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Give Kids a Smile: "The Need has Never Been Greater
Leaders, volunteers stress importance of GKAS during virtual national kickoff event
It was 20 years ago when a group of dentists gathered in a downtown St. Louis building — one that had been condemned and was ready to be demolished within the following month.
“Boy, don’t we remember that first venue?” said Jeffrey Dalin, D.D.S., Give Kids A Smile St. Louis co-founder. “But we delivered full-service dental care to 325 children.”
It was a story of the first two-day GKAS clinic that ultimately expanded nationally, thanks to the American Dental Association. Dr. Dalin shared that story during the Feb. 4 virtual 2021 GKAS National Kickoff event — a small reminder of how far the program has come, helping more than 6 million underserved kids nationally receive free dental services since 2003.
Due to the COVID-19 pandemic, the GKAS kickoff event, typically a large, in-person affair that includes volunteers providing free dental care to hundreds of children, looked a little different. Nonetheless, the 30-minute virtual event highlighted the program’s mission and importance.
The remarks of leaders, sponsors and volunteers stressed one certain fact: in light of the pandemic, Give Kids A Smile is needed more than ever this year.
In 2021, nearly 1,000 programs, comprised of over 8,100 dentists and approximately 17,000 volunteers, have signed up to provide oral health services to nearly 300,000 children. These programs will be held this year with enhanced safety and infections control protocols in place.
“With the impact of the current pandemic, the need has never been greater,” said ADA President Daniel J. Klemmedson, D.D.S., M.D.
To help ensure programs are safe and effective, the ADA has been able to provide program coordinators with planning resources, webinars, toolkits and donated personal protective equipment it acquired from the national stockpile after meeting with officials from the Federal Emergency Management Agency, the U.S. Department of Health and Human Services and the White House Task Force for COVID-19 response in 2020. With the support of GKAS national sponsors, ColgatePalmolive and Henry Schein, Inc., along with the support of Henry Schein’s supplier partners, the ADA’s GKAS program will once again provide treatment and education product kits for local volunteers to use at their events.
“This year’s program is also the first step in helping families find a dental home where they can receive ongoing care,” Dr. Klemmedson said. “Indeed, it’s something to smile about even in this challenging time.”
Among those participating this year, the Indian Health Service will collaborate with the ADA for the second year to hold events at its clinics across the U.S. Last year, IHS held 113 events across 27 states, providing nearly $700,000 worth of dental services to over 14,000 American Indian and Alaska Native children.
“We want to continue to show the public that our Indian Health Service and providers are committed to providing high quality dental care to American Indians and Alaska Natives,” said Rear Adm. Timothy Ricks, D.M.D., chief dental officer of the U.S. Public Health Service and assistant surgeon general. “We want to continue to raise awareness of the tremendous successes in reducing dental caries in American Indian and Alaska Native children and youth, but also continue to highlight the large disparities in dental disease in this population.”
As an example of how some states’ GKAS programs are responding to the pandemic, in 2021, the New Jersey Dental Association is extending its program throughout the entire month of February, hosting events organized by 1,500 volunteers in over 100 locations comprised of private practices, hospital residency programs, the Rutgers School of Dental Medicine and dental hygiene schools.
“We are very proud of our volunteer members as they include students from the dental school and from hygiene schools, as well as our pre-dental students as they share in the delivery of passionate care to our most vulnerable,” said Cavan M. Brunsden, D.M.D., statewide chair of New Jersey Dental Association GKAS.
In Ohio, more than 400 dentists have participated annually in GKAS events throughout the state to date.
“In 2021, due to the COVID-19 pandemic, many schools are still doing online education,” said David Kimberly, D.D.S., Ohio Dental Association president. “So Give Kids A Smile events may look different this year.”
Dr. Kimberly said that some Ohio events will feature dentists and their teams providing oral health instruction by video conferencing, reminding kids how to brush and floss properly and to eat healthy foods.
“Other direct health care events may be postponed until later in the year as we hopefully get back to more normal school routines this spring and fall,” he added.
The care provided at the Give Kids A Smile events throughout the country would not be possible without its national sponsors, Henry Schein, Inc. and Colgate-Palmolive.
“Our partnership with Give Kids A Smile provides great synergy with our own Bright Smiles Bright Futures program, which has reached over 1.3 billion children globally,” said Barbara Shearer, Ph.D., director of scientific affairs at Colgate-Palmolive Company and chair of the GKAS National Advisory Committee. “We have recently developed a new goal to reach 2 billion children by 2025, and our partnership with Give Kids A Smile will help us achieve this goal. This relationship between the ADA and Colgate is a great example of the power of partnership; however, none of this could be achieved without the volunteer dentists and dental teams. We are so inspired by their willingness to continue to volunteer and help their communities in these unprecedented times.”
AJ Caffentzis, Henry Schein, Inc. president, U.S. dental distribution, echoed Dr. Shearer’s sentiments on volunteers who make Give Kids A Smile possible.
“We are proud to support the thousands of dental professionals who volunteer their time and provide much needed care to underserved children,” Mr. Caffentzis said during the virtual kickoff event. “Good oral health is a key component to overall health. All children, regardless of their circumstances, deserve access to quality dental care and oral health education, and it’s needed now more than ever in light of the pandemic.”
Although GKAS will be celebrated nationally in February during National Children’s Dental Health Month, events take place throughout the year, such as GKAS back-to-school events held in August.
To view a recording of the kick-off event and for more information about GKAS go to ADA.org/gkas.
Kimber Solana ADA News
PRACTICE
ORAL PATHOLOGY PUZZLER: DO YOU SEE WHAT I SEE?
With COVID-19 being a big part of all of our lives (patients and practicioners) for more than a year now, I thought it would well worth it to present and discuss the top oral manifestations that are considered to be a possible result of being infected with the virus. I will focus on those that a dentist may be able to directly assist in remedying. This information comes from news reports, online searches and studies. Without getting into the specifics of the research, nor the debates, my purpose to just to present the top oral manifestations linked to SARS-CoV-2 and oral disease. I do this in hopes of helping you treat a patient (or patients) that may present to your office with symptoms and a correlation with a past or recent infection with COVID-19:
1. Gingival Inflammation: Current research (nationwide and here at the University of Utah School of Dentistry) is examining, and providing supporting evidence for, a link between periodontal disease and COVID-19 severity. Currently, it is estimated that patients with periodontitis are at least three times more likely to experience COVID-19 complications (death, ICU admission, ventilation, etc). I would encourage you to read the recent press release by the American Academy of Periodontology (https://www.perio.org/periodontitis_ COVID-19_complications). Periodontal disease can increase levels of circulating cytokines (i.e. IL-6, interleukin 6), which can lead to a cytokine storm(1). It is being reported in many studies that patients with periodontitis have an increased risk of exhibiting COVID related adverse outcomes. Taking this into consideration, you may consider strongly recommending routine periodontal and oral hygiene care during the current COVID pandemic.
2. Xerostomia: The most common reason for this being a symptom is due to wearing a mask (open mouth breathing). Studies also suggest that the virus can enter and reside in the salivary glands, leading to
decreased function (2). We all know that polypharmacy is a major reason our patients present with dry mouth. Just remember that when a patient has xerostomia, they have an increased risk for dental caries and yeast (candidal) infections. Anything we can do as providers to encourage the use of OTC dry mouth products, prescriptions when appropriate, supplement with fluoride, etc., can only be a benefit to our patients.
3. Aphthous-like ulcerations (moveable and attached mucosa): Case reports are out there which demonstrate
COVID-19 positive patients getting oral ulcerations as result of the SARS-CoV-2 virus. It is presumed that the virus causes damage to blood vessels, leading to tissue necrosis/breakdown. Stress and anxiety over the pandemic or other changes in life can lead to this as well. These same factors leading to recurrent herpes simplex also have to be considered. As I consult with Oral & Maxillofacial
Pathology colleagues across the country, this particular oral manifestation seems prominent. In my clinical practice, I use dexamethasone elixir 0.5mg/5mL, dispense 240 mL, instruct the patient to hold 1-2 teaspoons in the affected area for 5 minutes after meals (TID) and expectorate. It can greatly reduce symptoms and speed up the healing process.
Dr Bryan Trump, University of Utah
Works Cited Vaibhav Sahni, Shipra Gupta, COVID-19 & Periodontitis: The cytokine connection, Medical Hypotheses, Volume 144, 2020, 109908, ISSN 0306-9877, https://doi.org/10.1016/j. mehy.2020.109908. Xu J, Li Y, Gan F, Du Y, Yao Y. Salivary Glands: Potential Reservoirs for COVID-19 Asymptomatic Infection. Journal of Dental Research. 2020;99(8):989-989. doi:10.1177/0022034520918518 Petrescu N, Lucaciu O, Roman, A. Oral mucosa lesions in COVID-19. Oral Diseases. 2020.
https://doi.org/10.1111/odi.13499
SPEND YOUR TIME EXAMINING YOUR CLIENT’S TEETH, NOT YOUR COVERAGE.
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HPI POLL: DENTISTS SEE INCREASED PREVALENCE OF STRESS-RELATED ORAL HEALTH CONDITIONS
Monthly survey finds patient volume estimated at 81% of pre-pandemic levels
The vast majority of dentists indicate that the prevalence of stress-related oral health conditions among their respective patients have increased since the onset of the COVID-19 pandemic, according to the ADA Health Policy Institute’s latest data from its COVID-19 economic impact tracking poll conducted the week of Feb. 15.
More than 70% of dentists surveyed saw an increase of patients experiencing teeth grinding and clenching, conditions often associated with stress — up from just under 60% in the fall. More specifically, 71% of dentists surveyed reported an increase in prevalence of teeth grinding and clenching; 63% for chipped teeth; 63% for cracked teeth; and 62% for temporomandibular joint disorder symptoms, which includes headaches and jaw pain.
“Our polling has served as a barometer for pandemic stress affecting patients and communities seen through the eyes of dentists,” said Marko Vujicic, Ph.D., chief economist and vice president of the ADA Health Policy Institute. “The increase over time suggests stress-related conditions have become substantially more prevalent since the onset of COVID-19.”
Other findings from the Feb. 15 poll covered issues related to recovery and renewal, financial sustainability and consumer sentiment. It found that: • Patient volume was estimated at 81% of pre-
COVID-19 levels on average. Staffing in dental offices was at 99% of pre-COVID-19 levels. HPI expects a slight increase in patient flow in the coming months. • Over the past month, the most common measure taken by dentists to maintain financial sustainability was raising fees. Others responded to the financial challenges of practice ownership by taking out loans, reducing their dental team hours and changing suppliers. Dentists in large group practices have had to take fewer measures to maintain financial sustainability compared to those practicing solo. • More than a third of dentists are practicing some form of teledentistry, most commonly to triage emergencies, do post-ops and follow-up care and for consults. • Approximately 10% of dentists who were enrolled as
Medicaid providers prior to the COVID-19 pandemic have since disenrolled. • Consumer confidence in returning to the dental office hit a new high, with 90% reporting to have already been back or are ready to go.
In addition, despite speculation from recent news reports that frequent mask-wearing may impact dental health and cause
“mask mouth,” the survey found no meaningful change in the prevalence reported for conditions such as bad breath and dry mouth compared to pre-pandemic.
HPI launched its COVID-19 economic impact tracking poll on March 23, 2020. Dentists were asked to join to a panel in which they complete the now-monthly poll. In this latest wave, a nationally representative sample of approximately 2,500 dentists responded. Webinars on previous data are available on the ADA YouTube channel.
Links to reports and the interactive data dashboard are available at ADA.org/HPI.
Kimber Solana ADA News
PRACTICE
We never find success exclusively on our own, especially in dentistry. We have the fortune of many different support systems that guide us through the professional ebbs and flows of our careers. Early on in practice, it is important to be mindful of the learning opportunities and resources right at our fingertips on a daily basis. The sweat and the stress, the successes and the failures, and the ups and downs. They are all requisites and rights of passage to professional growth. The most obvious knowledge pools may be our owner dentists or CE course instructors or clinical publications. However, there are other simple, effective ways to grow as a clinician beyond solely continuing education and to cultivate or seek out the right practice environment for you. Embrace your resources; you’ve got more help than you know.
Tap into the Knowledge of Your Current Team
Arrive at your practice with open ears, open eyes, and an open mind. I have worked with assistants who have decades of experience in the field, compared to my three years of practice. They are incredible resources for clinical tips and tricks, patient management skills, and treatment plan communication strategies. They have assisted on countless procedure with a variety of doctors, and you can guarantee that they have identified the pearls with all of them. I find assistants to be a wealth of knowledge. When I am struggling with a procedure, my assistant may hand me an unprompted instrument or write me a note on the cassette wrapping for a reason. And guess what? It works. I have never been shy about asking my experienced assistants for feedback after a patient encounter. What did they think worked well? What did they think I could do differently? What did they notice about the patient that I did not? I have also learned an incredible amount from my patient care coordinators regarding scheduling, behavior management, and understanding patient patterns and tendencies.
Form a Study Group with Your Local Peers
Your local general dentists and specialists are exceptional resources, and I would encourage new dentists to form “study groups” with a diverse group of professionals in your area. With those practitioners, you can share case challenges in a judgment-free, supportive, casual environment. Arrange meetings at a frequency that works for your schedules. In a Zoom-oriented world currently, your study groups do not even need to be facilitated in person. The goal of reaching out to other practitioners is to generate a discussion regarding each of your clinical questions and needs. Dentistry is not an individual sport; we need other perspectives and voices in order to become a well-rounded provider as we gain experience. Additionally, you may even strengthen your referral network through assembling a study group.
Investigate the ADA Practice Transitions (ADAPT) Program
Everyone’s career trajectories move at different rates and in different directions. At a certain point, you may decide that you want to eventually buy your own practice or seek out a work environment that aligns with your practice philosophies and values. This is where the ADAPT Program can help you. ADAPT successfully passed its pilot stages and has recently launched in all fifty states. It “makes the process of buying, selling, or joining a dental practice more predictable and successful. However, ADAPT isn’t just another listing service. Instead, it connects dentists who share a similar practice approach – which leads to more successful transitions and careers.” According to the ADA ADAPT program website. You can create a profile and be connected by an ADA Advisor that keeps your philosophies and values at the heart of matches with other practice opportunities. This is a modern, up and coming benefit to new dentists that are members of the ADA. The volume of participants and its network will begin to thrive with its official launch, and it is a great resource to explore where your next steps may lead you in associateships or transitional practice ownership. To learn more about ADAPT visit http:// ada.org/en/member-center/member-benefits/practice-resources/ ada-practice-transitions. Or you can reach out to the program directly with inquiries at ADAPT@ada.org.
Dr Tyler Fix
