Bright Futures in Practice: Oral Health
What Is Bright Futures?   <ul><li>Bright Futures is   </li></ul><ul><li>A vision </li></ul><ul><li>A philosophy </li></ul>...
<ul><li>The first edition of the Bright Futures guidelines was published in 1994. </li></ul><ul><li>A second edition was p...
Bright Futures  in Practice Series <ul><li>Oral Health </li></ul><ul><li>Nutrition  </li></ul><ul><li>Physical Activity (f...
Bright Futures in Practice: Oral Health Manual   <ul><li>Emphasis: </li></ul><ul><li>Coordinate services between dental pr...
...Bright Futures in Practice: Oral Health Manual <ul><li>Designed for health professionals, this guide provides: </li></u...
<ul><li>Introduces the concepts of individualized, cost-effective  risk assessment </li></ul><ul><li>Emphasizes the contri...
Bright Futures Focus -  One Question <ul><li>What do children and families need to prevent disease and promote health? </l...
Four Innovations in Oral Health Supervision <ul><li>Contributions of Dental and Nondental Professionals in Oral Health Pro...
How Bright Futures in Practice: Oral Health is Organized <ul><li>Section I – Oral Health Supervision Guidelines </li></ul>...
Section I: Five Developmental Periods <ul><li>Prenatal </li></ul><ul><li>Infancy </li></ul><ul><li>Early Childhood </li></...
Section II:  Risk Assessment <ul><li>Dental Caries </li></ul><ul><li>Periodontal Disease </li></ul><ul><li>Malocclusion </...
Section III:  Measuring Outcomes <ul><li>Must be: </li></ul><ul><li>Comprehensible </li></ul><ul><li>Attainable </li></ul>...
Section IV: Making Oral Health Supervision Accessible <ul><li>Financial Concerns </li></ul><ul><li>Cultural Differences </...
Section V: Essentials of Oral Health <ul><li>To provide background on key points concerning oral conditions/ diseases. </l...
To Use Effectively: <ul><li>Tailor to the individual needs of the children and the community. </li></ul>Dental Office Wood...
<ul><li>Recognize the Culture </li></ul><ul><li>Competing Health Concerns </li></ul><ul><li>Health Behavior </li></ul><ul>...
Resources Dental Services Dental services are provided in the multiple localities to pre-school and school age children wh...
...Resources Fluoride Mouthrinse Program Children &quot;Swish and Spit&quot; for one minute once a week in a school fluori...
...Resources Health Education A public health hygienist teaches children about their &quot;first trip to the dentist.&quot;
...Resources Materials <ul><li>http://www.vahealth.org/teeth </li></ul><ul><li>Brochures Developed by VDH: </li></ul><ul><...
<ul><li>http://www. mchoralhealth .org/ </li></ul><ul><li>Publications </li></ul><ul><ul><li>Fact Sheets </li></ul></ul><u...
Oral Health in America <ul><li>Oral Health in America: A Report of the  Surgeon General May 2000 </li></ul>www. surgeongen...
Dental Caries (Tooth Decay) <ul><li>The Single Most Common Chronic Childhood Disease   </li></ul><ul><ul><li>5 Times More ...
Children and Oral Health <ul><li>This preventable health problem begins early:  </li></ul><ul><ul><li>17% of children aged...
...Children and Oral Health <ul><li>Studies by VDH show that 45% of children ages 5 to 18 have dental decay. </li></ul><ul...
Oral Cancer <ul><ul><li>*Centers for Disease Control and Prevention </li></ul></ul><ul><li>Each year, more than 30,000 new...
Virginia Oral Health Profile <ul><li>Dental Visits </li></ul><ul><ul><li>71.9%  of the population visited the dentist or d...
Dental Disease Trends <ul><li>In 1993 </li></ul><ul><li>Children 5 to 17: </li></ul><ul><ul><li>632,000 school days were l...
<ul><li>The rate of progression of diseases has slowed. </li></ul><ul><li>The substantial risk for new dental decay may ex...
<ul><li>New studies indicate that periodontal disease may be linked with: </li></ul><ul><li>Cardiovascular Disease </li></...
Manpower <ul><li>Dentist to Population Ratio: </li></ul><ul><li>1 general dentist to 2,536 people. </li></ul><ul><li>43 ou...
Gaps in Access to Care <ul><li>Children with or without dental insurance and non provider </li></ul><ul><li>Special Popula...
Bright Futures: Oral Health <ul><li>No matter how many brushes or paints that we use… each canvas will be different. </li>...
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Bright Futures in Practice: Oral Health

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  • Although advances in public health and medicine have improved the lives of many children, today’s families and children face new pressures. Often referred to as “the new morbidities,” these issues include Changing family structures and the loss of extended family relationships. Highly mobile populations that often lack continuity of care. Racial, ethnic, and economic disparities in health. Deteriorating neighborhoods and communities. Additional concerns include: The negative cycle of poverty and diminished access to health care. The links between prenatal risk, preterm or low birthweight birth, and infant mortality The rising rates of intentional and unintentional injuries, substance abuse, depression, and HIV infection.
  • Bright Futures Guidelines Today’s pediatric health professionals are challenged to respond to these new morbidities and to coordinate care for a variety of settings and families. To meet these challenges, the Bright Futures guidelines were developed by four multidisciplinary panels of experts and reviewed by nearly 1,000 professionals. The first edition of the Bright Futures guidelines was published in 1994 and revised in 1999 for publication in 2000. The guidelines are a comprehensive, family-centered, and community-based blueprint for health supervision. They emphasize health promotion and disease prevention in a developmental context, from the prenatal period through adolescence.
  • With the Bright Futures guidelines as a cornerstone document, a series of Bright Futures in Practice implementation guides is being developed to focus on specific areas of health promotion and disease prevention. These implementation guides, though not distributed through Pfizer, provide specific in-depth information to meet the needs of a diverse number of health practitioners. Two of the implementation guides are already available: Bright Futures in Practice: Oral Health was published in 1996, and Bright Futures in Practice: Nutrition was released in February 2000. Bright Futures is currently developing three other implementation guides on physical activity, mental health, and children with special health care needs. Each volume offers health promotion/disease prevention information, strategies, and anticipatory guidance for professionals and families.
  • Bright Futures in Practice: Oral health (1996) Bright Futures in Practice: Oral Health , (1996) is the first volume in the Bright Futures in Practice series. This guide addresses the oral health needs of children and adolescents from birth to age 21 by presenting specific guidelines on current oral health promotion and disease prevention and other preventive strategies and tools. Chaired by Paul Casamassimo, D.D.S., M.S., Bright Futures in Practice: Oral Health is designed for health professionals and educators, including dentists, dental hygienists, physicians, nurses, dietitians, teachers, and child care providers. The information in this guide can also be adapted for use with families. Note At the VDH June 7, 2001, Kick Off, an oral health manual was provided to participants for each local health departments
  • Bright Futures in Practice: Oral Health can be used to Inform families and health professionals about the essentials of oral health, including oral development, dental caries, periodontal disease, malocclusion, tobacco use, and injury Identify the services that infants, children, and adolescents need for improved oral health. Develop and implement oral health programs. Train health professionals and students
  • Bright Futures in Practice: Oral Health is based on several innovations. The guide Introduces the concepts of individualized, cost-effective risk assessment and measurable educational, behavioral, and physical health outcomes as integral to oral health supervision Emphasizes the contribution and partnership of dental professionals, other health professionals, and families in oral health supervision in an attempt to foster coordination, cooperation, and cost-effectiveness in oral health care delivery Stresses the importance of early oral health intervention for children , beginning with prenatal counseling and the scheduling of a dental visit by the child&apos;s first birthday
  • Dental Professionals as Partners in Prevention The family is the focus for health supervision. For all dental professionals, creating a partnership with families is one of the most important goals of health supervision. Interventions by health professionals, while important, represent only a small fraction of a child’s life and environment. Families are the major source or oral health promotion and prevention--for it is within the context of the family that information is translated into behavior. Dental professionals also have a larger role in their preventive care partnership with families. Since dental professionals often see children and families on a regular basis, they are sometimes the “first line” is assessing the overall health and well-being of children and can effectively determine risk. Dental professionals can make referral to other health professionals and can reinforce preventive health messages about immunizations, nutrition, developmental milestones, child care, safety practices, and other health habits such as tobacco use.
  • Four Innovations in Oral Health Supervision Bright Futures in Practice: Oral Health highlights four innovative area that are particularly significant in the context of contemporary trends health care: Contributions of both dental and nondental professionals in oral health provision are detailed in the guidelines, to foster greater coordination, cooperation, and cost-effectiveness in pediatric oral health care delivery. Nondental health professionals are the primary providers or oral health supervision during the first year of life, referring the infant to a dental professional for care if screening indicates a problem. After the child has a first dental visit, at age one, the dental professional is the primary provider of oral health supervision and th4e health professional provides screening and reinforces oral health messages during other health supervision visits. Early intervention is emphasized, beginning with prenatal counseling and the scheduling of a dental visit by the child’s first birthday. Unfortunately, “early intervention” is often regarded as starting children’s dental care at age three, despite the fact that the caries process may be well developed before this age. May children who have dental caries (often referred to as cavities or tooth decay) before the age of three do not receive adequate guidance or appropriate fluoride supplementation. Risk assessment is a health supervision strategy based on the premise that all children are not equally likely to develop oral health problems. Risk assessment helps the professional develop individual plans for a child’s preventive and treatment needs for four major problems--dental caries, periodontal disease, malocclusion, and injury--and thus develop more successful and cost-effective interventions. Oral health outcomes outlined in the guide are be definition, comprehensive, attainable, and measurable. By presenting a model for measuring the educational, behavioral, and physical aspects of oral health supervision, the guide helps dental and health professionals to identify oral health outcomes for individual children, adolescents, and families and to formulate meaningful measures of quality.
  • How This Guide Is Organized Section I – Oral Health Supervision Guidelines Section II – Risk Assessment Section II – Measuring Outcomes Section IV – Making Oral Health Supervision Accessible Section V – Essentials of Oral Health
  • ...How This Guide Is Organized Section I - Oral Health Supervision Guidelines The oral health supervision provide an overview of preventive oral health supervision for five developmental periods: 1. Prenatal 2. Infancy 3. Early Childhood 4. Middle Childhood 5. Adolescence Although age groupings are designed to take advantage of naturally occurring developmental milestones, many issues cut across multiple developmental periods. The guidelines in this section present a concise overview rather than a comprehensive description of pediatric oral health. The remaining sections of the guide provide specific tools and strategies as well as information on key components of oral health, to support and explain the guidelines. The guidelines serve as a starting point. Each child has an individual level of risk, as determined by a dentist. The guidelines do not prescribe a specific regimen of care, but build upon existing guidelines and treatment protocols, such as those of the American Academy of Pediatric Dentistry.
  • ...How This Guide Is Organized Section II - Risk Assessment Optimal oral health supervision requires that care be tailored to individual levels of disease risk. This section describes how to use risk assessment in oral health, and lists the risk and protective factors for the four major issues in oral health: 1. Dental Caries 2. Periodontal Disease 3. Malocclusion 4. Injury
  • ...How This Guide Is Organized Section III -Measuring Outcomes The guide includes a model for age-appropriate outcome measures that are essential in evaluating the effectiveness of interventions and must be a part of any contemporary health care program. By knowing the intended oral health outcomes, dental and other health professionals, the family, and the child or adolescent can target their efforts throughout the years of growth and development. Outcomes must be comprehensive, attainable, and measurable.
  • ...How This Guide Is Organized Section IV -Making Oral Health Supervision Accessible Many families do not participate in oral health supervision because of financial concerns, cultural differences, special health needs, or fear of discomfort or infection. Dental and health professionals need to address these concerns if all children are to benefit from oral health supervision.
  • ...How This Guide Is Organized Section IV -Essentials of Oral Health The assumptions underlying oral health supervision guidelines are derived both from a current understanding of science and from accepted standards of practice. Key points concerning common oral conditions and diseases are described briefly in this section to provide background for understanding and applying the oral guidelines.
  • Adapting for Individual Use To use guide effectively, start by examining the oral health supervision guidelines. For maximum effectiveness, tailor these principles to the individual needs of children and communities. In particular, risk assessment--as much clinical art as science--must be applied carefully to ensure greatest success.
  • ` ...Adapting for Individual Use To use guide effectively, start by examining the oral health supervision guidelines. For maximum effectiveness, tailor these principles to the individual needs of children and communities. In particular, risk assessment--as much clinical art as science--must be applied carefully to ensure greatest success.Adapt the risk models for each child, recognizing the roles of culture, competing health concerns, health behaviors, and social conditions. Adapting the guidelines to specific community resources requires consideration of: Funding Licensure Availability of trained personnel Patterns or practice Measure the successful use of risk assessments and targeted interventions according to the outcomes detailed in this guide.
  • Health Department Dental Programs Dental services are provided in the multiple localities to pre-school and school age children who meet eligibility requirements. Eligibility for these services may be determined by school lunch status and/or family income. Dental services are available at health department clinics or at dental trailers placed on school property. Adult care may be available on a limited basis in certain localities.
  • School Fluoride Mouthrinse Program School children across Virginia are eligible to participate in a weekly topical fluoride mouthrinse program. Targeted counties are those without community water fluoridation. Currently there are 46,000 children statewide participating in the program. Studies indicate up to a 15 percent reduction in tooth decay for children participating during elementary school years in fluoride mouthrinse programs. The Division of Dental Health supports the School Fluoride Mouthrinse Program through: Funding the fluoride mouthrinse programs in all areas for supplies. Training in implementing a new school mouthrinse program. Brochures and information regarding the fluoride mouthrinse program.
  • Dental Health Education Public health dental staff across the state may provide dental health education in school classrooms and at community health fairs. Each locality has different educational needs and the local public health dentist will assess the time available for these educational activities. The Division of Dental Health support Dental Health Education through: T raining for local health department dental staff, school nurses and other community groups. Development of educational materials. These materials are listed in the Publications/ Educational Materials Section of this web-site and are available in limited quantities for teachers, school nurses, nutritionists and other health professionals from the Division of Dental Health.
  • Dental Health Educational Materials Limited quantities (up to 50) of the pamphlets are available
  • National Maternal and Child Oral Health Resource Center The purpose of the National Maternal and Child Oral Health Resource Center is to respond to the needs of states and communities in addressing current and emerging public oral health issues. The resource center supports and stimulates health professionals, program administrators, educators, policymakers, and others with the goal of improving oral health services for infants, children, adolescents, and their families. The resource center collaborates with federal, state, and local agencies; national and state organizations and associations; and foundations, to gather, develop, and share quality and valued information and materials
  • On May 25, 2000, Surgeon General David Satcher released Oral Health in America: A Report of the Surgeon General, the 51st Surgeon General&apos;s report issued since 1964, when Luther Terry issued his landmark report on tobacco and health. The first-ever Surgeon General&apos;s report on oral health identifies a &amp;quot;silent epidemic&amp;quot; of dental and oral diseases that burdens some population groups and calls for a national effort to improve oral health among all Americans. The report, commissioned by Health and Human Services Secretary Donna E. Shalala, also focuses on the relationship between oral health and overall good health throughout life, the mouth as a &amp;quot;mirror for general health and well-being and the association between oral health problems and other health problems.&amp;quot; These reports have helped frame the science on vital health issues in a way that have helped educate, motivate and mobilize the public to more effectively deal with those issues. In addition to a lack of awareness of the importance of oral health among the public, the report found a significant disparity between racial and socioeconomic groups in regards to oral health and ensuing overall health issues. Based upon these findings, the Surgeon General called for action to promote access to oral health care for all Americans, especially the disadvantaged and minority children found to be at greatest risk for severe medical complications resulting from minimal oral care and treatment.
  • Dental Caries (Tooth Decay) The Single Most Common Chronic Childhood Disease 5 Times More Common Than Asthma 7 Time More Common Than Hay Fever
  • ...Children and Oral Health Dental decay is one of the most common chronic infectious diseases among U.S. children. This preventable health problem begins early: 17% of children aged 2-4 years have already had decay. By the age of 8, approximately 52% of children have experienced decay By the age of 17, dental decay affects 78% of children. Among low-income children: Almost 50% of tooth decay remains untreated, and may result in pain, dysfunction, underweight, and poor appearance — problems that can greatly reduce a child&apos;s capacity to succeed in the educational environment.
  • … Children and Oral Health Studies by VDH show that 45% of children ages 5 to 18 have dental decay. Children on free or reduced lunch have higher disease rates. Only 38% of children have their filling needs met.
  • Oral Cancer Each year, more than 30,000 new cases of cancer of the oral cavity and pharynx are diagnosed and over 8,000 deaths due to oral cancer occur. The 5-year survival rate for these cancers is only about 50 percent. Mortality from oral cancer is nearly twice as high in some minorities (especially black males) as it is in whites. Methods used to treat oral cancers (surgery, radiation, and chemotherapy) are disfiguring and costly. Preventing high risk behaviors, that include cigarette, cigar or pipe smoking, use of smokeless tobacco, and excessive use of alcohol are critical in preventing oral cancers. Early detection is key to increasing the survival rate for these cancers.
  • Virginia - Oral Health Profile Dental Visits 71.9% of the population visited the dentist or dental clinic within the past year. Data Source: BRFSS (1999) Teeth Cleaning 73.1% of the population had their teeth cleaned by a dentist or dental hygienist within the past year. Data Source: BRFSS (1999) Complete Tooth Loss 28.5% of the population 65+ have lost all of their teeth. Data Source: BRFSS (1999) Fluoridation Status 72.1% of the population on public water systems is receiving fluoridated water. Data Source: Fluoridation Census (1992)
  • Virginia - Oral Health Profile Dental Visits 71.9% of the population visited the dentist or dental clinic within the past year. Data Source: BRFSS (1999) Teeth Cleaning 73.1% of the population had their teeth cleaned by a dentist or dental hygienist within the past year. Data Source: BRFSS (1999) Complete Tooth Loss 28.5% of the population 65+ have lost all of their teeth. Data Source: BRFSS (1999) Fluoridation Status 72.1% of the population on public water systems is receiving fluoridated water. Data Source: Fluoridation Census (1992)
  • Bright Futures in Practice: Oral Health

    1. 1. Bright Futures in Practice: Oral Health
    2. 2. What Is Bright Futures? <ul><li>Bright Futures is </li></ul><ul><li>A vision </li></ul><ul><li>A philosophy </li></ul><ul><li>A set of expert guidelines </li></ul><ul><li>A practical developmental approach to providing health supervision </li></ul>
    3. 3. <ul><li>The first edition of the Bright Futures guidelines was published in 1994. </li></ul><ul><li>A second edition was published in 2000. </li></ul>Bright Futures Guidelines
    4. 4. Bright Futures in Practice Series <ul><li>Oral Health </li></ul><ul><li>Nutrition </li></ul><ul><li>Physical Activity (forthcoming) </li></ul><ul><li>Mental Health (forthcoming) </li></ul><ul><li>Children with Special Health Care Needs (forthcoming) </li></ul>
    5. 5. Bright Futures in Practice: Oral Health Manual <ul><li>Emphasis: </li></ul><ul><li>Coordinate services between dental professionals and health professionals </li></ul><ul><li>Assess risk factors and protective factors </li></ul><ul><li>Measure oral health outcomes </li></ul><ul><li>Make oral health care accessible </li></ul><ul><li>Provide early intervention </li></ul>
    6. 6. ...Bright Futures in Practice: Oral Health Manual <ul><li>Designed for health professionals, this guide provides: </li></ul><ul><ul><li>An overview of preventive oral health supervision for children and adolescents from birth to age 21 </li></ul></ul><ul><ul><li>Risk assessment </li></ul></ul><ul><ul><li>A model for appropriate outcome measures. </li></ul></ul>
    7. 7. <ul><li>Introduces the concepts of individualized, cost-effective risk assessment </li></ul><ul><li>Emphasizes the contribution and partnership of dental professionals, other health professionals, and families in oral health supervision. </li></ul><ul><li>Stresses the importance of early oral health intervention for children. </li></ul>… .Bright Futures in Practice: Oral Health Manual
    8. 8. Bright Futures Focus - One Question <ul><li>What do children and families need to prevent disease and promote health? </li></ul><ul><ul><li>Family is focus for health supervision. </li></ul></ul><ul><ul><li>Dental professionals also have a larger role in their preventive care partnership with families. </li></ul></ul>
    9. 9. Four Innovations in Oral Health Supervision <ul><li>Contributions of Dental and Nondental Professionals in Oral Health Provision </li></ul><ul><li>Early Intervention </li></ul><ul><li>Risk Assessment </li></ul><ul><li>Oral Health Outcomes </li></ul>
    10. 10. How Bright Futures in Practice: Oral Health is Organized <ul><li>Section I – Oral Health Supervision Guidelines </li></ul><ul><li>Section II – Risk Assessment </li></ul><ul><li>Section II – Measuring Outcomes </li></ul><ul><li>Section IV – Making Oral Health Supervision Accessible </li></ul><ul><li>Section V – Essentials of Oral Health </li></ul>
    11. 11. Section I: Five Developmental Periods <ul><li>Prenatal </li></ul><ul><li>Infancy </li></ul><ul><li>Early Childhood </li></ul><ul><li>Middle Childhood </li></ul><ul><li>Adolescence </li></ul>
    12. 12. Section II: Risk Assessment <ul><li>Dental Caries </li></ul><ul><li>Periodontal Disease </li></ul><ul><li>Malocclusion </li></ul><ul><li>Injury </li></ul>
    13. 13. Section III: Measuring Outcomes <ul><li>Must be: </li></ul><ul><li>Comprehensible </li></ul><ul><li>Attainable </li></ul><ul><li>Measurable </li></ul>
    14. 14. Section IV: Making Oral Health Supervision Accessible <ul><li>Financial Concerns </li></ul><ul><li>Cultural Differences </li></ul><ul><li>Special Health Care Needs </li></ul><ul><li>Fear of Discomfort/ Infections </li></ul>
    15. 15. Section V: Essentials of Oral Health <ul><li>To provide background on key points concerning oral conditions/ diseases. </li></ul>
    16. 16. To Use Effectively: <ul><li>Tailor to the individual needs of the children and the community. </li></ul>Dental Office Woodlawn Elementary School Carroll County School Division, Va.
    17. 17. <ul><li>Recognize the Culture </li></ul><ul><li>Competing Health Concerns </li></ul><ul><li>Health Behavior </li></ul><ul><li>Social Conditions </li></ul>...To Use Effectively:
    18. 18. Resources Dental Services Dental services are provided in the multiple localities to pre-school and school age children who meet eligibility requirements.
    19. 19. ...Resources Fluoride Mouthrinse Program Children &quot;Swish and Spit&quot; for one minute once a week in a school fluoride mouthrinse program in Goochland, Virginia.
    20. 20. ...Resources Health Education A public health hygienist teaches children about their &quot;first trip to the dentist.&quot;
    21. 21. ...Resources Materials <ul><li>http://www.vahealth.org/teeth </li></ul><ul><li>Brochures Developed by VDH: </li></ul><ul><ul><li>Dental Sealant &quot;Seal Away Tooth Decay&quot; </li></ul></ul><ul><ul><li>Baby Bottle Tooth Decay &quot;Baby's First Step to Healthy Teeth&quot; </li></ul></ul><ul><ul><li>School Fluoride Mouthrinse Program &quot;Swish Away Decay&quot; </li></ul></ul><ul><ul><li>Why Floss? </li></ul></ul><ul><ul><li>Tips for Healthy Smiles: Prevention/Care/Education (Public Health Dentistry in VA) </li></ul></ul>
    22. 22. <ul><li>http://www. mchoralhealth .org/ </li></ul><ul><li>Publications </li></ul><ul><ul><li>Fact Sheets </li></ul></ul><ul><ul><li>Resource Materials </li></ul></ul><ul><ul><li>Practice and Policy Guidelines </li></ul></ul><ul><ul><li>Conference Proceedings </li></ul></ul>...Resources National Maternal and Child Oral Health Resource Center
    23. 23. Oral Health in America <ul><li>Oral Health in America: A Report of the Surgeon General May 2000 </li></ul>www. surgeongeneral . gov /library/ oralhealth / <ul><li>“ Silent Epidemic” </li></ul>David Satcher, M.D., Ph.D. Assistant Secretary for Health and Surgeon General Office of Public Health and Science
    24. 24. Dental Caries (Tooth Decay) <ul><li>The Single Most Common Chronic Childhood Disease </li></ul><ul><ul><li>5 Times More Common Than Asthma </li></ul></ul><ul><ul><li>7 Time More Common Than Hay Fever </li></ul></ul>
    25. 25. Children and Oral Health <ul><li>This preventable health problem begins early: </li></ul><ul><ul><li>17% of children aged 2-4 years have already had decay. </li></ul></ul><ul><ul><li>By the age of 8, approximately 52% of children have experienced decay </li></ul></ul><ul><ul><li>By the age of 17, dental decay affects 78% of children. </li></ul></ul><ul><ul><li>*Centers for Disease Control and Prevention </li></ul></ul>
    26. 26. ...Children and Oral Health <ul><li>Studies by VDH show that 45% of children ages 5 to 18 have dental decay. </li></ul><ul><li>Children on free or reduced lunch have higher disease rates. </li></ul><ul><li>Only 38% of children have their filling needs met. </li></ul><ul><ul><li>*VDH Studies 1950-1998 </li></ul></ul>
    27. 27. Oral Cancer <ul><ul><li>*Centers for Disease Control and Prevention </li></ul></ul><ul><li>Each year, more than 30,000 new cases of cancer of the oral cavity and pharynx are diagnosed and over 8,000 deaths due to oral cancer occur. </li></ul><ul><li>Preventing high risk behaviors </li></ul><ul><ul><li>Cigarette, cigar or pipe smoking </li></ul></ul><ul><ul><li>Use of smokeless tobacco </li></ul></ul><ul><ul><li>Excessive use of alcohol </li></ul></ul>
    28. 28. Virginia Oral Health Profile <ul><li>Dental Visits </li></ul><ul><ul><li>71.9% of the population visited the dentist or dental clinic within the past year. </li></ul></ul><ul><li>Teeth Cleaning </li></ul><ul><ul><li>73.1% of the population had their teeth cleaned by a dentist or dental hygienist within the past year. </li></ul></ul><ul><li>Complete Tooth Loss </li></ul><ul><ul><li>28.5% of the population 65+ have lost all of their teeth. </li></ul></ul><ul><li>Fluoridation Status </li></ul><ul><ul><li>72.1% of the population on public water systems is receiving fluoridated water. </li></ul></ul>
    29. 29. Dental Disease Trends <ul><li>In 1993 </li></ul><ul><li>Children 5 to 17: </li></ul><ul><ul><li>632,000 school days were lost. </li></ul></ul><ul><li>Adults > 18: </li></ul><ul><ul><li>3.6 million Work Days were lost. </li></ul></ul><ul><ul><li>*National Center for Health Statistics </li></ul></ul>
    30. 30. <ul><li>The rate of progression of diseases has slowed. </li></ul><ul><li>The substantial risk for new dental decay may extend beyond early adolescence. </li></ul>...Dental Disease Trends
    31. 31. <ul><li>New studies indicate that periodontal disease may be linked with: </li></ul><ul><li>Cardiovascular Disease </li></ul><ul><li>Diabetes </li></ul><ul><li>Premature Births </li></ul>...Dental Disease Trends New Studies
    32. 32. Manpower <ul><li>Dentist to Population Ratio: </li></ul><ul><li>1 general dentist to 2,536 people. </li></ul><ul><li>43 out of 136 cities and counties were identified as having less than dentist per 5,000 people. </li></ul>*Item 311-Report of Availability of Dental Services in Virginia
    33. 33. Gaps in Access to Care <ul><li>Children with or without dental insurance and non provider </li></ul><ul><li>Special Populations </li></ul><ul><ul><li>Elderly/Nursing Home </li></ul></ul><ul><ul><li>Head Start </li></ul></ul><ul><ul><li>Disabled </li></ul></ul><ul><ul><li>Adult Indigent </li></ul></ul>
    34. 34. Bright Futures: Oral Health <ul><li>No matter how many brushes or paints that we use… each canvas will be different. </li></ul>

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