After 30 years without one, New Jersey will now have a state dental director, a development supporters hope will lead to public initiatives that benefit the oral health of residents and to better rankings for the state on national assessments of dental policies and programs.
The state Department of Health announced on Monday the appointment of Dr. Darwin K. Hayes, a dentist and dental educator who led one of the nation’s largest oral-health training programs, in the Bronx. He will earn nearly $128,400 and his salary is covered by two multi-year federal grants, officials said.
In this position, Hayes will oversee dental programs and services and will work with professional organizations, education leaders, public-health officials and other stakeholders to develop an oral-health plan for the state. He will also coordinate with other departments to integrate oral-health strategies with their efforts, DOH said, and join healthcare educators to find new ways to reduce opiate prescribing among dentists.
Dental-health advocates also hope Hayes’s appointment will serve to expand access in New Jersey to fluoridated water, which experts call a critical pillar in dental care and public health. But while increasing fluoridation has been a priority for some lawmakers, legislation to make that a reality has failed to advance.
According to the federal Centers for Disease Control and Prevention, New Jersey is one of 17 states that lack a comprehensive oral-health plan. And it ranks 49th nationwide in the percentage of population with access to fluoride-infused drinking water. Less than 15 percent of communities have fluoridated water here, versus a national average of just under 75 percent; Pennsylvania ranks 41st with nearly 55 percent coverage, and New York is 30th with more than 71 percent accessing treated water.
Spotlight on oral health
“It really highlights that we don’t have a strong advocate with regard to oral health here in the state,” explained Cecile A. Feldman, dean of Rutgers University’s School of Dental Medicine, “and having a director of oral health can really help with that tremendously.”
States are not required to have a dental director, and for the last three decades the Health Department has instead funded a nurse practitioner to coordinate an oral-health education program for children, which taught dental care and provided fluoride rinses to schoolchildren.
But the official who filled that role retired in December 2017, the DOH said, and Gov. Phil Murphy’s administration took the opportunity to appoint someone who could heighten the focus on oral health — not just during childhood, but over an individual’s entire lifespan.
“We are pleased to welcome Dr. Hayes as part of our leadership team,” Deputy Commissioner Deborah Hartel said. “With his knowledge and expertise, the Department will be able to expand oral health initiatives to address our most vulnerable populations.”
Oral-health advocates have argued for years that a high-level public servant focused on these issues would force the state to take stock of its shortcomings in dental health, and help it attract grant funding. The issue was flagged by participants in an oral-health webinar NJ Spotlight hosted in November 2016 and had remained a critical concern ever since.
“This has been a priority for the Dental Association for more than a generation,” said Jim Schulz, director of governmental and public affairs with the New Jersey Dental Association, the state’s trade group, which includes Hayes as a member. “We think this is terrific,” Schulz added, praising Hayes’ resume and his “depth of experience working with the next generation of dentists.”
Dental health linked to overall well-being
Observers like Feldman and Schulz hope that, among other things, Hayes will establish an oral-health surveillance system — something they said exists in many other states — to identify baseline needs and gaps in dental care.
In addition to expanding access to fluoridated drinking water, Feldman would like to see the state do more to promote the use of preventive sealants among children, something that is increasingly common elsewhere. And Schulz said his members are eager to work with the director’s office to reduce the use of hospital emergency rooms for certain dental care, an issue that has become a concern nationwide.
Above all, they see it as an appointment that will allow the state to focus new attention and resources on the critical connection between dental care and chronic diseases, like cancer and cardiovascular issues. There has been a growing awareness of how healthy teeth and gums are critical for proper nutrition and dentists are being more integrated into the wider medical system in recent years.
“Oral health is very connected to systemic health,” Feldman said. A state dental director “is really someone who can help advocate for that and make it known.”
Funding for these initiatives will also be critical, “but the first thing is to put together a comprehensive plan that identifies priorities,” she added.
Hayes for seven years was a leader at a post-graduate education and residency program associated with BronxCare Health System. As the second-largest training program nationwide, it produced more than 800 new dentists over the past three decades. In this role, he helped run a $3.5 million federal grant project focused on better integrating oral health and primary care.
Hayes received an undergraduate degree from the University of Maryland School of Dentistry, completed his advanced training and residency through a program at Bronx-Lebanon Hospital and received a certificate from the University of the Pacific, in San Francisco. He also completed a masters-degree program in healthcare administration at George Washington University’s Milken Institute of School of Public Health, in Washington, D.C.