Transcript New York State Department of Health

Bureau of Dental Health:
An Overview of Programs
Timothy Cooke, BDS, MPH
Bureau of Dental Health
Albany, NY.
(518) 474-1961
[email protected]
Vision & Mission
 The Bureau of Dental Health will provide an environment to
encourage all New Yorkers to develop an awareness of the
importance of oral health, and to assure it’s inclusion in public
health programs targeted toward the building of healthier
communities.
 Our mission is to improve the oral health of all New Yorkers.
We design and implement public health initiatives to prevent
and control oral diseases and other adverse conditions,
promote healthy behaviors, and improve the skills of all dental
care providers. We partner with local health departments,
health care providers, community organizations, and residents
of the state to build healthier communities.
Functions
 Assess and monitor oral health status
 Provide guidance for planning policy development to support
community efforts directed toward assuring oral health
 Mobilize community partnerships to design and implement
programs directed toward prevention and control of oral
diseases and conditions
 Inform and educate the public regarding issues related to
healthy lifestyle, health plans, and availability of care
Functions continued………….
 Integrate oral health programs and policies into other health
care programs
 Assure the capacity and promote the competency of public
health dentists, general practitioners, and dental hygienists
 Evaluate the effectiveness, accessibility, and quality of
population-based and personal service
 Promote research and demonstration programs to develop
innovative solutions to problems
Organizational chart
Commissioner
Office of Public Health
Center of Community Health
Division of Family Health
Bureau of Dental Health
Preventive Services & Dental Care
Research & Epidemiology
Education
Preventive Dentistry Program
Surveillance system
Dental Public Health Residency
School based dental progams
Program evaluation
School of Public Health
Internship Program
School Fluoride Rinse
/Tablet Program
Oral cancer prevention
In-service training
PHCP Orthodontic program
Guidelines and Recommendations
Website
Fluoridation
Newburgh-Kingston study
Educational materials
NYS Collaborative System
Innovative Dental Services
Technical Support
Rural
Health
School Health
Migrant
Health
Office of Children
and Families
Community Health
Centers
Indian Health
Local Health
BUREAU OF
DENTAL HEALTH
Child Health Plus
Medicaid
Managed care
Investigation of
disease
transmission
Dental Care for
persons with
HIV
Oral Diseases
Dental Caries
 Despite improvements in overall disease levels, dental caries
remains the commonest childhood disease*
7x as common as asthma
Responsible for children missing 52m school days annually
 54% of 3rd grade children in NY have suffered dental caries,
33% have active disease+
 Caries can affect teeth soon after eruption: Early Childhood
Caries
3000 children annually in NY are hospitalized for treatment
Cost close to $1m
 Major disparities in caries experience by income
*Oral Health in America: A Report of the Surgeon General ~ DHHS 2000
+ NY surveillance 2002-04, unpublished data
Early Childhood Caries
Periodontal Disease
 Severe periodontal disease (measured as 6 millimeters of
periodontal attachment loss) affects about 14 percent of
adults aged 45 to 54
 Twenty-three percent of 65- to 74-year-olds have severe
periodontal disease
 About 30 percent of adults 65 years and older are
edentulous, compared to 46 percent 20 years ago
 Potential link to pre-term/ low birth weight babies
 Associated with heart disease
 Two-way link with diabetes
Oral Health in America: A Report of the Surgeon General ~ DHHS 2000
Oral and Pharyngeal Cancer
Oral and pharyngeal cancers are diagnosed in
about 30,000 Americans annually; 8,000 die from
these diseases each year
Oral Health in America: A Report of the Surgeon General ~ DHHS 2000
Five-year relative
survival rates for select
cancers for White and
Black persons
White Patients
Black Patients
*Note: NOS= not otherwise specified
Testis
Thyroid
Prostate
Melanomas of Skin
Breast (Females)
Corpus & Uterus, NOS*
Hodgkin’s
Urinary Bladder
Cervix Uteri
Larynx
Colon
Kidney/Renal
Rectum
Oral Cav & Phynx
Non-Hodgkin’s
Ovary
Leukemias
Brain & NOS*
Multiple Myeloma
Stomach
Lung and Bronchus
Esophagus
Liver & Intrahep
Pancreas
68
71
88 96
95
89
93
84
88
85
86
56
82
76
83
34
62
71
59
66
53
62
52
60
58
61
51
56
52
41
50
47
44
33
30
39
28
31
19
22
14
11
13
9
6
3
4
4
Five-year relative survival rates
Source: Kosary, 1996
Oral Health in America: A Report of the Surgeon General ~ DHHS 2000
Programs
Fluoridation
*http://apps.nccd.cdc.gov/MWF/Index.asp
New York State Fluoride
Supplement Program
Self Applied Fluoride Education and Rinse Program
(SAFER)
95,000 children in 300 schools
 Fluoride tablets and drops
5000 children in Head-Start, WIC, Migrants and Countybased public health programs
Public Insurance
Medicaid:
 About 1.6 m (23%) eligible children receive dental care
 $76.7 million or 2% of all expenditures
 Program has been enhanced substantially
 Adult dental coverage always under threat
Child health plus:
 Approximately 450,000 are enrolled
Municipal Health Services Plan
State supports local health units. Activities are:
Dental health education
Dental clinics
School-based programs
Assessment
Orthodontic Program
Supports reimbursement for
Cleft lip, cleft palate or ankylosis
Severe deviations resulting from disease or trauma in
either jaw
Malocclusions best described as:
Maxillary prognathism
Mandibular protrusion
Micro or macro development of jaws
School-based Programs
Programs that do not need DOH oversight:
Dental health in school curricula
Dental note program in New York City
Fluoride rinse/tablet program
Screening & referral program
Providing clinical services requires approval by DOH:
Prophylaxis & dental sealant application
Treatment programs
Clinical Service Provision
Mobile dental equipment
Mobile Van
Fixed school site
Health Education Program
Fluoridation
Preventive Care
Early Childhood Caries
Pregnancy and oral health
Dental Sealants
Infection Control
Management of persons with HIV and AIDS
Oral Cancer
Grants
Preventive Dentistry Grants
Establish community partnerships
Identify effective intervention and mobilize resources
Facilitate linkages and assure quality systems of care
Expansion of the use of preventive services
Evaluate outcomes and monitor progress
Develop local coalition
Innovative Services Grants
Innovative projects:
 Try new approaches to meeting local oral health needs
 Piloting potential “best practices”
 Disseminate new ideas
Technical Assistance Center
Recent Activities
New York State Oral Health Plan
CDC funded project
Approach used for all chronic disease programs
Developed by 80-90 stakeholders
Outlines key Goals, Objectives and Strategies
 Short and long term
 Organizations and coalitions will select
appropriate activities and interventions
Statewide Oral Health Coalition
Will coordinate activities around State Oral Health
Plan implementation
Core of members active in developing the plan
Will work with regional and local oral health
coalitions
Guidelines Project
Guidelines for the dental care of pregnant women
and young children
No precedent for these guidelines
Convened expert panel:
OB/Gyns
Dentists
Pediatricians
Will (hopefully!) be released soon
Burden Document
Uses CDC outline
Presenting all the available data on oral disease in
NY in one place
Will be published later in 2006
Questions?