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Slide 1: Focus Area 21: Oral Health Progress Review National Center for Health Statistics February 7, 2008 Richard J. Klein
Slide 2: Oral Health • According to the 2000 Surgeon General’s Report on Oral Health, oral health is essential to the general health and well-being of all Americans. Dental caries is the most common chronic disease in children. Despite increases in coverage, nearly 3 times as many children lacked dental insurance compared to those lacking medical insurance in both 1995 and 2003-04. Americans without dental insurance are more likely to have unmet dental needs compared to those with insurance. • • •
Slide 3: Highlighted Objectives 21-1a-c 21-4 21-5b 21-8a 21-9 21-10 21-12 Dental Caries Experience Complete Tooth Loss Destructive Periodontal Disease Dental Sealants, Children 8 years Community Water Fluoridation Annual Dental Visits Preventive Dental Services Among Low-Income youth 21-14 Community Health Centers with Oral Health Service Component 21-17a,b Dental Public Health Infrastructure Target met Improving Little or no progress* Getting worse *Percent of targeted change achieved is between -10% and 10%, or change not statistically significant.
Slide 4: Ever Had Caries in Permanent Teeth Adolescents 15 Years 1988-94 1999-2004 Decrease desired Percent 100 2010 Target: 51 75 50 25 0 Total White Black Mexican American Female Male Note: I= 95% confidence interval. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-1c
Slide 5: Ever Had Caries* Children 6-8 Years 1988-94 1999-2004 Decrease desired Percent 100 2010 Target: 42 75 50 25 0 Total White Black Mexican American Female Male *In primary or permanent teeth. Note: I= 95% confidence interval. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-1b
Slide 6: Ever Had Caries in Primary Teeth Children 2-4 Years 1988-94 1999-2004 Decrease desired Percent 100 2010 Target: 11 75 50 25 0 Total White Black Mexican American Female Male Note: I= 95% confidence interval. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-1a
Slide 7: Residents Served with Community Water Fluoridation Increase desired 2010 Target: 75 Percent 0-24 25-49 50-74 75-100 1992: 62% 2006: 69% Note: Proportion of persons receiving optimally fluoridated water from public systems among resident population served by public water systems. Source: CDC Fluoridation Census, NCCDPHP, CDC Obj. 21-9
Slide 8: Use of Dental Sealants Children 8 Years 1988-94 1999-2004 Increase desired Percent 75 2010 Target: 50 50 25 0 Total White Black Mexican American Female Male Note: I= 95% confidence interval. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-8a
Slide 9: Annual Preventive Dental Services Low Income Youth Under 19 Years 1996 2004 Increase desired Percent 75 2010 Target: 66 50 25 0 Total White Black Hispanic American Asian Indian * Female Male Note: I= 95% confidence interval. *Data statistically unreliable. Low income is less than 200% of Federal poverty level. Preventive services include examination, dental sealant application, fluoride treatment, cleaning, or X-ray examination in the past year. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select only one race prior to 2003. For 2003 and later years, respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. American Indian includes Alaska Native, and Asian includes Pacific Islander. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-12
Slide 10: Annual Dental Visits 2 Years and Older 1996 2004 Age-adjusted Percent Increase desired 2010 Target: 56 75 50 25 0 Total White Black Hispanic American Asian Indian < 12 yr 12 yr 12+ yr Education Note: I= 95% confidence interval. Data are age adjusted to the 2000 standard population. Education estimates are based on persons aged 25 years and over. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select only one race prior to 2003. For 2003 and later years, respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. American Indian includes Alaska Native, and Asian includes Pacific Islander. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-10
Slide 11: Older Adults 65-74 Years Decrease desired Complete Tooth Loss 1988-94 1999-2004 Percent 50 2010 Target: 22 25 0 Total White Black Mexican American < 12 yr 12 yr 12+ yr Education Obj. 21-4 Note: I= 95% confidence interval. Education estimates are based on persons aged 25 years and over. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Slide 12: Destructive Periodontal Disease Adults 35-44 Years 1988-94 1999-2004 Decrease desired Percent 50 2010 Target: 14 25 0 Total White Black Mexican American Female Male Note: I= 95% confidence interval. Respondents were asked to select only one race prior to 1999. For 1999 and later years, respondents were asked to select one or more races. For all years, the categories black and white include persons who reported only one racial group and exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-5b
Slide 13: Community Health Centers with Onsite Dental Services Number 1,000 800 600 400 200 0 59 52 53 57 60 61 64 70 Health Centers Dental Services at Center Increase desired 2010 Target: 75 Percent 100 80 69 66 60 40 20 0 1997 1998 1999 2000 2001 2002 2003 Source: Bureau of Primary Health Care, HRSA. 2004 2005 2006 Obj. 21-14
Slide 14: Dental Programs Directed by Public Health Dental Professionals Increase desired Number 200 150 100 50 39 0 51 123 152 2010 Target: 41 State and local dental programs serving 250,000+ Program directed by a dental professional with public health training 2003 Source: Association of State and Territorial Dental Directors. 2006 Obj. 21-17a
Slide 15: Dental Programs Directed by Public Health Dental Professionals Increase desired Number 50 2010 Target: 9 32 25 34 Indian Health Service and Tribal dental programs serving 30,000+ Program directed by a dental professional with public health training 0 9 10 2003 Source: Division of Oral Health, IHS. 2006 Obj. 21-17b
Slide 16: Progress Toward 2010 Targets Target Met 21-17a State and local dental programs 21-17b Indian Health Service and Tribal dental programs Little or No Progress Moved Toward Target 21-3 21-5b 21-9 21-12 21-14 21-15 21-1a No permanent tooth loss, 35-44 yrs Destructive periodontal disease, 35-44 yrs Community water fluoridation Preventive dental services among low-income youth under 19 yrs Community health centers with oral health service component Cleft lip or palate referral Dental caries, 2-4 yrs 21-1b Dental caries, 6–8 yrs 21-1c Dental caries, 15 yrs 21-2a-d Untreated dental decay, 2-4, 6-8, 15 and 35-44 yrs 21-4 Complete tooth loss, 65-74 yrs 21-6 Early detection of oral and pharyngeal cancers 21-8a Dental sealants, 8 yrs 21-8b Dental sealants, 14 yrs 21-10 Dental visits, 2+ yrs Baseline Only 21-5a 21-7 Moved Away from Target Gingivitis, 35-44 yrs Annual exam for oral and pharyngeal cancers, 40+ yrs 21-11 Use of oral health care by long-term care residents 21-13a,b School-based health centers with oral health component 21-16 Oral and craniofacial statebased surveillance
Slide 17: Summary • Most oral health objectives moved • • • • toward their 2010 targets, although some of the improvements were not statistically significant. Dental caries in preschool children moved away from the 2010 target. Use of dental sealants among children increased. Oral health continues to improve in the adult population. Disparities by race/ethnicity and education persist for many objectives.
Slide 18: Acknowledgements FA21 Interagency Workgroup Jay Anderson, HRSA Laurie Barker, CDC Patrick Blahut, IHS Bruce Dye, CDC Tim Iafolla, NIDCR Gina Thornton-Evans, CDC Office of Disease Prevention and Health Promotion Christopher Barrett
Slide 19: Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphom e.htm