1 Measuring the Oral Health of Washington’s Children Challenges and Practical Solutions

2 Beth Hines, RDH,MPH Washington State Department of Health June 28, 2000

3 Outline Challenges and Practical Solutions Tools for direct primary data collection –Smile Survey 1994 and 2000

4 Tools for indirect primary data collection: –Lead Poisoning Prevalence Survey –PRAMS –Disability Survey

5 Challenges HP 2010 Objectives MCH Block Grant Indicator on Sealants

6 Oral Health surveys are: –time intensive –staff intensive –expensive

7 Practical Solutions Screening versus examination Screening models: –Smile Survey 1994 –BSS and STP 2000

8 Piggybacking on other surveys: –Lead –PRAMS –Disability

9 Smile Survey Counties

10 Smile Survey 1994 Random selection of schools in targeted high risk counties w/ urban & rural rep. 6,590 children screened 6,399 sample analyzed

11 1,063 Headstart and ECEAP (mean age 4.3) 4,635 Elementary School (mean age 6.9) 701 High School ( mean age 15.1)

12 Headstart Kids % Needing Treatment

13 Age 6-8 % Needing Treatment

14 Percent with Sealants / Ages 6-8

15 Smile Survey 2000 Washington State Assessment of Children’s Oral Health Status

16 Sampling Random sample of elementary schools w/ 25 or more in 2nd & 3rd grades 7960 children in 56 schools Convenience sample of 12 Headstart/ECEAP and Early Headstart

17 Protocol Smile Survey ASTDD/CDC STP - BSS Basic Screening Survey County Based Tools Training and Calibration

18 Access to Care Questions Parent questionnaire –dental insurance –time since last dental visit –reason for last dental visit –problems accessing dental care

19 ESL ask elementary school children - What language does your family speak at home? –ask Early/Head Start teacher - What language does this child’s family speak at home?

20 School children –Count number of primary & permanent teeth with cavities –Range: 0-24 –If a child has 5 cavities Coding for Untreated Cavities 05

21 Lead Poisoning Prevalence Survey And Oral Health Assessment Survey

22 Sampling Age cohort: age 1-2 years Stratified random sample of birth certificates

23 2 strata by census tract: –high risk: 9 counties (high Hispanic pop) N:540 –low risk: remaining 30 counties N: 360 –oversample Hispanics and children of farmworkers

24 Methodology Questionnaire / Demographics, Access, Risk for lead exposure, Injury prevention Finger Stick - blood sample

25 Dental Exam / Visible Caries Saliva Sample / Strep Mutans Count Water Sample / Fluoride Content

26 Statewide estimate of Early Childhood Caries Relationship between blood lead levels and caries Purpose:

27 Purpose Potential risk factors for caries: Strep Mutans levels Fluoride exposure Feeding patterns Variables associated with birth mother

28 PRAMS Pregnancy Risk Assessment Monitoring System And Oral Health...

29 1. This question is about the care of your teeth during your most recent pregnancy. I needed to see a dentist for a problem Y/N

30 I went to a dentist or dental clinic Y/N A dental or other health care worker talked with me about how to care for my teeth and gums Y/N

31 2. How long has it been since you had your teeth cleaned by a dentist or a dental hygienist? ______ Months

32 Washington State Disability Surveillance Survey And Oral Health….

33 How long has it been since your child with disabilities last visited the dentist or a dental clinic?

34 What is the reason you have taken your child to the dentist in the last year? Does your child have untreated tooth decay or gum disease?

35 Do you have any kind of insurance coverage that pays for some or all of your routine dental care, including dental insurance, prepaid plans such as HMOs, or government plans such as Medicaid?

Assessment must be a priority