Oral Health
Section Newsletter
Fall 2003

Message from the Chair

Oct. 1, 2003
By Jane E. M. Steffensen

The Oral Health Section is looking forward to an exciting program during the APHA Annual Meeting, Nov. 15-19, 2003, in San Francisco. I hope you are planning to attend the Annual Meeting on the west coast as it provides a myriad of opportunities to sharpen our public health skills, replenish our passion for public health, and foster friendships with colleagues. Look online at the extensive program of scientific sessions and CE opportunities at the Continuing Education Institutes. Be sure to attend the General Sessions as these sessions always engage and energize the attendees by focusing on public health opportunities and challenges.

A daily schedule of the Oral Health Section Program is summarized later in this Newsletter. Thank you to Sandie Beebe, 2003 Annual Meeting Program Chair, Scott Presson, and Oscar Arevalo for their work in planning the program as well as the presenters and those who volunteered as abstract reviewers and session moderators.

The Oral Health Section planning committee has organized a full program of oral health sessions:
• Access to Oral Care
• Aging & Oral Health
• Reducing Disparities in Early Childhood Caries
• School & Community-Based Models for Access and Prevention
• Current Issues in Water Fluoridation
• Oral Epidemiology, Surveillance & Health Services Research
• Integration of Oral Health with General Health
• Outreach Programs for Allied Health Care in the Community (Joint-Sponsored - Vision Care & Oral Health Sections)
• Ambulatory Care Topics (Joint-sponsored by Oral Health, Vision Care & Chiropractic Health Care Sections)
• Oral Health Poster Session I & II
• Topics in Maternal and Child Health Poster Session (Joint-sponsored by Oral Health & Maternal and Child Health Sections)
• Infant Child Health Poster Session (Joint-Sponsored by Oral Health Section & Maternal and Child Health Sections)

The Oral Health Section also looks forward to the John W. Knutson Award Ceremony on Monday, Nov. 17, 2003, at 6:30 p.m. followed by the Annual Section Dinner at Chevy’s Restaurant. This year the Knutson Award will be presented to Dushanka V. Kleinman, DDS, MScD, Chief Dental Officer of the USPHS, and Deputy Director of the National Institute of Dental and Craniofacial Research, NIH (See Article and Dinner Announcement in this Newsletter.) A thank you to John Brown, Chair Knutson Award Committee and committee members Stuart Lockwood, Scott Presson, and Diane Brunson.
In addition, thank you to Howard Pollick and his Local Arrangements Committee for organizing the dinner and dance contest in San Francisco.

Also, during the meeting all Section Members are welcome to attend the Oral Health Section Council Meeting on Sunday, Nov. 16, 2003, 8:00 a.m. – 11:30 a.m. and 2:30 p.m. – 7:30 p.m. (the Opening General Session will be that day 12:00 – 2:00 p.m.). All Section Members are also invited to the Oral Health Section Annual Business Meeting, on Tuesday, Nov. 18, 2003, 8:00-10:00 p.m. The Oral Health Section Governing Councilors Sue Sanzi-Schaedel and Larry Hill will be representing the Section at the APHA Governing Council Sessions. This year's discussions will include future directions as the APHA Strategic Plan is developed. All members are welcome to observe and hear more about the Association’s activities during the Governing Council Sessions.

On Tuesday, Nov. 18, 2003, the social activities include the Oral Health Reception sponsored by the American Dental Hygienists’ Association, 6:30 – 8:00 p.m., and the Annual Myron Allukian Flying Feet Dance Contest at the top of the Sir Francis Drake Hotel, after the Section Annual Business Meeting.

The Oral Health Section will again this year have a joint exhibit booth at the Public Health Expo. The Section needs volunteers for a two-hour shift at the booth. Please contact Clemencia Vargas, Exhibit Booth Chair, at <cmv001@dental.umaryland.edu> to volunteer at the booth and support the Oral Health Section. Also, special thanks to Clemencia Vargas for coordinating the oral health section activities at the booth.

I would like to draw your attention to new resources and opportunities to move oral health actions forward. We hope that the information and resources included in this Newsletter assist you in your daily work of improving oral health for children and adults.

Since the last Newsletter the Department of Health and Human Services released the National Call To Action to Promote Oral Health aimed at improving oral health and preventing disease for all Americans. Surgeon General Richard Carmona, released the report on April 29, 2003, at the 2003 National Oral Health Conference in Milwaukee. The National Call to Action marks the latest in an ongoing effort to address the country’s oral health needs in the new century. The National Call to Action <http://www.surgeongeneral.gov/topics/oralhealth/> builds on "Oral Health in America: A Report of the Surgeon General" (May 2000) and the "Healthy People 2010 Oral Health Objectives." The National Call to Action seeks to expand past efforts by enlisting the expertise of individuals, health care providers, communities, and policymakers at all levels of society. The National Call to Action identifies five action areas:
• Change perceptions of oral health;
• Overcome barriers to care by replicating effective programs and proven efforts;
• Build the science base and accelerate science transfer;
• Increase oral health workforce diversity, capacity and flexibility; and
• Increase collaboration.

Please see the interview with Dr. Caswell Evans in this issue of the Newsletter to learn more about the National Call To Action. The Oral Health Section will examine future opportunities to collaborate with partners and move forward on actions outlined by the National Call To Action oral health agenda.

The Association of State and Territorial Dental Directors (ASTDD) Internet-Based Resources -
Best Practices Project
• Dental Public Health Activities - A Collection of Descriptive Summaries

These sites provide reviews of several contemporary dental public health activities that can be replicated in states and communities. The Project aims to cultivate best practices that help: (a) build infrastructure and capacity in state, territorial and community oral health programs; (b) meet the Call To Action set by the Surgeon General's Report on Oral Health and National Call To Action to Promote Oral Health; and (c) achieve Healthy People 2010 Objectives to enhance the oral health of all Americans and reduce health disparities.

Safety Net Dental Clinic Manual <www.dentalclinicmanual.com/> is a new practical online reference document that reviews: Partnerships and Planning; Facility Design; Staffing; Finances; Clinic Operations; and Quality Improvements. It is in easy-to-use format with links to user-friendly tools including clinic policies, efficiency tips, professional standards, supply lists, floor plans, design tips, photos of equipment options, budget worksheets, funding strategies, quality improvement plans, fact sheets and Web sites. (See Article in this Newsletter.)

New initiatives and activities have been funded in 2003-2004 by the State Oral Health Collaborative Systems Grants (SOHCS), Maternal and Child Health Bureau, HRSA. Recently awarded, 47 grantees, will be working to strengthen collaborative efforts among public/private partnerships to improve oral health, for additional information visit, <http://newsroom.hrsa.gov/releases/2003/MCHoral.htm>.
There are also ongoing activities associated with Head Start and Oral Health Forums at the regional, state, and territorial levels as well as with professional organizations. (See Article in this Newsletter.)

Interface Between Medicine and Dentistry in Meeting the Oral Health Needs of Young Children discusses the coordination of primary health care and primary dental care systems, and materials are available <www.cdhp.org>. The Interfaces Project is a collaboration between the Children's Dental Health Project (CDHP), the American Academy of Pediatric Dentistry Filling Gaps project grant, and a component of the HRSA/Maternal and Child Health Bureau's S-CHIP Community Integrated Services Systems program (See Article in this Newsletter.)

"A State of Decay: The Oral Health of Older Americans" An Oral Health America Special Grading Project <www.oralhealthamerica.org> examined the lack of access to care for seniors in the United States through private dental insurance and Medicaid. The Report was released at the Forum: Senate Special Committee on Aging, "Ageism in Health Care: Are Our Nation's Seniors Receiving Proper Oral Health Care?" Sept. 22, 2003, Dirksen Senate Office Building. The Report was developed by Oral Health America, Campaign for Oral Health Parity funded in part by The W.K. Kellogg Foundation. The Forum examined the oral health issues facing seniors and included discussions of potential solutions.

Please note that this Chair’s Message is part of a new Internet-based system for submitting section newsletters to APHA for publication. Due to the establishment of this new system the publication process was delayed from the Summer into the Fall. Thank you, section members, for your patience during this change. Also, thank you to Newsletter Editor Magda de la Torre for working on learning the new system to get this newsletter on-ine. We would like to hear feedback on the newsletter. As an APHA member and reader of the Oral Health Section newsletter please provide any ideas or comments on the newsletter to Magda at <delatorrem@uthscsa.edu>.

In closing I offer a couple of quotes to ponder from President Franklin D. Roosevelt as we end 2003 and look forward to 2004:

"It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something."

Recently I had the opportunity to visit the FDR Memorial in Washington, DC. The Memorial really offers one much to consider in light of his lifetime and as a reflection of our times today. A few more wise words from FDR:

"The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little."

APHA 2003 Oral Health Section Program

Hope you are planning to join us for the 2003 Annual Meeting in San Francisco!

The Oral Health Section's primary meeting location will be the Renaissance Parc Fifty-Five Hotel at 55 Cyril Magnin St. The hotel will be a shuttle stop to the Moscone Convention Center at 747 Howard St. Other sessions including the Annual Meeting Registration, Opening and Closing General Sessions, Poster Sessions, Public Health Expo and Oral Heath Sessions co-sponsored with Vision Care and Maternal and Child Health, (Poster location) will take place at the Moscone Convention Center.

The Annual Meeting program and abstracts are available online at <www.apha.org/meetings>.

NEW!! This year all scientific session presenters have the option of linking their handouts directly to their abstracts on the APHA Online Program, providing attendees with access to their data and copies of their papers prior to and following the meeting.

Thanks to everyone who submitted abstracts, will serve as moderators at sessions, volunteered to participate at the exhibit booth and helped plan the Oral Health Section’s special events.

APHA Annual Meeting 2003 – San Francisco


In “The City by the Bay” – San Francisco, California Visit the APHA Annual Meeting Web site <www.apha.org/meeting>
for updates on registration and program


Related Files:

The John W. Knutson Distinguished Service Award in Dental Public Health 2003

Contributed by John P. Brown, BDS, PhD
Chair, APHA Oral Health Section Awards Committee

The 2003 John W. Knutson Distinguished Service Award in Dental Public Health will be made to Dushanka V. Kleinman, DDS, MScD, at the APHA 131st Annual Meeting in San Francisco on Nov. 17, 2003, at 6:30 p.m.

Dr. Kleinman is the Chief Dental Officer of the USPHS, and Deputy Director of the National Institute of Dental and Craniofacial Research of NIH. She is a graduate in Dentistry of the University of Illinois College of Dentistry, completed a residency at the University of Chicago Hospitals Zoller Clinic, and then obtained the Master of Science degree in Dental Public Health from Boston University. She served as a faculty member at the University of Maryland before being commissioned into the U.S. Public Health Service Corps in 1978, and presently holds the rank of Rear Admiral. Dr. Kleinman is a diplomate and past president of the American Board of Dental Public Health, and has been president of the American Association of Women Dentists and the American Association of Public Health Dentistry.

As the Deputy Director of NIDCR, she oversees, with the Director, the Institute’s wide scope of extramural and intramural biomedical and behavioral research and related policy, plus programmatic and advisory committee activities. In addition she represents the NIDCR programs at all levels of government, and ensures effective liaison with national and international research and public health communities. She is experienced in preventive dentistry, epidemiology, and geriatric dental education curriculum development, tobacco control, injury prevention, women’s health, and established the Healthy Children Ready to Learn initiative. Dr. Kleinman played a major role in overseeing and managing the development of the first Surgeon General’s Report on Oral Health, and the associated Conference on Children and Oral Health. She has contributed much to the advancement and management of oral health sciences and has demonstrated her leadership in extending research findings into practice.

This award recognizes the accomplishments of John W. Knutson who was the first dentist to be president of APHA. He collaborated in the 1937-1947 Hagerstown studies of the epidemiology of caries. In the 1940s he studied outcomes of dental referral programs and systematically researched topical fluoride effectiveness. He made seminal contributions to the understanding and implementation of the role of dental health and dentistry in public health.

The John W. Knutson Distinguished Service Award is made by the APHA Oral Health Section, based on nominations received annually by an Awards Committee. The section acknowledges and thanks Colgate Oral Pharmaceuticals for their sponsorship of the Award. Please join the APHA Oral Health Section at the Award Ceremony in San Francisco on Nov. 17, 2003, at 6:30 p.m. The Oral Health Section Dinner will follow the awards ceremony.

Oral Health Section 2003 Dinner

The Oral Health Section 2003 Dinner honors the annual Knutson Awardee. The dinner will be held Monday, Nov. 17, 2003, after the Knutson Award Ceremony at Chevy’s Restaurant, on 3rd & Howard – 201 3rd Street, San Francisco, CA 94105, 415-543-8060 (about 3/4 mile from the Renaissance Parc Hotel).<http://www.chevys.com/new_flash_frame.html>

The restaurant has a Mexican menu and a separate room will accommodate the Oral Health Section for a sit-down dinner. Everyone can have banquet fajitas, including grilled shrimp, beef, chicken, and/or vegetables with side dishes of beans, rice, pico de gallo and tortillas. Beverages by the pitcher (for 5 people) of soda/iced tea/lemonade and an appetizer of guacamole and chips for $30 per person including tax and gratuity.

Due to the restaurant’s policy, personal checks and credit cards cannot be utilized. Cash only can be paid to Dr. Howard Pollick during the Oral Health Sessions before the dinner and at the restaurant. He will then give each attendee a ticket to be used as a receipt.

Thank you to Dr. Howard Pollick and his local arrangements committee for organizing the Annual Dinner.

Myron Allukian Flying Feet Dance Contest

The Myron Allukian Flying Feet Dance Contest will be held Tuesday, Nov. 18, 2003, at 10 p.m. at The Starlight Room at the top of the Sir Francis Drake Hotel, 450 Powell Street, San Francisco, 415-395-8595.

There's no cover charge on Tuesday nights!
For further information on The Starlight Room visit: <www.harrydenton.com/homepage.htm>.

Tuesday's music schedule includes the Fred Ross Project from 8 p.m.-12 a.m. and DJ Sammi.

APHA 2003 - Oral Health Section Exhibit Booth

One of the main components of the APHA Annual Meeting is the Public Health Expo. in the Exhibitors Hall. Last year the Oral Health Section participated in a Mega-booth with Chiropractic, Vision, and Podiatry. The Mega-booth, which included screening, education, and distribution of educational material in the four areas, won the second prize as the best exhibit. Meeting participants' response was excellent; Dr. Oscar Arevalo provided over 100 oral health screenings and booth volunteers discussed with many more participants oral health issues, from tooth brushing to public health programs development.

Again this year the four sections will work together. The Oral Health Section will offer oral health screenings and oral health education. We plan to distribute toothbrushes, toothpaste and education materials. As last year, we will need a large number of volunteers. All section members can help staff the booth in 2-hour shifts, and those with a California dental license can provide screenings. Direct contacts to obtain toothbrushes and toothpaste are very welcome. If you are interested in participating in the booth please email Clemencia Vargas at <cmv001@dental.umaryland.edu>.

New members and students are specially invited to volunteer at the booth because it is a great way to become involved and network with a diverse cross section of enthusiastic APHA members in the exhibit hall.

Oral Health Section Election

Results from the Oral Health Section Election:

Kathy Lituri, RDH, MPH

Section Council
Oscar Arevalo, DDS, ScD, MS, MBA, MS
Eli Schwarz, DDS, MPH, PhD

Governing Council
Julie Ann Janssen, RDH, MA

Elected candidates will assume office after the close of the 131st APHA Annual Meeting, to be held Nov. 15-19, 2003, in San Francisco.

Special thanks to the members who accepted to have their names placed on the nominations for the Oral Health Section election and for continued support of section activities.

Spotlight on Oral Health Programs


New Mexico’s Office of Dental Health Combats
Childhood Tooth Decay Epidemic

Contributed by Oral Health Section Member:
Ron Romero, DDS, MPH, Oral Health Section Council
Director, Office of Dental Health
New Mexico Department of Health /PHD/ HSB
E-mail: <ronr@doh.state.nm.us>

“This summer we’re saving smiles.”
Ron Romero, DDS, MPH
New Mexico Dental Director

New Mexico Department of Health News Release- 07/08/03

Santa Fe, NM -- Has your child been to a dentist lately? If not, it could mean more than just a cavity or two. It could mean significant damage to his overall health, growth, development and learning - for the rest of his life.

“Left untreated, the pain and infection caused by childhood tooth decay could very well lead to problems in eating, speaking, the ability to learn, absence from school and a low self esteem,” said New Mexico Dental Director, Dr. Ron Romero. “It could mean less and less success later in life.”

Tooth decay is one of the most preventable childhood diseases, yet dental care remains the most prevalent unmet health care need for children in New Mexico. As an example, Dr. Romero says over one-third of Navajo children living in New Mexico have missed school because of dental-related pain and discomfort. Nationwide, the Surgeon General identifies dental and oral disease as a silent epidemic.

“This summer we’re working to turn that around in New Mexico,” Dr Romero said. This summer, the state Office of Dental Health is offering dental sealants at not cost for children ages 6 to 12 at various Public Health District offices in the Albuquerque, Las Cruces, and Santa Fe areas.

New Mexico Holds Oral Health / Head Start Forum, “Making Connections: Embracing the Future”

On May 8-9, 2003, over one hundred dental professionals, Head Start Program staff, advocates and stakeholders from across the state convened at the Albuquerque Convention Center to discuss issues affecting the state’s Head Start population and to develop strategies for improving oral health.

The keynote speaker, Phil Weinstein, PhD, of the University of Washington presented “New Dentistry for New Mexico: A New Deal for High Risk Families” during the opening session and “New Tools to Control Caries” the following day. Other presentations included Dental Health and Disease, Addressing Access Issues, and Nutrition.

Roundtable discussions were conducted and information gathered from representatives from the State’s four Public Health Districts. The expected outcomes of the forum will be to develop an action plan, objectives and strategies to address oral health problems for the Head Start/Early Head Start participants. The Planning Committee will continue to meet to monitor progress.

New Mexico to hold a “Dental Education Summit”

On August 21-23, 2003, many representatives from academic, oral health, government and private organizations met in Albuquerque to address the current and future status of dental education. The Education Summit brought a distinguished panel of experts from across the country to discuss their experiences, provide expert testimony, and assist the state in making decisions regarding the future of dental education in New Mexico.

The Dental Education Summit is a joint venture between state agencies, academic institutions and the dental association. During the 2003 Legislative session, House Memorial 1 was passed requesting the state conduct this Summit. Sen. Jeff Bingaman, D-N.M., was the keynote speaker and was instrumental in securing funding to address this critical issue.

Legislature Adds Dental Professionals to the New Mexico Health Service Corps (NMHSC)

On July 25, 2003, a committee was convened to promulgate regulations to add dentists and dental hygienists to the list of health professionals eligible to participate in the NMHSC. In addition to the amendment, an appropriation of $250,000 was passed and specifically earmarked for dental professionals. This legislation had been introduced during the 2001 and 2002 legislative sessions but failed to pass.

Passage of this legislation was a collaborative effort between the New Mexico Department of Health, Health Systems Bureau, Office of Dental Health, Office of Primary Care/Rural Health, NM Primary Care Association, NM Health Resources, and many other organizations, advocates, and partners.

Tobacco Use Prevention and Cessation Program

A Continuing Medical and Dental Education Program for Health Practitioners in New Mexico Workbook was unveiled at the NM Dental Association’s Annual Meeting in June 2003. The workbook contains coding/claims, office tools, patient education, and referral information practitioners may use to reference when counseling patients. This effort is a Clinical Prevention Initiative project funded by the NM Department of Health, Tobacco Use Prevention and Control program. The workbook was developed to provide medical and dental practitioners current information and guidelines relating to office-based smoking cessation counseling and pharmacotherapy.

In New Mexico, smoking prevalence is high with more death and disability caused by cigarette smoking than all other preventable causes combined.

• 50% of dental patients are smokers
• 22% of adults smoke
• 42% of women of reproductive age smoke
• Over 20% of 12th graders smoke regularly

Dental practitioners are in a position to make a great contribution to the lives of their smoking patients by educating their patients on the risks of tobacco use, early detection of oral and pharyngeal cancers and promoting smoking cessation programs.


Related Files:

Online Safety Net Dental Clinic Manual

The resource you’ve been waiting for is finally here!

The Safety Net Dental Clinic Manual is a collaborative project of the Ohio Department of Health, the Indian Health Service, and the Association of State and Territorial Dental Directors, with hosting and Web site maintenance provided by the National Maternal and Child Oral Health Resource Center. The Manual is funded primarily by Health Resources and Services Administration’s Maternal and Child Health Bureau. It contains information on partnerships and planning, facilities and staffing, financing, clinic operations, and quality assurance/quality improvement. The manual contains 5 chapters.

Chapter 1: Partnerships and Planning
Chapter 2: Facilities and Staffing
Chapter 3: Financing
Chapter 4: Clinic Operations
Chapter 5: Quality Assurance/Quality Improvement

Go to <www.dentalclinicmanual.com> to use the new online Safety Net Dental Clinic Manual. This online, practical reference will help you make good program decisions. The easy-to-use manual provides links to user-friendly tools including clinic policies, efficiency tips, professional standards, supply lists, floor plans, design tips, photos of equipment options, interactive budget worksheets, funding strategies, quality improvement plans, fact sheets, and Web sites. The format is flexible to permit a brief or comprehensive review of the content. A feedback form is available for you to submit comments or suggestions for future revisions. Try it. You’ll like it!

A companion online manual for Mobile and Portable Dental Systems is in the process of being developed and will also be hosted sometime in 2004 by the National MCH Clearinghouse at <www.mobile-portabledentalmanual.com>.

Head Start and Oral Health Partnerships Project

Contributed by Beverly Isman, RDH, MPH, ELS and Kathy Geurink, RDH, MA

In 1999 the Head Start/WIC/HRSA/HCFA Forum on Early Childhood Oral Health was convened to discuss strategies for improving oral health status among low-income children. Several papers were presented that reviewed current evidence related to oral health and nutrition, caries risk assessment and prevention, and access to oral health services. Also, this National Forum addressed issues and outlined strategies to increase collaboration at the federal, state and local levels to improve oral health status and enhance access to oral health care services. Participants at the Head Start and Partners Oral Health Forum expressed support for replication of this type of activity at the regional, state, and local levels across the country.

One outcome of this Forum was the formulation of an Intra-Agency Agreement between the Administration for Children and Families (ACF), Head Start Bureau (HSB) and Maternal and Child Health Bureau (MCHB), HRSA to develop linkages to support oral health in Head Start. Several activities were initiated in 2001 and 2003. These projects include:

  • Provision of oral health expertise by MCHB to Head Start Bureau (HSB);

  • Association of State and Territorial Dental Directors (ASTDD) Head Start Oral Health Project(assessment of state activities, identification of model programs and support of state forums);

  • Regional Head Start Forums for Enhancing Partnerships for Health Start and Oral Health;

  • Professional Organization Forums to Increase Awareness of Early Head Start and Head Start Program Needs;

  • Ohio Department of Health, Head Start Oral Health Initiative; and

  • Head Start Dental Screening / Triage Project in Chester, Penn.

Since the initiation of the project a number of activities have occurred. Regional Head Start Oral Health Forums have been held in DHHS Regions III, VI, VII, VIII, IX, and Region XII (Migrant and Seasonal Head Start). ASTDD has granted $5,000 awards for Head Start Oral Health Forums in 34 states and U.S. territories/jurisdictions. A fourth cycle of requests for proposals for state forums was announced on Sept. 1, 2003, with a due date of Oct. 31, 2003. A list of grantee contacts and copies of final reports/action plans received for the state and territorial forums can be viewed on the ASTDD website at <www.astdd.org> (click on projects/HRSA/Head Start). Also, Regional Forum Reports can be viewed at <www.mchoralhealth.org/HeadStart/headstart.html>. HRSA MCHB and ACF Head Start Bureau staff are meeting with representatives from national organizations such as AAPD, ADHA and other organizations. These forms are developing strategies to enhance the roles of professional associations that will build partnerships to benefit Head Start participants.

ASTDD supports a national ASTDD Advisory Committee that works with the Head Start Bureau, the MCH Bureau, the National Maternal and Child Oral Health Resource Center, and the National Center on Oral Health Policy on a number of activities. Recently the committee and its partners published a fact sheet and two tip sheets on Head Start and Oral Health. These materials can be downloaded in .pdf format, or copies can be ordered via <www.mchoralhealth.org>. Head Start materials from other sources are also included on this Web site.

As results from the Projects in Pennsylvania and Ohio become available in Fall 2003, they will also be presented at national meetings and posted on the MCHB Oral Health Resource Center Web site.

The National Maternal and Child Oral Health Resource Center is now collecting and posting materials related to Head Start and Oral Health. Materials are available at <www.mchoralhealth.org/HeadStart/headstart.html> and include the Proceedings and Commissioned Papers from the 1999 National Head Start Partners Oral Health Forum. Also posted are reports from recent Professional Organization Forums, Regional Forums, and State and Territorial Forums. The Web site is continually adding resources to promote oral health in Early Head Start and Head Start.

Additional Head Start Web site Resources include:

Head Start State Collaborative Offices: The purpose of the Head Start-State Collaboration grants is to create a visible partnership at the state level to support the development of multi-agency and public/private partnerships. <www.acf.hhs.gov/programs/hsb/contacts/statecollab1.htm>

Early Head Start National Resource Center: The EHS NRC works in partnership with the Regional Training and Technical Assistance (T&TA) specialist to ensure that Early Head Start programs have information and training on "best practices" on a range of topics. <www.ehsnrc.org/>

Head Start Bureau (The Administration for Children and Families—ACF): Funds and administers Head Start programs; Head Start serves the child development needs of preschool children (birth through age five) and their low-income families. <http://www2.acf.hhs.gov/programs/hsb/>

Head Start Information and Publication Center (HSIPC): Head Start Information and Publication Center (HSIPC), a service of the Head Start Bureau, supports the Head Start community and other organizations working in the interest of children and families by providing information products and services; conference and meeting support; publication distribution; and marketing and outreach efforts. <www.headstartinfo.org/>

National Head Start Association: The National Head Start Association (NHSA) is a private not-for profit membership organization representing more than 900,000 children, 190,000 staff and 2,500 Head Start programs in America. <www.nhsa.org/>

Indian Health Service Head Start Program: The Indian Health Service Head Start Program is the primary provider of health training and technical assistance for Head Start programs funded by the Head Start Bureau-American Indian/Alaska Native Programs Branch (AI/ANPB). <www.ihs.gov/NonMedicalPrograms/HeadStart/index.asp>

National Head Start Training and Technical Assistance Resource Center (NRC): assists the Head Start Bureau by 1) planning and coordinating activities that promote HSB priorities, 2) promoting awareness and adoption of best practices, and 3) identifying trends and initiatives in early childhood development and making recommendations for future actions. <www.hsnrc.org/>

A National Call To Action To Promote Oral Health

Magda de la Torre, Editor, Oral Health Section Newsletter, conducted a telephone interview with Dr. Caswell Evans, Director, National Oral Health Initiative, Office of the Surgeon General. Dr. Evans provided his insighst on the process and formation of the National Call To Action. Most importantly, an insight on how we as members of APHA, in particular the Oral Health Section, can contribute to the success of promoting oral health. Dr. Evans is a Past President of APHA and a Past Chair of the Oral Health Section.

1. Elaborate on the Surgeon General's Report vs. the Call To Action.

The Oral Health in America: A Report of the Surgeon General provided the state of the science regarding oral health status in the United States. Surgeon Generals' reports are not vehicles for conducting new research or making new discoveries. As a Surgeon General’s Report, Oral Health in America presened existing data and information packaged in a manner that facilitates its distribution to a wide audience beyond oral health professionals and advocates. As a common characteristic, Surgeon Generals' reports do not include overt or explicit recommendations for action. Therefore, A National Call To Action To Promote Oral Health can be viewed as a companion document providing an action agenda that supports the Surgeon General’s report. The Call to Action established recommended actions for individuals, groups and advocates for improving the oral health of the nation. The Call To Action was developed as a product of a public-private partnership under the leadership of the Surgeon General’s office. The two major goals of the Call To Action are: to eliminate oral health disparities; and to improve quality of life. The vision is to promote general health and well-being by promoting oral health through critical partnerships at all levels.

2. Dr. Evans, what is your role in the Call To Action initiative?

I coordinated, managed and directed aspects of the process leading to the release of the Call To Action. For example, we conducted five listening sessions around the country as an integral element to gather information and obtain public comment regarding the issue and themes that should serve as the focus for the Call To Action.

3. How does the Call To Action relate to Healthy People 2010?

Healthy People 2010 provides measurable national objectives for health, including a set of oral health objectives. The Call To Action outlines and provides guidance for actions that can be implemented and followed to assist in attaining the Healthy People 2010 objectives. The Call To Action serves as a “ladder” to get closer to achieving the Healthy People 2010 objectives.

4. What partnership networks were created? How was APHA involved in the Call To Action?

More than 90 public and private organizations contributed to form the partnership network. The network represents oral health advocates as stakeholders and contributors involved in the development of the Call To Action. APHA was among 10 other organizations that participated at the highest level of leadership in the partnership network.

5. How did the Listening Sessions contribute to the Call To Action?

The Call To Action is a participatory product of public-private organizations and concerned individuals. To garner the broadest level of input possible, five national listening sessions were held during 2002 in San Diego, Denver, Atlanta, Chicago, and Cambridge/Boston. Participation was open to all interested organizations and individuals. The testimony provided and concepts presented served to advise the development of the Call To Action. To assure broad participation, some sites had long-distance telephone connections so that testimony could be received from people in other states and locales who were not able to attend a listening session in person. To further facilitate input from individuals and organizations not attending a listening session, their written comments and suggestions were submitted via e-mail or fax.

6. Would you discuss the five principal actions in the Call To Action?

There are five categories of actions for individuals and groups, including community leaders, health care professionals, research investigators, policymakers, volunteers, health advocates, educators and others concerned about oral health. The measure of success for these actions will be further improvements in the oral health of the nation. Progress in that regard can be measured by tracking attainment of the Healthy People 2010 goals. Certainly, the degree to which oral health is improved is a contribution to a gain in overall health and well-being of the U.S. population. The partnership network proposed four guiding principles to achieve the actions. The actions should be culturally sensitive, science based, integrated into overall health and well-being efforts, and routinely evaluated.

Action 1. Change perceptions of Oral Health

Perception needs to be changed so that oral health is viewed as integral to general health and well-being. The perception has been that oral health is less important than, and separate from, general health. Any entity that is engaged in health should include oral health among their programs and services. Oral health should not be viewed as different or separate from general health. Oral health care should be provided and received in the context of a health care service. The perceptions of providers of oral health care, nurses, physicians, other health care workers, and patients as well, need to change. Consequently, there are recommended actions that focus on changing public perceptions, those of policy makers, and those of health care providers.

Action 2. Overcome barriers by replicating effective programs and proven efforts

These actions focus on the reduction of disease and disability by replicating programs that have been effective, particularly those that have improved access to oral health care. There also are a set of recommended actions to enhance health promotion and health literacy.

Action 3. Building the science base and accelerate science transfer

Biomedical and behavioral research will provide the knowledge base for evolving health care practice. There are many things that we need to know more about and understand better in order to improve oral health and the provision of care. Research will establish baseline data for the improvement of diagnosis, treatment and prevention. Research will help move science into public and private practice.

Action 4. Increase oral health workforce diversity, capacity and flexibility

This set of actions addresses the workforce infrastructure for meeting patient needs, enhancing oral heath work capacity and flexibility, and developing local solutions. The demographic composition of our country is changing and becoming more diverse, and our ability to meet the community needs today, and the future, must be addressed. We need to ask ourselves, “Are we truly using our existing workforce as fully as we can?”

Action 5. Increase collaborations

The private and public sector each have unique characteristics. Strong and effective partnership among organizations can have positive results and lead to greater improvement in the oral health of the population. Strengthening existing collaborations and creating new collaborations are vital to the success of the Call To Action.

7. What emphasis is there on prevention?

Prevention is emphasized in the Call To Action in the traditional methods of oral disease prevention and health promotion. In addition, there are distinct recommendations for the development and establishment of policy initiatives to reduce disease and disability, incorporate oral health as a part of general health, and improve oral health literacy.

8. What are the next steps?

For the Call To Action to be successful it is critical that the public, particularly the concerned advocates, read, understand and adopt the framework of the Call To Action. This effort is now in the hands of the public and the concerned advocates. It is up to the leadership of the partner organizations to take appropriate action and to move forward. New or rekindled partnerships need to be developed. All concerned organizations are probably addressing one or more of the proposed actions in their existing work agenda. These efforts need to be coordinated and better focused and the Call To Action can provide a firm and shared foundation. With Oral Health in America: A Report of the Surgeon General and now A National Call To Action To Promote Oral Health we have two prominent documents that can be used effectively and provide guidance for change. Healthy People 2010 can be used for measuring progress and change.

9. How can APHA continue to collaborate with the Call To Action?

APHA can serve as an excellent vehicle to disseminate the messages and strategies recommended in the Call To Action. APHA can continue to collaborate in a leadership role in this effort, and even provide a convening role, keeping the public-private partnership network mobilized. APHA can serve as a leader in this process.

10. How can the APHA Oral Health Section and other sections (Health Educators, Public Health Nurses, MCH, Geriatrics, etc.) participate in the Call to Action?

The Oral Health Section of APHA can be instrumental in developing a resolution that can be brought before the Governing Council. The Oral Health Section is in a pivotal position to work in collaboration with other sections to emphasize, educate and advocate for oral health to be added to other initiatives, programs and services. The Oral Health Section can work with other Sections, Special Primary Interest Groups or Caucuses, including Community Health Planning and Policy Development, Food and Nutrition, Gerontological Health, Maternal and Child Health, Public Health Education and Health Promotion, Public Health Nursing, and School Health Education and Services, which represent a full spectrum of health advocates, because all are affected by the message of the Call To Action. The Call To Action forms a tangible part of the Oral Health Section’s working agenda.

11. How can the Call To Action initiative capitalize on APHA, as a multidisciplinary organization?

The Call to Action presents a broad-based action agenda and outlines shared strategies to promote oral health, and thereby improving general health and well-being. APHA incorporates multidisciplinary health interests, and the structure of APHA supports the type of multidisciplinary collaboration that is critical to the success for any of the actions and reaching the goal of improving oral health. Each distinctive entity within APHA has health promotion and disease prevention interests and objectives that affect oral health; for example, tobacco control, dietary counseling, health education aimed at pregnant women and new mothers, school health, and support for oral facial protection for sports, among others. APHA has the capacity to enable the Sections, Special Primary Interest Groups and Caucuses, and the unique interests they represent, to join in partnership building around oral health.

12. Where can the Call To Action be located?

Both the Call To Action and the Surgeon General’s Report on Oral Health can be found on the Surgeon General’s Web site as follows: <www.surgeongeneral.gov/topics/oralhealth/>.

The Interface Between Medicine and Dentistry in Meeting the Oral Health Needs of Young Children

Dental care in this country is provided by private and safety-net systems of care that are independent of medical primary care systems. As a result, children who are followed for primary care typically do not have their oral health issues addressed by their physician or nurse practitioner. One of the greatest challenges in attempting to improve oral health is better coordination of the primary health and dental care systems. However, integrating these separate organizational, financing, and delivery systems is challenging because of a number of unresolved "interface" issues.

The Children's Dental Health Project (CDHP) and the American Academy of Pediatric Dentistry (AAPD) have partnered in a grant to develop literature exploring the issues that have been raised by dental professionals and health professionals about coordination of primary health care and dental primary care systems. This grant, titled "Interfaces: Explicating the Interfaces between Primary Care Dentistry and Medicine for At-Risk Young Children," is made under AAPD's Filling Gaps project, a component of the HRSA/Maternal and Child Health Bureau's S-CHIP Community Integrated Services Systems program. The goal of Filling Gaps is to identify and develop best practice protocols and training materials to increase the access of preschool children to dental care and to improve their dental health.

The Interfaces Project has produced a paper describing each of six interface issues:
• Children with special health care needs
• Delivery systems and financing issues
• Dental caries epidemiology, mechanisms, prevention and care delivery
• Education and training issues
• Health care policies
• Legal opportunities and constraints

The six background papers have been summarized in a white paper and executive summary. The white paper was distributed to 60 communities of interest for comment. Nine experts from medicine, dentistry and health policy have written responses to the white paper, and the Interfaces project has produced a summary of these responses. On July 28, 2003, an invitational meeting was convened on Interfaces in Washington, DC.

The papers produced for the Interfaces Project and PowerPoint presentations from the Invitational Meeting are available at <www.cdhp.org>. For information about the Interfaces Project, contact Ann De Biasi, MHA, Washington Director, CDHP at <adebiasi@cdhp.org>.


Distinguished Leaders in Dental Public Health

Herschel S. Horowitz, DDS, MPH, died peacefully and at home in Bethesda, Maryland on Aug. 10, 2003. Dr. Horowitz was a dental researcher for the Public Health Service in which he obtained the level of Captain. He crusaded internationally for adding fluoride to public water supplies to prevent dental caries. His work at the National Institute of Dental and Craniofacial Research, where he was chief of Community Programs and of clinical trials for the Caries Prevention and Research Branch, included investigations of fluorides in toothpaste and mouth rinses. He studied adding fluoride to dental sealants and school water supplies, and he headed development of an international fluoride measurement index.

Dr. Horowitz received a dental degree and master's degree in public health from the University of Michigan. He served in the Army Dental Corps in Japan in the 1950s. He was a public health dentist in Detroit before being commissioned by the Public Health Service in 1960. After he retired from the National Institutes of Health in 1985, he was a consultant to the World Health Organization and the Pan American Health Organization, and worked extensively in Central and South America, Japan, South Korea and China.

Dr. Horowitz was a diplomate of the American Board of Dental Public Health and served as its President in 1983. His honors included the H. Trendley Dean Memorial Award of the International Association for Dental Research and the Distinguished Service Award of the American Association of Public Health Dentistry. He was the 1994 recepient of the John W. Knutson Distinguished Service Award in Dental Public Health of the Oral Health Section, APHA. Dr. Horowitz was a friend and colleague of the Oral Health Section. He served as a leader in the Oral Health Section as well as in other roles within APHA.

Survivors include his beloved wife of nearly 33 years, Dr. Alice M. Horowitz of Bethesda; two stepchildren, Robert L. Johnson and Jan J. Coulter, both of California; and three granddaughters.

Memorial services have been scheduled for December 17, 2003 from 1:00-5:30pm at Wilson Hall, Building 1, NIH Campus, Bethesda, MD. For additional information on the Memorial Symposium please read the article following the obituaries. Contributions may be made to American Association of Public Health Dentistry (AAPHD) Foundation, c/o Herschel S. Horowitz Scholarship Fund, 1224 Center West, Suite 400B, Springfield, IL 62704.

Viron L. Diefenbach DDS, MPH, died April 28, 2003 in Silver Spring, Md. Dr. Diefenbach was a former Director of the Division of Dental Health and Assistant Surgeon General in the U.S. Public Health Service, Assistant Executive Director of the American Dental Association, and Dean of the University of Illinois at Chicago School of Public Health

A native of Baltimore, Dr. Diefenbach, known as "Dief," was a 1949 graduate of the University of Maryland Dental School. In 1954, he received an MPH degree from the University of Pittsburgh. He became interested in the emerging field of dental public health and was at the forefront of many oral health issues.

Dr. Diefenbach joined the Public Health Service in 1949 as a dental intern in Norfolk and served in Chicago before serving in the Office of the U.S. Surgeon General in Washington in 1955 and 1956. He then served in Denver before returning to Washington in 1962. He retired as Assistant Surgeon General in 1970. During his years with the Public Health Service, he was involved in some of the early studies showing the importance of water fluoridation to prevent dental caries. He also advocated the ways that dental hygienists and dental assistants can increase efficiency and effectively provide dental care. He made important contributions to insurance coverage of dental care and international oral health promotion and research.

Dr. Diefenbach later became assistant executive director of the American Dental Association in Chicago. Then he joined the faculty of the UIC School of Public Health as a health resources management professor. He served as dean from 1978 to 1983 and later continued his affiliation with the school as a professor emeritus.

Dr. Diefenbach was the recipient of the John W. Knutson Distinguished Service Award in Dental Public Health presented by the Oral Health Section of APHA in 1999. He was a diplomate of the American Board of Dental Public Health. His other honors include the Meritorious Service Medal from the USPHS, the Scholarship Gold Medal from the University of Maryland, and membership in Omicron Kappa Upsilon.

A student scholarship fund has been established in Dr. Diefenbach’s memory at the University of Illinois. Donations can be made by mail to the Viron L. Diefenbach Public Health Scholarship Fund, University of Illinois Foundation, Harker Hall, 1305 Green St, Urbana, Ill. 61801. Make checks made payable to the UIF Diefenbach Fund.

These distinguished oral health leaders will be greatly missed

Herschel S. Horowitz Memorial Symposium - A Celebration of His Science and His Life

Herschel S. Horowitz Memorial Symposium
A Celebration of His Science and His Life

December 17, 2003
1:00-5:30 p.m.
Wilson Hall, Building 1
NIH Campus, Bethesda MD

Dr. Dushanka Kleinman
Deputy Director, NIDCR

Welcome and Opening Comments:

Dr. Lawrence Tabak
Director, NIDCR

1:10- 1:25
Perspectives from the Dental Profession:

Dr. James Bramson
Executive Director,
American Dental Association

Dr. Herschel S. Horowitz: His Science
and Public Health Legacy:

Dr. Amid Ismail
University of Michigan School of Dentistry

Personal Reflections:

Dr. Tony Volpe
Vice President, Clinical Dental Research

Fluoride Research and the Early Days
of Clinical Trials:

Dr. Stanley Heifetz
Clinical Professor
School of Dentistry
University of Southern California

Perspectives from Dental Public Health

Dr. Joseph Doherty
Past Executive Director
American Association of Public Health Dentistry

Pit and Fissure Sealants: Then, Now
and Next Steps:

Dr. Richard Simonsen
Associate Dean
Arizona School of Dentistry and Oral Health

Perspectives from the International Community

NIDR, NIDCR, and Beyond
Dr. Lois K. Cohen
Associate Director for International Health, NIDCR

Pan American Health Organization
Dr. Saskia Estupian-Day
Regional Advisor for Oral Health
Pan American Health Organization

Catalyzing a Preventive Approach
in Korea

Professor Kin Johng-Bai
Chairman, Department of Preventive and Public Health
Dentistry, College of Dentistry
Seoul National University

Continuing the Legacy: Comments from
Friends, Friends of the NIDCR and the
AAPHD Foundation Herschel S. Horowitz
Scholarship Fund

Dr. Linda Niessen
Vice President
Clinical Education
DENTSPLY International


APHA Grassroots Advocacy & Affiliate Affairs

In January APHA purchased its first e-advocacy tool to help mobilize its members to send letters to their members of Congress electronically. In the last six months APHA has organized several advocacy efforts through the system. In June APHA used its e-advocacy tool to rally more than 1,500 public health professionals to send electronic letters to their members of Congress. As members become comfortable with this tool, APHA anticipates that these numbers will dramatically increase as our members become more familiar with the system. APHA's new advocacy tool, <www.capwiz.com/apha/home/>, has many great features that we encourage all members and public health professionals to use when advocating on behalf of a public health issue. These resources include:

• Mega Vote: Sign up to receive a weekly email on how your Senators and Representative voted during the week on important issues. APHA provides this resource through our e-advocacy site.
• Elected Official Finder: Find biographical information on elected officials including the president, members of congress and agency heads.
• Issues and Legislation: In this section you will find Capitol Hill Basics, pending public health legislation and key public health votes.
• Media Guide: Send electronic letters to the editor on issues important to public health directly to your local media outlets with APHA's media advocacy tool.
• Legislative Action Center: See the latest APHA Action Alerts. Send e-mails to your members of Congress on legislation important to APHA. This tool also allows members to customize our list.

JOIN APHA'S LEGISLATIVE NETWORK <www.apha.org/legislative/eform.cfm>
APHA staff work hard to ensure that public health is being fairly represented on Capitol Hill. More than ever, this is a critical time for public health and as public health professionals APHA needs your help to ensure that our needs and accomplishments are being recognized on Capitol Hill. The most powerful message a member of Congress recieves comes from a constituent in his/her home district. That is why it is essential that APHA have a legislative advocacy network. APHA has a strong membership base, and it is paramount to show our association's power by intensifying our advocacy efforts. Having a network of public health professionals willing to take action is essential to ensuring that the legislative priorities of APHA are addressed. While APHA will continue to request that its membership as a whole take action on issues effecting public health, the legislative network will serve as the "grasstops" of APHA's entire Advocacy network. Join Now!

APHA appreciates the advocacy efforts of its members and the entire public health community on issues that ultimately affect all of America. Members of APHA can view a more in-depth legislative update on APHA's Web site. This legislative information is updated weekly.

APHA's Government Relations staff work very closely with the Action Board on advocacy efforts within Sections. The Action Board is made up of a representative from each Section, a member at large and three Affiliate members. This year the Action Board divided into three work groups that addressed APHA's three priority areas: health disparities; access to health care; and infrastructure. The health disparities workgroup contributed their expertise to staff from Senators Frist and Kennedy's offices. Also, APHA Government Relations would like to highlight APHA members' participation in Hill visits or Legislative Efforts in the future.

Hill Visits or Section Legislative Efforts
If members of your section participated in Hill visits or other legislative activities, that might also be beneficial to highlight. For example Dr. Steven Wallace, Chair-Elect of the Gerontological Health Section was one of three speakers at Congressman Watson's Town Hall Meeting on Medicare Prescription Drug Coverage on July 19, 2003

For additional information about APHA's advocacy efforts, please contact:
Lakitia Mayo
Director of Grassroots Advocacy and Affiliate Affairs
American Public Health Association
800 I Street, NW
Washington, DC 20001
(202) 777-2515 Phone
(202) 777-2532 Fax


Internet-Based Resources

ASTDD Seven-Step Needs Assessment Manual
The new revised edition has been completed and is on the ASTDD Web site, <www.astdd.org>. It can be downloaded, or the ASTDD Central Office has CD's which are available at $10 each. This model provides a step-by-step, logical approach to help you conduct an oral health needs assessment.

Best Practices Project

Dental Public Health Activities -- A Collection of Descriptive Summaries

These sites provide reviews of several contemporary dental public health activities that can be replicated in states and communities. The Project aims to cultivate best practices that help: (a) build infrastructure and capacity in state, territorial and community oral health programs; (b) meet the Call To Action set by the Surgeon General's Report on Oral Health and National Call To Action to Promote Oral Health; and (c) achieve Healthy People 2010 objectives to enhance the oral health of all Americans and reduce health disparities.

Safety Net Dental Clinic Manual
<www.dentalclinicmanual.com/> is a new practical online reference document that reviews: Partnerships and Planning; Facility Design; Staffing; Finances Clinic Operations and Quality Improvements. (See Article in this Newsletter.)

Mark Your Calendars: Upcoming Meetings

American Dietetic Association
Oct. 25-28, 2003
San Antonio, Texas
For more information visit: < http://www.eatright.org/Public/>

American Dental Association Annual Session & Technical Exhibition
Oct. 23-26, 2003
San Francisco, California
For more information visit: <www.ada.org>

Hispanic Dental Association Meeting
Oct. 10-11, 2003
Washington, DC
For more information visit: <www.hda.org>

Midwest Farmworker Stream Forum
“A Deeply Rooted Commitment to Migrant Health
Nov. 6-8, 2003
Houston, Texas
For more information visit: <www.ncfh.org>

International Conference on Evidence-Based Dentistry
Nov. 6-7, 2003
Atlanta, Georgia
For more information visit: <www.us.elsevierhealth.com/CE/ICED/>

Society for Public Health Education Annual Meeting
"Leadership and Diversity: Bridges to a Golden Health Education Era"
Nov.14-16, 2003
San Francisco, California
For more information visit: <http://www.sophe.org/>

Western Migrant Stream Forum
Jan. 30-Feb. 1, 2004
Seattle, Washington
For more information visit: < http://www.nwrpca.org/>