2020. The presentation addresses recent research, community and clinical experiences of men with eating disorders to deepen our understanding to improve caring. Stories, stats, questions, video clips and polls were included to seek input from those participating.
For example: Do males comprise 33-40% of those we are caring for? If NO, WHY NOT?
You may find use for some of these in future presentations or team discussions.
Tips to Improve Caring include:
*Team based interest/working groups to plan better for
males; include cross site/jurisdiction knowledge
exchange/peer support for clinicians/mentorship
*Include male former patients/MWED in planning/advising
*Include males in research AND disseminate this research to honor their contribution
rather than “the number of males were insufficient to report on”
*Include retrospective reviews on past males for quality improvement
*Review non-published findings on males in your own research
*Demonstrate that you’re informed/comfortable working with MWED
*Know the literature/resources & limits of both for males with eating disorders
*Use your creativity & planning to consider all-male therapeutic groups including online therapeutic or support groups?
*Schedule male appointments back to back/same time. Males see they are not the only male in treatment/care
*Seize the moment to engage the person who is seeking support (hope, optimism and repeat check-in)
A take away team or self-reflection exercise asks:
What are we doing in our own practice or setting to__
-Demonstrate a “male friendly” welcoming environment for
boys/men with Eating Disorders?
-Better understand… boys/men with Eating Disorders?
-Better support/treat/demonstrate caring … boys/men with
Eating Disorders?
Health innovation for all conference sustaining and transforming our health s...Paul Gallant
IHI Open School UBC Chapter, Health Innovation for All Conference. Sustaining and Transforming Our Health System(s)
Presentation by: Paul W. Gallant, Gallant HealthWorks
Session Summary:
This interactive workshop encourages participants to contribute their knowledge, views and experiences as health system(s) stakeholders to discuss questions based on the concepts and trends presented.
Better Healthcare Through Community and Stakeholder Engagement, 2015 Webinar ...Paul Gallant
"An enjoyable presentation, well-delivered with excellent insight into community and stakeholder engagement strategies. Terry Dyni - July 23, 2015" on the webinar version. This version is my complete slide deck from a live webinar presentation requested by the Conference Board of Canada. April, 2015. Thanks for your interest in Better Healthcare Through Community and Stakeholder Engagement.
Compliments of Paul W. Gallant, CHE, GALLANT HEALTHWORKS & Associates (GHWA), Vancouver, BC, Canada. PS See the last slide for contact details or to arrange customized training/facilitation or advice on your organizational needs.
This Webinar is the first in the Enhancing Linkages to HIV Primary Care and Services Webinar series, produced in association with the Health Resources and Services Administration's (HRSA's) Integrating HIV Innovative Practices (IHIP) project. The series’ three sessions each focus on a different aspect of linking people living with HIV/AIDS to HIV primary care and services in the jails setting.
This Webinar series is part of a collection of dissemination materials on the SPNS EnhanceLink Jail Linkage Initiative (http://hab.hrsa.gov/abouthab/special/carejail.html). These include:
- Training manual: https://careacttarget.org/library/creating-jail-linkage-program-training-manual
- Curriculum: https://careacttarget.org/library/creating-jail-linkage-program-curriculum, and
- Pocket guide: https://careacttarget.org/sites/default/files/JailsLinkageIHIPPocketCard.pdf
All of these resources can be found on the IHIP landing page (http://www.careacttarget.org/ihip) on the TARGET Center Web site. In addition, all Webinar sessions in this series will be recorded and also made available on the IHIP page.
Improving the Health of Adults with Limited Literacy: What's the Evidence?Health Evidence™
Health Evidence, in partnership with the National Collaborating Centre for Determinants of Health (NCCDH), hosted a 60 minute webinar, funded by the Canadian Institutes of Health Research (KTB-112487), on interventions to improve the health of adults with limited literacy, presenting key messages, and implications for practice on Wednesday October 31, 2012 at 1:00 pm EST. Maureen Dobbins, Scientific Director of Health Evidence, lead the webinar, which included interactive discussion with Karen Fish, Knowledge Translation Specialist, and Connie Clement, Scientific Director, both from the NCCDH.
This webinar focused on interpreting the evidence in the following review:
Clement, S., Ibrahim, S., Crichton, N., Wolf, M., Rowlands, G. (2009). Complex interventions to improve the health of people with limited literacy: A systematic review. Patient Education & Counseling, 75(3): 340-351.
The results of investment in small companies have been analyzed. The characteristics of innovative enterprises and possible funding sources for innovations have been developed.
this dental administration incorporates routine dental examinations or registration, oral wellbeing guidance, scale and cleaning, extractions, fillings, X-beams, crevice sealants and root channel medicines and looks to address all ebb and flow dental concerns.
This Webinar provides an overview of common oral health barriers for people living with HIV/AIDS (PLWHA) and the importance of overcoming these barriers. It will also share some of the ways HRSA has helped link PLWHA to oral health care, including the SPNS Oral Health Initiative. Featured presenters include:
- Dr. Mahyar Mofidi; Branch Chief of the Division of Community HIV/AIDS Programs and Chief Dental Officer of the HRSA HIV/AIDS Bureau
- Jane Fox, MPH; Project Director of SPNS Oral Health Initiative Evaluation Center for HIV and Oral Health (ECHO), Boston University School of Public Health.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Top HR & Workplace Benefits Trends to Improve Employee Satisfaction + Family ...Aggregage
In this webinar, you will learn and understand how to offer flexible oral and vision benefits and convenient access to this type of care for children and families.
1. Oral health for life
Introducing key concepts of wellness to contain
costs and improve outcomes
The body is part of the mouth
… and the mouth is part of the body
Don McGowan
McGowan Insurance Services, Oakville, ON
www.oralhealthforlife.ca
2. Oral health for life
Brushed your
teeth this
morning?
5000x
magnification
of bacteria
on a tooth
brush bristle
after use
3. Oral health for life
Got that
“clean teeth
feeling”?
(Not!)
5000x magnification of
the tooth surface
(yellow), bacterial film
(blue) and red blood
cells after brushing
4. Oral health for life
Flossed
lately?
5000x magnification
of bacterial biofilm
at the gum line –
the origins of both
dental decay and
gum disease
5. Oral health for life
Otherwise, the drill is coming after you!
5000x magnification
of the dental drill
with bacteria on its
surface
6. Oral health for life
Now that I have grabbed your attention,
what’s our agenda?
1. The Nature of dental diseases
2. Do group dental benefits address this Nature?
3. The principles of wellness in dental care
4. What a dental wellness plan looks like
5. A case study
6. So what?
7. Oral health for life
1. The Nature of dental diseases
• They are chronic infections – an un-balanced biofilm
• These infections result from external (behavioral) factors
• Multiple medication use for other chronic disorders
• Smoking
• Prior infections which go untreated
• Snacking & sipping
• They cause systemic health problems
• They enter the blood stream & thereby the arterial plaque
• They trigger inflammation
8. Oral health for life
Really, dental costs originate from
infections?
On the tooth surface
(blue chains are S. mutans)
At the gum line
(T. denticola, P. gingivalis)
9. Oral health for life
Kind of like other medical conditions!
Ulcers are a treatable bacterial infection
Appendicitis is an infection which can be treated
more affordably with antibiotics than surgery
10. Oral health for life
These oral infections …
• Re-establish themselves quickly after oral hygiene, a
dental cleaning or a dental scaling
• Are unaffected by drilling and filling
• May be encouraged by drilling and filling (iatrogenesis)
• Are clustered in the plan membership
• 15% to 20% of plan membership
• The cluster grows with age
• In tandem with the increase of other chronic diseases (e.g. diabetes)
• In response to more and more drill and fill
11. Oral health for life
The infections cause this …
A middle aged high- risk
plan member who regularly
spends > $1000 per year
12. Oral health for life
Which, in turn, causes a growing
affordability problem for the community
25%
15%
13%
11%
8%
6%
0% 5% 10% 15% 20% 25% 30%
dental care
see a doctor
prescription drugs
see a specialist
follow-up care
mental health counselling
"During the past year, was there a time when
you needed any of these services, but couldn't
afford it?" American adults, 2014
Source: FED, 2014. The economic well-being of US households.
13. Oral health for life
And, different behavior in the waiting room
• 20% decline in adult attendance in the past 10 years
• A steady drop in dental incomes since 2006
• A more intense focus on patients with dental insurance
and maximizing the use of dental coverage
In other words, the dental benefits system
is increasingly prone to over-treatment
given demographic factors, affordability
problems, and the need for revenue by
the dental practice.
14. Oral health for life
2. Do group dental plans respond to
this Nature?
Ask yourself:
• Are we finding those plan members with these infections?
• Are we treating these infections?
• Is our plan design based on the Nature of dental
diseases?
• Do we tie preventive services to disease risk?
15. Oral health for life
Because of recurrent
drilling & filling
With no commensurate
increase in prevention
Source: Del Aguila M et al, 2002
Dental spending peaks
past age 55
The conventional (surgical) response to these oral infections
16. Oral health for life
How effective is your dental plan in managing these oral
infections?
Procedure % of total plan
spending
Evidence it works to manage oral
infections?
Drilling and filling 40% No controlled studies, some evidence it promotes more
more infection by creating more vulnerable surfaces
In-office fluoride for
adults, including
fluoride varnish
5% No well controlled studies
Regular hygiene
cleaning
30% No evidence, no well controlled studies
Chlorhexidine rinse 1% No evidence in managing dental decay
Periodontal scaling 10% No evidence in low risk adults
Are we working from the science,
or from traditions and conventions?
17. Oral health for life
3. The principles of dental wellness
• Meet the plan members’ wants and needs – to help
engage the membership in change
• Address the cause of the disease, not the outcome
• Make sure there is good evidence for any change
• Address risk – one size doesn’t fit all
18. Oral health for life
Why do your plan members go to the
dentist?
Reasons given for visiting the dentist by Ontario adult dental patients, 2013
(7 practices, N = 130)
Multiplechoiceanswersinaquestionnaire
40%I want a healthy mouth for a healthy body
I want to minimize my costs of care 12%
7%I want better looking teeth
28%I want to prevent dental decay
11%
2%I have some dental pain
0% 10% 20% 30% 40% 50%
I think I need a filling or a crown
Source: CHX Technologies, 2013
19. Oral health for life
What kind of dental services are most
preferred by your plan members?
45%
29%
13%
13%
13%
20%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
risk assessment
new preventive coating
dental implants
veneers
Invisalign
digital xrays
% of adult patients wanting the dentist to speak
to them about these services, Ontario, 2013
Source: CHX Technologies, 2013
20. Oral health for life
Why the patients’ focus on overall health?
• We have a sicker, sensitized workforce
• 52% of workers at mid-life have at least 1 chronic condition
(Sanofi Healthcare Survey 2015)
• Half of social media’s use is related to health information (Pew Research)
• Growing media coverage of the importance of oral health to
inflammation and key chronic diseases
Health
Brush teeth to 'prevent' heart disease
By Emma Wilkinson Health reporter, BBC News
•28 May 2010
People who fail to brush their teeth twice a day are putting
themselves at risk of heart disease, research suggests.
21. Oral health for life
Chronic medical conditions increase
levels of dental decay
• A Type 2 diabetic has 2x the level of decay (Hintao J et al 2007)
• Those on cardiovascular drugs or anti-depressants have
significantly more dental surgery (Maupome G et al 2006, Rindal B
et al 2005 )
• Those with Parkinson’s and certain forms of arthritis have more
than 5x the level of decay (Connolly et al, 2012; Napenas et al
2014; Baron M 2014)
• Those taking a diuretic have 7x the risk of dry mouth (and
associated dental decay) (Kakudate N et al 2014)
22. Oral health for life
22
The most common prescription drugs for GSC’s members,
age 50 to 70, 2014
5 of the top 10 drugs taken by
GSC’s older clients are strongly
associated with dental decay.
A combination of anti-depressants
and anti-hypertensives elevate root
decay increment by 3x (Singh M et
al, 2006)
Root decay is an un-restorable
condition which leads to root
canals or extractions/implants
within 3 years
Root decay is a significant risk
factor for coronary artery disease
(Mauriello S et al, 2006)
Drug and dental benefits
can no longer be separated
Source: GSC, Change for Life Report, Spring 2015
23. Oral health for life
Your high risk dental patients are also
high risk medical patients
23
$992.19
$381.51
$- $200.00 $400.00 $600.00 $800.00 $1,000.00$1,200.00
spending on drugs for those
with dental spending
spending on drugs for those
without dental spending
Mean disbursements on drugs for those who go/don't
go to the dentist, Canada, 2012 (n=640)
Source: McGowan Insurance Services
24. Oral health for life
Focus on the chronic spenders … the
high risk dental patient
-$500
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
$4,500
$5,000
0 100 200 300 400 500 600 700
Disbursementondentalclaims
plan members
Dental disbursements by number of plan members, Canada, 2012
(n=640)
15% spend 60%
25. Oral health for life
How do we find those at high risk? Use
evidence-based risk factors.
5%
10%
10%
17%
27%
27%
33%
0% 5% 10% 15% 20% 25% 30% 35%
You have HBP with mood disorders
You have mood disorders
You have a dry mouth
You smoke
You take 3+ medications daily
You get scaling of your gums regularly
You have had 3+ fillings/crowns in the past 2 years
Risk factor profile of Ontario adult dental patients, 2013 (n=133)
26. Oral health for life
4. What a dental wellness plan looks like
• It uses shared diagnosis …
• To find those at high risk
• To motivate high risk plan members to ask for more
prevention when it is needed
• It offers evidence-based treatment of the cause of dental
decay
• It differentiates levels of care by risk
• It educates beyond the benefits booklet
27. Oral health for life
Shared diagnosis
• The patient assesses his/her own risk in the waiting room
• The dental team confirms the risk and discusses options
Many studies of shared
decision making show better
management of chronic
diseases
28. Oral health for life
What happens with shared diagnosis?
• 45% of adults will push for more preventive care if
needed
• 50% remain largely disengaged from their care – will
follow what the dentist suggests (for a while)
• 5% don’t care
• The dental team will comply if reimbursement is based
on risk
• The plan member will comply if default is low risk
29. Oral health for life
Add an evidence-based treatment of the
cause of dental decay in high risk adults
• A topical antibacterial coating called
Prevora
• Unique evidence of safety and
efficacy in 2 controlled studies of
community-dwelling adults
• Approved by Health Canada &
European authorities
• FDA approval scheduled for 2017
• CDA procedure codes 13601-13602 Prevora is painlessly applied by
the hygienist in 5 visits in year 1,
then 2 visits per year thereafter
30. Oral health for life
Differentiate dental benefits by risk
Risk Level % of plan
members
Recall
interval
Spending
limit
Design
changes
Low risk 70% to 80% 18 to 24
months*
$X
High risk 20% 6 months $Y Add
Prevora
* Evidence from Chaffee BJ et al 2015 and NICE show
that low risk adult plan members can be recalled up
to 24 months without affecting oral health
32. Oral health for life
6. So what?
• Your client likely spends more on fixing decayed teeth,
than on any other chronic condition
• Your plan design is not evidence-based
• It does nothing about the cause of dental disease
• It is unsustainable as your plan membership ages
• And then there is the growing evidence that …
The mouth is part of the body
33. Oral health for life
Poor oral health contributes to poor
overall health
• Key pathogen for dental decay is the most common microorganism in the
arterial plaque of end-stage coronary patients (Nakano K et al 2009)
• Dental decay at the gum line is a more important risk factor for a cardiac
event than elevated cholesterol (Mauriello 2006)
• Gum disease doubles the risk of age-related macular degeneration (Wagley
S et al 2015), doubles the risk of a heart attack over 5 years (Noguchi S et al
2014), doubles the risk of ankylosing spondylitis (Ratz T et al 2015) ….