Taking a leadership role, the Illinois Department of Public Health’s Division of Oral Health has helped to successfully integrate oral health professionals into the emergency medical response system in Illinois by raising awareness, building needed partnerships, identifying and garnering resources, and facilitating training, policy development, surveillance, and evaluation. Applying the same principals and standards to the integration of oral health and disaster preparedness and response as it does to all facets of dental public health, the division has partnered with the Disaster Emergency Medicine Readiness Training Center at the University of Illinois at Chicago and many other key stakeholders to cement oral health as an integral component to the public health response system in Illinois.
The critical nature of emergency response came into sharp focus for the Illinois Department of Public Health’s (IDPH) oral health staff on September 11, 2001, when the state’s first Oral Health Summit was cut short by news of the terrorist attack in New York City. Instead of discussing strategies to implement the oral health plan they were ratifying, summit participants dispersed. Many, including several state leaders, were summoned to quickly respond to the potential for a similar event happening in Illinois. After the immediate upheaval from the attack began to subside, public health professionals across the United States began looking at how states and localities were prepared to respond to large-scale emergencies. What they found was not encouraging.
During the intervening years, public health professionals have moved aggressively to address the gaps in emergency preparation and disaster response. One approach has involved bringing new partners into the effort. The IDPH Division of Oral Health responded to this particular challenge by actively seeking out and forging new partnerships and by building on existing relationships to give oral health professionals a greater voice and a larger role in planning and implementing emergency response systems.
To understand the role dentists and dental hygienists can have in emergency response, it is first important to appreciate the skills and resources this group of professionals brings to the table. Dentists and dental hygienists have basic skills and abilities that allow them to function as partners with other health care providers in responding to a disaster. Oral health resources in the form of well-equipped and supplied dental offices and clinics have the potential to provide additional facilities for use during an emergency. As licensed health care professionals, dentists and dental hygienists should feel a responsibility to act if a disaster should occur in their communities. In Illinois, including dentists and dental hygienists as front-line responders could add approximately 14,000 licensed professionals to the response system. This significant pool of experience and human capital makes oral health professionals a valuable part of public health’s emergency response efforts.
Encouraging oral health professionals in Illinois to see themselves as important components of state and local emergency preparedness efforts has been a natural role for Division of Oral Health staff. It also fits well with the division’s mission, which is to ensure that the people of Illinois have access to population-based interventions that prevent and reduce oral disease and promote oral health as integral to overall health. Taking a leadership role, the division has helped to successfully integrate oral health professionals into the emergency medical response system in Illinois by performing the following:
Building needed partnerships
Identifying and garnering resources
Facilitating training, policy development, surveillance, and evaluation
What has been done
Although the state’s first oral health plan did not address the role of dentists and dental hygienists in disaster response, it did provide Illinois with a dynamic roadmap by which to accomplish this goal. The plan’s guidance in building an oral health infrastructure in the state and in establishing and extending partnerships has enabled Illinois to initiate and maintain an exemplary oral health component in its overall disaster response program. But how did the state get to this point?
In 2002, Dr. Lewis Lampiris, then chief of the Division of Oral Health, participated in a consensus workshop sponsored by the American Dental Association (ADA). The workshop, entitled “The Role of Dentistry in Bioterrorism,” helped to bring Illinois to the forefront of national response efforts by the ADA and other national groups. It also established an important working partnership between Illinois and the ADA that persists today.
During the summer of 2003, the division worked with Dr. Michael Colvard to establish the Disaster Emergency Medicine Readiness Training (DEMRT) Center at the University of Illinois at Chicago. In addition, Dr. Lampiris helped to secure funding for DEMRT through the IDPH’s Office of Preparedness and Response. IDPH resources of funding, a multidisciplinary workforce, and expertise are critical not only to fuel DEMRT’s activities but also to cement oral health as an integral component of the public health response system. By linking various IDPH divisions to DEMRT, an important new partnership was forged. DEMRT began to recruit, train, and retain volunteer medical responders, among them oral health professionals, who would be able to participate on local, state, or federal response teams. DEMRT provides the state surveillance and evaluation data that translates into information describing a successful program. This information is shared with a wide national audience as a model to help build similar efforts through out the United States. DEMRT provides a linkage not only between the IDPH and the University of Illinois and its College of Dentistry but also to associated professional organizations, such as the American Medical Association and a myriad of federal agencies, including the US Public Health Service.
In collaboration with DEMRT and the Illinois State Dental Society, the division began working in 2004 to expand the capacity to educate Illinois dentists and dental hygienists about the importance of emergency response preparation and to create training programs for dental responders at the local level. The division also helped to link oral health programs in local health departments to DEMRT to enable them to build training opportunities for dentists and dental hygienists, both in public and private practices, into community preparedness efforts.
In May 2005, the Division of Oral Health facilitated a satellite broadcast for dentists and dental hygienists in Illinois. The program, entitled “Disaster Preparedness: The Dental Team’s Role,” was planned and co-sponsored by DEMRT, IDPH, the Illinois State Dental Society, and the Illinois Dental Hygienists’ Association. The presentations were designed to help the participants understand public health and preparedness efforts at the state and local level and how dentists and dental hygienists could become important partners. The IDPH Training Center arranged for 28 broadcast sites around the state. At each site, a Division of Oral Health staff person or other trained facilitator hosted the event and managed post-broadcast discussions.
The program brought together a panel of local, state, and national leaders in oral health and emergency preparedness. Response to the program was very positive. Participants indicated they understood their role in emergency response. They also were positive about seeking additional training and reaching out to the emergency response systems in their communities.
Another collaborative effort undertaken in 2005 by IDPH, DEMRT, and the Illinois State Dental Society effectively validated the role of dentists and dental hygienists in emergency response. Advocacy efforts by the group led to the amendment of the Illinois Dental Practice Act (P.A. 94-0409 25/4 Section 4[r]). As of December 31 that year, a “dental emergency responder” was defined as a dentist or dental hygienist appropriately certified in emergency medical response (as determined by the Illinois Department of Public Health). The act was further amended to allow a responder to practice within the bounds of his or her license when providing care during a declared emergency (P.A. 94-0409 25/54.2 Section 54.2).
In 2006, the Division of Oral Health helped to lead the state in expanding and refining its statewide oral health plan. Unlike the first plan, this document dedicated a significant amount of attention to emergency preparedness, thereby ensuring it a platform for ongoing policymaking and program development. As with the first plan, the division enlisted a broad constituency of state and local leaders, as well as those at the grassroots level. All shared an intense interest in improving the oral health of all Illinoisans and in expanding the plan’s scope to include emergency response. By engaging these diverse stakeholders in the planning process, the division has ensured a strong and effective base for future actions.