ADHA Participates in ADEA-hosted Briefing on Capitol Hill

Participants Recognize Children’s Dental Health Month

Washington, DC - On February 27, 2009 the American Dental Education Association (ADEA) hosted a Congressional briefing the brought together a host of oral health care organizations.  The event was held in recognition of Children’s Dental Health Month and drew attention to policy efforts that seek to improve access to oral health care services for children.

ADHA, along with the American Dental Association, Children’s Dental Health Project, and the American Academy of Pediatric Dentists offered remarks.  Staff from Representative Elijah Cummings (MD) office—a champion of oral health policy in Congress—also spoke on the importance of efforts that seek to make oral health care accessible to vulnerable populations. 

The briefing was held nearly two years to the day after 12 year old Deamonte Driver of Maryland died as a result of complications resulting from an abscessed tooth.  His tragic death shone a national spotlight on the importance of oral health and the difficulties that tens of millions of Americans face in obtaining oral health care. 

ADHA was represented at the briefing by Kathy Lyter, MHA, BS, RDH, a public health dental hygienist who serves as Dental Director for the Montgomery County Department of Health & Human Services dental programs.  Ms. Lyter offered commentary about the effort within Maryland to improve access to care in the wake of Deamonte Driver’s death.  She also highlighted ADHA’s commitment to work with others in oral health, noting the recent success in having SCHIP legislation signed into law.  Kathy also spoke of ADHA’s interest in working collaboratively on upcoming health reform policy efforts.  Kathy’s full remarks are included below. 

Please contact ADHA’s Governmental Affairs Division with any questions regarding the briefing (312.440.8925; gov.affairs@adha.net).

ADHA Remarks Delivered by Kathy Lyter:

Good morning.  On behalf of the American Dental Hygienists’ Association, I would like to extend a welcome to all of you, and in particular extend thanks to Congressman Cummings and Senator Cardin for their commitment to policy efforts that highlight the importance of oral health and increase access to and coverage for oral health care services. 

My name is Kathy Lyter and I am a dental hygienist who serves as Director of Public Health Services Dental Programs for the Montgomery County Department of Health and Human Services in neighboring Maryland.  I am a long-time member of the American Dental Hygienists’ Association, the organization I speak on behalf of today, and have also been active in the Maryland Dental Hygienists’ Association. 

As we are all aware, oral health is a vital component to total health.  I see the impact that oral health care, or lack thereof, has on our public health populations on a day to day basis.  As a dental hygienist who works in public health settings, I focus on the prevention of oral disease and promotion of good oral health practices for the community-at-large.  As a community effort, our public health dental hygienists partner with other public and private entities in providing services such as community education outreach, dental sealants, fluoride treatments, therapeutic hygiene treatment, and case management.   Virtually all dental disease is preventable and hygienists are the prevention specialist on the dental team. 

In Maryland, the untimely and tragic death of Deamonte Driver focused a national spotlight on the barriers that too many of our children face in accessing oral health care services.  In the wake of that tragedy, the state of Maryland has made some significant strides in improving patients’ ability to access care. Amidst the expansion of Maryland’s State Office of Oral Health also came the formation of the Governor’s Dental Action Committee (DAC), which included members from all of the oral health stakeholder groups in the state. DAC members collectively developed seven major recommendations to improve access to oral health care access in the state. Three of those recommendations had a direct impact on advancing the increased utilization of dental hygienists in public health programs.  The first, which passed into law last October, allows for more effective use of dental hygienists working in public health settings by allowing hygienists working in public health settings to implement their full scope of practice without the direct supervision of a dentist.   DAC also recommended the launch of a statewide “oral health literacy campaign” targeting pregnant women and parents with core messages about the importance of good oral health.  Each day in local health departments in Maryland, dental hygienists convey these messages to the pregnant women and parents who come to us for care.  A third recommendation from DAC related to mandatory dental screenings in public schools.  An interesting historical note is that dental hygiene was actually founded as a school-based profession – a “dental nurse” in the school if you will.   Hopefully, the future will bring an increasing amount of dental care into Maryland schools and schools across the nation. 

At the national level, the American Dental Hygienists’ Association extends the efforts undertaken at the state level by hygienists in Maryland and across the country through its work to increase access to and coverage for oral health care.  ADHA serves as the voice for the more than 150,000 licensed dental hygienists in this country.  As we seek solutions to the well-documented access to care crisis, ADHA remains committed to working with policymakers and other stakeholders, including all of our partners here today. 

Dental hygienists, by virtue of their education and experience, are well-placed to offer preventive services in a host of settings—private dental offices, schools, nursing homes, and public clinics are some of the many settings hygienists throughout the country work in.  Optimizing the existing dental hygiene workforce, which is one of the top ten fastest growing health care professions in the country and is anticipated to grow by 30 percent between 2006-2016, is one way to bolster access to preventive services. 

Dental hygienists currently operate under 51 different state practice acts that allow for varying levels of supervision, services, and practice settings.  Twenty-nine states now have direct access policies in place, which allow dental hygienists to initiate preventive care in a setting outside of a dental office without the presence of a dentist.  In 1995, only 5 states permitted dental hygienists to directly access patients. This nearly six-fold fold increase in less than 15 years clearly reflects the direction the nation is moving. Direct access policies enable dental hygienists to bring care to patients in settings accessible to those who cannot get care in a private dental office.

ADHA is heartened by the recent passage of the CHIP bill, which includes significant dental provisions.  The provisions contained in CHIP are an important first step in reforming our health care delivery system to improve coverage for and access to care for the millions of Americans who go without care.  The inclusion of significant dental benefits in CHIP was a demonstration of the power of collaboration within the dental community.

One provision of CHIP that ADHA supported is a GAO study on the “feasibility and appropriateness” of mid-level providers in oral health who work in collaboration with dentists.  The study is timely and relevant given the recent Institute of Medicine workshop on the future of the dental workforce and growing interest in adding new members to the dental team.  The GAO study is an opportunity to generate objective, third-party data on the need for new providers.  ADHA has proposed the Advanced Dental Hygiene Practitioner, a Master’s level provider focused on the provision of educational, preventive, therapeutic, and minimally invasive oral health care services to underserved populations.

ADHA fully recognizes the importance of implementing a host of solutions to address the oral health care crisis—from raising Medicaid reimbursement rates, to expanding patients’ understanding of the importance of oral health, to increasing grant and loan forgiveness opportunities for dental providers who work with underserved populations—a myriad of policies must be considered and applied. 

As important policy issues, like health reform, take shape, ADHA maintains its commitment to work in partnership with policymakers and other dental stakeholders to improve the oral health delivery system and increase access to care.  It will truly require a collective effort to put in place policies that ensure all Americans, particularly vulnerable populations like children, have adequate coverage for and access to oral health care services. We look forward to working with all of you to shape a future in which all Americans can readily access oral health services.  Remember, oral health is an integral part of overall health and you can’t be healthy without good oral health.