May 2022 Volume LVII Number 3


Feature Story: Keep on Dancing

May 2012 Volume XLVIII Number 3

As Dr. Rhea Haugseth’s term as AAPD president comes to an end, we recently spoke about her experience
as president, milestones she’s particularly proud of strengths of the AAPD, innovations in the field of pediatric dentistry, and future challenges affecting the pediatric dentistry industry, among other topics.

Here’s what Haugseth had to say about her year in review:

1. When assuming the role as president, you made it very clear that your interests would focus on welcoming all dialogue that advances efforts in the fight for children’s oral health. Do you feel that this has been accomplished? Please explain in detail.

I do feel that the AAPD is the recognized leader in children’s oral health advocacy. Even with our first child advocate, Dr. David Johnsen in 1992, we were voicing the same message to legislators as we do now – that "all children deserve the highest possible quality dental care to help them achieve and maintain optimum oral health." Our 2001 adoption of the definition of a dental home and the ADA’s passage of this in 2005, have helped focus the attention on children’s oral health and the importance of the age 1 dental visit towards a child attaining and maintaining optimum oral health.
Over the years, there have been many organizations challenging us over our position on the access to care issue for the patient population we treat, which spans from infants to adolescents, along with special health care needs patients of all ages. We have continued to express our support of Expanded Function Dental Assistants (EFDAs) in our practices. In fact, these dental team members can greatly increase our efficiency and enable us to treat many more patients. Based on the AAPD Member Needs Assessment survey, 70 percent of pediatric dentists see children with Medicaid, and those offices have demonstrated that approximately 20 percent of their patients have Medicaid coverage – therefore, we, along with EFDAs, can greatly impact and increase children’s access to dental care.

The AAPD is recognized as a true champion for improving children’s oral health not only in the United States, but throughout the entire world. We will continue in our efforts to ensure all children have access to the best dental care possible and help them to achieve optimum oral health.

This fight to improve children’s oral health also encompasses our legislative efforts for Title VII funding. These funds can be used to expand our residency program slots and faculty loan repayment. We need more pediatric dentists to treat the 25 percent of children with 80 percent of the decay. These children often exhibit very complex treatment needs, along with behavior management issues. They usually need the type of dental care that specialists in pediatric dentistry are trained to provide. Pediatric dentists not only treat a large number of children, but they also teach the general dentists – who take care of the majority of children in this country – to provide the proper dental treatment for children. Therefore, we need more pediatric dental faculty to train pediatric dentists, as well as teach pediatric dental care to general dentists.

These are just a few of the issues that impact children’s oral health where the AAPD has taken a leadership position in the fight for improving children’s oral health.

2. Do you think in our country today that there exists a two-tiered standard of care for our nation’s most vulnerable children? If so, please elaborate.

I believe that there are children in this country who live in poverty and low-income households that may lack availability to an ongoing source of quality dental care. We know that children who have a dental home are receiving proper dental care. We can make a tremendous impact on these children and their families by providing the highest quality dental care that is available and found in a dental home. However, children without a dental home may not be receiving dental care on an ongoing basis. They may be seen in an emergency room visit where they receive an antibiotic, but no actual dental treatment. By increasing the number of trained pediatric dentists and highly trained dental team members, including EFDAs, we can provide valuable dental care to this extremely vulnerable segment of our population who may be at an extremely high risk for dental decay. We know that optimum oral health is highly correlated with optimum overall health with the reverse also being true. A dental home, with a dentist as the leader of the dental team providing the best dental care, will eliminate any two-tiered standard of care for our children. These children deserve the best care that we can provide – all children do!

3. How would you describe your experience as president of the AAPD?
This past year as the AAPD president has truly been a rewarding experience. I have had the pleasure of meeting so many people across our nation, as well as in Greece and Scotland. I have enjoyed discussing pediatric dentistry with numerous dental professionals throughout the last 12 months, where many times our discussions usually ended with the telling of stories about our favorite patients. We all have them and it unites us in our ultimate quest – taking care of the kids, regardless of which country, state or city that you call home. Being able to experience the enthusiasm and interest that even non-dentists express as we discuss pediatric patients, has been most impressive. Children’s oral health has gained momentum and is now among the forefront of crucial issues in so many ways. We are at a crossroads of care in this country, and I have seen firsthand how we can influence and help direct the future of children’s oral health and the profession of pediatric dentistry.

It has been an extremely busy year filled with fun, new friendships and great experiences mixed in with a vast amount of work. There have been lots of meetings with many diverse organizations; wonderful
media interviews where I got to express AAPD’s various positions on key oral health topics; and amazing opportunities to promote pediatric dentistry and our wish for optimum oral health for all children. It has been fantabulous!

4. Are there achievements/milestones of AAPD under your leadership that you’re particularly proud?

During AAPD’s Annual Session in New York City, I had the pleasure of interacting with various councils and committees during their meetings, where their respective charges and my expectations for the coming year were discussed. We have such wonderful council and committee members who had some exciting and innovative ideas for their groups. I was very impressed with the commitment of these AAPD volunteer members to the AAPD and the membership as they work to accomplish their charges. In particular, the Committee on Special Health Care Needs presented their concerns to me about the difficulty in transitioning AAPD members’ special needs patients to general dentists when adult dentistry is required. This struck home with me and I decided to do what I could to help. Throughout my year, I spoke with the ADA, AGD and Hispanic Dental Association about the need to increase the cadre of general dentists who are willing to treat these patients in their offices, as AAPD members have done over the years. We have begun the process of inter-organizational collaboration, which hopefully will develop into a shared commitment to seek ways where we can truly impact the access to adult dentistry for this special group of patients.

I am very happy to report that the AAPD has been invited by the ADA to present a half-day course on transitioning these patients to general dentists at ADA’s 2012 Annual Session. We will also be adding a teaching segment on this topic during our Comprehensive Pediatric Dentistry for General Practitioners course. Our hope is that this is just the beginning, and that we can continue to show our general dentist colleagues how they too can treat these challenging, but wonderful patients. We know how truly appreciative they and their families are, and what a pleasure it is to take care of these exceptional individuals.

5. What according to you are strengths of AAPD?

The AAPD continues to be the leading authority on children’s dental health. We are "all about the children," as reflected in our policies and guidelines, which are recognized as the standard by many other national and international organizations who have adopted them as their own. As we continue to evaluate these on evidence-based dentistry, AAPD policies and guidelines will only grow in strength and recognition.

Our hardworking headquarters staff under the direction of AAPD CEO Dr. John Rutkauskas provides our volunteer leadership with tremendous support. With their help, we have achieved so much for the children for whom we serve and for our members. This is evident by our 96 percent membership retention rate – the envy of many other dental organizations! It is our hope that you, our members, like and appreciate all that your leaders have done and continue to do to further our mission – taking care of children.

We also provide so many resources to our members, whether it is CE, publications, patient educational materials, advocacy for children and policies and guidelines to ensure proper, safe, and effective modalities
for all children undergoing dental treatment.

Continuous interactions with our members enable us to develop interesting new benefits for all members. Innovative opportunities continue to be initiated, explored and evaluated so that we remain competitive in today’s marketplace. In addition, the AAPD continues to provide avenues for collaboration amongst our members and many diverse organizations seeking our expertise and knowledge.

At this time, we are in a great place and we will continue to investigate ways to increase our influence when it comes to what is best for children.

6. Are there particular innovations in the field of pediatric dentistry that you’re excited about? How would you recommend addressing the faculty shortage issue?

Probably the most exciting innovation is looking at individualized therapies for our patients – more prevention than restorative focused. Once a patient has their dentition restored, it is up to us to provide the best available preventive treatments. Being able to treat incipient white spots and decalcified lesions without surgical procedures, is truly exciting. Continued research will open up advancements in prevention, conservative restorative care and innovative tooth replacement treatments that will produce truly healthy, decay-free and beautiful smiles in our patients.

The faculty shortage issue is prevalent throughout all academic work forces and is not unique to pediatric dentistry. I think we need to recognize dental students who have an affinity for teaching and/or research, and further develop and hone those skill sets early in their studies and career choices. Faculty salaries must be raised so that they are competitive in today’s economy, as well as offer benefits which can compete with private practice incomes. Current student debt is truly staggering, and we need to develop programs that help decrease this debt and increase our dental workforce to help address the access to care issue so dentists and students interested in academia are able to pursue this career choice.

7. Do you feel that the AAPD’s Get it Done in Year One is resonating with the lay public? Access to care is an issue that’s top of mind for all members, but in your opinion, do you think that parents/caregivers are truly grasping this important message about getting it done in year one and establishing a dental home?

I do not feel that we have made a tremendous improvement in getting parents to understand the value of establishing a dental home by age 1. I frequently see new patients at 18 months whose parents and caregivers have been discussing this with their pediatrician since their child turned one. The doctor still seems to say ages 2-3. Luckily, a lot of these parents researched the Web and found the information that led them to my office. Unfortunately, too many parents go with their pediatrician’s recommendation and I don’t get to see them until age 3, and they now have cavities that need restorations. What a shame! We know that early intervention and education can truly prevent these early decay issues. It is a complex problem.

We know that year-one dental visits can actually save money by lowering future dental costs over the next five years, compared to those children who are seen years later for their first dental visit. It is very frustrating to have a parent say that they could not find a dentist who would see them and their baby at age 1 where they lived, before coming to see me. There is no easy answer. The fact is that dental disease is preventable, and by educating these children’s parents and caregivers, we can help them achieve and maintain optimum oral health in these children. It is up to us to keep speaking these facts to our medical colleagues, general dentists and parent groups. Our members need to see children at age 1 in their practices or academic settings. Only then we can demonstrate the tremendous influence this will have on children’s overall health, including their ability to learn.

It is exhilarating to recognize that children’s oral health has risen to the forefront of children’s overall health. We know the tremendous impact that optimum oral health plays in our nation’s children’s oral health – while the converse is also true.

We are excited by the impact that the Ad Council’s campaign on children’s oral health will have on the health of this country’s children and the children of our world. We can make a difference – join us in taking care of the kids. We can improve their lives and their futures!

8. How will the health care reform law impact pediatric dentistry?

The Affordable Care Act will bring more children into an already overburdened and under funded public insurance program. This increase in enrollees without an increase in funding will affect their access to care in a dental home with a dentist leading the dental team. Historically, our most susceptible children have utilized these programs.
We now have the addition of kids in a higher socioeconomic class.

However, the Essential Health Benefits program may ensure basic coverage for both preventive and restorative care beginning early in a child’s life for children currently without dental insurance whose parents or guardians seek coverage via state health insurance exchanges. All of this remains to be seen in what the final package will include as far as benefits and who will ensure its incorporation.

9. Have you learned anything about policy in your time as AAPD president that will affect the way you practice?

My practice is highly focused on prevention. We spend lots of time with the patient and the parents/caregivers providing information, demonstrating proper preventive home care techniques and evaluating their home care performance at each and every visit. We encourage adult participation in home care, diet and nutritional choices, trauma prevention and teaching these children about oral health. In addition, we focus on ways to prevent dental disease from an early age. I firmly believe in this model, and it has been incorporated into my practice. It has served my patients and me well for over 31 years, and if any changes were to occur, it will be in incorporating more individualized preventive regimens and modalities to influence disease prevention.

10. Looking ahead, what challenges do you foresee affecting the pediatric dentistry industry? How can AAPD and its members maintain their reputation and industry-leading position as the authority on children’s oral health?

The dental industry is always looking for new and improved ways to affect dental disease prevention or treating the disease as it arises. We know that basic prevention works – that is, brushing with fluoridated toothpaste, flossing, fluoride, sealants and mouth guards to prevent dental trauma. The new focus will be on individualized therapeutic
treatments, perhaps based on bacteria colonization, salivary flow and genetic makeup. At this point, we don’t know what we don’t know. Hopefully, continued research, innovative thinking and creative products will continue to influence adults and their children in how the best oral health will influence overall health.

We can continue to be the authoritative leader in children’s oral health by promoting what we have always promoted – we are here to help the children of this world. We want them to be healthy, happy and disease-free. Maintaining that as our main focus and all that we do, reflects this goal. We will remain the leaders in what is best for children’s oral health. We are here to help them and their families by providing the best care possible in a warm, caring and loving environment.

By remaining true to the vision and mission of the AAPD, we will continue to influence legislators and other organizations to look at children as the most vulnerable segment of our population who deserve the very best of what we can provide, and the best of who we are. It is and always will be our goal to do what is best for kids!