Dental executive to be honored for integration of oral, medical care

Close your eyes. Imagine the last time you went for a dental checkup.

"Chances are," said dentist Dr. Daniel Croley, "everyone pictures the same thing — old magazines, smooth jazz" — a traditional visit focused on your pearly whites. "Now imagine you're there with this idea that you're going to potentially stave off other diseases. Now it's a preventive visit, not a tooth check."

"We check your blood pressure, we check for signs of cancer, " Croley said. "We check your A1C to see if you have prediabetes."

Croley's modern take on dentistry is the impetus behind Healthy Smiles, Healthy Hearts, a collaboration between Delta Dental of California and the American Heart Association to bridge the gap between oral health, total health and well-being by helping patients, dental care teams and primary care teams better understand and address the connection.

Croley, vice president and chief dental officer at Delta Dental of California, is a recipient of the American Heart Association Award of Meritorious Achievement, which recognizes specific accomplishments or projects that support the association's national initiatives. He will be honored at the organization's National Volunteer Awards ceremony in Plano, Texas, on June 17.

Croley's vision championing a program to expand care settings focused on total health and well-being demonstrates his relentless commitment to whole-health integration, according to American Heart Association CEO Nancy Brown.

"Thanks to Dan's leadership, we've aligned with Delta Dental of California to drive high-quality, integrated care for communities nationwide and advance our shared mission for healthier lives," she said.

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"I'll say this about my childhood: I didn't grow up dreaming of being a dentist," Croley said. "I went to college thinking I would go to medical school."

Croley was diligent about getting his teeth cleaned during college, in the late 1980s, when one day his dentist asked, "Have you ever thought about dental school?" That spurred Croley to start visiting the dentist more — not as a patient, but as an observer.

"What really hooked me was the patient engagement," he said. "I like to connect with people."

Croley earned his bachelor of science and doctor of dental medicine degrees at the University of Kentucky in Lexington. He then completed a general practice residency at the Department of Veterans Affairs hospital in Louisville, graduating in 1991.

His patient-focused career blossomed early.

"My clinical skills were honed, and I had pretty good speed. I was really focused on accurate diagnosis — asking thorough questions about a patient's health history and putting the answers into treatment planning," he said. "Sometimes the definitive answers were not strictly based on dental diagnosis; sometimes there were systemic issues that had to be explored to resolve root cause problems that led to oral disease."

But life took a turn at the Chicago dental practice he'd acquired in 1992.

"I started having trouble with my hands going numb; I thought it was carpal tunnel. It ended up being a vascular shoulder condition called thoracic outlet syndrome."

The blood vessels between his neck and shoulder were being compressed, causing pain and numb fingers. Unfortunately, "heads-down dentistry" exacerbated the symptoms, Croley said.

"I looked like Frankenstein's monster," he added. "I had wrist braces and figure-8 elastics on my back. Physically, it was weird. My body wasn't acting right."

Only in his mid-30s, facing anxiety and depression because of the need for a radical shift in his career, he sold his practice and looked for a new path to use his health care knowledge in a new way. In the late 1990s, that meant perusing newspaper job ads, where a regional dental director listing caught his eye. Thus began a long career with Delta Dental of California.

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Croley envisions a culture of whole health "in which the mouth is put back into the body. For some reason, years ago, the mouth became segregated from the rest of the body, but there's a tight connection between what goes on in both," he said.

Research on cardiovascular disease and oral infections showed an association. People may say, "'If I don't floss my teeth, are you telling me I'm going to have a heart attack?' No, but it will increase your risk," Croley said.

"If you're worried you haven't been diligent enough about your oral health, there's no shame," Croley added. "Instead, adopt this philosophy: Today's a good day to start doing better."

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In the early 2020s, Croley's willingness to speak up at an American Heart Association Bay Area meeting with a mix of dentists and physicians sparked an opportunity.

"I wasn't shy," he said. "I said, 'I think you're missing an overall component of patients' health.'" That meeting planted the seed for Healthy Smiles, Healthy Hearts. "I feel very connected with the AHA because the mission is about patient care."

Mariell Jessup, M.D., the American Heart Association's chief science and medical officer, said the program will boost patient experiences and scientific discovery. "Developing resources to create a standardized process for blood pressure screenings and referrals in the dental setting has the potential to be a lifesaving collaboration," she said.

There are more than 134,000 dental practices in the United States, and each year about 28 million patients see their dentist — but not a physician, such as a primary care professional, according to U.S. government statistics.

"It's all about catching it early in the disease process versus waiting for something bad to happen," Croley said. "If you have heart disease, you probably have dental issues."

The aim of Healthy Smiles, Healthy Hearts is to advance equitable, integrated care by providing resources that focus on early prevention — and, of course, to help people understand the connection between oral health and heart health, and how to protect both.

Julie Sharpe, the American Heart Association's executive vice president of corporate relations, said the program will advance high-quality, integrated care for communities nationwide. "Dr. Croley is a bold visionary and a man of action. He has a public health mindset and is passionate about improving health for all."

That starts with his family. Dr. Croley and his wife, Beth, have been married for 33 years. Beth is a practicing marriage and family therapist. Son Jeff, 23, is a law student with a heart for justice, Croley said, and Jack, 26, is a bookworm and math whiz who lives in a great community for adults with cognitive challenges. Jack was born with an infection that caused brain damage.

"We were fortunate that a neonatal nurse was moonlighting when he was born, and we were able to get good infectious disease care. We believe that because of that, he has the skills he has today," Croley said.

"While integration of care is important to me for both my sons, for Jeff, I'm teaching him about care integration so he can best take care of his own health, and for Jack, I'm advocating for that with his health care providers, so they can join me in Jack's care."

Croley said whole-person health has always been a focus. "I studied it in school, practiced it in direct patient care, and experienced it personally through Jack's life. It will always be a core belief that I want to convey to everyone."