Florida Oral Health Alliance Meeting Friday, June 1, 2018 Twitter: @FL_OH_Alliance #OH2020FL 1
Result: All Florida children, youth and families have good oral health and well-being, especially those that are vulnerable. 2
Headline Indicator #1: Percentage of Medicaid-eligible Children Ages 0 - 20 Receiving any Dental Services 60% 50% 48% 47% 47% 46% 46% 45% 40% 38% 35% 30% 29% 29% 27% 23% 20% 10% 0% 2011 2012 2013 2014 2015 2016 National Florida 3 Source: Florida Form CMS-416 line 12a data retrieved in July 2017 from the Florida Institute for Health Innovation.
Headline Indicator #2: Percentage of Medicaid-eligible Children Ages 1 - 20 Receiving Preventive Dental Services 50.0% 46% 45% 44% 43% 42% 41.5% 40.0% 36% 33% 30.0% 27% 25% 20.0% 19% 14% 10.0% 0.0% 2011 2012 2013 2014 2015 2016 National Florida 4 Source: Florida Form CMS-416 line 12b minus <1 data retrieved in July 2017 from the Florida Institute for Health Innovation .
Meeting Results By the end of the meeting, participants will have: Received information on new data and tools available to inform statewide oral health programs and policies Learned about statewide efforts to improve access and public perception of community water fluoridation Discussed how best to advance the Alliance's prioritized strategies based on these new resources Defined next steps for the oral health hot-spotting subcommittee to support implementation of targeted oral health interventions 5
2016-2017 Oral Health Status of Florida’s Third Grade Children Louiza Saint-Hillien, Data Analyst, Florida Department of Health 6
Oral Health Status of Florida’s Third Grade Children 2016-2017 Presenter: Louiza Saint-Hillien, MPH
Overview of Presentation • Introduction • Method • Results • Florida’s National Ranking • Limitations of the Project • Recommendations for Improving the Oral Health of Florida’s Children
Introduction : Burden of Oral Disease Among Children • Dental caries (tooth decay) is the most preventable chronic disease among young children and adolescents, five times more common than asthma (Benjamin, R.M., 2010) • Nationally in 2015-2016, 43.1% of youth aged 2-19 years had dental caries, with rates for Black and Hispanic children higher than for Whites and Asian children (Fleming E., Afful J., 2018) • Children with poor oral health are three times more likely to miss school and four times more likely to perform poorly than their healthy peers (Jackson, S., 2011) • Low income children are 20% less likely to receive dental sealants, a cost-effective procedure that can prevent 80% of tooth decay (Centers for Disease Control and Prevention, 2016). • Barriers from receiving dental sealants or other dental care include the lack of access to dental services, dental care costs, and inadequate oral health literacy (U.S. Department of Health and Human Services Oral Health Coordinating Committee, 2016).
Method : Basic Screening Survey • The Florida 2016-2017 Third Grade Oral Health Screening Project was based on the Basic Screening Survey (BSS) tool supported by the Association of State and Territorial Dental Directors (ASTDD). • The BSS captured information on the following dental health indicators: Untreated Decay Treated Decay Caries Experience Dental Sealants Urgency of Need for Dental Care • Dental screenings were provided by the contracted Florida Dental Hygienists’ Association Registered Dental Hygienists (RDHs) following the BSS protocols. Source: Association of State and Territorial Dental Directors (ASTDD),2008
Third Grade Oral Health Screening Form
Method : Sampling Florida 2016-2017 Third Grade Oral Health Surveillance Region Map Procedure and Selected Counties • 42 of Florida’s public elementary schools throughout 19 counties were selected within the 6 regions. • Schools were contacted and consented to participate in the survey. • Consent forms were sent to the participating schools and distributed to the third grade children. • Only students that returned a positive parental consent form were screened by registered dental hygienists. • Outcome data were weighted to represent all of Florida’s third grade children.
Consent and Questionnaire Form for Parents
Demographic Characteristics of Children Participating in Florida’s 2016 - Results : Demographic 2017 Third Grade Oral Health Screening Project Characteristic N (%) Characteristics of Total Participants 1,259 Age (Years) Participating Children 7 2 (0.2%) 8 395 (31.4%) 9 762 (60.5%) 10/11 99 (7.9%) Missing 1 (0.0%) Gender • 4,427 third grade children were Male 587 (46.6%) enrolled at the 42 participating Female 667 (53.0%) schools during the 2016-2017 Missing 5 (0.4%) school year. Race/Ethnicity Non-Hispanic White 427 (33.9%) • 1,685 children returned their Non-Hispanic Black 276 (21.9%) consent forms Hispanic 372 (29.5%) Asian 51 (4.1%) • 1,331 children positively Other 108 (8.6%) Missing 25 (2.0%) consented to be screened Eligible for Free/Reduced Lunch • 1,259 children participated and Yes 746 (59.3%) No 347 (27.6%) were screened Don’t Know/Don’t Remember 100 (7.9%) • Missing 66 (5.2%) The average age of participating Dental Insurance Coverage children was 8.77 years. Private Insurance 362 (28.8%) Medicaid 489 (38.8%) No Insurance 173 (13.7%) Other 11 (0.9%) Don’t Know/Don’t Remember 26 (2.1%) Missing 198 (15.7%)
Results : Oral Health Indicators Oral Health Status (Percent and 95% C.I.) of Florida's Third Grade Children 2016-2017 50.0% 45.5% 45.0% 40.5% 40.0% 35.0% 30.0% 25.1% 25.0% 20.6% 20.0% 15.0% 10.0% 5.0% 3.0% 0.0% Untreated Decay Caries Experience Dental Sealants Early Dental Care Need Urgent Dental Care Need 25.1% (21.4, 28.9) 45.5% (41.5, 49.5) 40.5% (34.3, 46.6) 20.6% (17.1, 24.0) 3.0% (1.6, 4.4)
Results : Oral Health Indicators by Age Prevalence (95% Confidence Interval) of the Oral Health Indicators, by Age • Highest prevalence of Age Caries Untreated Dental Early Need for Urgent Need for untreated decay : children Experience Decay Sealants Dental Care Dental Care aged 10 and 11 years (31.7%) 7-8 45.2% 27.6% 37.9% 22.3% 3.6% • Lowest prevalence of (38.6, 51.8) (20.6, 34.6) (30.0, 45.8) (15.2, 29.4) (1.3, 5.9) untreated decay : children aged 9 years (22.8%) 9 45.6% 22.8% 43.0% 18.9% 2.7% • Highest prevalence of (40.6, 50.6) (19.1, 26.5) (36.0, 50.0) (15.9, 21.8) (1.2, 4.1) dental sealants : children aged 9 years (43.0%) 10-11 45.7% 31.7% 32.6% 25.4% 2.9% • Lowest prevalence of (34.9, 56.6) (22.5, 40.8) (23.5, 41.7) (17.1, 33.7) (0.0, 6.4) dental sealants : children aged 10 and 11 years (32.6%)
Results : Oral Health Indicators by Race/Ethnicity Percent of Untreated Decay and Dental Sealants among Florida's Third Grade Children 2016-2017, by • Highest prevalence of Race/Ethnicity untreated decay : Non- 55.0% Hispanic Black children 50.0% 46.3% (34.6) 43.7% 42.6% 45.0% 40.0% • 36.2% Lowest prevalence of 34.6% 33.3% 35.0% untreated decay : Other 30.5% 30.0% racial groups (15.8%) 23.0% 25.0% 20.6% • 20.0% Highest prevalence of 15.8% 15.0% dental sealants : Other 10.0% racial groups (46.3%) 5.0% • Lowest rate of dental 0.0% Untreated Decay Dental Sealants sealants : Non-Hispanic Non-Hispanic White Non-Hispanic Black Hispanic Non-Hispanic Asian Other Black children (33.3%)
Results : Oral Health Indicators by Region Prevalence (95% Confidence Interval) of the Oral Health Indicators, by Region • The Northwest region: Region Caries Untreated Dental Early Need for Urgent Need for • Highest rate of Experience Decay Sealants Dental Care Dental Care untreated decay (53.3%) Atlantic Coast 41.5% 19.0% 44.0% 16.0% 4.5% (30.0, 53.0) (9.4, 28.5) (27.6, 60.5) (10.5, 20.9) (0.0, 10.6) • Highest rate of caries experience (66.1%) Central 43.0% 25.2% 23.9% 16.2% 0.9% • (34.3, 51.8) (15.8, 34.6) (12.1, 35.7) (4.9, 27.4) (0.0, 2.0) Highest rate of dental sealants (57.4%) Northeast 32.8% 19.9% 46.0% 16.1% 3.8% • (23.6, 42.0) (9.3, 30.5) (24.6, 67.5) (8.2, 24.1) (0.0, 9.0) Lowest rate of untreated decay : Atlantic Coast Northwest 66.1% 53.3% 57.4% 38.6% 8.8% (19.0%) (49.3, 82.9) (31.2, 75.5) (33.2, 81.7) (7.7, 69.5) (7.5, 10.0) • Lowest rate of caries South 36.3% 23.3% 44.5% 19.8% 3.8% experience : Northeast (28.1, 44.5) (17.3, 29.3) (32.5, 56.5) (16.3, 23.4) (0.1, 7.5) region (32.8%) West Coast 58.3% 26.2% 43.2% 25.0% 2.0% • Lowest rate of dental (50.1, 66.5) (19.4, 32.9) (30.8, 55.6) (20.3, 29.7) (0.0, 4.1) sealants : Central region (23.9%)
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