Last month, Sen. John Hickenlooper (D-CO) questioned dentists on dental hygiene education during a Senate Health Committee hearing.
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NewsTranscript
00:00 Being here, I had the funny experience
00:04 of seeing kind of a full circle.
00:06 52 years ago, I helped a kind of wild, rebellious young man
00:13 named Mark Maselli start a community health
00:14 center in Middletown, Connecticut called the Community
00:17 Health Center, Inc.
00:18 And he started with a single dentist.
00:21 And he had one afternoon a week.
00:22 People could come in and get their teeth
00:25 done from the low-income communities
00:26 around North Main Street in Middletown, Connecticut.
00:29 And then he got two afternoons a week.
00:32 Now he's got 220 locations, I think.
00:37 But they don't have dental care everywhere.
00:39 In other words, that pendulum swang--
00:43 swang?
00:44 Swung.
00:45 Let's stick to dentistry here.
00:47 It's come around full circle so that obviously we're not
00:53 getting the appropriate level of dental hygiene
00:58 to our entire country.
01:01 So Dr. Simon, how can we share best practices
01:04 of what we've seen in health centers
01:06 to improve the integration of dental care with primary care
01:09 and expand access for patients?
01:13 I think we have a model for that, which
01:15 is the many large consolidated health systems that
01:17 provide the bulk of medical care in our country.
01:20 They employ vast numbers of health care providers,
01:23 but very rarely have dental providers as part of that mix.
01:26 Even though they are receiving subsidies
01:29 that are related to oral health care, for example,
01:31 for all of the emergency department visits, where--
01:34 by the way, Senator Cassidy, you can't get a tooth extracted.
01:37 The emergency department can't even do that for you
01:38 for the most part.
01:39 I got a friend that does it, but I'll leave it there.
01:41 That's amazing.
01:42 I wish all EDs had that, but most of them don't.
01:45 So I think we have a lot of work to do of using existing health
01:48 infrastructure in a more efficient way.
01:50 If we could build a clinic in every hospital,
01:52 that's one less location people have to go to
01:55 to get their dental care.
01:56 And they would note that while there are amazing private
01:58 practice physicians like Dr. Isbell,
02:00 the younger generation of dentists
02:01 is more interested and more likely to work
02:03 in different locations.
02:04 And I think a lot of young dentists
02:05 would jump at the chance to work alongside
02:07 their medical colleagues in a setting like that.
02:10 I think you're exactly right.
02:11 And I think it is--
02:12 it should be-- we should have a sense of urgency about this,
02:16 more than what we see.
02:19 And again, Mr. Mosselli was a community organizer,
02:23 is how he got into this.
02:24 But he was constantly bringing together persuasive arguments
02:29 about this.
02:29 And one of the things I remember vividly, 40 years ago at least,
02:34 and Dr. Minner-Jordan, maybe I'll ask you as well,
02:38 they saw and heard alarming stories of kids
02:43 from disadvantaged backgrounds who
02:45 had real self-image problems having
02:46 to do with their dental hygiene and felt
02:50 they didn't want to go to school.
02:52 They didn't feel comfortable in the neighborhood.
02:56 Is there research on that that demonstrates
02:58 how valuable that is?
03:00 There is research.
03:01 And Senator Hickenlooper, thank you
03:03 so much for raising the very real fact
03:06 that there are so many children who go without oral health
03:08 disease prevention.
03:09 And therefore-- and I shared this story in our opening--
03:12 young children, as young as three years old,
03:14 need to be put under anesthesia in order
03:16 to fix some of those cavities that cannot
03:18 be fixed in a dental chair.
03:19 This certainly impacts their ability
03:21 to participate in their education,
03:23 to have self-esteem, and then as they become adults,
03:27 to be able to seek employment.
03:29 And so happy to share additional information
03:31 with your office on this important topic,
03:33 just underscoring the real need for prevention
03:36 and for education.
03:37 Thank you.
03:39 Last question.
03:42 You've talked some-- all of you have
03:44 talked about the dental workforce shortage
03:47 and what that means.
03:48 And I think Colorado's been working very hard to lead
03:51 in this effort to educate the next generation of dental
03:55 hygiene professionals.
03:56 We've got Community College of Denver
03:57 and the Front Range Community College,
03:59 the Colorado Mountain College, Pikes Peak Community College.
04:01 I can go down the list of all these institutions
04:05 that have committed to expand their programs by 2025
04:07 because we're asking them.
04:09 We're reaching out and providing some funding.
04:12 This is going to certainly help expand the workforce capacity,
04:15 especially in diverse and underserved communities.
04:17 But I'd like each of you-- and I can just do this quickly
04:20 because I've only got 38 seconds.
04:23 What else can we do to help foster
04:24 the growth of dental support professional programs,
04:27 like the ones we were talking about in Colorado,
04:30 at more schools, more training programs, more states?
04:35 People have to believe that they can be in this field.
04:37 If they don't see anyone that looks like them
04:39 or they aren't able to visit a dentist themselves,
04:41 then they won't be able to.
04:43 When I was in dental school, I was
04:44 one of the very few people there that didn't
04:46 have a parent who was a dentist.
04:47 If that's the only way you can enter this field,
04:49 we are not going to do a good job of diversifying it.
04:52 I would quickly add, we need to continue
04:54 to remove the siloing between dental oral health
04:57 and medical health and ensure that we're cross-training
05:00 and create the idea of interdisciplinary teams that
05:03 are focused on the patient and their families.
05:05 We need to incentivize people from underserved communities
05:08 to actually go in to get the training who
05:10 are culturally sensitive and return to those communities.
05:13 Exactly.
05:14 We are doing that in Alabama.
05:16 We're trying to develop programs for students
05:18 that are in high school from rural areas.
05:22 It's really hard for this, with social media,
05:25 as Dr. Swann's mentioned, to get students,
05:27 once they've gone to Birmingham or Atlanta or Nashville
05:31 to dental school, they've got student debt.
05:34 To get them to go back, we have probably six counties
05:37 in Alabama that there's some of my guys that are still there,
05:40 but there's not any young dentists there.
05:42 So really get them there.
05:43 Really giving opportunities from the financial base of it,
05:47 of them going to school with contracts,
05:50 understanding they understand what dentistry means
05:52 and why it's so important to the patients,
05:54 because those patients in those areas deserve quality care.
05:57 It's really important.
05:59 And then open access when they're in our hospitals.
06:01 Like, I've served on two hospital staffs for 43 years.
06:04 But guess what?
06:04 All the dental equipment's gone.
06:06 It's dead.
06:06 All my Down syndrome, all my special need,
06:09 all my nursing home patients.
06:11 Guess what?
06:12 There's not an OR that I can go into for those very
06:16 apprehensive, for those very severe.
06:17 I have a daughter that lives in an electric wheelchair that
06:20 has SMA.
06:20 I understand disabilities.
06:22 I understand barriers.
06:23 So we bring stretchers into our office in Gaza and Alabama
06:26 with ambulances, bring them to us
06:28 to take care of those people that deserve care.
06:30 But some of those people, it would be really great
06:32 if we worked across medical borders
06:35 and we had an opportunity to see,
06:37 whether one Friday a month or whatever, to see those patients.
06:41 General dentists are doing that.
06:42 General dentists have done that for 50 years.
06:44 And general dentists can do that in your state and mine.
06:47 But that's not happening anymore.
06:49 But we've got to educate young people
06:51 the importance of high grade of profession.
06:53 Dentistry is a wonderful profession.
06:54 I think everybody--
06:55 I don't want to--
06:57 the chair is going to come down on me.
06:59 I'm already two minutes over.
07:00 But anyway, I think this is one of our best panels.
07:03 OK, good.
07:04 Thanks, Senator.
07:05 Senator Kaine.
07:06 Thanks, Chair Sanders.
07:07 And thanks to the panel.
07:08 Dr. Swann, I want to talk to you about a part of the world