Oral Health

Did you know that a healthy smile includes more than just your teeth?  It also includes your gums, tongue, throat, jaws, and lips.  According to the State Cancer Profile, Louisiana has the 3rd highest rate of oral cavity and pharynx cancers in the United States.  Additionally, 83% of parishes suffer from Dental Health Professional Shortage Areas (HPSAs).  This means that the majority of our state is experiencing a shortage of dental care.  Well-Ahead Louisiana works to create healthy smiles through oral health education and by expanding access to preventative dental services.

oral health in Louisiana

             
            

Need help finding dental services? 
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            Click here to learn more about
            Dental HPSAs.
 

oral health 411

Oral disease is preventable.  Brushing your teeth twice a day, flossing, and visiting a dentist regularly are small steps toward a healthy smile.  Healthy lifestyle choices like avoiding tobacco use and a eating a healthy diet also build a healthy smile.  But, did you know that your oral health also has a direct impact on other chronic conditions like diabetes and high blood pressure? Learn how you can keep your smile healthy below.

Children and Adolescents

Tooth decay is the most common chronic disease of childhood, with 40% of children having caries by the time they enter kindergarten.Early childhood caries (ECC) can cause significant pain for children and can lead to oral infection, visible dental decay, destruction and loss of teeth, and damage to permanent teeth.  This can impact a child's self-esteem, sleep patterns, school readiness, weight gain, and more.  Child care centers can play an important role in the reduction of ECC by educating children and their parents on the importance of healthy oral hygiene.

Resources & Toolkits:

1. Pierce KM, Rozier RG, Vann WF. Accuracy of pediatric primary care providers' screening and referral for early childhood caries. Pediatrics 2002;109(5):E82. Available at : "http://pediatrics.aappublications.org/content/109/5/e82.long". 

 

Adults and Older Adults

Oral health is important for adults and older adults, yet it is often overlooked. There are a number of associations between common health conditions and oral health that may be surprising, such as diabetes, low self-esteem due to tooth loss, and osteoporosis to name only a few. 

Learn more about how to take care of your teeth, throughout your lifetime!

Colgate

Mouth Healthy, American Dental Association (ADA)

Oral Health and Chronic Disease

Oral disease is almost completely preventable, but it still affects children and adults throughout Louisiana every day. In addition, oral health has a direct impact on many other diseases and conditions, including diabetes, heart disease, and stroke. Gum disease in pregnant women is also associated with premature births and low birth weight.

There are safe and effective ways to prevent oral health disease that everyone can adopt. These include brushing twice daily with fluoridated toothpaste, drinking fluoridated water, not using tobacco products, eating healthy, and seeing a dentist regularly.

 

  

Diabetes
                   
  • Tooth decay is a most common oral health problem among diabetics.
  • People with poorly controlled diabetes are at greater risk for dental problems.
  • Diabetics are more susceptible for developing oral infections and periodontal disease due to diabetes reducing the body’s resistance to infection.
  • Diabetics that have periodontal disease struggle with keeping their blood sugar levels controlled. This can lead to more serious matters.

High Blood Pressure
                                   
  • Gum disease and hypertension may be linked by way of inflammation and blood pressure elevation.
  • Studies have also linked the incidence of heart disease to poor oral health.
  • Elevated high blood pressure (hypertension) can affect your ability to receive oral healthcare ---Most dentist will not preform dental treatments on patients with hypertension because it could lead to a detrimental situation. – Patients with hypertension may have to receive clearance from their doctor prior to treatment.

Tobacco Use
                   
  • 50% of smoking adults have gum (periodontal) disease because of the increase of plaque and tarter build-up.
  • Smoking leads to reduced effectiveness of treatment for gum disease.

  • Smokers are twice as likely to lose their teeth as non-smokers and need extensive dental treatment like, root canals.

Nutrition
                   
  • A poor diet can lead to tooth decay and gum disease.
  • Foods and drinks high in sugar not only impact your general health, but are also a common cause of tooth decay
  • Fluoridated water is the best beverage for preventing dental problems.

creating healthy smiles

Well-Ahead Louisiana coordinates efforts that create healthy smiles.  Best practices include School-Based Dental Sealant Programs and Community Water Fluoridation.  Both are evidence-based and proven effective for preventing tooth decay.  In addition, our team conducts an oral health basic screening among Louisiana third grade students and promotes fluoride varnish application to pediatricians and parents statewide.   

Bright Smiles for Bright Futures: Basic Screening Survey

Dental health is often a child's top unmet health need. This project also helps Well-Ahead Louisiana collect data in hopes of securing funding for future oral health programming for Louisiana students. Your child's screening results will be treated as private health information. All data collected will be reported in aggregate form, ensuring the privacy of both students and schools.

The Oral Health Program (OHP) is ramping up for the continuation of the school-based oral health screening program, Bright Smiles for Bright Futures, 3rd-Grade Basic Screening Survey (BSS).  During the summer months the program is busy planning, preparing and training to lay the ground work for the final round of this project.  The importance of youth oral health screenings provided through the Bright Smiles for Bright Futures, Basic Screening Survey is to produce statistical estimates on dental health indicators. Tooth decay is the #1 childhood disease that impacts the lives of children at an early age. 

This nationwide open-mouth survey is used by many states to have a consistent model for obtaining data for oral health improvement.   The survey is conducted in Louisiana schools statewide every 3-5 years and the first survey was conducted in 1997-1998.  Our state currently holds a “D” National ranking in overall oral health outcomes so providing a representative sample is crucial for developing needed interventions.

The next five-year BSS began in the 2016-2017 school year.  Louisiana’s school participation rate was low and therefore a representative sample size was not collected.  It was decided that the project would get an additional school year to collect the remaining data needed.  In the first year out outreach 33 of the 60 targeted schools participated in the project resulting in a total of 902 3rd graders screened.

Hygienists screened and educated all 3rd-graders students who participated.  Hygienist screen students looking for 4 oral health indicators including untreated tooth decay, fillings, sealants, and treatment urgency level for needed dental care.

Many participating schools gave the Oral Health Program (OHP) great feedback in regards to the education, resources and screening provided to the students by the hygienist.  The screenings have opened the door for further interest in evidence-based prevention programs (dental sealants and fluoride varnish applications) as some principals have indicated the need to have these programs in their schools.

This summer, the OHP was successful in sharing BSS information with Superintendents through the Louisiana Association of School Superintendents Conference.  There are other innovative opportunities being planned for a better outcome in 2nd phase.  By the end of the 2017-2018 school year the program hopes to have collected data from 2,000 3rd-grade students in a total of 60 Louisiana schools! 

  • Bright Smiles for Bright Futures BSS Report

  • 2016-2018 Bright Smiles for Bright Futures BSS Schools

    • All schools who have been selected to participate have been notified

      • If you need additional copies of paperwork for your schools screening please use the links below:

        • Department of Education Superintendent Letter of Support -- here

        • Parent Take Home Flyer -- see it here

        • Educational Coloring Sheet – see it here

        • Student Consent Form – see it here

        • School Participation Form – see it here

        • Letter to the Principal – see it here

Louisiana Seals Smiles: School-Based Dental Sealant Program

Dental sealants are thin, colorless, plastic coatings that are placed on teeth to prevent cavity formation. Teeth have tiny grooves and pits where bacteria can hide and damage the tooth's enamel. Sealants protect these grooves and pits from bacteria and help prevent cavities. While any tooth may receive a sealant, it is most common for children to have their 6-year-old and 12-year-old molars (first and second molars) sealed. 

The application of dental sealants is a quick, pain-free process. It first requires that the tooth be cleaned and prepared for the sealant. The sealant is then painted on the tooth surface, and the tooth is allowed to dry. After the sealant is placed, the tooth surface should look and feel the same as before. Sealants are very strong and should last for many years. The dentist will check the sealant at check-ups to make sure it is still intact. The sealant can be replaced with a new one as necessary.

Click here to learn more about school based dental sealant programs

The Louisiana Oral Health Program operated a school-based dental sealant program, Louisiana Seals Smiles, a school-based/linked program that targeted first, second, and sixth grade children in Louisiana.  The six-year program provided dental sealants and fluoride varnish to eligible children throughout the state free of charge while in their school settings. The program partnered with several key providers (The Health Enrichment Network, Health Centers in Schools, the University of Louisiana at Monroe, the Louisiana State University School of Dentistry, Primary Care Providers of East Feliciana, and Dental Caravan, Inc.) in 2014 to serve schools in various parishes of the state.  

 

During 2012-2015, a total of 7,824 children were screened and 4,283 received dental sealants in over fifteen parishes. Due to funding limitations, this program is not currently being operated.

Number of Children Who Received Preventative Dental Services 2012-2015

Year

Screened

# Children Sealed

2012-2013

2171

1120

2013-2014

3578

2121

2014-2015

2075

1042

Total

7,824

4,283

Source: Sealant Efficiency Assessment for Locals and States (SEALS) 2012-2015 

Click here to learn more about Louisiana Seals Smiles.

Fluoride Varnish

Fluoride varnish is a coating that is painted directly to child’s teeth in order to prevent tooth decay.  Tooth decay, if untreated, can turn into a cavity.  Fluoride varnish not only assists in preventing future cavities but it may even help to reverse cavities that have already started developing.  If your child does not go to a dentist on a regular basis, and he/she is six months to five years old, your pediatrician can also apply the protecting varnish.  Fluoride is safe for your teeth and only takes minutes to apply.

The Louisiana DHH Medicaid Fluoride Varnish Policy published in December 2011 requires physicians to complete the DHH “Smiles for Life” Certification in order to bill for fluoride varnish applications in offices  For more information about his policy please click the here: DHH Medicaid Fluoride Varnish Policy

  • How much is a medical professional reimbursed for applying the varnish?

Louisiana Medicaid covers reimbursement to medical providers at $24.19 once every six months for the therapeutic application of topical fluoride varnish for patients age 6 months to 5 years with a moderate to high risk for caries. (Billable under procedure code D1206.)

  • Does a medical professional need to include any additional interventions/services in order to be reimbursed for fluoride varnish application by Medicaid?

This healthcare common procedure coding system code (HCPCS code) represents application of the fluoride varnish, as well as performance of an oral health assessment, education of parents and anticipatory guidance. These services are considered inclusive and are not separately reimbursable.  HCPCS code D1206 is only reimbursable when performed on the same date of service as an office visit or preventive screening visit. Providers shall not require recipients to return to the office to receive the varnish application.

  • Who can apply fluoride varnish?

Disciplines that may apply the fluoride varnish are include: dental providers, physicians, nurse practitioners, physician assistants, registered nurses and licensed practical nurses. Physicians are responsible to provide training to participating staff to ensure competency in fluoride varnish applications.

  • Who can be reimbursed? 

Physicians, nurse practitioners and physician assistants are eligible for reimbursement. In order to qualify, providers must review the "Smiles for Life" training module for fluoride varnish and successfully pass the post assessment.

“Smiles for Life” Certification Training (The physician must complete the one-time, one hour, online training to be eligible for reimbursement.):  Smiles for Life: A National Oral Health Curriculum, 3rd edition 

Community Water Fluoridation

The safety and benefits of fluoride are well documented, and for 70 years people in the United States have benefited from drinking water with fluoride. Fluoridated water keeps our teeth strong and reduces decay by approximately 25%. This saves us money and helps us live better, healthier lives. For every dollar spent on community water fluoridation, up to $38 is saved in treatment costs for tooth decay.

In Louisiana only 43% of residents receive the benefits of community water fluoridation, compared to almost 75% nationally.  Does your parish have fluoridated water? Click here to find out! In 2008, Governor Jindal signed Act 761, which mandates that water systems with over 5,000 connections initiate water fluoridation. Learn which water systems are eligible for community water fluoridation here

In 1996, a study conducted in Louisiana found that Medicaid-eligible children who live in communities without fluoridation are three-times more likely to end up in the hospital to undergo dental treatment than Medicaid-eligible children living in fluoridated communities. The cost of dental treatment per Medicaid eligible child residing in a non-fluoridated community was approximately twice as high.

The Oral Health Program is working to increase access to optimally fluoridated water by working with partners and communities throughout the state.

Click here to learn more about Community Water Fluoridation.

Still have questions?

Provider Resources

Dentists, physicians, community leaders, and schools can help create healthy smiles in Louisiana.  Use the resources below to get started.

Dentists

Interested in participating in the Louisiana Dental Loan Program? Find more information here. 

Smiles for Life Bright Futures in Practice: Oral Health—Pocket Guide, 2nd Edition is designed to help health professionals implement specific oral health guidelines during pregnancy and postpartum, infancy, early childhood, middle childhood, and adolescence, and it addresses risk assessment for dental caries, periodontal disease, malocclusion, and injury. Contact the Oral Health Program to receive a guide.

 

Physicians

All medical professionals have steak in creating Healthy Smiles.  Physicians have the ability to do more than educate their patients on proper oral health.  Pediatric physicians, registered nurses, physician assistants, and medical assistants who work with infants and children can apply fluoride varnish to protect children’s teeth even before they have them.  This intervention will assist in paving the way to a beautiful healthy smile for the youth population they serve.

Smiles for Life Bright Futures in Practice: Oral Health—Pocket Guide, 2nd Edition is designed to help health professionals implement specific oral health guidelines during pregnancy and postpartum, infancy, early childhood, middle childhood, and adolescence, and it addresses risk assessment for dental caries, periodontal disease, malocclusion, and injury. Contact the Oral Health Program to receive a guide.

School Staff

Healthy children learn more easily, and it is estimated that 51 million school hours are lost each year to dental-related illness. In addition, an estimated 17 million children in the U.S go without dental care each year. 

The classroom is a wonderful opportunity to teach children about the importance of oral health and staying healthy and active. Below are a number of resources available to help teachers and schools create a curriculum with activities and fun ways to teach children about oral health. 

  • Bright Smiles for Bright Futures BSS Report

  • 2016-2018 Bright Smiles for Bright Futures BSS Schools

    • All schools who have been selected to participate have been notified

      • If you need additional copies of paperwork for your schools screening please use the links below:

        • Department of Education Superintendent Letter of Support -- here

        • Parent Take Home Flyer -- see it here

        • Educational Coloring Sheet – see it here

        • Student Consent Form – see it here

        • School Participation Form – see it here

        • Letter to the Principal – see it here

School nurses can go to Smiles for Life for more resources on oral health and to do online training for continuing education credits. 

Community Leaders

Community Leaders in Water Fluoridation

Assumption Parish WW District 1 | City of Bossier City Water System | Shreveport Water System | City of Lake Charles Water System | Calcasieu Parish WW District No 1 | E. Jefferson WW District 1 | Gretna Waterworks | W. Jefferson WW District 2 | Lafourche Water District 1 | Thibodaux Waterworks | Natchitoches Water System | New Orleans Algiers Water Works | New Orleans Carrollton WW | Belle Chasse Water District | St. Charles Water District 1 East Bank | St. Charles Water District 2 West Bank | Houma Water Treatment Service Area | Schriever Water Treatment Service Area

Oral Health Champion Organization Community Leaders

Community leaders engage themselves in enhancing the oral health of our state through the purposeful work of the statewide Oral Health Coalition.  The Coalition includes both state and local organization who act as Oral Health Champions for the citizens of Louisiana. Check out who they are below!

Daughters of Charity New Orleans
Health Centers in Schools
Just Kids Dental, General & Specialty Dentistry For Kids
Louisiana Dental Association
Louisiana Dental Hygienists’ Association
Louisiana Department of Health
Louisiana Department of Health, Bureau of Primary Care & Rural Health
Louisiana Department of Health, Oral Health Program
Louisiana Independent Pharmacies Association
Louisiana Primary Care Association 
LSU Health Sciences Center, School of Dentistry
LSU Health Sciences Center, School of Pediatrics
Our Lady of the Lake Pediatric Residency Program
Southeast Community Health Systems
University of Louisiana Monroe
232-HELP, INC.

Get Involved!

Would you like to be a part of Louisiana's healthy smiles work? Do you have an invested interest in the oral health of our state? Learn how you can get involved below.  

Fluoridation Advisory Board

The Fluoridation Advisory Board (FAB) was created legislatively through Act 908, of the 1997 Regular Legislative Session with the intent to assisting the Louisiana Department of Health to establish a fluoridation program for the purpose of promoting dental health of LA citizens, especially preventing tooth decay among children.

Members are appointed to serve on the board to support the initiation of Community Water Fluoridation (CWF) by promoting and educating on its invaluable benefits.  The Board is supported administratively by the Oral Health Program (OHP).

The OHP through the FAB identify and fund communities when sources are available to fluoridate. Monitoring and inspections of fluoridated public water systems and ensuring safe delivery of optimally fluoridated water and implementation is ongoing.

The Fluoridation Advisory Board (FAB) last met on June 2, 2017.  This board is comprised of invested Oral Health Champions throughout each region of Louisiana.  This board is the result of two different pieces of legislation that created this state mandated board:

Act 761

Act 312

FAB Agenda & Meeting Minutes

FAB Meeting Agenda June 2, 2017

 FAB Meeting Minutes June 2, 2017

 

Oral Health Coalition

The Louisiana Statewide Oral Health Coalition is a voluntary collaborative made up of individuals and organizations from throughout the state who are dedicated to improving the oral health of all Louisianans. The first major effort of the Coalition was to create a state plan for improving the oral health of Louisiana residents. The state plan is a method to connect these agencies, improve upon their work, establish collaborations, and reach more of the state's population. Furthermore, the Coalition has made a commitment to improve oral health by utilizing evidence-based, best practices that will better use the resources at hand.

Mission: To coordinate the provision of information, resources, and services so that all people of all ages can have excellent oral health.

Vision: A Louisiana where people of all ages have excellent oral health.

How can I contribute? The Coalition is always looking for new methods and ideas for oral health programs. Membership is open to any agency, organization, or individual who demonstrates an interest in oral health for Louisiana. Your membership is desired and valued.

Areas of Focus:

  • Access - Increase access to quality, comprehensive, and continuous oral health services for all Louisiana citizens throughout their life stages.
  • Education - Through the use of linguistically appropriate, culturally competent materials and methods, empower Louisiana citizens to improve their oral health by changing perceptions and increasing awareness of oral health and hygiene practices.
  • Prevention - Improve and maintain oral health, and prevent the progression of oral disease through interventions that address risk factors and at-risk populations.
  • Surveillance and Evaluation - Maintain and expand a statewide oral health surveillance system to monitor the status of oral disease in Louisiana, improve oral health outcomes through implementation of evidence based strategies, and guide policy changes that will improve oral health for all Louisiana citizens.
  • Workforce - Support the efforts to ensure the preparation, recruitment, and retention of an oral health workforce that is adequate and skilled, so that it may better serve the state's population.

 

How can I join? Email LAOralHealthCoalition@LA.GOV

 

Member Organizations

223-HELP/Louisiana 2-1-1
Capital Area Agency on Aging
Children & Family Services, Head Start Program
EatMoveGrow, Inc.
Excelth Inc.
Fluoridation Advisory Board
Governor’s Office of Elderly Affairs
Health Centers in Schools
Just Kids Dental
Kool Smiles
Louisiana Chapter of the American Academy of Pediatrics
Louisiana Dental Association
Louisiana Dental Hygienists Association
Louisiana Department of Education
Louisiana Department of Education – Head Start Collaboration Office
Louisiana Department of Health - Bureau of Chronic Disease and Health Promotions
Louisiana Department of Health - Bureau of Primary Care & Rural Health
Louisiana Department of Health - Medicaid
Louisiana Diabetes Educators Network
Louisiana Primary Care Association
Louisiana School Health Collaborative
LSU Health Sciences Center Pediatrics (Shreveport)
LSU Health Sciences Center School of Dentistry
Office for Citizens with Developmental Disabilities of LDH
Our Lady of Lake Pediatric Residency
Southeast Community Health Systems
Southeast Louisiana Area Health Education Center
University of Louisiana at Monroe, Department of Hygiene

Oral Health Coalition Webinars:

A Provider's Guide to Fluoride Varnish Applications

 

Oral Health Coalition Agendas & Meeting Minutes:

July 2017 Oral Health Coalition Meeting