State dental directors share how pandemic has changed their worlds

Every dentist has seen and been a part of significant change over the past year.

That includes state dental directors.

The mission of state oral health programs is to improve the oral health and oral health literacy of the residents, while eliminating disparities that may exist due to access to care. This is a challenge under the best of circumstances. Like many things, the complications presented have increased markedly during COVID-19.

Five state dental directors, from coast to coast, shared with ADA News how their jobs have changed over the past year and how they have met the challenges to support their states’ dentists amid the COVID-19 pandemic.

Each said that while the pandemic has presented challenges, it also has highlighted the important role of access to oral health care when it comes to overall health.

Rhode Island

Dr. Zwetchkenbaum

For many of those who work at the Rhode Island Department of Health, it’s been an all-hands-on-deck approach because of the huge need for reaching out to people who test positive and then do contact tracing, said Samuel Zwetchkenbaum, D.D.S., the state’s dental director.

“I was deployed from my usual work from March to May, deactivated June to September, and now redeployed since early October,” Dr. Zwetchkenbaum said. “Essentially, I am told that regular duties are mostly suspended and most of my time should be on COVID work.”

Dr. Zwetchkenbaum said the experience has connected him more positively with the dentists of Rhode Island and hopefully has given the dental community a greater sense of the work of the Department of Health.

“We know that we are all in this together,” he said. “I hope the relationships built during this time can extend so that we can work on greater problems, including addressing access to care for vulnerable populations.”

California

Prevention of transmission of the virus in the dental setting by creating a safe environment has been a top priority for Jayanth Kumar, D.D.S., California state dental director.

Dr. Kumar

“This is essential for patients and employees,” he said. “It is important to emphasize preventive dental visits and daily home care to avoid dental problems. With this pandemic, new information is constantly emerging. Therefore, there is a need to communicate updated information to the dental community as well as the public.”

The California Department of Public Health’s Office of Oral Health has assumed a lead role for providing guidance to dental health care personnel for resuming dental practice in the Golden State, said Dr. Kumar.

“Working closely with several branches within the California Department of Public Health, the California Dental Association, local health departments and other partners, we have participated in developing tools, training and resources to implement the recommendations for preventing transmission of SARS-CoV-2 in dental settings,” he said.

Luckily, there is support for state dental directors.

“The Association of State and Territorial Dental Directors holds monthly meetings,” Dr. Kumar said. “This provides an opportunity to share and learn about experiences, best practices and innovative ideas.”

Illinois

Mona Van Kanegan, D.D.S., Illinois state dental director, said that the pandemic provided an opportunity for closer communication between her work at the Illinois Department of Public Health and other academic, health profession and public health-focused leaders in Illinois.

Dr. Van Kanegan

Dr. Van Kanegan said that as the COVID-19 surge continues across Illinois, every dentist and dental team member must continue to be vigilant about their own health as well as that of their patients. Screening, self-monitoring and practicing protective measures are important both in and out of the office.

“The COVID-19 pandemic is disproportionately impacting vulnerable populations, adding to the existing disparities in oral health care,” she said. “Unavailable health care workers due to COVID-19 infections will further stress the health care system for all. It is imperative to remind and to reinforce previously issued guidance with special attention to close staff-staff unprotected contacts likely to occur in dental offices and pose a risk of transmission.”

Being a dentist has helped her and others to largely weather the crisis so far, Dr. Van Kanegan said.

“I would say as dentists we are flexible, we are leaders and we have a degree of influence,” she said. “These qualities are in our nature and our work and have helped in the pandemic response.  I saw the outcome that we needed and thought through different approaches and developed a plan. As a profession, we know how to train and bring people along with us.”

Missouri

John Dane, D.D.S., Missouri state dental director, said initially he was spending almost all of his time working with dentists, dental societies and dental hygienists answering questions and working on a back-to-work guidance document.

Dr. Dane

The biggest program change, Dr. Dane said, is that with schools closed, their largest program that provides screening and fluoride varnish in schools was unable to provide this much-needed care.  

“Even this fall, most schools would not let outsiders into the school,” Dr. Dane said. “We spend a lot of program time working with the schools to support the oral health of students in any way we can.”

The pandemic has forced him to be more flexible with his time, Dr. Dane said. He has had to shift routine meetings to make room for special COVID-related meetings and he gets phone calls after hours from dental practices and a COVID hotline.  

“Personally I have become more sensitive to the potential risks with my family and office staff,” Dr. Dane said. “There is a lot of concern, but having information helps reduce the anxiety.”

Wisconsin

Russell Dunkel, D.D.S., Wisconsin state dental director, said both his role and responsibilities have expanded as a result of the COVID-19 pandemic.

Throughout it all, his mission remains clear.

Dr. Dunkel

“First and foremost, I believe my most important work centers around the mission of the Wisconsin Department of Health Services: ‘To protect and promote the health and safety of the people of Wisconsin,’” he said.

To that end, it is imperative that for him to try to assimilate all the knowledge he can in order to provide leadership, guidance and education to the health care community and the public at large.

“In dentistry, we have historically tended to work in our own little silos and the experiences of the pandemic have strengthened my beliefs that we cannot continue to function in this manner any longer,” he said. “I have had an even greater opportunity then before to work with a larger number of diverse, highly educated, extremely passionate group of individuals who are extremely committed to the work we are doing. It is now a constant reminder of the acronym for TEAM: Together Everyone Accomplishes More.”