1. An Overview of Oral Health in North Dakota Presented by: Kathleen Mangskau, RDH, MPA

2. Oral Health Surveillance Data Source zBRFSS zYRBS zEarly Childhood Caries zStatewide Epi Surveys zProvider Distribution Number of Indicators 4 5 1 4 3

3. Oral Health Surveillance (cont.) Data Source zVital Records ( congenital anomalies ) zMedicaid Data zFluoridation Data zNew Mothers’ Survey Number of Indicators 1 2 1 3 Total 24

4. Prevention z96% of ND population on public water supplies has access to fluoridated water z5,262 children in 76 schools in fluoride deficient areas participate in fluoride mouthrinse/tablet programs z44% of 8-year olds have dental sealants z5,000 children annually receive oral health education in the classroom

5. Percentage of Residents with Fluoridated Water

6. Percentage of Children with Dental Sealants

7. Oral Health Status z51% of 6-8 yr.-olds have tooth decay z70% of 14 yr.-olds have tooth decay z10% of young children suffer from baby bottle tooth decay Source: 1993-94 ND Oral Health Survey 1995 Head Start Survey

8. Treatment Need z25% of 6-8 yr olds have untreated decay z22% of 14 yr olds have untreated decay Source: 1993-94 ND Oral Health Survey

9. Disparities

10. Baby Bottle Tooth Decay Rate zWhite - 10% zNative American - 29%

11. Dental Caries is Common zDental caries (tooth decay) is the most common chronic disease of childhood. It occurs 5-8 times as frequently as asthma. Caries is a preventable disease. zMore than 80 percent of tooth decay is found in 25 percent of the child population.

12. Access Programs for Children zMedicaid zCHIP zCaring for Children Program

13. Access Programs for Adults zMedicaid zVA Dental Benefits Program

14. Access Problems zMedicaid clients zSpecial populations zLow-income adults zElderly

15. State Initiatives to Improve Dental Access zIncrease in Medicaid fees zStreamlined Medicaid claims processing zProject Will Show

16. Local Initiatives to Improve Dental Access zRed River Region Dental Access Project yCommunity Strategic Planning yExpansion of CHC yExpansion of Apple Tree Dental services

17. Delivery System zNumber of private practice dentists in the state is slowly declining zDental safety net is inadequate y1 CHC in Fargo yonly 3 local health agencies employ dental staff yNo clinical dental services provided in local public health agencies z12 Counties designated dental HPSAs

18. Dental HPSAs

19. ND Dentist to Population Ratio zNorth Dakota ratio 1:2246 zUS ratio 1:1859

20. Dentists 1 2 - 5 6 - 10 11 - 30 31 or more No Dentists Note: Counties outlined in green have been designated as dental shortage area s North Dakota Dentists By Zip Code, 1999

21. Practicing Dentists North Dakota Source: North Dakota Department of Health, Oral Health Program, 1999 *Estimate

22. Dentists per 100,000 U.S. Population 1950–2020 59.5 52.7 Source: Bureau of Health Professions, HRSA, DHHS. Data from the Eighth Report to Congress 1991 and unpublished reports. 1950196019701980199020002005201020152020 Figure 1

23. North Dakota Dental Education Institutions z0 Dental schools z1 Dental hygiene school z1 Dental assisting school

24. Resources Associated with Safety Net Providers National zNational Health Service Corp Loan Repayment Program State zNone

25. How Can We Assure Oral Health Access for our Citizens zOur goal today is to develop strategies to improve oral health access