dr. julie watts mckee dental director. 2 core mission: to assure oral health for kentucky. 2
TRANSCRIPT
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Kentucky Oral Health Program Overview
Dr. Julie Watts McKeeDental Director
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Core Mission:To assure oral health for Kentucky.
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Statistics: Decay Rates: 2011-2012
10% U.S. Children with decayKentucky rate: currently unknown
2001-200419.5% of 2-5 year olds in U.S. with untreated
decay2001
42.8% of Kentucky children with untreated decay
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Statistics: Access and Utilization46% of all Medicaid/KCHIP children
One dental service60% of 6-9 year olds received services
40% of all received a preventive service54% of 6-9 year olds received preventiveOral Health Service by a non-dentist provider
PhysiciansHealth Departments
Nurses Hygienists
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Statistics: Preventive ServicesFluoride Varnish
200440% reduction in smooth surface decay. Last year: 22,000 in local health deparmentsSmiling Schools: 17,000 this year
Public Health Hygiene7 sites30,000 services4,600 patients
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Statistics: Behavioral Risk Factor Surveillance SystemHigh rate of extractions
7th highest in adults with an extractionDental Visits
42nd in the nation (not good)60% of adults with a dental visit
7th in edentulism in senior Kentuckians.This is an improvement over the years
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Statistics: Dental WorkforceDeloitte Report
Rural areas need dentistsJefferson County needs 150 more dentists
Maldistribution435,000 newly covered mouthsFew new providers13 new dentist license in Appalachia
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Statistics: Water FluoridationReduces 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
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Key Stakeholders: Health DepartmentsSpecific Funding VarnishSealantsHygiene ProgramsSpecial ProjectsMedicaid Reimbursements
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Key Stakeholders: Dental SchoolsUniversity of Kentucky
OutreachVarnish SuppliesSpecial Projects
University of LouisvilleSpecial Projects
Collaboration is evident
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Key Stakeholders: AppalachiaSmiling Schools
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Key Stakeholders: Boards and Associations Kentucky Board of DentistryKentucky Dental Association
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Key Stakeholders: Water PlantsRegulatory Responsibility
MonitoringReporting
Technical Assistance
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Emerging Issues: Data CollectionUniversity of Kentucky
Prevalence StudyEarly Learners
Delta DentalPrevalence Study
Third and Sixth GradersUniversity of Louisville
On-Going Surveillance System
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Emerging Issues: PH HygienistsSeven Pilot Programs
Start up fundingLooking for two more
Electronic Health RecordsDental is the Canary
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Emerging Issues: Increased Decay Rates in Early ChildhoodPermanent Teeth Decay Rates (Nationally)
Dropping SlowlyPrimary Teeth Decay Rates (Nationally)
Slight, but significant increaseKentucky?
We’ll see
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Emerging Issues: TeledentistryOral Health
Interested in developing networkInvolves dental schoolsInvolves private dentists
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Emerging Issues: Workforce DistributionPossible maldistribution?Medicaid ExpansionLeads to delay or avoidance of care
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Emerging Issues: Community Dental Health WorkersCommunity Dental Health Coordinator
Reduces careReduces impactProven in other areas of patient navigation
and education
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Emerging Issues: Adult DenturesSignificant Increase in Medicaid ExtractionsPent Up Dental Need in Expansion PatientsDentures
EmployabilityBetter Nutrition
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Program Cost Effectiveness:Community Water Fluoridation
Annual per-person cost savings$16-$19 a year
KentuckySaves $69 Million a year
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Program Cost Effectiveness:Fluoride Varnish
20% reduction shown in Kentucky projectsVaries on the studied parameters
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Program Cost EffectivenessSealants
Evidence Based ProcedureAfter two years
$53Oregon
1313% in 20 years$125 cost of filling-avoided
If avoided, PH RDH has avoided $987,164
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The Future of Oral HealthNationally
Provider numbers StableDecreasingIncreasing
StateKeep on striving for the best oral health status
for all Kentuckians