THANK YOU FOR JOINING US THIS AFTERNOON FOR THIS WEBINAR ADDRESSING THE DEVELOPMENT OF A 2020 SURGEON GENERAL'S REPORT ON ORAL HEALTH. I'M DR. ROCHELLE ROLLINS, SENIOR POLICY OFFICER, OFFICE OF SURGEON GENERAL. I'M PLEASED TO BE HERE TODAY TO MODERATE THIS WEBINAR. STEPPING IN FOR THE PUBLIC HEALTH CHIEF DENTAL OFFICER REAR ADMIRAL TIM REX WHO UP FORTUNATELY IS NOT ABLE TO JOIN US TODAY. DR. RICKS WORKS AT THE INDIAN HEALTH SERVICE PARTIALLY AFFECTED BY LAPSE OF GOVERNMENT FUNDING. TO LEAD OFF I NOW LIKE TO SHARE A MESSAGE WITH YOU FROM OUR NATION'S SURGEON GENERAL VICE ADMIRAL JEROME ADAMS. >> HELLO. THANK YOU FOR JOINING US TODAY TO LEARN ABOUT THE DEVELOPMENT OF A NEW SURGEON GENERAL'S REPORT ON ORAL HEALTH. IT'S BEEN NEARLY 20 YEARS SINCE THEN U.S. SURGEON GENERAL DR. DAVID THACHER ISSUED THE FIRST REPORT ON ORAL HEALTH IN AMERICA. THE GOAL OF THE REPORT WAS TO DEFINE, DESCRIBE AND EVALUATE THE INTERACTION BETWEEN ORAL HEALTH AND HEALTH AND WELL BEING THROUGHOUT THE LIFE SPAN AND IN THE CONTEXT OF CHANGES IN SOCIETY. IN THAT FIRST REPORT WHICH CALLED FOR NATIONAL EFFORT TO IMPROVE ORAL HEALTH AMONG ALL AMERICANS CERTAINLY DID THAT. IT ALSO DREW MUCH NEEDED ATTENTION TO THE IMPORTANCE OF ORAL HEALTH AND SPARKED ADDITIONAL INVESTMENTS IN ORAL HEALTH PROGRAMS BY THE PUBLIC AND PRIVATE SECTORS. SINCE THAT TIME, ORAL HEALTH HAS CERTAINLY IMPROVED FOR MANY AMERICANS. OUR PUBLIC AND PRIVATE PARTNERS HAVE BEEN WORKING DILIGENTLY TO OVERCOME CHALLENGES IN THE 2000 REPORT. WHETHER TO UNDERTAKE SCIENTIFIC RESEARCH TO ADVANCE OUR UNDERSTANDING OF DENTAL ORAL AND CRANIOFACIAL DISEASES TO CREATE AND TEST NEW WAYS TO IMPROVE ACCESS TO DENTAL CARE, OR TO DEVELOP INNOVATIVE WAYS TO BRING PREVENTIVE ORAL HEALTH SERVICES TO PEOPLE OF ALL AGES. BUT UNFORTUNATELY, NOT ALL GROUPS HAVE BENEFITED EQUALLY. WE CONTINUE TO SEE VULNERABLE POPULATIONS IN THIS COUNTRY AFFECTED DISPROPORTIONATELY BY DENTAL DISEASE. I BELIEVE THAT AS A NATION WE CAN AND WE MUST DO BETTER. IMPROVING ORAL HEALTH IS A PERSONAL PASSION OF MINE. EVER SINCE I WORKED AS ANESTHESIOLOGIST IN COUNTY HOSPITAL AND SAW AFFECTS OF SEVERE ORAL DISEASE, CONDITIONS THAT COULD HAVE BEEN PREVENTED, BUT BECAUSE THEY WEREN'T, INDIVIDUALS UNDERWENT UNNECESSARY SURGICAL TREATMENT. THE NEW SURGEON GENERAL'S REPORT WILL ADDRESS CRITICAL ISSUES AND PERSISTENT CHALLENGE AS WELL AS NEW AND EMERGING OPPORTUNITIES. MY CHARGE FOR THE GROUP WORKING TO DEVELOP THE NEW REPORT IS AS FOLLOWS: TO DESCRIBE AND EVALUATE ORAL HEALTH AND THE INTERACTION BETWEEN ORAL HEALTH AND GENERAL HEALTH THROUGHOUT THE LIFE SPAN, CONSIDERING ADVANCES IN SCIENCE, HEALTHCARE INTEGRATION, AND SOCIAL INFLUENCES TO ARTICULATE NEW DIRECTIONS FOR IMPROVING ORAL HEALTH AND ORAL HEALTH EQUITY ACROSS COMMUNITIES. I VIEW THIS EFFORT AS ONE OF THE MOST IMPORTANT DURING MY TENURE AS SURGEON GENERAL. I ENCOURAGE YOU ALL TO WORK WITH ME TO LIFT UP ORAL HEALTH. HELP MAKE THE CASE THE YOUR COMMUNITIES OF IMPORTANCE OF ORAL HEALTH TO INDIVIDUAL AND COMMUNITY WELL BEING AND QUALITY OF LIFE. I INVITE YOU TO SEND EXAMPLES OF PROMISING PRACTICES TO IMPROVE ORAL HEALTH IN THE COMMUNITY TO OUR WRITING TEAM. LET'S WORK TOGETHER TO ENSURE THAT EVERYONE IN AMERICA CAN ACHIEVE OPTIMAL ORAL HEALTH. THANK YOU. >> THANK YOU, DR. ADAMS. WE' DELIGHTED YOU COMMISSIONED A NEW SURGEON GENERAL REPORT ON ORAL HEALTH. AN IMPORTANT MILESTONE FOR OUR NATION THE REPORT WILL LOOK AT HOW FAR WE HAVE COME IN IMPROVING ORAL HEALTH FOR THE NATION CITIZENS SINCE PUBLICATION OF THE FIRST REPORT IN 2000. AND WILL GUIDE US WITH OPPORTUNITY TO HIGHLIGHT CONTEMPORARY ISSUES AND CHALLENGES. AS WELL AS NEW KNOWLEDGE THAT HOSTS PROMISE FOR TRANSFORMING THE HEALTH, ORAL HEALTH OF THE NATION. NOW I WOULD LIKE TO INTRODUCE THE STAFF OF THE NIH NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH, WHO ARE RESPONSIBLE FOR THE DEVELOPMENT OF THE REPORT. CAPTAIN BRUCE DYE IS SERVING AS PROJECT CO-DIRECTOR. HE IS A DENTAL EPIDEMIOLOGY OFFICER WHO CURRENTLY DIRECTS THE INSTITUTES HEALTH INFORMATICS AND DENTAL PUBLIC HEALTH FELLOWSHIP PROGRAM. DR. DYE WILL DISCUSS WHAT HAS CHANGED SINCE THE 2000 REPORT. WHY A NEW SURGEON GENERAL'S REPORT IS NEEDED. FOLLOWING DR. DYE, WE'LL HEAR FROM THE PROJECT CO-DIRECTOR IN SCIENTIFIC EDITOR, DR. JUDITH ABINO. SHE JOINED THE TEAM FROM THE UNIVESITY OF COLORADO WHERE SHE'S PRESIDENT EMERITUS AND PROFESSOR OF BOTH AT SCHOOL OF PUBLIC HEALTH AND SCHOOL OF DENTAL MEDICINE AT THE UNIVERSITY OF COLORADO DENVER. DR. ALBINO WILL PRESENT ON THE PROCESS BEING USED TO DEVELOP THE REPORT AND GATHER INPUT. >> THANK YOU, DR. ROLLINS. HELLO AND A WARM WELCOME FROM THE NIH. IN 2000 THE FIRST SURGEON GENERAL'S REPORT ON ORAL HEALTH SPOKE ABOUT ORAL HEALTH MEANING MUCH MORE THAN HEALTHY TEETH. AS THE SURGEON GENERAL REMINDED US THE 2000 REPORT NOT ONLY HIGHLIGHTED ME MAJOR DISEASES AND CONDITIONS THAT AFFECT THE MOUTH AND CRANIOFACIAL AREA IT PROVIDED INFORMATION ARTICULATED A BROADER CONNECTION BETWEEN ORAL HEALTH OVERALL HEALTH AND WELL BEING. SINCE 2000 THIS REPORT HAS INFLUENCED RESEARCH HEALTH POLICY AND PATIENT CARE. MUCH HAS CHANGED IN THE PAST TWO DECADES SINCE THE RELEASE OF THIS REPORT. SCIENCE AND TECHNOLOGY HAVE CHANGED SUBSTANTIALLY SINCE 2000. IN 2000 THE FIRST CREW LAUNCHED TO THE INTERNATIONAL SPACE STATION BEGINNING FIRST UNINTERRUPTED HUMAN PRESENCE IN EARTH'S ORBIT. SINCE THEN THE SIGNS ORIGINATENING SPACE LED TO ADVANCES IN ROBOTIC SURGERIES PREVENTING BONE LOSS AND WOUND HEALING TECHNIQUES AND IMMUNOLOGY. THE FIRST DRAFT OF THE HUMAN GENOME WAS REVEALED IN 2000 AND PROJECT WAS COMPLETED IN 2003 CREATING NEW OPPORTUNITIES IN MEDICINE AND BIOTECHNOLOGY. iTUNES PROMOTED DIGITAL MUSIC AND VIDEO, ONE YEAR LATER APPLE UNVEILED THE FIRST iCLOTH FOR $399 AND THE iPHONE CAME SIX YEARS LATER. THOSE EARLIER EVENTS HAD A PROFOUND IMPACT HOW WE THINK AND USE TECHNOLOGY AND LIVE OUR LIVES. FOR EXAMPLE WHEN THE FIRST SURGEON GENERAL'S REPORT ON ORAL HEALTH WAS PUBLISHED THE SMART PHONE DIDN'T EXIST. TODAY WE LIVE IN A DIGITAL WORLD, OVER THE PAST TWO DECADES ADVANCES IN SCIENCE AND TECHNOLOGY HAVE LED TO MUCH STRONGER FOCUS ON DIGITAL DENTISTRY AND INCREASED INTEREST IN PRECISION HEALTHCARE. THESE FACTORS AND PERSISTENT CHALLENGES IN FINANCING AND ACCESS THE CARE HAVE MAJOR IMPACT ON OUR HEALTHCARE SYSTEM WHICH AFFECTS THE WAY WE RECEIVE DENTAL CARE. ADVANCES IN DATA SCIENCES ESPECIALLY MANAGING AND ANALYZING ELECTRONIC HEALTH RECORDS, NEW DISCOVERIES INVOLVING THE ORAL MICROBIOME HA POTENTIAL TO PROVIDE INSIGHTS ON FACTORS THAT INFLUENCE ORAL HEALTH. THE COST OF LIVING HAS ALSO CHANGE IN THE PAST TWO DECADES. THE MEDIAN COST OF HOME, AVERAGE MONTHLY REPRESENT DOUBLED. GASOLINE STAMPS AND EGGS ALL INCREASED BY 35% AT LEAST AND THE MEDIAN HOUSEHOLD INCOME HAS CHANGED LITTLE. THE DEMOGRAPHICS OF THE U.S. CHANGED SINCE THE LAST REPORT. THE POPULATION HAS GROWN FROM 281 MILLION TO ESTIMATED 327 MILLION TODAY. IN OUR COUNTRY IS MORE DIVERSE WITH MORE LIVING AND LARGER URBAN AREAS AND LIVING LONGER. DEMOGRAPHERS USE THE CONCEPT OF DEPENDENCY RATIO TO SHOW HOW THE NUMBER OF YOUTH AND OLDER ADULTS IMPACT WORKING ADULTS. THE DEPENDENCY RATIOS FOR THE UNITED STATES SHOW SUBSTANTIAL CHANGES IN OCCURRED SINCE THE 2000 REPORT. THERE'S BEEN A SLIGHT DECLINE IN NUMBER OF YOUTH FOR EVERY 100 WORKING AGE ADULTS BUT THERE'S BEEN SUSTAINED INCREASE IN NUMBER OF OLDER ADULTS FOR EVERY 100 WORKING AGE ADULTS. PROJECTIONS TO 2040 SHOW INCREASING NUMBER OF OLDER ADULTS COMPARED TO WORKING AGE ADULTS INDICATING AMERICA'S POPULATION IS GRAYING. THE RATIO CHANGE HAS IMPORTANT IMPLICATIONS NOT ONLY FOR SOURCES OF SOCIAL AND ECONOMIC CAPITAL NEEDED TO SUPPORT YOUTH AND ELDERL BUT FOR CONSIDERING HOW WE IMPROVE THE ORAL HEALTH OF OUR NATION. THERE ARE SEVERAL ORAL DISEASES AND DISORDERS THAT AFFECT PEOPLE, BUT DENTAL CARRIES AND COMPLETE TOOTH LOSS HAVE SUBSTANTIAL BURDEN THAT IMPACTS WELL BEING, GLOBALLY AND HIGH SDI COUNTRIES LIKE THE UNITED SATES. THE NUMBER OF PREF EVENTUAL CASES OF ORAL DISEASE IS HIGH IN THE WORLD AFFECTING NEARLY HALF OF THE GLOBAL POPULATION WITH DENTAL CARRIES REPRESENTING THE GREATEST BURDEN. HOWEVER, WHEN WE THINK OF BURDEN IN ANOTHER WAY, LIKE DISABILITY, USING DISABILITY ADJUSTED LIFE YEARS, THE BURDEN CARRIES IS MUCH LOWER BUT THE BURDEN COMPLETE TOOTH LOSS IS MUCH HIGHER. THIS IS MORE THAN TWICE AS HIGH AND HIGH SDI COUNTRIES LIKE THE UNITED STATES THAN OVERALL GLOBALLY. FROM THERE ARE STRONG SOCIAL DETERMINANTS FOR DENTAL CARRIES AND TOOTH LOSS AND WHEN WE THINK HOW THE NUMBER AND PROPORTIONS OF YOUTH AND ADULTS ARE CHANGING IN THE UNITED STATES, THESE DEMOGRAPHIC CHANGES HAVE THE POTENTIAL TO SUBSTANTIALLY AFFECT OUR NATION'S ORAL HEALTH MOVING FORWARD. THE FIRST SURGEON GENERAL'S REPORT ON ORAL HEALTH IS DATA FROM NUMBER OF NATIONAL SOURCES INCLUDING THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY. WHEN THE FIRST REPORT WAS WRITTEN, THE BEST CURRENT DATA AVAILABLE WAS FROM EARLY TO MID 1990s. IF WE CONSIDER THE DATA USED FROM THE REPORT ADS BASELINE INFORMATION, WE CAN DETERMINE THE ORAL HEALTH STATUS HAS CHANGED IN THE PAST TWO DECADES. THIS SLIDE SHOWS THAT UNTREATED TOOTH DECAY IN PRE-SCHOOL CHILDREN DECREASE SIGNIFICANTLY IN THE PAST DECADE BY 50% OVERALL. WITH SUBSTANTIAL DECREASES SEEN ACROSS ALL POVERTY LEVELS. THIS REPRESENTS A MAJOR ACHIEVEMENT SINCE RELEASE OF THE FIRST REPORT. HOWEVER, THE PERCENT OF PRE-SCHOOL CHILDREN NOT EXPERIENCING DENTAL CARRIES HAS REMAINED UNCHANGED SINCE FIRST REPORT AND THIS IS TRUE REGARDLESS OF HOUSEHOLD INCOME LEVEL. THIS INDICATES WE HAVE MADE ADVANCES IN ENSURING MORE PRE-SCHOOL CHILDREN RECEIVE TREATMENT FOR DENTAL CARRIES BUT WE HAVE BEEN UNABLE TO SUBSTANTIALLY OLDER CARRIES INITIATION IN YOUNG CHILDREN. IN THE PAST DECADE WE HAVE SEEN THE DECREASE IN PERCENT OF CHILDREN AGE 6 TO 11 YEARS WITH UNTREATED DENTAL CARRIES. THIS DECREASE IS AFFECTED FOR AND NEAR POOR CHILDREN THE MOST. HOWEVER PERCENT OF SCHOOL AGE CHILDREN DENTAL CARRIES FREE, THAT IS HAVING NO CAVITIES IN THEIR PERMANENT TEETH, HAS IMPROVED VERY LITTLE SINCE THE FIRST REPORT. SINCE THE FIRST REPORT, THERE'S BEEN VERY LITTLE CHANGE IN THE PERCENT OF ADOLESCENTS WITH UNTREATED TOOTH DECAY OVERALL, HOWEVER, WE HAVE SEEN SOME IMPROVEMENT FOR ADOLESCENTS LIVING IN POVERTY. THERE'S BEEN LITTLE IMPROVEMENT IN PERCENT OF DENTAL CARRIES THE PAST DECADE, HISPANIC DECADE HAVE MORE CARRIES EXPERIENCE THAN NON-HIS PA IN I CAN BLACK AND WHITE -- HISPANIC BLACK AND WHITE TEENAGERS. WE ARE AT RISK FOR EXPERIENCING DENTAL CARRIES FOR THE LIFETIME, HOWEVER THE MAJORITY OF AMERICANS THE FIRST EXPERIENCE OCCURS EARLY IN LIFE. THE DRAMATIC DROP IN PREVALENCE OF PEOPLE WITH NO DENTAL CARRIES EXPERIENCE BEGINS IN ELEMENTARY SCHOOL QUICKLY EXTENDS THROUGH MIDDLE HIGH SCHOOL AND INTO EARLY ADULTHOOD. THIS PATTERN REMAINED UNCHANGED SINCE THE FIRST SURGEON GENERAL'S REPORT ON ORAL HEALTH. AND SUGGESTS THAT WE MUST FIND A WAY TO SLOW DOWN DENTAL CARRIES INITIATION IN OUR YOUTH IF WE WANT TO INCREASE THE PREVALENCE OF AMERICAN ADULTS WHO REMAIN CARRIES FREE THROUGHOUT THEIR LIFETIME. IMPROVING THE PREVALENCE OF PEOPLE WITH NO DENTAL CARRIES EXPERIENCE IS IMPORTANT. BUT HAVING ENOUGH NATURAL TEETH IS ESSENTIAL TO OUR WELL BEING AND OVERALL HEALTH SATISFACTION. HAVING 21 OR MORE NATURAL TEETH OR FUNCTIONAL DENTITION IS ONE WAY TO ASSESS IMPROVEMENTS IN ORAL HEALTH QUALITY OF LIFE. SINCE THE FIRST REPORT, THE PERCENT OF OLDER ADULTS WITH FUNCTIONAL DENTITION IS INCREASING FOR MOST OLDER ADULTS BUT DISPARITIES CONTINUE TO EXIST BY POVERTY STATUS. ANOTHER GREAT ACHIEVEMENT SINCE INTRODUCTION OF FIRST REPORT ON ORAL HEALTH HAS BEEN THE ONGOING SIGNIFICANT DECLINE IN COMPLETE TOOTH ROSS AMONG OLDER ADULTS IN THE UNITED STATES. SINCE THE FIRST REPORT THE PREVALENCE OF DENTALLISM, COMPLETE TOOTH LOSS AMONG ADULTS AGE 65 AND OLDER HAS BEEN REDUCED BY HALF. THE DECLINE IN COMPLETE TOOTH LOSS BENEFITED MANY OLDER AMERICANS IRRESPECTIVE OF POVERTY STATUS. SINCE 2000 OUR UNDERSTANDING OF THE ROLE OF HPV INFECTION IN CAUSING CANCER HAS SUBSTANTIALLY IMPROVED. TODAY ORAL PHARYNGEAL CANCER IS THE MOST COMMON HPV ASSOCIATED CANCER MORE COMMON THAN CERVICAL CANCER AND MEN THREE AND A HALF MORE TIMES LIKELY TO HAVE ORAL PHARYNGEAL CANCER THAN WOMEN. WHEN WE THINK ABOUT CHANGES IN HEALTH ECONOMETRICS OF DENTAL CARE, THE PERCENT OF PEOPLE WITH DENTAL INSURANCE IMPROVED SINCE 2000 FROM 66% TO 71%. BUT IMPROVEMENT HAS BEEN GREATER FOR THOSE UNDER 21 YEARS. THIS INCREASE IN DENTAL COVERAGE IS PROBABLY DUE TO DEPENDENT COVERAGE POLICY OF THE ACA AS WELL AS EXPANSION FOR KIDS AN MEDICAID AND THE CHILDREN'S HEALTH INSURANCE PROGRAM. THERE'S ALSO BEEN INCREASE IN PERSONAL DENTAL EXPENSES, THESE HAVE INCREASED BY $70 OVERALL SINCE THE LAST REPORT BUT FOR PEOPLE YOUNGER THAN 21 YEARS, OUT OF POCKET EXPENSES REMAIN THE SAME. TOTAL DENTAL EXPENDITURES CONTINUED TO CLIMB SINCE THE FIRST REPORT. IN 2000 USING 2,016-DOLLARS, 85 BILLION WAS SPENT ON DENTAL CARE IN THE UNITED STATES. THIS RISEN TO 124 BILLION IN 2016. DENTAL CARE CONTINUES TO PRESENT THE HIGHEST LEVEL OF FINANCIAL BARRIER COMPARED TO OTHER TYPES OF HEALTHCARE SERVICES. THIS PARTICULARLY AFFECTS WORKING AGE ADULTS FOLLOWED BY THE ELDERLY AND THEN BY THOSE AGE 18 AND YOUNGER. DENTAL CARE COST BARRIERS SUBSTANTIALLY AFFECT WORKING AGE ADULTS WITH NO INSURANCE AND THOSE ONLY COVERED BY MEDICAID. MORE THAN 25% OF UNINSURED WORKING AGE ADULTS DIDN'T GET DENTAL CARE THEY NEED IN THE PAST YEAR BECAUSE OF COSTS WHILE ONLY 5% THOSE WORKING AGE ADULTS WITH HEALTH INSURANCE INCLUDING DENTAL INSURANCE DIDN'T GET ANY DENTAL CARE THEY NEEDED. MUCH HAS CHANGED THE PAST TWO DECADES SINCE RELEASE OF THE FIRST REPORT ON ORAL HEALTH. WE HAVE SEEN SUBSTANTIAL IMPROVEMENT IN REDUCING UNTREATED DENTAL CARRIES IN YOUNG CHILDREN BUT NOT SO MUCH FOR OLDER YOUTH AN ADULTS. MORE IMPORTANTLY, WE HAVE BEEN UNABLE TO ALTER THE NATURAL HISTORY OF DENTAL CARRIES THAT SIGNIFICANTLY INCREASES THE NUMBER OF AMERICANS EXPERIENCING NO DENTAL AID THROUGHOUT THEIR LIFETIME AND WE HAVE SEEN GREAT SUCCESS IN REDUCING TOOTH LOSS AND IMPROVEMENT IN TOOTH RE TENSION TO TEN SURE QUALITY OF LIFE FOR OLDER ADULTS. THOUGH ORAL HEALTH IMPROVED FOR SOME AMERICANS, HEALTH DISPARITIES PERSIST. DENTAL EXPENDITURES CONTINUE THE RISE AND COST OF DENTAL CARES CONTINUES TO BE A CHALLENGE FOR MANY AMERICANS. AMERICA IS BECOMING MORE DIVERSE AND AGING. MUCH IN SCIENCE AND TECHNOLOGY IN DENTAL WORK FORCE HAVE ALSO CHANGED IN THE PAST TWO DECADES. THERE'S BEEN AN EMERGENCE IN RAPID IMPLEMENTATION OF DIGITAL DENTISTRY FOR INFORMATION MANAGEMENT AND PATIENT CARE. THERE'S BEEN CHANGES IN DATA SCIENCE LEADING TO NEW OPPORTUNITIES FOR EXTRACTING INFORMATION FROM ELECTRONIC HEALTH RECORDS. THE ADVANCES IN BIOLOGY AND PARTICULAR NEW DISCOVERIES RELATED TO THE HUMAN GENOME AND THE ORAL MICROBIOME OFFER GREAT PROMISE. BUT AS WE ARE EXCITED ABOUT THE PROMISE OF SCIENCE TO ADVANCE PRECISION HEALTHCARE WE MUST REMAIN VIGILANT IN THE POSSIBILITY THESE TECHNOLOGICAL ADVANCES EXACERBATE HEALTH INEQUITY. THERE'S IMPROVED UNDERSTANDING HOW SOCIAL DETERMINANTS AFFECT PUBLIC HEALTH AND ECONOMIC FACTORS AFFECTING PROFESSIONAL TRAINING AND WORK FORCE MODELS ARE CHANGING HOW WE RECEIVE DENTAL CARE. FOR THESE REASONS AND MANY OTHERS, WE NEED A NEW REPORT TO UNDERSCORE CRITICAL NATURE OF POOR ORAL HEALTH AS PUBLIC HEALTH ISSUE PROVIDE A COMPREHENSIVE REVIEW OF THE IMPORTANCE OF ORAL HEALTH THROUGHOUT LIFE, DESCRIBE IMPORTANT CONTEMPORARY ISSUES AFFECTING ORAL HEALTH AND PROMISE OF SCIENCE TO TRAININGS FORM THE ORAL HEALTH OF THE NATION AND OUTLINE A VISION FOR FUTURE DIRECTIONS AND EDUCATE ENCOURAGE AND CALL UPON ALL AMERICANS TO TAKE ACTION. >> THANK YOU, DR. DYE. I'LL TURN OUR ATTENTION NOW TO CURRENT PLANS FOR THE REPORT. HOW IT WILL BE ORGANIZED, WHAT YOU CAN EXPECT TO SEE IN THE COMPLETED DOCUMENT, AND HOW YOU CAN HEALTH TO SHAPE THIS IMPORTANT REPORT. SURGEON GENERAL ADAMS CHARGE TO THOSE RESPONSIBLE FOR PREPARING THE REPORT IS OUR PRIMARY GUIDE FOR CONTENT. AS WE BEGIN PLANNING AND WORKING ON THE 2020 REPORT, WE MUST LOOK BACK TO THE FINDINGS OF THE 2000 REPORT. IN THE MANNER DR. DYE SUGGESTED WE SHALL ASK WHAT HAS CHANGED SINCE THEN AND WHAT IS NEW. BUT MORE IMPORTANT WE SHALL CONSIDER THESE CHANGES AS WELL AS OTHER NEW DEVELOPMENTS AND NEW KNOWLEDGE IN TERMS OF HOW THEY CAN HELP US IDENTIFY STRATEGIES AND SOLUTIONS TO MEET TODAY'S CHALLENGES. THIS WILL BE THE FIRST STEP IN ENSURING THAT ALL INDIVIDUALS AND ALL COMMUNITIES CAN SHARE EQUALLY IN THE VALUE GOOD ORAL HEALTH ADD TO OUR LIVES. BOTH INDIVIDUALLY AND AS A SOCIETY. HOW WILL WE DO ALL OF THIS? IT IS INDEED A DAUNTING CHALLENGE BUT WE HAVE A CLEAR STARTING POINT WITH THE SURGEON GENERAL'S CHARGE. THE REPORT WILL BE BASED IN SCIENCE. WE WILL THOROUGHLY EXAMINE CURRENT KNOWLEDGE INCLUDING EVIDENCE OF SUCCESSFUL PRACTICES AS WELL AS RESEARCH. EACH OF THE SIX MAJOR SECTIONS OF THE REPORT WILL BEGIN WITH AN ASSESSMENT OF CURRENT KNOWLEDGE PRACTICES AND PERSPECTIVES RELATED TO ASPECT OF ORAL HEALTH CONSIDERED IN THAT SECTION. THIS WILL BE FOLLOWED BY A CAREFUL PROCESS OF WRITING AND EDITING. ALL CARRIED OUT BY RECOGNIZED EXPERTS IN THE MANY CONTENT AREAS COVERED BY THE REPORT. AN INDEPENDENT GROUP OF REVIEWERS THEN WILL GO OVER THE REPORT AND SUGGEST ANY NEEDED ADDITIONS OR REVISION. THE 2000 SURGEON GENERAL'S REPORT CAREFULLY ASSESSED THE STATUS OF POPULATION HEALTH WITH RESPECT TO ORAL DISEASES, DETERMINING THE BURDEN OF DISEASE AND RELATING THE AFFECTS OF THOSE DISEASES TO OVERALL HEALTH AND WELL BEING. THE 2000 REPORT WILL INCLUDE INFORMATION ABOUT THE SAME TOPICS BUT DO SO FROM THE PERSPECTIVE OF CURRENT DEMOGRAPHICS AND CHALLENGES. WE WILL LOOK AT THE AFFECT OF ORAL HEALTH ON THE OVERALL WELL BEING OF COMMUNITIES, ON THE ECONOMY AND ON MILITARY READINESS. WE WILL LEARN FROM THOSE GROUPS OF PEOPLE WHO ARE ENJOYING THE BENEFITS OF GOOD ORAL HEALTH AND WE WILL WORK TO UNDERSTAND WHY OTHER GROUPS ARE NOT ENJOYING THOSE SAME BENEFITS. TWO SECTIONS IS OF THE REPORT WILL LOOK AT HOW WE EXPERIENCE ORAL HEALTH AT DIFFERENT TIMES OF LIFE. IN CHILDHOOD, IN ADOLESCENTS, IN ADULTHOOD AND IN OUR LATER LIFE YEARS. DR. DYE DETAILED SOME OF THE CHANGES THAT OCCURRED IN ORAL HEALTH STATUS FOR THESE GROUPS AND WE WILL WORK FURTHER TO DESCRIBE AND TO UNDERSTAND HOW THE CHANGING DEMOGRAPHICS OF OUR COUNTRY AFFECT ORAL HEALTH, HOW THEY AFFECT QUALITY OF LIFE. AND ACCESS TO ORAL HEALTHCARE. THEN WE WILL TURN TO SOMEOF THE MAJOR PROBLEMS OF SOCIETY TODAY INCLUDING SUBSTANCE ABUSE, SUBSTANCE ABUSE AND DISORDERS, THE OPIOID EPIDEMIC AND MENTAL HEALTH CONCERNS. AS WELL AS THE USE OF TOBACCO, ALCOHOL AND OTHER BEHAVIORS THAT CAN CARRY ORAL HEALTH RISK. THE SOCIAL CULTURAL PROBLEMS OF OUR DAY ARE NOT ISOLATED FROM ISSUES OF ORAL HEALTH AND OUR CHARGE IS TO ADDRESS ORAL HEALTH FOR ALL INCLUDING CONSIDERATION OF THE SERIOUS AND OFTEN PERILOUS CHALLENGES THAT IMPACT THE LIVES OF SO MANY. WE WILL LOOK AT QUESTIONS OF ORAL HEALTH AS PART OF OVERALL HEALTH AND WHAT THAT MEANS FOR HEALTHCARE SYSTEMS, INCLUDING QUESTIONS OF HOW, WHERE AND BY WHOM ORAL HEALTH CARE IS PROVIDED. WE WILL EXHAUSTIVELY REVIEW THE RESEARCH AND IDENTIFY APPROAHES AND STRATEGIES THAT ARE HELPING TO ADDRESS NEEDS BY BREAKING DOWN BARRIERS TO ACCESS. WE WILL SEEK OUT CREATIVE NEW PROGRAMS AND NEW WAYS OF DELIVERING ORAL HEALTHCARE AND WE WILL IDENTIFY THE BEST NEW WAYS OF PREVENTING AS WELL AS TREATING ORAL DISEASE. FINALLY WE'LL LOOK AT EXCITING NEW DEVELOPMENTS IN SCIENCE AND TECHNOLOGY THAT HOLD POTENTIAL FOR TRANSFORMING ORAL HEALTH. AND FOR ENSURING THAT IT BECOMES A VALUE-ADDED IN THE LIVES OF ALL. WE WILL ACTIVELY SEEK INFORMATION OR DISCOVERIES THAT MAY SUGGEST NEW DIRECTIONS WHETHER THIS WORK COMES FROM DENTISTRY, OR OTHER AREAS OF SCIENCE, TECHNOLOGY AND PRACTICE. REQUIRE PROVEN EXPERTISE, DOCUMENTED EXPERIENCE, AND CREATIVE IDEAS. THAT IS WHY WE'RE WORKING HARD TO GATHER BROAD AND DIVERSE INPUT ON THE TOPICS I HAVE DESCRIBED. ON THIS SLIDE YOU WILL SEE OUR MULTIPLE APPROACHES TO GATHERING INPUT AND THE MANY INDIVIDUALS AND GROUPS WHO HAVE BEEN OR WHO WILL BE INVOLVED IN DEVELOPING THE 2020 SURGEON GENERAL'S REPORT ON ORAL HEALTH. ALL OF THESE SOURCES AND PROCESS STEPS ARE ESSENTIAL. TODAY I WANT TO EMPHASIZE THE IMPORTANCE OF THIS WEBINAR, AS A MAJOR METHOD OF GLEANING CRITICAL INFORMATION AND IDEAS FROM THE BROADEST POSSIBLE AUDIENCE. WE NEED YOUR THINKING ABOUT TOPICS THAT SHOULD BE COVER IN THE REPORT AND WE WANT TO KNOW WHAT YOU HAVE SEEN OR EXPERIENCED THAT IS RELEVANT TO THOSE TOPICS. THIS SLIDE DESCRIBES MORE SPECIFICALLY WHAT WE NEED FROM YOU THIS IF THIS REPORT IS TO REFLECT INCLUSIVE VIEW THAT SURGEON GENERAL ADAMS IS SEEKING. I EMPHASIZE AGAIN, THE REPORT IS ABOUT THE MEANING OF ORAL HEALTH FOR ALL PEOPLE. IF YOU HAVE INFORMATION ABOUT ORAL HEALTH PROBLEMS OR CHALLENGES, FACED BY SPECIFIC GROUPS OF PEOPLE WE WANT TO HEAR ABOUT THOSE. TO THE EXTENT THERE ARE DOCUMENTED PROGRAMS OR ACTIVITIES THAT REPRESENT NEW WAYS OF THINKING ABOUT ORAL HEALTH WE NEED TO HEAR ABOUT THOSE. WE ARE ESPECIALLY INTERESTED IN LEARNING NEW KINDS OF PARTNERSHIPS, THESE MAY INVOLVE ORGANIZATIONS OR SETTINGS THAT ARE NOT TRADITIONALLY ASSOCIATED WITH ORAL HEALTH. OR HEALTH PROVIDERS WHO HAVE NOT CONVENTIONALLY BEEN FOCUSED ON ORAL HEALTH. NO MATTER HOW UNUSUAL THE APPROACH, IF IT INCREASES OUR ABILITY TO EXTEND THE BENEFITS OF ORAL HEALTH TO MORE PEOPLE, WE WANT TO KNOW ABOUT IT. I HOPE I HAVE MADE IT CLEAR THAT WE WANT YOUR IDEAS. YOUR SUGGESTIONS, YOUR OPINIONS, YOUR THOUGHTS AND YOUR VIEWS ABOUT ORAL HEALTH AND ABOUT HOW WE CAN ADDRESS THE CHALLENGE OF IMPROVING ORAL HEALTH AND ORAL HEALTH EQUITY ACROSS COMMUNITIES. PLEASE SEND YOUR CONTRIBUTIONS BEFORE THE END OF THE PUBLIC COMMENT PERIOD FOR THIS WEBINAR ON JANUARY 25th. THE WEBINAR ITSELF WILL BE& ARCHIVED AND YOU WILL BE ABLE TO ACCESS IT FOR A YEAR. THIS LAST SLIDE DISPLAYS THE INFORMATION YOU NEED TO PROVIDE INPHUT FOLLOWING THE MEMBER GNAR. IF YOU ARE UNSURE WHETHER TO RESPOND PLEASE ERR ON THE SIDE OF YES. YOUR OPINIONS AND SUGGESTIONS WILL INFLUENCE THE PROCESS AND HELP DETERMINE THE ULTIMATE SHAPE AND CONTENT OF THIS REPORT. THANK YOU FOR YOUR INTEREST AND FOR INVESTING YOUR TIME TODAY. BUT PLEASE DON'T LET IT STOP THERE. I PERSONALLY FEEL HONORED TO BE PART OF A PROCESS THAT WILL BE MEANINGFUL FOR ALL OF US AND I HOPE THAT YOU WILL WANT TO PARTICIPATE AS WELL. YOU CAN DO THAT BY SENDING US YOUR IDEAS NOW. LET'S ALL MAKE SURE THAT THE SURGEON GENERAL'S VISION OF BETTER ORAL HEALTH FOR ALL BECOMES A REALITY. I LOOK FORWARD TO HEARING FROM YOU. THANK YOU FOR JOINING US.