ADA Executive Director Visits CDM

On November 28, students and faculty at Columbia University College of Dental Medicine welcomed Dr. Raymond Cohlmia, executive director of the American Dental Association (ADA), who spoke about his vision for the future of the ADA and his view of the opportunities and challenges for those working in the oral health field.

Cohlmia, who took the reins of the ADA in 2021, has experience on both the academic and practical sides of dentistry. Prior to his role at the ADA, he was the dean of the University of Oklahoma College of Dentistry and was in private practice for 26 years. Cohlmia says that in all of his roles, his goal is to have a positive impact on people’s lives. “When I was considering this position at the ADA, I thought, ‘Okay, this is an opportunity to expand my impact.’ I believe we can all come together to make a difference, 159,000 dentists who also believe in the value of changing and improving the lives of the people we serve. I want the ADA to go to the next level, to provide more care to the people we serve each and every day.”

In order to better reflect the tectonic shifts in the profession, and to better represent its practitioners, the ADA, the largest and oldest dental organization, is changing Cohlmia says.

Between 40 and 50 percent of the US population visits the dentist in a year. There is a marked reduction in untreated caries in children and racial disparities are narrowing. However untreated carie rates in adults have remained static and have even increased amo9ng low-income adults. Among seniors the treatment gap has become even wider between low- and high-income populations. Not surprisingly, he noted, cost is the largest barrier for people seeking treatment.

He noted that, in general, dentist practices are only now returning to pre-pandemic levels, and many are plagued by staffing shortages, which may be one factor that is driving the trend of practice consolidation.

Dr. Cohlmia says he is working to make sure that the ADA has a more proactive role in the future of oral healthcare. But he noted that the profession still has some work to do. He offered five takeaways that he says should be a part of all discussions about the future of dentistry:

1. The mouth is connected to body. Lots of new, compelling research today demonstrates oral health's link to overall health and well-being, medical care costs, and the economy
2. There have been big gains in oral health among kids including steady improvements in oral health measures, big increases in dental care visits. The largest gains have been among low-income children and non-white children. Significant expansions of dental coverage for kids, especially through public programs have driven these improvements.
3. There has been much less progress for adults and seniors. For working-age adults, oral health outcomes have not improved. Dental care use has been declining very slowly. Disparities by income and race have been stable. For seniors, there are some improvements in some oral health outcomes, but mostly among the wealthy.
4. Cost barriers are significant. Dental care stands out from other health care services in terms of being unaffordable. Working-age adults, especially low-income adults, face the highest cost barriers to dental care. Cost is the top reason adults and seniors do not go to the dentist.
5. The current model of dental care delivery and financing is working fairly well for about half the U.S. population, including the vast majority of kids and middle- and upper-income adults and seniors.

He also discussed the need for dental insurance reform – “We are reimbursed $.20 on the dollar. That needs to change.” – and the need for licensing portability.

Cohlmia is particularly excited about the potential in artificial intelligence. “AI, I believe, will be instrumental in helping us provide more care to more people than we’ve ever seen before, which is our responsibility as professionals. Using AI and other technologies and tools can help bridge the gap for people in remote areas and others experiencing barriers to access to care.”

Students and faculty who attended the lecture appreciated the broad view that Cohlmia shared. Salar Zeinali Gelabi, a resident in prosthodontics at CDM, said that Cohlmia provided attendees with a big picture that they might otherwise not get. “We are providers focused on small, specific treatments. It’s useful to take a few steps back and to find see the direction that the profession is heading in. It’s encourag8ing to see someone actively and passionately involved in fixing the infrastructure.”

Dr. Christian Stohler, dean of CDM, said that he is very encouraged by Cohlmia’s deep understanding of the challenges facing the professi9on. “Dr. Cohlmia is willing to rock the boat. I beloi8eve he has the ability to transform the profession. I have never been as hopeful about the future of dentistry.”