May 2022 Volume LVII Number 3


Dr. Joe Castellano Reflects on Presidential Year

May 2019 Volume LIV Number 3

Q.  As AAPD President, your agenda has focused on three goals: working closely with the AAPD’s Safety Commit- tee to develop processes to ensure pediatric dentistry  is a leader in workplace and patient safety, continued monitoring of the sedation environment and protecting the safe and effective use of sedation in pediatric dental offices, as well as supporting AAPD’s legislative agenda, including title VII funding and support of  the Student Loan Refinancing and Restoration Act. Can you please share how each of  these goals has been accomplished?
A. An area of focus that began last year, and will continue this year for the Academy, is safety. Safety is becoming increasingly scruti- nized in all areas of healthcare. AAPD’s Committee on Safety is charged with studying all the possible ways that we can keep our patients safe while in our offices and clinics. They are looking at many areas, including patient care, waterlines, fire prevention and environmental safety to name a few.
A couple of  the resources they are currently developing are:
  • An online safety resource manual/toolkit, which will be available to members for things related to safety. This will be a dynamic online resource that will provide links to many other sources with areas of expertise like the CDC, OSAP, etc. Practices will be able to use it for specific safety issues for which they may want more detailed information.
  • A symposium — Preventable Harm in Pediatric Dental Practices — is being planned for November 2019 for the AAPD Symposia series.
AAPD’s Sedation and Anesthesia Committee has been monitor- ing the sedation environment and working with various entities to make sure we are at the table in any discussion related to pediatric sedation in the dental setting. The Committee is also working on a project to gather morbidity and mortality data in collaboration with various residency programs, to begin establishment of a database. This database will help to evaluate sedation outcomes in the future with the eventual goal of all residency programs able to participate in the future to amass a significant database that can better help guide sedation safety and practice in their states.
Numerous states are now requiring inspection of dental offices to maintain sedation privileges. The board of trustees has ap- proved a working arrangement with The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF, or "Quad-A") to help us develop a method of self-inspection of those offices that perform deep sedation/general anesthesia to make sure they meet and exceed the standards. When completed, this certification program will provide a venue whereby our members can "certify" their offices and satisfy legal requirements.
This year’s legislative priorities focused on securing Title VII funding for FY 2019 in the amount of $12 million dollars ear- marked for pediatric dentistry. I am happy to report that the fund- ing was approved in early October 2018. The funding will again be a priority for FY 2020.
The "Resident Education Deferred Interest (REDI) Act" is something that we began work on last year and will again pursue during this legislative session. The REDI Act will allow interest- free deferment on student loans for borrowers serving in a dental or medical residency. This means that any resident who obtains a deferment will not accrue student loan interest during the resi- dency training period. Passage of this legislation is an important part of student loan repayment reform. Providing such interest accrual relief during residency may also make the option of open- ing practices in underserved areas or entering faculty or research positions more attractive and affordable to residents.
Q.   What are the achievements/milestones of AAPD under your leadership of which you’re most proud?
A.   Of course, as mentioned above, safety is a big one. I am also very proud of the continued growth of the relationships between the District and State Chapters and the AAPD. We are all on the same team. Their members are our members, and our members are their members. By working together, we can better serve the membership and make sure they have available to them the neces- sary resources to best care for the children.
Q.   How would you recommend addressing the faculty shortage issue?
A. Overcoming faculty shortage is something we need to continue working on. Although we have been successful in increasing the number of pediatric dental training slots over the years through our Title VII funding, we need to continue to focus on making sure we have an adequate pediatric dental faculty workforce to train the residents and dental students. The high debt that residents graduate with makes it difficult for them to choose a career in academia. We will continue to have legislative priorities focusing on the dental faculty loan repayment program. Some of the funding we receive through Title VII allows for grants to be given to full time academicians to pay off their student loan debts over a five-year period. We are also currently working and making those payments non-taxable income which will help those dollars go farther.
Q.  You participated in a national Satellite Media Tour as part of our media outreach for National Children’s Den- tal Health Month. Can you please share insight into this experience? Which messages in particular do you feel the media were most receptive toward?
A.    The Satellite Media Tour was a great experience. Our partners at Weber Shandwick did a fantastic job in setting up 27 interviews with different radio and television stations across the country. It was pretty much non-stop interviews for almost five hours. We talked about diet and oral hygiene, but the biggest message was the importance of the Age One dental visit and the Dental Home. We wanted to make sure the audience understood the importance and value of a Dental Home and why getting their child to the pediatric dentist by their first birthday gave them the best chance for a childhood free of dental decay.
Q.   In your opinion, how can dental professionals do a bet- ter job of reaching parents and educating them on the importance of a Dental Home and Age One dental visit?
A.   I think the best way to educate parents on the importance of a Dental Home and Age One visit is to talk it up. We need to con- tinue to get the message out. We have come a long way but there is still more work to be done. An AAPD survey that was done in August showed that about 74 percent of parents don’t take their child to the dentist by their first birthday. We need to make use of every opportunity we have to get the message out. Through our interview opportunities, in talking with our medical colleagues, and through our community outreach, we need to educate every- one on the value of the Dental Home and the Age One visit.
Q.   Earlier this year we announced the second edition of our State of Little Teeth report. Which information in this report will be most helpful to members? To parents/ caregivers? Anything in the report that surprised you?
A.   The second edition of The State of Little Teeth is a 5-year follow- up on the first edition. It examines the U.S. public health crisis of tooth decay among today’s children. The report found that although decay has decreased overall, one in five children under the age of 5 have still experienced tooth decay. Furthermore, about half of children 6–11 and over half of children 12–19 have experienced decay. Children living in poverty are twice as likely to have decay and twice as likely that it will remain untreated when compared to their more affluent peers. These facts really empha- size the importance of educating the public on the importance of the Age One visit and early establishment of a Dental Home. Getting the children into the pediatric dental office early maxi- mizes the opportunity for education and prevention and reduces their risk of decay.
Q. Tell us about the shifting characteristics/demographics  of AAPD’s membership. How have our efforts been in at- tracting affiliate and international members?
A.   AAPD’s membership continues to be very strong. We have over 10,500 members, 6,591 of which are active pediatric dentist members. We have a 92 percent retention rate for the 2018 fiscal year. Fifty-one percent of the membership is female. One-third of the membership is 30–39 years-old and 56 percent are 30–49 years-old. For post doc students, 67 percent are female and 33 percent are male. AAPD’s future looks bright!
We are continuing to work on attracting affiliate (general dentist) and international memberships. To date we have 480 Affiliates and around 162 international members. We continue to try and find ways to create value for them. The Affiliate category is an area that we feel we can grow so we can better educate the general dentists that see children. As the Big Authority on Little Teeth, who better than the AAPD to educate those that choose to treat children?
Q.   The AAPD’s vision is for optimal oral health for all children. What have we done in 2019 to help support this vision? What more can we do?
A.   The AAPD continually works toward our vision of optimal oral health for all children. We continually update and improve the Reference Manual. Our Reference Manual, in essence, defines the specialty of Pediatric Dentistry — who we are and what we do. Our Definitions, Polices, Best Practices and Clinical Guidelines inform pediatric dentists and other stakeholders on the safest and most effective way to treat children. Our advocacy efforts through our legislative agenda, our relationships with key legislators in Congress, and our Pediatric Oral Health Advocacy Conference in D.C. ensure that we are well connected and focused on the issues directly related to pediatric dentistry and the children we serve. The AAPD’s focus on safety will put pediatric dentistry in the forefront of health care. We are working to develop a culture of safety and do all that is possible to ensure that our offices, clinics and procedures are as safe as possible for our patients and families. The AAPD has done great work this year in advancing our vision and we will continue to innovate and offer new ways to keep the ball rolling.
Q.  Anything else you would like to add?
A.   It has been a privilege to serve as president of this great organiza- tion. Traveling to various meetings this past year, I have had the opportunity to talk with many of our members, and I must say, our AAPD members are special people who truly take to heart caring for the kids. In the end, I think we are all children at heart — upbeat, kind spirited and fun. Pediatric dentists serve and advocate for the most vulnerable children in our communities as if they were our own. It has been such an honor to have been able to lead an organization and its members that place the needs of children before their own. Thank you for allowing me to serve as your president this past year, and thank you for being a part of the AAPD family.

Click here for a PDF version of this article.