“Can you imagine a time when we fully incorporate mental and dental health into our thinking about health? What is it about problems above the neck that seems to exclude them so often from policy about health care?”
That’s what Institute of Medicine President Harvey Fineberg asked in 2009. On April 8th the IOM released a new consensus committee report, “Advancing Oral Health in America”. That committee’s 2011 response to Dr. Fineberg was essentially—“not this time—change starts here.” I had the great privilege of participating on that committee along with 14 others from a variety of backgrounds and expertise. Certainly, we were daunted by the enormity of the nation’s oral health challenge but also hopeful that there are, in fact, tools and approaches that could begin to make a difference.
The IOM convened this committee based on a 2009 HRSA request for recommendations on a potential HHS oral health initiative. The committee deliberated for almost a year while the long and contentious health care reform debate reverberated. The specific charge for this committee was relatively narrow: to provide strategic recommendations to HHS, specifically, regarding a department-wide oral health initiative. Nevertheless, the national health care reform debate only served to highlight the concurrent need for reform in both oral health as well as health care, overall.
And there were a few ghosts in the mix, so to speak—namely past reports, statements, actions, initiatives in oral health—good faith efforts all—juxtaposed against the harsh fact that the problems remain. More than 10 years prior, the surgeon general issued a landmark report entitled, “Oral Health in America”. It described the poor state of oral health as a “silent epidemic”. Unfortunately and in spite of that warning, that epidemic remained altogether too silent. In fact, arguably, nothing fundamentally has changed in those 10 years. Entirely preventable oral diseases remain prevalent. Oral health is part and parcel of overall health care—but the professions treat them as distinct and separate. Vulnerable groups continue to suffer from disparate oral health outcomes. Continue reading…