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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Oral Health

Explore oral health indicators, access, prevention, and disparities among adults and children in Wisconsin. Source: Wisconsin Department of Health Services.

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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Oral Health

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  1. Healthiest Wisconsin 2020 Baseline and Health Disparities ReportOral Health

  2. Chapter outline Chapter Outline Background • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report • Healthiest Wisconsin 2020 objectives and indicators • Rationale • Key points Data • Tooth removal and dental care among adults • Dental care utilization • Access • Prevention • Dental health needs among children References Links to additional reports and resources Contacts

  3. Report overview Report Overview This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

  4. Report overview Report Format Sample annotated slide Full Report • Format: PDF • Intended use: reference document Chapters • Format: Annotated PowerPoint slide set • Intended uses: presentations to • Decision-makers • Service providers • Community leaders • The public

  5. Report overview Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes

  6. Report overview Report Outline: Detail Section 3: Health focus areas Section 4: Infrastructure focus areas

  7. Report overview Report Outline: Detail Section 5: Data summaries by population

  8. Report overview Data notes Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. Population estimates that are considered unreliable are excluded. Misclassification of racial/ethnic groups may affect the accuracy of rates. Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

  9. Report overview Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

  10. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 1 By 2020, assure access to ongoing oral health education and comprehensive prevention, screening and early intervention, and treatment of dental disease in order to promote healthy behaviors and improve and maintain oral health. Objective 1 Indicators • Percent of third-graders with dental sealants and untreated decay. • Percent of Head Start children with untreated decay. • Percent of adults with self-reported oral health problems. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Oral Health Focus Area Profile.

  11. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 2 By 2020, assure appropriate access to effective and adequate oral health delivery systems, utilizing a diverse and adequate workforce, for populations of differing races, ethnicities, sexual identities and orientations, gender identities, and educational or economic status and those with disabilities. Objective 2 Indicators • Proportion of BadgerCare+ enrollees with at least one dental claim in a year. • Number of oral health related emergency room visits by population group. • Percent of schools with school-based dental screening/sealant programs. • Number of dental providers by type of provider by demographics and location. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Oral Health Focus Area Profile.

  12. Rationale Rationale • Good oral health means being free of mouth pain, tooth decay, tooth loss, oral and throat cancer, gum (periodontal) disease, and other diseases that affect the mouth and surrounding structures. • Oral health is integral to general health throughout the life span and can be achieved by everyone. • Many systemic diseases may initially start with and be identified through oral symptoms. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Oral Health Focus Area Profile

  13. Key points Key points Adults • Only one-quarter of Medicaid/Badgercare+ enrollees had a dental service in the past year. • The number of emergency department visits for non-traumatic dental complaints increased by 20% from 2006 to 2010. • Four out of ten adults had at least one permanent tooth removed due to tooth decay or gum disease, while three out of ten did not visit a dentist within the past year. • In 2010, nearly 90% of the population on public water systems had access to fluoridated water in Wisconsin, exceeding the national target of 80%.

  14. Key points Key points Adults • Compared to Whites and Asians, Black, Hispanic, and American Indian adults were significantly more likely to have permanent teeth removed due to tooth decay or gum disease, and not to have visited a dentist, dental hygienist, or dental clinic in the past year. • Permanent tooth removal and lack of dental visits are significantly more common among people earning lower incomes. • More than half of adults with a disability had at least one permanent tooth removed due to tooth decay or gum disease, while more than one-third did not have a dental visit in the past year.

  15. Key points Key points Youth The percentage of third-grade children with untreated tooth decay decreased by 35% from the 2001-2002 school year to the 2007-2008 school year. School-based dental sealant programs have expanded rapidly since the 2009-2010 school year. Twenty-six percent of children in Head Start (aged 3-5) had untreated decay. Schools with a higher proportion of students from low income households were considerably more likely to have children with untreated tooth decay than schools with a higher SES population. One in three Asian, Black, or Hispanic third-grade children had untreated tooth decay, compared to one in six White children.

  16. Tooth removal and dental care among adults

  17. Tooth removal and dental care among adults Rates of tooth removal and dental visits in the past year among Wisconsin adults, by sex, 2010-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset. Note: Tooth removal question asked in 2010 and 2011. Dentist visit question asked in 2010.

  18. Tooth removal and dental care among adults Rates of tooth removal and dental visits in the past year among Wisconsin adults, by age, 2010-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset. Note: Tooth removal question asked in 2010 and 2011. Dentist visit question asked in 2010.

  19. Tooth removal and dental care among adults Age-adjusted rates of tooth removal and dental visits in the past year among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Tooth removal question asked in 2008, 2010, and 2011. Dentist visit question asked in 2008 and 2010.

  20. Tooth removal and dental care among adults Age-adjusted rates of tooth removal and dental visits in the past year among Wisconsin adults, by household income level, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Tooth removal question asked in 2008, 2010, and 2011. Dentist visit question asked in 2008 and 2010.

  21. Tooth removal and dental care among adults Age-adjusted rates of tooth removal and dental visits in the past year among Wisconsin adults, by level of urbanization, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Tooth removal question asked in 2008, 2010 and 2011. Dentist visit question asked in 2008 and 2010.

  22. Tooth removal and dental care among adults Rates of tooth removal and dental visits in the past year, by disability status, Wisconsin adults ages 18-64, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Tooth removal question asked in 2008, 2010, and 2011. Dentist visit question asked in 2008 and 2010.

  23. Tooth removal and dental care among adults Rates of tooth removal and dental visits in the past year among Wisconsin adults, by sexual orientation, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note:Tooth removal question asked in 2008, 2010, and 2011. Dentist visit question asked in 2008 and 2010.

  24. Dental care utilization

  25. Dental care utilization Percentage of Medicaid/BadgerCare+ enrollees who received a dental service in the past year, Wisconsin, 2009 Source: Wisconsin Department of Health Services, 2010 — Burden of Oral Disease in Wisconsin.

  26. Dental care utilization Emergency department visits for non-traumatic dental complaints, Wisconsin, 2006-2010 Source: Wisconsin Department of Health Services, Office of Health Informatics, Wisconsin Emergency Department Data unpublished data.

  27. Dental care utilization Emergency department visits for non-traumatic dental complaints by age group, rate per 100,000, Wisconsin, 2010 Source: Wisconsin Department of Health Services, Office of Health Informatics, Wisconsin Emergency Department Data (unpublished).

  28. Access to dental care

  29. Access to dental care Lack of routine preventive medical and dental care and unmet medical and dental needs among children, by poverty status, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Estimates were not available for all groups. FPL is the Federal Poverty Level, based on household size and income.

  30. Access to dental care Number of dentists per 100,000 people by county urbanization characteristics, Wisconsin, 2010 Source: Wisconsin Department of Safety and Professional Services licensure lists; population estimates from Wisconsin Department of Health Services, Office of Health Informatics.

  31. Access to dental care Number of full-time-equivalent (FTE) dentists needed to reduce significant shortages for Medicaid members, 2009 Source: Wisconsin Department of Health Services, Primary Care Office, Shortage Designation Program.

  32. Prevention of tooth decay

  33. Prevention of tooth decay Percentage of population on public water systems receivingfluoridated water, by state, 2010 U.S. rate: 73.9% Source: Centers for Disease Control and Prevention, 2010 Water Fluoridation Statistics

  34. Prevention of tooth decay Percentage of schools with school-based dental sealant programs, Wisconsin, 2009-2012 2011-2012 2009-2010 2010-2011 Sources: Wisconsin Department of Health Services dental sealant program data; Wisconsin Department of Public Instruction public school enrollment data. Note: Public schools grades 1 through 8

  35. Dental health needs among children

  36. Dental health needs among children Percentage of children with untreated tooth decay, Wisconsin, selected years 2001-2009 Head Start children with untreated decay Third-grade children with untreated decay Sources: Wisconsin Department of Health Services, Make Your Smile Count Survey and Healthy Smiles for Healthy Head Start Survey.

  37. Dental health needs among children Percentage of third-grade students with untreated decay and dental sealants by race/ethnicity, Wisconsin, 2007-2008 school year Source: Wisconsin Department of Health Services, Make Your Smile Count Survey.

  38. Dental health needs among children Percentage of third-grade students with untreated decay and no dental sealants by school percentage of students eligible for the free/reduced price lunch (FRL) program, Wisconsin, 2007-2008 Sources: Wisconsin Department of Health Services, Make Your Smile Count survey.

  39. Dental health needs among children Percentage of children with oral health needs by disability status, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health.

  40. References References University of Wisconsin Population Health Institute. County Health Rankings, 2013. http://www.countyhealthrankings.org/our-approach Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/ Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf American Dental Association. American Dental Association Statement on Regular Dental Visits. http://www.ada.org/8700.aspx Centers for Disease Control and Prevention (CDC). Oral Health for Older Americans. http://www.cdc.gov/OralHealth/publications/factsheets/adult_oral_health/adult_older.htm Wisconsin Department of Health Services. Burden of Oral Disease in Wisconsin, 2010: http://www.dhs.wisconsin.gov/publications/P0/P00209.pdf

  41. References National Center for Health Statistics: Oral Health Status and Access to Oral Health Care for U.S. Adults Aged 18-64: National Health Interview Survey, 2008. http://www.cdc.gov/nchs/data/series/sr_10/sr10_253.pdf The Henry Kaiser Foundation. State Health Facts. http://kff.org/other/state-indicator/total-dentists/ Wisconsin Department of Health Services, Wisconsin Primary Care Office. Number of Dentists Needed to Reduce Significant Shortages for Medicaid Members. http://www.dhs.wisconsin.gov/publications/p0/p00368.pdf CDC. Community Water Fluoridation. http://www.cdc.gov/fluoridation/ CDC. Preventing Cavities, Gum Disease, Tooth Loss, and Oral CancersAt A Glance 2011. http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm Data Resource Center for Child and Adolescent Health. Who Are Children with Special Health Care Needs? http://childhealthdata.org/docs/nsch-docs/whoarecshcn_revised_07b-pdf.pdf

  42. Links Links to additional reports and resources • Burden of Oral Disease in Wisconsin, 2010: http://www.dhs.wisconsin.gov/publications/P0/P00209.pdf • Make Your Smile Count, 2008: http://www.dhs.wisconsin.gov/publications/p0/p00095.pdf • Healthy Smiles for a Healthy Head Start, 2009: http://www.dhs.wisconsin.gov/publications/p0/P00275.pdf • County Oral Health Wisconsin Surveillance System (COWSS): http://www.dhs.wisconsin.gov/health/oral_health/cowss/2012Counties/index.htm • Centers for Disease Control and Prevention (CDC). Division of Oral Health: http://www.cdc.gov/oralhealth/

  43. Contacts Contact Melissa Olson, MS Epidemiologist Wisconsin Oral Health Program Bureau of Community Health Promotion Division of Public Health Wisconsin Department of Health Services Email: Melissa.Olson@dhs.wisconsin.gov

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