Helping To Heal Understanding How Pediatric Dentists Can Impact Oral Health Poverty
Feb 14, 2016
Helping To Heal
Understanding How Pediatric Dentists Can Impact Oral Health Poverty
Helping to Heal: Understanding How Pediatric Dentists Can Impact Oral Health Poverty
Outline
I. ObjectivesI. IntroductionII. What is poverty?III. Why is poverty a challenge for public health
and for the profession of dental medicine? IV. Problem Analysis: Oral Health V. The Pediatric Dentist definedVI. AAPD Mission & Vision
VII. The Business Rational A Fee Schedule Comparison
VII. The Moral Rational a. The Oral Health Crisis in the Classroom b. Signs & Symptoms
c. A Cycle of Pain: Consequences of untreated tooth decay d. From Maryland to Mississippi and Abroad e. A BOY’S SILENT PLEA STIRS
CHANGE IN MARYLANDf. GIRL STARVES AFTER TEETH
PULLEDVIII. Socially-sensitive Practice Management KnowledgeXI. Conclusion: Looking toward the future
Objectives
• Inform and update oral health care professionals about poverty.
• Describe the challenges poverty represents for public health and for health professionals.
• Provide socially-sensitive practice management knowledge.
This Miniclinic presentation emphasizes the moral rationale for pediatric dentists to take the lead and empower the profession of dental medicine and help to relieve the oral health poverty that exists among millions of children. Participants will gain invaluable, socially-sensitive practice management knowledge. This presentation will better enable dental professionals to provide the much needed restorative treatment for children who live day after day with the overwhelming suffering of untreated tooth decay.
Put a feather in your cap!
Introduction
What is poverty?
The United Nations defines poverty as a human condition characterized by the sustained or chronic deprivation of the resources, capabilities, choices, security and power necessary for the enjoyment of an adequate standard of living and other civil, cultural, economic, political and social rights.
Why is poverty a challenge for public health and for the profession of dental medicine?
There is considerable evidence that low socioeconomic status and poverty constitute the main determinants of poor health in industrialized societies. The poorer people are, the more they are at risk of developing diseases, and ultimately, of dying prematurely.
Problem Analysis: Oral Health
Societal/ Policy Level/ Tertiary Precursors
Family/ Institutional Level/ Secondary Precursors
Individual Level/ Primary Precursors
Oral Health
Pain and suffering, potential for poor nutrition, cosmetic disfigurement, lowered self-esteem, potential for chronic infection including periodontal disease, and ultimate increased treatment costs.
Cultural/Ethnic Issues Poverty
Low Medicaid Reimbursement Rates Lack of fluoridation in water systems
Lack of Medical Provider training about oral health
Candy and Soda Pop in Schools
Lack of training of allied health providers to address oral health issues
Lack of education concerning oral health issues
Lack of Nutrition Knowledge
Lack of Insurance
Lack of Providers that take Medicaid
Lack of SpecialtyTreatment Resources
“They’re Only Baby Teeth” Medicaid Reimbursement Lack of Transportation
Lack of Fluoride rinse campaign in schools
Lack of Parental Education concerning the importance of oral health care
Parent may have transmitted bacteria to child that could cause early childhood caries
Fear of Dentistry
Unmanageable behavior in dental office
Poor Oral Hygiene
Poor Nutrition
Targeted Indicator :
Consequences:
Why poverty is a challenge for the profession of dental medicine?
• Dental caries is the single most common chronic • Childhood disease 5 times more common than asthma• Over 50 percent of 5 - 9 year old children have at least • One cavity or filling, and that proportion increases to 78 • Percent among 17year olds
• Unintentional and intentional injuries commonly affect
• Craniofacial tissues • Poor children suffer twice as much dental carries as their more affluent peers, and their disease
is more likely to be untreated• For each child without medical insurance, there are at least 2.6 children without dental insurance
• Uninsured children are 2.5 times less likely than insured children to receive dental care
The Pediatric Dentist defined
Pediatric dentists are the pediatricians of dentistry,exclusively trained to address the unique oral healthneeds of children. The specialized education in childpsychology, growth and development, managementof oral-facial trauma, sedation and generalanesthesia places us at the forefront of leading thecharge in providing equal access to dental care forall children.
Pediatric Dental Practices are High Patient Volume Practices that are Prevention-Oriented· Pediatric dentists and orthodontists have 2-3 times as many scheduled visits per week as do general dentists
or other specialists.· The three most common pediatric dentistry procedures are prophylaxis, fluoride treatment, and a periodic oral
evaluation
Pediatric Dentistry Volume of Patients Treated and Services Rendered
104 107
50
144138
80
0
20
40
60
80
100
120
140
160
Solo PediatricDentists
Non-soloPediatricDentists
GeneralDentists
Patients/Week(Excluding HygieneVisits)
Patients/Week(Including Hygiene Visits
Pediatric dentists report the highest percentage of patients insured through public assistance, among all dentists
% of Patients w/Public Assistance
18.1%
6.9%5.6%
3.2% 2.7%1.4% 1.3%
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atric
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illofa
cial
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eon
Gen
eral
dent
ist
Orth
odon
tist
Endo
dont
ist
Perio
dont
ist
Pros
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Updated, September 2007
The percentage of public assistance patients in a practice.ADA 2007 Survey of Dental Fees
Updated, September 2007
The AAPD Mission The mission of the AAPD is to advocate policies,
guidelines and programs that promote optimal oral health and oral health care for children. The AAPD serves and represents its membership in the areas of professional development and governmental and legislative activities. It is a liaison to other health care groups and the public.
The vision of the AAPD is optimal health and care for infants, children, adolescents and persons with special health care needs. The AAPD is the leader in representing the oral health interests of children. The pediatric dentist is a recognized primary oral health care provider and resource for specialty referral.
The AAPD Vision
The Business Rationale A Fee Schedule Comparison: Private Pay versus Medicaid
Maryland Illinois California Medicaid vs. BCBS Medicaid vs. MetLife Medicaid vs. Aetna___
ConsultationInitial ExaminationEmergency ExaminationProphylaxisFluoride TreatmentPulpotomyPulpectomyStainless Steel CrownResin CrownResin RestorationsAmalgam RestorationExtraction
The Moral Rationale
Signs &
Symptoms
The Faces of the Oral Health Crisis in the
Classroom
From Maryland
ToMississippi
A Cycle of Pain: Consequences of untreated tooth decay.
Signs & Symptoms
The Faces of the Oral Health Crisis in the Classroom
Deamonte Driver, Prince George’s County, MD – January, 2007- Age 12
Alexander Collander, Bil0xi, MS – March, 2007 – Age 6
Diamond Brownridge - Chicago, IL - November, 2006 -Age 5
Sophie Waller, Truro, England - December, 2005 - Age 8
From Maryland to Mississippiand Abroad
A BOY’S SILENT PLEA STIRS CHANGE IN MARYLANDPEDIATRIC DENTISTRY TODAY
March 2009 Volume XLV.Number 2
Deamonte Driver, sitting next to his mother, Alyce, shows the scars from incisions for his brain surgery.
Photo Credit: By Linda Davidson -- The Washington PostRelated Article: For Want of a Dentist, page B01
British Girl Starves After Teeth Pulled CBS News – London, February 10, 2009
A Cycle of Pain: Consequences of untreated tooth decay
Could society have caused this end result because of untreated tooth decay?
Socially-sensitive Practice Management Knowledge
Community Outreach
Outreach to
ProfessionalsOutreach
to
Schools
Outreach toGovernment
Community Outreach
Outreach Professionals
Outreach To Schools
Outreach To Schools
Outreach To Government
Conclusion: Looking toward the future
• Fighting poverty has been justified for reasons ranging from human rights and social justice to economic, political and even religious concerns.
• Oral health professions and their members must embark on the national movement toward poverty reduction and contribute to alleviating its consequences.
Efforts must aim to:
1) improve relationships with underserved members of society
2) develop strategies for positive and effective interactions 3) improve access to dental services for poor populations
Pediatric Dentists Can Make The Difference
Thank you for beinga pediatric dentist
that cares enough to help make a difference!
Special Thanks to:American Academy of Pediatric DentistryDr. George Acs, Department of Dentistry, Children's National Medical Center Dr. Burton Edelstein, Executive Director, Children's Dental Health ProjectMs. Aqsaa Chaudhry, Franklin Senior High SchoolDr. Caswell A.Evans, Project Director, Oral Health In America: A Report of the Surgeon General
The End