April 2018
Volume 14, Issue 4

Leaving a Lasting Mark

How dentistry's philanthropic efforts are improving communities

Amanda Harvey

Oral healthcare professionals are blessed with prosperity and possess the generosity of spirit to give back. This month, Inside Dentistry takes a look at the philanthropic efforts that are helping to deliver critical oral healthcare both locally and nationally, some of the principal players who are paying it forward, and opportunities to get involved-from health foundations to health fairs.

Many dental professionals already participate in dental philanthropy programs, but meeting the needs of underserved patients is an ongoing effort. This philanthropic culture within the dental profession promotes positive change and fosters a sense of community that helps to better serve those less fortunate, especially pediatric and elderly patients. Although other demographics are in need of oral health intervention and several non-profit organizations are dedicated to helping these groups, children and elderly adults are the most frequently underserved.

Young Teeth Experience Big Problems

Dental caries is the most common chronic illness among school-age children in the United States. According to a report from the Henry J. Kaiser Family Foundation, more than 40% of US children aged 2 to 11 have dental caries in their baby teeth, and many of them go untreated.1 This was the case for 12-year-old Deamonte Driver, who died in 2012 from complications associated with an abscessed tooth in which bacteria traveled to his brain.2Unable to afford dental insurance, his mother tried to find a provider who accepted Medicaid to treat him, but ultimately, he was hospitalized and underwent two brain surgeries that failed to save his life.

"With limited or no access to oral healthcare, children from low-income households and some minority groups have a much higher rate of tooth decay. These children are at significant risk for impaired cognitive and social development, educational disparities, and a lifetime of shame associated with dental disease. Youth living in rural communities and dental health professional shortage areas face difficulty in accessing even the most basic dental services. Children with special needs also face significant barriers to care. Many dental offices are not equipped to provide care to patients with developmental or intellectual disabilities due to the cost of care, lack of specialized training, inaccessibility for children in wheelchairs or with physical limitations, and other barriers. It is not uncommon for nonverbal children and adolescents to have significant and painful tooth decay that goes undiagnosed for far too long," explains Jill Malmgren, executive director of America's ToothFairy: National Children's Oral Health Foundation.

Older Teeth and Quality of Life

Regarding the elderly population, Beth Truett, president and CEO of Oral Health America, notes that "there are approximately 250,000 people retiring each month between February 2011 and 2029, and only 9.8% of people who retire do so with a dental benefit."

Although there is a portion of the population who can afford Medicare Advantage or private dental insurance and some who can still work into their earlier senior years to obtain dental insurance via an employer, as this population gets older, a fixed income may prevent them from affording insurance and working to obtain insurance may no longer be possible.

"The needs of an 85-year-old are more acute than those of a 65-year-old, so in the absence of insurance or Medicare Part B to cover dental care, you are looking at a situation that is not only impacting people's teeth and oral tissues, but also their ability to eat and thus, their ability to remain independent," adds Truett.

The Need for Philanthropy

Oral health extends beyond the oral cavity through the oral-systemic link to affect total health. Providing oral healthcare to patients who do not have the means to obtain it promotes their overall health and quality of life and possibly extends their lives. The oral health community should consider that six of the seven leading causes of death in the United States are chronic diseases that have been associated with oral health conditions, including heart disease, lower respiratory disease, stroke, and Alzheimer's disease.3

"Oral health is the gateway to overall health; however, it is sometimes overlooked due to economic, societal, or other factors. Dental philanthropic efforts bridge the gaps in oral healthcare and education for people who otherwise may not receive it," comments William Calnon, DDS, president of the ADA Foundation's board of directors.

In addition to the lifesaving benefits of dental philanthropy, it also feels good to give back to your patients. "I think dental philanthropy is an extremely important commitment for all of us in this profession and something that I see a lot of people do willingly," says Cherilyn Sheets, DDS, the founder of Children's Dental Center and a private practitioner in Newport Beach, California. "When you do something like that, the joy that you receive back is way more than the effort you put into it. That is the unspoken reward. People involved in dental philanthropy see that what they're doing touches lives and recognizing that touches their lives."

Yet another benefit is staff engagement. Giving back to the community doesn't have to revolve solely around the dentist-it can include the entire team. "Engaging the entire dental team in philanthropic causes can increase staff morale and help with team building. For example, dental teams can host fundraisers in support of a charity. In addition to giving back, coordinating such efforts can often provide leadership roles for members of the dental team," notes Lisa Fitch, CAE, director of the American Academy of Cosmetic Dentistry Charitable Foundation.

Getting Involved

National Programs

There are many local and national campaigns currently in operation in the United States, and they serve a variety of demographics and communities (See "Start Your Search Here"). For example, the ADA Foundation provides more than $2 million in annual support to dental professionals, dental students, and community volunteers for various philanthropic programs. This includes the ADA Foundation's flagship Give Kids A Smile oral health program, through which 5.5 million underserved children have received free oral health services from more than a half million volunteers over the last 13 years.4

According to Calnon, the ADA Foundation fortifies the efforts of partnering professionals and organizations with patients and each other to serve as a catalyst for better oral health outcomes. In 2017, it provided 187 organizations and individuals across the United States with grants, awards, and scholarships. "Dentists can give back to their communities in myriad ways, including a wide range of volunteer activities at the local, state, national, and international levels. This year, through the ADA Foundation's Give Kids A Smile program alone, more than 30,000 volunteers, including more than 6,600 dentists, have already committed to providing oral health services to kids in need. It's amazing," adds Calnon.

The Dental Trade Alliance Foundation is another national organization with a mission to make others aware of oral health's impact on overall health and help those in need gain access to oral healthcare, achieving a measurable impact and facilitating real change.

"A large portion of the population has no dental reimbursement coverage to help them pay for the cost of dental care, and those with the fewest financial resources tend to be the ones with the most dental disease. Without philanthropy from dental companies, dentists, and others, these patients would not receive the critical care that they need. The members of the Dental Trade Alliance participate in programs across the country. Their contributions of money, supplies, and time are essential to the success of these programs, such as the Mission of Mercy," says Gary W. Price, president and CEO of the Dental Trade Alliance.

Another charitable organization serving a different demographic of patients is the American Academy of Cosmetic Dentistry Charitable Foundation, which provides cosmetic dental services and support programs to adults who have suffered dental injuries as a result of domestic and sexual violence. The foundation launched the Give Back a Smile program in May 1999 and with the efforts of American Academy of Cosmetic Dentistry member dentists, laboratories, and other dental professional volunteers, has since restored the smiles of more than 1,700 survivors of domestic and sexual violence.

"Dental professionals have unique skills that can make an impact not only on someone's smile, but also on his or her overall well-being. Professional membership associations like the American Academy of Cosmetic Dentistry offer life-changing opportunities for dental professionals to give back. To effectively carry out their missions, charities need both financial support and donations of time. Philanthropic involvement can also serve to differentiate your dental practice by creating local awareness through cause marketing," adds Fitch.

The American Academy of Pediatric Dentistry's charitable foundation, Healthy Smiles, Healthy Children, funds community-based initiatives for pediatric and other dental professionals to treat underserved pediatric patients. They also provide dental homes to children where they can receive consistent dental care. Two years ago, the foundation did a study on members and their interests and found that 80% of pediatric dentists provide pro bono care every year. Of these providers, each delivered an average of more than 50 hours annually. This included only domestic pro bono work and did not take into consideration the volunteers who travel for mission trips to underserved countries, according to Paul Amundsen, MNA, CFRE, vice president for development and charitable programs at Healthy Smiles, Healthy Children.

"We really zero in on dental homes for all kids, and that manifests itself in our focus on offering and supporting community-based initiatives that provide care for underserved children. We are really fortunate because 12% to 14% of our members gift at least annually and 30% of our members gifted at least one time during the last 4 years. They are very generous with their time and financial support," notes Amundsen. "While you support your national and local organizations, we also suggest letting your national organization know about what you are doing locally. Healthy Smiles, Healthy Children has the resources to fund programs that are providing care to children, but sometimes we are not aware of them. That may be a common thread among a lot of national organizations. Our criteria permit us to support any program that provides dental homes to children that is dentist-led."

Private, Nonprofit Organizations

There are very few private, nonprofit organizations that focus on oral health across the lifespan. One such organization, Oral Health America, has two primary programs and a Campaign for Oral Health Equity. These initiatives support its mission to change lives by connecting communities with resources to drive access to care, increase health literacy, and advocate for policies that improve overall health through better oral health for all Americans, especially those who are most vulnerable.5

Oral Health America's oldest program, Smiles Across America®, focuses on children aged 24 months to 18 years. "The school-based oral health work that we do is in the area of prevention. We have 377 partners across the United States. Although some of them also receive grant funding, all of them receive products, technical assistance, education through our free CE webinar series, and the ability to lower operating costs through donated sealants and fluoride varnish. Our goal is to prevent caries among the youngest cohorts of 24 to 49 months and to arrest caries and improve learning and long-term health among school-age kids," comments Truett.

The second program, the Wisdom Tooth Project®, focuses on older adults. Toothwisdom.org provides information to help older patients in every state find low-cost dental services. It also engages the dental community by offering practical information on dental related topics to help answer patients' questions and alleviate their fears. The website served as a starting point for this program, but "now we're also engaging older adults who are ‘aging in place.' Oral Health America just completed a 3-year pilot of a course called Tooth Wisdom: Get Smart About Your Mouth. This course is designed to be taught in senior centers, churches, synagogues, and any other place where older adult consumers naturally gather," adds Truett. "It achieves some of the same goals that Smiles Across America does in schools in that it works toward helping older adults understand that prevention is appropriate at every age and that there are times when you can do things for yourself and there are times when you really need to seek professional care."

The Campaign for Oral Health Equity revolves around communication via social media, other online sources, and public affairs to educate people about the importance of oral health in overall health and take part in legislative issues impacting oral health policies.

Another program to consider is Kids Smiles, which provides underserved children with preventive and restorative oral healthcare and health education programs. For example, in honor of National Children's Dental Health Month in February, Kids Smiles launched a local Grin & Share It campaign to raise funds to provide free oral healthcare to children with limited or no insurance. Kids Smiles also supports Give Kids a Smile Day, a program initially launched by the ADA that brings national attention to the importance of pediatric oral health and promotes the need for volunteerism to help underserved pediatric patients.

"Whether in urban, rural, or suburban areas, millions of children and adults throughout the United States are unable to access dental care each year. There are many ways with varying levels of commitment that dental professionals can help address this need by donating their time, talent, or financial resources. The challenges that people face in accessing dental care can be varied and complex. Diversity in ideas, expertise, and resources is essential to building effective and sustainable programs that help individuals overcome those challenges and receive the oral healthcare they need and deserve," says Beth Young, development director at Kids Smiles.

Formed in 2006, America's ToothFairy: National Children's Oral Health Foundation serves the community as a resource provider that supports nonprofit partners who deliver education, prevention, and treatment to underserved children. Their programs focus on increasing access to oral healthcare and education with an emphasis on disease prevention.

"We collaborate with a wide range of other nonprofit organizations, coalitions, and community stakeholders in oral health and other areas (eg, nutrition, education, etc.) at the community, regional, state, and national levels. America's ToothFairy supports efforts focused on improving children's oral health and participates in initiatives promoting disease prevention, oral health and its link to overall systemic health, advocacy, interprofessional engagement, school-based oral health programs, access to safe drinking water (as an alternative to sugar-sweetened beverages), the fluorination of water, improved access to care, and services for children with special needs," notes Malmgren.

Dental Service Organization Activism

When it comes to access to dental care, US veterans are another often underserved demographic because they may not be eligible for dental benefits through the US Department of Veterans Affairs unless they are 100% disabled, have a service-related mouth injury, or were a prisoner of war.

To help support and empower those who have served, dentists and team members from Aspen Dental practices donate their time and skills to serve veterans each year through the Healthy Mouth Movement. For example, Aspen supports local communities through the MouthMobile, a traveling dentist's office on wheels with two operatories and digital x-ray equipment that provides free care to veterans who cannot access oral healthcare in their communities. In 2017, the MouthMobile provided care to patients in 29 communities across the country.

In addition, once per year, hundreds of Aspen Dental practices across the United States open exclusively to veterans and provide dental care at no cost. In 2017, over 4,500 veterans received services on that one day alone. This year's day of service is scheduled for June 9, 2018.

"Since 2014, through the Healthy Mouth Movement, approximately 10,000 dentists and their teams from Aspen Dental practices across the country have volunteered their time and donated over $10 million in dentistry to over 17,000 veterans and people in need. This is all part of our mission to break down the barriers to better care, better smiles, and better lives," says Anita Imadomwanyi, DDS, director of clinical support and charitable giving at Aspen Dental. "At each MouthMobile stop and during our day of service, our goal is to relieve patients' pain, make them aware of what other dental needs they have, and connect them to free or low-cost resources so they can continue to address their dental care needs long-term."

The Pacific Dental Services® Foundation, a 501(c)(3) charitable organization, provides support and advocacy to help patients overcome financial and geographical barriers preventing access to dental treatment. One of their core focus areas is training dental professionals to provide care for the special needs community. The foundation collaborates with leaders in the special needs community, including those from Autism Speaks, A.T. Still University, the American Academy of Developmental Medicine and Dentistry, and the Special Olympics. Staffed by clinician volunteers, the foundation's Mobile Dental Clinic serves individuals in challenged urban areas and rural communities.

"At Pacific Dental Services, we are passionate about providing access to oral healthcare services. Through Smile Generation® Serve Day, our annual day of service, our team members have served approximately 12,500 patients with a collective $20 million in donated dentistry over the past seven years," comments Stephen E. Thorne IV, founder and CEO of Pacific Dental Services. To facilitate the day, dental offices supported by Pacific Dental Services partner with local nonprofit organizations, including Special Olympics New Mexico, Veterans of America in Arizona, the Salvation Army in California, and the Las Vegas Rescue Mission.

Dentists Who Give Back

Cherilyn Sheets, DDS, not only founded the Children's Dental Center 20 years ago but she also continues to give back to her community at the local and national levels through her involvement with America's ToothFairy.

"Dental philanthropy is something that is needed now and will always be needed in the future because there will always be groups of patients who have needs that are not handled by social programs. To be able to have people identify those needs and have a desire to do something about it is part of what makes this country so great," notes Sheets. "All of us have three things that we can donate. We can donate our time, we can donate our treasure, and we can donate our talent. In both of the organizations that I've been so closely involved with, we have received wonderful contributions of time, treasure, and talent from dentists, specialists, dental hygienists, dental assistants, laboratory technicians, and people who have worked in administrative roles in dental offices or corporations."

Chad C. Duplantis, DDS, FAGD, owns a private practice in Fort Worth, Texas and has participated in dental philanthropic efforts for many years, including the Save a Smile and Christina's Smile dental programs, which provide dental care for underprivileged children.

"Both of these programs are based upon in-school screenings. They focus on childhood dental disease prevention and care, and we treat children from these programs each year, both in our office and in mobile dental clinics," says Duplantis.

He also participates in local programs, including one that was started by his church last year in which a clinic was built in an underprivileged neighborhood to treat (mainly) adults with no access to dental care. Although this clinic is still in an early stage, it is a growing effort.

"Dentists need to realize that there is a need. Once we realize that there is a need, we need to realize that we have a talent that is unique. We can get people out of pain, and we can change lives through this talent. Word of mouth is a great way to find out what local campaigns are available. I've discovered that you won't have to ask too many people to find a place to plug into," adds Duplantis.

It All Comes Down to This

The title "dentist" is consistently listed on a variety of media outlets' best jobs lists, and in 2017, it even snagged the No. 44 spot on the CNNMoney list and the No. 1 spot on the U.S. News & World Report list.6,7 Although the educational demands involved in becoming a dentist are grueling and expensive, this career choice is rewarded with a comfortable salary and excellent growth potential, which puts dentists in a unique position to give back to their communities and feel good about helping patients.

"The most important message is that every single person at every skill level can make a contribution to help others, and I would really encourage all dental professionals to do so, both for the people they're helping and also for themselves," concludes Sheets.

References

1. Children and Oral Health: Assessing Needs, Coverage, and Access. The Henry J. Kaiser Family Foundation. https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7681-04.pdf. Published June 2012. Accessed February 19, 2018.

2. Gavett G. Tragic Results When Dental Care Is Out Of Reach. Frontline. WHYY/PBS. https://www.pbs.org/wgbh/frontline/article/tragic-results-when-dental-care-
is-out-of-reach/. Published June 26, 2012. Accessed February 19, 2018.

3. Toop J, Sorci R. The oral-systemic link: monsters in your mouth. Inside Dentistry.2015;
11(10):80-83.

4. Helping Children Through Give Kids A Smile. American Dental Association. https://www.ada.org/en/public-programs/give-kids-a-smile. Accessed February 19, 2018.

5. About Oral Health America. Oral Health America. https://oralhealthamerica.org/about/. Accessed February 19, 2018.

6. Braverman B. Best Jobs in America. CNNMoney.http://money.cnn.com/gallery/pf/2017/01/05/best-jobs-2017/44.html. Updated May 9, 2017. Accessed February 19, 2018.

7. Dentist Overview. U.S. News & World Report. https://money.usnews.com/careers/best-jobs/dentist. Accessed February 19, 2018.

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