State dental director to tackle oral health challenges

Jayanth V. Kumar, DDS, MPH, will begin serving as California's new state dental director on Aug. 1.

Kumar comes to the California Department of Public Health (CDPH) with more than 25 years of experience in the New York State Bureau of Dental Health. He has held the positions of state dental director and acting director since 2009 and is responsible for developing the first comprehensive state oral health plan for New York.

Kumar will direct and manage the oral health program in the CDPH and, in collaboration with the Department of Health Care Services, provide leadership in developing and implementing innovative strategies and policies to reduce oral health disparities in California. In addition to a state oral health plan, Kumar will also be responsible for establishing prevention and oral health education projects and working to secure funding for prevention-focused oral health programs, particularly for children.

Kumar recently took time to speak to CDA Update staff about his new role and some of his objectives.

How does your background lend to fulfilling the duties of this position?

I have held various positions in the New York State Department of Health and most recently as its state dental director. Having participated in many expert panels, national committees and in the private practice of dentistry, I understand the challenges and opportunities for promoting oral health both in communities and in health care settings.

As a CDC-funded grantee for more than 10 years, I was involved in the development of a surveillance system, state oral health plans, coalitions and partnerships, and promotion of evidence-based programs. I have broad experience in the implementation of many programs and policies ranging from school-based interventions and community water fluoridation to addressing common risk factors in dental settings. I have been involved in the development of learning collaboratives, performance management programs and dental workforce initiatives.

What about your background/experience in New York do you think might be most useful in your new position in California?

In my previous position in New York State, we were able to bring together a diverse group of partners and stakeholders for developing a common agenda for promoting oral health and preventing dental diseases. We were able to leverage federal, state and local resources to make progress toward achieving oral health objectives. We partnered with professional organizations, health projects, advocacy groups, educational institutions and health foundations to promote oral health programs and policies.

What do you most look forward to as you think about your new role?

I look forward to assisting the California Department of Public Health in building a robust state oral health program for achieving equity in health and wellness. CDPH's chronic disease and risk factor programs aim to promote health and eliminate preventable chronic diseases including tooth decay.

According to the Centers for Disease Control and Prevention, strong state-based oral health programs are critical to the nation's health. A state oral health program is considered successful if it has access to current data on oral health status, high-quality oral health surveillance, a state oral health plan developed through a collaborative process with implementation strategies, and evidence-based programs and policies.

What do you see as some of the biggest challenges facing dentistry in California and across the country?

The disparities in oral health by income, race, education and geographic locations are profound. We have seen steady improvements in oral health in the last few decades but not all populations have benefited equally. As a result, some studies are showing widening of disparities in oral health among certain population groups. Understanding the causes of disparities and finding effective solutions to address such disparities is a huge challenge. This will require access to current data for assessing problems. Therefore, establishment of a surveillance system to gather data and the timely dissemination of its findings are a high priority. While many states have established such a system and routinely report data to the National Oral Health Surveillance System, the complexity gets compounded in a large diverse state such as California. Here, dental professionals can make a significant contribution by participating in efforts to gather data and disseminate findings.  

Regarding the recent state audit of the Denti-Cal program — what do you see as the important first steps in fixing those problems?

I am aware of the audit and I'm looking forward to working with the Department of Health Care Services on how we can collectively move forward in addressing the state's oral health challenges and in strengthening the overall oral health program.

Talk about the types of things you might like to see become part of the state's oral health plan.

A state oral health plan should address issues identified in a process of assessment, which includes an environmental scan of existing reports and information. In general, the purpose of such plans is to describe how a state health department and the communities it serves will work together to improve the health of the population. It provides a common agenda and a roadmap for action for communities, stakeholders and partners. It can also help to set priorities, direct resources, and implement programs and policies. The plan should reflect the results of a collaborative planning process. 

The planning process begins by asking the question about progress with respect to various national and state health goals and objectives. For example, the California Wellness Plan, a roadmap developed through a collaborative process, has identified access to dental care as a priority. The Healthy People 2020, the nation's 10-year goals and objectives for health promotion and disease prevention, has benchmarks for achieving better oral health. A review of evidence-based interventions, proven practice guidelines and promising approaches should help to identify strategies for addressing identified goals and objectives. The selection of priorities for action will depend on the resources that communities, stakeholders and partners can generate.

From your experience, what are some of the challenges of increasing the level of awareness and importance of prevention and oral health education?

The dental profession has championed disease prevention approaches both at the community level and in dental practices. As a result of these efforts, we have seen significant improvements in oral health over the last 50 years. However, the widespread adoption of preventive measures, such as brushing with a fluoride-containing toothpaste, regular dental visits, community water fluoridation, school-based programs and other risk reduction strategies, has faced challenges. Further improvements can be achieved if individuals, health care providers and decision-makers are sufficiently informed about the importance of oral health and available preventive measures so that they can take appropriate actions.

In recent years, there has been an increasing emphasis on improving oral health literacy at the national level. Several states have recognized that limited health literacy is negatively associated with the use of preventive services and health outcomes, and have taken steps to improve oral health literacy. For example, Maryland's "Healthy Teeth, Healthy Kids" campaign targets parents and caregivers through a comprehensive literacy campaign utilizing outreach through community organizations. In New York State, a Cavity-Free Collaborative is being established in selected communities to create a replicable best practice model for eradicating dental disease in young children. Multiple strategies are being pursued at changing social norms within communities so early cavity experience becomes unacceptable. The lessons learned from such campaigns will help to design effective programs to address limited oral health literacy and improve population health.

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Gov. Jerry Brown today announced that Jayanth V. Kumar, DDS, MPH, will serve as California's new state dental director. For years, CDA has advocated for a state dental director — the establishment of this position is a major achievement for the state's oral health program and access to care planning goals.