2020
- 100 Million Mouths Campaign launched
Background
The 100 Million Mouths Campaign (100MMC), a national initiative by the Center for Integration of Primary Care and Oral Health, a collaboration between the Harvard School of Dental Medicine and the University of Massachusetts Chan Medical School, was launched in 2020. The campaign aims to bridge the gap between oral health care and primary care by training 50 oral health education champions—one in each state—to integrate oral health into the curricula of health profession schools.
The campaign was developed in response to the fact that over 100 million Americans each year do not see a dentist but are likely to see a primary care health professional. By equipping primary care health professionals with oral health knowledge, the initiative seeks to improve access to oral health care, especially in underserved communities.
Initially funded by the Health Resources and Services Administration, the campaign is supported by the Arcora Foundation, the CareQuest Institute for Oral Health, Colgate-Palmolive, and various Delta Dental foundations.
Impact
Since its inception, 100MMC has trained oral health education champions in 26 states. These champions represent a diverse range of health professionals, such as dental hygienists, nurse practitioners, pediatricians, and physician assistants.
Champions work with medical, nursing, and residency programs to integrate oral health into the curricula of health profession schools. They collaborate with local experts, including those working in health departments and state oral health programs, to ensure that the curricula address their communities’ needs.
The campaign has made significant strides toward enhancing oral health education. By 2024, over 9,000 health professionals had been trained to provide oral health care, with more than 2,000 trained in the application of fluoride varnish. Oral health champions’ involvement has led to increased teaching hours and improved oral health competencies among primary care training program graduates. By targeting states with significant barriers to accessing oral health care and working with vulnerable populations, the campaign addresses health disparities. In addition, it fosters partnerships between oral health professionals and primary care health professionals, resulting in improved interprofessional collaboration and coordination of care.
Sources
Gray S. 2022. 100 million mouths, other initiatives putting oral health at the forefront of primary care. UMass Chan Medical School News [e-newsletter].
Harvard School of Dental Medicine. No date. 100 Million Mouths Campaign [webpage].
Ticku S, Savageau JA, Riedy CA, Harvan RA, Silk H. 2023. 100 million mouths campaign: Creating a pilot to advance oral health equity. The Annals of Family Medicine 21(Supplement 2):S86–S91.
- COVID-19 Pandemic and Oral Health in the United States begins
Background
In December 2019, cases of a pneumonia-like illness were reported in Wuhan, China. The causative agent was identified as a novel coronavirus, later named SARS-CoV-2. SARS-CoV-2 led to the disease known as COVID-19. The virus primarily spreads through respiratory droplets and aerosols, making it highly contagious.
On March 11, 2020, the World Health Organization designated the global spread of COVID-19 as a pandemic. On January 27, 2020, the Secretary of Health and Human Services, Alex M. Azar II, declared a public health emergency under Section 319 of the Public Health Service Act.
In March 2020, the Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) recommended that dental practices postpone all elective oral health care and provide emergency-only care to mitigate the spread of the virus and conserve personal protective equipment. These measures remained in place until CDC and ADA provided updated guidelines for the safe resumption of routine oral health care.
The pandemic prompted widespread implementation of public health measures, including lockdowns, travel restrictions, and social distancing, to mitigate virus transmission. Health care systems worldwide faced unprecedented challenges, leading to the postponement of elective procedures and a shift toward telehealth services.
Impact
Dental public health experienced significant disruptions during the COVID-19 pandemic:
- Suspension of routine oral health care: To reduce virus transmission, many dental offices limited care to emergency care, postponing routine check-ups and elective procedures. This led to a decrease in dental visits and in the provision of preventive oral health care and ultimately led to an increase in untreated oral diseases.
- Closure of school-based dental programs: School-based dental programs, which often serve as the primary source of preventive care for families with low incomes, were suspended due to school closures. Consequently, many children did not receive essential care, such as application of dental sealants, which increased their risk for tooth decay and other oral health issues.
- Increase in oral health disparities: Populations facing existing barriers to accessing oral health care, including people from racial and ethnic minority groups and from families with low incomes, experienced heightened challenges to accessing oral health care during the pandemic. Exacerbating factors included loss of employment and dental insurance, reduced availability of Medicaid-covered dental services, and limited access to oral health professionals who accept Medicaid.
- Adoption of teledentistry: The necessity for remote oral health care led to increased use of teledentistry, allowing for virtual consultations and triage, which helped maintain patient engagement while minimizing exposure risks.
- Strain on oral health workforce: The oral health workforce faced significant disruptions. Many dental hygienists left the profession during the pandemic, with some choosing not to return. As of August 2021, about 4.9 percent of dental hygienists who had been employed in March 2020 were no longer working in the field. This reduction stressed dental practices, particularly as patient volumes began to rebound.
Sources
Brian Z, Weintraub JA. 2020. Oral health and COVID-19: Increasing the need for prevention and access. Preventing Chronic Disease 17:E82.
Krans AM, Chen A, Gahlon G, Stein BD. 2021. 2020 trends in dental office visits during the COVID–19 pandemic. Journal of the American Dental Association 152(7):535–541.e1.
Rappe J, Hoeft E. 2022. Research Reveals Impact of COVID–19 on Dental Hygienists [webpage].
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