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Measuring the Oral Health of Washington’s Children Challenges and Practical Solutions. Beth Hines, RDH,MPH Washington State Department of Health June 28, 2000. Outline. Challenges and Practical Solutions Tools for direct primary data collection Smile Survey 1994 and 2000.
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Measuring the Oral Health of Washington’s ChildrenChallenges and Practical Solutions
Beth Hines, RDH,MPHWashington State Department of HealthJune 28, 2000
Outline • Challenges and Practical Solutions • Tools for direct primary data collection • Smile Survey 1994 and 2000
Tools for indirect primary data collection: • Lead Poisoning Prevalence Survey • PRAMS • Disability Survey
Challenges • HP 2010 Objectives • MCH Block Grant Indicator on Sealants
Oral Health surveys are: • time intensive • staff intensive • expensive
Practical Solutions • Screening versus examination • Screening models: • Smile Survey 1994 • BSS and STP 2000
Piggybacking on other surveys: • Lead • PRAMS • Disability
Smile Survey 1994 10 Counties
Smile Survey 1994 • Random selection of schools in targeted high risk counties w/ urban & rural rep. • 6,590 children screened • 6,399 sample analyzed
1,063 Headstart and ECEAP (mean age 4.3) • 4,635 Elementary School (mean age 6.9) • 701 High School ( mean age 15.1)
Smile Survey 2000 Washington State Assessment of Children’s Oral Health Status
Sampling • Random sample of elementary schools w/ 25 or more in 2nd & 3rd grades • 7960 children in 56 schools • Convenience sample of 12 Headstart/ECEAP and Early Headstart
Protocol • Smile Survey • ASTDD/CDC • STP - BSS Basic Screening Survey • County Based Tools • Training and Calibration
Access to Care Questions • Parent questionnaire • dental insurance • time since last dental visit • reason for last dental visit • problems accessing dental care
ESL • ask elementary school children - What language does your family speak at home? • ask Early/Head Start teacher - What language does this child’s family speak at home?
0 5 Coding for Untreated Cavities • School children • Count number of primary & permanent teeth with cavities • Range: 0-24 • If a child has 5 cavities
Lead Poisoning Prevalence Survey And Oral Health Assessment Survey
Sampling • Age cohort: age 1-2 years • Stratified random sample of birth certificates
2 strata by census tract: • high risk: 9 counties (high Hispanic pop) N:540 • low risk: remaining 30 counties N: 360 • oversample Hispanics and children of farmworkers
Methodology • Questionnaire / Demographics , Access, Risk for lead exposure, Injury prevention • Finger Stick - blood sample
Dental Exam / Visible Caries • Saliva Sample / Strep Mutans Count • Water Sample / Fluoride Content
Purpose: • Statewide estimate of Early Childhood Caries • Relationship between blood lead levels and caries
Purpose • Potential risk factors for caries: • Strep Mutans levels • Fluoride exposure • Feeding patterns • Variables associated with birth mother
PRAMSPregnancy Risk Assessment Monitoring System And Oral Health...
1. This question is about the care of your teeth during your most recent pregnancy. • I needed to see a dentist for a problem Y/N
I went to a dentist or dental clinic Y/N • A dental or other health care worker talked with me about how to care for my teeth and gums Y/N
2. How long has it been since you had your teeth cleaned by a dentist or a dental hygienist? ______ Months
Washington StateDisability Surveillance Survey And Oral Health….
How long has it been since your child with disabilities last visited the dentist or a dental clinic?
What is the reason you have taken your child to the dentist in the last year? • Does your child have untreated tooth decay or gum disease?
Do you have any kind of insurance coverage that pays for some or all of your routine dental care, including dental insurance, prepaid plans such as HMOs, or government plans such as Medicaid?
Assessment must be a priority