4/28/2010 Idaho Oral Health Alliance: Opportunities and Challenges Agenda Linda D. Boyd, RDH, RD, EdD Director & Professor • Nature of oral disease Division of Graduate Studies • Prevalence of oral disease Department of Dental Hygiene p yg – Periodontal disease P i d t l di Idaho State University – Dental caries boydlind@isu.edu • Integration of oral health into total health • Idaho State Oral Health Plan – Policy – Prevention – Access • Collaboration of health care professionals Nature of Oral Disease Prevalence of oral disease • Oral cavity main portal of entry for many • Periodontal disease pathogens – 61% of adults 25 years and older • Periodontal disease is a chronic, P i d t l di i h i – 86% of adults 45 and older have at least one site inflammatory disease of periodontal disease in the mouth • Dental caries is a transmissible, infectious disease Gingivitis Moderate Periodontitis Severe Periodontitis U. S. Department of Health and Human Services. 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, NIH, 2000. Prevalence of Oral Disease Oral Health Disparities • Caries • Disparities exist in prevalence & severity of – Children aged 2-4 years caries prevalence oral diseases from 18% in 1988-1994 to 24% in 1999-2004 1 f 18% i 1988 1994 t 24% i 1999 2004 1 – Mexican American & African-American adults • Data from NHANES1999-2002 indicate 28% of and children have more untreated decay than children ages 2-5 yrs have dental caries and 20% have Whites untreated tooth decay – African-American and Mexican American adults – 59% of children aged 5-17 2 are more likely to have gingivitis or more severe – 85% of adults over 18 2 periodontal disease than Whites 1 U. S. Department of Health and Human Services. 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, NIH, 2000. U. S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, 2 Tinanoff N, Reisine S. Update on early childhood caries since the Surgeon General's Report. Acad Pediatr . 2009 ;9(6):396-403. MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, NIH, 2000. 1
4/28/2010 Prevalence of Oral Disease in Idaho Integration of Oral Health into Total Health • Idaho Smile Survey, 2009 – 67.1 of 3 rd graders had caries experience • The mouth and oral cavity are an integral and interrelated part of the human body interrelated part of the human body – 1 in 5 had untreated tooth decay 1 in 5 had untreated tooth decay – Research has shown associations between • Rate of third-grade students needing urgent restorative dental services due to pain, infection, inflammation or chronic periodontal disease and several systemic bleeding declined from 5.4% (2001) to 2.8% conditions including, but not limited to: • Lower incomes associated w/higher rates of active • Diabetes tooth decay, caries experience and urgent care needs • Low birth weight outcomes – Hispanic students had higher rates of active tooth decay, • Cardiovascular disease caries experience & urgent needs compared to non-Hispanic Whites Seymour GJ, Ford PJ, Cullinan MP, Leishman S, Yamazaki K. Relationship between Idaho Dept of Health & Welfare. Idaho Smile Survey,, 2009, periodontal infections and systemic disease. Clin Microbiol Infect. 2007 Oct;13 Suppl 4:3-10. Integration of Oral Health into Total For Want For Want of of a a Dentist… Dentist… Health • In February 2007, 12 yr old Deamonte Driver • Impact of dental caries died of a toothache in Prince George’s – Estimated 51 million school hrs/year lost because of Estimated 51 million school hrs/year lost because of County, Maryland dental-related illness – Early tooth loss caused by dental decay results in failure – A routine $80 tooth extraction might have saved to thrive, impaired speech development, absence from him and inability to concentrate in school & self-esteem – If his mother had been insured – Poor oral health related to decreased school – If his family had not lost its Medicaid performance, poor social relationships & less success later in life – If Medicaid dentists weren't so hard to find Oral Health and Learning: When Children's Health Suffers, So Does Their Ability to Learn (2nd ed.) 2003 by National Maternal http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html and Child Oral Health Resource Center, Georgetown University. http://www.mchoralhealth.org/pdfs/learningfactsheet.pdf Idaho State Oral Health Plan 2010-2015 Idaho State Oral Health Plan 2010-2015 • Plan consists of three interconnected goals- • GOAL 1. PREVENTION Prevention, Access to Care , and Policy –Priority 1. Populations-Based Preventive Measures Measures – GOAL 1. PREVENTION: GOAL 1 PREVENTION E Emphasizes h i strategies to provide oral health education –Priority 2. Oral Health Education of the Public messages, preventive care provided by oral –Priority 3. Prevention of Periodontal Diseases health professionals, and community public –Priority 4. Chronic Disease and Risk Behavior health programs such as community water –Priority 5. Training, Collaboration and Education fluoridation and school-based fluoride and of non-Dental Health Professionals sealant programs. 2
4/28/2010 Idaho State Oral Health Plan 2010-2015 Idaho State Oral Health Plan 2010-2015 • GOAL 2. ACCESS TO CARE – GOAL 2. ACCESS TO CARE: Identifies the most common barriers to oral health care in –Priority 1. Pregnant Women Idaho and recommends solutions that will help to Idaho and recommends solutions that will help to –Priority 2. Children and Adolescents Priority 2 Children and Adolescents ensure effective care for pregnant women, –Priority 3. Adults & Older Adults children, adults, and seniors, as well as people –Priority 4. Medicaid who are at high risk for poor oral health. Idaho State Oral Health Plan 2010-2015 Idaho State Oral Health Plan 2010-2015 • GOAL 2. ACCESS TO CARE – GOAL 3. POLICY: Recognizes the importance of creating policies to ensure access to care and –Priority 5. Headstart prevention, seeking funding and supporting oral prevention, seeking funding and supporting oral –Priority 6. Oral Health Workforce Priority 6 Oral Health Workforce health programs. –Priority 7. Federally Qualified Health Clinics –Priority 8. Hospital Emergency Medical Care Idaho State Oral Health Plan 2010-2015 Idaho State Oral Health Plan 2010-2015 • GOAL 3. POLICY • GOAL 3. POLICY (CONT) – Priority 1. Public Health Leadership – Priority 6. Oral Health Workforce – Priority 2. Data & Surveillance – Priority 7. Evidence-Based Approaches to Care – Priority 3. The Idaho Oral Health Plan 2010-2015 – Priority 8. Health Information Technology (HIT) – Priority 4. Public-Private Partnerships – Priority 9. Publicly Funded Dental Insurance – Priority 5. Funding Idaho Oral Health Programs 3
4/28/2010 Collaboration of Health Care Collaboration of Health Care Professionals Professionals • FQHCs serve patients with highest levels of • Idaho Oral Health Alliance (IOHA) oral disease & least able to access care oral disease & least able to access care. – Non-profit organization of dental professionals – Non-profit organization of dental professionals, public health agencies, businesses, community – HRSA data show FQHCs treat 14 mil medical health providers and individuals, dedicated to users & capacity for only 2.1 mil dental users better oral and overall health for all Idahoans – Unmet need combined with chronic nature of oral • http://www.idahooralhealth.org/ disease and desired focus on prevention and • Covering Idaho Kids http://idahokidscount.org/index.php control of risk factors makes oral health an area for developing collaborative interventions • Diabetes Alliance of Idaho Conclusion • Next Steps— – Strategies for Encouraging Collaboration Strategies for Encouraging Collaboration – Strategies for Addressing Oral Health Issues 4
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