f ocus area 21: oral health progress review
DESCRIPTION
F ocus Area 21: Oral Health Progress Review. March 17, 2004. The Burden of Oral Disease. Estimated new cases of oral/pharyngeal cancers in U.S. will affect 28,000 + persons in 2004 Profound disparities exist in disease levels and receipt of care 100+ million Americans lack dental insurance. - PowerPoint PPT PresentationTRANSCRIPT
Focus Area 21: Oral HealthProgress ReviewMarch 17, 2004
• Estimated new cases of oral/pharyngeal cancers in U.S. will affect 28,000 + persons in 2004
• Profound disparities exist in disease levels and receipt of care
• 100+ million Americans lack dental insurance
The Burden of Oral Disease
• Reduction in decay among U.S. teens in the 1990s (NHANES 1988-94 to 1999-2000) saved more than 30 million teeth from decay and almost $3 billion in treatment costs
Progress:
Improving Cannot assess (limited data)
Oral Health Objectives
Getting worse
21-16 Oral and craniofacial State-based surveillance system
21-7 Annual exams for oral and pharyngeal cancers
Children 2-4 years Children 6-8 years Adolescents 15 years
21-1 Dental caries experience
Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years
21-2 Untreated dental decay
21-3 No permanent tooth loss
21-4 Complete loss
21-5 Periodontal diseases
21-6 Early detection of oral and pharyngeal cancers
21-8 Dental sealants
21-9 Community water fluoridation
21-12 Dental services of for low-income children
21-13 School-based health centers with oral health components
21-14 Health centers with oral health service components
Children 8 years Adolescents 14 years
21-10 Use of oral health care system
21-11 Use of oral health system by long- term care facilities residents
21-15 Referral for cleft lip or palate
21-17 Tribal, State & local programs
21-16 Oral and craniofacial State-based surveillance system
21-7 Annual exams for oral and pharyngeal cancers
Improving Cannot assess (limited data)
Oral Health Objectives
Getting worse
Oral Health Objectives Children 2-4 years Children 6-8 years Adolescents 15 years
21-1 Dental caries experience
Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years
21-2 Untreated dental decay
21-3 No permanent tooth loss
21-4 Complete loss
21-5 Periodontal diseases
21-6 Early detection of oral and pharyngeal cancers
21-8 Dental sealants
21-9 Community water fluoridation
21-12 Dental services of for low-income children
21-13 School-based health centers with oral health components
21-14 Health centers with oral health service components
Children 8 years Adolescents 14 years
21-10 Use of oral health care system
21-11 Use of oral health system by long- term care facilities residents
21-15 Referral for cleft lip or palate
21-17 Tribal, State & local programs
Children 2-4 years Children 6-8 years Adolescents 15 years
21-1 Dental caries experience
Improving Cannot assess (limited data)
Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years
21-2 Untreated dental decay
21-3 No permanent tooth loss
21-4 Complete loss
21-5 Periodontal diseases
21-6 Early detection of oral and pharyngeal cancers
21-7 Annual exams for oral and pharyngeal cancers
21-8 Dental sealants
21-9 Community water fluoridation
21-12 Dental services of for low-income children
21-13 School-based health centers with oral health components
21-14 Health centers with oral health service components
Children 8 years Adolescents 14 years
21-10 Use of oral health care system
21-11 Use of oral health system by long- term care facilities residents
21-15 Referral for cleft lip or palate
21-16 Oral and craniofacial State-based surveillance system
Oral Health Objectives
Getting worse
21-17 Tribal, State & local programs
21-7 Annual exams for oral and pharyngeal cancers
Improving Getting worse Cannot assess (limited data)
Oral Health Objectives Children 2-4 years Children 6-8 years Adolescents 15 years
21-1 Dental caries experience
Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years
21-2 Untreated dental decay
21-3 No permanent tooth loss
21-4 Complete loss
21-5 Periodontal diseases
21-8 Dental sealants
21-9 Community water fluoridation
21-12 Dental services of for low-income children
21-13 School-based health centers with oral health components
21-14 Health centers with oral health service components
Children 8 years Adolescents 14 years
21-10 Use of oral health care system
21-11 Use of oral health system by long- term care facilities residents
21-15 Referral for cleft lip or palate
21-16 Oral and craniofacial State-based surveillance system
21-17 Tribal, State & local programs
Oral Health Objectives
21-6 Early detection of oral and pharyngeal cancers
21-1 Dental caries experience in children
21-3 No permanent tooth loss in adults
21-6 Early detection of oral and pharyngeal cancers
21-8 Sealants
21-10 Use of oral health care system
21-12 Dental services of for low-income children
21-14 Health centers with oral health services
Highlighted Objectives
21-1 Dental caries experience in children
21-3 No permanent tooth loss in adults
21-6 Early detection of oral and pharyngeal cancers
21-8 Sealants
21-10 Use of oral health care system
21-12 Dental services of for low-income children
21-14 Health centers with oral health services
5-15 Dental visits among persons with diabetes
Highlighted Objectives
0
20
40
60
80
Obj. 21-1c
Adolescents 12-18 Years Who Ever Had Caries in Permanent Teeth, 1988-94
Total Black MexicanAmerican
White MaleFemale
Percent2010 Target1988-94
Note: Target is for adolescents 15 years old. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
0
20
40
60
80
Obj. 21-1c
Adolescents 12-18 Years Who Ever Had Caries in Permanent Teeth, 1988-94 and
1999-2000
Note: Target is for adolescents 15 years old. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Total Black MexicanAmerican
White MaleFemale
Percent2010 Target1988-94 1999-2000
0
10
20
30
40
50
Obj. 21-1aNote: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Total Black MexicanAmerican
White MaleFemale
Percent
2010 Target
1988-94
Children 2-4 Years Who Have Ever Had Caries in Primary Teeth, 1988-94
0
10
20
30
40
50
Obj. 21-1a
Children 2-4 Years Who Have Ever Had Caries in Primary Teeth, 1988-94 and
1999-2000
Note: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Total Black MexicanAmerican
White MaleFemale
2010 Target
1988-94 1999-2000Percent
Note: from Niendorff & Jones, JPHD 2000: 60: 245. Data are for IHS service areas. Source: 1991 Patient Survey, IHS.
24%
Early Childhood Caries (ECC) in American Indian/Alaska Native
Children 0-4 Years
1991
Early Childhood Caries (ECC) in American Indian/Alaska Native
Children 0-4 Years
Note: from Niendorff & Jones, JPHD 2000: 60: 245. and Kaste et al., JPHD 1999; 59: 199.Source: 1991 Patient Survey, IHS; National Health and Nutrition Examination Survey, NCHS, CDC.
1991
24%Less than 2% of all U.S. children 1-2 years in 1988-94 had ECC
Dental Sealants
0
10
20
30
40
50
Note: Targets are for children 8 years and 14 years. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Total
Percent2010
Targets
6-11 Years 12-18 Years
Black MexicanAmerican
White Total Black MexicanAmerican
White
Dental Sealants: 1988-94
Obj. 21-8
1988-94 1988-94
0
10
20
30
40
50
Total
2010Targets
6-11 Years 12-18 Years
Black MexicanAmerican
White Total Black MexicanAmerican
White
Dental Sealants: 1988-94 and 1999-2000
Obj. 21-8
1999-2000 1999-20001988-94 1988-94
Unreliable estimate, relative standard error >30%.Note: Targets are for children 8 years and 14 years. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Percent
0
20
40
60
Obj. 21-3
Total Black MexicanAmerican
White MaleFemale
1988-94
2010 Target
Note: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Percent
No Permanent Tooth Loss in Adults35-44 Years: 1988-94
0
20
40
60
Obj. 21-3Note: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.Source: National Health and Nutrition Examination Survey, NCHS, CDC.
No Permanent Tooth Loss in Adults35-44 Years: 1988-94 and 1999-2000
2010 Target
Total Black MexicanAmerican
White MaleFemale
1988-94 1999-2000Percent
Obj. 21-6
Early Detection of Oral and Pharyngeal Cancers: 1990-95
1990-95
0
20
40
60
2010 Target
Note: Data are for Stage 1 (localized) tumors, excluding Kaposi Sarcoma tumors. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race.Source: Surveillance, Epidemiology, and End Results Program, NIH, NCI.
Percent
Total Black HispanicWhite MaleFemale
0
20
40
60
Obj. 21-6
Early Detection of Oral and Pharyngeal Cancers: 1990-95 and
1996-20001990-95 1996-2000
2010 Target
Note: Data are for Stage 1 (localized) tumors, excluding Kaposi Sarcoma tumors. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race.Source: Surveillance, Epidemiology, and End Results Program, NIH, NCI.
Percent
Total Black HispanicWhite MaleFemale
2010 Target = 57%
20%
1996
Obj. 21-12Note: Data are for children under 19 years. Low income is less than 200% of poverty level. Preventive services include examinations, cleaning, x-rays, fluoride treatments and sealant applications.Source: Medical Expenditure Panel Survey, AHRQ.
Receipt of Preventive Services by Low Income Children
31%
2010 Target = 57%
20%
1996 2000
Receipt of Preventive Services by Low Income Children
Obj. 21-12Note: Data are for children under 19 years. Low income is less than 200% of poverty level. Preventive services include examinations, cleaning, x-rays, fluoride treatments and sealant applications.Source: Medical Expenditure Panel Survey, AHRQ.
0
20
40
60
Annual Dental Visits: 1996
Obj. 21-10Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ.
2010 Target
1996
Race/ethnicity
Percent
Total White Black Hispanic
Hispanic0
20
40
60
Obj. 21-10
1996
Race/ethnicity Disability status
Percent2010 Target
Annual Dental Visits: 1996
Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ.
Total White Black With Without
0
20
40
60
Obj. 21-10
Total White Black Hispanic
1996 2000
With Without
Percent2010 Target
Annual Dental Visits: 1996 and 2000
Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ.
Race/ethnicity Disability status
Community Health Centers with Onsite Dental Services
350
672
365
694
406
690
416
730
446
748
518
843
0
200
400
600
800
1000
0
20
40
60
80
100
Obj. 21-14Source: Bureau of Primary Health Care, HRSA.
1997 1998 1999 2000 2001 2002
NumberDental Services at Center Health Centers
Community Health Centers with Onsite Dental Services
59 5760 61
5352
0
200
400
600
800
1000
0
20
40
60
80
100Number
Obj. 21-14
Percent
2010 Target
Source: Bureau of Primary Health Care, HRSA.
1997 1998 1999 2000 2001 2002
Dental Services at Center Health Centers
0
20
40
60
80
Obj. 5-15Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: National Health Interview Survey, NCHS, CDC.
Annual Dental Visits for Personswith Diabetes: 2002
Total Black HispanicWhite RuralUrban
Persons withdiabetes
Race/ethnicity
100-199 >200<100
Poverty level (%)
Percent
2010 Target
Urbanicity
0
20
40
60
80
Obj. 5-15Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: National Health Interview Survey, NCHS, CDC.
Annual Dental Visits for Personswith and without Diabetes: 2002
Total Black HispanicWhite RuralUrban
Persons withdiabetes
Race/ethnicity Urbanicity
100-199 >200<100
Persons withoutdiabetes
Percent
2010 Target
Poverty level (%)
0
20
40
60
80
1997 1998 1999 2000 2001 2002
Obj. 5-15Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Source: National Health Interview Survey, NCHS, CDC.
Annual Dental Visits for Personswith and without Diabetes: 1997-
20022010 Target
Persons with diabetes
Percent
Persons without diabetes
Progress review data and slides
can be found on the web at:
http://www.cdc.gov/nchs/hphome.htmhttp://www.cdc.gov/nchs/hphome.htm
12 IHS Service Areas