compiled by Jane E.M. Steffensen, MPH, CHES
These materials were provided to the Workshop Participants

Texas Resources

Final Report: Review of the Texas Oral Health Program. Prepared for Texas Department of Health by the Association of State and Territorial Dental Directors, September 1999. Texas Department of Health, 1100 West 49th St., Austin, TX 78756-3199.

Texas Department of Health. Introduction to the Texas Department of Health Strategic Plan, Fiscal Year 2001-2005, Pages 1-7. Austin, TX: Texas Department of Health
Website: http://www.tdh.state.tx.us/stratplan/default.htm

Chapter 43, Oral Health Improvement, Texas Health and Safety Code
Website: http://www.capitol.state.tx.us/statutes/hstoc.html

HRSA State Health Workforce Profiles, Texas, US DHHS, PHS, HRSA, Bureau of Health Professions National Center for Health Workforce Information and Analysis, December 2000.
Website: http://www.bhpr.hrsa.gov/healthworkforce/profiles/default.htm

National Resources

U.S. Department of Health and Human Services. Oral Health in America, A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institute of Health, 2000 (Executive Summary)
Website: http://www.nidcr.nih.gov/sgr/sgrohweb/TOC.htm

Healthy People 2010 Oral Health Objectives and Oral Health in the United States National Trends and Targets, Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia. PA: W.B. Saunders Co., 2002.

Based on Healthy People 2000 and Health People 2010:
Healthy People 2010 Focus Area 21 Oral Health
Website: http://www.health.gov/healthypeople/

Measuring and Tracking Healthy People 2010 Oral Health Objectives
Tracking Healthy People 2010, (Specific Definitions and Methods for Measuring Oral Health Objectives). - Oral Health Chapter in
Website: http://www.health.gov/healthypeople/document/HTML/tracking/contents.htm

Data 2010 – The Healthy People 2010 Database
(Following Oral Health Trends)
Website: http://wonder.cdc.gov/data2010

Healthy People 2000 Progress Review of Oral Health, December 15, 1999, Briefing Book Materials, Objective Charts and Disparity Charts
Website: http://www.cdc.gov/nchs/about/otheract/hp2000/oralhealth/oralhealth.htm

Measuring and Tracking Healthy People 2000 Oral Health Objectives
Statistical Notes 12 Operational Definitions for Year 2000 Objectives: Priority Area 13, Oral Health, 20 pp. (PHS) 97-1237, (Specific Definitions and Methods for Measuring Oral Health Objectives) - No. 12 Statistical Notes for Oral Health in Website: http://www.cdc.gov/nchs/products/pubs/pubd/hp2k/statnt/20-1.htm

Healthy People 2010 contains 467 objectives, grouped in 28 focus areas. Oral health has been a specific focus area in Healthy People 2000 and Healthy People 2010. Oral health is integrated into many of the focus areas of the other 27 chapters in the Healthy People 2010 objectives for the nation. Three major issues related to oral health and included in other chapters are:
- Increasing the minority oral health work force for dentists and dental hygienists.
- Providing oral health examinations and needed dental care for patients with diabetes.
- Reducing deaths from oral and pharyngeal cancer.

Table 4-1 outlines the key topics of the Healthy People 2010 national oral health objectives. Table 4-2 reviews the national trends and targets of key oral health indicators in the United States.

Table 4-1

Healthy People 2010 - Oral Health Objectives
Oral health goal: To prevent and control oral and craniofacial diseases, conditions, and injuries and improve access to related services
No. Topic of Objective Measure to Monitor Objective
3-6* Deaths from oral and pharyngeal cancer No. oral cancer deaths per 100,000 population
21-1 Dental caries experience % of persons with 1 dft or DMFT
21-2 Untreated dental decay % of persons with 1 dt or DT
21-3 No permanent tooth loss % of persons with 28 teeth, no teeth extracted
21-4 Complete tooth loss % of persons with all teeth extracted, edentulous
21-5 Reduce periodontal disease
Gingivitis
Destructive periodontal disease
% of persons with 1 bleeding site
% of persons 4 mm LOA in at least 1 site
21-6 Early detection of oral and pharyngeal cancer % of individuals with oral and pharyngeal cancer diagnosed
at earliest stage
21-7 Annual examinations for oral and pharyngeal cancer

% of individuals with recent oral/ pharyngeal
examination past year

21-8 Dental sealants % of persons with 1 sealants on permanent molars
21-9 Community water fluoridation % of people served by community water systems
with optimal levels of fluoride
21-10 Use of oral health care system % of individuals with annual dental visit
21-11 Use of oral health care system by residents
in long-term care facilities
% of nursing home residents with dental service
in last year
21-12
Preventive dental services for low- income children

% of low income children and adolescents with
preventive dental service within last year
21-13 School-based health centers with oral health component % of school-based health centers with
oral health component
21-14 Health centers with oral health component % of health departments and community-based
health centers with oral health component
21-15 Referral for cleft lip or palate % of states with system for recording and
referring orofacial clefts
21-16 State-based surveillance system % of states with an oral health surveillance system
21-17 Tribal, state, and local dental programs % state, tribal, territorial, and local health agencies with
an effective public dental health program
(directed by a dental professional with public health training)
* Numbers refer to the chapter and objective referenced in Healthy People 2010. For example, 21-1 is Chapter 21, Objective 1.

DT, decayed permanent teeth; DMFT, decayed, missing and filled permanent teeth; dt, decayed primary teeth; dft, decayed and filled primary teeth; LOA, loss of periodontal attachment

Adapted from Healthy People 2010: Understanding and Improving Health (conference ed, 2 vols). Washington, DC: U. S. Department of Health and Human Services, 2000.4


Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 2002.

Table 4-2

Oral Health in the United States:
National Trends and Targets*
Oral Health Indicator Age
(yr.)
Baseline Data
(for HP 2000
Target)
HP
2000
Target

Final Data
for HP 2000
Target
(Baseline for HP
2010 Target)


Summary
(Attainment of
HP 2000
Target)
HP
2010
Target
Dental Caries Experience
Reduce dental caries in young children
(primary teeth)
2-4 - - 18% - 11%

Reduce dental caries in children
(primary or permanent teeth)
6-8 54% 35% 52% Progress 42%
Reduce dental caries in adolescents
(permanent
teeth)
15 78% 60% 61% Progress 51%
Untreated Dental Decay
Reduce untreated dental decay in
young children (primary teeth)
2-4 - - 16% - 9%
Reduce untreated dental decay in children
(primary or permanent teeth)
6-8 28% 20% 29% Reveresed 21%
Reduce untreated dental decay in adolescents
(Permanent Teeth)
15 24% 15% 20% Progress 15%
Reduce untreated dental decay in adults 35-44 - - 27% - 15%

Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 2002.
Table 4-2

Oral Health in the United States:
National Trends and Targets*
Oral Health Indicator Age
(yr.)
Baseline Data
(for HP 2000
Target)
HP
2000
Target

Final Data
for HP 2000
Target
(Baseline for HP
2010 Target)


Summary
(Attainment of
HP 2000
Target)
HP
2010
Target
No Permanent Tooth Loss
Increase adults who have never lost
a permanent tooth
35-44 31% 45% 31% No Change 42%
Complete Tooth Loss
Reduce adults who have lost
all their teeth
65+ 36% 20% 30% Progress -
Reduce adults who have lost
all their teeth
65-74 - - 26% - 20%
Reduce Periodontal Disease
Reduce gingivitis among adults 35-44 41% 30% 48% Reversed 41%
Reduce destructive periodontal
disease
35-44 25% 15% 22% Progress 14%
Reduce Oral and
Pharyngeal Cancer Deaths

(Age-adjusted rate per 100,000)
Reduce oral and pharyngeal cancer
deaths in males
45-74 13.6% 10.5% 10.3% Met -
Reduce oral and pharyngeal cancer
deaths in females)
45-74 4.8% 4.1% 3.5% Met -
Reduce oral and pharyngeal
cancer deaths in all
All - - 2.9% - 2.6%

Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 2002.

Table 4-2

Oral Health in the United States:
National Trends and Targets*
Oral Health Indicator Age
(yr.)
Baseline Data
(for HP 2000
Target)
HP
2000
Target

Final Data
for HP 2000
Target
(Baseline for HP
2010 Target)


Summary
(Attainment of
HP 2000
Target)
HP
2010
Target
Early Detection of Oral and
Pharyngeal Cancer
Increase early detection of oral and pharyngeal cancer All - - 35%   50%
Annual Examinations for Oral and
Pharyngeal Cancer
 
Increase annual examinations for oral
and pharyngeal cancer (age adjusted)
40+ - - 14% - 35%
Dental Sealants
Increase dental sealants in children 8 11% 50% 23% Progress 50%
Increase dental sealants in adolescents 14 8% 50% 24% Progress 50%
Community Water Fluoridation
Increase no. of persons on public water
system receiving fluoridated water
All 61% 75% 62% Progress 75%

Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 2002.

Table 4-2

Oral Health in the United States:
National Trends and Targets*
Oral Health Indicator Age
(yr.)
Baseline Data
(for HP 2000
Target)
HP
2000
Target

Final Data
for HP 2000
Target
(Baseline for HP
2010 Target)


Summary
(Attainment of
HP 2000
Target)
HP
2010
Target
Use of Oral Health Care System
(Annual dental visit age-adjusted)
Increase oral health screening,
referral, follow-up first-time
school attendees,
at first school experience
5 66% 90% 75% Progress 83%
Increase use of oral health care
system by adults
35+ 54% 70% 63% Progress -
Increase use of oral health care
system by children and adults
>2 - - 65% - 83%
Increase use of preventive dental
services for low- income children
<19 - - 20% - 57%
Use of Oral Health Care System
by Residents in Long-Term Care Facilities
For long-term care, oral examination
and services provided within 90 days
  No Data 100% No Data - -
Increase use of oral health care system
by residents in long-term care facilities
- - 19% - 25%

Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 2002.

Table 4-2

Oral Health in the United States:
National Trends and Targets*
Oral Health Indicator Age
(yr.)
Baseline Data
(for HP 2000
Target)
HP
2000
Target

Final Data
for HP 2000
Target
(Baseline for HP
2010 Target)


Summary
(Attainment of
HP 2000
Target)
HP
2010
Target
Preventive Behaviors <19 - - 20% - 57%
Increase topical / systemic fluorides
among nonfluoridated
All 50% 85% No Data No Data -
Increase caregivers using feeding
practices that prevent early
childhood caries
All 55% 75% No Data No Data -
Extend use of protective head, face,
eye, and mouth equipment
All No Data No Data No Data No Data -
Smokeless Tobacco Use
Reduce smokeless tobacco use
among males
12-17 6.6% 4% 3.7% Met **
Reduce smokeless tobacco use
among males
18-24 8.9% 4% 6.9% Progress **
School-Based Health Centers
with Oral Health Component
(Developmental Objective)

All
centers

- - Data not
collected
- Data not
collected
Health Centers with Oral Health
Service Components
(Developmental Objective)
All centers - - 34% - 75%

Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 2002.

Table 4-2

Oral Health in the United States:
National Trends and Targets*
Oral Health Indicator Age
(yr.)
Baseline Data
(for HP 2000
Target)
HP
2000
Target

Final Data
for HP 2000
Target
(Baseline for HP
2010 Target)


Summary
(Attainment of
HP 2000
Target)
HP
2010
Target
Referral for Cleft Lip or Palate  
Increase states with system for
recording and referring
orofacial clefts
All States 11 States 40 States 23 States Progress 51 States
State-Based Surveillance System All States - - 0 - 51 States
Tribal, State, and Local Dental Programs All jurisdictions - - Data not collected - Data not collected

*Table includes oral health measures from Healthy People 2000 (HP 2000), and Healthy People 2010 (HP 2010).

[** Targets outlined in final version of Table 4-2 in book]

Data from Centers for Disease Control and Prevention: Healthy People 2000 Review, 1999-2000. Hyattsville, MD, Public Health Service 199931; and Healthy People 2010; Understanding and Improving Health (Conference ed. 2 vols.) Washington, DC US Department of Health and Human Services, 20004.

Tables from Steffensen JEM: Measuring Progress in Oral Health. In Geurink KV: Community Oral Health Practice for the Dental Hygienist. Philadelphia, PA: WB Saunders, 20002
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