 |
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 Ž 1 dft or DMFT |
| 21-2 |
Untreated
dental decay |
%
of persons with Ž 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 Ž 1 bleeding site
% of persons Ž 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 Ž 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 |
