An Overview of Oral Health in North Dakota Presented by: Kathleen Mangskau, RDH, MPA.

An Overview of Oral Healthin North Dakota

Presented by:Kathleen Mangskau, RDH, MPA

Oral Health Surveillance

Data SourceBRFSSYRBSEarly Childhood

CariesStatewide Epi

SurveysProvider

Distribution

Number of Indicators451

43

Oral Health Surveillance (cont.)

Data SourceVital Records

(congenital anomalies)Medicaid DataFluoridation DataNew Mothers’

Survey

Number of Indicators1

213

Total 24

Prevention

96% of ND population on public water supplies has access to fluoridated water

5,262 children in 76 schools in fluoride deficient areas participate in fluoride mouthrinse/tablet programs

44% of 8-year olds have dental sealants5,000 children annually receive oral

health education in the classroom

Percentage of Residentswith Fluoridated Water

7562

96

0

20

40

60

80

100

HP 2000Goal

US Average NorthDakota

Per

cent

Percentage of Childrenwith Dental Sealants

50 4423

0

20

40

60

80

100

HP 2000

Goal

US

Average

North

Dakota

Perc

ent

Oral Health Status

51% of 6-8 yr.-olds have tooth decay70% of 14 yr.-olds have tooth decay10% of young children suffer from

baby bottle tooth decay

Source: 1993-94 ND Oral Health Survey 1995 Head Start Survey

Treatment Need

25% of 6-8 yr olds have untreated decay22% of 14 yr olds have untreated decay

Source: 1993-94 ND Oral Health Survey

Disparities

Percent of Children

with Untreated Caries

24

47

0

20

40

60

80

100

White Native

American

Per

cent

Disparities

Baby Bottle Tooth Decay RateWhite - 10%Native American - 29%

Dental Caries is Common

Dental caries (tooth decay) is the most common chronic disease of childhood. It occurs 5-8 times as frequently as asthma. Caries is a preventable disease.

More than 80 percent of tooth decay is found in 25 percent of the child population.

Access Programs for Children

MedicaidCHIPCaring for Children Program

Access Programs for Adults

MedicaidVA Dental Benefits Program

Access Problems

Medicaid clientsSpecial populationsLow-income adultsElderly

State Initiatives to Improve Dental Access

Increase in Medicaid feesStreamlined Medicaid claims

processingProject Will Show

Local Initiatives to Improve Dental Access

Red River Region Dental Access Project Community Strategic Planning Expansion of CHC Expansion of Apple Tree Dental services

Delivery System

Number of private practice dentists in the state is slowly declining

Dental safety net is inadequate 1 CHC in Fargo only 3 local health agencies employ

dental staff No clinical dental services provided in

local public health agencies12 Counties designated dental HPSAs

GoldenValley

Dunn

Ward

Cass

McLean

Grant

McKenzie

Morton

Williams

Stark

Stutsman

Wells

Slope

Kidder Barnes

McHenry

Walsh

Mountrail

Divide

Sioux

Burleigh

Burke Cavalier

Benson

Emmons

Bottineau

Traill

Dickey

Pierce

Richland

Ramsey

Mercer

Logan

Billings

Nelson

Adams

Towner

Bowman

Rolette Pembina

Eddy

La Moure

Oliver

Hettinger

GrandForks

SteeleSheridan

SargentMcIntosh

Griggs

Ransom

Foster

Renville

Dental Health Professional Shortage Areas, 1999

Dental HPSAs

ND Dentist to Population Ratio

North Dakota ratio 1:2246US ratio 1:1859

Dentists12 - 56 - 1011 - 3031 or moreNo Dentists

Note: Counties outlined in green have been designated as dental shortage areas

North Dakota DentistsBy Zip Code, 1999

Practicing DentistsNorth Dakota

0

50

100

150

200

250

300

350

19

88

19

90

19

92

19

94

19

96

19

98

19

99

20

10

*

Source: North Dakota Department of Health, Oral Health Program, 1999

*Estimate

Dentists per 100,000 U.S. Population1950–2020

0

10

20

30

40

50

60

70 59.5 52.

7

Source: Bureau of Health Professions, HRSA, DHHS. Data from the Eighth Report to Congress 1991 and unpublished reports.

1950 1960 1970 1980 1990 2000 2005 2010 2015 2020

Figure 1

North Dakota Dental Education Institutions

0 Dental schools1 Dental hygiene school1 Dental assisting school

Resources Associated with Safety Net Providers

NationalNational Health Service Corp Loan

Repayment ProgramStateNone

How Can We Assure Oral Health Access for our Citizens

Our goal today is to develop strategies to improve oral health access