GOOD MORNING, EVERYONE.
WELCOME TO OUR WILL LAST NIH
HEALTH DISPARITY INTEREST GROUP
OF 2024.
I HOPE YOU'RE GETTING READY TO
ENJOY THE HOLIDAY SEASON AND
HAVING HOT CHOCOLATE AND NICE
TREE OR OTHER WAYS TO CELEBRATE
THE HOLIDAY SEASON.
I'M THE DIRECTOR OF NATIONAL
INSTITUTE OF HEALTH AND HEALTH
DISPARITIES.
WE'RE FORTUNATE TO HAVE
DR. JENNIFER WEBSTER-CYRIAQUE
WITH US AND SHE'LL BE PRESENTING
TO US.
LET ME GIVE A BRIEF INTRODUCTION
OF HER ACCOMPLISHED CAREER.
SHE NOW THE ACTING DIRECTOR OF
NATIONAL INSTITUTE OF DENTAL AND
CRANIOFACIAL RESEARCH AT THE
NATIONAL INSTITUTES OF HEALTH.
IS A VERY ACCOMPLISHED CLINICIAN
RESEARCHER AND LEADER.
DR. WEBSTER-CYRIAQUE HAS
BRIEFEDLY SERVED AS A FACULTY
MEMBER AT A UNIVERSITY OF NORTH
CAROLINA SCHOOL OF DENTISTRY AND
MEDICINE FOR MORE THAN TWO
DECADES.
SHE WAS A TENURED PROFESSOR
THERE AND ALSO SERVED AS THE
ATTENDING ON CLINICAL SERVICE AT
THE UNC HOSPITAL DENTAL CLINIC
AND LEAD RESEARCH TO POTENTIAL
FOR SALIVARY GLAND DISEASE IN
PEOPLE LIVING WITH HIV AND
ASSESSED THE MICROBIOME AND
POTENTIAL FOR CANCER VIRUSES AND
STUDIED THE ORAL BIOMEDICAL AND
HIV OUTCOME.
IN ADDITION TO HER RESEARCH,
DR. WEBSTER-CYRIAQUE HAS BEEN
THE CHAIR AND VICE CHAIR OF THE
ORAL HIV/AIDS RESEARCH ALLIANCE.
AS A RESEARCH DIRECTOR AT THE
NATIONAL DENTAL ASSOCIATION
FOUNDATION.
DIRECTOR OF THE TRAINING ALONG
WITH MULTIPLE ROLES WITH
INTERNATIONAL ASSOCIATIONS OF
DENTAL RESEARCH.
SINCE 2024 SHE LED THE UNC
MALAWI PROJECT OF THE FIRST
DENTAL SCHOOL OF 2019.
I'M SURE YOU CAN GO ON FOR HALF
AN HOUR WITH THE ACCOMPLISHMENTS
BUT WOULD RATHER STOP HERE SO
YOU HAVE A CHANCE OF WHAT
DR. WEBSTER-CYRIAQUE WILL BRING
TO US.
WITH NO FURTHER ADO, THE STAGE
IS YOURS.
>> THANK YOU SO MUCH FOR THE
PRIVILEGE TO SHARE WITH YOU SOME
INSIGHTS RELATED TO ORAL HEALTH
DISPARITIES.
THE CHALLENGE FOR US IS THAT
HERE IN THE U.S. RIGHT NOW WE
HAVE ORAL HEALTH FOR SOME AND IT
IS OUR MISSION HERE AT NIDCR WE
MOVE TO ORAL HEALTH FOR ALL.
BOTTOM LINE IS WE'LL NEVER BE
EVER ATTAIN TRUE HEALTH AND OVER
ALL WELLNESS IF YOU DON'T HAVE
GOOD ORAL HEALTH.
IT'S NOT EXCLUSIVE.
IN RECENT SURVEYS WE KNOW ABOUT
A THIRD OF ADULT WITH SURVEYS
HAD AT LEAST ONE CHRONIC HEALTH
CONDITION AND ALMOST 70% OF
THESE PEOPLE ALSO HAD AN
UNADDRESSED ORAL HEALTH SYMPTOM
BUT ABOUT 60% HASN'T SOUGHT CARE
FOR THE ORAL HEALTH SYSTEM AND
WE KNOW THESE ORAL DISEASES ARE
CLEARLY LINKED TO CARDIOVASCULAR
DISEASE, DIABETES, PRETERM LOW
BIRTH WEIGHT AND OTHER DISEASE.
WE ALSO KNOW THAT THE MAJORITY
OF CANCERS ARE HPV POSITIVE OF
HEAD AND NECK CANCERS AND HAVE A
SIGNIFICANT OPPORTUNITY FOR
PREVENTION WITH VACCINE UPTAKE
AND MANY ORAL DISEASES ARE
INDEED PREVENTIBLE.
IF YOU LOSE TOO MANY TEETH, WHAT
WE'VE SEEN IS NOT HAVING AT
LEAST 20 TEETH WHICH WE SAY IS A
FUNCTIONAL DENTATION AND ABLE TO
SPEAK AND CHEW AND FUNCTION IF
YOU HAVE LESS THAN 20 TEETH HAS
BEEN ASSOCIATED WITH HAVING
DIABETES, RHEUMATOID DISEASE AND
EM
EMMA -- EMPHYSEMA AND THEY'RE
ASSOCIATED WITH IT WILL LOW
BIRTH WEIGHT AND CARDIOVASCULAR
DISEASE HAVE ALL BEEN LINKED TO
ORAL HEALTH.
SO WHAT'S THE PROBLEM?
WE OFTEN THINK OF CAVITIES BUT
IF YOU HAVE A MOUTH LIKE THIS,
THE ABILITY YOU'RE ABLE TO
OBTAIN ADEQUATE NUTRITION AND
EAT THE THINGS THAT ARE GOOD FOR
YOU CRUCIFEROUS WILL VEGETABLES
AND FRUITS AND PROTEINS IT'S A
REAL CHALLENGE, RIGHT?
AND IT IMPEDES YOUR DIGESTIVE
PROCESSES BECAUSE THERE'S PAIN
IN YOUR MOUTH AND ISSUES WITH
HEART BURN AND DIGEST.
WHAT DO YOU DO WHEN YOU HAVE NO
WILL TEETH OR LACK OF DENTITION.
PEOPLE WILL GO TO SOFTER
CARBOHYDRATE LADEN FOODS THAT
INCREASE INFLAMMATION LOCALLY
AND SYSTEMICALLY AND
INFLAMMATION ANYWHERE IS NOT A
WITH THING.
THE OTHER THING WE'RE AIR WA --
AWARE OF IS WILL DENTAL HEALTH
AFFECTS EMPLOYMENT.
THE APPEARANCE OF THEIR MOUTH
AND TEETH CAN AFFECT THE ABILITY
TO INTERVIEW OR THE TYPE OF JOB.
IF YOU'RE MEETING THE PUBLIC
IT'S DIFFICULT TO NOT HAVE A
GOOD DENTITION AND 30% OF LOW
INCOME ADULTS SAID THEIR POOR
ORAL HEALTH AFFECTED THEM
INTERVIEWING FOR A JOB AND A
THIRD HAVE NOT BEEN ABLE TO FIND
A JOB DIRECTLY BECAUSE OF POOR
ORAL HEALTH.
THIS TRANSLATES TO OVER 200,000
PEOPLE OUT OF VIABLE EMPLOYMENT
HERE IN THE U.S. BECAUSE OF
PREVENTIBLE DENTAL DISEASE.
AND WHAT WE KNOW IS THAT WHEN
YOU HAVE BETTER ORAL HEALTH IT
LOWERS OVER ALL HEALTH CARE
COST.
HERE IN THE U.S. PEOPLE WITH
HEART DISEASE SAVED UP TO $675
PER YEAR OF HEALTH CARE SPENDING
WHEN THEY HAD ROUTINE ORAL
HEALTH CARE.
AMONG DIABETICS THE SAVINGS WAS
UP TO $3,000 AND PEOPLE WHO HAD
DIABETES WITH OTHER CONDITIONS
SAVED MORE.
AND IMPROVED ORAL HEALTH ALSO
REDUCED MEDICAL COSTS ASSOCIATED
WITH PREGNANCY.
UP TO $2400.
THIS NOT -- PER PREGNANCY.
THIS IS NOT TRIVIAL.
WHAT DIFFERENCE DOES MEDICARE
MAKE?
THERE'S NOW 41 STATES THAT
EXPANDED MEDICAID ELIGIBILITY AS
PART OF THE AFFORDABLE CARE ACT.
AND MEDICAID ALLOWS WILL HEALTH
INSURANCE FOR AMERICANS WHO ARE
LOW INCOME AND IT IS MANDATORY
WHILE IT'S OPTIONAL FOR ADULTS
IT'S MANDATORY COVERAGE FOR
CHILDREN.
AND SO WHAT WE NOW HAVE SEEN
WITH THIS EXPANSION IS ENHANCED
ACCESS FOR MILLIONS OF LOWER
INCOME ADULTS AND STATES WHO
PROVIDED THIS COMPREHENSIVE
DENTAL COVERAGE HAVE SEEN A 14%
REDUCTION IN EMERGENCY ROOM
VISITS AND LOOKING SPECIFICALLY
AT KENTUCKY AND NEW YORK AND
KENTUCKY THOSE WHO VISITED A
DENTIST WERE AT LOWER RISK OF
BEING DIAGNOSED WITH DIABETES
AND HEART DISEASE AND THIS
REDUCED HEALTH CARE COST AND IN
NEW YORK WITH THE MEDICAID
EXPANSION WAS SHOWN TO REDUCE
E.R. ROOM AND IN PATIENT COST
SPENDING.
IT'S LOW-LIFT, HIGH REWARD IN
TERMS OF THE DIFFERENCE IT THE
ORAL HEALTH CAN MAKE.
AND WHEN WE THINK ABOUT IT, THE
COST OF NOT HAVING GOOD ORAL
HEALTH CARE IS VERY HIGH.
IT'S HIGH TO THE INDIVIDUAL.
WHY?
IT CAN CONTRIBUTE TO POORERIOR
POORER OVER ALL HEALTH AND NOT
ABLE TO GET ADEQUATE NUTRITION.
WHEN PEOPLE ARE IN PAIN
ESPECIALLY KIDS THEY HAVE
DECREASED ACADEMIC ACHIEVEMENT
AND BECAUSE HERE IN THE U.S. A
CANT -- SIGNIFICANT AMOUNT IS
OUT OF POCKET EVEN WITH IF
INSURANCE IT CAUSES INCREASED
STRESS.
AT THE SOCIETAL LEVEL WE HAVE
SIGNIFICANT ISSUES WITH
DENTISTRY BEING IN THE TOP THREE
FOR REDUCED MILITARY READINESS.
ALSO, WHEN PEOPLE ARE IN PAIN
AND HAVE SIGNIFICANT ORAL HEALTH
CARE ISSUES AND ED OVER ALL
HEALTH CARE COSTS.
SO THE COST IS IS HIGH AND AGAIN
THESE DISEASES ARE LARGELY
PREVENTIBLE.
IF WE LOOK ACROSS THE WILL WORLD
AT WILL HIGH INCOME COUNTRIES
INCLUDING THE U.S., WHEN WE LOOK
AT TREATMENT COSTS THEY'RE ABOUT
$303 BILLION BUT LOOK AT
PRODUCTIVITY LOSS, $315 BILLION
BECAUSE OF NOT HAVING GOOD ORAL
HEALTH CARE.
HOW BIG IS THE PROBLEM?
IT'S BIG GLOBALLY.
IT'S BIGGER THAN ANY OTHER
DISEASE.
THESE ARE THE MOST PREVALENT
DISEASES IN THE ENTIRE WORLD.
HERE'S DATA FROM THE W.H.O. AND
THIS DATA IS IN THE MILLIONS.
SO 3.374 MILLION COMPARED TO
CARDIOVASCULAR DISEASE AND
DIABETES AND CHRONIC RESPIRATORY
STEEZ
-- DISEASE AND CANCER.
AND BETWEEN 1990 AND 2000 THE
NUMBER OF CASES OF CARIES
INCREASED WORLDWIDE BY ALMOST
60% MOSTLY DUE TO POPULATION
GROWTH IN LOW AND LOWER MIDDLE
INCOME COUNTRIES.
IT'S A GLOBAL CHALLENGE.
IT'S THE MOST COMMON DISEASE IN
THE ENTIRE WORLD.
WITH OVER ALL $500 BILLION
BURDEN.
UNTREATED CAVITIES IN PERMANENT
TEETH IS THE MOST PREVALENT
DISEASE IN THE WORLD AND
PERIDONTITIS AND IN THE UNITED
STATES ABOUT 50% OF WORKING AGE
ADULTS HAVE GUM DISEASE.
AND THE NUMBERS ARE EVEN HIGHER
IF WE LOOK AT OLDER ADULTS OLDER
THAN 64.
WHEN WE LOOK AT CANCERS OF THE
LIP AND ORAL CAVITY, THESE ARE
AMONG THE TOP 15 AND ABOUT 158
MILLION HAVE COMPLETE TOOTH LOST
AND CLEFT PALATE IS THE MOST
COMMON AND SEE THIS IN 1 IN 7
LIVE BIRTHS AND THE NECROTIZING
DISEASE THAT STARTS IN THE MOUTH
AND PREVENTIBLE BUT MOST PEOPLE
GET IT LATE AND THIS HAPPENS AT
A GREATER FREQUENCY IN
SUB-SAHARAN AFRICA WHERE THE
MORTALITY RATE IS 90%.
AGAIN, HPV RELATED ORAL CANCERS
ARE IN THE U.S.
NOW, WHAT IS OUR CHALLENGE HERE?
OUR MISSION IS ORAL HEALTH FOR
ALL BUT RIGHT NOW WE HAVE ORAL
HEALTH FOR SOME AND THIS WAS
LAID OUT IN THE REPORT PUBLISHED
BACK IN 2021 AND WE SEE GAPS
BASED ON WHERE PEOPLE LIVE,
BASED ON THE SOCIO ECONOMIC
STATUS AND BASED ON RACE AND
ETHNICITY.
AS OF THIS YEAR, THERE'S ALMOST
60 MILLION AMERICANS LIVING IN A
SHORTAGE AREA OF HEALTH
PROFESSIONALS AND HALF ARE IN
RURAL COMMUNITIES.
UNTREATED TOOTH DECAY IS MORE
COMMON FOR THOSE LOW INCOME AND
RACIAL AND ETHNIC MINORITY
GROUPS FOR THOSE WHO HAVE NO
HEALTH INSURANCE.
AGAIN, MEDICAID IS MAKING A
DIFFERENCE BUT STILL THE STEEZ
-- DISEASE IS PREVALENT AND GUM
DISEASE IS MORE PREVALENT AND
SEE COMPLETE TOOTH LOSS
DISPROPORTIONATELY EXPERIENCED
BY OLDER ADULTS WHO ARE LOWER
INCOME AND HAVE LESS THAN A HIGH
SCHOOL EDUCATION.
WHAT IF WE CAN HAVE HERE IN THE
U.S. A FUNCTION DENTITION AND
IT'S BEEN SUCCESSFUL IN JAPAN
AND PEOPLE MAINTAIN THEY'RE
DENTITION AND HAVE LEFT ISSUES
WITH ATHEROSCLEROTIC DISEASE AND
DEMENTIA.
WHAT IF THE SWEET 16 MEANT NO
CAVITIES AT THE AGE OF 16?
THESE ARE THINGS WE CAN ASPIRE
TO.
THERE'S BEEN WORK ON INDIVIDUAL
BEHAVIORS AND IT'S IMPORTANT BUT
NOT ENOUGH.
THE CURRENT SOCIAL DETERMINATES
LOOK AT ACCESS TO HEALTH CARE
AND SOCIAL AND COMMUNITY CONTEXT
AND ECONOMIC STABILITY AND THIS
IS IMPORTANT HOWEVER ARE WE
INCLUDING ORAL HEALTH LITERACY?
WHEN WE THINK OF HEALTH CARE
QUALITY ARE WE ASKING QUESTIONS
ABOUT DENTAL HEALTH AND HOW
CLOSE IS YOUR NEAREST DEN IT --
DENTIST.
WHEN WE THINK OF FOOD SCARCITY
DO WE THINK ABOUT WHAT TYPES OF
FOODS PEOPLE ARE ACCESSING AND
IN TERMS OF SOCIAL COMMUNITY AND
CONTEXT, ARE WE ASKING ABOUT
RELATIONSHIPS, EMPLOYMENT AND
THE ABILITY TO EAT AND SPEAK
BECAUSE ALL OF THESE THINGS ARE
IT INFLUENCED BY YOUR ORAL
CAVITY AND FINALLY WITH REGARD
TO ECONOMIC STABILITY, WHAT
ABOUT DENTAL INSURANCE?
WHAT ABOUT THOSE OUT OF POCKET
COSTS?
WHAT'S NOT BEING CAPTURED IS
SOCIAL DETERMINATES FOR HEALTH
WE'RE WORKING OWN AN INSTRUMENT
SPEARHEADED BY DR. SHARON
JACKSON AND WORKING TOGETHER
WITH SUE HAMMOND AND THEY'RE
LOOKING AT SOCIAL AND CLINICAL
PROFILES OF ADULT PATIENTS
THINKING ABOUT THE NUANCED
FACTORS THAT ALSO INFLUENCE AN
INDIVIDUAL'S ORAL HEALTH.
SO HERE WE'RE LOOKING AT SOCIAL
ECONOMIC FACTORS THAT ASK
SPECIFICALLY AROUND EMPLOYMENT
AND DENTAL INSURANCE.
WHEN WE THINK ABOUT THE HEALTH
BEHAVIORS, WE'RE ASKING ABOUT
TOBACCO AND ALCOHOL USE ALSO IN
THE CONTEXT OF ORAL HEALTH AND
ALSO WHAT ARE PEOPLE'S HABITS
AROUND TAKING CARE OF THEIR
MOUTHS?
ARE THEY BRUSHING AND FLOSSING.
WE'RE ASKING ABOUT LANGUAGE
PROFICIENCY AND BARRIERS AND
ORAL HEALTH LITERACY AND AROUND
THE PHYSICAL ENVIRONMENT, DOES
IT REQUIRE PUBLIC TRANGS FOR --
TRANSPORTATION TO ACCESS HEALTH
CARE AND WHAT TYPE OF FOOD
SECURITY TO YOU HAVE?
DOES THIS PUT YOU AT RISK FOR
ORAL DISEASE AND WHEN WE ASK
ABOUT CLINICAL CARE, WHAT IS
YOUR ACCESS TO ORAL HEALTH CARE
PROFESSIONALS AND ACCESS TO
DENTISTRY.
WHEN WE PUT THIS TOGETHER WE
HAVE A MORE COMPREHENSIVE SOCIAL
DETERMINATE THAT BRINGS INTO
VIEW ORAL AND OVER ALL HEALTH.
THE GOAL OF UPSTREAM MECHANISM
TO INTERVENE AND MOVE TOWARDS
ORAL HEALTH FOR ALL.
SO THIS IS THE PROJECT THAT IS
ONGOING.
IT WILL BE THE QUESTIONNAIRE
WILL BE PILOTED AT THE NIH
CLINICAL CENTER AND WE'RE
WORKING ON THAT NOW.
WHAT WE NEED IS A PRECISION
PUBLIC HEALTH APPROACH AND
DELIVER THE RIGHT INTERVENTION
TO THE RIGHT POPULATION AT THE
RIGHT TIME.
AND IN ORDER TO GET TO ORAL
HEALTH EQUITY, WE HAVE TO
PRECISELY DEFINE OUR
POPULATIONS.
AND THINK ABOUT INTERSECTION
1Y589 AND -- INTERSECTIONALITY
AND ALLOW FOR THE GAPS IN
OUTCOMES AND INTERVENTIONS CAN
HELP CHANGE THE CONTEXT AND
CONDITIONS.
IT'S GOING TO TAKE PARTNERSHIP
WITH THE POPULATION AND
COMMUNITY TO LEVERAGE TRUST AND
RECOGNIZE MUTUAL BENEFITS AND
ALSO MAKING SURE THAT WE'RE
DISSEMINATING BOTH DATA AND
COMMUNITY INFORMED STRATEGIES IN
ORDER TO ADDRESS THESE
STRUCTURAL DETERMINATES AND
IMPACT ORAL HEALTH AT THE
POPULATION LEVEL.
SO ONE CONCEPT THAT WAS CLEARED
IS COMMUNITY-ENGAGED
PARTICIPATORY RESEARCH TO
ADVANCE DATA AND ADAPT FOR ORAL
HEALTH EQUITY.
AND THE GOALS ARE TO BUILD
COLLABORATIVE COMMUNITY-BASED
INTERVENTION PROJECTS AND DATA
MINING OPPORTUNITIES TO
ACCELERATE PROGRESS TOWARDS
RE-TUESDAY ORAL HEALTH
DISPARITIES AND INEQUITIES.
FOR ONE TEAM TO SUPPORT PROJECTS
THAT USE THESE COMMUNITY-BASED
PARTICIPATORY APPROACHES TO
DESIGN, IMPLEMENT AND WILL
DESIGN INTERVENTION BASED
STRATEGIES.
THE GOAL IS TO CREATE A HUB THAT
WILL SPECIALIZE IN COMMUNITY
ENGAGEMENT AND DATA COORDINATION
AND MANAGEMENT AND THIS WILL BE
A CVPR RESEARCH CONSORTIUM
JOINING IN THE NIMHT FOR HEALTH
DISPARITIES AND ARTIFICIAL
INTELLIGENCE BIAS PLATFORM.
ONE OPPORTUNITY UNDER THE
CONCEPT IS TO LEVERAGE
CO-LOCATED FACILITIES
RECOGNIZING THE OPPORTUNITIES TO
MAKE A DIFFERENCE IN TERMS OF
WHOLE PERSON HEALTH.
HERE'S THE CHALLENGE.
YOU HAVE A PERSON HERE.
THEY'VE GOT MULTIPLE MALADIES
AND INFLAMED IF WE PROVIDE ORAL
HEALTH CAN HELP THE SITUATION.
SO IN PLACES WHERE YOU HAVE
MEDICAL AND DENTAL CO-LOCATED
THERE'S THE OPPORTUNITY TO
PROVIDE EDUCATION TO THE MEDICAL
AND DENTAL TO DO ORAL EXAMS AND
FOR DENTAL TO PROVIDE
COMPREHENSIVE CARE AND THEN
DIMINISH SOURCES OF
INFLAMMATION.
WHY IS THIS SO IMPORTANT?
LAST YEAR IN 2023 THE UNITED
STATES PUBLIC HEALTH TASK FORCE
SHARED INSUFFICIENT EVIDENCE
THAT ORAL HEALTH PREVENTION BE
PROMOTED IN THE SETTING OF
PRIMARY CARE.
WE NEED TO TO THE STUDIES TOE
SHOW IT'S FEASIBLE AND A
MODIFIABLE RISK FACTOR.
HERE THEY CAN SHIFT THEIR
MICROBIOME AND WE DEVELOPED THE
DDS HUB.
DDS IS FOR DENTAL AND YES PUN
INTENDED AND FOR US IT ALSO
STAND FOR DATA DRIVEN SCIENCE.
THE HUB WILL LAUNCHES AT THE END
OF THE MONTH IN DECEMBER AND
WE'RE BUILDING AN IDCR DATA
SCIENCE KNOWLEDGE BASE TO
INTEGRATE DENTAL CRANIOFACIAL
WITH OVER ALL HEALTH.
THIS CROSS-CUTTING INITIATIVE
WILL BE A PLACE TO FIND AND
CURATE DATA AND MANAGE AND SHARE
YOUR DATA AND UTILIZE ANALYTIC
RESOURCES IN THE CLOUD LIKE THE
SHARE PLATFORM WHERE YOU CAN
BRING LARGER DATA SETS AND
GENERATE AND ASK QUESTIONS.
IN OUR FIELD THERE HAVE BEEN
BEEN A NUMBER OF RANDOMIZED
CONTROL TRIALS THAT NEED TO BE.
OFTEN STUDY HAVE SMALL SAMPLE
SIZES.
THIS IS A HUGE OPPORTUNITY IS
BUT ALSO A PLACE TO LEARN ABOUT
GRANTS AND FUNDING AND ENGAGE
WITH US.
THIS PLACE WILL CENTRALIZE THE
REPOSITORIES AND DATA FOR DENTAL
ORAL AND CRANIOFACIAL RESEARCH
FROM ALL AROUND THE WORLD.
WHAT ABOUT THE WORKFORCE?
IF EVERY PERSON WHO NEEDED TO
SEE THE DENTIST OR ORAL HEALTH
PROFESSIONAL TRIED TO DO IT
TODAY IN THE U.S., COULDN'T DO
IT.
THERE'S NOT ENOUGH PEOPLE.
SEVERAL INITIATIVES ONGOING
TARGETING THE K-12 GROUP THROUGH
SEPA GRANS AND TASK FORCE AND
OTHER COLLABORATIONS WE BUILT AN
ONLINE MODULE AND OPPORTUNITIES
TO ENGAGE GRANT TRAINEES TO
BUILD EXTRAMURAL NETWORKS WITH
SHARED CURRICULA AND WORK WITH
OTHER COMMUNITIES AND
PROFESSIONAL SOCIETIES AND
INDUSTRY TO WORK TOWARDS
IMPROVING OUR PATHWAY TO PEOPLE
CAN GET THE CARE THEY NEED.
WE HAVE TWO PRACTICE-BASED
NETWORK.
ONE IS LAUNCHING PRACTITIONERS
ACROSS THE U.S. AND RECENT LE
BEGAN WHAT WE CALL WILL PRIMED.
THIS IS A PRACTICE-BASED
RESEARCH NETWORK IN DENTAL
SCHOOLS.
DENTAL SCHOOLS ARE SAFETY NET
PROVIDERS.
THEY'RE GOING TO BE FOLKS WHO
MAY NOT HAVE WILL DENTAL HEALTH
AND IT'S RESEARCH EXPERIENCE
THROUGHOUT THEIR EDUCATION.
THIS IS SOMETHING WE'RE DOING IN
COLLABORATION WITH NCATS.
AS WE THINK OF CHRONIC
NON-COMMUNICABLE DISEASE WE
THINK OF CARDIOVASCULAR DISEASE
AND OTHERS AND THERE'S A MENTAL
HEALTH DISORDERS AND THERE'S
DIET AND TOBACCO.
IN 2018 CLIMATE WAS BROUGHT TO
BEAR AND AIR POLLUTION WHICH IS
ALSO A SHARED RISK FACTOR ACROSS
THESE NON-COMMUNICABLE DISEASES
AND THERE'S AN OPPORTUNITY TO
THINK ABOUT SUGAR AS A COMMON
RISK FACTOR ESPECIALLY FOR THOSE
IMPACTED.
THERE WAS A MEET OF THE W.H.O.
AND THE ESTABLISHMENT OF A
GLOBAL COALITION FOR ORAL HEALTH
TO PROVIDE CLEAR GUIDANCE AN
ORAL HEATH PRIORITIES AND
UPCOMING MEETING ON
NON-COMMUNICABLE DISEASES HELD
IN 2025.
HOPING TO BRING THE VISION TO
BEAR SO EVERYONE HAS AN
OPPORTUNITY FOR ORAL HEALTH SO
THE FOCUS ON UNIVERSAL COVERAGE.
PREVENTION IS CRITICAL I'VE
MENTIONED MANY TIMES AND ONE OF
THE GREATEST PUBLIC HEALTH
INTERVENTIONS IS FLUORIDE.
IT ALLOWS FOR EQUITABLE ACCESS
TO CAVITY PREVENTION.
ANYBODY REGARDLESS OF INCOME CAN
ACCESS THIS AT HOME, SCHOOL OR
WORK OR ANY PLACE PUBLIC WATER
IS AVAILABLE.
WE KNOW FLUORIDE AT LOW LEVELS
IS BENEFICIAL FOR ORAL HEALTH
AND WATER IS EFFECTIVE FOR
PREVENTING TOOTH DECAY.
WHY IS THIS IMPORTANT?
THIS TOOTH DECAY CAN LEAD TO
PAIN, MISSED DAYS FROM SCHOOL
AND WORK.
OTHER DENTAL PROCEDURES AND
SYSTEMIC INFECTIONS AND THESE
SYSTEMIC INFECTIONS CAN BE
DEADLY.
IN FACT THIS YOIRUNG GUY IS 12
YEARS OLD AND HE DIED OF A
TOOTHACHE BECAUSE HE WAS HAVING
PROBLEMS AND DIDN'T HAVE DENTAL
INSURANCE, HIS MOM WAS BRINGING
HIM TO THE DENTIST AND EMERGENCY
ROOM AND GETTING ANTIBODIES AND
PAIN MEDS AND HIS ORAL INFECTION
BECAME A BRAIN ABSCESS AND HE
DIED AND THE THAT DOESN'T NEED
TO HAPPEN.
IT DOESN'T ONLY HAPPEN IN PEOPLE
WHO DON'T HAVE MEANS LAST FALL
THERE WAS AN NFL PLAYER WHO DIED
OF A BACTEREMIA AND DIED AND
ACCESS TO FLUORIDE HELPS.
COMMUNITIES ARE NOT MANDATED TO
ADD FLUORIDE TO THEIR WATER AND
PEOPLE CAN REMOVE FLUORIDE FROM
THEIR DRINKING WATER BY
UTILIZING A FILTER IF THEY WOULD
LIKE TOE.
-- LIKE TO.
SOME FOLKS SAY, WELL, IF YOU'RE
USING TOOTHPASTE WHY DO YOU NEED
FLUORIDE IN THE WATER?
AND THERE'S IT SUPPLEMENTED ORAL
HEALTH CARE PRACTICE AND WHAT
DIFFERENCE DOES IT MAKE?
DR. JACKSON IS HELPING MOVE THAT
STUDY FORWARD.
I'LL WRAP UP HERE SHARING WITH
YOU SOME OF THE STUDIES AND
INITIATIVES THAT WE HAVE ONGOING
AT NIDCR.
FIRST INCREASED USE OF THE ORAL
HEALTH CARE SYSTEM AND WE HAVE A
COUPLE INITIATIVES ONGOING
SPECIFICALLY THE CLINICAL AND
PRACTICE-BASED RESEARCH PROGRAM
AS WELL AS OUR ORAL HEALTH
DISPARITIES AND INEQUITIES
PROGRAM.
HERE'S A COUPLE EXAMPLES OF
NIDCR FUNDED RESEARCH.
FOR EXAMPLE, MULTILEVEL
INTERVENTIONS TO REDUCE HEALTH
DISPARITIES AMONG ADULTS IN
PRIMARY CARE SETTINGS.
HERE'S AN EXAMPLE OF A STUDY.
HERE TARGETING DISABILITY
POPULATION LOOKING SPECIFICALLY
AT SENSORY ADAPTATIONS THE
DENTAL ENVIRONMENT IN CHILDREN
WHO HAVE AUTISM SPECTRUM
DISORDER.
WHAT ABOUT ADOLESCENTS.
ONE OBJECTIVE IS TO REDUCE THE
NUMBER OF ADOLESCENTS WHO HAVE
BEING ACTIVE AND UNTREATED DECAY
AND ASKING FOR SOLUTIONS THAT
CAN HALT TOOTH DECAY.
WHAT WAS FOUND IN THE RANDOMIZED
CONTROL TRIAL WAS THIS
INTERVENTION WAS SO EFFECTIVE IT
HAD TO BE STOPPED EARLY.
THIS IS A CLINICAL TRIAL OF 600
CHILDREN WITH SEVERE TOOTH
DECAY.
THIS SDF TREATMENT WHICH IS
FLUORIDE BASED WORKS VERY WELL.
ALSO LIFE TIME WILL IT TOOTH
DECAY WE'RE FUNDING RESEARCH
FOCUSSED ON SOCIAL NETWORKS AND
ORAL HEALTH BEHAVIORS IN PUBLIC
HEALTH COMMUNITIES AND WITHIN
THE CONTEXT OF THAT STUDY IS
LOOKING AT IT ONE GOAL IS TO
INFORM INTERVENTIONS RESPONSIVE
TO THE DYNAMICS OF THE
POPULATION THAT ARE AFFECTED BY
HEALTH DISPARITIES.
IF INTRODUCING THE PROPORTION OF
PEOPLE WHO CAN'T GET THE CARE
THEY NEED WHEN THEY NEED IT.
WE ARE FUNDING RESEARCH LOOKING
AT MOBILE APPS TO INCREASE TOOTH
BRUSHING SKILLS IN TEENS AND
THOSE AUTISTIC AND HARNESSING
TECHNOLOGY BY DEVELOPING AND
EVALUATING SCHOOL-BASED DIGITAL
ORAL HEALTH PROGRAMS.
THOSE ARE A FEW OF THE THINGS
WE'RE DOING.
IMPORTANTLY, WE ARE ADAPTING THE
NIMHD FRAMEWORK RECOGNIZING
INFLUENCE FROM INDIVIDUAL TO
SOCIETAL LEVEL.
AT THE INDIVIDUAL LEVEL THINGS
THAT ARE DIFFERENT ARE OF COURSE
THE ORAL MICROBIOME INFLAMMATION
GENETICS AND THE VIROME IN TERMS
OF THE BEHAVIORAL DOMAIN OR
HEALTH BEHAVIORS AND NUTRITION
ARE CRITICAL.
IN TERMS OF THE IT HEALTH CARE
SYSTEM, ORAL HEALTH LITERACY
TREATMENT PRACTICES AND
OPTIMIZED DENTAL MATERIALS ARE
CRITICAL HERE.
THERE ARE AT THE
INTERPROFESSIONAL OR PERSONAL
LEVEL THE PATIENT-CLINICIAN
RELATIONSHIP AND MEDICAL DENTAL
DECISION MAKING AND INTEGRATION
ARE SO IMPORTANT.
BUT AT THE COMMUNITY LEVEL LOOK
AT THE OPPORTUNITIES TO EMBED
PREVENTION IN COMMUNITY S TO
EMBED PREVENTION IN COMMUNITY
NORMS AND TO EMBED PREVENTION IN
THE AVAILABILITY OF SERVICES AND
SAFETY NET SERVICES.
UTILITY END HERE SHARING THE
COST OF POOR ORAL HEALTH IS HIGH
BOTH AT THE INDIVIDUAL AND
SOCIETAL LEVEL.
THERE'S MUCH TO BE DONE IN TERMS
OF ORAL HEALTH DISPARITIES AND
WE LOOK FORWARD TO YOU JOINING
US IN A WORLD OR COUNTRY WHERE
THERE'S ORAL HEALTH FOR ALL.
THANK YOU FOR YOUR ATTENTION.
THANK YOU FOR HAVING ME.
>> THANK YOU FOR YOUR
INFORMATIVE PRESENTATION AND IN
MANY WAYS I HEARD A SHORTER
VERSION OF THIS BUT RELIEVED IN
TERMS OF THE EXTENT TO WHICH
ORAL HEALTH HEALTH IMPACT IN
GENERAL AND SOCIO ECONOMIC
IMPACT YOU MENTIONED IN YOUR
PRESENTATION.
HOW DO WE GO ABOUT INCREASING
PEOPLE'S APPRECIATION OF THE
EXTENT OF ORAL HEALTH THAT
IMPACTS NOT JUST HAVING
TOOTHACHE OR SOMETHING SO SIMPLE
THOUGH KRUSH
EXCRUCIATI
EXCRUCIATING.
>> TEETH ARE IMPORTANT BUT IT'S
NOT JUST TEETH BUT EDUCATION AND
BRINGING IN OTHER SECTORS IN AN
INTENTIONAL WAY.
AND IN A BROADER WAY.
SCHOOL-BASED HEALTH CARE
PROGRAMS ARE IN IMPORTANT WHEN
PEOPLE TWO TO PHYSICIANS THEY'LL
SAY HAVE YOU HAD YOUR ORAL
HEALTH CARE CHECKED AND PEOPLE
WILL NOT LOOK BEYOND YOUR MOUTH
TO YOUR TONSILS BUT LOOK AT
WHAT'S HAPPENING THERE.
WITH NEED TO INCREASE AWARENESS
BECAUSE IT'S SOMETHING THAT IS
LOW RISK AND HIGH REWARD.
PEOPLE DON'T KNOW WHEN THEY
DON'T UNDERSTAND.
NOT EVERYBODY HAS ACCESS TO A
TOOTH BRUSH AND SOME HOUSEHOLDS
PEOPLE SHARE A TOOTH BRUSH NOT
RECOGNIZING FOR INDIVIDUALS WHO
MAY HAVE HIV OR HEPATITIS
SHARING THAT TOOTH BRUSH IS NOT
A GOOD IDEA.
IT WILL REQUIRE US INTERFACING
WITH SO MANY AND SO MANY ARE ON
DRUGS AS THEY ARE GET OLDER THAT
MAKES THE SALIVARY GLANDS ARE
AFFECTED AND HERE'S A WAY TO
BRING IN PHARMACY AND I NOTICE
YOU'RE ON X, Y, Z DRUG USE THIS
FLUORIDE RINSE OR WHAT HAVE YOU.
WE HAVE TO INTEGRATE CONNECT THE
HEAD BACK TO THE REST OF THE
BODY AS WE THINK ABOUT A
PERSON'S HEALTH WE'RE ALSO
ASKING ABOUT AND CONSIDER THEIR
ORAL HEALTH ACROSS MULTIPLE
SECTORS.
SEE
-- SEEMS LIKE A NEED FOR
CROSS-DISCIPLINES CONTRIBUTING
TO ORAL HEALTH AND THAT'S THE
APPROACH THAT NEEDS TO BE TAKEN.
I THINK PEOPLE UNDERSTAND WHEN
THEY'RE TEETH ARE FALLING OFF OR
HAVING A HARD TIME EATING BUT IT
TAKES MORE THAN A SINGLE PERSON
TOE REALLY ATTAIN IF ORAL HEALTH
AND WHAT THINGS HAVE WE LEARNED
FROM OTHER COUNTRIES BY
IMPROVING ORAL HEALTH.
>> SOME OTHER COUNTRIES HAVE
BEEN INTENTIONAL IN
INCORPORATING ORAL HEALTH
LITERACY WITH OTHER SECTORS AND
FOR EXAMPLE, NURSES ARE GIVE
INFORMATION AND SCHOOL TEACHERS
ARE GIVING INFORMATION ON ORAL
HEALTH.
PEOPLE WITHIN THEIR DAILY WALKS
ARE HEARING ABOUT IT IN A MORE
INTENTIONAL WAY.
THE OTHER THING COUNTRIES ARE
DOING IS MAKE WILL ORAL HEALTH
PART OF THEIR PRIMARY HEALTH
CARE AND THEIR COMMUNITY CENTERS
THEY HAVE DENTAL CLINICS RIGHT
THERE WITH MEDICAL CLINICS AND
THEY'RE ACTUALLY INTEGRATING
THEM.
THE OTHER THING IS UTILIZING THE
DENTAL CLINICS FOR EXPANDED
SERVICES.
DEMONSTRATING SHOTS, THEY CAN
HELP WITH SAYING, OH,
MRS. JOHNSON YOU HAVE A
MAMMOGRAM COMING UP.
KEEPING PEOPLE LINKED TO THE
OVER ALL HEALTH CARE SERVICES.
SO THERE'S MODELS OTHER
COUNTRIES ARE UTILIZING TO
INTEGRATE ORAL HEALTH.
>> I FIND THAT INTERESTING.
I WAS BORN AND RAISED IN HONG
KONG AND WE DON'T HAVE WITH WERE
BUSSED TO THE DENTIST AS A
CLASS AND WE WERE ALL WENT IN
AND SOME GOT TEETH EXTRACTED --
I DID BECAUSE I DIDN'T BRUSH MY
TEETH TOO WELL AND SOME GET
TREATMENTS AND CLEANING AND WE
GET EDUCATION ON HOW TO BRUSH
TEETH AND STUFF.
THAT'S HOW I GREW UP DURING MY
GRADE SCHOOL YEARS.
IT'S INTERESTING TO SEE HOW
INTERVENTIONS CAN BREAK TOWN --
BREAK DOWN ACCESS TO CARE WE CAN
DOING SCREENING AND DRIVING
TRUCKS TO ALLOW US TO REACH
AREAS THAT ARE HAVING ACCESS TO
WE SEE THE MEDICAL
INFRASTRUCTURE IN THE RURAL
AREAS ARE GETTING THINNER AND
THINNER.
AND THOSE BUSSES AND TRUCKS
SERVE THE PURPOSE OF PEOPLE
ACCESS.
WE SHOULD PUT MAYBE DENTAL
HYGIENE THERE.
>> AND UTILIZE COMMUNITY WORKERS
TO SHARE SHARE IF YOU SEE THIS
IN YOUR MOUTH IT'S CONCERNING
AND CALL THIS NUMBER OR
SOMETHING.
THERE'S OPPORTUNITIES WE IS
HAVEN'T AVAILED OURSELVES OF
THAT CAN MAKE A BIG DIFFERENCE.
SOME OF THE WORK WE WERE DOING
IN AFRICA WAS SOME OF THE FIRST
SIGNS A PERSON IS HIV POSITIVE
ARE LESIONS THAT MANIFEST IN
YOUR MOUTH AND THEY DON'T HURT
SO UNLESS YOU LOOK YOU WOULDN'T
KNOW BUT WE WERE TEACHING
COMMUNITY HEALTH WORKERS WHAT TO
LOOK FOR AND HOW TO GET PEOPLE
INTO CARE AND TEACHING PEOPLE
WHAT IT LOOK FOR BECAUSE ISSUES
WITH RESISTANCE OR PEOPLE NOT
BEING ADHERENT YOU CAN SEE
THINGS POP UP BEEN.
THE UTILITY IS QUITE SIGNIFICANT
AND UTILIZING HEALTH CARE
WORKERS IS AN AREA OF
OPPORTUNITY THAT CAN BE
LEVERAGED.
>> THAT'S RIGHT.
AND WE DO AMAZING WORK IN THE
COMMUNITY IN REACHING PEOPLE IN
WAYS US SITTING IN THE OFFICE
AND WHAT WE CAN'T REALLY DO.
>> ABSOLUTELY.
WE HAVE TO IMPROVE ORAL HEALTH
LITERACY IN GENERAL.
WHEN YOU SAY ORAL HEALTH
LITERACY WHAT DO YOU MEAN?
>> IF YOU HAVE SIGNIFICANT
INFLAMMATION IN YOUR MOUTH IT
COULD AFFECT YOUR HEART AND
DIABETES.
AND IF YOU'RE PREGNANT IT COULD
AFFECT YOUR PREGNANCY.
PEOPLE AREN'T AWARE THAT THESE
INFECTIONS GO UNMANAGED IF YOU
CAN GET SYSTEMIC INFECTIONS OR
BRAIN ABSCESS OR OTHER ISSUES.
PEOPLE AREN'T AWARE THAT FOR
EXAMPLE WHEN YOU LOOK AT
PNEUMONIAS AND ICUs MANY PEOPLE
WHO HAVE VENTILATOR ASSOCIATED
PNEUMONIA HAVE ORAL ORGANISMS
THAT ARE DRIVING THOSE
PNEUMONIAS.
WE NEED A CAMPAIGN TO CLEAN IT
CLEAN UP HERE SO PEOPLE DON'T
GET WORSE BUT PEOPLE DON'T THINK
ABOUT IT.
WHEN I TALK ABOUT ORAL HEALTH
LITERACY THAT'S WHAT I MEAN.
IT BECOMES A MORE COMMON TO HOW
WE THINK ABOUT HEALTH IN GENERAL
AND NOT AN ASIDE.
>> THANK YOU VERY MUCH FOR YOUR
TALK TODAY AND DISCUSSION.
CAN YOU TALK MORE ABOUT THE
INTEGRATION OF DENTAL AND
MEDICAL CARE IN THE U.S. BOTH
FROM THE SIDE OF LITERACY IN
TERMS OF CARETAKER ROLES AS WELL
AS DISCUSSING NOW THE COMMUNITY
INTERVENTION INITIATIVES THAT
ARE NEEDED.
>> BEFORE YOU DO I WANT TO MAKE
SURE THE AUDIENCE KNOWS ABOUT
THE INTERVENTION.
S.
>> I'M SHARON JACKSON AN
INVESTIGATOR WORKING WITH
DR. WEBSTER-CYRIAQUE AT NIDCR.
>> THAT'S A VERY BIG PICTURE
QUESTION.
I THINK SIGNIFICANT
OPPORTUNITIES EXIST.
ONE CHALLENGE IS WILL HOW WE ARE
ALL TRAINED.
THE DENTAL WILL SCHOOLS ARE
TRAINED AND THEN PEOPLE SPLIT
OFF.
THERE'S CERTAINLY OPPORTUNITIES
TO INTEGRATE WITHIN THE MEDICAL
AND NURSING CURRICULUM AND
PHARMACY CURRICULUM HERE ARE
THINGS IMPORTANT TO ORAL HEALTH
OR DENTISTRY AND VICE VERSA AND
THE DENTAL CURRICULUM HERE ARE
THINGS TO THINK ABOUT AS YOU
THINK ABOUT THE PERSON'S WHOLE
HEALTH.
I DON'T WANT FOR THE DENTIST TO
SAY OKAY, WE'RE GOING TO COME IN
AND DO THIS AND NOT PAY
ATTENTION TO THE FACT THE PERSON
MAY HAVE A CANCER UNDER THEIR
TONGUE OR THERE'S AN ISSUE WITH
THEIR GAIT AND HAVING TROUBLE
WALKING AND SHORTNESS OF BREATH,
ETCETERA.
WE ALL ARE NEEDING TO THINK
BIGGER PICTURE.
THERE'S MULTIPLE OPPORTUNITIES
WHERE THERE EXISTS ACROSS THE
HEALTH CARE SYSTEM AND OUTSIDE
THE HEALTH CARE SYSTEM TO BRING
TO HELP PEOPLE BE AWARE OF ORAL
HEALTH.
I THINK THAT PRESENTS A
CHALLENGE AND AN OPPORTUNITY.
BECAUSE I DO TOBACCO AND WE HAVE
OPPORTUNITIES FOR REDUCTION AND
THIS OTHER PLACE WE TALKED ABOUT
TOBACCO USE CESSATION IS GOING
TO BE IN THE BARBERSHOP AND
FLAIL S -- NAIL SALON AND HOW D
WE HAVE THE CONVERSATIONS IN THE
MUCH BROADER IMPACT IN VARIOUS
PLACES AS DR. WEBSTER-CYRIAQUE
MENTIONED TO IT'S ROUTINELY
TALKED ABOUT AS IMPORTANT WE
TALK ABOUT FOOD AND WHAT TO EAT
AND WHERE TO EAT AND WE NEED TO
TALK ABOUT HOW DO WE HAVE BETTER
ORAL HEALTH SO WE CAN EAT?
>> PERHAPS WE THINK ABOUT IT IN
THE CONTEXT OF THE ONGOING
CONVERSATIONS.
FOR EXAMPLE, IF WE'RE TALKING
ABOUT TOBACCO CESSATION THAT
COULD HAPPEN IN A DENTAL
ENVIRONMENT BUT DO PEOPLE KNOW
FOR PEOPLE WHO SMOKE THEY HAVE
SIGNIFICANT ISSUES WITH
PERIODO
PERIODONTAL DISEASE AND TOOTH
LOSS?
TO PEOPLE KNOW THEY'RE AT HIGHER
RISK FOR ORAL CANCERS AND THOSE
ARE TOUGH CANCERS IN TERMS OF
AND IN FACT WHEN WE LOOK AT HOW
WE'RE DOING COMPARED TO FIVE
YEAR SURVIVAL RATES OF OTHER
CANCERS, THE MORBIDITY AND
MORTALITY IS MUCH WORSE BECAUSE
WE DON'T HAVE THE BIOMARKERS.
THAT'S SOMETHING WE'RE WORKING
ON TOGETHER WITH THE NCI BUT
WHEN WE TALK ABOUT NUTRITION WE
TALK ABOUT ORAL HEALTH AND IT'S
TOUGH TO CHEW WITHOUT TEETH OR
BROCCOLI OR THINGS GOOD FOR US.
I THINK WE CAN TAKE ADVANTAGE OF
OPPORTUNITIES TO BRING IT IN IN
THE CONTEXT ONGOING
CONVERSATIONS.
>> I THINK PEOPLE UNDERSTAND THE
RELEVANCE BUT NOT AT WHAT
THEY'RE THINKING IN TERMS OF
KEEPING GUMS HEALTHY OR EVEN NFL
FOOTBALL PLAYER IS NOT THINKING
ABOUT ORAL HEALTH AND IT'S NOT
NECESSARY A SIMPLE ACCESS ISSUE.
YOU ALSO MENTIONED A CAMPAIGN.
SO DR. WEBSTER-CYRIAQUE I
ASSUME YOU'RE GETTING READY TO
GET ON TIKTOK.
>> I'M NOT GOOD AT SOCIAL MEDIA
PERSONALLY.
BUT HAPPY TO COLLABORATE WITH
OTHER PEOPLE AND SO WE ARE
WORKING ACROSS OTHER AGENCIES
LIKE CDC AND WORKING WITH THE
FDA ON ADDED SUGARS AND THERE'S
ABOUT 16 DIFFERENT FEDERAL
AGENCIES THAT HAVE AN ORAL
HEALTH COMPONENT.
SO WORKING ON TRYING TO LEVERAGE
THOSE GROUPS AND GET THE WORD
OUT THERE WAS A WONDERFUL
CAMPAIGN THROUGH THE INDIAN
HEALTH SERVICE AND IN NATIVE
POPULATIONS THE TEETH TEND TO
COME IN EARLIER.
IF PEOPLE DON'T KNOW AS SOON AS
THE TEETH COME IN WE SHOULD
START INTERVENING, CLEANING
THEM, DOING SOMETHING AND HAVE
SEEN HIGH RATES OF DECAY IN
THESE NATIVE POPULATIONS.
WE THOUGHT IT MUST BE NURSING
BABY CARIES AND THEY'RE IN THE
INTERVENING BECAUSE PEOPLE
DIDN'T KNOW.
SO THEY BEGAN THE CAMPAIGN
ACROSS THE INDIAN HEALTH
SERVICES AND THEY MADE THE
DIFFERENCE BUT THE KEY IS PEOPLE
NEED TO KNOW.
THOSE NEED TO BE EXPANDED.
ONCE WE HAVE A DEMONSTRATION AND
IT WORKS, WE CONSENT SAY OKAY
WE'LL KEEPING TO THIS IN
OKLAHOMA.
WE NOW NEED TO FIGURE OUT HOW TO
GET IT ACROSS AND DISSEMINATE IT
IN AN INTENTIONAL WAY YOU ALL
HAVE THE SELE NETWORKS TO
PROVIDE OPPORTUNITY FOR SHARING
OF INFORMING.
LOOK FORWARD TO WORKING WITH YOU
ALL ON THAT.
>> I'M DISAPPOINTED I WON'T SEE
YOU ON TIKTOK BUT WE'LL WORK
TOGETHER ON OTHER THINGS.
THAT'S AN INTERESTING THING
THOUGH BECAUSE I THINK THIS
QUESTION IS DO WE SEE
GENERATIONAL DIFFERENCES IN
TERMS OF ORAL HEALTH OR IS IT
PRETTY INSUFFICIENT ACROSS ALL
GENERATIONS?
SF
>> THIS IS IT COMPLEX.
I WAS WORKING IN RURAL
POPULATIONS AND PEOPLE WOULD SAY
THINGS LIKE WELL, MY GRANDMOTHER
HAD HER TEETH OUT SO YOU CAN
JUST TAKE ALL MY TEETH OUT.
IN THE INDIVIDUAL INTERVENTIONS
THERE'S BEEN SO MUCH FOCUS ON
TEACHING PEOPLE HOW TO FLOSS AND
ALL THAT AND WE KNOW
INTERVENTIONS WORK BECAUSE WHEN
WE ASK PEOPLE THE PEOPLE CAN
SAY, WHAT THEY'VE LEARNED BUT
DOES IT GET IMPLEMENTED?
SOME THINGS WE'RE LEARNING IS WE
NEED TO DO FAMILY LEVEL
INTERVENTIONS AND COMMUNITY
LEVEL INTERVENTIONS.
AND THAT'S SOMETIMES WHAT IT
TAKES TO MAKE SURE THESE ARE
EFFECTIVE BECAUSE AGAIN WE SPENT
TIME LOOKING AT THE INDIVIDUAL
LEVEL AND IT HASN'T MOVED THINGS
THE WAY WE NEED TO AND MORE AND
WORK IS UNDERSTANDING THINGS
THAT OCCUR AT THE FAMILY LEVEL
AND COMMUNITY LEVEL START TO
REMOVE STRUCTURAL CHALLENGES AND
START TO SEE IMPROVEMENT.
TAKING THE MULTI-LEVEL APPROACH
LIKE IN YOUR FRAMEWORK IT'S
IMPORTANT BECAUSE IT'S NOT JUST
ABOUT DID THIS PERSON BRUSH
THEIR TEETH.
>> ABSOLUTELY.
WE TRY TO EMPOWER PEOPLE TO DO
THE RIGHT THING BUT NEEDS
INDIVIDUAL AND COLLECTIVE LEVEL
ACTIONS AND HOW WE BETTER SHAPE
THE ENVIRONMENT TO PROMOTE
BETTER ORAL HEALTH FOR ALL.
WITH THAT, I WANT TO ONCE AGAIN
THANK DR. JENNIFER
WEBSTER-CYRIAQUE COMING TO US
AND GIVING US A WONDERFUL
PRESENTATION AND VERY WILL
THOUGHTFUL CONVERSATION
AFTERWARDS.
AND THANK ALL OF YOU FOR
PARTICIPATING AND LISTENING TO
THE LECTURE SERIES THROUGHOUT
2024.
WE ALL WISH YOU A WONDERFUL
HOLIDAY SEASON AND REKCONVENE I
THE NEW YEAR YOU CAN E-MAIL WHAT
THE NEXT LECTURE IS GOING TO BE.
WITH THAT ONCE AGAIN, THANK YOU
DR. WEBSTER-CYRIAQUE FOR YOUR
TIME AND THANK YOU FOR LISTENING
AND HAPPY HOLIDAYS.