How public health supports equity in oral health

Community leadership and expertise are key to prevent disease and improve access to dental care.

Good oral health is more than a healthy smile. Where we live, learn, work, worship, and play affect our oral and overall health. During National Public Health Week, Arcora Foundation recognizes how our unique cultures and communities not only influence our wellbeing—but give us the tools to thrive.

What is public health?

Public health promotes and protects your health and your community’s health. The focus is on disease prevention and healthy behaviors. Examples of how public health impacts oral health include:

  • Expanded access to fluoridated tap water, which is the most cost-effective and equitable way to prevent cavities for people of all backgrounds.
  • Free dental clinics hosted at community gathering spaces, such as food banks and community centers.
  • Health education, outreach, and care navigation provided in languages spoken in a community.
  • Awareness campaigns on the health impacts of choosing water over sugary beverages.

“Good oral health is essential to good overall health. The State Department of Health and Arcora Foundation share the belief that everyone in Washington deserves a healthy smile. I’ve appreciated the partnership with Arcora over the years on efforts that support good oral health as a public health priority. That work includes the Smile Survey, assisting local water systems with community water fluoridation, supporting the Washington State Oral Health Coalition, and more. Our work together continues to ensure everyone has the prevention and access resources they need for a lifetime of good oral health.”

Shelley Guinn RDH, MPH
State Oral Health Program Coordinator
Washington State Department of Health

Arcora partners with state and local organizations to champion these and other public health efforts. Community-based solutions and respect for cultural norms and values can lead to the most meaningful progress. Through community learning grants and engagement opportunities, we center lived experiences in ongoing, collaborative partnerships to improve oral health outcomes.

Community health workers: innovators in public health.

Community health workers (CHWs) are trusted public health advocates and community navigators. One longstanding and valued partner, Community Health Worker Coalition for Migrants and Refugees (CHWCMR), leads innovative CHW practices to achieve health equity and social and environmental justice for migrant and refugee communities in Washington state.

Ileana Ponce-Gonzalez, founder and executive director of CHWCMR, explains the key role CHWs play in improving public health.

How do CHWs support public health?

Community health workers are trusted members of the community. They act as public health professionals, come from the communities in which they carry out their work, and act as defenders or representatives of community members. They bring together individuals in need of health care, helping them understand and have access to health education and services. Here are three ways CHWs promote public health:

1. Provide reach and cultural links that go beyond the traditionally underserved communities to increase access to care, ease of use, and use of health resources.

2. Reduce costs to both providers and patients through prevention, health education, and early detection of disease and medical care emergencies.

3. Help the communication between patient and provider, facilitate continuity of care, and act as advocate and guide for the patient within the health care system to improve the quality of care.

What challenges do migrants and refugees face in achieving good oral and overall health?

CHWCMR has more than 11 years of working with migrant and seasonal farm workers in our state. People we work with can have financial and language barriers. Health care providers can lack empathy for them, which can make them feel lost and resigned. Because they live in rural areas, this population can face additional barriers that include:

  • Access to fresh food—processed foods as alternatives, which can be high in preservatives and salt.
  • Safe drinking water—sugary beverages as alternatives, which pose risk factors for cavities, diabetes, and other health concerns.
  • Access to care—Washington has many Federally Qualified Health Centers (FQHCs). For communities such as Vista Hermosa in Pasco, the nearest FQHC is 40 miles away.

CHWs are essential to work against these barriers. Our farmworkers, migrants, and refugees have limited time to make medical or dental appointments, and many of them lack transportation and housing.

How has partnering with Arcora Foundation supported CHWCMR’s work to improve oral and overall health for migrant and refugee community members?

Since 2017, CHWCMR has collaborated with Arcora Foundation to improve oral health in migrant and underserved populations. We worked together on a series of project and community-based oral health education programs. All our programs use a CHW model. Here are some examples:

  • 2023—project to decrease consumption of sugary beverages, increase consumption of fluoridated water, and make dentist appointments through Arcora’s DentistLink tool for 20 participants.
  • 2021—conducted an oral health needs assessment in Spanish of 91 participants by phone in the Tri-Cities and Olympia and King, Pierce, Skagit, Snohomish, and Yakima counties.
  • 2017-2020—workshops taught 784 participants about the importance of good oral hygiene, regular dental visits, and healthy eating and drinking habits through 36 workshops.

Excerpt from CHW training flipbook

“Thank you for giving us the opportunity to improve oral health disparity in this state. We need more support because the gap between oral health education and services and our community is abysmal. We need not only economic support, but also organizations like Arcora to advocate for our work and accomplishments. We are the people on the front lines, the ones who know and work with the community.”

Ileana Ponce-Gonzalez, MD, MPH
Founder and Executive Director
Community Health Worker Coalition for Migrants and Refugees

Centering communities and cultures in strategic direction.

Arcora strives to demonstrate a greater capacity for equitable practices and public health policies to better engage with communities as an authentic partner. We center community expertise in our work to achieve good oral health for those who face barriers to dental care—especially in Black, Indigenous, and People of Color (BIPOC) communities. We invite you to visit our 2023 Community Report to learn more about recent milestones toward a healthier, more equitable future for all.

About National Public Health Week

During the first full week of April each year, the American Public Health Association brings together communities across the United States to observe National Public Health Week as a time to recognize the contributions of public health and highlight issues that are important to improving our nation’s health. For 2023, we are “Centering and Celebrating Cultures in Health” to ensure everyone, in all cultural communities, has a chance at a long and healthy life. To do so, we must address and prevent the underlying causes of poor health and disease risk. We can use social determinants of health to understand how those causes are different for each person based on various factors like race, gender, sexual orientation, gender identity and financial situation.

Celebrate Black History Month with a commitment to improve oral health for Black people

A Black father kisses his daughter in front of a lush green tree. The daughter is smiling wide and wearing a white dress.

Andrew Lofton and Kimberly Wilson—Arcora Foundation board members—share the importance of good oral health for Black people.

Black history is U.S. history.

Each February, Black History Month allows time to reflect on Black people’s contributions to our country. Medicine, science, civil rights, politics, business, the arts—Black voices have added to and advanced the richness of our country. Arcora Foundation celebrates the integral role of the Black experience in U.S. history. 

Oral health is overall health. 

Just as Black history is U.S. history, oral health is overall health. Arcora has taken intentional steps to improve oral health outcomes for Black people. We’re deepening relationships with Black communities across Washington state and the organizations that serve them. Our partners share our view that good oral health is good overall health. But data show that Black, Indigenous, and people of color face barriers to good oral health. Arcora’s 2022-2024 strategic plan details our plan to bend the arc of oral health toward equity through our prevention and access work. 

This Black History Month, our Board of Trustees Chair Andrew Lofton and Board Member Kimberly Wilson reflect on their involvement with Arcora and the importance of oral health for Black people. 

Andrew Lofton

“Black people have opportunities for advancement in so many areas in our society. Oral health is one of them. Good oral health is just one of the building blocks for good overall health. Poor health outcomes have implications for Black people in all walks of life. Those poor outcomes can be debilitating, expensive, and create additional barriers for Black people to reach their goals. 

“I became interested in Arcora Foundation because of their work to expand access—especially for BIPOC populations. I first learned about Arcora while I worked at the Seattle Housing Authority. At the time, the Authority was exploring ways to support families that are low income achieve better overall health outcomes. I discovered Arcora’s work to increase access to oral health care, its emphasis on underserved populations, and the role oral health care plays in good health outcomes. 

“Good oral health means opportunities to treat problems and diseases before they become significant health issues. It also means access to quality oral health whether you have insurance or your ability to pay. From my work at the Authority, I was acutely aware that low-income families and communities are often disproportionately denied access and opportunities to services that affect their overall health.  Arcora was and continues to be an organization working to change that. Arcora centers its work in equity to achieve good oral health for everyone.”

Andrew Loften is the active Arcora Foundation Board of Trustees chair. He served as the Executive Director of the Seattle Housing Authority from 2012 until his retirement in 2021.

Kimberly A.C. Wilson

Kimberly Wilson

“As an African-American woman who grew up without fluoridated water, and whose grandparents had lost several of their teeth before I was born, oral health is really important to me. 

“Those with the least access to preventive services and dental treatment have the greatest rates of oral disease. Education level, income, ethnicity are all reflected in oral health access statistics but race is especially acute: African Americans have some of the poorest oral health outcomes of any racial or ethnic group in the U.S. The numbers tell a grim story: 

  • Which children experience the greatest disparity with tooth decay in this country? African Americans.
  • Which group has a higher prevalence of periodontal disease than almost all other racial groups? African Americans.
  • Among Americans aged 20-65, which racial/ethnic group experiences untreated tooth decay at nearly twice the rate of white Americans? And which seniors suffer total tooth loss at almost double the rate of white individuals over age 65? Again, Black Americans.
  • The five-year survival rate among white American men diagnosed with oral pharyngeal cancers is 61 percent. For Black men, the rate is just over half of that, at 36 percent.

“These outcomes have a real cost on our socio-emotional and psychological health, along with our general wellbeing. Two in every five middle-aged adults in the U.S. report that dental issues result in pain, eating problems and missed work. For little ones, oral health issues can keep them home from school or unable to participate fully.

“Joining Arcora’s Board of Trustees was meaningful to me because these outcomes impact the quality of life for members of my community. Arcora’s approach to advancing oral health in Washington through equity makes sense. Moreover, it helps to change outcomes for the most vulnerable communities, including mine.”

Kimberly A.C. Wilson is the Executive Director of Hedgebrook, a literary nonprofit whose mission is to support visionary women writers whose stories and ideas shape our culture now and for generations to come.

Want to deepen your understanding of Black people’s contributions to U.S. history? The Association for the Study of African American Life and History—which also describes how Black History Month came to be and lists themes for each year—is a good place to start. 

We can’t do this work without you. Advancing oral health requires public and private partnerships, policy advocacy, and funding. Join us in our mission to bend the arc of oral health toward equity. Learn more and contact us at info@arcorafoundation.org.

Investments in children’s oral health can produce a lifetime of healthy smiles

Oral health programs and policy lead to better health outcomes for our state’s children. 

Heather again! In my first blog, I told you about the history and successes of ABCD. In part 2, I’ll talk about how the continued support of legislators allows us to build on our successes.


Statewide investments in healthier childhoods. 

Last year was an exciting time for the ABCD program. With funding from the 2021 legislative session, we deepened outreach to families of color for children under age 2 and expanded ABCD to serve children with developmental disabilities through age 12. As of January 2023, 173 dental providers are now certified to provide care to this newly covered group of children with special health needs.  

“This additional funding, along with the resources and support from partners, gives ABCD programs and providers opportunities to connect more young children—especially those who have been left behind—with high quality dental care close to home. That’s equity in action.” 

Mary Ann Walker
ABCD coordinator
Yakima County

The ABCD program would not be possible without our statewide network of certified providers and champions. Nearly 4,000 dental professionals use their time and talents to ensure children from lower-income households receive the same compassionate, attentive care as any other child. In the 2022 legislative session, the state recognized their invaluable work through a $21.1 million investment in fee-for-service pediatric Medicaid rates. These new Medicaid rates in turn helped support the highest ABCD reimbursement rates ever. 

Investments like these show the state’s dedication and commitment to a healthier, more equitable state. The 2023 session is another opportunity to strengthen this commitment through several bills and budget ask with the goal of improving oral health for children and their families. 

Increased access to care for Apple Health (Medicaid) enrollees.

DentistLink is a no-cost dental referral service designed for people with Apple Health (Medicaid) or no dental coverage. This service helps individuals quickly and easily find care in their community. It’s also an invaluable tool for our ABCD program when connecting families to a local provider. 

2022 was DentistLink’s first full year as a formal public/private partnership between Arcora and the Washington State Health Care Authority. Funding in the 2021-2023 state budget established this agreement. We’ve seen great successes in this partnership. Our free Find-a-Dentist tool was accessed more than 70,000 times, helping to connect people to the right dentist for their needs. Our outreach team connected with the community through 50 partner outreach events across the state. Through continued state investment in this partnership, DentistLink can continue to scale up and connect more Apple Health (Medicaid) enrollees to dental care. 

“DentistLink is a lifesaver. Without you I would probably never have seen a dentist. I’m so very grateful. You seriously saved my life.” 

Randall
DentistLink user
Colbert, WA 

Prevent tooth decay through community water fluoridation. 

Cavities are the most common chronic condition of childhood. While some may view cavities as an expected part of life, we know that tooth decay is largely preventable. Yes, a cavity-free childhood is possible! 

Community water fluoridation is the most effective and equitable way to ensure everyone benefits from this proven form of cavity prevention. In 2022, the state provided $532,000 for the Office of Drinking Water in the State Department of Health to establish a program to support local water systems and provide outreach on community water fluoridation. HB 1251/SB 5215 will further improve awareness for residents who already have access to fluoridated water. To use another classic saying, “Knowledge is power.” 

In addition to these oral health initiatives, I encourage our state policymakers to invest in other programs that support the health and wellbeing of children in underserved communities—including support for community health centers and school-based health centers, universal free school lunch, and funding a Medicaid-equivalent program for our immigrant community members.  

Do you or your child need support accessing dental care? Contact your local ABCD coordinator or receive a free referral through DentistLink at DentistLink.org or by calling 844-888-5465. And what a better time to start your young one’s oral health care journey than in the month dedicated to their smile! 

Heather Gallagher is the Managing Director for the statewide Access to Baby and Child Dentistry (ABCD) program. In addition to ABCD, Heather has managed multiple programs with a focus on early supports for children and families.

A cavity-free future is possible for our state’s children

A large group of ABCD coordinators and partners pose in front of a hotel conference room screen which reads "Welcome! September Coordinators Meeting."
Pictured: Statewide ABCD coordinator meeting, September 2022.

Heather Gallagher, ABCD managing director, shares the ABCD program’s secret to making Washington state a leader in young children accessing dental care.

I’m excited to highlight the work of Washington state’s Access to Baby and Child Dentistry program. Look out for my second blog coming out tomorrow, in which I share how statewide investments can further fuel Arcora’s work in bending the arc of oral health toward equity. 


February is Children’s Dental Health Month. As the statewide Access to Baby and Child Dentistry (ABCD) Managing Director, I may be a bit biased in it also being my favorite month! As the saying goes, “The most precious sight is the smile of a child.” Arcora Foundation is building a future where every child’s smile isn’t just precious—but healthy as well. 

It takes a multi-pronged, integrated approach to support children’s oral and overall health. And we can’t do it alone. Through access to care programs—like ABCD and DentistLink—and prevention measures—like community water fluoridation—our team, in collaboration with partners and policymakers, leads our work with equity to ensure all Washington kiddos can reach their full health potential. 

Supporting children’s oral health through a longstanding system of care.

ABCD launched in Spokane in the mid-1990s as a way to connect Apple Health (Medicaid)-enrolled children from birth to age 6 with specially trained dental providers in their community. In fact, two of those early ABCD patients were my own kids! I was grateful and relieved to have this local service available to me back then; what a full-circle moment to now be leading this program and providing that sense of relief to more parents like me.

When ABCD started, only 20% of Washington state young children accessed dental care. Today, this number has more than doubled (45% in FY2021) for children from lower-income households—making Washington a national leader in the number of young kids receiving essential dental care.

Before my time at Arcora, I had the joy of working directly with families as the Spokane Regional Health District’s ABCD coordinator. The health care system can be overwhelming for anyone, but especially for caregivers looking to give their children the best start in life. Thankfully, the ABCD program and its team of local coordinators help take the stress out of dental care. 

Anna Cruz headshot

“When I work with a family, I also try to engage the child. Promoting early access to a dental home among parents and educators is as important as teaching children that caring for their teeth is the best way to prevent cavities.”

Anna Cruz
ABCD coordinator and community health worker
Clark County Public Health

Coordinators are primarily family advocates. Across all 39 counties, ABCD coordinators provide referrals, family education, and additional services necessary to help young children thrive. Does your child need a dental appointment? You got it! Can I also grab you an extra pack of diapers while you’re here? We can help with that, too!

I can’t praise our ABCD managing partners, coordinators, and providers enough. And it’s not just me singing their praises (though trust me, no one wants to hear me sing). The Washington state legislature has proven year after year that oral health equity programs and policies are worth investing in. By deepening and expanding the reach of this system of care, we’re one step closer to Arcora’s vision where all people enjoy good oral and overall health, with no one left behind. 

Caregivers, you’re doing great.

Finally, I want to take a minute to celebrate our state’s caregivers. You are your child’s greatest champion, and we see your dedication to their health and wellbeing. Because of you, they’re on a path to thrive long into adulthood. 

You’re also their first educator for healthy habits. The earlier you start, the easier it will be for these habits to stick as your kids get older. Here are some key habits ABCD recommends to all families

  • Brush twice a day with fluoride toothpaste. For children under age 2, use a rice grain-sized amount of toothpaste. For children 3 and over, use a pea-sized amount. A good rule of thumb is to help your child brush until they can tie their own shoes. 
  • Floss once a day as soon as teeth touch. Flossing can clean 40% of the day’s “gunk” that brushing alone misses. 
  • Make water the drink of choice. Plain water is the best drink for a child’s oral and overall health. Ask your doctor and dentist about access to fluoridated water in your community and other ways your child can receive the cavity-fighting benefits of fluoride, such as fluoride varnish. 
  • Snack smart. Choose teeth-healthy snacks like fresh fruit, nuts, white milk, and cheese. Limit cavity-causing snacks like juice, candies, fruit snacks, and crackers. 
  • First birthday, first dental visit. Children should begin receiving oral health services from a dentist or primary care provider by their first birthday. Apple Health (Medicaid) covers dental services for both children and adults. 
Headshot of Edie Higby

“Finding creative and fun ways of teaching proper brushing routines, healthy eating habits and when to find a dental home are all things a family can actively engage and plan with their child together. When we are able to make the connection between oral health concepts in early learning and the importance and power of a smile—physically and emotionally—that’s is when the magical “Ah-Ha” moment happens. And that’s how we change the world, one magical moment and smile at a time.”

Edie Higby
Family Services Manager & ABCD Outreach Coordinator NE Tri-County
Rural Resources Community Action

Author, 10 Tips From The Tooth Fairy

Do you or your child need support accessing dental care? Contact your local ABCD coordinator or receive a free referral through DentistLink at DentistLink.org or by calling 844-888-5465. And what a better time to start your young one’s oral health care journey than in the month dedicated to their smile! 

Community-based oral health efforts get a $520,000 funding boost from Arcora Foundation

18 organizations receive grants and sponsorships to help address most pressing health needs. 

A request, a need, and a solution. 

In 2021, a client at Seattle’s Tubman Center for Health & Freedom‘s Blaxinate Lounge shared about her untreated oral health concerns. Because the Tubman Health team treated her with respect and empathy, she asked if one of them could accompany her to the dentist. 

This client interaction inspired the team to develop the new Tubman Guides program. It honors this community member and other clients who asked for help to improve their care experiences. Tubman Guides will provide care coordination, emotional support and advocacy, and other wrap-around services to Black community members in Central and South Seattle. Their goal is to promote access to care for people pushed to the margins of the health care system. Navigators—especially those who reflect the communities they serve—play a key role to connect people to care.

Programs like this not only recognize that oral health is essential to overall health, but also the importance of centering solutions to people’s most pressing health issues within the communities where they live. 

A commitment to community-driven solutions. 

At Arcora Foundation, our health equity framework includes the reallocation of power and resources to community-led efforts to prevent oral disease and improve access to care. As part of this work, we’re honored to award $520,000 in grants and sponsorships to Tubman Center for Health & Freedom and 17 other incredible community-based organizations to help more people reach their full health potential. 

These funds will support projects and events that aim to advance good oral health through one or more of the following approaches: 

  • Increase access to dental care. 
  • Motivate behavior change. 
  • Address systemic barriers. 

“We truly appreciate Arcora’s critical seed money to create an innovative community health worker program that will support the needs of medically marginalized community members and also connect community health practitioners to good-paying jobs with opportunities for career progression.” 

Julie Chinitz, Director of Development, Tubman Center for Health & Freedom

Expanded partnerships through funding. 

More than 80 organizations applied for this round of funding. We selected recipients, in part, based on how well the project intends to narrow disparity gaps—particularly Black, Indigenous, and communities of color where disparities in oral health are significant. Other factors included the project’s community of focus, the geographic location, the alignment with Arcora’s mission, and available budget. Congratulations to our latest funding recipients: 

We continue to evolve as an organization, including how we reallocate our resources through grants and ongoing sponsorship funding. We thank all the organizations who took time to provide feedback and insights during this latest grant cycle. Sign up for our newsletter to be notified of upcoming funding opportunities and other timely information.  

Partnerships are essential to advance oral health across Washington state. Grantmaking and sponsorship funding are one of the many ways Arcora supports community-based efforts to improve oral and overall health, with no one left behind. To learn more about our partnerships and initiatives, click here.