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Young chidren's oral health status in the saskatoon health region: 2006 2015

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May 16th 2016

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Young chidren's oral health status in the saskatoon health region: 2006 2015

  1. 1. Saskatoon Health Region Young Children’s Oral Health Status: 2006-2015 Maryam Jafari School of Public Health, U of S Ms. Leslie Topola Manager, SHR, Population and Public Health
  2. 2. Overview • Oral Health Program-Population and Public Health • Background Information: Oral Health in Young Children • The Current Report
  3. 3. Oral Health Program, Population and Public Health Primary Health Services • School Services Dental Screening • Fluoride Services Fluoride Varnish Clinics Public Health Dental Clinic
  4. 4. Tooth Decay: 5 times more common than asthma • 57% of 6–11 years old (Canadian Health Measure Survey 2007-2009) Early Childhood Tooth Decay (ECTD) • Younger than 6 year old (primary teeth) • No national information • More than one fourth of children ( Ontario) • Heath Impact: • Economic Impact: Day surgery $3.4 million (Saskatchewan) $1.9 million (Saskatoon Health Region) ECTD Severe ECTD Background
  5. 5. Etiology • Streptococcus Mutans • Fermentable Carbohydrate • Socioeconomic Status Overnight Feeding!
  6. 6. Prevention Strategies • Reduce the bacteria of mother Prevention and Treatment • Minimize the transmission of bacteria of mother • Fluoride Community (Water, Milk, Salt) Individual (Fluoride Varnish,…) • Antibacterial agents • Fissure sealants NO Saliva Sharing!
  7. 7. Objectives • Monitor the trends of oral health status children 0-6year olds • Provide baseline for future screening/analysis for children 0-5 year old • Assess oral health of 6 year old against Canadian Oral Health Framework 2013-2018 • Establish oral health target for 0-5 year old • Determine disparities in the oral health status • Child’s Residence, Neighborhood Income Status
  8. 8. Methods • Data Collection (already done) • Dental Assistants • Dental Therapists • Public Health Nurses • Nurse Practitioners
  9. 9. Methods • Data Analysis • Oral Health Indicators • “deft”, “DMFT”, “deft+DMFT” • Early Childhood Tooth Decay • Severe Childhood Tooth Decay • Caries-Free • Untreated Cavities • No Evidence of Care • Priority deft : decayed, extracted, filled teeth DMFT: Decayed, Missing, Filled Teeth
  10. 10. Results 1- Trend of oral health status (in general): 2- Trend of oral health (Urban vs. Rural ; Non-low Income vs Low Income Neighborhoods)
  11. 11. Oral Health Status Trend
  12. 12. • N=23,787 • Age groups: • Younger than 1 Year Old ( 2006-2014) • 1 Year Old • 2 Year Old • 3 Year Old • 4 Year Old • 5 Year Old • 6 Year Old ( 2008-2014)
  13. 13. % Early Childhood Tooth Decay+ Severe-Early Childhood Tooth Decay 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 %ECTD+S-ECTD <1y/o 1y/o 2y/o 3y/o 4y/o 5y/o 2014 48% 35% 33% 21% 5% 3%
  14. 14. Early Childhood Tooth Decay+ Severe-ECTD : 0-2 Year Old Children 0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 14.00% 16.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 %S-ECTD
  15. 15. Early Childhood Tooth Decay and Severe-ECTD: 3-5 Year Old Children 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 %ECTD+S-ECTD
  16. 16. Early Childhood Tooth Decay and Severe-ECTD: 3-5 Year Old Children 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 %ECTD 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 %S-ECTD
  17. 17. Canadian Oral health Framework (COHF) 2013-2018 Target: 6 Year Old Children # Objective Indicator 1.a Reduce the number of teeth affected by cavities in 6-Year Olds deft +DMFT of <2.5 1.b Reduce the percentage of 6 year old children who experienced cavities 55% of 6 year old children have deft +DMFT=0 (Cavity-Free) 1.c Reduce the percentage of 6 year old children with untreated cavities <15% of 6 year old children have d+D>0 (Untreated Cavities)
  18. 18. 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 2008 2009 2010 2011 2012 2013 2014 Average“deft+DMFT” COHF Target: 6 Year Old Children 2.5
  19. 19. COHF Target: 6 Year Old Children 55% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 2008 2009 2010 2011 2012 2013 2014 PercentageCavity-Free
  20. 20. COHF Target: 6 Year Old Children 55% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 2008 2009 2010 2011 2012 2013 2014 PercentageCavity-Free 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 2008 2009 2010 2011 2012 2013 2014 %UntreatedCavities 15%
  21. 21. Saskatoon Health Region Recommended Target: 0-5 Year Old Children # Objective Indicator 1.a Reduce the percentage of 5 Year Olds who experienced cavities. 64% of 5 Year Olds have deft +DMFT=0 1.b Reduce the percentage of 4 Year Olds who experienced cavities. 73% of 4 Year Olds have deft +DMFT=0 1.c Reduce the percentage of 3 Year Olds who experienced cavities. 82% of 3 Year Olds have deft +DMFT=0 1.d Reduce the percentage of 2 Year Olds who experienced cavities. 91% of 2 Year Olds have deft +DMFT=0 1.e Reduce the percentage of ≤1 Year Olds who experienced cavities. 100% of ≤1 Year Olds have deft +DMFT=0
  22. 22. • Oral health in 1, 2, 3, 4, 5 year old children has improved. • Oral health in children younger than 1 has declined. • Oral health in 6 year old children has declined • The best measurements were seen in 2008 • The best measurements in recent year were seen in 2013
  23. 23. Oral Health Status (Income Status/ Child’s Residence )
  24. 24. LIM vs. Non-LIM Neighborhoods: • Low Income Measure (LIM) • Low Income: 30% of families in the neighborhood meet the definition of LIM (Statistics Canada) • Age groups: • 0-2 Year Old • 3-5 Year Old • 6 Year Old
  25. 25. Average “ deft+DMFT”: 0-2 Year Old Children 0 0.2 0.4 0.6 0.8 1 2006 2007 2008 2009 2010 2011 2012 2013 2014 Average“deft+DMFT” Non-LIM LIM
  26. 26. Urban vs. Rural areas: • Urban: Saskatoon, Humboldt • Age groups: • 0-2 Year Old • 3-5 Year Old • 6 Year Old
  27. 27. Average “ deft+DMFT”: 3-5 Year Old Children 0 0.5 1 1.5 2 2.5 3 3.5 4 2006 2007 2008 2009 2010 2011 2012 2013 2014 Average“deft+DMFT” Urban Rural
  28. 28. Summary • Oral health in Non-Low Income Neighborhoods has improved. • Oral health in Low Income Neighborhoods has remained stable/showed unfavorable trend. • Children in Non-Low Income Neighborhoods had better health compared to Low Income Neighborhoods. • Oral health in both Urban and Rural children has improved. • Rural children had better oral health compared to Urban children
  29. 29. Discussion Improvements of oral health in Rural areas • Involvement of Nurse Practitioners/Public Health Nurses in rural areas • Possible confounders (Aboriginal status, dental insurance) wasn’t assessed • Role of water fluoridation wasn’t assessed Fluoride water content has not improved over the years. No significant differences in oral health in Fluoridated vs non- Fluoridated areas (SHR Dental Screening Program Report 2013-2014) • Fluoride Varnish Program wasn’t evaluated • Changes in lifestyle and habits in urban areas
  30. 30. Recommendations • Involve Nurse Practitioners/Public Health Nurses in Fluoride Varnish Programs in Urban areas (Low Income Neighborhoods) • Conduct data entry the same day (web-based in real time) • Conduct a national dental survey for children younger than 6 year old. • Canadian Health Measure Survey 2007-2009 ( 6-11 year old children) • Provide free consultation/checkup for the children 1 year old (Canadian Dental Association) • Incorporate oral preventive health care in the universal health care system • Incorporate oral exam as a part of routine prenatal care • Improve training in pediatric dental care and pregnant women dental care in dental school
  31. 31. Acknowledgments Dental Health Screening Advisors • Leslie Topola • Julie Laberge-Lalonde • Cynthia Ostafie Examiners and Data Collection Nurse Practitioners and Public Health Nurses Oral Health Professional • Leah Abrook • Julie Laberge-Lalonde • Linda O’Keefe • Cynthia Ostafie • Gwen Sawicki • Diane Schitka • Chris Vandale • Leanne Ziolkowski Office Administration • Barbara Anderson • Joyce Birchfield • Terry Dunlop • Josh Marko • Bob Toso
  32. 32. References:  King A. Oral health – more than just cavities: a report by Ontario’s Chief Medical Officer of Health. Ontario: Queen’s Printer for Ontario; 2012. Available from: http://www.health.gov.on.ca/en/common/ministry/publications/reports/oral_health/oral_health.pdf  Oral health during pregnancy and early childhood: evidence-based guidelines for health professionals. J Calif Dent Assoc. 2010; 38(6):391. Available from: www.cdafoundation.org/Portals/0/pdfs/poh_guidelines.pdf  Saskatoon Health Region. Oral Health Program Population and Public Health. Dental Health Screening Program Report 2013-2014. Saskatoon, Saskatchewan: Saskatoon Health Region; 2014. Available from: https://www.saskatoonhealthregion.ca/locations_services/Services/OralHealth/Documents/SHR%20FI NAL%20Dental%20Screening%20Report%202013-2014.pdf  Saskatoon Health Region. Saskatchewan Dental Health Screening Program report 2013-2014; 2014. Available from: https://www.saskatoonhealthregion.ca/locations_services/Services/Oral- Health/Documents/Saskatchewan%202013 14%20Dental%20Screening%20Report.pdf

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