Title: Actions to Improve Oral Health Outcomes in New Hampshire
Applicant Organization: State of NH, Department of Health and Human Services
Address: 29 Hazen Drive, Concord, NH
Project Director: Whitney Hammond, MSW, Administrator, Chronic Disease Prevention & Screening Section
Phone: 603-271-4959 Email: firstname.lastname@example.org
In New Hampshire, oral diseases remain a devastating problem among a significant percentage of residents, with access to oral health care varying greatly across the state. NH is home to 1.34 million people who reside within 10 counties, the majority of which are rural. Residents of these counties are older, poorer, and less educated than their urbanized counterparts and are less likely to have access to dental providers and services that could help them avoid oral pain, infection and dysfunction, tooth decay, tooth loss, and other oral health problems. As such, New Hampshire is seeking funding for both Component I (Sealants, CWF, and Oral Health Surveillance) and Component II (Medical-Dental Integration).
The proposed initiative for Component I aims to decrease dental caries and oral health disparities by: (1) Increasing the reach of school sealant programs by working with those programs serving eligible schools and promoting adherence to CDC infection prevention guidelines in eligible schools; (2) Promoting quality control and management of fluoridated systems, education on the benefits of CWF, and policy changes to improve and increase the amount of optimally fluoridated water in New Hampshire; and (3) Developing and maintaining the State’s oral health surveillance system and dissemination of findings about the burden of oral diseases and access to preventive services to inform program and policy decisions. The outcomes of the proposal will be: a decrease in dental caries and oral health disparities; an increase in sealant program enrollment in eligible schools; an increase in the proportion of people served by community water systems who receive optimally fluoridated water; and increased dissemination of oral health surveillance data on oral disease, risk factors and use of preventive oral health services.
The proposed initiative for Component II aims to enhance the integration of oral health and medical services for people with diabetes or at-risk for diabetes in New Hampshire. The proposed project will pilot an integration of medical and oral health services in a rural Federally Qualified Health Center (FQHC) and a rural health center which both have dental centers at the same location. Both sites will implement a bi-directional referral system for patients with diabetes or at risk for pre-diabetes. The pilot will be evaluated with a focus on understanding facilitators and barriers to integration, to understand the impact on oral health and diabetes outcomes, and to understand costs related to integrated care. Following the pilot, additional sites would be recruited to participate in integration projects. The project will also support statewide professional education and recognition around integrating oral health and diabetes services. The outcomes of the proposal are: 1) integration of the Oral Health Program with the Diabetes Program within the NH DHHS Chronic Disease Section; integration between oral health providers and primary care providers; 2) increased integration of diabetes clinical support into dental practices; 3) and a long-term decrease in the co-morbid periodontal disease and diabetes.