A Working Definition of Advocacy

A Working Definition of Advocacy

James K. Zenk, D.D.S.*:

Advocacy — the #1 reason given by dentists for joining the ADA/MDA.

I would like to begin this update with a quote from our ADA president, Dr. Robert Faiella:
“The ADA must be the standard bearer. We will advocate, innovate, build consensus, and provide the tools for dentists and others to take on the enormous challenges the nation faces in  improving oral health among those who lack adequate access both to knowledge and care.” 
 
From this presidential guidance and a position of leadership, the ADA Board of Trustees has launched “Action for Dental Health”. Action for Dental Health is a declaration of dentistry’s  commitment to leadership in developing actionable, measurable solutions to oral health disparities, and has directed the organization to pursue its implementation aggressively. 
 
Action for Dental Health aims to prevent dental disease before it starts and reduce the proportion of adults and children with untreated dental disease through oral health education, disease prevention, and providing treatment now to people in need of care. Our goal is to help all Americans attain their best oral health. State associations will be critical partners in  advancing the initiatives outlined in Action for Dental Health as the campaign plays out over the weeks, months, and years ahead. 
 
Key initiatives to providing care now to people suffering with untreated dental disease are: 
1. Reduce the number of people who visit the emergency room for dental conditions by referring them to community health centers or private dental practices where they can receive  proper dental care. Millions of people are turning to hospital emergency rooms for treatment of dental pain and infection. Dental caries and abscesses — almost entirely preventable —  account for nearly 80% of dental-related ER visits. While emergency rooms can provide pain relief and treat infection, few hospitals have dentists on staff, so they are not able to  provide comprehensive dental care. Studies completed by the ADA Health Policy Resource Center show that young adults ages 21-34 accounted for most of the overall increases in the  percentage of dental visits that take place in the ER setting. They hypothesize that this increase is related to a decline in dental benefits among adults in this age group. Based on  various estimates on the average cost of a dental ER visit, it cost the American health care system anywhere from $867 million to $2.1 billion a year to treat dental conditions in hospital  emergency rooms. Moving patients with dental pain out of the ER and into the dental chair ensures that they get the right care at the right place.
 
2. Expanding access to care for the elderly in nursing homes. Delivering dental care to this patient population has been problematic.
 
3. Increasing programs where dentists can directly provide care to those who are suffering from lack of dental care today. Programs like Give Kids a Smile and Missions of Mercy provide  important platforms for dentists to deliver care directly to those in need. These programs, along with the free and discounted care that individual dentists provide every day, aggregate  into billions of dollars.
 
The second key initiative of the ADA Action for Dental Health is to strengthen and expand the public/private safety net to provide more care to more Americans.
1. Helping provide more care to people by having private practice dentists contract with Federally Qualified Health Centers. This would expand capacity without increasing the FQHC clinics  “bricks and mortar” expenses and staffing overhead. Contracting with the FQHC clinics would allow the private dentists to work with the underserved populations without having to  contend with many of the administrative headaches of the Medicaid program.
 
2. Fighting for increased dental health protections and simplified administration under Medicaid. A combination of fee increases and administrative reforms would increase the number of  participating dentists. 
 
The third key initiative of the ADA Action for Dental Health is bringing dental health education and disease prevention into communities.
1. Ensuring more Americans have access to drinking water with fluoride. Endorsed by U.S. Surgeon General Regina Benjamin, M.D. as “one of the most effective choices communities can  make to prevent health problems while actually improving the oral health of their citizens”, community water fluoridation programs benefit everyone, especially those without access to  regular dental care. For most cities, every $1.00 invested in water fluoridation yields $38.00 in savings in dental treatment costs. 
 
2. Increasing the number of Community Dental Health Coordinators (CDHCs). CDHCs are community health workers with dental skills focusing on education and prevention. They forge  strong relationships with people in underserved communities with disproportionately high rates of dental disease, and connect these people to dentists who will provide comprehensive  treatment. 
 
3. Strengthening collaborations with other health professionals and organizations. Better collaboration among dental and medical professionals can be a means to ensure all Americans  understand that their dental health is a crucial part of their overall health.
 
The ADA/ MDA must lead the way and continue to advocate for better oral health for all and develop innovative solutions to improve access and oral health.
 
 
 
*Dr. Zenk is the Trustee to the Tenth District of the American Dental Association, representing Iowa, Minnesota, Nebraska, North Dakota, and South Dakota. He is a general dentist in  Montevideo, Minnesota. Email is zenkj@ada.org.