Opinion: It is time to increase oral health representation on the board of nonprofit health organizations

Disha Thakkar is a 2023-2024 N.C. Schweitzer Fellow.

Editor’s note: This opinion piece was penned by Schweitzer Fellow Disha Thakkar as part of her required activities. The NC Albert Schweitzer Fellowship is a one-year interdisciplinary, mentored fellowship program focused on health-related community service and leadership development.

Oral health disparities are worsening. More than 34 million school hours were lost in the United States in 2008 because of unplanned urgent dental care. More than $45 billion is lost in productivity in the United States each year because of untreated oral disease. Access to preventative dental care is the burning need of the hour. In August 2023, CDA (California Dental Association) published a collection of articles advocating for oral health integration in the evolving health care ecosystem. One of the ways we can significantly proceed towards this integration is by increasing the board representation for oral health and involving dentists in decision-making at various health organizations.

Oral health integration has been at the forefront of the conversation for two decades now. The Surgeon General’s report on oral health released in 2000 highlighted the importance of oral health as an integral component of general health and well-being. The report called upon various stakeholders to take actions to improve oral health and prevent unnecessary pain and suffering. It was followed in 2003 by A National Call to Action to Promote Oral Health, which outlined steps and strategies to implement those actions. Twenty years after the initial report, translation of those recommendations into policies, practices and delivery in the health care system is still evolving.

Oral health is inseparable from overall heath. Oral health status can reveal signs and symptoms of many general health conditions. More than 100 systemic conditions have oral manifestations, including nutritional deficiencies, autoimmune diseases, cardiovascular diseases, stroke, respiratory infections, diabetes and pancreatic cancer. There is increasing evidence of oral diseases impacting systemic health and quality of life. Periodontal diseases can result in increased systemic bacterial exposure and increased inflammatory factors associated with a range of diseases and conditions such as diabetes, coronary heart diseases, stroke, arthritis, respiratory diseases and renal diseases. Furthermore, several studies link poor oral health to metabolic syndrome, obesity, severe mental illnesses, Alzheimer’s disease and adverse pregnancy outcomes. The connections between oral health and systemic health are undeniable. Yet, dentistry still fails to be integrated into primary care.

The IOM (Institute of Medicine) report highlights that dental coverage is primarily provided and paid for separately from general health insurance. It further mentions that the dentists are trained separately from physicians, and policymakers often fail to incorporate oral health into health care policy decisions, despite increasing evidence linking oral health and overall health of patients. As board members, dentists can take an active role in establishing policies and making strategic decisions. This will give us a chance to make significant improvements in oral health awareness and access, ultimately preventing oral and overall diseases. One study even found the number of dentists on hospital boards that include dentists’ number significantly less than physicians and nurses. There is a lack of data in this area, though, indicating the need for more studies to understand the actual number of dentists making policy-based decisions for health.

As dentists, we can advocate for ourselves to be on the board of a local or a national health organization. We can also make it a point to attend city council meetings representing our organizations so we can participate in the discussions of policymaking. As a fourth-year dental student at UNC Adams School of Dentistry and NCOHC Schweitzer Fellow 2023-2024, I will be addressing this issue to Senator Adcock in the General Assembly meeting on April 03, 2024.

It is important to raise awareness on this issue with dental students, create skill development opportunities and train them to serve in these vital roles when selected as a board member. This could be done by reaching out to the students via school publications or engaging them in an educational seminar.

Despite the important role oral health professionals play in the overall health of people, there is barely any oral health representation on various health care organizations’ boards. Dentists need to be involved in policymaking as we understand the clinical, demographic and economic needs of a very important aspect of overall health.

Disha Thakkar

2023-24 NC Schweitzer Fellow

UNC Adams School of Dentistry, Class of 2024