Public Health Workgroup

Chair - LCDR Lee Wright - ubr1@cdc.gov 
CAPT Sarah Shoffstall-Cone - sshoffstallcone@anthc.org 
CDR Sayo Adunola - fadunola@hrsa.gov 
CDR Tara Van-Orden - tvanorden@rsicclinic.org 
CDR Ling Ye - ling.ye.mil@health.mil 
LCDR Ajikawaga Felli - ajikwaga.felli@hhs.gov 

Purpose

The mission of the Dental Professional Advisory Committee (DePAC) Public Health Workgroup is to educate and advocate for public health issues that affect the oral health of those served by the U.S. Public Health Service dental officers.

Objectives and Activities

• Act as a resource to DePAC and USPHS for dental public health topics.
• Develop and communicate current dental public health evidence based best practices and recent breakthroughs in the field.
  • Arrange presentations on public health topics.
  • Develop briefs on current public health topics.
• Support the Surgeon General’s activities and priorities.
• Promote cooperation and communication among dentists in the USPHS and public health professional organizations.
• Encourage individual membership in and involvement with public health societies and professional organizations in order to promote open communication with non-PHS colleagues.
• Perform duties as assigned by the USPHS Chief Dental Officer and DePAC Chair.
• This listing of functions is not all-inclusive and additional functions may be added in the future.

Public Health Minutes

Human Papillomavirus (HPV) related to oral cancer:

• HPV is the most common sexually transmitted disease in the U.S.
• There are over 200 types of HPV; however, most cancers are caused by types 6, 11, 16 or 18. Type 16 is associated with HPV-attributed oral pharyngeal cancer.
• About 10% of men and 3.6% of women have oral HPV; most people clear the virus in 1-2 years, but it persists in some people.
• Only about 1% of individuals that develop a high-risk type oral HPV infection will eventually develop cancer.
• Approximately 34,800 cancers are caused by HPV in the United States each year, including 13,500 oropharyngeal cancers among men and women.
• Oropharyngeal cancer is the most common HPV-linked cancer in the U.S. (surpassed cervical cancer).
• There is currently one licensed HPV vaccine available in the United States, Gardasil® 9, which has the most comprehensive prevention coverage, including types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Prior HPV vaccines had less prevention coverage.
• Centers for Disease Control and Prevention (CDC) recommends HPV vaccine for males & females 9-45 years; 2 doses (9–14 year olds) and 3 doses (15-26 year olds); 27-45 year olds should discuss the vaccine with their clinicians.
• During 2017–2018, the percentage of adolescents up-to-date with the HPV vaccine series increased from 48.6% to 51.1%, although the increases were only observed among males.

Silver Diamine Fluoride:

• Silver ion antimicrobials have been used extensively and safely in medicine for over 100 years.
• As early as 1891, dental researchers showed that silver ion antimicrobials arrested dental caries.
• Silver products work as an antimicrobial to kill bacteria and prevent formation of a new biofilm.
• SDF provides the added benefit of creating fluorapatite as a byproduct of silver phosphate, making the tooth more resistant to further decay.
• Numerous research studies have shown the efficacy and safety of SDF.
• State regulatory authorities determine who may apply SDF (in some states, hygienists or dental assistants may be able to apply SDF).
• Ideal candidates for SDF treatment are those at high caries-risk such as young children suffering from early childhood caries, those suffering from xerostomia, and older adults in assisted living facilities.
• Other Resources:
  • Chairside Guide: Silver Diamine Fluoride
  • University of California San Francisco Protocol for Caries Arrest Using Silver Diamine Fluoride