The State of Nevada Department of Health and Human Services (DHHS), Division of Health Care Financing and Policy is applying for the CDC State Promotion of strategies to advance oral health. - Nevada is the 7th largest state in the nation by area and is comprised of 16 counties and one independent city. With just two urban centers – one in Washoe County (Reno) and one in the Clark County (Las Vegas), most of the state is rural/frontier, and all residents statewide live in a Dental Health Professional Shortage Area (DHPSA). While Nevada has seen some improvements in oral health during the last few years, the state continues to experience an oral health crisis. For example, 62% of 3rd graders do not have dental sealants and 75% of elementary/middle schools do not have an evidence-based prevention (sealant/fluoride varnish) program, 33% of low-income 3rd graders have untreated tooth decay and 66% have experienced decay, just one of 16 counties is receiving the health and economic benefits of fluoridation, and Medicaid only covers emergency care for most residents 21 years of age and older. While the Nevada oral health program has limited state resources, its recent history of accomplishments and commitment to oral health position it to be a catalyst and facilitator for better oral health for its residents. The Nevada oral health program will use the first year of funding and technical expertise from the CDC Oral Health Division to concentrate on building a sound and sustainable oral health surveillance system to identify and address disparities with a focus on social determinants of (oral) health/wellness. In addition, secondary data will be used to educate and promote oral health statewide with a focus on evidence-based programs and education. Priorities for the first year include: 1. Building infrastructure with experienced, qualified personnel and consultants who will enhance the oral health program’s capacity to promote oral disease prevention and evaluate the effectiveness of programs and activities; 2. Enhancing the established oral health surveillance system and data dashboard, which will identify oral health disparities and their relationship with other chronic diseases including diabetes; 3. Educating and promoting oral health among policy makers, the public health community, dental leaders, stakeholders, and the public with the intent of increasing access to care among under resourced rural/frontier communities and underserved such as the intellectually and developmentally disabled residents. 4. Promotion and expansion of effective evidence-based prevention dental services (EBPDS) including school sealant and fluoride varnish programs and community water fluoridation for prioritized/vulnerable populations and communities based on burden of disease as well as location; 5. Supporting infection prevention and control with education and trainings among dental professionals statewide, initially targeting school-based EBPDS (sealant/fluoride varnish) programs. Methodology: All recipient activities will be accomplished following the objectives and process measures outlined in the work plan. Evaluation will be conducted in partnership with the University of Nevada, Reno, School of Public Health. In addition, the oral health program will collaborate with other state agencies and institutions as well as oral health stakeholders, and residents to share diverse resources effectively and efficiently to equitably address oral health disparities. In subsequent funded years, the oral health program will work to enhance collaborations with other CDC funded chronic disease programs to facilitate integration of oral health into primary care. In addition, community-based prevention programs and access for prioritized vulnerable populations will be supported and increased so all Nevada residents, and especially those at greatest risk for oral health disparities, will achieve their optimal lifespan with the best possible quality of health in every stage of life.
