Understanding oral health disparities and the link to overall health
As part of our ongoing discussion series, Under the Same Sky, Abner Mason, founder and CEO of SameSky Health, met with Myechia Minter-Jordan (MD, MBA), president and CEO, and Kaz Rafia (DDS, MBA, MPH), chief health equity officer of CareQuest Institute for Oral Health. This conversation focused on the connection between oral health, behavioral health, and overall health, and the impact of oral health disparities. As a physician and dentist respectively, Dr. Minter-Jordan and Dr. Rafia brought their unique perspectives and understanding of this complex subject, and discussed how health equity plays a part. View the recording.
The mission of the CareQuest Institute for Oral Health is to improve oral health for all by creating a system that is accessible, integrated, and equitable. Dr. Minter-Jordan stated that we need to be pushing forward the notion that oral health is healthcare for patients and families to get the outcomes that they deserve.
“[Oral health] is a really important part of healthcare that doesn’t get enough attention. We need to do a better job of highlighting the importance of oral health…It’s often a missed opportunity to improve health more generally.””
But why is oral health so important to overall health? Dr. Minter-Jordan explained that we know there is a correlation between diabetes and oral health, cardiovascular disease is related to poor oral health, and periodontal treatment during pregnancy is linked to a lower risk of perinatal mortality, preterm birth, and low birthweight babies. In fact, 60-75% of pregnant people experience oral health issues that raise the likelihood of poor birth outcomes and major complications. According to CareQuest, poor oral health increases the risk of diabetes, high blood pressure, obesity, dementia, mental health, and adverse birth outcomes. When you think about how that plays out in society, like people having to miss school and work because of poor oral health, and then layer on additional inequities, you begin to see how oral health leads to societal impacts and also economic impacts.
“The idea of oral health being siloed is just the manifestation of the system that’s been built. The moral case [to bring oral health into the overall healthcare conversation] is there but there is also a business case that will help us address these inequities that we are finding through research and experience.””
CareQuest is on a mission to undo over a century of siloing between the medical and dental worlds. Dr. Rafia explained that oral health is inseparable from the rest of the body, but the current system isn’t working for everyone. Their research shows that providers want more medical-dental integration, but they just don’t have the tools or support needed to implement it. Only one-third of oral health providers currently screen patients for diabetes. More than half of providers would be willing if they had better tools such as technical assistance, referral pathways, and data to identify those at risk for diabetes.
These gaps in care, lack of medical-dental integration, and minimal oral health literacy among communities have real cost implications. According to CareQuest, the United States loses almost $50 billion every year in productivity due to dental conditions, and the cost of emergency departments seeing non-traumatic dental cases is $3.5 billion annually. If we start to prioritize oral health as a natural and important part of overall health, and really invest in advancing healthcare systems that are patient-centered and integrated, we could all reap the benefits as a society. The economic imperative for advancing health equity and medical-dental integration exists.
Unfortunately, the lack of standardized, desegregated data collection methodology has impeded us as a system to uncover all the existing gaps, and it’s allowed for inadequate allocation of resources. Dr. Rafia stated that there needs to be more ways to advance race, ethnicity and language, disability, veteran status, sexual orientation, and gender identity demographic data collection that’s culturally responsive and informed by insights and input from the very communities we hope to lift up.
Systemic change is very complicated, but CareQuest is working to advocate and support policies that expand access, promote medical-dental integration, and are equitable. Dr. Myechia Minter-Jordan mentioned that when we think of oral health providers as being part of the healthcare professions, it opens up so many different avenues that oral health has the ability to impact, and this is how we can help advance health equity for all.
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