NUTRITION AND ORAL HEALTH: EXPLORING THE NEED FOR INTRADISCIPLINARY COLLABORATION
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CHAIR'S MESSAGE
RESOURCE
A YEAR CALLING FOR PERSISTENCE PG. 2
TH
TEH EE D
EUDC
UAC TAO
TOR ’RS’ S
WINTER 2021 • VOLUME 77, ISSUE 2
F E AT U R E A R T I C L E
NUTRITION AND
ORAL HEALTH:
EXPLORING THE NEED FOR
INTRADISCIPLINARY
COLLABORATION
+
NEW:
DIVERSITY AND
INCLUSION COLUMN
and
HOD REPORT:
WWW.NEHPDPG.ORG NUTRITION AND
JOIN OUR CLOSED GROUP
ON FACEBOOK:
HEALTH EQUITY
NUTRITION EDUCATORS
OF HEALTH PROFESSIONALS
TO SHARE IDEAS AND NETWORK
? DID YOU
KNOW
On average, 34 million school hours
are lost each year because of un-
planned (emergency) dental care, and
over $45 billion in US productivity is
lost each year due to untreated dental
disease1.
Community water fluoridation re-
mains one of the most cost-effective
methods of delivering fluoride to all
community members regardless of
age, educational attainment, or in-
come level, and saves money for fami-
lies and the US health care system2.
A mother’s oral health status
is a strong predictor of her child’s
oral health status3.
1. Centers for Medicare Achievements in public
and Medicaid Services. 2018 health, 1900-1999: fluori-
National Health Expenditure dation of drinking water to
Data. NHE Tables; Table prevent dental caries. MMWR.
12: https://www.cms.gov/ 1999;48(41):933-940.
Research-Statistics-Da-
ta-and-Systems/Statis- 3. Xiao J, Alkhers N, Kopy-
tics-Trends-and-Reports/ cka-Kedzierawski DT, et al.
NationalHealthExpendData/ Prenatal oral health care and
NationalHealthAccountsHis- early childhood caries preven-
toricalexternal icon. tion: a systematic review and
meta-analysis. Caries Res.
2. Centers for Disease 2019;53:411–421.
Control and Prevention.
PHOTO: SHARON MCCUTCHEON / PEXELS
Contents
THE EDUCATOR’S RESOURCE
WINTER 2021 VOLUME 77, ISSUE 2
2
5
CHAIR’S MESSAGE
A year calling for persistence
3
MEMBER SPOTLIGHT
Meet Emily Johnston
F E AT U R E
10 COMMUNICATIONS NUTRITION AND
REPORT ORAL HEALTH:
What does 2021 have in store? EXPLORING THE NEED
FOR INTRADISCIPLINARY
11
DIVERSITY AND COLLABORATION
INCLUSION
In Support of Diversity,
Equity, and Inclusion
12
PUBLIC POLICY
The term "persistence"
13
(HOD) UPDATE
Fall 2020 House of Delegates
Meeting Recap: A Systems
Approach to Accelerating
Nutrition and Health Equity
14
NEHP OFFICER DIRECTORY
2020-2021
The authors have no conflict of interest
to declare and have not received any funding
to write their article.
COVER PHOTO: GEORGE BECKER/PEXELS-; (THIS PAGE): ILLUSTRATION: PIXABAY.COM
WINTER 2021 THE EDUCATOR’S RESOURCE / 1
CHAIR’S MESSAGE
A Year Calling for
of oral health, an issue that may likely
be one of the leading areas of neglect
in many, if not most, communities.
Persistence Please take time to look up leading
health disparities in your community
and determine where oral health is
listed. Strategize on ways to collaborate
with other health professionals in your
community to address this issue. I was
involved in an inter-professional nutrition
and oral health activity that involved
health professions faculty from the local
CYNTHIA P. CADIEUX
community college and a local university,
PHD, RDN, FAND
students of several health professions
cadieucp@evms.edu
programs at both institutions, and the
community. The activity was a Tooth
W
Fair. Organizing the tooth fair required
elcome to 2021 and a year professionally. A position I held around
learning about the issues, planning the
that perhaps begins for many the same time required that I interact
event, assigning roles for participants
with anxiety, apprehension, with lobbyists and travel to the
to fulfill, allowing students to practice
frustration, hesitation, uncertainty, and Department of Education in Washington,
teaching about nutrition and oral health at
unknowing. At the same time, some D.C. on a regular basis. I learned so much
the Tooth Fair and also in the classroom,
may be feeling very ebullient, energized, about the federal government, lobbying,
evaluating the event, and faculty
hopeful, organized, and thankful. The and the importance of staying informed
collaboration on writing and publishing
list of words used to describe how one on issues of importance. I encourage
an article about the inter-professional
is feeling at any given point in time is everyone to become involved in matters of
event for a journal. The event was a
diverse, personal, and endless. I am a public policy.
huge success and was repeated during
lover of words. I keep a list of words that It will take persistence to accelerate
subsequent years.
are new to me along with a definition nutrition and health equity. It takes
NEHP is off to a great start in 2021,
and find the discovery of new words and persistence to learn about issues, decide
but we need your input to strategize
word histories intriguing. The word I am where one stands on issues and to which
activities. Please take a minute to complete
choosing to highlight today is persistence. causes one commits resources. The House
the membership survey by clicking on
The definition of persistence appears of Delegates Report in this newsletter is
this link: https://bit.ly/37YfvBM. I cannot
in this newsletter in the Public Policy full of resources for members to explore.
underscore how important it is for any
article. I recall attending the Public Policy Persistence fuels the iterative process
group to solicit member input and to
Workshop in Washington, D.C. when I referred to in the Diversity, Equity and
plan based on this input. The NEHP
was a young Assistant Professor in the Inclusion article. Persistence underlies
Leadership Team relies on information
early 2000s. I learned so much about lifelong learning, a professional obligation.
from members and wishes to provide
policy and advocacy at that workshop and In the excellent article on oral health
the types of resources members find
began to formulate a plan to stay informed and nutrition, the authors bring to NEHP
most useful. Thank you in advance for
and engaged as a citizen personally and members the timely and important subject
completing the survey as soon as possible.
I close with a quote that illustrates
persistence. “Let me tell you the secret
that has led to my goal. My strength lies
PE R SIS T E N CE
solely in my tenacity.” – Louis Pasteur
Be persistent, be tenacious in learning
and becoming involved in addressing
FUELS THE ITERATIVE PROCESS REFERRED the issues highlighted in this issue of The
TO IN THE DIVERSITY, EQUITY AND INCLUSION ARTICLE. Educator’s Resource. Good luck getting
started in this new year that brings so
PERSISTENCE UNDERLIES LIFELONG LEARNING, many opportunities to be good and do
A PROFESSIONAL OBLIGATION. good in our personal and professional lives.
On behalf of NEHP, we are glad you are
members of this dietetic practice group.
2 / THE EDUCATOR’S RESOURCE WINTER 2021
MEMBER SPOTLIGHT INTERVIEW Meet Emily A. Johnston PhD, MPH, RDN, CDE WINTER 2021 THE EDUCATOR’S RESOURCE / 3
MEMBER SPOTLIGHT INTERVIEW
Meet
Emily A. Johnston
PhD, MPH, RDN, CDE
EMILY IS AN ASSISTANT PROFESSOR What led you to your current role? “wait, I can eat eggs!” or “rice isn’t bad
OF BIOMEDICAL EDUCATION AND THE While I was working on my PhD, I for you?” from a community audience.
was able to observe a culinary medicine Working with nutrition students, I
FACULTY LEAD FOR NUTRITION AND
class. I thought it was a fantastic way of love to hear about their goals, practice
CULINARY MEDICINE AT CALIFORNIA teaching future healthcare professionals areas of interest, and what made them
HEALTH SCIENCES UNIVERSITY about nutrition and I wanted to teach want to become an RDN. In culinary
COLLEGE OF OSTEOPATHIC MEDICINE. it myself. I joined a few professional medicine classes, I love it when students
CURRENTLY, SHE IS NEHP’S organizations not directly related to learn a new cooking method or try
nutrition and I met the chair of my a new food and are surprised at how
NOMINATING COMMITTEE CHAIR-
current department at CHSU through simple it is to make or how delicious
ELECT. EMILY HAD BEEN INTERESTED committee work for the International it tastes. Lastly, I have become more
IN NUTRITION FROM A YOUNG AGE Association of Medical Science involved in student research and I love
THANKS TO HER GRANDMOTHER Educators (IAMSE). They were looking to hear students tell me about their
to hire a faculty member that could research interests and working with
WHO ATE OATMEAL (LOWERS
teach culinary medicine and assist them to craft a research question and
CHOLESTEROL!) WITH MOLASSES study aims.
with the biochemistry coursework. I
(GOOD SOURCE OF IRON!) EVERY interviewed and was hired at CHSU
MORNING FOR BREAKFAST AND LOVED after completing my PhD. Given the unprecedented
RICHARD SIMMONS’ WORKOUT VIDEOS. circumstances in education due
Tell us about your teaching style. to COVID-19, where do you see the
AFTER LEARNING IN A HIGH SCHOOL
I feel that active learning is future of online learning?
COOKING CLASS THAT NUTRITION incredibly important. At my current This year has taught me that I
WAS A FIELD OF STUDY, EMILY institution, we utilize team-based should expect the unexpected, so I
DECIDED TO BECOME A DIETITIAN. SHE learning. The level of student really have no idea. I never thought I
COMPLETED HER UNDERGRADUATE engagement is incredible, and I really would want to teach or learn virtually,
enjoy interacting with students in but since COVID-19 caused a rapid,
DEGREE IN NUTRITION AND DIETETICS
this type of classroom. I strive to unavoidable change to online teaching
AT UNC GREENSBORO, HER DIETETIC make the content I teach relevant to and learning, I realized that I enjoy
INTERNSHIP AT MONTCLAIR STATE students personally by showing them teaching online. Virtual teaching and
UNIVERSITY, AND HER MASTER’S how their lifestyles can improve their learning provide flexibility, in some
DEGREE IN PUBLIC HEALTH AT RUTGERS academic or athletic performance and cases allow for larger class sizes, and
by making learning activities practical. may make universal design for learners
UNIVERSITY. EMILY TRAINED UNDER A
I include many self-assessments in with diverse learning styles simpler.
CDE, BECAME A CERTIFIED DIABETES my coursework with the intention I think once we are able to return to
EDUCATOR HERSELF AND WORKED of making the guidelines real and in-person learning, hybrid classes
IN OUTPATIENT CARE. HER WORK applicable to students. I’m an advocate will become the most popular. One
AS A RDN HIGHLIGHTED THE LACK for interdisciplinary education and positive side effect of the pandemic and
working with a local dietetic internship the ensuing lockdowns has been the
OF NUTRITION EDUCATION THAT
to include interns in our culinary creativity exhibited by people unwilling
PHYSICIANS RECEIVE AND SHE DECIDED medicine classes and hope to include to let barriers stop them. In education,
TO GO BACK TO SCHOOL FOR A PHD other healthcare- professionals-in- I think this will lead to more advanced
SO SHE COULD TEACH NUTRITION TO training in the future as well. virtual learning tools and platforms
and I look forward to seeing how
MEDICAL STUDENTS. HER AREAS OF
What do you like best about being virtual learning will continue to evolve.
RESEARCH INTEREST ARE NUTRITION an educator?
IN MEDICAL TRAINING AND CARE AND I love teaching nutrition to a
INTERPROFESSIONAL EDUCATION. variety of audiences. I love to hear,
4 / THE EDUCATOR’S RESOURCE WINTER 2021
F E AT U R E A R T I C L E
N U T R I T I O N A N D O R A L H E A LT H
Nutrition and Oral Health:
Exploring the need for intradisciplinary collaboration
By Jillian Kaye, MS, RDN, Adjunct Clinical Instructor, Department of Cariology and Comprehensive Care,
New York University and Nadine Tassabehji, PhD, RDN, Clinical Instructor, Department of Comprehensive
Care, School of Dental Medicine, Tufts University
Oral health is closely related to many they experience any of the characteristic
chronic diseases and health problems.1 abdominal symptoms.3 Additionally, many
Dentists examine not only the teeth but also population-based studies have found poor
the condition of the gums and other areas oral health to be significantly associated with
of the mouth, the findings of which can many common chronic health conditions
uncover a red flag for other health issues we see today, such as cardiovascular
throughout the body. These discoveries disease, obesity, diabetes, anemia, kidney
can occur often before the individual or disease and respiratory disorders.1, 4 This
Jillian Nadine their general practitioner is aware of any evidence underscores the role of the dentist
Kaye Tassabehji problems, and therefore, the oral cavity is in understanding the relationship between
often referred to as a mirror of one’s overall oral health and diet, but more importantly
health.2 For example, some individuals recognizing the nutritional and dietary
with inflammatory bowel disease will factors that can contribute to the etiology,
develop ulcerations in their mouth before progression, and treatment of dental
JONATHAN BORBA / UNSPLASH
WINTER 2021 THE EDUCATOR’S RESOURCE / 5
F E AT U R E A R T I C L E
N U T R I T I O N A N D O R A L H E A LT H
1 in 3 felt confident providing
nutrition education to their patients.8
This situation emphasizes the knowledge
gap and need to address key clinical
elements such as dietary recalls, nutrition
counseling and understanding when to
refer a patient to an RDN. ADEA reported
that across 24 American dental schools,
Intradisciplinary on average 15.9 hours were dedicated
Collaboration to didactic nutrition education with
zero clinical hours. Compared to dental
As oral and overall health are hygiene programs where 32.7 hours were
connected in a synergistic manner with Barriers to dedicated to didactic nutrition education
nutrition at the center, the collaboration Intradisciplinary with 9.3 clinical hours of reinforcement.8
between oral health professionals and
Registered Dietitian Nutritionists (RDN)
Collaboration Such limits on educational nutrition
hours accompanied by little to no
has never been more crucial. Oral disease Despite growing research clinical application, leave dentists feeling
such as oral infection, gingivitis, and and understanding regarding the “unqualified” to provide nutrition
severe dental caries particularly among connection between nutrition and counseling. For this reason, along with a
older adults can impact the ability to eat oral health, collaborations between lack of time during appointments, drives
and chew. If unaddressed, this scenario the two professions remain sparse. dental professionals to rarely include
can further exacerbate the disease process, While professional organizations discussing nutrition with their patients
compromise the immune system, and from each discipline have highlighted Lastly, there are too few qualified
increase the risk of malnutrition. the importance of nutrition and diet instructors among dental school faculty.
Decades of research supporting in oral health promotion, disease Nutrition topics are often taught by basic
the role of nutrition in oral health has prevention and treatment, the education science faculty or dental faculty that lack
led several national medical and health standards, curriculum, and credentialing training in nutrition education. If the
organizations to advocate for more requirements have not followed suit. There educators teaching these key nutrition
collaborative efforts between the dental are several barriers limiting the success of concepts are not trained to decipher
and dietetic community. The Surgeon these partnerships. the scientific evidence that dictates
General’s report on “Oral Health America” First, there are no guidelines for a dietary recommendations, students
indicates that diet and nutrition are major standard nutrition course or nutrition may be misinformed or may not see the
multifactorial environmental factors in topics critical in dental education. significance of what they are learning.
the development of oral disease.1 The Crowded curriculums limit incorporating Conversely, the absence of comprehensive
American Dental Association,5 American nutrition in the core of dental education. oral health initiatives within dietetic
Dental Hygienists Association6 and the Each school is left to their own devices programs or internships, yields very few
Academy of Pediatric Dentistry7 have to reinvent the wheel. Unlike dental RDNs seeking these positions, therefore
all issued nutrition guidelines for dental hygiene programs that are required by the hardly any nutrition professionals are
practice. The American Dental Education Commission on Dental Accreditation to seen on dental teams. With demand for
Association (ADEA), a prominent provide nutrition training, dental schools RDNs within dental schools remaining
organization in dental education, recently lack specific accreditation requirements consistently low, so does the funding for
issued a report recommending that dental that would compel them to these positions, which
students exhibit the ability to provide provide nutrition education are often part-time,
intervention, motivation, and nutrition to their students, consequently, and so includ
as essential health promotion and disease they are not obliged to very few
prevention strategies.8 In addition, the provide this knowledge, hours
Academy of Nutrition and Dietetics has skill, or training.10 dedicated
issued a position statement supporting the Second, there is a to nutrition
importance of nutrition and diet in oral limited amount of time within the
health.9 Clearly, there is wide agreement on allocated to practice dental
the need for nutrition knowledge in oral relevant nutrition concepts curriculum.
health education, but there is a lack of an clinically with patients.8
agreed upon pathway of specific actions to Most dentists have some
achieve such an integration of concepts. nutrition training, but only
PHOTOMIX COMPANY / PEXELS; MALI MAEDER / PEXELS
6 / THE EDUCATOR’S RESOURCE WINTER 2021
F E AT U R E A R T I C L E
N U T R I T I O N A N D O R A L H E A LT H
A Call for Further Dental schools should also be Conclusion
required to provide interprofessional
Collaboration educational opportunities that foster
While the goal of both
professions is health promotion
Despite the barriers to integrating relationships between the two professions. and disease prevention, it is counter
nutrition education into dental This is critical both within the dental productive for dentists and dietitians
curriculums, there still has been school as well as at the community level. to work in such independent and
significant strides over the past few years. Understanding each other’s roles and isolated silos. Intradisciplinary
More dental schools have been seeking to responsibilities creates a shared level of education fosters a shared respect
employ RDNs, and there are now course respect while enhancing patient care. and understanding of the scope of
textbooks on nutrition and oral health The real limiting factor for proper practice and shared goals across
(see For Further Reading section). integration is dental insurance coverage different health professionals.
Even with efforts to keep nutrition for nutrition counseling. By far the Nutrition and oral health have a
education at baseline within dental biggest driving force for any health care bidirectional relationship with
schools, it is imperative to achieve a level initiative is insurance coverage. This is one another and the need for
of integration that will be meaningful. especially so when trying to integrate more collaboration between the
Dental schools need to employ RDNs nutrition counseling provided in dental two professions will ultimately
full-time, dedicating adequate hours schools. Despite very few states allowing improve patient care. Despite the
to developing nutrition-based course for Medicaid reimbursement, dental barriers, RDNs should advocate for
material, accompanied by benchmark insurance does not reimburse widely incorporating nutrition education
testing to assess understanding. for nutrition counseling for the control in the field of dentistry, which
will not only help with oral health
Additionally, RDNs need proper training and prevention of oral disease.11 Until
outcomes but also with overall health
in oral health to understand how their insurance companies understand the
outcomes. Educators have a key role
recommendations may be aligned impact diet has on oral health, dental
in setting the stage and encouraging
with those of dental experts. This will professionals will continue to not take
the mindset for this important
encourage RDNs to work closely with the time out of their already short
intradisciplinary collaboration, and
dental schools to advocate the need for appointment to address something that is can start right in the classroom.
employment. financially not lucrative.
MARTIN SLAVOLJUBOVSKI / PIXABAY
WINTER 2021 THE EDUCATOR’S RESOURCE / 7
F E AT U R E A R T I C L E
N U T R I T I O N A N D O R A L H E A LT H
What Nutrition Professionals
Should Know About Oral Health
The etiology of cavities is multifactorial, involving genetics, host
susceptibility, dental hygiene, saliva, quantity of cariogenic bacteria in
the mouth, fluoride, and DIET! Given the fact that dental caries is one
of the most common chronic diseases in children and adolescents and
affects the majority of adults,12 it is essential for nutrition professionals
to consider the significant ties between diet and oral health when
counseling patients.9 However, many nutrition professionals fail to
consider the ways in which their nutrition recommendations may impact
oral health. Below are key factors nutrition professionals should know.
MORE THAN JUST SUGAR BALANCING ACT IDEAS FOR INTEGRATING
Contrary to popular belief, sugar When cariogenic foods/beverages ORAL CARE WITH NUTRITION
does not directly cause cavities. When are consumed in isolation, teeth are EDUCATION
fermentable carbohydrates (simple sugar, directly exposed to acid. However, 1. Discuss patient cases in a
starches) are consumed, salivary amylase if items must be consumed, do so in multidisciplinary setting that includes
breaks down complex carbohydrates conjunction with a meal, rather than dietitians, dentists, and nurses, etc.
into smaller sugar molecules.13, 14 These alone.14, 19 Consuming sugary or acidic 2. Dietetic interns and dental residents
simple sugars are the preferred food foods with foods rich in protein or together can create posters and other
source for the cariogenic bacteria healthy fats causes foods to stick less to patient education material for dental
present in the mouth.13, 15 The bacteria teeth. These cario-protective foods also waiting rooms.
metabolizes these sugars, creating acidic provide minerals (calcium, phosphorus) 3. Provide health professionals with
byproducts, lowering pH and leading to to make teeth strong and do not interact handouts that explain the role of
demineralization and eventual erosion with the bacteria in the mouth, buffering nutrition in oral health and disease.
of the teeth’s enamel.14, 16, 17 This is acid production, ultimately protecting 4. Provide lunch and learn and/or
why acidic foods/beverages also cause the teeth. webinars on nutrition issues to faculty
demineralization. Remineralization can and staff at dental schools and
occur when the mouth pH rises above CONSISTENCY IS KEY! dietetic/ nutrition programs.
the critical pH. Therefore, acidity and 5. Offer CE credits on nutrition and oral
The longer sugar is in the mouth
change in the mouth’s pH, that leads to health issues to both dietitians and
the longer it feeds bacteria.18, 19
the formation of cavities.4 oral health professionals.
Thus, promoting
an acidic 6. Thread nutrition education
FREQUENCY, FREQUENCY, environment throughout dental education
FREQUENCY for a longer curriculum, as well as weave oral
The frequency in which an period of time, health concepts within dietetic
individual consumes sugar and/or acidic and prolonging internship rotations.
foods/beverages is more important than demineralization. 7. Suggested topics for teachings
the amount consumed. Each time one Overall, it is best to provide dietary Dietary interventions for dry mouth
eats/drinks a fermentable-carbohydrate recommendations aimed at reducing and the health consequences of this
or acidic food/beverage, the mouth’s pH exposure and limit sticky or chewy foods condition.
drops below the critical level roughly like dried fruits and gummy candies/ Dietary prevention for
within 2-3 minutes.18 It usually takes vitamins. Patients should not linger early childhood caries, including
around 20 minutes for the mouth’s pH to when consuming sugary foods/beverages recommendations for new mothers.
return to neutral pH. Frequent exposure (sipping coffee all day); rather they should The impact of tooth decay and gum
of the teeth to an acidic environment, consume these items quickly (F E AT U R E A R T I C L E
N U T R I T I O N A N D O R A L H E A LT H
FOR FURTHER READING
The Dental Hygienist’s Guide to Nutritional Care. Stegeman, C. and
Davis, J. 5th Edition. 2018.
Nutrition for Dental Health. Sroda, R. and Reinhard, T. 3rd Edition. 2018.
Diet and Nutrition in Oral Health. Palmer, C.A. and Boyd, L.D.
3rd Edition. 2007.
Teeth: The Story of Beauty, Inequality, and the Struggle for Oral
Health in America. Otto, M. 1st Edition. 2016.
REFERENCES
1. Health USDo, Human S. Oral Health in America: A Report of the Surgeon
General. Rockville, MD: U.S. Department of Health and Human Services,
National Institute of Dental and Craniofacial Research, National
Institute of Health; 2000.
2. Stanski R, Palmer C. Oral health and nutrition as gatekeepers to overall
health: We are all in this together. European Journal of General Dentistry
2015;4(3):99-105.
3. Lankarani KB, Sivandzadeh GR, Hassanpour S. Oral manifestation in
inflammatory bowel disease: a review. World journal of
gastroenterology 2013;19(46):8571-79.
4. Oral health in America: a report of the Surgeon General. Journal of the
California Dental Association 2000;28(9):685-95.
5. Touger-Decker R, Mobley CC, American Dietetic A. Position of the
American Dietetic Association: oral health and nutrition. J Am Diet Assoc
2007;107(8):1418-28.
6. Johnson DL, Gurenlian JR, Freudenthal JJ. A Study of Nutrition in Entry-
Level Dental Hygiene Education Programs. J Dent Educ 2016;80(1):73-82.
7. Policy on Dietary Recommendations for Infants, Children, and
Adolescents. Pediatr Dent 2018;40(6):65-67.
8. DiMaria-Ghalili RA, Mirtallo JM, Tobin BW, et al. Challenges and
opportunities for nutrition education and training in the health care
professions: intraprofessional and interprofessional call to action. Am J
Clin Nutr 2014;99(5 Suppl):1184S-93S.
9. Van Horn L, Lenders CM, Pratt CA, et al. Advancing Nutrition Education,
Training, and Research for Medical Students, Residents, Fellows,
Attending Physicians, and Other Clinicians: Building Competencies
and Interdisciplinary Coordination. Advances in nutrition (Bethesda,
Md.) 2019;10(6):1181-200.
10. Divaris K, Bhaskar V, McGraw KA. Pediatric obesity-related curricular
content and training in dental schools and dental hygiene programs:
systematic review and recommendations. J Public Health Dent 2017;77
Suppl 1:S96-s103.
11. Dentists AsP Are Your Kids Covered? Medicaid Coverage for the
Essential Oral Health Benefits. 2017. "https://www.aapd.org/
assets/1/7/AreYourKidsCoveredfinal.pdf".
12. Corrêa-Faria P, Paixão-Gonçalves S, Paiva SM, Pordeus IA. Incidence of
dental caries in primary dentition and risk factors: a longitudinal study.
Braz Oral Res 2016;30(1).
13. Parry J, Shaw L, Arnaud MJ, Smith AJ. Investigation of mineral waters
and soft drinks in relation to dental erosion. J Oral Rehabil
2001;28(8):766-72.
14. Touger-Decker R, van Loveren C. Sugars and dental caries. Am J Clin Nutr
2003;78(4):881S-92S.
15. Curriculum guidelines for Dental Nutrition. American Association
of Dental Schools. Section on Biochemistry and Nutrition. J Dent Educ
1989;53(4):255-6.
16. Guideline on Perinatal and Infant Oral Health Care. Pediatr Dent
2016;38(5):54-58.
17. Guideline on Perinatal and Infant Oral Health Care. Pediatr Dent
2016;38(6):150-54.
18. Stegeman CA, Davis, J.R. Nutrition aspects of dental caries: causes,
prevention, and treatment. 5th ed. St. Louis, MO: Elsevier; 2019.
19. Kidd E. Essentials of dental caries. 3rd ed. New York, NY: Oxford
University Press; 2005.
TIMA MIROSHNICHENKO / PEXELS
WINTER 2021 THE EDUCATOR’S RESOURCE / 9COMMUNICATIONS REPORT
We are also eagerly awaiting the
EMMA M. LAING announcement about who will be selected
PHD, RDN, LD to receive the 2021 NEHP Excellence
emonk@uga.edu in Nutrition Education Award. The
application was sent via email to our
members in November, and award
I
t was wonderful having the chance to by: Melissa Altman-Traub MS, RDN, LDN. notification will be announced no later
connect with many of you virtually at This presentation and other past webinars than March 1, 2021. A commemorative
FNCE® 2020 in October. Thank you can be found on the NEHP website under plaque and $250.00 award will be
for participating in our DPG Showcase the 'E-learning' tab: https://nehp.eatrightpro. presented to the recipient.
and in our various give-aways and trivia org/benefits/elearning. Stay tuned for Lastly, we invite you to connect
contests. A highlight of FNCE® week for information regarding future webinars. with us via our closed Facebook group.
me was connecting with our members via This group provides a wonderful space
Zoom for our inaugural Virtual Social So, what does 2021 have in store? where we can get to know one another
Hour held on October 19th. The purpose For starters, we want to hear from and expand our networking potential.
of these social hours is to join colleagues YOU! Please take a few moments to Members post links to resources,
to share teaching strategies, life as participate in our membership survey. It questions, ideas for the classroom or
educators during COVID-19, newsletter should take no longer than 5-10 minutes online courses, learning opportunities,
topics, future practice in nutrition and of your time. Click HERE to begin. and teaching positions. If you have been
dietetics, and more. We're excited to find out how our DPG is quoted in the media, recognized for
supporting you and we would like your an award, or have another professional
Future NEHP Social Hours will feedback as we plan for future years. The highlight to share, please email me
be held on the dates below, deadline to complete the survey is March at emonk@uga.edu, and I would be
and I welcome you to join us! 1, 2021. delighted to share your news on this
You can also use this link if we can't platform. Facebook link: https://www.
Time: Feb 24, 2021
hyperlink text: https://bit.ly/37YfvBM facebook.com/groups/423581444394785/
8:00 PM Eastern Time
(US and Canada)
Join Zoom Meeting
https://unf.zoom.
us/j/99172212068
Meeting ID: 991 7221 2068
Time: May 25, 2021
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(US and Canada)
Join Zoom Meeting
https://unf.zoom.
us/j/91222002807
Meeting ID: 912 2200 2807
Another highlight for our members
this fall was attending the NEHP-hosted
webinar on September 23rd titled,
"Classroom Management." The event was
moderated by: Kristen Hicks-Roof PhD,
RDN, LDN, CLC, FAND and was presented
NEHP ZOOM PHOTO / NEHP
10 / THE EDUCATOR’S RESOURCE WINTER 2021DIVERSITY AND INCLUSION
In Support of Diversity, Here are some ideas to get started:
Equity, and Inclusion
Educate yourself. Enroll and
participate in any bias trainings
offered at your institution.
Openly discuss with students the
widespread bias and stigma that
festers within the healthcare system
and talk about the negative impact it
has on vulnerable populations.
Teach and encourage your students
to look within and learn about their
JENNIFER M. WATERS own beliefs and biases so that they
MS RDN, CNSC, LDN can identify opportunities to evolve.
Add or alter existing learning activities
to involve role-play and
Cultural Humility: tendencies, and behaviors. This
communication with people of
introspection and subsequent self-
Pushing Past the Limits awareness allows us to recognize and different cultures. Avoid singling out
of Cultural Competence improve any behaviors or tendencies or tokenizing any of your students.
The practice of cultural that may be perpetuating the Practice what you preach and lead by
competence has become familiar inequitable care of culturally-diverse example. As educators, we should
terrain for most healthcare individuals. The self-evaluation and also practice cultural humility when
evolution should be a long-standing working with our students as there are
professionals, and though it is
commitment that we make to many inequities in higher education
important for RDNs to continue
ourselves and our patients. Having as well.
developing culturally-sensitive
skills surrounding food, heritage, cultural humility also requires us Begin your lifelong journey of
family dynamics, and health beliefs, to practice without ego. By phasing practicing (or teaching) with
there is a way for us to go one step out the sense of superiority of the cultural humility by taking one of
further through cultural humility. healthcare professional over the the many different bias tests from
As distinguished from cultural patient, we encourage more humble Harvard University’s Project Implicit.
competence1 , cultural humility is and supportive patient interactions. https://implicit.harvard.edu/implicit/
Engaging in and committing to selectatest.html
defined as “a lifelong commitment
to self-evaluation and critique, to these practices helps us to establish
redressing the power imbalances in mutual respect and partnership with
the physician-patient dynamic, and patients while helping to diminish REFERENCES
to developing mutually beneficial and power imbalances, inequities, and
1. Tervalon M, Murray-Garcia J. Cultural humility
non-paternalistic partnerships with systemic stigma and oppression in the versus cultural competence: A critical distinction
communities on behalf of individuals healthcare environment.2 in defining physician training outcomes in
and defined populations.” Although As the educators of future healthcare multicultural education. J Health Care Poor
Underserved 1998; 9(2):117-125.
this definition was written specifically professionals, it is imperative that we 2.Foronda C, Baptiste D, Reinholdt MM, Ousman
to address the physician-patient lay the foundation for our students to K. Cultural humility: A concept analysis. J
relationship, it can and should be begin this process before entering the Transcult Nurs 2016;27(3):210-217.
applied to other healthcare disciplines. workforce.
While cultural competence is
predicated on having an open-mind a lifelong commitment to self-evaluation and
and a willingness to learn about and
interact with individuals who are
critique, to redressing the power imbalances
different from us, cultural humility in the physician-patient dynamic, and to developing
involves engaging in an iterative
process that entails honest reflexivity
mutually beneficial and non-paternalistic
(looking within ourselves), leading partnerships with communities on behalf
us to better understand and accept
our own biases, beliefs, limitations,
of individuals and defined populations.
WINTER 2021 THE EDUCATOR’S RESOURCE / 11PUBLIC POLICY UPDATE
W
e do need to be persistent in our efforts to
influence state and national leaders in the
value of our profession and our ability to
improve health.
Public policy and advocacy are core functions of the ROGER A. SHEWMAKE
Academy and are critical to achieving our mission, vision
PhD, LN, FAND
and goals. Not only does public policy significantly shape
NEHP Public Policy Chair
the public image of the Academy, but it also shapes the
nutrition and dietetics profession.
rshewmak@gmail.com
The Advocacy arm of the Academy has been diligent
in providing our membership tools and resources for
influencing leadership across the country.
PERSISTENCE
per·sis·tence | \ pər-ˈsi-stən(t)s , -ˈzi-
The Medical Nutrition Therapy (MNT) Act efforts NOUN
provide a good example of the means to educate yourself
and others in regard to this very important legislation. 1: the action or fact of persisting
2: the quality or state of being persistent especially:
The Medical Nutrition Therapy Act of 2020 allows PERSEVERANCE
Medicare beneficiaries to access the care they need by
providing Medicare Part B coverage for MNT for: 2a: continuing or inclined to persist in a course
• Prediabetes 2b: continuing to exist despite interference
• Obesity Merriam-Webster
• Hypertension
• Dyslipidemia
• Malnutrition
• Eating disorders
• Cancer
• Celiac disease
• HIV/AIDS
• Any other disease or condition causing
unintentional weight loss
To improve your advocacy efforts, the Academy has
created a Grassroots advocacy toolkit and checklist for
the MNT Act and is calling on policy leaders to use this
resource and encourage their membership to urge their
members of Congress to co-sponsor this important piece
of legislation.
(https://www.eatrightpro.org/advocacy/legislation/all-
legislation/medical-nutrition-therapy-act)
You can download the Academy's Medical Nutrition policy leaders work to creatively engage members to participate in
Therapy Act of 2020 issue brief and leave behind local, state and national grassroots efforts for their DPG’s content area,
materials for more information. including: sharing information about policy issues affecting the DPG
at meetings or on webinars; providing policy content for newsletters,
Visit the Action Center to urge your members of social media or websites; and advocating on behalf of the DPG at
Congress to support the Medical Nutrition Therapy Act state or national legislative visits. DPGs provide the expert voice the
of 2020. The action center provides an efficient means to Academy needs to develop stances and positions, write regulations and
contact your U.S. Representatives and Senators. comment on policy issue areas.
The Academy’s Dietetic Practice Groups (DPGs) are Your expertise, time, and financial resources are
vital to achieving the Academy’s public policy goals. DPG FUNDAMENTAL to the Academy’s Public Policy Initiatives!
12 / THE EDUCATOR’S RESOURCE WINTER 2021HOUSE OF DELEGATES (HOD) UPDATE
Fall 2020 House of Delegates Meeting Recap:
A Systems Approach to Accelerating Nutrition and Health Equity
T
he Academy of Nutrition and Dietetics RESOURCES
House of Delegates (HOD) convened its • Understanding and Promoting Nutrition and
Fall 2020 Virtual Meeting on Thursday, Health Equity
October 15 and Friday, October 16. Meeting • Practicing Cultural Competence and Cultural
participants discussed nutrition and health equity Humility in the Care of Diverse Patients
as a subtopic of diversity and inclusion. • Combatting Unconscious Bias and Preventing
Microaggressions: A Professional Duty
CRITICAL ISSUE QUESTION: • Equity vs. Equality video by Robert Wood
How can the Academy and its members Johnson Foundation
accelerate nutrition and health equity? • Project Implicit® Race IAT Test
Why Nutrition and Health Equity? • Diversity and Inclusion page on the Academy
GINA PAZZAGLIA, COVID-19 has underscored existing disparities website
PHD, RDN Black, Latinx, and Native American communities • Academy’s Definition of Terms (new terms for
GPS3@PSU.EDU are experiencing. These communities suffer from diversity and inclusion)
a disproportionate burden of COVID-19 cases and
deaths. The HOD explored a Systems Approach to
During the meeting, delegates gained a Nutrition and Health Equity through the lens of
knowledge base on the impact of racial and social the Social Ecological Model, the Academy Strategic
injustices on nutrition and health equity. The Plan, and information from the Nutrition Equity
resources, below, are intended to help delegates Summits, as depicted below:
and their constituents understand the topic and
practice with cultural humility in the communities
in which they live, work, and play.
WINTER 2021 THE EDUCATOR’S RESOURCE / 13N E HP O F F IC E R DIR E C TORY
2020-2021
Chair Webinar Coordinator Membership Chair
Cynthia P. Cadieux, PhD, RDN, FAND Kristin Hicks-Roof, PhD, RDN, LDN Emma M. Laing, PhD, RDN
cadieucp@evms.edu hicks.roof@unf.edu emonk@uga.edu
Chair-Elect Website Coordinator Sponsorship Coordinator
Kristin Hicks-Roof, PhD, RDN, LDN Lona Sandon, PhD, RDN, LD Contact DPG Chair,
hicks.roof@unf.edu lona.sandon@UTSouthwestern.edu if interested in position
Past-Chair Member Communications DPG Diversity Liaison
Joanne Christaldi, PhD, RDN Coordinator Lona Sandon, PhD, RDN, LD
jchristaldi@wcupa.edu Emma M. Laing PhD, RDN lona.sandon@UTSouthwestern.edu
emmamlaing@gmail.com
Treasurer
Kathleen A. Gould, EdD, MA, RDN, LDN Delegate to Academy HOD
kgould@towson.edu Gina Pazzaglia, PhD, RD
gps3@psu.edu
Secretary
Diana Cuy Castellanos, PhD, RD CEU Chair
dcuycastellanos1@udaytpn.edu Kristin Andolaro, MS, RD, LDN, CHES
andolaro@gmail.com
Public Policy Chair
Roger Shewmake, PhD, LN Awards Chair
rshewmak@gmail.com Mary-Ellen Dorfman, MPH, RD, CDN
medkhd@optonline.net
Newsletter Co-Editors
Elizabeth Eilender, MS, RD, CDN Nominating Committee Chair
ee845@hunter.cuny.edu Chimene Castor, EdD, RDN, FAND
ccastor214@gmail.com
Jennifer Waters, MS, RDN, CNSC, LDN
jenwaters8813@gmail.com
Nominating Committee
Communications Coordinator Chair-Elect
Lynn Janas, PhD Emily A. Johnston, PHD, MPH, RDN, CDE
lynn.janas@rosalindfranklin.edu eajohnst@gmail.com
Viewpoints and statements in this newsletter do not necessarily reflect policies and/or official positions of the Academy of Nutrition
and Dietetics. © 2019 Nutrition Educators of Health Professionals DPG of the Academy of Nutrition and Dietetics.
14 / THE EDUCATOR’S RESOURCE WINTER 2021You can also read
