Dr. Julie Watts McKee Dental Director

2 Core Mission: To assure oral health for Kentucky. 2

3 Statistics: Decay Rates: % U.S. Children with decay Kentucky rate: currently unknown % of 2-5 year olds in U.S. with untreated decay % of Kentucky children with untreated decay 3

4 Statistics: Access and Utilization 46% of all Medicaid/KCHIP children One dental service 60% of 6-9 year olds received services 40% of all received a preventive service 54% of 6-9 year olds received preventive Oral Health Service by a non-dentist provider Physicians Health Departments Nurses Hygienists

5 Statistics: Preventive Services Fluoride Varnish % reduction in smooth surface decay. Last year: 22,000 in local health deparments Smiling Schools: 17,000 this year Public Health Hygiene 7 sites 30,000 services 4,600 patients

6 Statistics: Behavioral Risk Factor Surveillance System High rate of extractions 7 th highest in adults with an extraction Dental Visits 42 nd in the nation (not good) 60% of adults with a dental visit 7 th in edentulism in senior Kentuckians. This is an improvement over the years

7 Statistics: Dental Workforce Deloitte Report Rural areas need dentists Jefferson County needs 150 more dentists Maldistribution 435,000 newly covered mouths Few new providers 13 new dentist license in Appalachia

8 Statistics: Water Fluoridation Reduces decay between 40 and 50% 99.8% of Kentuckians have optimally fluoridated drinking water. Highest covered state Washington, DC at 100% New regulations 0.7 Parts Per Million

9 Key Stakeholders: Health Departments Specific Funding Varnish Sealants Hygiene Programs Special Projects Medicaid Reimbursements

10 Key Stakeholders: Dental Schools University of Kentucky Outreach Varnish Supplies Special Projects University of Louisville Special Projects Collaboration is evident

11 Key Stakeholders: Appalachia Smiling Schools

12 Key Stakeholders: Boards and Associations Kentucky Board of Dentistry Kentucky Dental Association

13 Key Stakeholders: Water Plants Regulatory Responsibility Monitoring Reporting Technical Assistance

14 Emerging Issues: Data Collection University of Kentucky Prevalence Study Early Learners Delta Dental Prevalence Study Third and Sixth Graders University of Louisville On-Going Surveillance System

15 Emerging Issues: PH Hygienists Seven Pilot Programs Start up funding Looking for two more Electronic Health Records Dental is the Canary

16 Emerging Issues: Increased Decay Rates in Early Childhood Permanent Teeth Decay Rates (Nationally) Dropping Slowly Primary Teeth Decay Rates (Nationally) Slight, but significant increase Kentucky? We’ll see

17 Emerging Issues: Teledentistry Oral Health Interested in developing network Involves dental schools Involves private dentists

18 Emerging Issues: Workforce Distribution Possible maldistribution? Medicaid Expansion Leads to delay or avoidance of care

19 Emerging Issues: Community Dental Health Workers Community Dental Health Coordinator Reduces care Reduces impact Proven in other areas of patient navigation and education

20 Emerging Issues: Adult Dentures Significant Increase in Medicaid Extractions Pent Up Dental Need in Expansion Patients Dentures Employability Better Nutrition

21 Program Cost Effectiveness: Community Water Fluoridation Annual per-person cost savings $16-$19 a year Kentucky Saves $69 Million a year

22 Program Cost Effectiveness: Fluoride Varnish 20% reduction shown in Kentucky projects Varies on the studied parameters

23 Program Cost Effectiveness Sealants Evidence Based Procedure After two years $53 Oregon 1313% in 20 years $125 cost of filling-avoided If avoided, PH RDH has avoided $987,164

24 The Future of Oral Health Nationally Provider numbers Stable Decreasing Increasing State Keep on striving for the best oral health status for all Kentuckians