← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Caitlin Walker, Manager at the Delta Dental Community Care Foundation & Rebecca Cornille, Chief Dental Officer at Vista Community Clinic
00:22:51
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- [00:00]
A
Hello, this is Ariana Portolattin with the Beckers Dental and DSO Review Podcast. I'm thrilled to be joined today by Caitlin Walker, manager of the Delta Dental Community care Foundation, and Dr. Rebecca Corneal, chief Dental Officer at Vista Community Clinic in California. Caitlin. Dr. Corneille, thank you so much for being here today. It's a pleasure to have you both on our podcast today.
- [00:20]
B
Thank you so much for having us. Yes, of course.
- [00:23]
A
Great. So looking forward to getting our conversation started here. To start us off, though, for our listeners, can you introduce yourself and tell us a little bit about both of your backgrounds? Whoever wants to start first, go ahead.
- [00:35]
B
Sure thing. I'll start. I'm Caitlin Walker. I'm program manager at the Delta Dental Community Care Foundation. I've been working in health philanthropy for about 15 years, and the Delta Dental Community Care foundation exists to expand access to care, strengthen the oral health workforce, and advocate for systemic change to improve oral health outcomes across our enterprise states or 15 states in Washington, D.C. but my focus over the last four years has been to elevate the issue of oral health access for older adults specifically. And we found it to be one of the most overlooked public health challenges in the United States. So we're really excited to talk with you today about what we're learning through our efforts and our partnership with Dr. Corneille's organization, Vista Community Clinic.
- [01:22]
C
Hi, I'm Dr. Rebecca Corneille. I'm a dentist and a chief dental officer of Vista Community Clinic, which is a federally qualified health center that serves over 68,000 unique patients in Southern California. In our dental department, we care for about 19,000 patients, 26% of whom are age 60 or older. I have 20 years of experience in the community clinic setting, getting creative and innovative and collaborative as we work to try to meet the needs and meet the mission of caring for patients across the lifespan, but especially for our senior patients.
- [02:02]
A
All right, thank you both for those great introductions. First question for you here. What are some of the biggest issues that you are following in the dental industry this year?
- [02:12]
B
Thanks for the question. Yeah, I think first and foremost, oral health is overall health. And this is really the foundational principle of our work. Our senior population in the US Is growing, and they generally are a group that really lacks access to quality oral care. And that is something we're finding is really impacting their overall well being. So by 2030, one in five Americans will be over the age of 65. But what we're finding at Delta Dental is over 80% of those folks are not going to the dentist as much as recommended. And about half of the older adult population lacks dental coverage at all. So our goal is for all older adults to have access to affordable, quality oral healthcare so they can really age with dignity. The foundation especially is focused on low income older adults and communities of color who we know experience more barriers to care and worse oral health outcomes throughout their lives. Just as an example, a quarter of older adults living in poverty have lost all of their natural teeth across the US that's compared to just 10% overall. So that's a huge overlooked population. We know this impacts people's lives beyond their oral health. It's affecting their nutrition, their chronic conditions, and really the ability to engage in a social life which really impacts mental health and well being. We have an opportunity as a foundation and our partners to alleviate some of this pain and pressure through our impact work. And we're really looking to do so. Actually, something I want to talk about today is in 2022, the foundation launched the Senior Oral Health Partnership. So this program is investing in building partnerships that both address, assess and address the most important barriers to oral health care in their communities. And our partners, including Dr. Corneal, through organizations like the Vista Community Clinic, those partners are really doing this work on the ground. We have four active partnerships across the country that are now bringing care to seniors who otherwise would not have it. So like I said, we're in four communities including Washington, D.C. santa Cruz County, San Diego county, and most recently the Mississippi Delta region.
- [04:39]
A
Great. Dr. Corneille, anything to add there?
- [04:42]
C
Yes. So as part of the San Diego Partnership, I'm one of nine partners in the area that's really looking to address the oral health care needs of seniors. We're looking at and really focusing on the integration of dental and medical care as a critical component of advancing health equity and creating innovative models across patients lifespans. We're really looking at making sure that we're providing and creating a model that we can replicate across the country in the various partnerships. And what we're able to do is specifically at Vista Community Clinic is for example, working with patients who have diabetes and making sure that we're connecting them to appropriate medical care or optometry. Since diabetes can impact both oral health and eye health. We're also connecting patients to mental health resources if they need it, transportation, food insecurity, et cetera. And we find that this is particularly challenging for seniors who might fall into various areas where they're not able to access oral health care or even primary health care due to coverage or transportation. Or the other things that I've mentioned. Access to dental care is a primary barrier for underserved communities. Yet the dental clinic can sometimes be the most accessible entry point for the wider health care system. Unfortunately, pain can be a very powerful driver in that patients might access our clinic first through our dental department, but then we learn that they have other primary care needs that need to be met, and we're able to connect them to those resources through our organization.
- [06:38]
A
That's great. Yeah, I can tell that there's a lot of working parts through this program and definitely an underserved population. So very interesting to learn more about what you're doing there. I'd love to know. I know you guys talked about how this is definitely an overlooked issue. How did this come to be so overlooked in the industry? Caitlin, why don't we start with you?
- [07:00]
B
Sure.
- [07:00]
A
Yeah.
- [07:02]
B
Just speaking from the philanthropic lens, we know from national stats that less than 1% of philanthropic giving is going to any cause related to aging. So that was a really striking thing to learn about just who we are. As the foundation world, we're not paying attention to issues related to aging. And I think just in general, our culture is not very good about recognizing folks needs as they age. There's that barrier. But I think oral care is an even more niche area that we talk a lot about prevention for young people, which is great and of course really important. But as people age, like I said, they're not covered by Medicare, traditional Medicare. So we have half of the population that has no coverage after the age of 65, when a lot of issues are compounding and right at the moment where they really need care. And so it's something that we're hoping that the conversation can be elevated to, to include oral health. There's a robust conversation nationally about aging and health, but oftentimes the oral health care is missing from that conversation and from that table.
- [08:25]
A
Okay. And Dr. Corneille, can you speak to the clinical lens as to why this issue is so overlooked?
- [08:32]
C
Yes. To Caitlin's point, oftentimes, in my experience in 20 years in this setting, is that there's often opportunities to work with the youngest in our population for prevention, which is very important. But when the focus shifts strictly to our youth, we aren't paying attention to those needs of the seniors or the older adults in our communities who oftentimes didn't have access to the same prevention models that are currently existing or have been developed. And that can be compounded, especially in low income populations where access and affordability are a real Issue clinically all of the time. I see and hear of senior patients who want to access oral health care, but there's a lot of financial restrictions there. Being on a fixed income, it can be incredibly challenging if they're on Medicare and there's no oral health component of Medicare, there's no way to pay for the care that they need, and oftentimes requires making decisions between, you know, food on the table, rent, et cetera, versus going to the dentist. And it just shouldn't be that way. We need to care for our seniors who have been overlooked for this period of time. And while we work to continue to prevent oral health disease, it's really important we do everything we can to bring a voice to those who are voiceless, who are voiceless or those who have been overlooked.
- [10:11]
A
Yeah. And I know you mentioned aging with dignity and being able to give that to this population. So, Dr. Cornea, I'd love to know, are there any anecdotes that you can share, any patient stories that you can share without naming any specific names on just how you've helped someone within this population group?
- [10:34]
C
Yes. So we have, with the help of Delta Dental, been able to create a model and a position called an integrated coordinator. And this integration coordinator is operating behind the scenes, essentially connecting the dots in the healthcare system for our patients. And what that looks like is essentially a senior who is in our system. If they're accessing medical care, we're trying to connect them to dental care and vice versa. What this looks like for the patient is they receive a phone call from our integration coordinator in order to assess their need and desire to see a dentist or any of their other needs. Oftentimes, these phone calls can bring up issues related to transportation, not, yes, I'd love to come, but I can't get there, or I need someone to come with me, or language barriers, those types of things, they help connect them to the career and schedule those appointments. They also complete an intake that allows us to, as the dentist, to walk into the room with a little background information of what this patient might need. You know, they have some mobility issues, therefore, you know, we need to be prepared in a larger room, there's a wheelchair or there's a walker, et cetera. And it also helps highlight the patient's priorities. They often have something they want addressed. They might have pain, they might not. They might not have had a cleaning in many, many years. There might be aesthetic concerns, speech concerns, inability to gain nutrition, lacking prostheses, all types of things. And so we basically are Helping them get through the door, get that appointment, and start navigating those challenges with them. And oftentimes they're not just strictly oral health chall. And the great thing about an integration coordinator is without them, I would still try to spend as much of that valuable chairside time with them trying to navigate this. But when we have someone who is essentially an even greater expert in just navigating the healthcare system, I'm able to focus on their oral healthcare needs and really maximize the time I have with them and getting them more comfortable with where they are in their health.
- [13:08]
A
Great. Well, it's nice to see how widespread that impact is, so thank you for sharing that. Caitlin, do you have anything to add on what you've been able to see in your role?
- [13:17]
B
Oh, yeah, definitely. So across the four partnerships, we do try to tell patient stories just to sort of give the context from each community. And one story that's really stuck with us all from the Washington D.C. partnership is a woman, she's probably 94 now, named Dolores, who she talked about just not being able to participate with her social activities that really keep her energized. And specifically attending one of her family members weddings was really difficult given her the condition of her oral health and not being able to chew food and smile. And she spoke with our partners at Howard University about that difficulty and how the treatment allowed her to go to this wedding and feel great and continue to eat a nutritious diet. And she was just beaming as she shared that. It just really shows us how important this is not just to their oral health, but just their quality of life and how it can keep folks engaged in their day to day activities.
- [14:27]
A
Yeah, yeah, definitely a good point to make. So thank you for sharing that story. That was great to hear as well. Moving on to the next question, I'd love to hear from you both. What are you most excited about when it comes to dentistry right now? And is there anything that makes you nervous about clinical care or just the dental industry as a whole? Dr. Corneille, why don't we start with you?
- [14:48]
C
Well, we're definitely excited about the momentum of whole person care and integration, especially medical and dental services, and trying to move beyond the traditional separation of dentistry from overall health. This model is proving to be practical and replicable across the country. And as part of our partnership, we've shown that integrating dental and medical and mental health services is a very effective strategy. The main concern that we have related to this is just the urgency to scale this. There's an oral health crisis for our older adults, and we have this successful model, but we really need to break down those barriers to care and create systemic change in order to continue to improve taking care of our aging adults.
- [15:42]
A
Okay. Caitlin, what about you? Anything to add as far as anything that you are excited about or nervous about within the industry?
- [15:50]
B
Sure, yeah. Right now there's, I think, plenty of both exciting things and things that make me nervous. But truly the most exciting thing is seeing our community, community partners have the impact they're having. In the last four years, our partners have served over 22,000 older adults. And that's not just with one visit. That's, you know, establishing a dental home. So we're really proud and energized about that. But I'll tell you something that happened very recently that's given me a lot of hope about our progress. Just two weeks ago, leaders from all four of our Senior Oral Health Partnership communities met up in Washington, D.C. at the Senior Oral Health Summit, which is our annual convening event. And we were really focused on our collective learning and action to reduce barriers to care for this population. We also brought our partners and providers directly to lawmakers on Capitol Hill, which was our first time doing something like that as a group. And we were able to really make a powerful case for expanding access to oral care for, for seniors and also to Dr. Corneal's point about expanding medical dental integration and the models that are working well and just elevating those two things as public health priorities. And I think that the biggest concern, I guess, is just how urgent the need is and what we're seeing on the ground as far as the need that our older adults have in this area. It's a complex issue. There's entrenched barriers around affordability, around accessibility that we're really trying to learn more about and, and put our efforts toward overcoming. But we're going to need to engage across sectors on this. We really can't do it alone, and we don't have all the answers at this point. But what we're doing now is just actively listening, trying to pull more partners in from across sectors and fields and really using our platforms to tell the stories of older adults and their needs. And I'll just share one thing from one of the visits that we had on Capitol Hill a couple weeks ago. We were sharing just the importance of oral health when it comes to older adults overall health. And we just shared with a health staffer of a senator that Medicare doesn't cover dental. And so a large portion of older adults in the Us don't have any coverage at all. And the health staffer was shocked to learn that. And so it was, I think, just highlighting how important it is to continue to talk about this. There are people making decisions about our healthcare who don't know how this population is impacted. And so it's really incumbent on us to, like Dr. Corneal said, be a voice for the voiceless.
- [18:52]
A
Definitely. Thank you so much for making those points very important. Last question for you both here. What will the most effective healthcare leaders need to be successful within the next two to three years? Dr. Corneille, let's start with you again.
- [19:06]
C
I would say to Caitlin's previous point, it's very important that we really build connections across different disciplines, medical, dental, mental health, public health advocacy, to really create a seamless experience for patients. I recognize sitting at a community clinic that I'm at a bit of an advantage because I have cross discipline colleagues at my fingertips, which is amazing. And this is the perfect place to develop some of these models to roll out across the country in order to help serve people more comprehensively. I think it's really important to have an unwavering commitment to health equity. Success will be measured by the ability to design systems that dismantle these barriers that we've talked about in terms of access and afford for our vulnerable populations. And really we focus on treating human beings and we have to extend that beyond our clinic walls. We have to address social determinants of health and really work to build healthier communities, not just provide basic health care.
- [20:22]
A
All right, Caitlin, anything to add from your end?
- [20:27]
B
I'll just agree wholeheartedly with Dr. Corneal and one thing I like to say is just we can't continue talk only with our fellow oral health professionals and advocates. We need to be at the table when conversations about aging and overall health are happening. Otherwise this issue will continue to go unaddressed. So our presence in these conversations are so important. And so we're actively reaching out to our colleagues in overall health and in medical care and mental health care and just continuing to make the point that oral health is so important as part of that overall health, and also want to make a plug for a platform called the People say for the listeners to check out. It's a really interesting collaboration between the SCAN foundation and the Public Policy Lab that just allows older adults in communities across the country to talk about the issues they face across a number of different topic areas across health, oral health, mental health. And it's a really interesting way to just sort of hear straight from older adults what their issues are. So I just want to make a plug for that as we continue to try to elevate the voices of older adults in these conversations.
- [21:55]
A
All right. Thank you both so much. You both made some very interesting and important points. I'm sure a lot of what you said will hit home for a lot of people working on the ground and, as you said, working in these spaces within this patient population. Thank you again, both of you, for being here today. Been a pleasure speaking with you, and I look forward to connecting with you again in the future.
- [22:16]
B
Thank you so much. It was great talking with you.
- [22:18]
C
Thank you.
- [22:18]
A
Great talking with you. Enjoy the rest of your day. Bye.
- [22:20]
B
Bye.