Giving Kids Something to Smile About: ADA President Dr. Chad Gehani on National Children’s Dental Health Month

Dr. Chad Gehani - President of the American Dental Association

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Marianne O ’ Hare : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter a show where we speak to the top thought leaders in
health innovation , health policy , care delivery and the great minds
who are shaping the health care of the f uture. This week Mar k and
Margaret speak with Dr. Chad Gehani, P resident of the American
Dental Association , the largest organization dedicated to a dvancing
the p ractice of d entistry and improving oral health for all Americans.
February is National Childre n's Dental Health Month and Give Kids a
Smile month to o. Dr. Gehani will talk about that and innovations that
are advancing dental care.

Lori Robertson also checks in the Managing Editor of F act C heck.org
looks at misstatements spoken about health policy in the public
domain, separating the fake from the facts . We end with a bright idea
that’s improving health and well being in everyday lives. If you have
comments, please email us at [email protected] o r find us on
Fa cebook, Twitter or wherever you l isten to podcasts. Y ou can also
hear is by asking Alexa to play the program C onversations on H ealth
C are. Now, stay tuned for our interview with American Dental
Asso ciation President Dr. Chad Gehani here on Conversations on
Health C are .

Mark Masselli : Welcome to Conversations on Health Care , I’ m Mark Masselli .

Margaret Flinter: And I am Margaret Flinter .

Mark Masselli : W e ’re speaking today with Dr. Chad Gehani President of the American
Dental Association, and former presiden t of the New York St ate
Dental Association, an endodontist he's a fellow of the American
College of dentist fellow of the In ternational College of Dentist and
honorary life member of the Indian Dental Association. He served on
the faculty at NYU College of Dentistry for more than 35 years. Dr.
G e hani w elcome to Conversations on Health Care .

Dr. Chad Gehani: Thank you.

Mark Masselli: You know, February is upon us and it ’ s National Children's Dental
Health Month and it's still remarkable in the time that we l ive that
dental cavities remain the most significant preventable disease among
young children . I wonder if you could help our listeners understand
the full scope of this unmet health need in America then how the ADA
is focusing on filling that nee d?

Dr. Ch ad Gehani: Tooth decay is the most chronic infectious disease that the human
race suffers specially the children . O ne out of five children under the
age of 11 does have untreated tooth decay. One out of seven teenage
children, again have cavities in their mouth. What we are trying to do
is to raise awareness amongst all of us that it is important for us to

Dr. Chad Gehani - President of the American Dental Association

prevent the tooth decay and to treat it at the much earlier stage .
Th rough Give Kids a Smi l e Program w e have reached hundreds of
thousands of people who could not afford dental care in general, as
well as we are trying to create awareness amongst the public that it is
important for all of us to prevent oral disease and specially tooth
decay, because prevention is lot better than treatment. Preventio n is
mu ch more cost effective, it cost much less if the public is getting the
support from the public funding. W e are just trying to increase the
awareness. We also have programs such as a Community Dental
Health Coordinators that really go out and in crease the d ental literacy
amongst the public.

Margaret Flinter: Dr. Gehani just mentioned something that I love about February and
have for gosh it seems like 20 years now, and that's Give Kids A Smile
what we call GKAS because I think it's such an exceptional that w e
have the missions of mercy , we have free clinics . B ut this is really all
about the kids and giving t he dentist, the dental hygienists and other
dental health professionals a chance to really g ive back to their
community. M aybe just share with our listene rs, how did Give Kids a
Smile get started and what is so special about that event?

Dr. Chad Gehani: Well, Give Kids a Smile started as a small program back in the year
2003. One dentist thought of doing some charitable work, and it just
started like that. N ow we have expanded and we have treated , I
would say , close to 6 million underserved children's across the
country , that’s huge amount s o we are very proud of this program.
We are also very thankful that it's more of a community work, just
one Dental Asso ciation . W e do have partners and we have Henry
Schein and Colgate assisting us reaching out to needy people.

As I mentioned earlier, there are children out there who suffer from
untreated tooth decay. T he untreated tooth decay not only causes
pain in the c hild's mouth, it also makes the children stay away from
the school. As a result of that they will lose interest in studying
further . I f they lose the front tooth, for example, they start developing
some psychological problems and that affects an overall gr owth in
general. I'm not just mentioning the dental and the medical tr eatment
here . I'm talking about the growth of our future , s o investing in our
own future at a relatively low cost or no cost . H ere , t he American
Dental Association is doing it as a commu nity service to the entire
nation , and we are very proud to do that year a fter year .

Mark Masselli: Well , and we want to give a shout out to the dentist who we work
with here all across the nation who participated in , what a great
service . Y ou were talking about preventing tooth decay. I really want
th
to talk a little bit about prevention, because this year marks the 75
anniversary of the decision to fluoridate America's drinking water .
R eally is a public health intervention to prevent tooth decay. I'm

Dr. Chad Gehani - President of the American Dental Association

wond ering if you could help us understand the impact of fluoridation
on the nation's drinking water and how that's led to better oral health
and dental health over the decades.

Margaret Flinter: D idn't that start i n Connecticu t, Mark?

Mark Masselli: I think it did.

Margaret Flinter: Or Connecticut lays credit to that , we have to tell you.

Dr. Chad Gehani: W hen I was a dental student, somebody asked me , they give me a
very small budget, and they asked me a question if we gave you only
$1 million, and we asked yo u to improve the overall health of the
entire population in United States, where will you spend the money
on? Guess what m y answer w as ?

Margaret Flinter: F luoride .

Dr. Chad Gehani: W ater fluoridation?

Mark Masselli: A bsolutely.

Dr. Chad Gehani: It is the c heapest and most effective safest way of preventing tooth
decay. I drink tap water in New York City myself. I make my children
d rink the tap water when they were young, and I have six
grandchildren a nd they all drink the city water because that is
fluorida ted. I t is the most effective and proven that we should be
using the water fluoridation within the controls that t he science
provides us to do so.

Mark Masselli: That's great.

Margaret Flinter: Well, Dr. Gehani we often talk about how there's no wrong door
when it comes to health care , and you can never start early enough.
Go upstream start counseling moms right from the very first moment.
We also know that primary care, primary medical care can be a great
entree point for our all health , and we've really t ried to bring the
service to where the kids are and where do the kids spend most of
their time ? They spend it in school , a nd so building these networks
from head start right up through high school, and that's allowed us to
reach tens of thousands of childr en a year. What are you thinking
about how we change our paradigm a little bit of waiting for the
children always come into our dental practices that are fully equipped
with all the technology you need to being able to move those services
more out into the community settings where the childr en spend so
much of their time?

Dr. Chad Gehani: You know, I like to go to the mountain rather than expecting the
mountain to walk to me. C hildren are in the school i t’ s lot easier for
me to go to the children there and give them some preventive care ,
how to prevent the dental disease. I t is more effective for us to go to

Dr. Chad Gehani - President of the American Dental Association

the school especially w ith this children who a re vulnerable . T he
children where both the parents w ork, they have limited pay or they
are below the pover ty level. These are the children who cannot afford
to miss a day , stay home and then mom says, o h I got to work now.
T his way they are not missing any school days.

We are also solving another purpose here. We are educating their
teachers, as well as we are creating an awareness amongst the entire
community in general that by treating oral problems you a re actually
solving the general health . G ood general health begins with good oral
health. We are also very excited that apart from the Give Kids a Smile
be in g one of our programs, which is a part of action for dental health.
We have o ther programs like dental health coordinators who can go
out in communities and raise the health literacy as well as encourage
the patients out there to make the appointment with a dentist , s o the
people who will generally not think of seeking good oral health will
now seek the oral health.

Mark Masselli: We're speaking today with Dr. Chad Ge hani, President of the
American Dental Association and former president of the New York
Sta te Dental Association. Dr. G ehani l et's take a look at the broader
demographics , a nd I know you have been personally involved in
efforts to break down ethnic, racial and economic barriers to make
sure that everyone has access to good dental health . I think , see this
promise of increasing access to dental care through Medicaid and by
deploying community health workers. I think we're excited about the
whole proposition of what community health workers can do. I'm
wondering if you could talk about disparity an d the lack of access to
dental care. Tell us a little bit about what the ADA under your
leadership is doing to help address some of these important issues ?

Dr. Chad Gehani: Well, the Health Policy Institute found that the utilization of the
dental care amo ngst the underserved population is lot less than the
population that has private insurance. We do advocate for public
funding for the underserved population. We should have one care for
every single American and they are entitled to the b est dental care.
W e do advocate a lot about expansion of the Medicaid for children as
well as for the adults. We do assist our states and also promoting
dental health at th e state level . Again, water fluoridation is one of the
safest, cheapest and most effective way of prev enting dental decay.
We strongly believe in that , s o we advocate of fluoridation.

Margaret Flinter: You know, Dr. Gehani o ne of the things that we're always very
focused on is are there enough providers in a given area? We are a
vast country in the United States. C ertainly, the needs of our rural
areas in particular are really quite pressing . L ots of ways to approach
that , we've seen some states take the position of expanded roles for
dental hygienists. The pediatric well child visit can be used for some of

Dr. Chad Gehani - President of the American Dental Association

the topical fluoride . Y ou've been in education. You've been in training
policy . Y ou've been a professor at NYU. What are we doing about this
issue of the next generation of workforce of training enough dentist
and also what's your vision of how we maximiz e t he incredible
specializ ed education and training that d entist have to be able to get
that service to people wherever they are ?

Dr. Chad Gehani: First off all , in my opinion, looking for different types of providers may
not be of great help. We did have some smaller experiment where
they brought in other types of trained people other than dentals
thinking that they will serve the underserved population that
experiment ha ve seemed to not produce the desired results. Overall, I
would not say it is a major m anpower issue , it’s more of fixing the
system , providing enough funding for the public health programs.
Th at's what we advocate for , many times educating the public
specially when we are discussing the children , educating their parents
or caregivers is muc h more important.

That's why the ADA is very proud that they have introduced
community dental health coordinators, which has worked in about 40
states. Again, water fluoridation and good oral habits , brushing after
every major meal , a lot of people forget to brush their teeth before
they go to bed. They can just go to bed and that's where they forget
that the bacteria don't know y ou provide some sweet , some candy to
the bacteria. They will multiply by seconds , s o educating the public
that good brushing, flo ssing is absolutely necessary.

Mark Masselli: You know I 'm excited about the work that you're doing at the
National Dental Practice Research Network. I want you to tell a little
bit about improving practice of dentistry and oral health. It's coming
out of your research network. What's the horizon look like in te rms of
some of the discoveries that you hope to see come out of this
institute ?

Dr. Chad Gehani: First of all, let me tell you what is happening in dentistry. When I went
to dental school, it used to take us about two to three weeks to make
a crown for our patients. Nowadays, a patient can walk in my office,
and by 2 :00 p . m . the patient will walk out with the crown fitted in th e
patient's mouth due to 3D printing , so it’s much more easier. We have
als o used our lasers in gum treatment. We have used lasers nowadays
for tooth decay or small cavities , I’m an endodontist, for root canals,
we used to make the patients come back three or four times. There
was no such t hing as root canal in one hour, so we ha ve done that.

At one tim e we prescribe antibiotics on e very root canal . N owadays,
the last time I might have prescribed antibiotics maybe four or five
months ago. W e've pretty much d o not prescribe antibiotics because
we have learned it is not necessary. T hose are some of the recent
advan cements . At one time we took an x - ray and send the patient

Dr. Chad Gehani - President of the American Dental Association

home because the x - rays we re not ready. Now we take the x - rays and
di gitally we have the x - rays. We can even transmit it to my colleague
or as a dentist I can h ave my dental hygienist take the x - rays and
transmitted to me and I can tell them by telephones what is the next
process to be done. T he life has become a lot easier for our patients.

We believe the innovations in dentistry are great as long as the
quality of care is the same or improved. I 'm very proud that we have
the ADA Science and Research Institute that is focused on new
innovations . O ur science is ever involving and I'm very proud of our
ADA Science and Research Institute .

Margaret Flinter: Well, that is very exciting. I think behalf of everyone who's ever had a
root canal we thank you for the research and the progress. We've
bee n speaking today with Dr. Chad Gehani . He's the president of the
American Dental Association, and you can learn more about their
work and events related to Nat ional Children's Dental Health m onth
by goin g to ada.org. Dr. Gehani w e want to thank you so much for
your leadership in this vital part of America's h ealth and for improving
access to dental health services for all people an d for joining us today
on Conversations on Health Care .

Dr. Chad Gehani: T hank you for giving me this opportunity to have a dialogue with you
and to explain to you what the American Dental Association believes
in, we believe in . We believes in service and we are celebrating Martin
Luther King Junior's birthday . Martin Luther King once said that not
everybody can be famous, but everybody can be great , so a lways try
to be great. T he greatness comes from service , s o serve your
community and serve them well.

Ma rk Masselli: You're a great leader thank you so much .

Margaret Flinter: Thank you much.

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Mark Masselli : At Conversations on Health Care we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy . Lori R obertson is an award winning journalist and Managing
Editor of F act Ch eck .org , a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of decep tion in US politics. Lori,
what have you got for us this week ?

Lori Robertson: Presid ent Donald Trump once again dominated our year end wrap up
of the whoppers of the year . B ut two democratic claims about the
public health issue of guns also made the list , one on bum p stocks and
the other on background checks. Three months after the Trump
A dministration's ban on bump stocks went into effect , Senator Kirsten
Gillibrand gave a town hall audience in June, the false impression that
he had broken his promise to ban the devices that can make semi

Dr. Chad Gehani - President of the American Dental Association

automatic r ifles fire more rapidly “ Remember after the s hooting in Las
Vegas, he said, y eah, yeah, we're going to ban the bump stocks . D id
he ban the bump stocks? No .” S he continued citing the NRAs
opposition, but the NRA ’ s opposition ultimately didn't stop Trump
who consistently spoke about banning bump stocks after the 2017 Las
Vegas mass shooting and another in February 2018 a t a Florida High
School. It took more than a year. But the Trump A dministration's
bump stock ban went into effect in March 2019.

After a mass shooting at a Colorado School in May, then Democratic
presidential candidate Beto O'Rourke pushed a popular democratic
positio n universal background checks f or gun purchases . B ut he
incorrectly claimed that state laws mandating universal checks, “ have
been shown to reduce gun violence by 50%. ” That turned out to be a
wildly inflated estimate . O’Rourke’s campaign s aid the statistic came
from every town for gun safety, but the gun control group told us it
had updated its website in light of rigorous new research.

A study published in the Journal of general internal medicine in March
found that universal background checks are associated with about a
15% reduction in firearm homicides. But the study stopped short of
concluding that the decline was caused by those laws. For more on
the biggest falseh oods of the year, see our website. I'm Lori
Robertson, Managing Editor of F act C heck.org .

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Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Cen ter at the University of Pennsylvania. If you have a fact that you'd
like checked, e - mail us at www.chcradio.com , we'll have
FactCheck.org's Lori Robertson check it out for you here on
Conversations on Health Care.

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Mark Masselli: Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Anxiety
disorders are on the rise among the nation's youth and experts in the
field of child psychology f eel th e condition starts much earlier in
childhood . I t's far more common than previously thought, with an
estimated one in five children being affected, but too often these so
called internalizing disorders go undiagnosed. Unlike children with
more expressive co nditions such as ADHD or Autism Spectrum
Disorder, young kids struggling with anxiety or depression often
internalize their symptoms, and may just seem like an introvert to the
casual observer . University of Vermont Child Psychologist Ellen
McGinnis says t he process of diagnosis for younger children is often
painstaking and can take months to confirm.

Dr. Chad Gehani - President of the American Dental Association

Ellen McGinni s : I was actually doing my dissertation during my PhD at University of
Michigan and to find an objective assessment battery for children
with int ernalizing disorders because they have similar things for
children with externalizing disorders and for autism, but not anxiety,
depression, which I think are the most overlooked disorders in that
age group .

Mark Masselli: Dr. McGinnis says the traditional method of diagnosis involves
creating scenarios that induce anxiety, and the results can be inexact .
S he teamed up with her husband and fellow researcher, biomedical
engineer Ryan McGinnis to create a wearable sensor that can pick up
on physical cues that suggest the presence of anxiety, using
accelerometers and simple algorithms to com pare normal stress
responses.

Ellen McGinni s : T he device is called an inertial Measurement Unit , a nd it's about the
size of a business card. We strapped that belts on each c hild when
they did a mood induction task and it has an accelerometer in it , a nd
so we're able to pick up how much the child is bending forward and
backward, and turning side to side, things like that. I t actually picks up
100 samples per second. W e were ab le to see if kids with anxiety and
depression move differently in response to a pot ential threatening
information , and they do.

Mark Masselli: Dr. McGinnis says that it can pick up anxiety and depression disorder
symptoms in a matter of minutes instead of months. Their research
paper published in the plus one shows the device was nearly 85%
accurate in making a correct diagnosis. The University of Vermont
based husband and wife team are expanding their research to test the
device in a much broader pediatric population.

Ellen McGinnis : What's really great about it is that we increase the sensitivity
compared to subjective parent reports. We 're picking up more kids
who might have go ne previously undetected .

Mark Masselli: A simple wearable tool that can assist parents and clinicians in
determining if a child is suffering from anxiety disorder, leading to less
guesswork and more rapid diagnosis and treatment. Now that's a
bright idea.

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Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health.

Marianne O ’ Hare : Conversations on Health Care is recorded at WESU at Wesleyan

Dr. Chad Gehani - President of the American Dental Association

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