oral health standards of care for children at risk saskatchewan ministry of health

POPULATION HEALTH BRANCH

Saskatchewan Ministry of Health


Oral Health Standards of Care for Children at Risk Oral Health Coalition

October 30, 2012


Building a Healthier Saskatchewan

• Provide update on enhanced services and take time to reflect on the past year

• Provide an overview of the data being collected provincially

• Share some early observations of services in 2011-12



Goal:• To reduce dental decay and contribute

to the healthy development of at risk mothers, infants, preschool and school age children.

• To reduce the need for hospital based general anaesthesia treatment services



• Oral Health Assessment, referral and follow-up– Assessments will provided to all children from

2 months to 5 years of age– Children with treatment needs are referred for

follow-up by appropriate oral health professional

– Children who receive services under GA are followed up in the community



• Fluoride Varnish– Children from 6 months of age to 5 years who

are identified at risk will be provided 2 fluoride varnish applications each year.

• Dental Sealants– provided to all Grade 1 and Grade 7 students

attending schools identified as being high risk


Saskatchewan Surgical Initiative

2012-13• $60.5M for SkSI• 99% of surgeries completed within 18

months• 97% within 12 months• 88% within 6 months• 77% within 3 months



•• 2546 children under the age of six 2546 children under the age of six received dental surgery under GA in received dental surgery under GA in 20102010--1212

•• 2721 children were seen in 20112721 children were seen in 2011--1212

•• Total of 5267 children in the past 2 yearsTotal of 5267 children in the past 2 years


Surgical Procedure Rates

Figure 4: Five-year Average Oral Surgical Procedures Rates by RHA of Patient, 2007-2011.

0% 5% 10% 15% 20% 25%

Sun Country

Five Hills

Cypress

Regina Qu'Appelle

Sunrise

Saskatoon

Heartland

Kelsey Trail

Prince Albert Parkland

Prairie North

Mamawetan Churchill River

Keewatin Yatthe

Athabasca

Saskatchewan

Percentage (%) of Children 0-5


Waitlist

SK Surgical Patient Registry: Number Waiting at Month End

0

200

400

600

800

1000

1200

1400

1600

1800

2000

2010-04

2010-05

2010-06

2010-07

2010-08

2010-09

2010-10

2010-11

2010-12

2011-01

2011-02

2011-03

2011-04

2011-05

2011-06

2011-07

2011-08

2011-09

2011-10

2011-11

2011-12

2012-01

2012-02

2012-03


Waitlist

SK Surgical Patient Registry: Number Waiting at Month End by Time Already Waited

0

50

100

150

200

250

300

350

2010-04

2010-05

2010-06

2010-07

2010-08

2010-09

2010-10

2010-11

2010-12

2011-01

2011-02

2011-03

2011-04

2011-05

2011-06

2011-07

2011-08

2011-09

2011-10

2011-11

2011-12

2012-01

2012-02

2012-03

Wait > 12mth Wait > 18mth


Average Monthly Procedures

Figure 2: Average Monthly Oral Surgical Procedures in Children 0-5 (x-bar control chart)

1 2 0

1 4 0

1 60

1 80

2 00

2 2 0

2 4 0

2 60

Oct-06

Jan-07

Apr-07

Jul-07

Oct-07

Jan-08

Apr-08

Jul-08

Oct-08

Jan-09

Apr-09

Jul-09

Oct-09

Jan-10

Apr-10

Jul-10

Oct-10

Jan-11

Apr-11

Jul-11

Oct-11

Jan-12

Quarter Beginning

Num

ber o

f Pro

cedu

res

per M

onth


SK Surgical Patient Registry: Summary of Surgery Performed by Region of Service and Children's Region 2011-12 Q4

0

50

100

150

200

250

300

350

400

Sun Country Five Hills Cypress ReginaQu'Appelle

Sunrise Saskatoon Heartland Kelsey Trail Prince AlbertParkland

Prairie North MamawetanChurchill

River

KeewatinYatthe

Athabasca Unknown orOut of

Province

Region of Service Children Reside


Surgical Procedures

Figure 3: Saskatchewan Oral Surgical Procedures Rates by Year, Children 0-5

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

Perc

enta

ge (%

)

Oral Surgery 3.3% 3.3% 3.1% 3.2% 3.6%

2007 2008 2009 2010 2011


Analysis and Recommendations

• 2010 incidence rate of 3.2% will be the baseline.

• Consider options to increase surgical activity in the summer.

• Consider implementation of additional preventive measures to meet the high needs of the north.



• Northern Proposal– Support for two DT positions to work with pre

& postnatal mothers & preschool children.– 3 northern RHA will work together to address

some of the remaining challenges in the north to ensure the standard of care is met.

– Services will include and compliment enhanced preventive services



Enhanced Preventive Dental ServicesEvaluation Sections:1. Child Health Clinics, Pre/postnatal services

and follow-up after dental treatment under GA

2. Fluoride Varnish Applications 3. Dental Sealants4. Overall program objectives



• Overall Evaluation ObjectivesTarget Actual90% of DT staff hired 100%100% of equipment/supplies in place 100%80% of Dental Assistants Hired* 77%100% of Eligible Schools Contacted 100%95% of at risk schools participating 95%



Target Actual

• 50% of eligible Gr. 1 students consent to services 63% • 65% of enrolled Gr.1’s receive a fluoride varnish 92%• 65% of enrolled Gr.1’s received sealants 66%• 65% of Grade 1 receive OHI 90%• 90% of PHNs are oriented to updated CHC

Guidelines 89%



Target• # of children assessed during child health

clinics – 32,000 per year

Actual • 17,970• 56% of our annual target



Target:• # of children at risk receiving a fluoride

varnish - 15,000 per year

Actual:• 10,411• 69% of our goal.



Target:• # of children receiving a sealant - 3,600

Actual:• 2824 children received 7,096 sealants• 78% of our goal



• Other goals to be measured:

– 5% reduction of Early Childhood Tooth Decay– 5% reduction in the number of children who

require dental surgery under GA.


Building a Healthier Saskatchewan One smile at a time.

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