an assessment of first dental visits between birth and the 1 st year, utah 2001-2005 shaheen...
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An Assessment of First Dental Visits Between Birth and the 1st Year, Utah 2001-2005
Shaheen Hossain, PhDKaren L. Zinner, MPH
Peggy A. Bowman RDH, BASteven Steed, DDS
Gail Rapp, MS11th Annual Maternal and Child Health Epidemiology Conference, Miami 2005
Presentation outline
AAPD (1986) and ADA (2000) recommend first
dental visit by 1st year of age
UDOH conducts a study (2001) to
determine compliance with the new policies
Utah implements several
interventions during 2002 -
2005
UDOH conducts a follow-up
survey (2005) to compare with 2001 baseline
data
AAPD - American Association of Pediatric DentistsADA - American Dental AssociationUDOH - Utah Department of Health
PolicyPolicy StudyStudy InterventionIntervention Follow-upFollow-up
Prevalence of dental caries Dental caries comprise the single most
common chronic disease affecting children in the U.S.
Rate for caries increases with age* 2 - 4 yrs 18% 6 - 8 yrs 52% 15 yrs 61% 17 yrs 78% ≥18 yrs 85%
Low income and minority childrenhave a higher risk of developing caries in primary teeth * HP 2010 baseline data for objective #21a-c, and US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General; 2000
Impact of untreated dental caries
Average cost for treatment of early childhood caries ranges from $1,500 to $2,000* per child
Missed school days Decreased school performance Impaired speech development Poor self-esteem
* US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General; 2000
Guideline on infant oral health care
Previous recommendations suggested that a child have an initial dental visit at age 3
AAPD (1986) implemented a policy recommending an initial dental visit within 6 months of the eruption of a child’s first tooth and no later than 12 months of age
ADA (2000) reinforced AAPD’s policy and recommended that a child’s first dental visit occur by age one
2001 Utah dentist survey
Purpose: Utah Oral Health Program (OHP) surveyed licensed general and pediatric dentists in Utah to assess the earliest age which they saw children
Time Period: Oct 2001 – Jan 2002
Surveys mailed: 1,339
Response rate: 63% (adjusted 61%, n=792)
Earliest age dentists see children, Utah 2001
2 yrs31.9%
3 yrs43.1%
4 yrs6.0%
5-6 yrs2.8%
0-1 yr16.2%
Most frequent response
Results of 2001 Utah dentist survey
UDOH activities during 2002-2005
Training and education(e.g. Presented at Annual American Dental Hygienists Association conference, Pediatric Grand Rounds, Utah local health departments, Utah Dental Association Annual conference, Telehealth broadcast and WIC conference)
Development of educational materials(e.g. Articles in Utah WIC program newsletter, Head Start newsletter, and Baby Your Baby)
Collaboration with Utah Dental Association(e.g. UDOH worked together with dental health care professionals to promote early dental visits, and UDA visits to local dental societies)
Held Oral Health Summit (Inspire Utahns to take an active role in enhancing oral and general health for all children in Utah)
New infant oral health care guidelines
American Academy of Pediatrics (2003*) recommends children should receive oral health evaluation by 6 months of age by a pediatrician or other qualified pediatric health care professional
Oral health risk assessment should include: Assess mother’s oral health Assess oral health risk of children Perform oral health examination and recognize risk of caries Assess child’s exposure to fluoride Educate parents on oral hygiene and diet Make referral to dental home if necessary
* Oral Health Risk Assessment Timing and Establishment of the Dental Home, Pediatrics. 2003. Vol. 111
Surgeon General’s Call to Action 2003
The goals of this Call to Action were: To promote oral health To improve quality of life To eliminate oral health disparities
Call to Action identified 5 action areas: Change perceptions of oral health Replicate effective programs and proven efforts Build the science base Increase oral health workforce diversity, capacity and flexibility Increase collaborations
“No one should suffer from oral diseases that can be effectively prevented and treated”
2005 Utah dentist survey
Purpose: Determine if there had been a change in the practice of seeing young children
Time Period: Feb 2005 – Mar 2005
Surveys mailed: 1,112
Response rate: 58% (adjusted 57%, n = 605)
Earliest age dentists see children, Utah 2005
Results of 2005 Utah dentist survey
Age
0-1 Yrs
2 Yrs
3 Yrs
4 Yrs
5-6 Yrs
Percentage
23.8%
35.6%
36.0%
3.3%
1.2%
Comparison of 2001 and 2005 surveys
16.2%
31.9%
43.1%
6.0%
2.8%
23.8%
35.6%36.1%
3.3%
1.2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
0-1 yrs 2 yrs 3 yrs 4 yrs 5-6 yrs
Age
Per
cen
t
2001 2005
Earliest age dentists see children, Utah 2001 and 2005
* z-test proportional difference using SAS 9.1
Survey comments
Most general practice dentists who commented said they felt pediatric dentists were better suited to treat young children (26.8%)
Additional reasons for not treating children at an early age
Had an adequate referral source (13.0%) Practice was not geared to treat young
children (8.0%)
Limitations
Limited demographic data was obtained in the surveys
Non-respondents may have different experiences and opinions regarding practice pattern (43% non-response rate)
Conclusions and implications Preventing dental decay should begin with
pregnant women and continue with the mother and child
Dentists need to be more informed regarding current oral health policies
Pediatricians’ roles need to be expanded to include promotion of children’s oral health
Public health professionals who serve mothers and infants need to provide education to parents on the etiology and prevention of caries
Contact information
Gail Rapp, M.S.
Oral Health Program Manager
Steven Steed, D.D.S.
Utah State Dental Director
Oral Health Program
Utah Department of Health
801-538-9177http://health.utah.gov/oralhealth/
Thank You!