DOVER — The Delaware Division of Public Health (DPH) is engaging dental providers in the launch of a statewide campaign directed at increasing awareness about the addictive nature of opioid medications used after dental procedures. Dentists are among the leading prescribers of opioid medications, particularly for surgical tooth extractions. In fact, dentists and oral surgeons are commonly in a position to prescribe adolescents their first opioid prescription after the removal of the third molars, also known as “wisdom teeth.” The highest number of dental-related opioid prescriptions are for teenagers ages 14 to 17, followed closely by young adults ages 18 to 24.

DPH has begun distributing a toolkit to every dental office in the state with resources for both dentists and patients to encourage safe and healthy pain management. Included is a provider letter and fact sheet, a patient brochure, and posters for display in dental offices. The campaign drives home the message that “all pain is not the same,” and therefore should be treated effectively without opioids whenever possible. The American Dental Association (ADA) strongly recommends considering non-steroidal anti-inflammatory drugs (NSAIDs) such as Motrin or Aleve as the first-line of therapy for acute pain management.

“Dental professionals have a unique opportunity to help curtail the opioid epidemic by suggesting opioid alternatives for pain management when possible, counseling patients on the risks of opioid use, and educating on proper disposal procedures,” said Dr. Nick Conte, Director of the DPH Bureau of Oral Health and Dental Services (BOHDS).

A 2011 study in the Journal of the American Dental Association (JADA) estimated that dentists are responsible for 12 percent of prescriptions for fast-acting opioid pain relievers, just below general practitioners and internal medicine doctors. The opioid drugs most commonly prescribed by dentists are hydrocodone and oxycodone, which are highly addictive and have the highest potential for abuse.

This statewide campaign supports a larger state initiative to lower the rate of opioid prescriptions, with the ultimate goal to reduce opioid-related overdoses and deaths. In 2018, DPH launched an expanded section on HelpIsHereDE.com for health care providers, loaded with information; tools, such as forms and screening templates; and resources, including patient materials. Patient and dental provider materials from the oral health toolkit have now been added to the health care provider section of the website. HelpIsHereDE.com is a website providing addiction prevention, treatment, and recovery resources and information for individuals, families and health care providers in Delaware.

According to the CDC, Delaware is ranked first in the nation for prescribing high-dose opioids, and is also ranked first for prescribing long-acting opioids. DPH Director Dr. Karyl Rattay says that while a small percentage of providers (1 percent) are writing 32 percent of opioid prescriptions, almost all providers are struggling with how to better help their patients.

“This isn’t just about telling providers what they need to do,” said Dr. Rattay of the expansion of the health care provider section of the website. “It’s about motivating them by telling them why they need to do it. It’s also about providing comprehensive, evolving support to the trusted caregivers in our community. Certainly, the entire crisis surrounding opioid addiction and drug-related deaths doesn’t lie solely in the hands of health care providers, but they are the critical starting point, and offer the greatest potential for impacting our state’s continual move toward safer use of opioids.”

Preliminary estimates for 2018 indicate 419 overdose deaths across the state, an increase of 21 percent from the 2017 total of 345 deaths, according to the Division of Forensic Science. The CDC ranked Delaware number six in the nation for overdose mortality rate in 2017.

If you or a loved one is struggling with addiction in Delaware, call DHSS’ 24/7 Crisis Hotline to be connected to treatment and recovery options. In New Castle County, call 1-800-652-2929. Or in Kent and Sussex counties, call 1-800-345-6785. To search online for treatment and recovery services in Delaware or nearby states, visit www.HelpIsHereDE.com.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

The Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

Dover – The Division of Public Health (DPH) is pleased to announce the launch of its newest school-based oral health outreach program, the Delaware Smile Check (DSC). Debut screenings took place in Sussex County at Seaford Central Elementary School on January 17, and the program has already been conducted at seven schools throughout the state To date,1,018 children have received screenings from a DPH hygienist who informs parents/guardians of each child’s oral health status through a report card that is sent home. In addition to the screenings, 1,018 students received preventive applications of fluoride varnish to strengthen teeth against decay and reverse early cavities.

The Delaware Smile Check is a grant-funded program that seeks to connect under-served children with dental homes and help coordinate treatment for children who have emergency dental needs. As a result of this program, 206 students have received referrals to treat suspected cavities, and 217 students who were identified as needing emergency care received help finding a dentist to treat them immediately.

“This is an amazing example of partnership between schools, the state and Delaware’s dental community,” said DPH Dental Director Nicholas Conte. “We appreciate the work everyone has done to provide these opportunities for the children.” So far, 46 dentists throughout the state have opened their doors to patients referred from this program, both insured and uninsured, to ensure they receive the treatment needed and establish a dental home for the future. As an additional component, just under 3,000 students from pre-k to grade 8 have received educational presentations in their schools from registered dental hygienists who gave lessons highlighting the importance of oral health.

“As a dental hygienist in Sussex County, I’m very excited to be joining forces with this community and school-based dental screening program. It has opened my eyes to the importance and genuine need of access to care, dental education, and dental disease prevention among children. I am very confident this program will become a success and am grateful for this opportunity to work within my local community,” said participating dental hygienist Ashley Hudson, RDH, BSDH.

The program currently relies entirely on grant funds and donations to provide the supplies necessary to carry out the screenings. Early in February, Dental Health Products, Inc. (DHPI) donated fluoride varnish, toothbrushes, and toothpaste that was distributed to high risk children in participating schools.

“The Division of Public Health is grateful for the generous donation of dental supplies to support the Smile Check Program,” said Director Dr. Karyl Rattay. “We know that a child’s oral health has an impact on their overall health and self-esteem. This will help our dental program serve our most vulnerable children and set them on the path to good oral and overall health for years to come.”

“Dental Health Products, Inc. (DHPI) is proud to support the dental professional community,” said LaDeana DeClark, special markets representative for DHPI. “The Smile Check Program diligently ensures local youth have the proper supplies to maintain optimal oral health. DHPI is more than a supply and equipment

dealer. DHPI is a partner for a common cause to improve oral health care for all ages.”

Twenty more schools are scheduled for the 2016-2017 school year and DPH is excited to expand the program to areas of the state that have been traditionally more difficult to access.

Schools interested in participating in this program should contact Gena Riley in the Bureau of Dental Health Services at Gena.Riley@delaware.gov.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

DOVER– The Division of Public Health (DPH) is pleased to welcome Dr. Nicholas Conte, as Dental Director for the DPH Bureau of Oral Health and Dental Services (BOHDS).

Dr. Conte is a prosthodontist who most recently served as the Director of Clinical Research and Education for Dentsply Sirona.

He has prior experience in both private practice and as a faculty member at New Jersey Dental School (renamed the Rutgers School of Dental Medicine), where he taught both undergraduate and post-graduate prosthodontics.

Dr. Conte has lectured extensively both nationally and internationally, conducted clinical research trials, and worked on product development teams for impression materials, composites, adhesives, and cements.

“We are fortunate to have someone with Dr. Conte’s qualifications joining the DPH family,” said DPH Director Dr. Karyl Rattay. “It is exciting to find a leader who has touched on so many different areas in his profession. His recognition of the value of oral health and how it impacts overall health will help lead the Bureau of Oral Health and Dental Services into the future.”

“I am very excited and honored to be named the Dental Director and to be a part of the Division of Public Health,” Dr. Conte said. “I look forward to continuing the great work that has already been done, maintaining important partnerships previously established within the state, and fostering new relationships with external partners. I also look forward to working with the Delaware dental community to improve general awareness about the importance of oral health and the key role it plays in our overall wellness.”

DPH dental clinics serve the Medicaid and uninsured communities (age 20 and under) surrounding each of its five state service centers throughout Delaware. The BODS has made great strides in promoting oral health in the state, including:

• launching the First Smile Delaware website. The website serves as a communications anchor point, providing a place where people can access information on oral health literacy, providers’ resources, parent resources, and prenatal, infant and young children patient education cards.
• recruiting a pediatric dentist to practice in Sussex County in 2013, through a special loan repayment award funded by the Oral Health Workforce Development grant. Prior to this, Sussex County had not had a pediatric dentist and this was considered to be one of the most pressing needs to provide dental care for children.
• providing dental care for Medicaid-eligible children at DPH’s five state-wide clinics.  More detail on the school-linked program is below.  An Electronic Dental Record (EDR) was implemented in December 2012 that will contribute to greater efficiency and quality of care.

The Bureau of Oral Health and Dental Services was awarded a Health Resources and Services Administration (HRSA) Oral Health Workforce Activities grant in the amount of $481,826 for each of the next three years. The grant will address:

• training dental professionals to improve access to dental care for people with disabilities.
• integration of oral health into primary care in Federally Qualified Health Centers (FQHCs).
• expansion of oral health outreach and disease prevention in schools and communities.

DPH has also implemented several oral health programs that are integrated within the school systems throughout the state.

• Seal-A-Smile Program – This program brings dental care to Delaware elementary schools through a state of the art mobile dental van. Children come onto the van for a quick exam by a volunteer dentist to determine which may qualify to have sealants placed.  A public health dental hygienist then places the sealants on these teeth along with a fluoride varnish. This program is primarily for children who have Medicaid. DPH is actively seeking additional dentists to volunteer and assist with the screening processes.
• Delaware Smile Check – This program aims to provide resources for children who are not receiving regular dental care.  A public health hygienist travels to the school and performs screenings using a portable dental chair and light in order to determine a child’s need for dental care. If the child has noticeable cavities or excess of plaque buildup, the hygienist will make a referral to a local dentist. The hygienist will also help coordinate treatment if he she sees an emergency situation, and follow up with to make sure he/she has been taken care of. The goal is to let parents/guardians know the oral health status of each child and provide them with the education and resources to get the best care possible. This program is available to all students regardless of their Medicaid status.
• School Linked Program – This is DPH’s largest and most successful program in which students with returned medical histories and permission slips are picked up during normal school hours, either before or after lunch, and transported to the nearest state service center to receive full comprehensive dental care.  This includes x-rays, cleanings, exams from the dentist, fillings, sealants, fluoride treatments and in some cases, extractions.  The program addresses barriers for parents/guardians who do not have a car/transportation or cannot afford to miss time from work to take their children to appointments.  Correspondence is relayed to parents/guardians after each check-up and before any follow up work is completed.  This program is available only for children who have Medicaid, however, no child with a dental need or emergency is refused treatment.

The Bureau also participates in community activities as often as possible such as Mission of Mercy, Stand Down, and Give Kids A Smile, while providing donations and coordinating educational outreach for various organizations.

For more information on BOHDS and the services it offers, call 302-744-4554 or visit http://dhss.delaware.gov/dhss/dph/hsm/ohphome.html.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH.  The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.
 
Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.